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SDA-RF-CH-1.4
BRE8ST
FEEDING
NATIONAL INSTITUTE OF NUTRITION
MEDICAL RESEARCH
INDIAN COUNCIL OF
Breast milk is thexnsturallfodd produced by the mother soon
after the birth of her baby. The average quantity of milk secreted
during the first six months in rural Indian iiothers is. about 600 ml
or equal to 4 glasses of milk. The breast m..lk output decreases as
the child becomes older.
Age of the baby
6-12 months
1 — 2 years
2— 3 years
Quant it y ...f milk produced
600 ml or 20 ozs
450 ml or 15 ozs
425 ml or 14 ozs
The nutritive valuve of bi-east milk is butter than buffaloe's
or cow's milk. During the first two days after child birth the
yellowish fluid that is secreted is known as colostrum. Many
women do not feed the child with this and discard it as they hold
the wrong belief that it is not good for the child.
On the other
hand colostrum is very nutritious and good for the child as it is
a good source of vitamin A and contains substances which protect
the child from diseases.
Breast milk is a wholesome and economics . food for the infant.
It does not require any preparation and is good from the hygienic
point of view.
It is important that cleanliness of the (lands and breasts, be
maintained by washing them before each feed. The mother should be
relaxed and should sit up and hold the child at each breast for
about 5 minutes, after which the child shoulJ be held up to burp.
Galactogogues are substances which are b .lieved to help in
increasing the production of breast milk and aro in vogue in certain
areas. Many of the commonly used galactogoguas such as garlic,
goat's meat, palak, khuskhus, gum arabic and jeera are harmless
ingredients. However, scientific evidence uses not indicate that
they are of any practical use in increasing nilk secretion.
The practice of breast feeding should be encouraged by all.
It is
important that after 4 months of breast feeding the child should be
given liquid and semi-solid supllements like fruit juices, mashed
cereals, vegetables, green leafy vegetables, eggs, etc., in addition t
■.n the breast milk.
\
After 6 months the milk secretion decreeses. At the same time
tine food tieeds of the child increase. Therefore, semi-solid and solid
foods should be given in addition to breast milk and not a substitute
^o^breast milk.
In rural areas, the period of breast feeding is prolonged, from
6 months to 3 years Or even longer. But it is impoi'tant to note
thgt after the 6th nnnth, additional foods t vor and above breast
are essential.
Cont.....2..,.,.
LOW - .COST NUTRITIOUS.SUPPLEMENTS
Breastmilk is sufficient for infant till the age of about four.
months. Thereafter^ in addition to breastmilk, certain suoplements
like cereals, pulses, vegetables, eggs, meat, milk and fruits should
be gradually introduced.
As the child grows older, he starts eating
all other food items that arc eaten by adulcs. Howevetn it has been
found that the food eaten at home by children coming from [5oor homes
is deficient in several nutrients.
It is therefore necessary that
the diets are enriched by some supplements that can be prepared and fed
to the child to ensure proper growth.
There are certain points to be remembered when preparing supplements
for infants and pre school children.
1.
The recipes are best based on locally
available foodstuffs.
2.
The cooking methods must be simple
3.
The cost must be minimal
4.
The recipes should be acceptable in taste
consistency and bulk to the child1 as well
as to the mother.
5.
Together, with whatever breasmilk is
available, the recipes must be able to
meet the need of calories, proteins and
other nutrients, fully.
There are some recipes that can be used as ready mixes, some as
pooridges, a»d other preparations like upma and ladoo, that have to
be cooked daily and fed to the child, and some as commercial products.
Examples of a few low cost nutritious supplements for infants and ?
preschool children are giver, below. They can be prepared from common
cereals, pulses, ruts and oilseeds which are the cheapest sources of
proteins and calories in our country..
READY
MIXES?
BA3RA INEANT FOOD
INGREDIENTS?
Bajra (dehusked and roasted)
?
60 g.
(4 table spoons).
'Ruast.ori greengram dhal or any
other dhal
•<,
.
*
15 9.
(l tgble spoon )
Roast ad gmuarlrut
:
10 g.
(2 tea spoons
)
Roasted gingolly(t. i 1) seeds
8
5 g.
(1 tea spoon
)
Skip milk powder..
1
15 g.
(1 table spootm )
Cnrt.
- 2 -
KETH OP
Powder all the roasted ingredients individually;
mix them in the proportions suggested and store in air-tight containers.
RAGI INFANT FOOD
Use 60 grams ( 4 table spoons) of ragi prepared as
given below instead of bajra in the above formula.
