Breastfeeding complementary feeding regimens

To date, there is no consensus on how and with what products to start feeding a newborn baby. Debates on this issue between specialists are ongoing. Such feeding schemes for breastfeeding vary somewhat, but the principles of their introduction are quite similar.

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Scheme of the first complementary feeding during breastfeeding

The existence of mankind is not one millennium. How many generations have been fed and raised. But this question remains relevant to this day. Several generations earlier, our grandmothers began to accustom the baby to everyday food from two to three months, adding apple juice to breastfeeding drop by drop. Today, the scheme of the first complementary feeding during breastfeeding has changed significantly.

Some modern women, in order not to lose the shape of their breasts, refuse to breastfeed their newborns at all. But there are still many more who attach great importance to this process. And this is good news.

Mother's milk is unique in its composition and up to a certain point fully satisfies the baby's needs for all nutrients, vitamins and minerals. Which allows the growing organism to develop normally. But over time, these substances are no longer enough. It is at this time that one product after another should be introduced, gradually increasing their quantity in the child's diet.

After certain studies and large-scale monitoring, most experts believe that such a moment comes after the baby reaches six months of age. But each child is individual and, before adding this or that product to his diet, you should understand how prepared his body is for an increase in the food load on him.

In most cases, by six months, mother's milk is no longer able to cover all the needs of the growing organism. Its needs grow, the need for protein structures, carbohydrates as a source of energy, numerous mineral and vitamin complexes increases.

Around this time, the mucous membrane and walls of the digestive tract lose their permeability, the process of producing special enzymes that participate in the process of processing and assimilation of food is normalized. Now the walls of the digestive organs are able to protect the entire body from allergens and toxins that enter with food or are products of its processing.

During this period, the baby's jaws also become more prepared. After all, they will gradually have to wean themselves off sucking milk from the mother's mammary glands and switch to coarser food that requires grinding and grinding before it gets into the stomach.

Only food can form a chewing reflex in a baby. And if you are late with complementary feeding, this time may be missed, and subsequently problems may arise when introducing any products and forming chewing skills. After reaching the age of seven to eight months, a baby usually resists, is capricious, not wanting to eat what is given to him. This is reflected in all feeding in general.

When introducing complementary foods earlier, many pediatricians believe that the baby’s body is not yet fully ready to accept food other than breast milk.

But there may be cases when, for medical reasons, pediatricians recommend introducing the first complementary feeding already at the threshold of 4 - 4.5 months. One of such indicators is the lack of breast milk in a young mother. In this case, the child does not receive the necessary volumes of food. This decision is made jointly by the mother and the doctor - pediatrician, observing the newborn.

In order for a mother to be able to assess the situation herself and understand that her child is ready for the introduction of the first complementary foods, she should know a number of signs by which a conclusion about his readiness is made.

1. The child becomes more agitated and demands to be fed more often than before.
2. Immediately after feeding, when the mother’s breast is already empty, the baby “demands a continuation of the banquet.”
3. If a mother tries to give her baby a spoon dipped in, for example, applesauce, the baby will not spit it back out of his mouth.
4. The baby begins to be interested in the process of adult nutrition, namely, what the mother eats. He tries to taste what is on the plate.
5. At the time of introducing the first complementary foods, the baby should be able to sit for a long time and hold objects, including food, in his fist.

If, after observing the baby and analyzing the situation, it turns out that most of these signs are noted, then we can confidently say that the baby is ready to accept additional food products into his diet.

It is worth remembering that doctors do not recommend adding a new product two to three days before vaccination, as well as for four to five days after receiving the vaccination.

Another taboo on introducing a new product is during periods of illness or active teething.

You shouldn't do this when it's sweltering outside either. After all, a baby can handle it worse than adults, due to their not yet perfect thermoregulation.

It is worth postponing new complementary feeding if the parents are planning a long trip or moving to a new place of residence. This is especially relevant when changing climate zones. Only after two to three weeks of adaptation can the issue of introducing a new food product be raised.

