Allergies, indigestion and other problems when introducing complementary foods. Introduction of complementary foods: the most common mistakes Large volume of complementary foods

Lure– this is the beginning of the introduction of new types of products to replenish the baby’s energy costs.

Based on WHO research data, general rules for complementary feeding were developed:

• the first product in the baby’s menu is introduced between 4 and 6 months: at six months for natural babies, at 4 - 4.5 months for formula babies;
• great attention is paid to readiness for a new type of food;
• Complementary feeding by month involves the introduction of various types of food: cereals, vegetables, meat, dairy products;
• food should be in pounded form (puree). If you have teeth, you can try kibble food;
• - a guarantee of health, it must be continued until the age of two.

Pediatrician, doctor of the highest category Yakov Yakovlev believes: “You need to treat the number 6 well. This is a great age for adult food."

When complementary foods are introduced after the optimal period, the child will begin to lose weight and experience a lack of microelements. In the worst case scenario, there is a developmental delay.

With the early introduction of new products, the risk of developing allergies increases due to the unavailability of enzymes in the digestive system.

Complementary feeding rules

• you need to give new food from 5 grams, increasing the portions over 2 weeks to 150 grams;
• the child must be healthy;
• the first complementary feeding is undesirable in the summer;
• another product should be introduced only after adaptation to the previous one, approximately every 2 to 3 weeks;
• food should be freshly cooked and warm.
• You need to carefully monitor the child’s condition. If diarrhea occurs, it is better to remove the product from the menu for a while and try again after a week.

Complementary feeding at 6 months

The baby's first dish is vegetable. If you are underweight, eat porridge. We start with hypoallergenic broccoli, zucchini and cauliflower.

Broccoli doesn't taste the best, so save it for last.

You can buy vegetable purees in jars or prepare them yourself. When preparing puree, you should take a vegetable, wash it, peel it. It's better to steam it. Then place the finished vegetable in a blender. Grind until pureed.

The most delicious purees are from Gerber, but in terms of price they are much more expensive than “Babushkino Lukoshko”.

Do not add spices, salt, or sugar for up to two years.

In 2 weeks, the child should get used to zucchini. Monitor the condition of your skin and stool.

Cauliflower will be the next step in expanding the diet, but subject to the absence of rashes and other elements on the baby’s skin.

It should be given before breastfeeding, at 12 noon.

You can offer one dish 5-6 times. If the baby has not eaten the entire portion offered to him, perhaps he is simply full.

Some of the latest in vegetable complementary feeding are pumpkin and carrots. They are allergenic products, be careful.

Potatoes are the latest of all vegetables to be introduced into a child’s menu. A very allergenic product, the absorption of which requires a mature enzymatic function of the intestine.

Important information for those parents who are interested.

Complementary feeding at 7 months

Fruits and cereals are next. We start with green apple and pears. Then offer prunes, apricots, peach or plums. Of course, in the summer there is a much greater choice of fruits.

We introduce fruits, like vegetables, starting with a teaspoon, from one fruit, after a month we move on to another.

Porridge is our nurse

Introducing complementary foods at 7 months should begin with dairy-free cereals. Up to 12 months there is no need for cow's and goat's milk, as grandmothers advise. These dairy products increase stomach acidity and can cause gastritis or ulcers.

You can add breast milk or formula to the porridge.

Start with gluten-free porridges - corn, buckwheat or rice. For children under one year old, gluten is quite difficult to digest.

Don't be afraid to buy baby cereal in stores. They are already crushed and ready for use, just diluted with water. No additives needed. Nestle produces a number of very tasty cereals at reasonable prices.

Porridge is given for breakfast, along with fruit. The quantity is the same as with vegetables. You can add 1/2 teaspoon of butter to the porridge.

8 months - meat time

By this time, the baby already has a full breakfast. Now we will create a menu for lunch. The first meat dishes are rabbit and turkey, as they are hypoallergenic. We start with 5 grams of canned meat puree, either separately or mixed with vegetables. You can prepare the meat dish yourself in the form of minced meat.

After turkey and rabbit, beef, chicken, and veal are given. It is better to avoid pork before 2 years of age.

We do not add vegetable oil to jarred meat puree. But if you cooked it yourself, you should add ½ teaspoon of vegetable oil to vegetables or meat puree.

Yolk is a storehouse of vitamins

We give the yolk 2 times a week, starting with ¼ part. Add to dishes or dilute with milk. Typically given in the morning. Then by the year we increase it to half.

Table for introducing complementary foods for breakfast and lunch while breastfeeding

Don't forget to give breast milk.

Formula-fed complementary foods table

It's time for cottage cheese and kefir

Ukrainian doctor Komarovsky O.E. advises starting complementary feeding with kefir, as it is similar to mother’s milk. But WHO recommends otherwise. It is better to buy kefir for children, from the companies “Nasha Masha” or “Frutonyanya”. Kefir should be unsweetened and without dyes.

We also start according to the “golden rule” - with a teaspoon. We serve kefir for dinner at 20.00. We also choose children's cottage cheese: “Agusha”, “Tyoma”. We start the cottage cheese with a teaspoon and by the age of 1 year we bring it to 50 grams. We serve it in the evening for dinner along with cottage cheese.

10 months - kibble food

The child can be given cookies and dried biscuits, since the baby already has the required number of teeth. Give the fruits in pieces, peeling them.

A child with food should always be supervised!

It is better to make fruit juices yourself. Store-bought ones contain a lot of acids and sugar.

At 10 months, give fish dishes 2 times a week. Start with low-fat varieties - hake, cod, perch.

What should not be given before 1 year of age?

• semolina porridge should not be given frequently, as it interferes with the absorption of iron and can provoke the development of anemia;
• candies, chocolate;
• goat, cow's milk;
• tropical fruits, citrus.

General table for introducing complementary feeding to children

Food in "banks"

Products are prepared only from environmentally friendly, carefully grown fruits and vegetables. This type of nutrition has a guaranteed composition. Lots of checks go through. It is impossible to find low quality baby food on the shelves.

There are no preservatives in this diet. Why do they last so long? Vacuum packaging and aseptic storage conditions do not allow the product to deteriorate.

You can start introducing complementary foods with industrial products. Then, when the child gets used to it, cook on his own. Be sure to check expiration dates.

Complementary feeding for children with atypical reactions

It is very difficult to feed a child if he has allergies. The following rules must be taken into account:

• do not add sugar to prepared foods, especially juices;
• start complementary feeding only with “clean” skin;
• observe monocomponentism. Do not mix multiple vegetables or fruits. This will make it easier to identify what you are allergic to if it appears;
• leave sweet fruit juices, potatoes, carrots, pumpkin for last, by 10-11 months;
• egg, fish are best introduced from 12 months;
• It takes at least 7 days for the baby to get used to each new dish;
• if a rash appears, the new product is canceled;
• If you are allergic to cow's milk, allergic reactions to beef are also likely.

Until the age of one year, the health of the baby is established. Proper balanced nutrition will help avoid many problems in the future. Your child will definitely like new foods if they are prepared with love. Each baby is individual, and only the mother will be able to understand when a new feeding period will begin.

Parents of small children make mistakes, learn and make mistakes again, this is the law of life. However, when introducing complementary foods, it is important to make as few mistakes as possible, since the foundation for future nutrition is laid; whether the child will be interested in healthy food or love fast food, it all depends on the parents and the first complementary foods. Of course, the example of parents is important. If adults eat with appetite and pleasure, mostly healthy food, follow the basic rules and communicate quietly at the table - seeing such an example, the baby will acquire a good appetite and pleasant manners!

Listed below are the main mistakes that parents make when introducing complementary foods.

