Many parents still do not have good knowledge of how to feed their infants and young children, causing most babies to visit hospital in the first year of life.
Infections such as respiratory infections, ear infections and urinary tract infections are all less common in breastfed babies.
Long-term conditions such as overweight and obesity, coeliac disease, cardiovascular disease and diabetes are less common in later life in babies who were breastfed.
Many other conditions have also been shown to be less common in breastfed babies, including sudden infant death syndrome (SIDS), allergic diseases such as asthma, eczema and leukaemia.
Breastfeeding also benefits mothers as they tend to have a lower risk of breast cancer, ovarian cancer and hip fractures while at the same time having better bone mineral density in later life.
Mums are also more likely to get back to their pre-pregnancy weight if they exclusively breastfeed for 3-4 months and more.
The composition of breast milk is fat 38 per cent, protein 0.9 per cent, lactose 7per cent, other 0.2 per cent, water 88.1 per cent.
Mothers therefore need to tickle the baby’s lips to encourage him/her to open wide and place their babies close so the lower jaw moves into the breast first.
If your baby fights your attempts to breastfeed, feed another way and spend lots of happy cuddle time at the breast.
When your baby is near the breast talk, laugh, play, and look into their eyes. Make breastfeeding time emotionally rewarding and make any feeding time away from the breast emotionally neutral.
Hold your sleeping baby against your breast during naptimes to help shorten the strike. Spend time touching and in skin-to-skin contact; when not feeding, hold baby with his bare torso against your skin, and stay that way as much as possible.
This is soothing to both of you, and the hormones released make baby more open to breastfeeding. If needed, throw a blanket over both of you. Take a bath with your baby, and use a sling or baby carrier to keep him close.
Offer the breast while baby is drowsy or in a light sleep as many babies accept the breast again for the first time while asleep or in a relaxed, sleepy state.
Try breastfeeding while baby naps. Use feeding positions baby likes best and experiment in order to make the most of your baby’s natural feeding reflexes, start in a semi-reclined position with baby tummy down on your body.
Mothers need to lean back, and allow baby to take naps on the breast. Pump before offering your breast to give baby milk he doesn’t have to work for. Or first try hand-expressing a little milk onto baby’s lips.
If a baby goes to the breast but won’t stay there, ask a helper to drip expressed milk on the breast or in the corner of the baby’s mouth with a spoon.
Swallowing your milk will trigger suckling, which triggers swallowing. If the baby comes off the breast, offer more expressed milk and try again.
Try breast-shaping and breastfeeding in motion, shaping the breast so that it’s easier to latch may help the baby take the breast deeper and trigger active suckling.
Keep in mind that some babies accept the breast only while being walked or rocked, so if baby is not responding to semi-reclined positions, it may be time to get moving. Try breastfeeding when baby’s not ravenous.
To feed well, the baby needs to feel calm and relaxed rather than hungry and stressed. If the baby’s agitated, calm them first. Some babies will take the breast more easily if they are not very hungry, so try feeding a little milk first, using whatever feeding method is working for you.
Start with one third to one half of his usual feeding, just to take the edge off his hunger before offering the breast. Make the most of times that breastfeeding is going well.
If your baby takes a bottle but not the breast, try a bait-and-switch. Start by bottle-feeding in a breastfeeding position and while the baby is actively sucking and swallowing, pull out the bottle nipple and insert yours. Some babies will just keep suckling.
When should infant start solid food?
Introducing solid foods before age four to six months is not helpful and could be harmful the reasons that expert groups recommend delaying the introduction of solid foods include:
Introducing solid foods before an infant is four to six months of age may interfere with the child's ability to take in an adequate number of calories or nutrients and may increase the risk of developing food allergies.
Young infants do not have the coordination and/or skills to safely swallow solid foods, which could lead to aspiration (inhaling food/liquid into the lungs).
Infants have a reflex (called the extrusion reflex), which causes them to raise the tongue and push against any object that is placed between their lips.
This reflex usually disappears between four and five months of age. Trying to spoon-feed a child who still has the extrusion reflex can be a frustrating and difficult experience for both the parent and the infant.
By four months of age, most infants usually have doubled their birth weight. When your infant has doubled his/her birth weight and weighs at least 13 pounds (5.9 kg), you may need to begin supplementing their liquid diet with additional foods to support growth and satisfy hunger as delaying solid food intake until after an infant is four months of age may reduce the child's risk of developing atopic dermatitis (eczema).