When starting to change the list of food products for a child, a young mother should learn several rules and accept a number of recommendations that will help her go through this path more easily and unnoticed.

• The introduction of complementary feeding should be done only with a spoon, no bottles. Even if the seller of the children's department explains that the bottle with a nipple was developed by the manufacturer specifically to facilitate complementary feeding, you should not fall for it. The toddler should initially get used to eating with a spoon. Otherwise, the baby's very perception of the rules of eating behavior will be disrupted. And retraining is much more difficult than teaching "from scratch". At first, you can use a special spoon made of metal coated with silicone or plastic. Before buying dishes for a baby, you should smell it. There should be no unpleasant odors. Otherwise, the dishes are made of low-quality material, which is unacceptable in our situation. Try to bend it slightly, the dishes should not give in, they should be strong and safe.
• You should keep a "Feeding Diary" on the pages of which the following parameters should be reflected: the time of introduction of complementary foods, their name, quantity and the baby's reaction to the product. This approach will help, in the event of an allergic reaction, to track down the culprit product. Be sure to also indicate the type of heat treatment: raw (for example, grated apple), steaming, stewing or boiling. If this is a product purchased in a specialized store, it is worth recording the manufacturer. It is advisable to make notes and your comments at least until the baby is one and a half years old.
• When changing the diet, changes also occur in the baby's bowel movements. The color and consistency of his feces change. Therefore, parents should not lose control of this issue.
• Don't rush and introduce large amounts of new food or add it too often. This can backfire, and the baby will refuse complementary feeding altogether and you will have to start the process from scratch.
• In order for a baby to taste a new product, it needs to be tried ten times. Therefore, the next “dish” should be offered no earlier than seven to ten days after the previous one.
• If your baby refuses complementary feeding, try to cheat by adding a little mother's milk to the product; this step will most likely make the capricious child more accommodating.

The fact of changing the consistency and quality of the stool will allow you to choose the first complementary food for your baby. If he had problems with defecation and constipation before, it is better to start with vegetables, since the fiber that prevails in them helps to loosen the stool.

In this regard, it is impossible to give a clear answer about fruits. Some of them, for example, apple, peach, apricot, make feces more liquid, while banana and pear, on the contrary, strengthen the stool.

Particular caution should be exercised when introducing the first complementary foods, because before this, the baby's digestive system has not encountered any food other than mother's milk. When a new product appears, liver function is activated, which leads to the appearance of small streaks of mucus and greenish inclusions in the feces. But there is no need to panic if the child feels normal. After a few days, this process will normalize. Do not worry if the introduced product leaves the body undigested at first. After all, liver enzymes are only "learning" to process new substances.

In some cases, listening to the advice of their mothers and grandmothers, young parents choose fruit or vegetable juice as the first complementary food, which is absolutely wrong. Until recently, and in some places even now, there was an opinion that juice cannot be considered a full-fledged product. It was perceived as a corrective vitamin supplement that is safe to give from the third to fourth month of life. But it is worth remembering that if a newborn is breastfed, then he will not need such a product until at least nine to ten months, but it will be much more useful to introduce juice after the age of one year.

As long-term studies by European doctors have shown, juice does not contain the vitamin and mineral complex necessary for a growing organism, and is not a complete diet. It can only replenish the child's body's needs for nutrients by 1-2%. And if we talk, for example, about the benefits of apple juice as a source of iron, then we can "stun" young parents with the fact that such iron is not absorbed by a small organism at all.

At the same time, introducing juice as the first complementary food can harm the child's fragile body. After all, juice is a fairly aggressive environment for the digestive system, consisting of multiple fruit acids. They irritate the mucous membrane, provoke diarrhea and upset the bowel movement. The sugar present in them worsens the child's appetite. At the same time, the baby may like sweet juices so much that he will categorically refuse to try anything new, since the rest of the complementary food has a less pronounced flavor.

If parents decide to treat their baby with juice, it is worth remembering that it is not given to a baby in concentrated form. This product requires dilution with water in a juice/water ratio of one to two or even three volumes of water.