1: Early introduction of complementary foods

Rushing to introduce complementary foods is the biggest mistake a child’s parents make. The fact is that the digestive system of a child up to 4 months, and in some children up to 6-7 months, is not ready to digest adult food, the microflora of the stomach and intestines is just being formed, and breast milk is best absorbed. Mother's milk contains all the essential nutrients and vitamins that a newborn needs. It is important to remember that breast milk contains substances that strengthen the immune system and form healthy intestinal microflora. Early feeding harms the digestive system. Reasons for introducing complementary foods such as the child is not getting enough breast milk, he has a monotonous diet, or I am tired of breastfeeding are the most common mistakes of mothers. If introduced early, the child begins to have stomach problems, allergic reactions, lack of interest in food, etc. are possible. Usually, at about 4-6 months, the child begins to be interested in his mother’s food, and he shows that the baby is ready to join adult food. Be sure to consult with your pediatrician!

2: Late introduction of complementary foods

Modern mothers, having read a large number of articles about the benefits of breast milk, decide to breastfeed for as long as possible and confuse that long-term breastfeeding and the introduction of complementary foods are two different concepts. Do not delay the introduction of complementary foods until later.

There are certain signs that your baby is ready to receive additional nutrition. The main thing to remember is that the first feeding is the mother’s desire not to feed, but to introduce her to the variety of foods and tastes of our world, to teach her tiny tummy to digest all this diversity, we are preparing the child for adult life, gradually and patiently.

Don't be afraid and add me to

Margarita Shtanova, child care consultant:

It is known that familiarity with the foods that mother and the whole family eats begins long before the child is born. Through the umbilical cord, the intrauterine fetus receives the first “knowledge” about the diet of its family. Along with all the necessary substances for life, he receives enzymes and information about what his mother ate today. Six months after birth, showing “remarkable” interest in the contents of his mother’s plate, the baby demands “in sign language” that he be given exactly this. What mom eats.

Why can't you start complementary feeding with juices? Juice is a very heavy product, containing a lot of acids, mineral salts and sugar. Even for adults, this is a too concentrated product that needs to be diluted. And for children it’s better to drink compote in general. Imagine a person has problems with his stomach, liver, kidneys... What is his diet? Porridge! Well boiled, sometimes in water, without milk. Not juices. The child eats breast milk, which is absorbed almost completely...

Consequences of early introduction of juice May be:

irritation of the gastrointestinal tract, dysbiosis, kidney problems, problems with the pancreas (as a result - a huge number of patients with pancreatitis in our generation). The allergy may not appear immediately. It happens that about a month after the early introduction of juice, a diathesis appears “it’s not clear why, they didn’t give anything new.”

Now - about juice and anemia. The method of introducing complementary foods with juice was especially common in the period before the 70s. And not only in Russia, but also in Europe and America. But already in the late 60s, the first recommendations appeared in America and Europe to limit such food activities for children. Russia, as always, is in the rear, observations of the “bourgeois children” have no weight, you need to step on the rake yourself 15 times to understand the meaning of what is happening. From observations of children aged 6-12 years old who grew up in the wake of early sexual intercourse, information was gathered that such methods can be fraught with long-term consequences. The danger lay in wait not only in the form of immediate allergic manifestations, but also in subsequent reactions of the maturing body.

From birth, the child’s gastrointestinal tract, receiving unadapted food (and recommendations to give juices starting from 3 weeks), worked under extreme conditions, “to wear and tear.” And during physiological stressful periods (pre-teenage and adolescence), he simply simply lost his temper, rewarding the child with a bouquet of diseases such as gastritis, pancreatitis, problems with the intestinal mucosa, etc. And again, turning to that time, let us remember that the main emphasis was on artificial nutrition (and at that time it was considered BETTER to supplement the child with formula than to support breastfeeding, and the mother was recommended to use the services of a nursery as soon as possible in order to return to work shift) - the child needed additional sources of nutrients. This is precisely where the principle of “lesser evil” has become relevant.

Yes, juices as a first complementary food are harmful. But insufficient nutrition due to the lack of breast milk, milk formula of an unbalanced composition with crystalline sugar (and our mothers should remember how they sifted sugar from mixtures with a sieve), cow's milk or kefir, is more dangerous for the child. Nutrient deficiency provokes severe developmental defects, while gastrointestinal problems, firstly, are more distant in time and, secondly, are potentially familiar and theoretically treatable. And now the numbers: I’ll give an example on hardware. More precisely, on its content in various food sources suitable for an infant and the child’s needs for it. In breast milk, the iron content is insignificant by itself, about 0.04 mg per 100 grams.

But iron in breast milk has a unique bioavailability - 50-75%. No other product in the world provides this. Those. the absorbed amount in mcg/100 grams is about 20-30. In modern adapted mixtures, the content of ferrous sulfate is about 0.2-0.4 mg/100 grams (in enriched mixtures 0.6 mg/100 grams). Taking into account its bioavailability (which is about 20%), the absorbed amount ranges from 40 to 120 mcg/100 grams. According to WHO, 20 mcg/100 grams is a sufficient amount to meet the needs of a child up to the age of 6-8 months on average. In mixtures in which there are no additional factors stimulating absorption, the iron content, as can be seen, is overestimated. But in the milk formula that our mothers fed us, the iron content is two times less than in breast milk - 0.02 mg/100 grams. Bioavailability is low - 10%... and the amount of iron absorbed is only 2 mcg/100 grams of the mixture.

Those. for a child who was bottle-fed at that time, the prevention of iron deficiency anemia was VERY relevant. Because from the available food he received less than 1/10 of the required amount. This was especially true for premature babies, because their own reserves were minimal due to the shortened period of perinatal development, and, as a rule, were depleted to a minimum level by 2 months. Juices acted as at least some alternative to solving such a problem.

Really AT LEAST SOMETHING. Because it is impossible to offer solid food (pieces, purees) to a child of physiological immaturity for complementary feeding. Exceptionally liquid. Such as juices and broths. So, juices... the iron content in fortified apple juice is about 0.4-0.5 mg/100 grams. Bioavailability - 1-2%. those. about 4 mcg/100 grams are absorbed. Therefore, by the age of physiological decrease in iron reserves in the body (about 4 months), the child should already have a SUFFICIENT amount of another source of iron in his diet - juice.

At least these 100 grams of juice per day. But if you give them to a child right away, he will, excuse me, die. That’s why they introduced it as early as possible in order to extend the period of adaptation. Smooth out the stress effect. And why was the recommendation universal - but the reason is simple - few pediatricians will understand whether the mother is really breastfeeding well without supplementing with cow's milk? And the recommendation must be standardized! Maybe the mother is deceiving or not telling about the baby’s nutritional habits? And the child suffers.

That is why, based on the principle of the lesser evil, this recommendation was made universal. If there is any harm, it will be small compared to the problems of growth defects in a child in the first year due to poor nutrition with unadapted food. That's all... The main problem is that in the conditions of modern nutrition for babies, the advantages of introducing juice have lost their relevance. And when there is no even dubious benefit, then what is left?

So, how to start correctly?

The baby's introduction begins with the introduction of microdoses (micro-samples) of products, namely introduction, without the goal of feeding the child a certain portion. A microdose for soft food is approximately the amount that can fit between the pads of a mother's thumb and index finger if she squeezes them, or on the tip of a teaspoon. For liquid products - one sip, poured into a small cup at the bottom. The child can “in one sitting” try what the mother eats and what he is interested in in up to three microdoses.

Only hard pieces are given to the baby's hand, from which he himself will not eat much (hard apples, carrots, stalks, dried fruits, etc.) Microsamples are given for 3-4 weeks. During this time, the baby can become familiar with many of the foods used in his family and learn to drink from a cup. Complementary feeding never replaces breastfeeding! The baby can be introduced to new foods before, after and during breastfeeding. Children often wash down microsamples with mother’s milk. Gradually, the amount of food is increased, allowing the child to eat more. The mother needs to maintain the child’s interest in food and the desire to try. From six months to one and a half years, a child should become familiar with all the foods that his family eats. To maintain the desire to try, the mother must limit the child’s food interest until 8-11 months: if the child has eaten 3-4 teaspoons of one product and asks for more, he should be given something else.