Soak ragi in water overnight. Drain the water; spread
the grains on a plate and allow to germinate by covering with a damp
cloth for one day. Dry the germinated ragi in the sun and roast till
it develops a malted flavour.
Powder and store in an air-tight tin.
If skim milk powder is not available? the infant food
can be made without it and stored.
In such a case, 100 ml. of milk
should be added to the powder at the time of preparing the porridge
or ladoo and given to the child.
SAPINA
INGREDIENTS;
Bajra (roasted)
• 60 grams
(4 tablespoons)
Greengram dhal(roasted)r . . . .
.15 grams (. 1 tablespoon;
■ 40 grams (2-2 tablespoons)
Sugar
G E H U N A
'’
INGREDIENTS?
Whole wheat
s 40 grams (2>f tablespoons)
Greengram dhal
s 25 grams (l£ tablespoons)
Groundnuts
S 10 grams (2 tablespoons )
Paggery
! 30 grams (2 tablespoons )
METHOD
The method of preparation of these two recipes is .
the same.
Roast all the ingredients, powder, mix well and store in
an air-tight container. Whenever required take three tablespoons—
ful of any of these recipes and mix with a small amount of hot. water
and feed to the child.
■» *
Cont...3..•..
3 -
RECIPES THAT NEED TO BE COOKED
UH EAT
GRAM
PORRIDGE
INGREDIENTS;
Roasted wheat flour
? 40 grams ( 2^ tablespoons)
Powdered, roasted Bengal 8 25 grams (
gram
tablespoons)
Powdered, roasted
groundnut
8 10 grams ( !2 tea spoons )
Sugar or jaggery
s 40 grams ( 2-^ tablespoons)
Spinach ( or any other
leafy vegetable)
8 30 grams ( 1-j
bundle
)
METHOD;
Roast groundnut, wheat and Bengalgram and powder thpm.
Mix the wheat, Bengalgram and groundnut powders and prepare a Matter
by addition of jaggery dissolved in a suitable amount of water and
made into a thin syrup.
Boil spinach in water till soft.
Mash and strain through a
clean cloth.
Add the vegetable juice to the batter and cook for a few
minutes with continuous stirring still semi-solid.
COMMERCIAL RECIPES
GROUNDNUT
BISCUITS
INGREDIENTS;
Groundnut (roasted)
s 25 grams ( li tablespoons)
Wheat flour(roasted)
8 25 grams ( 1^- tablespoons)
Sugar
s 20 grams
Baking powder
Salt
.' 1'.
( 4 tea spoons
)
s a pinch
8 to taste
METHOD
Powder the main ingredients and mix them. Add baking powder and
salt and mix thoroughly. Make a stiff dough by kneading the mixture.
Role like chapatis.
Cut out any shape desired with tin-lids or any sharp instruments-.
Place the biscuits.on metal trays and bake them well on heated sand in a
dekchi. (The dekchi should be kept covered with a lid and piedes of live
charcoal kept on the lid to ensure uniform all—round heating).
cent
4
Remove the biscuits when they are gcldenbrown
this usually takes about 20. minutes.
The quantities indicated are for use as a sup
plement per child per day. Similar biscuits can be prepared
using Bengalgram,. gingelly seeds, cowgram and horsegram.
THE DANGER OF UNDER FEEDING
Kwashiorkor and marasmus are two diseases caused by
insufficient intake of food. This leads to deficiency of
calories (energy) and protein (body building material).
VICTIMS
Kwashiorkor and marasmus occur most commonly in children
between 1-5 years of age.
Breast milk is sufficient for
children only uptn the age of 4 months. Supplementation
with cereals, pulses, milk and eggs after the age of 4 months
is -essential.
If this is delayed or not done, children do
not grow' properly and kwashiorkor and marasmus develop.
SIGNS AND SYMPTOMS:
OEDEMA: Children with kwashiorkor first show swelling of
the legs.
Later, the face and the whole body may
also become swollen.
SkIN CHANGES:
The skin becomes rough and sore.
HAIR CHANGES:
The hair may become scanty and also change colour
from black to various shades of brown. The child
also becomes irritable and disinterested in his
surroundings.
Children with marasmus become very thin and feeble due
to wasting of muscles.
However, there is no oedema.
TREATMENT:
The child should be made to eat more food at frequent
intervals. Severe cases with loss of appetite should Le
treated at the hospital. Milder cases can be treated at home
The diet must contain protein and energy rich foods. ACombination of cereals, millets, pulses and oilseeds will
provide the necessary nutrients.
If possible, milk, eggs
or flesh foods should also be given.
It is important to treat infections and diarrhoea
promptly.
The National Institute of Nutrition, Hyderabad has
formulated an energy-protein rich mixture to treat protein
calorie malnutrition at the home level.
