Feeding smart, right from the start.
Optimal nutrition in the first two years of life – early and exclusive breastfeeding and continued breastfeeding for two years or more, together with nutritionally adequate, safe, age-appropriate, responsive complementary feeding starting at six months – are critical to prevent stunting in infancy and early childhood and break the intergenerational cycle of undernutrition.
WHO and UNICEF recommend:
• early initiation of breastfeeding within 1 hour of birth;
• exclusive breastfeeding for the first 6 months of life; and
• introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.
Breastfeeding within the first hour of life is recognized as one of the most important actions for infant survival.
Colostrum, the rich milk produced by the mother during the first few days after delivery, provides essential nutrients as well as antibodies to boost the baby’s immune system, reducing the likelihood of death in the neonatal period. Breastfeeding within one hour of life protects the child from infections and reduces the risk of death by up to 22% in the first month of life. Skin-to-skin contact with the mother through breastfeeding fosters mother-infant bonding and keeps the child warm, reducing the child’s risk of dying of cold (hypothermia).
Every child should start breastfeeding within one hour of life to take advantage of the newborn’s intense suckling reflex and alert state and to stimulate breastmilk production. Starting breastfeeding within the first hour of birth and learning to breastfeed properly – the correct position and how to attachment – helps the mother produce more milk for her child and reduces excessive bleeding in mothers after birth and the risk of haemorrhage, a major cause of maternal death.
Breastmilk alone is sufficient to meet an infant’s requirement for food and water in the first six months of life. With frequent, on-demand feedings, babies do not need water or any other liquids even in hot climates; mother’s milk is all they need for survival and optimal growth and development. Foods given to infants in the first six months of life do not improve growth and, instead, are dangerous when they replace mother’s milk, because they can result in
frequent infections and poor growth and development.
Exclusively breastfed infants are at a lower risk of diseases like diarrhoea and pneumonia (major causes of death among children under five years), increase the time between pregnancies, which naturally helps to space births and breastfeeding is more economical because families do not need to spend money on expensive infant foods.
* Complementary feeding
After six months, infants need both breastmilk and complementary foods to continue to grow strong and develop fully.
Around the age of 6 months, an infant’s need for energy and nutrients starts to exceed what is provided by breast milk, and complementary foods are necessary to meet those needs. An infant of this age is also developmentally ready for other foods. If complementary foods are not introduced around the age of 6 months, or if they are given inappropriately, an infant’s growth may falter.
Guiding principles for appropriate complementary feeding are:
- continue frequent, on-demand breastfeeding until 2 years of age or beyond;
- practice responsive feeding (for example, feed infants directly and assist older children. Feed slowly and patiently, encourage them to eat but do not force them, talk to the child and maintain eye contact);
- practise good hygiene and proper food handling;
- start at 6 months with small amounts of food and increase gradually as the child gets older;
- gradually increase food consistency and variety;
- increase the number of times that the child is fed: 2–3 meals per day for infants 6–8 months of age and 3–4 meals per day for infants 9–23 months of age, with 1–2 additional snacks as required;
- use fortified complementary foods or vitamin-mineral supplements as needed; and
- during illness, increase fluid intake including more breastfeeding, and offer soft, favourite foods.
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