Parents naturally ask the question, where to start then? Today, pediatricians offer two main schemes for the first complementary feeding when breastfeeding. The first is mashed fruits, the second is homogeneous porridges and vegetables. The first scheme did not find much response due to the fact that the facts that concern fruit juices are also true for fruit purees. After all, it is offered to the child in its raw form, and, therefore, it contains all the same fruit acids that irritate the tissues of the digestive tract, and sugar can provoke the baby to refuse porridges, vegetables and meat in the future.

Based on this, most pediatricians are inclined to choose the second scheme for introducing complementary foods.

First complementary feeding during breastfeeding according to Komarovsky

So many people, so many opinions. This proverb is the best fit for the topic we are considering in this article. For example, Dr. Komarovsky, a pediatrician known to all young mothers today, who hosts his own show on one of the television channels, has his own point of view on this issue.

Referring to the arguments of nutritionists, the first complementary feeding during breastfeeding according to Komarovsky should begin with fermented milk products.

Despite the fact that vegetable purees are more useful and have a greater supply of nutrients, vitamins and minerals, nevertheless, as the doctor explains, these products are far from breast milk in their structure. And in order to smooth out the transitional food stress, the first complementary feeding should be a product closest to mother's milk. And this, as the doctor believes, is fermented milk products.

As Dr. Komarovsky explains, introducing vegetables can provoke an upset stomach in the baby, which negates all the benefits of this diet. Therefore, despite the theoretical advantages of vegetable purees, the pediatrician recommends starting not with healthier vegetables, but with the least "conflicting" fermented milk products. The advantage of "fermented milk" is also in the beneficial bacteria that are present in it. They are the ones that can effectively fight pathogenic intestinal flora, improving its functioning. At the same time, "good bacteria" participate in the synthesis of compounds that work on food processing, reducing the load that falls on the baby's liver in this process, which is also important.

According to his theory, which is in line with the generally accepted opinion, the first introduction of "adult" food should not begin until the baby reaches six months of age. Until that moment, his body is quite satisfied with what the mother's breast produces. At the same time, it is worth remembering that it is the nursing mother who should eat quality and varied food, excluding from her diet only those products that can cause an allergic reaction in the baby.

If the mother has problems with lactation and cannot establish milk production despite all her efforts, then the pediatrician advises to purchase a high-quality and well-adapted artificial milk formula. In such a situation, this is the best way out. At the same time, you should not refuse breastfeeding while the mother has at least a little milk. After all, a completely identical substitute for mother's milk has not yet been created. And breast milk is not only nutrition, but also protection of the child's body from negative pathogenic external invasion, since the newborn's immunity is still imperfect.

And it doesn't matter what type of food is chosen (classic, soy, hypoallergenic, low-lactose or any other), the main thing is that it is a quality product, developed specifically for the baby's age. The body of a newborn is so fragile that you shouldn't experiment with it, introducing adult food, trying to feed the child with good intentions.

As mentioned above, it is advisable to choose one of the fermented milk products as the first complementary food for the baby. For example, you can choose kefir offered by the baby kitchen or buy regular fresh low-fat kefir in the store. In this case, it is advisable to give adult food in the time interval from 9.00 to 11.00 in the morning, which usually falls on the second feeding.

Complementary feeding begins with two to three teaspoons of kefir, after which the baby "catches up" with breast milk. After introducing a new product, you should observe the child throughout the day. If there are no negative manifestations, the next day the amount of kefir can be doubled. And so on. That is, in practice, it will look like this: the first day - 10-15 ml, the second day - 20-30 ml, the third - 40-60 ml, the fourth - 80-120 ml and so on. It should be immediately noted: if negative symptoms appear after one of the doses, then you should, at a minimum, stop increasing the dosage. It would not be superfluous to get advice from a pediatrician. Perhaps, complementary feeding will have to be stopped altogether for a while, returning to adaptation mixtures, or simply stop introducing new foods for a while.

