Adequate nutrition during infancy and early childhood are fundamental to the development of each child. Experts say complementary feeding is crucial stage during infancy. It’s defined as the process when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, therefore, other foods and liquids are needed, along with breast milk. Dr Alex Mucumbitsi, the head of nutrition and hygiene department at National Early Childhood Development Program, says the target age range for complementary feeding is generally taken to be six to 24 months of age, even though breastfeeding may continue beyond two years. He says this is the peak age for growth faltering, deficiencies of certain micronutrients, and common childhood illnesses such as diarrhea. “After a child reaches two years of age, it is very difficult to reverse stunting that has occurred earlier. The immediate consequences of poor nutrition during this period include significant morbidity and mortality and delayed mental and motor development in the long-run,” he says. Erick Musengimana, a nutritionist at Rwanda Diabetes Association, Kigali, says optimal complementary feeding depends not only on what the child is fed on, but also on how, when, where, and by whom the child is fed. At six months of age, he says soft porridge and well-mashed food should be given to the baby, and that this should be done at least two to three times a day. He says two to three tablespoons during each meal should always be observed. “In case of illness, it’s recommended to give the baby small frequent meals and more fluids, including breast milk or other liquids,” he says. Also, Musengimana advises that caregivers avoid foods that may cause choking, for example, with shape and/or consistency that may cause them to become lodged in the trachea, like nuts, grapes, and raw carrots. Tea, coffee, soda and sugary or coloured drinks shouldn’t be given to the baby, and also, limiting amount of fresh juice is important. The food frequency, he says, should increase as the child grows. “Regular check-ups and immunisation is important,” he says. Mucumbitsi notes that infants should be fed directly, and for older children, assisting them when they feed themselves is important. This (feeding), he says, should be done slowly and patiently, and that encouraging children to eat, and not forcing them, is also important. He advises that in case children refuse some foods, trying out other kinds of food with different combinations, tastes, textures and methods of encouragement can work. Private Kamanzi, a nutritionist at Amazon Cabinet Clinic in Remera, Kigali, says during meals, if the child loses interest easily, caregiver shouldn’t stop or give up. Instead, he says, they should remember that feeding times are periods of learning and love, talking to children during feeding can help. Ways of feeding Kamanzi notes that in most cases, the encouragement for children to eat is rarely observed among caregivers. Instead, he says this is normally observed only when children refuse food or are ill, which is not correct. Meanwhile, he says, good hygiene and proper food handling should be observed at all times when handling the baby’s food. Storing baby’s food safely and serving foods immediately after preparation, using clean utensils to prepare and serve food, using clean cups and bowls when feeding children, are among the precautions that should be taken all the time. By the time the baby is 12 months old, most of them are able to eat the same types of foods consumed by the rest of the family. Therefore, Kamanzi says, keeping in mind the need for nutrient-dense foods is important. Aside from this, Kamanzi says the baby should be fed with a variety of foods to ensure that all nutrient needs are met. For instance, meat, poultry, fish or eggs should be eaten daily, or as often as possible. Vitamin A-rich fruits and vegetables should be eaten daily, he says, and providing a diet with adequate fat content is helpful to the child.