From the outside, the introduction of complementary foods should look something like this: the baby begs for pieces, and the mother gives him some, sometimes. In such a situation, the child is always happy to get acquainted with new food and does not overeat. The child must learn to work with cutlery. Until 8-11 months, these are spoons (there should be a lot of them, because they fall all the time), the child has his own plate when he begins to eat separately, usually after 8-11 months. Until this age, the baby can eat while sitting in his mother’s arms and from her plate. If the child is tired of eating or has lost interest, it is necessary to take him away from the table.

Introducing complementary foods to a child requires certain knowledge and experience. There will be no problems if the baby is healthy, is on properly organized breastfeeding, and his mother was shown how to introduce such complementary foods. This really needs to be shown, as does everything related to practice, such as breastfeeding and caring for a baby. If the mother has not been shown by another experienced mother how to start feeding her baby correctly, she may make some mistakes without even knowing that she is making them. Some mothers succeed.

These are the lucky mothers. How lucky, for example, are mothers who have never seen how to breastfeed their baby correctly, but who managed to establish feeding. You can make mistakes related not to feeding itself, but to the baby’s behavior at the table. For example, a baby eats for some time, to put it mildly, not very carefully; he prefers to take food with his hand, put it in a spoon, and then carry it to his mouth. Many mothers consider this behavior unacceptable, take the spoon away from the child and begin to feed him. The baby loses the desire to eat on his own. A child may really like a certain product and demand more and more, and the mother gives in to him, resulting in indigestion in the baby the next day.

With the correct introduction of complementary foods, the baby’s well-being does not deteriorate, the tummy does not “get upset”, it continues to develop normally. If the mother knows the options for normal behavior of the baby and adequately evaluates them and corrects them in time if necessary, the baby will never grow up to be a child who does not know how to behave correctly at the table, is sloppy or has a poor appetite. Unfortunately, almost no one now remembers what all women knew how to do 150 years ago... Signs of improperly introduced complementary feeding: the child eats very well for some time, and then refuses to try and eat anything. This means that the child was overfed and he overate. A way out of the situation: take the child with you to the table for 5 days, do not offer him anything, do not give him anything, and eat with appetite in his presence.

Very often, mothers fail to cope with the introduction of complementary foods precisely because they really want to feed the baby with other foods. In the minds of modern mothers, there is a strong belief that breast milk, due to its qualitative composition, is not a very reliable liquid and must be supplemented with other food. The fact that milk is a perfect product created by evolution specifically for feeding human children, absolutely complete in its digestibility and nutritional value, is completely ignored. Research has proven that the early introduction of other foods impairs the absorption of nutrients from milk, and a child begins to fully absorb these substances from other foods only after a year.

Baby's eating behavior- not artificially invented, but due to the peculiarities of the development of his body, primarily the gastrointestinal tract. Mothers must remember that their task is not to feed the child food, but to introduce him to it and maintain the child’s interest in food. If you want your baby to have a good appetite in the future, never try to feed the child after he has lost interest in the process of eating. It’s hard for a mother who spent half a day making purees or opening a ready-made jar to watch her child run away after eating two spoons. I just want to catch him, distract him with a book, a toy or TV, just to open his mouth. Do not do that! A baby who has the opportunity to kiss his mother’s breast will never suffer from hunger or thirst! If breastfeeding is organized correctly, then everything the baby needs will be taken from the mother’s breast.

How to be with pieces of food, if the baby’s food is not pureed, he might choke?

Food for your baby does not need to be chopped, but you need to start with small microdose pieces. If a child is given something from which he could potentially bite off a large piece, the child sits on the mother's lap and the mother watches him and as soon as a large piece is bitten off, the mother makes a hook with her finger and takes it out of her mouth. The child actively learns and gradually learns to chew with his still toothless jaws, and then with toothed ones. What if the baby spits out even very small pieces, or tries to burp them instead of swallowing?

Many children behave exactly this way: for a week or two they spit out all the pieces and periodically “chokes”, then they begin to spit out the pieces “every other time”, they swallow half of them, then, finally, they begin to swallow all the pieces. Mom needs to be patient and not insist. At the same time, the child must watch other people eat without spitting out the pieces.

When does complementary feeding stop being just an introduction to new foods and begin to replace feedings? Breastfeeding and the transition to food from a common table are parallel processes. Feedings are not replaced with complementary foods. The fact is that the main feedings from the breast in a child 6 months and older are associated with dreams. Babies suck a lot when falling asleep during daytime and nighttime naps, breastfeed when waking up from daytime dreams and in the morning, and suckle at night, especially closer to the morning.

And acquaintance with complementary foods and food from the common table occurs during mother’s breakfasts, lunches and dinners. A child eats relatively large portions of food already at the age of about a year and older. But even at this age, babies can often drink food from the breast. The baby continues to receive vitamins and other useful substances through breast milk in sufficient quantities and in forms optimal for absorption, provided that breastfeeding is properly organized and the mother does not lack nutrients.

How to be with salt, sugar, spices, and possibly harmful substances (for example, nitrates) contained in adult food that the baby will try? IN baby food All this is missing, and therefore it can be healthier for the baby than food from the common table? Food does contain salt, sugar, nitrates and more. And contains baby food. Baby food is made in such a way that the child absorbs it without adapting to the products that make it up.

There is no adaptation of the digestive system to the taste, consistency, or ingredients. The mother’s task is not to feed the child with other foods, which can be done with baby food, but to continue the slow process of adaptation of the child’s gastrointestinal tract to other foods.

This adaptation began when the child began to swallow amniotic fluid, the taste of which changed depending on the mother’s nutrition, and continued with the start of feeding on breast milk, the taste and composition of which changes not only during the day, but even during one feeding, and the mother feeds not baby food. While the child eats small amounts of food, he adapts to its components: salt, sugar, nitrates, as well as its other components. And when he eats significant amounts of food, he will be quite capable of coping with all this.

Does the child needextra liquid in connection with the start of complementary feeding? The baby continues to receive the main liquid from breast milk. A child usually begins to take an interest in water and drinking after one year. Usually the baby is interested in the contents of his mother’s cup and tastes it if you pour a little drink into the bottom of his cup.

What to do with a child over a year old who has no interest in food?

Until a year old, all attempts to introduce complementary foods led to nothing. The child cried, turned away, and even vomited. Now he eats very poorly and not everything, but only certain types of canned food. How to accustom a child to adult food and increase appetite? This is how children usually behave when they have not seen what and how other people eat. This often happens if a separate process is arranged from feeding the child and they are fed something special. You need to stop feeding your baby separately.

It is necessary to sit him at the table with everyone, or at least with his mother, and not try to feed him. Everyone should become indifferent whether the child eats or not, at least it is necessary to “pretend” that this is so... Let him watch how other family members eat for several days. If he starts asking to try something, let’s do it. Put on the plate the same thing as everyone else. In the presence of the baby, you need to eat with appetite. Don't try to distract yourself with TV, books or toys. Do not scold or punish if a child spills or smears something, clean it up immediately and demonstrate that everyone eats carefully.

If the baby is almost 5 months old, he is very interested in any food, looks into everyone’s mouth and demands to try it, is it possible to introduce pedagogical complementary foods to him now? The baby is a developed and inquisitive child. He really wants to do the same things with food as his mother does. But we must remember that the child’s gastrointestinal tract, at less than 5 months, is not yet very ready to be introduced to other foods. Enzyme systems are just beginning to mature. The situation in the intestines is now stable; interfering with it ahead of time is quite dangerous.

The mother’s task is to protect this stability from premature interventions. A child of this age should have a limited interest in food; in other words, take him out of the kitchen and not eat in his presence. If you don’t really like this advice, you can do something, but only at your own peril and risk.

