Wednesday, January 6, 2010

9 month old.. recently reduced feeding

curiosity is the need of time.. at this age. they will surely join you for lunch and dinner and stay on plate provided they find something interesting. so we just need to learn to divert attention while feeding to something which she can get glued to, like a new toy, a new funny move or just diverting to nature or audivisuals. simultaneusly, we need to see to it that the food bolus with each spoon is as small and as slow as possible and its sticky and uniform. kids at this age spit out dry and nonuniform feeds. they may accept something that may be held in hand and played with it. how about trying some cultet ,pattice, boiled potato or potato flakes or egg yellow.

also she needs to be taught to chew.. rather she needs to be trained over next few months to chew again and again while feeding, indirectly that converts food bolus in smaller part and slows the feeding process.

add variety by adding natural colors of tomato/vegetables/carrot/beet in small amounts. you may need to warm the feed during the same feeding session or redilute it to make it sticky.

till now she was accepting all this out of curiosity.. she is looking for some different feel.

the medical problems that cause reduced intake being commonly adenoids and tonsils at this age.

encourage liberal water drinking. reduce milk. introduce he to kitchen methods.. once you all start eating without pestering her.. sooner she will follow.


TIPS AND TRICKS: LEARN FROM SOME EXAMPLES BELOW:

http://drpeds.blogspot.com/






my daughter has completed 90 days now.she is on breastfeeding. i want to know from when i should start giving her others foods(juice,soups et).what is the schedule and what r the juices or fruits or soups i got to give. can u pls tell ur website if u have regarding this.i have been giving her juice of dry grapes.i would like to know if i can continue and how many should i give.now i have prob with her feeding.her intake is reduced.sometimes she is breast for a sec and turns away and then again. she keeps doing like this.seems her wt is reduced.how can i increase the wt .when she was born she was pink in color and fair,as day gone by she hs got a uneven complexion. her face is fair(brown)when compared to the others parts which r dark.what can i do. is there any oil that ican massage her with before bath. is there any other homemade to increase her color.she keepes rubbing her face at times.she gets restless. she startles most of the time even for a small sound or touch.



Answer: my daughter has completed 90 days now.she is on breastfeeding



.============ she should be exclusively breast feeding till 4-6 months minimum



.i want to know from when i should start giving her others foods(juice,soups et).



======= from 6 months agewhat is the schedule======== 6-8 months liquids, 8-10 months semisolids, 10-12 months solid foods, so that by end of a year child can have a normal diet; half of the plate you can eat.



and what r the juices or fruits or soups i got to give.



===== juices: banana shakes, apple / grape juices, melon juice



===== soups and porridges : with minced pulses / potratoes / atta a/ vegetable extract



can u pls tell ur website if u have regarding this



.=========== well some info you may be able to find at http://drpeds.blogspot.com, you may need to search on different pages.



i have been giving her juice of dry grapes.i would like to know if i can continue and how many should i give.



========= start only after 4-6 months, 1-2 ounz per feed 3-4 times a day alternating with normal feed / breast / other diet. prefer a variety. avoid monotony. use combinations. preferably avoid adding sugar and excess water to juice.



now i have prob with her feeding.her intake is reduced.



======== to be worried only when weight is falling!



sometimes she is breast for a sec and turns away and then again. she keeps doing like this



.============= may be she is gaining new milestones,; but also rule out any illness like heart related problems by a pediatric check up.



seems her wt is reduced.how can i increase the wt .



==== please check her weight, plot it over 4 weeks every weekly, check with standard available charts on web CDC website as growth charts. If you document less than 3 kg, or a weight loss at 90 day age; your child may need evaluation.



when she was born she was pink in color and fair,as day gone by she hs got a uneven complexion. her face is fair(brown)when compared to the others parts which r dark.



========= sometimes oil can also cause such colour change; but for safety get checked by your child specialist to rule out any problems of oxygenation.



what can i do. is there any oil that ican massage her with before bath. is there any other homemade to increase her color.



