Nutrition and growth

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In the first six months, when a baby is most at risk, exclusive breastfeeding helps to protect against diarrhoea and other common infections and gets the baby off to a good start in life.

At 6 months of age, the child needs other foods and drinks in addition to breastmilk. These provide energy, protein, vitamins and other nutrients needed to support growth and development.

A variety of foods – vegetables and fruits, meat, poultry, fish, eggs and dairy products – help to meet the child's nutrition needs. Breastfeeding for up to two years and beyond provides an important source of nutrients that protect against disease.

If soft, semi-solid or solid foods are introduced too late, the child may not be getting the necessary nutrients. This can slow down growth and development.

When introducing solid foods, it is important to start with soft, mushy foods and move gradually to more solid foods. The greater the variety of healthy foods, the more balanced and nutritious the child's diet.

The consistency and variety of foods should be adapted to a child's requirements and eating abilities. At 6 months of age infants can eat pureed or mashed foods, thick soups and porridges. By 8 months most infants can also eat 'finger foods' (snacks that children can eat by themselves). By 12 months, most children can eat the same types of foods as the rest of the family.

Parents or other caregivers should avoid giving foods that may cause choking, such as nuts, grapes and raw carrots and other foods that have a shape and/or consistency that may cause them to become lodged in the child's throat.

It may be difficult to meet all the child's nutrient requirements without a lot of foods from animal sources. So it may be necessary to give the child fortified foods or spreads or multiple vitamin and mineral supplements, such as powders, syrups or dissolvable tablets. A trained health worker can advise the parent or other caregiver about foods that provide the most nutrients and which supplements to use.

Following are some nutritious foods for young children (older than six months) to eat:

• Staple foods, including cereals (rice, wheat, maize, millet, quinoa), roots (cassava, yam, potatoes) and starchy fruits (plantain and breadfruit).
• High-protein foods, such as red meat, poultry, fish, liver and eggs (can be given as often as possible).
• Dairy products, such as cheese, yogurt, curds and dried milk (which can be mixed with other foods, such as cooked porridge). These are good choices in the second six months of a breastfed child's life. These are better choices than raw milk, which is harder for the child to digest.
• Green leafy and orange-coloured vegetables, such as spinach, broccoli, chard, carrots, pumpkins and sweet potatoes (which provide vitamins).
• Pulses, such as chickpeas, lentils, cowpeas, black-eyed peas, kidney beans and lima beans (to add variety and provide protein, energy and some iron).
• Oils, especially rapeseed oil, soy oil, red palm oil, butter or margarine.
• Seeds, including groundnut paste, other nut pastes and soaked or germinated seeds, such as pumpkin, sunflower, melon or sesame seeds (for energy and some vitamins).

It is difficult to provide all the nutrients needed by young children in a vegetarian diet. This is because foods from animal sources provide key nutrients, such as iron. A child eating a vegetarian diet needs additional nutrients in the form of multiple vitamin tablets or powders, fortified spreads or nutrient-rich food supplements.

Iron from plant foods is generally not absorbed very well by the body. However, plant foods such as pulses (white beans, chickpeas, lentils) have more iron. The iron will be better absorbed if eaten together with foods that are high in vitamin C, such as oranges and other citrus fruits and juices.