If there are no problems, then on the fourth or fifth day, you can add one teaspoon of cottage cheese to the baby's kefir. Mix everything thoroughly until a homogeneous mixture is obtained. Cottage cheese can be purchased in the store, or you can make it yourself, the main thing is that it is high-quality and fresh. If the first test was successful, the next day the amount of cottage cheese can be doubled. As Dr. Komarovsky says, at six to eight months, the dosage of cottage cheese can be about 30 daily grams, gradually this figure can be increased to 50 g.

It is also worth noting that it is advisable to give the child an unsweetened fermented milk product, but if he refuses to eat it, it is permissible to sweeten the food slightly. Although you should not overdo it. The reason for such a comment has already been mentioned above.

Some opponents express the idea that cottage cheese is too overloaded with calcium for such an organism, to which Komarovsky argues in the language of numbers. As studies show, 100 g of cottage cheese contains 156 mg of calcium, while mother's milk contains 25 mg (for comparison, cow's milk contains 60 mg). But since cottage cheese is introduced into complementary feeding little by little, then, accordingly, 30 g of cottage cheese will bring only 46.8 mg of calcium to the baby's organism. At the same time, only one feeding is replaced, all the others are breastfeeding or feeding with adapted mixtures.

In the future, this pediatrician does not have the table of introduced products that is familiar to some mothers, since the tabular version, although more visual, does not reflect all the nuances of the process under consideration.

Scheme of complementary feeding during breastfeeding according to WHO

The World Health Organization (WHO) does not let this process slip out of its control. It offers its own scheme, developed by research institutes, according to which young parents are offered to start transferring their baby to a wider range of products.

Today, there are quite a lot of such methods and charts, but informative, easy to use and effective ones are few. The complementary feeding scheme for breastfeeding according to WHO in our case is reduced, for clarity, to a table.

Document Without Name

Product	Deadline for entry	Type of processing, dish	Portion size.
Vegetables	From 6 months (for medical reasons, possibly from 4 – 4.5 months).	Initially, it should be introduced with white or green vegetables. The dish is a homogeneous puree of boiled vegetables.	Start with 0.5 teaspoon, gradually increasing to 100–200 g at a time.
Vegetable oil	Not earlier than 6 months.	Sunflower, corn, olive. Introduced into the main vegetable or meat dish.	Start with 3-5 drops up to one teaspoon.
Porridge on water	Not earlier than 6.5 – 7 months. If the baby’s weight is below normal, complementary feeding can be introduced from 4 – 5 months.	Start with gluten-free cereals: buckwheat, corn, rice. If tolerated well, oatmeal. With full adaptation to these products, multigrain porridges can be introduced later.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 100 – 200 g.
Butter	From 7 months of age.	As an addition to main dishes.	Initially – an eighth of a teaspoon. Gradually increase to 10-20 g.
Fruits	From 7-8 months of age.	First, choose fruits with a dull color (red fruits are introduced last). First - monopuree, with a gradual transition to fruit puree - assorted.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 100 – 200 g.
Porridge with milk	From 8-9 months of age.	Start with gluten-free cereals: buckwheat, corn, rice. If tolerated well, oatmeal. With full adaptation to these products, multigrain porridges can be introduced later.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 100 – 200 g.
Meat	From 8 months of age.	Meat puree. Preference: rabbit, turkey, veal, chicken, young beef. Single-component puree, and later multi-component puree.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 50 – 100 g.
Egg yolk	From 8 months of age.	As an addition to main dishes.	Initially - one eighth of the yolk. Gradually increase to half of the yolk per day.
Bakery products	From 9-10 months of age.	Biscuits: zoological, "Maria".	We start with an eighth part and gradually increase it to a whole. Up to one year of age, no more than 5 pieces per day are allowed.
Fermented milk products	From 9 months of age.	Without any additives: yogurt, kefir, biokefir (low fat).	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 100 – 200 g.
	From 10 months of age.	With fruit filling or other products.
Cottage cheese	From 9 months of age.	Without any additives	Start with 0.5 teaspoon, gradually increasing to 50 g. After a year - 100 g.
	From 10 months of age.	With fruit filling or other products.
Meat by-products (liver, tongue, heart)	From 9-10 months of age.	Homogeneous puree, one to two meals per week.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 50 – 100 g.
	From 12 to 14 months of age.	As a separate dish, approximately two to three meals a week.
Fish	From 10 months of age. If the child is prone to allergic reactions to foods, it is worth waiting until he or she reaches one year of age.	No more than twice a week.	Start with 0.5 teaspoon, gradually increasing to the norm for one feeding – 150 – 200 g.
Fruit juices. Dilution with water is mandatory. Ratio 1:2 or 1:3	From 10 to 12 months of age.	Initially, diluted juices prepared from light and greenish fruits are introduced, only gradually can the intensity of color be added, moving on to red fruits.	Start with 3-5 drops, gradually increasing the volume. At one year, the baby can already be given 100 ml of diluted juice.
Gluten cereals (milk porridge): semolina, barley, millet, pearl barley.	From 12 months of age.	First, a strongly boiled single-component porridge is introduced, gradually moving on to more crumbly options.	Start with 2-3 teaspoons, gradually increasing to the norm of 200-250 g.
Berry puree	From 12 months of age.	Almost any.	Start with 0.5 teaspoon, gradually increasing to the norm of 100–150 g.