We have already encountered a situation where a mother, even who knows how to properly introduce complementary foods, shows impatience and, as a result, the child suffered a breakdown in the digestive system, which then had to be dealt with for a long time. If the mother has the opportunity to introduce complementary feeding under the full-time guidance of a lactation consultant (the best option), then it will be possible to do this from 5.5 months of age. If you can only act on your own, introducing complementary foods before the baby is six months old is not recommended.

Are there any peculiarities in the management of pedagogical complementary feeding if the baby or his parents - allergy sufferers? Of course, there are features. Such a baby is introduced to foods more slowly, starting with hypoallergenic ones, and the amount of complementary foods is increased much more slowly than usual.

The speed of product introduction can be described as “one step forward, two steps back.” Mom should follow a hypoallergenic diet, excluding foods that cause her allergies or any other discomfort. A breastfeeding mother should not introduce new foods to her baby due to an exacerbation of her own illness. All product trials must be completed by applying to the breast. It is necessary to introduce no more than one product per day and monitor the baby’s reaction to it for at least 3 days. Why can babies who eat baby food at 7-8 months eat 100-200g of puree or cereal, but children who started with pedagogical complementary feeding do not do this? A child in the second half of life eats little because he does not want to be full yet. He only imitates his mother in her actions.

He eats up milk. Perhaps there is a genetically built-in mechanism in the human baby that does not allow him to eat a lot at this age. Just a couple of thousand years ago, a child would probably have had big problems in the digestive system if he had been fed 100g of game meat brought by his dad from a hunt. Another thing is that then no one would have thought of doing this to a child. Even our great-grandmothers, 100 years ago, who cooked food for a family of 5-10 people on a stove or wood-burning stove, did not think (and were not able), on the one hand, to feed the child something specially prepared separately from everyone else, and on the other hand, there was no thought of giving the baby more common porridge or soup to fill him up... Baby food is made so that the child can eat a lot of it.

And you can feed it to any baby, but is it necessary? There are children who for the time being eat this “baby food” and with pleasure, however, most of them have to be entertained during the feeding process so that their mouths open. Many people have to entertain themselves while eating for quite a long time, some - until adolescence. A situation often occurs when a child, who ate with pleasure and a lot, up to a year or a little over a year, as he grows older, begins to refuse food and turns into a toddler, whom it is simply torture for parents to feed. Such children are not at all interested in food. There are, of course, children who relatively “safely” bypass the baby food stage. “Safely” is put in quotation marks because... Now the long-term consequences of introducing large quantities of baby food to a child when he is biologically not quite ready for such a load are just beginning to be studied; the results will not be soon.

INTRODUCTION

Relevance of the topic . Rational nutrition of children is an important condition that ensures proper physical and mental development, immunological protection, which largely determines the well-being of the body throughout subsequent life. Modern studies conducted at the initiative of WHO in 2006-2016 have established that one of the leading causes of the development of gastroenterological, allergic and immunological diseases among children and adults is the early or incorrect introduction of complementary foods.

A child of the first year of life experiences a special need for a nutritious diet due to intensive growth, rapid psychomotor development and the formation of all organs and systems. But as an infant grows and develops, there is a need to expand his diet and introduce additional products to breast milk or its substitutes, which are called complementary foods.Lure - introduction of new food, more concentrated and high-calorie, gradually and consistently replacing breastfeeding.

Complementary feeding is necessary for covering the emerging deficit of energy, proteins, fats, micronutrients; introduction of proteins, fats, and carbohydrates into the diet; eating denser foods when switching to an “adult type” diet, which is required for the further development of the child’s chewing apparatus and gastrointestinal tract.

The question of when to start introducing complementary foods still remains open. The general consensus now is that it should not be started before 4 months of age and delayed until after 6 months of age. If an infant under 6 months is at risk of nutritional deficiencies, improving maternal nutrition may be more effective.
The age when a child begins to receive complementary foods is the most vulnerable. The gradual transfer of an infant to an “adult type” diet is sometimes accompanied by functional disorders of the digestive system (vomiting, intestinal colic, flatulence, constipation).

The introduction of complementary foods is the first step of a child on the path to the world of tastes. This is a huge stage in his life, the importance of which is difficult to overestimate. Not only food and taste preferences, but also the functioning of the digestive system and health in general depend on how one gets acquainted with new products. In order for everything to go smoothly and complementary foods to fully fulfill their functions, it is important to avoid mistakes.

Goal of the work: studying the problems of introducing complementary foods.

Object of study: children and their mothers during the period of introducing complementary foods.

Subject of study: problems with the introduction of complementary foods that occur in mothers and children.

Research objectives:

Study theoretical material and medical literature on the topic of the course work.

Summarize data from sources.

To study the essence of problems when introducing complementary foods to a child.

Analyze this information;

Draw conclusions on the research part and the work done as a whole.

CHAPTER 1

Theoretical part

1.1. Basic information about introducing complementary foods.

When breast milk ceases to fully satisfy the nutritional needs of an infant, it is necessary to introduce complementary foods into his diet (Appendix 1).Lure - introduction of new food products into the diet of an infant in addition to breast milk or infant formula. It is introduced for the purpose of gradual replacement of mother's milk, as well as with a gradual transition to nutrition with other food products.

Complementary feeding usually covers the period of life from 6 to 24 months, which is a very vulnerable period. During this time, many children begin to suffer from malnutrition, which contributes significantly to the high prevalence of malnutrition among children under five years of age worldwide.

WHO has developed Complementary Feeding Guidelines for Breastfed Children, which set standards for developing locally adapted feeding guidelines. These are complemented by the Feeding Guidelines for Non-Breastfed Children, which provide guidance on appropriate feeding in circumstances where children aged six months and over do not receive breast milk as part of their diet.

« Around the age At six months, the baby’s energy and nutrient needs begin to exceed those levelsat which point they can be satisfied with breast milk and the introduction of complementary feeding becomes necessary. At this age, the child is ready to eat other foods and is developmentally ready. Not introducing complementary foods after the baby reaches six months of age or inappropriately introducing complementary foods can affect the child’s growth.” (WHO fact sheet N°342 “Infant and young child nutrition”, January 2016) (Appendix 2)

Pediatric complementary feeding

Basic Rules:

Any new product can be introduced only when the child is healthy.

You cannot introduce a new product into the diet 1 week before and 1 week after the next preventive vaccination.

Each new product should be given a little (5-10 grams). The tolerability of the new product should be closely monitored. If the child is not allergic to the administered product, its amount can be increased 1-2 weeks before the recommended dose.

Complementary foods should be given first, followed by breast milk. The exception is fruit juices.

Never introduce two products at once, because if the child is allergic, it is difficult to determine what exactly. A new component can be added in 4-5 days.

From 6-7 months (except for night meals), the child eats only at his own table.

You should not give your child food (apple, dry food, bread) between feedings; this reduces appetite and does not allow the stomach to rest.

From 9 to 10 months it is important to teach the child to eat independently - 2 spoons

Do not leave “adult” food on the tables.

If a child has a decreased appetite (due to ARVI, teething), it is better to skip one feeding completely than to give a “piece” between feedings.

During feeding, the environment should be calm. All family members should sit together, thus the child develops traditions of sharing breakfast, lunch and dinner, and the child, imitating adults, eats his food well.

Timing of product introduction

Until the age of 6 months, a healthy child does not need complementary feeding (Appendix 3).

If the child is absolutely healthy (no allergies or stomach problems), the first dietary supplement at 6 months isvegetable puree . It should not contain salt, sugar, or milk powder.

As a rule, fruit juices are introduced into the diet first, then fruit puree. You cannot introduce new puree and new juice at the same time. Apple juice is introduced first. There should be no sugar in the juice.

