Nutrition- The bumpy road to your baby’s great appetite

Sep 27, 2009

NAMUSISI is a first- time mother with a four-year-old baby. She has trouble with her child’s eating habits. She literally forces the baby to eat because he has a poor appetite.

By Arthur Baguma

NAMUSISI is a first- time mother with a four-year-old baby. She has trouble with her child’s eating habits. She literally forces the baby to eat because he has a poor appetite.

Like many other mothers, what Namusisi does not know is that a child at that age cannot be apportioned how much to eat without medical advice.

According to nutrition experts, the best way to determine whether the child is eating the right quantity and type of nutrients is regular medical visits to monitor the weight and health of the child.

Dr Hanifa Bachou, the head of nutrition department at Mulago Hospital says the best way to tell whether your child eats right is through monitoring their health and weight.

She explains that a child is given a health card at birth. Every month, the child should be monitored so that its growth and eating habits are within the normal health curve.

“On a monthly basis the child’s weight should be taken and plotted against the health card. If a child is doing well, the graph should be going up and not declining,” says Bachou.

Bachou emphasises that if the graph stagnates or declines, there is a problem which could be as a result of illness or other environmental conditions.

She notes that from the time health cards are given at birth, the health monitoring of the child should go on up to the age of six years.

She also advises that every six months the child should be de-wormed.
According to Human Nutrition Research, children between the ages of one and four should not be forced to eating pre-planned quantities of food.

There are no definitive recommendations on portion sizes for this age group. At this age, children are often good at regulating their appetite.

However, other conditions like sickness and the environment could affect their appetite pattern. That is why it is advisable to regularly rely on health monitoring to determine the nutrition needs of a child.

Prof Joyce Kikafunda, a nutrition expert at Makerere University, notes that if a child does not have appetite, then the food should be alternated.

“Children’s appetites vary from day to day and they know when they have had enough to eat.

Your child will get enough to eat if you offer regular meals and snacks and let him choose from what is served,” she advises.

Kikafunda adds that the right food and nutrients help to form strong teeth and bones, muscles and a healthy body of the child. She advises that a young child’s diet needs special care and planning—the need for energy and nutrients is high among children.

Their diet must be made up of small, regular, nutrient-dense meals. Kikafunda says to avoid nutrient deficiencies, the child should be exclusively breastfed from birth to six months.

And from six months a child can be put on supplementary food on top of breastfeeding. Breastfeeding should stop at the age of two years or even beyond if it is possible.

Key nutrients
Nutrition experts say there is no need to rely on pre-prepared toddler foods. If the family diet is healthy, children can have family food.

At least one kind of starchy carbohydrate, such as bread, rice, pasta, noodles, cereals or potatoes, should be served with all meals.
Young children have small appetites, so fibre-rich carbohydrates can be bulky and inhibit the absorption of some minerals.

But you can gradually introduce higher fibre carbohydrate foods, such as whole wheat pasta and brown rice, so that by the time children are five, they are eating the same fibre-rich foods as the rest of the family. Experts also advise that fruit and vegetables should be eaten often.

Refusing food
Many children go through phases of refusing to eat certain foods or anything at all. This is common with children between one and five years and is a normal part of growing up.

It is quite normal for young children to refuse a new type of food without even trying it. If this happens, do not force your child to eat. Take the food away and introduce it again in a few days’ time.

Research shows that new foods often need to be offered several times before some children will try them.

Offer regular meals and snacks to establish a structured eating pattern rather than allowing your child to pick at food throughout the day. Make meal times fun. Use brightly coloured plates thus presenting the food in an attractive way.

The Food Standards Agency recommends at least two servings of fish a week, one of which should be oily. But do not give your child more than four servings of oily fish a week for boys and two servings a week for girls.

Shark, swordfish or marlin should also be avoided, as these contain high levels of mercury, which might affect a child’s developing nervous system

Allergies
If you notice a swelling in your child’s mouth, face or breathing difficulties during or after eating, seek medical advice.

Symptoms such as a rash or vomiting after eating may suggest a reaction to a food.Diagnosing allergies without medical advice may compromise the quality of your child’s diet and result in nutritional deficiencies.

To lessen the risk of peanut allergies, foods containing peanuts should not be given to children under three years if the child has a parent or sibling with a diagnosed allergy. Whole nuts should not be given to any child under five years because of the risk of chocking them.

Getting a child to eat
Eat together as a family. Include children in buying and preparing foods to encourage their interest in eating.

Have a wide variety of foods and choose colourful and interesting utensils on which to serve the food. Make eating fun.

Offer small portions on a small plate and allow your child to have more if they are still hungry.

Keep sweet foods out of sight until the main meal has been eaten.

Important nutrients for pre-schoolers

Iron
A glass of orange juice or citrus fruit and vegetables with the evening meal can help maximise iron absorption from non-meat sources.

Calcium
This is vital for the growth of bones and teeth. Milk and other dairy products are consumed daily as a regular part of the diet. Your child should have about half a litre of milk a day. Milk can be used in cereal or drinks, puddings and sauces. Alternatively, cheese or yoghurt can be given instead of milk.

Vitamins A and D
Extra Vitamin A and D can be given in supplements that are available at your local health centre. Vitamin A is needed for healthy skin and cell development. It often lacks in diets within this age group. Vitamin D is essential for the body’s calcium metabolism and can be produced by the body when the skin is exposed to sunlight.

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