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Feeding young children can be an intense and emotional experience for both, the parent and the child.
It is the ability achieved by a child by a certain age.
What is a Developmental Milestone?
Prenatal (Weeks' gestation) Birth Postnatal (months after birth) 15 Chymotrypsin Trypsin 20 25 30 35 40 3 6 9 12 24 Carboxypeptidase B Enterokinase Pancreatic amylase — — Salivary amylase Pancreatic lipase Gastric and lingual lipases Percentages refer to childhood enzyme levels 6000 250/ 170/ 100/
Role of Digestive Enzymes & Saliva on Feeding
Role of Oro- facial Development in Feeding
6 10-12 Indicative age (mo) Oral cavity Teeth 18 Oral cavity size increasing 24 Larynx lowering Pharynx elongation Incisors MLSe and bone development First molars 36 Sa20nd molars rmanenth Canines
Vertical movement Backward-forward movement Tongue Vertical movement Mandibule Control of the food bolus in the mouth La teralmovement Diagonal movement Closed for keeping food bolus in the mouth Spoon puree removing Circular rotary movement Lips Feeding skills Propulsion I retropropulsion Streching - Nipple Aspiration: Intense activity Suckling-Swallowing Munching Sucking Grasping-Biting
Age-related taste preferences
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5 – 6 months – Bitter/ strong tastes when first introduced at this age lead to a refusal as it is considered toxic/ dangerous 18 months – Reject salt water and accept salt in table foods. (Delaney & Arvedson , 2008)
CRITICAL PERIODS FOR TASTE PREFERENCES
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Suck reflex integrates Runny purees Rooting reflex integrates Tongue thrust reduces Hard munchables Bite and dissolve Tongue laterilisation Soft finger foods/ solid foods Graded bite Integration of phasic bite and tongue lateralisation Mixed textures Phasic bite pattern and Jaw stability increases Thick purees/ mashed
Role of Oral Motor Readiness in Texture Progression
At around 6 months
At around 12 months
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Age-related Texture Preferences
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In- utero to Birth
6-7 months
4-6 months
7-10 months
10 -12 months
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12 months
Age of Infant By Month Age Grouping %quence of Introducing FOMis Texture of Complementary Ws Fæiing Style 5 6 11 12 Birth through 3 months Breast milk or Infant Formula Breastfeeding/ 4 months through 6 months Complementa Strained/ pureed e Feeding c 6 months through 8 months fM)ds thin consistency for c 8 months through 12 months Mas ed Ground/ Finely Chopp„ed n Feeding Feeding Self Feedinv Feeding Finger Foods
Complementary Food Recommendations as per the Texture and Feeding Style Readiness
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HUNGER SIGNALS
SATIETY SIGNALS
Appetite Regulation During the Child’s Growth
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BIRTH TO 2 YEARS
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Appropriate Feed Up to 6 Months
Ideally, a baby should receive the first breastfeed within the first hour of birth. No other fluid or food items like honey, ghutti, animal milk, tea, water or glucose water should be given to the newborn.
Infants should be exclusively breastfed for the first six months to achieve optimal growth, development and health. (WHO, 2002)
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Additional complementary feeding should be initiated by 6 months of age.
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Appropriate Feed For 6-9 Months
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Breastfeeding should be continued.
Thick porridge made of maize, cassava, millets, to which milk, soy, groundnuts, sugar, jaggery or ghee can be added Mixtures of pureed foods made from potatoes, cassava, posho (maize or millet), rice, mixed with fish, beans or pounded groundnuts. Addition of green vegetables would allow consumption of nutritious foods. Commercially prepared infant foods/formulae
Appropriate Feed For 6-9 Months
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Appropriate Feed for 10-12 Months
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APPROPRIATE FEED FOR 12 – 24 MONTHS
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Appropriate Feed For 12-24 Months
Practical Guidelines on the Quality, Frequency, and Amount of Food to Offer Children of Age 6–23 Months
Age Energy needed per day in addition to breast milk Texture Frequency Amount of food an average child will usually eat at each meal 6-8 months 200 kcal per day Start with thick porridge, well-mashed foods. Continue with mashed family foods. 2-3 meals per day. Depending on the child’s appetite, 1-2 snacks may be offered. Start with 2-3 tablespoons per feed, increasing gradually to ½ of 250-ml cup 9-11 months 300 kcal per day Finely chopped or mashed foods and foods that baby can pick up 3-4 meals per day. Depending on the child’s appetite, 1-2 snacks may be offered. ½ of a 250-ml cup/ bowl 12-23 months 550 kcal per day Family foods, chopped or mashed if necessary 3-4 meals per day. Depending on the child’s appetite, 1-2 snacks may be offered. ¼ to full 250-ml cup/ bowl
Feeding in Special Scenarios Maternal Factors
CONDITIONS IN WHICH BREASTFEEDING CAN BE CONTINUED CONDITIONS THAT WARRANT TEMPORARY CESSATION OF BREAST FEEDING CONDITIONS IN WHICH BREASTFEEDING IS CONTRAINDICATED
(Infant and Young Child Feeding Guidelines, IAP, 2016)
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