Is your child feeding right?

By Vicky Wandawa

AFTER her maternity leave, Lorraine, a first time mother, had to return to work. However, she was panicky and felt like it was not the right time for her to leave her three-month old baby under the care of a househelp.

Lorraine says she kept pondering: “Will the nanny feed my child well? Will she wash the bottles well? Will she respond to his cries promptly?” The questions were endless.

“After some time, I took my boy for immunisation and felt guilty when the nurse said his weight was dropping. He was not sick, so the problem had to be with the feeding. I felt silly as the nurse lectured me about proper feeding. She told me if I was not keen on breastfeeding, my baby would suffer from malnutrition.”

When Lorraine inquired from the maid about feeding the baby, the maid was ignorant and even admitted to sometimes feeding him once in five hours.

She had to thoroughly coach the maid on how often a baby should be fed.

Lorraine’s baby is now healthy.

Sabrina Kitaka, a paediatrician at Mulago Hospital, says the first three months are very vital for babies’ nutrition.

“Babies should feed at least every two hours or once every hour at most. When it comes to babies born prematurely, feeding should be at least every hour and at most every 30 minutes,” Kitaka advises.

Joseph Sseremba, a paediatrician with Sseremba Medical Centre, says babies have small stomachs and need to feed as often as possible because they take in a little, use it up and need more very often.

When it comes to breastfeeding, there is no such thing as over breastfeeding. A mother should feed their baby on demand.

Sseremba advises that even when a baby is fast asleep and a mother realises it is feeding time, they should wake them.

A poorly fed baby risks suffering from a condition known as malnutrition.

“This condition has a great impact on the white blood cells, hence reducing the baby’s immunity to infections,” Kitaka explains.

Sseremba also advises that weaning babies should be a gradual process, adding that mothers should not halt breastfeeding at once.

He also warns that since less breastfeeding is done during weaning, there are high chances of malnutrition. Hence, mothers should work hard at giving their babies a balanced diet. “The babies should be fed from the different food groups, namely protein, carbohydrates, fats, vitamins and minerals, everyday.”

Porridge, especially made from millet, is a great start for the weaning process, particularly because of its high protein content. Solid foods, such as eggs, mashed potatoes and fish, can gradually be introduced into the diet. Fruits can also be given in form of juice.

Proteins can be found in both animal and vegetable foods. Animal proteins include fish, eggs and meat. Vegetable proteins include beans, peas, soya and meat.

Carbohydrates can be found in porridge and fats in milk. For the vitamins and minerals, fruits are the ideal source.

Although children should be fed a balanced diet at all meals, younger ones need more animal protein and older ones need more carbohydrates.

Furthermore, Julie Wamala, a nutritionist at Mwana Mugimu, a child’s clinic in Mulago Hospital, advises that it is better to use the steam method when preparing the children’s meals because it retains more nutrients.

Picky eaters
Christine, a banker and mother of two, complains of her three-year-old’s poor appetite.

“Getting her to eat requires chasing her round the house. She can keep food in her mouth for up to 15 minutes before she swallows.”

Kitaka advises mothers to desist from forcing their children to eat. “Forced feeding is dangerous because it may lead to accidents such as choking.”

She warns that the harder a child is forced to eat, the more chances are that the child will not eat.

“Simply be patient with them. Try to make meal times as comfortable as possible by doing things such as singing to them and promising prizes for eating.”

Kitaka also adds that food should be made as colourful as possible to attract the children. For example, adding carrots to rice will make it look more appetising.

“Try to be creative with the food. For example, if you made fish fingers, the children will see it as something different from the usual fish and will want to try it out.”

When picky eaters, start showing interest in eating, it is advisable to feed them with as much carbohydrates and protein as possible.

Sseremba advises parents of picky eaters to have food available at all times such that when the children show even the slightest interest in eating, the food is available.

He also explains that children’s eating habits should be monitored, adding that when a child that has been eating well suddenly loses appetite or becomes a picky eater, medical attention should be sought to find out why.

With the vegetables being a great
part of the diet, some mothers might wonder just how to get their children to eat them.

Nancy, a mother of one, complains: “I can’t get my two-year-old son to eat vegetables. He picks them out of his plate and throws them away.”

Wamala advises that a parent can get his or her child to eat vegetables by grating them, for example carrots. For other vegetables such as tomatoes, make juice out of them and give it to the child.

She also advises parents to ensure that the children are fed on time. Wamala discourages parents from giving the children snacks in between meals, saying they will kill their appetite.

Kitaka also recommends multi-vitamins to boost children’s appetites. Besides boosting appetite, multi-vitamins have nutrients needed by children.

However, Kitaka notes that multi-vitamins can only be given to children who are above six months.

Weight and children
It is important for mothers to monitor their children’s weight because it has a lot to do with their health status.

Kitaka says ideally, children should be weighed every month particularly before they make two years. She adds that mothers can monitor their children’s weight using the immunisation card which has a graph for monitoring weight.

Sseremba explains that children are expect to add on weight as they grow.

However, Kitaka warns parents against over feeding their children and making them obese.

She encourages parents of obese children to help them do physical work and avoid giving them snacks in between meals.

Kitaka advises parents of children who appear underweight to seek medical care. She says being underweight could be a result of poor feeding, infection or even chronic diseases such as congenital diseases.