It consists of
wheat, roasted Bengal gram dhal, groundnuts and jaggery.
These ingredients can be suitably changed depending upon
local availability. The comoosition of the mixture is
given below*
<
- 2 -
Whole wheat
(roasted)
•
40 grams
Bengal gram (roasted)
Groundnut
(roasted)
Waggery
16 grams
■
10 grams
o
20 grams
TOTAL
S6
Calories
o
Prot ein
•
330
11 .3 grams
Many children with protein calorie malnutrition have been
treated with this food mixture, fl picture of one of these
children is shown below.
child showed improvement after
a few weeks and was completely cured within 3 months.
*******
TriyjT'H T^T'TpGg| - —r
-
-
.
,
. .
rroanfmi.ll- is a nutritious food arc1 rests the- K-by1 s
requirements fully till the Zth~r,mth"n-C"?ife. Later, breast
milk alone is not erouch to meet -the nutritional, needs of the
“■rowin." child. - This calls for additional food-anwil-ornntp.If-additional foods-pro. not-.p.von,- the-, boby-do<~-s rot —rovz-oroherly'anri-can-show-stunted.--rowth*
•
: ■ —
I'iTAJTT'G
The gradual switching over of the child from breast milk
alone to other foods is cal1ed 'wearing1,
Most rural Indian mother do rot give supplementary foods
because of the fear that infants will not be able to digest solid
or eirer semi-solid foods. This is unfortunately a wrong belief.
The right type of foods cooked in the right way and introduced
gradually are easily digested and will greatly benefit the child.
The first foods added to the child’s diet after 4 months
can be in the liquid form. Pnffaloe’s or cow’s milk, mashed vegetables
like potatoes, tender" beans, carrots and green.leafy vegetables
can be safely given. Many mother add too much water to milk thus
making it less nutritious. This practice should be discouraged.
Introducing new foods to infants is not always very easy as
some infants may not accept them readily, but the mother should continue
to coax the child till h° accents it.
At the age of 5-6 months cereals and millets can be
introduced in the form of porridges. Small amounts of nulses
should be added to the preparation to make it more nutritious.
The belief that nulses aro gas producing and cause distension on
the stomach should not exclude the use of nul’sos in infant feeding.
Infants tolerates a fairly "ood amount of nulses. Green leafy
vegetables should also be added, since they provide many nutrients
like vitamins A and 0, Iron and Calcium.
These nutrients are essential for good vision, blood
formation and healthy bones. A preparation using cereal, pulses
and greens is given below:
KICHCPI
table spoons (SO Grams)
Rice
-
Greengram dha.1 (roasted)
- 2 table spoons
(25 grams)
Leafy vegetables
(Palak or Amaranth)
- 1 bundle .
(15 grams)
Salt
- As. rpqui rod
.
Cont
2
- 2 -
METHOD
Rice and dhal are cleaned, washed and conked together.
Palak is cooked and strained through a clean cloth. The
vegetable juice is adied to the cooked rice-dhal mixture.
Salt
is added and mixed.
Soft ripa fruits should be mashed and given to the baby.
A ripe bababa is relished by all babies.
Orange and sweet lime
juices are good sources of vitamin 0. These, however, are more
expensive than are green leafy -vegetables.
It should be remembered that clean vessels and boiled
and cooked water should be used while preparing any food supplement.
Hands should be cleaned well before preparing the food.
Eggs, and flesh foods can be.fed to the infant aound the
first year of life whenever they are available and can be afforded
by the parents.
Initially the egg should be given in a soft
boiled form.
. If the mother is busy with other work and cannot prepare
fresh supplements every day, she can prepare ready mixed by roasting
cereals and millets (like wheat, ragi and bajra) and pulses (like
Bengalgram and greengram) and powdering them separately. These
powders can be mixed and stored in clean tins for a few months.
Small amounts of these powders can be prepared as porridges and
fed to babies.
An example is given below"
RAG I N fl
Ragi
- 4 tablespoons (60 gms)
• Bengalgram dhal(roasted)- 4 teaspoons (
. Sugar
20 gms)
- 3-J tablespoons (50 gms)
METH 00
Powder all the ingredients and cook in sufficient water.
Addition of.milk makes the porridge more nutritious.
' .
The amounts indicated for each recipe are meant to be
given per day per child. They should be distributed in the child's
diet in equal amounts during the whole day.
Instead of ragi or
bajra, wheat can be.used* Similarly, any type of pulse can be used
insted of Bengalgram dhal.
Such supplements started at the proper time will go a
long way in keeping the infant healthy, and assuring proper growth*
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