Baby feedings at 1 month

what products are possible, features of complementary foods

It is no secret that young and not very experienced mothers receive information on the nutrition of an infant, including recommendations on how to introduce the first complementary foods, mainly from two sources: grandmother's stories and from the Internet. Unfortunately, both of these respected sources of information may voluntarily or not voluntarily, but be very mistaken, since grandmothers grew up in a more prosperous time in terms of environmental conditions, and the Internet is littered with various articles that are rarely written by professionals, moreover, they rely either on explicit outdated guides on baby food, or frankly on unverified information.

In this article, I will try to combine the latest scientific data and recommendations on how to introduce the first complementary foods with many years of observations from the experience of a practical pediatrician and an allergist-immunologist.

At what age is it time to introduce the first complementary foods

According to the recommendations of the Research Institute of Nutrition of the Russian Academy of Medical Sciences, the first complementary foods can be introduced from 4.5 - 5 months, regardless of the type of feeding. This is "average". In practice, the choice of when to start introducing complementary foods still depends on the individual characteristics of the child. For example, for a child with widespread atopic dermatitis (diathesis), we will not introduce complementary foods until at least acute skin symptoms, such as cracks, weeping or secondary eczema, have steadily disappeared. Increased dryness and flaking of the skin, of course, require constant application of moisturizers to the skin, but in no case are they a contraindication to the start of the introduction of the first complementary foods.

Another important point when choosing the time to start introducing complementary foods is the dynamics of the child's weight gain. The more intensively the child gains in height and weight, the sooner he may need additional calories, since the energy value of breast milk or artificial formula alone will most likely not be enough for a child who grows faster than his peers by 4 - 5 months. We must not forget that natural products contain a fairly large range of minerals and vitamins, and a mother’s body, alas, cannot be an eternal and bottomless source of useful nutrients, somewhere something will gradually begin to be missed.

In addition, the nature of lactation in the mother has a great influence on the timing of the introduction of complementary foods. If a nursing mother begins to feel a lack of milk, I would prefer to first give her advice on stimulating lactation, and at the same time begin to introduce complementary foods. It will be better than introducing an artificial mixture. But I repeat that the earliest start date for the introduction of the first complementary foods is the age of 4 months, before the child's body is not yet ready, the risk of developing allergies is also high.

So, we agree with you that the first complementary foods can be introduced no earlier than 4 months of a child's life.

First complementary foods: Which foods to choose?

The first complementary foods, as a rule, should consist of vegetable or fruit purees, but in no case juices. Still, juices, even for children, are highly filtered, mainly contain a large amount of organic acids and “light” carbohydrates (that is, sugar, to make it clear to everyone). I will not waste time explaining why juices are harmful to an infant, but I will describe a clinical case from practice.

Parents with an 8-month-old girl came to the reception. Somewhere from 5 months she practically did not gain weight, although before that all indicators were normal. In the analyzes, apart from visible signs of iron deficiency, slightly reduced hemoglobin, no pathology was also detected. The main complaint: "does not eat anything." And when I began to find out what she still eats, it turned out that the child drinks half a liter of juice every day. But porridge or cottage cheese, or mashed potatoes cannot be forced together, they spit everything out. I don't like the taste. And so - for three months. The child, of course, became very nervous, yelling at night, demanding juice.

So draw your own conclusions and be careful.

For the first feeding, this is now recognized by everyone, the best dishes are vegetable purees from green varieties of vegetables: zucchini, cauliflower, broccoli. The first complementary foods are introduced, starting with half a teaspoon, in the morning for three days, then gradually increase the amount of the product to 40-50 grams per week. Supplemented with breast milk or formula.

For problems with stools, constipation, it’s good to start introducing prune puree, green apple, you can try pumpkin, even apricot puree, but in no case start with carrots. Beta-carotenoids, which are abundant in carrots, are generally poorly absorbed and can cause allergies in a child.

Second food. Porridge or meat?

Even 5 - 6 years ago, we taught students at the medical institute that from 5 - 5.5 months old, an infant should begin to give cereal porridge for complementary foods. This is rice, buckwheat, corn. The first week you can cook 5% porridge: 5 grams of ground cereal per 100 ml of water. Then the porridges are cooked already denser: 10 grams of cereal per 100 ml of water. But now, basically everyone uses instant (soluble) cereals, which are diluted with water according to the instructions on the package. In addition, ready-to-eat liquid cereals are on sale: for example, Bellakt, Frutonyanya, etc.

Why meat? You ask. According to modern recommendations (they really began to change quite often), but in this case I support: if a child has a pronounced decrease in hemoglobin in the blood below 100 g / l by the age of 5 months, it makes sense to start introducing fruit or vegetable purees as a second types of complementary foods - meat purees as a source of the most well-absorbed heme iron. You need to choose from varieties such as turkey, rabbit, lamb. Beef and veal can only be offered to children who did not have red cheeks and diathesis.

