Babies are drinking too much milk in the 6 to 18 month window period. This period is critical in establishing healthy eating behaviour. Too much milk not only deprives the body of nutrients it needs from solid foodstuffs, it also leads to iron deficiency and contributes to chronic or recurrent constipation. Riekie Van der Vyfer, a local dietician based at Quenet's Family Pharmacy, gives some tips to help getting baby off the bottle (and breast).
1. Make family mealtime a priority. Have a routine meal together as a family at least once a day - dinner is most practical.
2. Avoid distractions during mealtime. No TV.
3. Maintain a calm and pleasant attitude during mealtime.
4. Encourage the appetite during the day : have shorter and more frequent meals : limit meal duration to 20-30 minutes and have 4-6 meals or snacks per day with water in-between meals. No milk/juice/sweetened beverages between meals - use these rather as a reward after meals.
5. Systematically introduce new foods and don't give up easily - try new foodstuffs up to 8-15 times before giving up.
6. Give age-appropriate foods.
7. Encourage self-feeding.
8. Accept age-appropriate mess.
As recommended by the World Health Organization.
1. Thaw ready-to-eat frozen food in the fridge or microwave - don't thaw at room temperature.
Is it important? Yes. Iron deficiency is common and may have lasting adverse effects on your child’s cognitive abilities. It has also been associated with headaches and the development of ADHD (attention deficit hyperactivity disorder) and strokes in children.
What can we do to decrease the prevalence of iron deficiency? At delivery, your baby’s umbilical cord should only be clamped after 30-60 seconds, if safe to do so for mom and baby. If your baby is at high risk for the development of iron deficiency, he or she needs to be supplemented with iron from 2 weeks after birth. This is especially important for babies of mothers who had iron deficiency during the course of their pregnancy, premature or low birth weight (<2.5kg) babies, and babies who lost blood before (in the womb), during or after delivery. If breastfeeding exclusively, your baby needs to be supplemented with iron from 4 months of age. When starting with supplemental feeds @ 4-6 months, start with an iron-enriched baby cereal and do not wait until after 7 months to start with pureed meats. Delay giving unmodified cow’s milk until after 12 months of age, as its intake before this time can lead to poor iron absorption and silent bleeding in your baby’s gut, with chronic blood loss aggravating the iron deficiency. Toddlers older than a year of age should not be drinking more than 600ml of unmodified cow’s milk per day; if they are and cannot be weaned from doing so in the short term, they should be supplemented with iron. Routine iron supplementation is also recommended if your child (between the age of one and five years) is eating less than 3 portions of iron-rich foodstuffs per day (<85g meat per day). Liver, prune juice, spinach and iron-fortified cereal are some of the less well-known iron-rich foodstuffs. Meat not only contains good amounts of iron, but also inherent factors that promote the absorption of iron from other (non-meat) iron-rich foods. Food elements having a negative effect on the absorption of iron, include tea, coffee and calcium (beware excessive amounts of dairy in the diet). Tea may decrease iron absorption by 90%. Ascorbic acid (vitamin C) promotes the absorption of iron : it is a good idea to give a (diluted) vitamin C-enriched juice with (iron-rich) meals. Children should be dewormed at least every 6 months in the first 5 years of life – the worms attach to the inside of the gut, leading to significant blood loss over time if the amount of worms are enough.