Withholding solid foods after the infant is six months of age may lead to decreased growth because the child may not consume adequate calories from breast milk or formula alone.
In addition, delaying beyond six months may lead to the child's resistance to trying solid foods.
Withholding solid foods until after the infant is six months of age does not appear to prevent the development of allergies or eczema.
Babies also need to be encouraged to explore for themselves as babies who are spoon-fed may be given more to eat than they would choose.
Spoon-feeding purées delays the experience of chewing; babies fed food they dislike on a spoon may become fussy eaters.
Allowing full independence in eating encourages the development of a range of motor skills while encouraging babies to be involved in mealtimes (similar food). Always be there during feeding.
What is ‘baby-led’ weaning?
Most infants are introduced to complementary foods both by being offered small tastes of new foods on a spoon, and by being encouraged to hold foods that they can taste themselves.
In ‘baby-led weaning’, food is not given to the baby on a spoon at all, instead babies are encouraged to explore for themselves all the food on offer to them and to eat whatever they can get into their mouths independently.
It is suggested that babies who are spoon-fed may be given more to eat than they would choose.
The spoon feeding purées delays the experience of chewing; that babies fed food they dislike on a spoon may become fussy eaters.
Allowing full independence in eating encourages the development of a range of motor skills. Encouraging babies to be involved in mealtimes, to eat similar foods to those enjoyed by others
At the table, to hold finger foods and spoons and to try to feed they are all recommended practices.
Offering babies tastes of first foods on a spoon is, however, a good way for many babies to experience a wide range of tastes.
Babies may spit food out when they first try it as the taste and texture may be unfamiliar, but trying a whole range of tastes and textures during the second six months of life is important if we want children to eat a range of different foods as toddlers.
Few people would disagree with many of the principles of baby-led weaning, but if babies are less independent in their eating, offering foods on a spoon at mealtimes as well can be encouraged during the first year of life to ensure that they eat well and get all the nutrients they need.
There is no greater risk of choking when babies feed themselves than when they are fed by spoon.
Vegetables are good first tastes to introduce to infants.
Try vegetables one at a time to start with, to introduce new flavours, and then try combinations. To thicken smooth or mashed vegetables, add potatoes or sweet potatoes.
Make sure a wide variety of vegetable foods is offered and that foods from across the rainbow of vegetable colors are introduced into babies’ diets.
Never add salt or sugar to foods served to babies.
Starchy foods: A range of starchy foods can be offered as first foods. These can be starchy root vegetables such as potato, sweet potato, yam, rice, porridge made from oats; semolina (ground wheat), or polenta (corn meal)
You can cook and mash rice, porridge and other cereals rather than buy expensive infant versions, and ground rice and semolina are smooth cereals when made up.
Cereals can be mixed with breast milk or infant formula. These protein foods are also rich in other important nutrients. Many of these foods are rich in iron and zinc, which are important nutrients for babies.
Well cooked eggs are an excellent first food as they are easy to prepare and easy to mash if that is needed. Fish and meat can be introduced as first foods.
Pieces of well cooked meat and fish can also be offered as finger foods.
Dairy and dairy alternatives: dairy foods, and calcium-fortified dairy alternatives, are good first foods to introduce to babies at about 6 months of age as they are naturally smooth, can be mixed with other tastes and textures, and don’t require any preparation.
Choose unsweetened full-fat milk yoghurt or milk alternative products.
Once infants have accepted other savory tastes, fruit can be introduced.
Fruit will be accepted more readily than vegetables by most babies as it has a sweet taste. If fruits are naturally sour, add a sweeter fruit such as apple or banana to make it more palatable.
If serving fruit as finger foods make sure the pieces are soft and manageable, and avoid chunks of apple or harder fruits.
If babies are introduced to new foods and flavors at about 6 months of age, are able to watch and mimic older children and adults eating the same foods, and are encouraged to be independent eaters, they are likely to accept a range of foods.
If the introduction of foods is left until later in the first year, babies may be less keen to try new foods. So introducing foods at about 6 months of age is important.
Most advice around fussy eating is aimed at toddlers who are more likely to go through a phase of food, refusal, but some of the tips to encourage babies to eat well, above, may be useful if families are anxious about fussy eating in babies.
Breastfed babies are more likely to accept new food tastes because flavors from food that their mums eat will have passed into the breast milk, preparing babies for a range of foods.
The writer is a Pediatrician at the Regency Medical Centre, Dar es Salaam