In the absence of problems with low hemoglobin, feel free to introduce porridge as the second meal of complementary foods, especially if the child is small and does not gain weight very well. In this case, we can recommend breeding cereals with the addition of breast milk or a mixture (Nan, Nutrilon, Celia, Nanny). With mixtures based on goat's milk, parents of children with a predisposition to allergies should be very careful. Goat milk formulas are not the best choice for babies who are allergic or intolerant to cow's milk protein, whatever the internet says. Believe me, there are serious scientific articles by foreign authors, which provided data on a very high frequency of cross-allergy between cow and goat milk proteins in children who were transferred to goat milk mixtures. And I saw it myself in my practice, when a child with dermatitis was transferred to a mixture of goat's milk, there was a clear improvement for a month or two, and then all over again and with a doubled degree of allergic skin damage.

Introduction to fermented milk products

This is the most difficult question. I am sure that most of our grandparents demand that their stupid parents start drinking milk and kefir as soon as possible. In a number of cases, children really start to absorb sour-milk products quite well after 6 months, but before this age I am very careful even with sour-milk Agusha, and even introducing milk or kefir before 6 months is a bad form, believe me, and can lead to very bad consequences for the child. I understand the Western European medical community, which has recently banned its pediatricians from recommending fermented milk products for complementary foods for children under 3 years of age, just imagine!

They (the Europeans) need to do something with their artificial milk mixtures. Even 20 years ago, we did not know other mixtures after the "two", that is, the second formula for children from 6 to 12 months. Then there were formulas for children from 1 to 2 years old, then from 2 to 3 years old, and now there are already mixtures for children up to 4 years old, and I think if this goes on, then until the age of sixteen there will be their own milk substitutes. Dismiss me, I don't think this approach is correct. But the fact is that our grandparents had much better genetics than the generation of our children, alas. In the context of the growth of medical capabilities, genetically determined diseases are also growing, and in this case, intolerance to cow's milk protein, and with every 10 years there are more and more such people among us. But if a child really suffers from an allergy to cow's milk protein or is severely deficient in enzymes, then he will carry this peculiarity through his whole life, and most likely he will not drink milk or kefir himself, and there is no need to force him if he himself won't want to!

But you are lucky with genetics, and no one in the family has ever had an allergy (which is hard to imagine nowadays), and most importantly, if your child has always had perfectly clean skin, then the first of the dairy products - cottage cheese, you will begin to offer your child with 7 months, kefir - from 10 months. Milk - after a year. It will be better this way.

But if your family does not have a very close and joyful relationship with milk, then it is better to postpone even the introduction of kefir and yogurt into complementary foods for a child until the age of 18 months.

Fish day and first meal

Fish is a very healthy product, rich in vitamins and antioxidants, but it must also be introduced carefully. I advise you to start introducing the first fish food at about 7-8 months. It is better to start with species such as cod, hake, haddock. The rules are the same: the first three days on the "gram," then slowly add. If there are no problems in a week or two, you can try such delicacies as tuna or salmon, of course, canned children, if you can find it. It is better not to mess with trout and salmon in the first year of life, this fish is all stuffed with dyes and antibiotics.

No matter how hard I tried, the article about the first complementary foods turned out to be long. Thank you for reading to the end, I hope it will be useful. If you have questions about the introduction of complementary foods, you can write your appeals on our website in the question to a specialist section. A short answer can be obtained on the Internet, but in order to make a diagnosis and give a detailed consultation, of course, you need to come to a face-to-face appointment with a pediatrician and a pediatric allergist.

Rules for the introduction of complementary foods for a child 4 - 12 months: first complementary foods, menus, charts, tables, principles of nutrition for a baby

Modern principles of feeding children is a kind of fusion of practical experience and the latest scientific developments. They are based on the recommendations of the European Association of Pediatric Gastroenterologists, Hepatologists, Nutritionists ESPGHAN , the American Academy of Pediatrics AAP and national recommendations of relevant ministries and associations.

Modern recommendations are based on the analysis of the results of many studies on the composition, timing of the introduction of complementary foods in Europe for healthy full-term newborns, taking into account various aspects of the introduction of complementary foods, its impact on indicators of physical and mental development. Timely introduction of complementary foods contributes to the optimal development of all systems and organs of the child, physical parameters, psychomotor development, and the activity of the nervous system. The period of introduction of complementary foods is very important for the growth and development of the child, as well as an outstanding stage in the transition of the child from breastfeeding to feeding from the general table.