Introduced at 7 monthsporridge . Porridge is introduced in the morning starting with 1 tablespoon of ready-made porridge and 1 tablespoon is added daily, increasing the volume to 100–120 g. and completely replace milk feeding. Porridge cocktails, made from different varieties of cereals, contain large amounts of a substance called gluten. The intestinal microflora of an infant is not yet fully formed and may lack the enzyme that breaks down gluten. Products of incomplete breakdown of gluten are toxic and have a harmful effect on the intestinal walls, so preference should be given to porridges that do not contain gluten - rice, buckwheat, corn. A little later, you can introduce semolina and oatmeal. If you are allergic to cow's milk, porridge must be prepared with vegetable broth or diluted with a special soy mixture or a mixture based on milk protein hydrolyzate. The box should say “no sugar, no gluten, no milk, no dyes.”

At 7-7.5 months it is introducedfruit puree - green apple. All fruit purees must be sugar-free. Before giving puree, you should consider the following: blueberry, blackcurrant and cherry puree contain tannins, therefore, they have a fixing effect and can cause constipation. As for beetroot, carrot, apricot and plum purees, on the contrary, they are recommended for those children who have constipation. Citrus fruits and strawberry puree should be given very carefully, because in many children they cause an allergic reaction. It is not recommended to give grape puree to babies, as it contains a high amount of sugar and can cause fermentation processes in the intestines. It is recommended to introduce fruit purees into food after vegetables and cereals, as they can cause the child to dislike other less sweet tastes of food.

At 8 months you can introducecottage cheese . It is added to fruit puree (afternoon snack) starting with 1/2 teaspoon, gradually increasing the volume to 1 tablespoon over the course of a week (cottage cheese is a highly allergenic product and is administered only after consultation with a pediatrician).

At 8.5 months you can introduce meat.Meat puree industrially produced ones should be purchased without vegetable additives in order to know exactly the amount of meat eaten by the child. The volume of meat cannot be exceeded. Recommended – turkey, pig, lamb, beef. Meat broth is not recommended for children under two years of age.

9 months - Dairy products it is recommended to give in the form of so-called “follow-up formulas” - special products with a reduced content of cow's milk protein (to reduce the risk of allergies) (Appendix 4).

1.2. Problems of organizing complementary feeding

1.2.1 Early complementary feeding

Not so long ago, early complementary feeding was considered the norm, and the baby was fed juices and cereals from an early age. However, WHO experts now agree that complementary feeding should be started no earlier than 4–6 months. Until this time, breastfeeding is preferable. And after the introduction of complementary foods, breastfeeding should be maintained for as long as possible.

Why is early introduction of complementary foods dangerous? First of all, indigestion in a child. In the first year of a child’s life, it is still just forming - and it is very important not to force things. In the first 4 months, the baby's intestines and digestive glands are still immature. During this period, the digestive system is able to easily digest and completely absorb only mother’s milk, and the introduction of other food may not have the best effect on its metabolism. This is also fraught with long-term health problems in adulthood.

How do you know when it’s time to introduce complementary foods? You should follow the advice of your pediatrician, who knows best about the child’s health and developmental characteristics. As a rule, if the child is healthy, active, and gaining weight well, then the first complementary foods are recommended to be introduced at 5.5–6 months. However, it is necessary to understand that each child is individual - and only a specialist can determine the timing of the introduction of complementary foods.

It is important to track the moment when the child’s innate pushing reflex fades away, usually by 4–5 months. This reflex is protective, since the baby has not yet matured a consolidated reflex for swallowing solid food.

1.2.2. Late feeding

There is also the opposite situation, when a mother is comfortable breastfeeding, and she does not want to change anything at all. After all, the introduction of complementary foods is associated, at a minimum, with the need to warm up baby purees and waste time on the process of spoon feeding.

Introducing complementary foods too late will not benefit the baby. Yes, he gets everything he needs from milk, but we must remember, firstly, that by 4-6 months his nutritional needs increase significantly, and secondly, the time has come to learn to chew solid food and get acquainted with world of tastes.

The consequences of introducing complementary foods too late (after 6 months) can be:

iron deficiency anemia due to depletion of iron reserves in the baby's body, which he received in utero from the mother - there is very little iron in breast milk;

lack of interest in food - numerous observations show that with late and unsystematic introduction of complementary foods, the child subsequently refuses many of the foods he needs;

delayed physical development (after 6 months, breast milk or formula alone is not enough for a baby - if you recalculate his needs for some nutrients, then to fully satisfy them you need to receive 2-3 liters of milk per day);

insufficient intake of vitamins and microelements;

significant allergenic load and digestive problems due to the need to quickly introduce a large number of products, since there is no longer enough time for their gradual introduction.

The reason to postpone the introduction of complementary foods to a later date may be the child’s illness, identified food allergies, or other reasons. In any case, all this happens under the supervision of a doctor.

Regarding the age of introduction of complementary feeding within the range between 4 and 6 months, it was noted that it has no effect on growth rate (weight and body length). At the same time, later (after 6 months) introduction of complementary foods can lead to a decrease in weight and height indicators. In contrast, early (3 to 4 months) introduction of complementary feeding may contribute to infant weight gain, which may have long-term negative consequences in terms of increased risk of obesity, type 2 diabetes, and cardiovascular disease in adulthood. Introducing complementary foods too early is also associated with overweight or obesity in children at two years of age.

1.2.3 Quick complementary feeding (product change)

Very often, parents strive to introduce their baby to all the variety of tastes as quickly as possible. When introducing complementary foods, it is important to take into account that each new product is introduced over 5–7 days - starting with 1/2 teaspoon and gradually increasing the portion to the norm for age (it is usually indicated on the packaging of baby food, as well as in printed materials, which, As a rule, a pediatrician provides care for a young mother).

You should never try to introduce two or more products to your baby at the same time: it is difficult to track which product the child reacted to with digestive upset or skin rashes if this happens.

Also, you should not force things and give your child complementary foods “inappropriate for his age.” Even if a 7-month-old baby is a great chewer, it doesn't mean he's ready to move from homogenized purees to chunky purees.

1.2.4 Large volume of complementary foods

If the mother is in no hurry and does everything correctly, but there is another extreme: if the child likes it, then he is given more than the physiological norm.

One of the goals of complementary feeding is to teach a child to distinguish between the feeling of hunger and the feeling of fullness, which allows healthy eating habits to be established in early childhood. By overfeeding the child, the mother develops an incorrect perception of food in him. A child who is overfed is at risk of obesity, metabolic disorders and increased stress on the excretory system. If a mother increases the portion too quickly when introducing complementary foods, this can result in indigestion and stool upset, regurgitation, and even an allergic reaction for the baby. Experts note that some products provoke delayed allergies, which manifest themselves when a critical mass of a particular allergen accumulates in the body.

It is important to start complementary feeding with 1/2 teaspoon of the product and each time increase the portion by half a spoon, maximum by one. Yes, it's tedious, but it's simply necessary. It is important to introduce a new product in the first half of the day to monitor the reaction to it.

The ideal solution for the correct introduction of complementary foods is keeping a food diary. It is necessary to record how many spoons and what product were received, how the child took the new product, whether there was a reaction from the gastrointestinal tract or an allergic reaction. This will allow you to draw conclusions about his food preferences and identify not only a tendency to allergies, but also those foods that cause abdominal discomfort.

1.2.5 Late introduction of individual products

You can often hear from mothers that the child does not want to try new foods, and they simply postpone the introduction of complementary foods until later. However, behind this behavior is most often the mother’s mistake - and it lies in the fact that the child is first given breast milk to eat, and only then is offered to try vegetable or fruit puree. Naturally, a well-fed child does not show the slightest interest in food. First, you need to invite your baby to eat 1-2 tablespoons of a new product for him, and only then supplement him with milk. And you don’t have to worry that he will remain hungry: he will eat as much milk as he needs. Complementary feeding is a serious period; it is a test of the mother's discipline, organization, and patience. The success of the entire event primarily depends on the mother’s mood. PThe first complementary food should contain all the basic micronutrients, protein and energy, the deficiency of which develops by the 6th month of life. According to the latest recommendations of the Committee on NutritionESPGHAN(2016) the first complementary foods should be introduced no earlier than the 17th week and no later than the 26th week of the child’s life.