======== prferably avoid; let the time take care.she keepes rubbing her face at times.she gets restless.=== commonly with a nose block or cold, needs a check by doctor.



she startles most of the time even for a small sound or touch.



==== many times its normal, but if you find its unusually present even for soft sounds she may need evaluation for some uncommon illness which your doctor may tell ( like Tay Sach Disease).



=====================================







my baby is 1 year old. She completed one year on 4th March 2006. I need your help to give her healthy diet.

In the morning I used to give her milk and biscuits but now she refuses to take. I give her formula milk, 3 feeds one in the morning, afternoon and at night (150 ml) per feed. She also eat small qty rice, bannanas etc. She got two teeths.

Pl. suggest healthy food for by baby. Now her weight is 9.7 Kgs.

Thanks,

xxxxxxxxx

follow some basic principles given here:











so for these 150 calories: you can distribute over different items



vegetable usually contain less calories but more of nutrients



pulses contain more proteins cereals and



fruits contain more carbohydrates.



oils and fats and some pulses contain good fats.



a good feed includes around 60-70% cereals, 15-20% pulses and 10-15% fat.



on an avaerage



100 g cereal = 150 cal



100 g pulses = 100 cal



1 ml oil = 9 calories



banana and egg are high calorie and in addition egg is a high quality protein.



CONFUSED?



.............Thats what your normal diet must be!



so for 10 kg or 1 year child, he should be eating half of a diet of an adult.



so he should be taking something closer to



1/2 wati rice-pulse twice a day1



/2 bread twice a day



2 milk feeds twice a day



,with one or half serving of banana and other fruit Juice / soups !



that should be ok!



dont be strict, give your baby some liberty to what he takes.



As long as his weight is normal for age, he must be doing / eating Ok for age !





MILK REQUIREMENT DECREASES AFTER FIRST YEAR OF AGE.





MILK ISNT THE ONLY DIET FOR KIDZ MORE THAN 6 MONTHS AGE.





BISCUITS WITH MILK SEEMS TO BE AN EASY DIET, BUT MAY HAVE ITS OWN PROBLEMS.





FORMULA MILK IF NOT GIVEN PROPERLY MAY HAVE ITS CONSEQUENCES.





ITS IMPORTANT TO WEAN THE CHILD FROM MILK, YES EVEN COWS MILK AND FORMULA MILK AND FEEDS... AS THE BABY IS NOW 1 YR OLD.





NEED FOR DIFFERENT NUTRIENTS AND CALORIE INCREASES TREMENDOUSLY AS BABY IS NOW MORE ACTIVE AND RUNNING AROUND; AND BABY IS NOW CAPABLE OF CHEWING SOLIDS AND SEMISOLIDS.





DONT YOU COOK NORMAL DIET FOR YOURSELF?





EATING CAPACITY OF A 1 YR OLD CHILD IS AS GOOD AS HALF OF YOURS. IF THE BABY DOESNT GET PROPER QUANTITY, ITS MORE LIKELY THAT BABY MAY GET MALNOURISHED... AND MAY BE VITAMIN DEFICIENT.





SO WHAT SHOULD YOU DO?





USE THE SAME DIET ITEMS AS YOU DO.





INTRODUCE A NEW FOOD SLOWLY IN SMALL QUANTITY, AS SMALL AS PINCH , MAY BE EVEN ONCE A DAY.. BUT ALMOST EVERY DAY.





LET THE CHILD GET USED TO THE TASTE.





THEN GRADUALLY INCREASE THE AMOUNT AND DURATION OVER A WEK OR TWO SO THAT BY END OF MONTH HE IS TAKING THAT FOOD LIBERALLY.





SO, THIS WAY INTRODUCE A VARIETY IN DIET.





NOW WHATS THE REQUIREMENT OF A 1 YR OLD KID?





IT IS ALMOST 1000 CALORIES PER DAY.