• It is inappropriate to develop separate recommendations for the introduction of complementary foods for breastfed or artificially fed children, the approaches in these cases are the same
• Breast milk mothers remains the gold standard of exclusive breastfeeding for at least 4 months (17 weeks) of an infant's life, up to 6 months (26 weeks) of exclusive or predominant breastfeeding
• The digestive tract and kidney function are mature enough for a baby to accept complementary foods at 4 months of age, and between 5 and 6 months the baby develops the necessary motor skills to consume solid foods. Therefore, at this age, it is important to give food of the right consistency and in the right way
• A well-nourished mother can provide all the nutrients, vitamins, and minerals her baby needs through exclusive breastfeeding up to a maximum of 6 months of age
• Some children may need iron supplementation earlier than 6 months
• It is important to continue breastfeeding in parallel with the introduction of complementary foods. This has been shown to reduce the risk of gastrointestinal and respiratory infections, as well as hospitalizations in a child
• When comparing initiation of complementary foods at 4 or 6 months of age, no significant differences were found in the effect on growth and body weight, development of obesity during the first 3 years of life
• At the same time, a high risk of developing overweight and obesity was established with the introduction of complementary foods before 4 months of age
• Complementary foods (solid or liquid food other than breast milk or infant formula) should be started not earlier than 4 months and not later than 6 months
• With age, with the introduction of complementary foods, the child should be offered food varied in texture, texture, taste, smell
• Children have an innate tendency to distinguish and prefer sweet and salty foods, reluctantly eat bitter, which we cannot change. But we can shape and adjust the child's taste preferences through training, systematically offering the child foods with different tastes, including sour, bitter green vegetables
• Whole cow's milk is not recommended for children under 12 months of age. The use of cow's milk is associated with the intake of an increased amount of energy, protein, fat, and lower - iron. Therefore, children who consumed large amounts of cow's milk at an early age had a higher risk of developing iron deficiency anemia
• Eating more protein when complementary foods increase the risk of overweight and obesity, especially in individuals with a predisposition to this, so protein intake should not exceed 15% of energy intake during the day
• The baby's need for iron is very high during the entire period of complementary feeding, so it is necessary to ensure the provision of iron-rich foods, especially for breastfed children
• Allergenic products can be administered from 4 months of age at any time, since it is during this period that immune tolerance to the allergen is formed. For example, children at high risk of developing allergic reactions to peanuts should be administered at 4-12 months of age under specialist supervision. No relationship was found between the timing of the introduction of allergenic complementary foods and the development of allergic or immunological diseases. However, this does not mean the need for early introduction of allergenic products to everyone, but it emphasizes that there is no need to postpone the introduction of allergenic products after 4 months for a longer period;
• Gluten can be offered to a child aged 4-12 months, but large amounts of gluten should be avoided during the first weeks after initiation of its introduction, thereafter a safe amount has not been established. The type of feeding (breast/artificial) was not identified with the introduction of gluten to reduce the risk of developing celiac disease, type 1 diabetes;
• Sugar or salt should not be added to complementary foods, and sweetened drinks and juices should be avoided. Sugary drinks are liked by babies in the first months, but if they are not given, but after 6 months, the children no longer like them very much. Sugar affects future eating behavior. Sugar is an important factor in the development of caries - it contributes to caries, as glucans can be formed, which increase the adhesion of bacteria to tooth enamel, disrupt the diffusion balance of acid and buffer systems, which ultimately contributes to damage to the enamel.
• Vegetarian diets are contraindicated in young children due to the risk of vitamin B12, iron, zinc, folate, long chain fatty acid, protein and calcium deficiencies, which can lead to irreversible adverse effects and impaired cognitive development;
• Vegetarian diet can be used only under the close supervision of a doctor and nutritionist, with the obligatory additional administration of vitamins B, D, iron, zinc, calcium, proteins, PUFAs, which can ensure the appropriate growth and development of the child. It is important that parents should be aware of the risk of irreversible harmful consequences (mental disability, death of the child) that may develop if they do not follow the recommendations of specialists.

The General Rules for the introduction of complementary foods for children of the first year of life:

• Introduce the first feeding It is better in the morning feeding 9-11 in the morning to trace the reaction of the child to the new product.
• Sugar and salt free .
• Give the first complementary foods to the child when he is calm and not tired .
• Start with 0.5-2 teaspoons. If the child refuses, do not insist, try to give later or the next day.
• If the reaction is normal - no rash, no skin changes, no stool changes, double the dose the next day. Gradually bring the baby's first complementary foods to the age norm 80-200 g
• If there is an allergic reaction or other intolerance reaction - refuse to introduce this complementary food for three days, if the adverse reaction occurs again - do not give this product, contact your pediatrician.
• Each subsequent new complementary food must be one-component only: marrow, cabbage, broccoli, buckwheat, meat, etc.
• Mixed food dish give when the child has already got to know all the products separately.
• It is not advisable to introduce new foods three days before and after vaccinations.