Table 1. Adverse consequences of late introduction of complementary foods [Tutelyan V. A., 2007]

5 technical mistakes when introducing complementary foods:

Adding salt and sweetening food.

Introducing complementary foods to a sick child.

Getting to know products that are “not for age”.

Starting complementary feeding with multicomponent products.

Premature replacement of breast milk (infant formula) with cow's milk, kefir or other unadapted dairy product.

Below we briefly present the main stages of the transition of an infant's diet from mother's milk to food from the family table. These stages form a continuous process, and the transition from one stage to the next is relatively quick and smooth. It is very important to recognize differences between children in their developmental readiness for the introduction of complementary foods, and therefore to recognize individual patterns in the pace of introduction of various complementary foods. The following recommendations are intended to help ensure that infants are provided with sufficient amounts of nutrients, that nutrient bioavailability and density are maximized, and that appropriate behavioral skills are stimulated and developed.

Stage 1

Skill development

The goal at this initial stage is to teach the infant to spoon feed. Initially, only a small amount of food (about one or two teaspoons) is needed, and it should be given on the tip of a clean teaspoon or finger. It may take time for your child to learn to use their lips to lift food from a spoon and to move food ready to be swallowed to the back of the mouth. Some of the food may flow down the chin and be spat out. This is to be expected from the start and does not mean that your child does not like the food.

Liquids

Breastfeeding on demand should continue with the same frequency and intensity as during exclusive breastfeeding, and breast milk should remain the main source of fluid, nutrients and energy. During this period, no other liquids are needed.

Foods of transition

The first food offered to the child should be mashed foods consisting of one ingredient, soft consistency, without added sugar, salt or seasonings.

Meal frequency

Small amounts of complementary foods once or twice a day will help your baby learn the skills of eating food and enjoying new taste sensations. Food should be offered after breastfeeding to avoid replacing breast milk with complementary foods.

Stage 2

Skill development

Once your baby has become accustomed to spoon feeding, new flavors and textures can be added to improve dietary variety and motor skill development. Developmental indicators that infants are ready for thicker purees include their ability to sit without support and transfer objects from one hand to the other.

Liquids

Breastfeeding should be continued on demand and breast milk should remain the main source of fluids, nutrients and energy. An infant may not maintain the same frequency and intensity of breastfeeding as during exclusive breastfeeding.

Foods of transition

You can introduce well-cooked mashed meat (especially liver), legumes, vegetables, fruits and various grain products. To encourage children to embrace new foods, it's a good idea to introduce a new flavor, such as meat, along with a familiar favorite, such as mashed fruit or vegetables. Likewise, when introducing lumpier foods, you should mix your child's favorite food with a new, coarser-textured food (for example, carrots in small but noticeable chunks). Spicy foods should be encouraged instead of sweets, and desserts should be low in sugar.

Meal frequency

After a few weeks of starting complementary feeding, the infant should take small amounts of foods chosen from a wide variety of foods, two to three times a day.

By 7–8 months, the diet should be as follows: Morning, breakfast – porridge with fruit puree. Day, lunch - vegetable puree, then with the addition of meat, then vegetable soup with meat. Afternoon snack – cottage cheese or yogurt with fruit puree. Dinner: breast milk or infant formula. At night - breast milk or infant formula.

During the day, you can offer breast milk at the baby’s request as much as he wants or time breast milk at the time of the main feedings.

The World Health Organization recommends starting complementary feeding with various vegetables, cereals, meat, fish, and only then is it allowed to introduce juices into the baby’s menu. Modern nutrition experts recommend being very careful when introducing juices, since this product is a stimulator of the enzymatic activity of the child’s gastrointestinal tract.

Timing of introduction of complementary foods

It is not recommended to combine the introduction of complementary foods with any changes in the child’s usual way of life (moving, for example).
Proper introduction of complementary foods can save your baby from food allergies in the future.

Some mothers make a dangerous mistake when starting to introduce complementary foods. They try to diversify the child’s diet as much as possible and immediately try to give the baby various new foods. This is often the cause of allergic reactions. Each new product should be introduced in small portions and with caution. If your baby doesn't like a new product, you can always replace it with another one. The range of complementary feeding products is very large, so you can choose exactly the one that will suit your baby’s taste and will be most beneficial for him. And of course, we should not forget about breastfeeding, the role of which is very important in the initial stages of a child’s growth and development.

Age of introduction of complementary feeding and indicators of physical development and health of the child

Summary table (Appendix 5) of recommendations regarding the timing of the introduction of complementary feeding, which shows that despite some differences in national recommendations, all scientific communities and nutrition experts agree that complementary feeding should not be introduced earlier than 4 and later than 6 months of a child’s life .

1.4. Pedagogical and energy complementary foods (Appendix 6)

Pedagogical complementary feeding is a stage of feeding with microdoses of foods, which lasts 1.5-2 months and during which the child is really allowed to try almost EVERYTHING that the mother eats.

It is replaced by energy feeding, when the child begins not only to try, but also tries to get enough, but since he still doesn’t eat much, he still gets the entire necessary diet.

The next stage - feeding from a common table - begins when the child begins to eat completely independently.

Nutrition for a child from our eco-friendly adult - this is the main onenutrition principle , regardless of what stage of complementary feeding the child is at, and whether it is complementary feeding or independent feeding. The child will definitely eat the same as his parents.

The diet of modern man is very different from his ecological niche, so it would be good to start gradually approaching it. In this vein, it is useful to familiarize yourself with the research of Weston Price.

It is necessary to start adjusting the family’s diet during pregnancy. But it also happens that expectant mothers do not attach much importance to this. And when the time comes to introduce complementary foods, they begin to rack their brains over how to find a way to feed the child healthy foods without changing their habits.

In any case, if a mother wants her child to eat only healthy food, then she should eat it herself. And at the initial stage of introducing complementary foods, the diet of the WHOLE FAMILY must be balanced and enriched. Moreover, when increasing the amount of food the child eats, we try to reduce or not eat in front of the child what we would not want him to eat later.

If it is customary in the family to drink milk, eat cottage cheese, and prepare meat broths, then the child will get all this, first in microdoses for adaptation, and then in more serious portions. It is not advisable to temporarily become vegetarians or somehow change the diet before the child is 2-3 years old. Now while he is breastfed, he has maximum adaptive abilities and with the support of his mother's milk.

Conclusion to Chapter 1:

Lure - introduction of new food products into the diet of an infant in addition to breast milk or infant formula. It is introduced for the purpose of gradual replacement of mother's milk, as well as with a gradual transition to nutrition with other food products. The first complementary foods are introduced at 6 months. Because mostly children begin to suffer from lack of nutrition.

Any complementary foods are introduced when the child is healthy. We also looked at the main problems when introducing complementary foods, the consequences of late and early complementary feeding.

When studying theoretical material, we identified the main problems when introducing complementary foods: early complementary feeding, late complementary feeding, fast complementary feeding (product change), large volume of complementary feeding dishes, late introduction of individual products. Adverse consequences of untimely introduction of complementary foods were identified, and 5 technical errors during the introduction of complementary foods were studied.

Recommendations from European countries regarding the timing of introducing complementary foods have some differences from national recommendations; all scientific communities and nutrition experts agree that complementary foods should not be introduced earlier than 4 and later than 6 months of a child’s life.

Research conducted in recent years regarding the effect of different timing of the introduction of complementary feeding on the development and health of children has not given any reason to change existing recommendations, and ESPGHAN experts confirm that currently the recommendations remain the same: complementary feeding should be introduced no earlier than 17 and not later than 26 weeks of the child’s life.