When switching to complementary feeding, a number of other factors should be taken into account:

• With any type of feeding (breast, artificial or suspended), you should start introducing vegetables and fruits with light (white) and greenish types. In this case, it is possible to prevent the development of an allergic reaction to the coloring enzyme. In this case, it is worth choosing those vegetables and fruits that are grown in the area where the family lives and correspond to the season. Naturally, this fact should be chosen whenever possible.
• First, you need to start cooking porridge in water, or you can add a little expressed breast milk to it.
• After porridges have been introduced into the baby’s diet, after one and a half months, it is permissible to switch from single porridges to their mixture: assorted cereals and grains, puree – assorted.
• At first, the use of various seasonings, including sugar and salt, is not allowed.
• If the baby refuses to take complementary feeding. You can try to cheat by adding a little mother's milk to the dish or sweetening it, for example, with fruit puree. This issue is resolved according to the situation and depending on what complementary feeding is being introduced at the moment.
• You should not rush to add large amounts of new food or increase portions abruptly and too often. The baby will refuse complementary feeding altogether, and this process will have to be started from scratch.
• A child needs some time to try a new product. Therefore, the next “dish” should be offered no earlier than seven to ten days after the previous one.
• If vaccination is planned, then two days before and four to five days after, no new product should be introduced into the baby’s menu.
• Do not introduce a new product during periods of illness or active teething.
• This taboo is also imposed during periods of sweltering heat. Since the child's thermoregulation system is not yet perfect, the baby suffers greatly from the heat and has no time to experiment with food. During such periods, he is more capricious.
• It is worth postponing new complementary feeding if the parents are planning a long trip or moving to a new place of residence. This is especially relevant when changing climate zones. Only after two to three weeks of adaptation can the issue of introducing a new food product be raised.
• Between feedings, you should unobtrusively offer your baby some water.

If parents follow all the recommendations and the schedule for introducing complementary foods, they will be able to avoid many health problems for the little person, raising him healthy, strong and developed.

Introduction of complementary foods during breastfeeding according to the Russian Academy of Medical Sciences

Russian science is not standing aside either. Scientists and nutritionists of the Russian Academy of Medical Sciences (RAMS) have developed their own scheme for transferring a baby to a varied diet. According to experts, the first complementary feeding, with normal development of the baby, can be introduced only after he reaches six months of age. Upon reaching six months, the digestive system and jaw apparatus of the child are prepared to process other food, in addition to the mother's product. And it is at this stage that the baby's mother's breast milk alone becomes insufficient.

The introduction of complementary foods during breastfeeding according to the Russian Academy of Medical Sciences allows adding new products to the infant's diet as early as four months, but this is allowed only in a number of isolated cases. One of the most common reasons is a lack of mother's milk, that is, the baby stops eating enough and requires more food.