1. Holds head
2. Able to stand alone, practically without support, sit on a special high chair with side support
3. Opens mouth when a spoonful of food is brought
4. Turns away from a spoonful of food when not hungry
5. Closes mouth with spoon in mouth holds food in mouth and then swallows rather than pushing or spitting it out

The first complementary foods at 4 months

Age at 4 months as the minimum for the introduction of complementary foods was also chosen because at 4 months the child's gastrointestinal tract becomes more mature: the initially increased permeability of the small intestine mucosa decreases, the number of digestive enzymes, a sufficient level of local immunity is formed, the child acquires the ability to swallow semi-liquid and thicker food, associated with the extinction of the “spoon ejection reflex”.

Therefore, to the question whether it is necessary to give complementary foods to a 3-month-old baby , one can unequivocally answer: no, it's too early!

But 4 months, this is the time when you can think about the introduction of complementary foods. At the same time, it should be remembered that at the age of 4 months, the child has enough mother's milk or a highly adapted milk formula for its full development. In addition, when they talk about complementary foods at 4 months, they usually mean the end of the 4th month of life. It is important to continue breastfeeding in parallel with the introduction of complementary foods.

Video: complementary foods at 4 months

If you enter complementary foods at the 4th month of the child’s life -this is usually a single-component Puree , if the child does not gain weight not well well gained well , then it can be gluten-free cereals: rice and buckwheat . It is better to start with vegetable puree. Kids are smart and if he tries a sweeter fruit puree, he can refuse vegetable puree for quite some time and you may have difficulty introducing this very healthy dish.

What is useful in vegetable supplements and what is the best way to prepare it?

Vegetable puree - for the first feeding can be prepared from cauliflower, zucchini, pumpkin, broccoli - these are low-allergenic products, are among the ten most useful vegetables in the diet of children, contain a large amount of healthy proteins, fiber and vitamins, microelements ! Fiber helps move food through the digestive tract and promote beneficial microflora in the gut. Pectins absorb and remove toxins from the baby's body. Vegetables have a positive effect on the acid-base balance of the body, creating conditions for the proper functioning of all organs and systems.

Cauliflower - is a good source of fiber, protein, minerals and vitamins: A, B1, B2, B3 (PP), B6, as well as a small amount of vitamins K, D and tocopherol (vitamin E). In the inflorescences of cabbage there is a lot of magnesium, sodium, potassium, phosphorus, calcium, iron. It contains twice as much iron as green peas, peppers and lettuce. Cauliflower protein is easily digestible and its content is quite high. Cauliflower protein contains essential vitamin U (methionine). It is one of the essential amino acids that cannot be synthesized by the human body. Other essential amino acids are also present in a small amount: arginine, tryptophan.

Zucchini - rich in vitamins and microelements. It contains potassium, magnesium, phosphorus, calcium, vitamins C, B1 and B2 and others, folic acid. Which plays an important role in the processes of hematopoiesis. Zucchini is rich in such important trace elements as iron and copper. They are necessary for the formation of nervous tissue, normalization of metabolism, as well as for the formation of hemoglobin, which is a good prevention of anemia.

Broccoli is a very useful vegetable, which is a type of cauliflower. Pleasant soft taste and good digestibility of the product, unique composition have a beneficial effect on the health of both adults and children. Eat unopened cabbage inflorescences. This is also a low-allergenic vegetable, rich in protein, fiber, vitamins, calcium, iron, trace elements and even phytoncides. The content of calcium and magnesium is sufficient to balance the functioning of the nervous system, ensure the normal regulation of the child's sleep and wake cycle, and good stress resistance. A child with such nutrition becomes calmer, less excited and naughty.

Broccoli is the leader in choline and methionine content. Only 50 g of broccoli provides the baby with a full set of nutrients for a day.

Pumpkin is the largest vegetable on Earth. It is one of the ten most useful vegetables in the diet of children, contains a large amount of useful proteins, fiber and vitamins, including beta-carotene, vitamin C, E, K, iron, potassium, magnesium, trace elements that are indispensable for children's nutrition, as they strengthen immunity and help fight inflammation, have a beneficial effect on the nervous system. By the content of carotene, pumpkin exceeds carrots by 5 times.

Vitamins and microelements contained in pumpkin help the child grow, provide healthy sleep, are responsible for the condition of the skin and eyes, improve metabolic processes, and accelerate the removal of harmful substances from the child's body. Due to its beneficial qualities, pumpkin can be one of the first types of complementary foods for an infant.

All vegetable purees have a specific vegetable smell, this is absolutely normal

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