Complimentary Feeding and

Problems with
Complementary Feeding
Dr Nishantha Rubasinghe

Effects of poor nutrition

Sub-optimal growth,

Poor cognitive development and poor

academic performance in children

Decreased work capacity and productivity in

adult life

The National Nutrition

Policy

Exclusive breast-feeding for 6 months,180

days

Followed by complementary feeding

together with continued breast feeding for
2years and beyond.

The National Nutrition

Policy

Strengthening complementary feeding

practices

Strengthening Growth Monitoring and

Promotion

What is the need to introduce

complementary food?

To meet the increase in nutritional demand

which can not be met by breast milk alone.

To train babies to eat food with different

tastes and consistencies

To improve their feeding skills (self feed by

the age of 2)

Why at 6 months
Before 6 months BM provides adequate
nutrition
Reduced incidence of infections

Enhanced neurodevelopment

Timing

After 180days of life.

The baby is now developmentally ready to eat.

Introducing complementary food before 180

days may lead to higher risk of allergies.

If the babies growth is compromised /or mother

is unable provide enough BM , CF can be
introduced after120 days of life.

6 to 8 months
(200kcal/Day)
Continue frequent BF
Introduce as a thick feed to start with
1 to 2 tea spoons at a time
Well mashed rice or potato at first then
gradually introduce mashed legumes fish
sprats and yellow vegetables, greens and
yolk of an egg, introducing one item at a
time.

6 to 8 months

Increase gradually to 3 meals a day

Try to achieve up to a teacup of food

each meal

9 to 11 months
(300kcal/day)

Coarsely chopped/mashed food

Introduce finger foods

3 to 4 meals plus breast feeds

1 to 2 snacks may be offered

Amount about tea cup each meal

12 to 23 months
Introduce family meals 3 main meals
Encourage self feeding
About a teacup full at each meal
Can offer 2 snacks

General rules
No added sugar or salt
Clean preparation of food
Keep it covered
Separate set of bawls and spoons
No need to sterilize after 8 months

General rules
Give variety of food
Nutritionally balanced diet(protein, iron and
vitamin rich)
Introduce egg yolk from 7 months and egg
white at 9 months
Fats such as 1 to 2 tea spoons of coconut
oil, butter or margarine can be added to
make food more energy dense.
Locally available fruit should be given
( mashed or pulped not as juices)

General rules
Natural locally available foods are preferred
to processed foods
Introduce yoghurt or curd with no honey or
sugar added as snacks
Avoid foods that can choke the child

Safe preparation and

storage
Wash hands with soap and water before
preparing food
Keep them well covered
Use clean utensils
Separate cups, bowls and spoons for the
child
Avoid using feeding bottles

Feeding skills
Up 9 months care givers should feed the
child
Do not distract the child
Introduce finger food at 8 to 9 months
By 2 years they should self feed
Do not force feed
Identify the hunger clues and satiety
If they refuse experiment different methods
and food

Supplements
Vitamin A mega doses at 6 months and
every 6 months until 5 years
Multi vitamin supplements are not
recommended routinely
Consider iron supplementation from 6
months to 1 year

Feeding during illness

Offer small energy dense meals
Give a extra feed during recovery to
encourage catch up growth