Some mothers are afraid that when introducing complementary feeding, their milk will start to disappear, but this is not entirely true. The first complementary feeding is usually prescribed when the baby is ready to accept it, that is, he feels a lack of breastfeeding. At the same time, the introduced supplements are more of a “supplementary” procedure at first, and only over time “replace” the breastfeeding procedure.

At the same time, proper accustoming to a particular food product, this process allows the development of the baby's digestive physiology, forming chewing skills and improving the process of digesting a particular food.

It should also not be forgotten that both early and late addition of new products can lead to a number of deviations. Incorrect "eating behavior" can be established, which will be problematic to rebuild later. Therefore, if the baby is developing normally, the ideal period for introducing additional nutrition is six to seven months.

The scheme for introducing complementary foods during breastfeeding according to the Russian Academy of Medical Sciences is similar in many points to feeding according to the WHO, but there are also a number of differences. For example, if fruit juices in the second case are allowed only from 10 months, then according to the recommendations of the Russian Academy of Medical Sciences, they can be given to the baby little by little from the age of six months.

They have also revised their own recent recommendations. So, according to the Russian Academy of Medical Sciences, fermented milk products were allowed to be taken from 5 months, while the new version of the document postpones the baby's introduction to them until the age of eight months. This is explained by the fact that fermented milk products contain gluten, which can cause an allergic reaction in many babies.

Meat products are allowed to be introduced a little earlier. Until recently, they could only be introduced from 8 months, but now this period has moved to 7 months. While the WHO stipulates - 9 - 10 months of age. Pediatricians consider the actions of some parents who ignore animal products inappropriate. Considering themselves vegetarians, they try to instill this culture in their children from birth. But such ignoring of meat is unacceptable. In order to develop normally, a baby must receive a whole range of various substances, minerals and vitamins. In this regard, you can't do without meat.

According to experts, you can start giving fruit and vegetable puree to a baby as early as six months of age. At the same time, monopure is initially allowed, that is, prepared using one type of product. At first, you should avoid fruits and vegetables that are brightly colored, as the likelihood of developing an allergy to the coloring enzyme increases.

The most suitable vegetables for the first feeding are: broccoli, zucchini, cauliflower. It is better to add potato tubers later (not earlier than eight months), ideally it can be one of the ingredients of a mix or assorted puree.

Some pediatricians recommend well-boiled and mashed gluten-free cereals cooked in water as the first complementary food. Such cereals include buckwheat, corn, and rice. If tolerated well, you can also add rolled oats. If the child refuses to try this, it is worth risking introducing a little mother's milk into the complementary food. The "mother's smell" will most quickly make the capricious child change "anger to mercy."

According to the recommendations of the Russian Academy of Medical Sciences (after the latest revision), milk porridge (made with cow's milk) is allowed to be given to a baby from six to seven months, while the World Health Organization designates this as from eight to nine months.

But whatever these methods are, it is necessary to carefully monitor the child's condition after introducing each subsequent product or increasing the amount of its introduction and, if any negative signs appear, stop increasing the portions of complementary foods, or even exclude it from the baby's menu for a while. In such a situation, you should consult a doctor - a pediatrician. He will help to determine the cause of the malaise. Perhaps this is an allergic reaction to complementary foods, or perhaps the symptoms that have appeared are absolutely not related to the food product. It is quite possible that the child has overheated a little (prolonged exposure to the sun or clothing that does not match the weather) or he has fallen ill. And there may be several such reasons.

The birth of a child is a joyful and exciting period in the life of any woman. Parents are no less excited when they observe the successes of their child's development. The period up to one year of age is especially difficult. It is during this period that the baby must learn a lot, including eating, and a variety of foods. In order not to harm such a fragile organism, young parents should know and correctly adhere to the complementary feeding scheme when breastfeeding. There are many modern methods for introducing the first "adult" food. And in order to decide on the most suitable one, it is worth consulting with your pediatrician who is monitoring the baby. He will not only advise the complementary feeding scheme, but will also be able to, if necessary, adjust the diet during the introduction. Go for it, learn and let your baby grow up healthy, strong and happy!