CHAPTER 2

Research part

Our research work was aimed at the practical study of the problems of introducing complementary feeding to children that arise in mothers and, directly, in their children.

2.1. General information about the study participants

We began our research by compiling an author’s questionnaire (Appendix 7.8), which is located at:

. The survey was conducted during practical training at the branch of the State Healthcare Institution SO "Children's City Clinic" in Balakovo. 81 mothers took part in the survey.

Question No. 1. “Indicate your age.” The respondents answered as follows (Fig. 1.):

Rice. Age of mothers.

Conclusion: under 18 years old – 3.8% (3); 18-21 years old – 10% (8); 22-30 years old - 63.8% (51);

31-40 years old - 21.3% (17); over 40 years old - 1.3% (1).

Question No. 2. “At what age (months) did you start introducing complementary foods to your child?” The respondents answered as follows (Figure 2):

Fig2. Age (month) when complementary feeding was introduced to the child

Conclusion : Most mothers began introducing complementary foods according to WHO and Russian recommendations from 4-6 months.

Question No. 3. “Which of the main reasons for problems with the introduction of complementary foods can you name?” Mothers responded as follows (Figure 3):

Fig3. The main causes of problems when introducing complementary foods according to mothers.

Conclusion: Lack of experience – 33.3% (27);

Lack of information from medical workers – 32.1% (25);

Child’s health status – 12.3% (10);

And 22.2% (18) of respondents offered their own answer.

Question No. 4. “Where do you live?” Mothers responded as follows (Figure 4):

Figure 4. Place of residence.

Conclusion: Most mothers are residents city, nearest suburb – 85.2% (69); village with a local hospital – 6.2% (5); village, village where there is a FAP – 3.7% (3); and offered their own answer - 4.9% (4).

Question No. 5 “Did you have any problems introducing complementary foods?” The respondents answered as follows (Figure 5)

Fig5. Problems with introducing complementary foods.

Conclusion: 66.7% (54) of the surveyed mothers denied that there were any problems with the introduction of complementary feeding, 30.9% (25) had such problems, and 2.5% (2) of mothers gave their own answer.

Question No. 6. “Did an allergic reaction occur during the introduction of complementary foods?” Most mothers answered as follows (Figure 6):

Fig.6. Allergic reaction during the introduction of complementary foods

Conclusion: 71.6% (58) of respondents denied the presence of allergic manifestations during the introduction of complementary foods, 25.9% (21) mothers had such a problem and 2.5% (2) gave their own answer (difficult to answer).

Question No. 7. “Which complementary food did you introduce to your child first?” (Fig. 7):

Fig7. First feeding.

Conclusion: 66.7% (54) of respondents introduced vegetable puree as their first complementary feeding, 25.9% (21) porridge, 0% (0) meat puree, 1.2% (1) cottage cheese, 6.2% (5) believe fruit puree as a complementary food dish, which is not true, because This is a corrective additive.

Question No. 8. “Did a medical worker explain to you the tactics of introducing complementary foods?” The majority of parents answered as follows (Figure 8):

Fig8. Training in complementary feeding tactics.

Conclusion: 43.2% (35) of parents answered “unfortunately, they didn’t explain”, 16.0% (13) yes, the specialist explained it in full, 36.8% (29) - yes, but they explained it formally, 4.9% (4) gave their own version of the answer, which indicates insufficient attention of medical workers to this issue.

Question No. 9. “Where do you get basic information on child nutrition?” The respondents answered as follows (Fig. 9):

Fig. 9. Method of obtaining information about the tactics of introducing complementary foods and the child’s nutrition.

Conclusion: 18.4% (14) of parents answered that information is provided by a medical professional or nutritionist; 19.7% (15) get it from a book on nutrition and pediatrics, 6.6% (5) from articles in medical journals, 64.5% (49) from the media (including the Internet), 9 2% (7) of parents believe that “I don’t need anyone’s advice” and gave their own answer (relatives) - 7.9% (6) of respondents.

Question No. 10. “Are you monitoring the child’s tolerance to the new product?” Mothers responded as follows (Fig. 10):

Fig10. Monitoring the tolerability of a new product in a child.

Conclusion: 98.8% (80) majority of respondents answered “Yes”, which is correct. 1.2% (1) - do not do this.

Question No. 11. “Are you introducing two foods into your child’s diet at once for the first time?” The respondents answered as follows (Fig. 11):

Fig11. Introduction of 2 new products into the child’s diet at the same time.

Conclusion: 86.4% (70) of respondents correctly answered no, 13.6% (11) of mothers do just that, despite the burden on the child’s gastrointestinal tract.

Question No. 12. “Do you think it is right to introduce complementary foods when there is a decrease in appetite due to ARVI or teething?” Most mothers answered as follows (Fig. 12):

Fig12 Opinion about the possibility of starting the introduction of complementary foods in case of loss of appetite due to acute respiratory viral infections and teething.

Conclusion: 85.2% (69) of respondents answered that they do not do this; 13.6% (11) of mothers can start complementary feeding during illness. 1.2% (1) found it difficult to answer.

Question No. 13. “With the late introduction of complementary foods, did the child have a delay in the development of the masticatory apparatus?” The respondents answered as follows (Fig. 13):

Fig13. The share of answers to the question “With the late introduction of complementary foods, did the child have a delay in the development of the masticatory apparatus?”

Conclusion: 75.3% (61) denied this fact, 8.7% (7) had such a problem, 16.0% (13) gave their answer in the comments.

Question No. 14. “Do you add salt or sweeten your child’s food during the first feeding?” The majority answered as follows (Fig. 14):

Fig14. Technical errors when introducing complementary foods

Conclusion: 87.7% (71) of respondents do the right thing without making this mistake, but 12.3% (10) of mothers do.

Question No. 15. “How often have you given your child various new foods since the start of complementary feeding?” The respondents answered as follows (Fig. 15):

Fig15. Frequency of introduction of new complementary foods.

Conclusion: 67.9% (55) of respondents answered every 2-3 weeks, 21% (17) every 1-2 months, 1.2% (1) every 2-4 months, 9.9% (8) gave their own answer .

Question No. 16. “What should you do if your child categorically refuses to try food?” Mothers responded as follows (Fig. 16):

Fig16. Actions of the mother when the child categorically refuses to try food.

Conclusion: 60.5% (49) will persistently give small portions daily so that the child gets used to what is right; 24.9% (20) will no longer give this food to the child, 14.8% (12) gave their own answer.

Question No. 17. “Tell me what criteria, in your opinion, indicate that it’s time to introduce complementary foods?” (Fig.17.)

Fig17. Criteria for the timing of introduction of complementary foods.

Conclusion: 40.7% (33) of respondents answered that on the recommendation of a pediatrician, 30.9% (25) if the child does not eat enough, 12.3% (10) when the mother/child herself wants. And only 16% (13) of mothers know relatively little about the criteria for the timing of the introduction of complementary foods, but not a single mother gave exact correct answers.

Question No. 18. “Can you name your mistakes and problems when introducing complementary foods to your child?” (Fig.18.)

Fig18. Mistakes and problems when introducing complementary foods.

Conclusion : 23.8% (19) of respondents believe that they made mistakes when introducing complementary foods; 68.8% (55) of mothers deny this fact and 7.5% (6) mothers offered their own option.

Question No. 19. “Do you think it is acceptable to give food (apple, dry food, bread) between feedings?” (Fig. 19):

Fig19. Acceptability of food between main feedings.

Conclusion: 82.7% (67) of mothers do not correctly believe that when introducing new complementary feeding dishes, snacking in the intervals between meal times is acceptable; 16.0% (13) does not make such mistakes and 1.2% (1) mother offered her own option - she gives only water.

