What foods are needed by children?

All children need a balanced diet, but a child’s age, maturity and physical size determines how this is best achieved. Young children have relatively bigger nutritional requirements per kg than adults because of their need to grow.

Infants under 6 months need a liquid diet because chewing and swallowing must still develop and mature. Breast milk alone is the ideal diet (designed by nature) for these infants. It meets the nutritional needs and is a balanced diet. Breastfeeding avoids the risks attached to unsafe handling and contamination of alternative feeds. If breast milk is not available, formula feeds should be given. If a formula has to be chosen, select a suitable commercial starter formula feed and follow the mixing instructions and recommended volumes as given on the tin. Usually one scoop (provided by the manufacturer) of milk powder is added to 25 ml water.

Beyond 6 months of age the infant’s nutritional needs can no longer be met completely by breast milk or formula alone. Solids must be introduced. Breast milk or formula feeds should, however, still form an important part of the diet. Soft family foods such as porridge, mashed vegetables or fruit should be started. By 8 months children can chew and ‘finger foods’ can be started. Solids should be given 3 times a day to infants that are still breastfeeding or are formula fed.

By one year of age most children can be given family foods 5 times a day. Small children have small stomachs and therefore need more frequent meals than adults to achieve an adequate total nutritional intake. Breastfeed as often as the child wants. If possible, breastfeeding should be continued until at least 2 years of age. Most children will tolerate cow’s milk from 1 year of age. After 1 year of age, a normal child who is not breastfed should not receive more than about 500 ml milk per day.

Complementary foods are given to fill the gap between the total nutritional needs of the infant and the nutrition provided by breast milk or formula feeds. Complementary foods are usually not needed before 6 months.

The advantages and risks of breastfeeding must be carefully considered in infants born to HIV positive women.

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