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A mother feeding her baby milk

Supplementary Feeding for Infants

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In the first few months of life, infants are exclusively used to mothers’ milk or liquids. Suckling, either from the breast or the bottle, is the induction technique. The infant can get along with this amount of eating for the next three to four months. As a result, the baby requires more nourishment for growth, which can be provided by additional semisolid food.

What is supplementary feeding?

Supplementary feeding for infants entails introducing food that is a little bit thicker and more varied, and this food must be propelled with the tongue to the rear of the mouth. Weaning or supplementary feeding can begin when the infant is 4 to 5 months old. A spoonful of semisolid food should be given to the infant at a time. Keeping this in mind, a baby may spit out food as they learn to swallow slightly thicker food. This does not imply that they are not hungry or that they don’t like the food. Give little amounts three to four times a day once the infant has mastered the skill. Reduce the amount of milk in accordance with the rise in the number of additional feedings. By five to six months, the amount of food should not exceed 20 to 25 teaspoons split across three to four little meals due to the baby’s limited stomach capacity.

 

Supplementary feeding should always be taken into account in the context of the general food ration as it is not a replacement for insufficient general meals. Programs for supplementary feeding include the following:

  • Blanket supplementary feeding is a temporary solution to stop the nutritional condition of high-risk populations from deteriorating, such as elderly people, pregnant women, breastfeeding mothers, young children, and women at risk for HIV/AIDS. The World Food Programme, UNHCR, and implementing organizations collaborate to ensure the prompt delivery of a sufficient general food ration in emergencies. However, subpopulations that are either currently malnourished or have a high risk of becoming malnourished may require additional meals for a while. For example, at the outset of a food emergency when the food pipeline for the general food ration is still insufficient, blanket supplementary feeding should be taken into consideration.
  • Targeted supplementary feeding, according to established cut-off criteria (Mid-Upper-Arm Circumference(MUAC) 12.5 cm or weight of 70% to 79% weight-for-height), is given to elderly people, pregnant women in their second or third trimester, lactating women up to six months after giving birth, and children aged six months to five years who are acutely malnourished. Families affected by HIV/AIDS are one particular category that is causing much worry. The goal of targeted supplementary feeding is to reduce the need for broad therapeutic feeding, especially among children, and to prevent severe acute malnutrition among moderately malnourished individuals. On a small scale, targeted supplementary feeding is frequently used.
  • Supplementary feeding linked to therapeutic feeding is given to children who have finished therapeutic feeding but are still moderately malnourished. When a child reaches 85% of the median weight-for-height and maintains this weight for two consecutive weighs, they are often released from these supplementary feeding programs.

Planning numbers of 15% acute malnutrition among children under five can be used to estimate these kids’ supplementary food needs when data on the prevalence of acute malnutrition is lacking in a nutrition emergency.

For instance: 

For a 30,000-person disaster-affected population;

  • The estimated number of children under the age of five (15–20%) is 4,500 to 6,000.
  • The estimated number of children (15%) who are moderately underweight is 675 to 900.

2.5% can be used to estimate the proportion of pregnant women in the population for supplementary food interventions aimed at pregnant or breastfeeding women. 2.5% can also be used to determine the proportion of breastfeeding mothers in the population. 

Examples of additional feeding rations

Dry rations for home preparation should be offered whenever possible. When individuals are unable to prepare for themselves after a big disaster or when the distribution of dry rations puts them in danger, such as when travelling home, wet rations (cooked food) should only be provided. While on-site feeding or wet rations supply 500 kcal/person/day, take-home supplementary food dry rations offer 1,000 to 1,250 kcal/person/day.

To be tasty and incorporate ingredients that are readily available locally, supplementary food must be prepared in a culturally appropriate manner. The World Food Programme has gathered recipes from all across the world for making staple dishes including pancakes, thick porridge, thin porridge, and unleavened bread with fortified blended food

When fortified blended foods or cereal/pulse mixes are unavailable, high-energy biscuits (known as BP5 and BP100) are occasionally utilized as supplementary nutrition. If using the biscuits to feed small children, they should first be dissolved in water. High-energy biscuits should not be used in therapeutic feeding for children who are recovering from severe malnutrition. However, high-energy biscuits can supplement pregnant women’s meals and energy intakes in the second trimester to lower the likelihood of low birth weight.

Standards for starting and stopping emergency supplementary feeding

Blanket supplementary feeding

  • When to start:  
  • When an emergency first arises, before the food pipeline and general food ration are improved and sustained.
  • Scurvy, beriberi, or pellagra outbreaks among the target group.
  • When to close:
  • When the distribution of food rations and the food pipeline are sufficient.
  • When the target population is free of scurvy, beriberi, or pellagra cases.

Targeted supplementary feeding

  •  When to start:  
  • When there is a need for large-scale therapeutic feeding and to prevent a decline in the nutritional health of the population’s most vulnerable groups (children under five, pregnant women, nursing women, families affected by HIV/AIDS, and the elderly). 
  • When to stop:
  • When the rate of acute malnutrition around the world is steady or decreasing.

Supplementary feeding linked to therapeutic feeding

  • When to start:
  • When there are too many people who are critically malnourished to be treated effectively in the current medical facilities.
  • When to end:
  • When the number of people who are extremely malnourished falls to a level where they can be treated effectively in clinics or hospitals.

Advantages of Infant Supplementary Feeding

Supplementary feeding is essential for infants’ health and nutritional well-being. They are extra sources of vitamins A and C, iron, protein, and other vital nutrients. These are typically lacking in the nutrition that babies are given. Pulses, cereals, juices, fruits, and soups, particularly those made with leafy vegetables, are the foods that help an infant start his path to discovering a variety of tastes. Foods of animal origin and dairy products can be added after they have been digested and tolerated. Supplementary feeding is crucial for an infant’s nutrition when a mother experiences entire or partial breastfeeding failure due to a medical condition.

For more information regarding breastfeeding and nutrition of the baby, feel free to check out our Maternal, Infant, and Young Child Nutrition course here.

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