Question No. 20. “Do you think that late introduction of complementary foods can lead to: ?” Respondents chose the following answer options (Figure 20):

Fig20. Mothers' opinions about the dangers of late introduction of complementary feeding.

Conclusion: 25.9% (21) of mothers believe that the later complementary feeding is introduced, the better the child’s appetite will be. Late introduction of complementary foods can lead to delayed physical or mental development - says 29.6% (24) mothers; to loss of food interest – 17.3% (14); and 27.2% (22) mothers proposed their own option, and some of them are confident that breastfeeding fully compensates for the needs of a child older than 6 months, which is not true.

Question No. 21. “The ideal solution for the correct introduction of complementary foods is keeping a food diary. Did/are you leading him?” (Fig. 21.):

Fig21. Keeping a food diary.

Conclusion: Yes - 18.5% (15) of mothers keep such a diary, because... children have allergic reactions to food, 80.2% (65) of mothers do not do this and 1.2% (1) mother offered their own option - only 1 month.

Question No. 22. According to the latest recommendations of the WHO ESPGHAN Nutrition Committee (2016), the first complementary foods should be introduced no earlier than the 17th week of life and no later than the 26th week of the child’s life. At what age did you introduce complementary foods to your child? (Fig. 22.)

Fig22. Age of introducing complementary foods to a child.

Conclusion: 4-5 months – 53.1% (43); 6-7 months – 39.2% (32); 7-9 months – 2.5% (2); 4.9% offered their own option (4). This question is a repetition of question No. 2. Its purpose is to point to WHO recommendations. And from the results it is clear that most of the mothers were inaccurate in their answer to question No. 2.

Question No. 23. “Tick the correct statements.” Respondents answered as follows (Figure 23):

Fig23. Parents' opinions on the statements.

Conclusion: It is not recommended to give meat broths to children under 2 years of age - 22 people (27.2%) answered correctly; 7 mothers (8.6%) consider semolina porridge to be beneficial for their child, which is absolutely not true; if a mother wants her child to be healthy and eat only healthy food, then she herself should eat correctly, says only 44 people (54.3%); complementary feeding should begin with various vegetables, cereals, meat, fish , cottage cheese, and only then introducing juices into the child’s menu is considered correct by 39 people (48.1%); If an allergic reaction occurs to a certain complementary food product, the child decides never to put it on the menu again 20 people (24.7%), which is not the right decision; It is important to recognize the differences between children in their developmental readiness for the introduction of complementary foods and to recognize individual patterns in the pace of introduction of various complementary foods, 64 people (79.0%) believe true.

Conclusion to chapter 2:

The study showed that mothers' knowledge about the tactics of introducing complementary foods is superficial. Mothers make typical mistakes when introducing new dishes and the order in which complementary foods are introduced. Few mothers are aware of the concepts of pedagogical and energetic complementary feeding. In their statements, many parents make both technical errors and errors regarding the timing of the introduction of complementary foods.

It follows from this that medical workers do not sufficiently address the issue of organizing the correct introduction of complementary foods and do not approach this issue individually. Mothers receive information from the media (Internet), which is not always a reliable source.

Based on the results of the study and identified problematic issues, we developed material for sanitary education work with parents (Appendix 9).

CONCLUSION

After 4-6 months of breastfeeding, the nutritional value of milk gradually decreases, and the baby’s appetite grows, and his need for basic nutrients is unsatisfied.

At the age of six months, the child begins to show food interest in the “adult table”: the child’s body needs additional sources of nutrition. At this point, teeth usually begin to cut and the gastrointestinal tract is fully prepared to accept new types of food.

The period of transitional nutrition, that is, the introduction of complementary foods, is a time of gradual transition from mother's milk to the type of complex nutrition that will support the body of the child, and then the adult, for all subsequent years. This is a very important stage in a child’s life, since in order to develop mature feeding skills, he must move from sucking the breast to increasingly complex work: learning to roll food with his tongue, swallow thick food, chew, and bite off a piece. If a child is not taught this in time, he may subsequently have problems digesting “adult” food, which may lead to functional disorders in the gastrointestinal tract.

During the course work, we reviewed modern literary scientific data on the problems of introducing complementary foods. Conclusions were drawn on the theoretical section, an author’s questionnaire was created, on the basis of which a study was conducted and conclusions were drawn that confirmed the data from literary sources discussed in Chapter 1. Based on the results of the research work, we identified problematic issues in the knowledge and statements of the mother respondents, so we material for sanitary educational work has been developed - a booklet “Problems of introducing complementary foods”.

We consider the goals and objectives of the course work to be achieved.

BIBLIOGRAPHY

WHO Fact Sheet N°342 “Infant and young child nutrition”, January 2016)

2. At what age (months) did you start introducing complementary foods to your child?

Your answer

3. Where do you live?

City, nearest suburb

Village with local hospital

Village, village where there is a first aid station

Village, village where there is no first aid station

4.Which of the main reasons for problems with the introduction of complementary foods can you name?

Lack of experience

Lack of information from medical professionals

Child's health status

Your answer

4.Did you have any problems when introducing complementary foods?

No

Your answer

5.During the introduction of complementary foods, did an allergic reaction appear on the child’s skin?

No

Your answer

6.Which complementary food did you introduce to your child first?

Vegetable puree

Porridge

Meat puree

Cottage cheese

Your answer

7.Did health workers explain to you the tactics for introducing complementary foods?

Yes, the specialist explained it in full

Yes, they explained it formally

Unfortunately, they didn't explain

Your answer

8.Where do YOU ​​get basic information on child nutrition?

Medical workers, nutritionists

Books on nutrition and pediatrics

Articles in medical journals

Media (Internet)

I don't need anyone's advice

Your answer

9.Are you monitoring your child’s tolerance to a new product?

No

Your answer

10.Are you introducing two products into your child’s diet at once for the first time?

Yes

No

Your answer

11. Do you think it is right to start introducing complementary foods when there is a decrease in appetite due to ARVI or teething?

No

Your answer

12. With the late introduction of complementary foods, did the child have a delay in the development of the masticatory apparatus?

No

Your answer

13. Do you add salt or sweeten your child’s food during the first feeding?

No

Your answer

14.How often have you given your child various new foods since the start of complementary feeding?

Every 2-3 weeks

Every 1-2 months

Every 2-4 months

Your answer

15.What should you do if your child categorically refuses to try food?

I will give it in small portions so that the child gets used to it.

I will not give this food to my child again.

Your answer

16.What criteria, in your opinion, indicate that it’s time to introduce complementary foods?

If the child does not finish eating

When I want it myself

Your answer

17.Can you name your mistakes and problems when introducing complementary foods to your child?

No

Your answer

18. Do you think it is acceptable to give your child food (apple, dry food, bread) between feedings?

No

Your answer

19. Do you think that introducing complementary foods too late can lead to:

The appearance of anemia

Delayed physical or neuropsychic development

Loss of food interest

Your answer

20.The ideal solution for the correct introduction of complementary foods is keeping a food diary. Did you lead/are leading him?

No

Your answer

22.According to the latest recommendations of the WHO ESPGHAN Nutrition Committee (2016), the first complementary foods should be introduced no earlier than the 17th week of life and no later than the 26th week of the child’s life. At what age did you introduce your child's first complementary foods?

4-5 months

6-7 months

7-9 months

Your answer

23. Check the correct statements:

It is not recommended to give meat broths to children under 2 years of age.

Semolina porridge is good for a child

If a mother wants her child to be healthy and eat only healthy food, then she should eat it herself

You should start complementary feeding with various vegetables, cereals, meat, fish, cottage cheese, and only then introduce juices into the child’s menu

If an allergic reaction occurs to a certain complementary food product, never introduce it to your child’s menu again.

It is important to recognize differences between children in their developmental readiness to introduce complementary foods and recognize individual patterns in the pace of introduction of different complementary foods

Appendix 9