HERE IS A SCHEDULE FOR EXAMPLE:





BREAK FAST:





100ML MILK 8 AM = 70 CAL





WITH 1 BREAD = 100 CAL





SMALL MEAL =





VEG SOUP THICK = 60 CAL





HALF ROTI = 50 CAL





HALF WATI RICE WITH DAL = 100 CAL





LUNCH =





HALF GHEE ROTI = 80 CAL





HALF WATI RICE WITH DAL /VEG = 100 CAL





EVENING SNACK =







FRUIT SALAD SMALL BOWL = 50 CAL





MILK 50 ML WITH SUGAR = 100 CAL



DINNER:







HALF GHEE ROTI = 80 CAL





HALF WATI RICE WITH DAL /VEG = 100 CAL





100 ML MILK 8 PM = 70 CAL





HALF BANANA 50 CAL





THIS IS JUST A GUIDELINE, DONT BE SURPRISED BY THE NUMBER OF TIMES THIS KID WILL ASK FOR FOOD.





SAME FOOD QUOTA CAN BE DIVIDED TO FEED OVER 1-3 HOURS RATHER THAN INSISTING HIM TO FINISH ALL IN AN HR.





THIS IS OFCOURSE ONCE THE CHILD HAS BEEN SUCCESSFULLY INTRODUCED TO THESE DIET ITEMS.

ONE CAN SEEK FOR MORE VARIETY.









=== well from beets, carrots , spinach,potato and anyother veegetable you eat can be easily minced or mashed or juiced or souped to give. it adds colour consistency and flavour to routine diet apart from giving minerals, fibre and supplements.



also,can i add badam in his diet?



======== although not a must, half a day wont harm. do give adequate water with it. and also donot give large pieces that she cant chew. give powder or mix in juice or milk.



if so, in what form?



======= powdered or paste.in what form,



iron can be added in his diet?



======== best way is to add green vegetable soups, but even iron supplements will do. some salt/cornflake preparations are also iron fortified.



can u suggest sample diet for guide.



======



2 wati cereals in morning with half wati water. with half banana.



half of a mashed potato with salt, with khichri/ porridge or



kheer 1 wati with one banana.



add curds and ghee liberal as per taste.



give some pieces of bread or chapati to chew.



sheera or light rava upma in evening with or without a health drink milk or like.



2 wati cereal like dahi rice or dal rice or ghee rice with tomato soup or small ragi kheer,



or egg burji or half fry may be easily acceptable.



a similar diet is displayed somewhere on my website.



if any problems please write back. sometimes you may reduce the speed and give feed more often. in cough, cold, children prefer warm and liquid feeds.





feeding alow weight child?



considering your kid about 10 kg as expected at 1 year age, his calorie requirement should be around 1000 cal per day with protein requirement upto 8 gm/day,



7.8 Kg although is a lower weight for 1 year age as per growth charts, it can be easily improved with diet modifications if the child doesnt suffer from any other health element.



Yet his diet modification aim should be to achieve 1000 cal per day over 2 months.



remember 2 principles for good diet intake at this age:





1.give more palatable feeds with variety.





2. feed in small quantity but more frequently.





children at this age have two important reasons for slow weight gain



1. frequent throat infections



2. increased activity





You have added enough variety of feeds, thats a good sign that your child shows acceptance to variety.





weight loss is seen only when diet is less or lacking in calorie , that is = it is the quantitative defect hence can be easily adjusted







your kid takes: formula 120-150ml +some fruits +soups 1chapati +kheer rice +with moong dal+200mlequal to to around 600-700 cal per day.





did u notice that you are feeding your kid only 5-6 times a day when they need to be offered some or other food every 3 hourly.





you did not specify quantity of kheer erc, on an average a feed should contain 100 - 150 ml per feed.





if the child refuses feed, he may need a burp or break and then retry feed after some time.





you may enrich your feeds with calories by using ghee, oil, curds.





Making feeds thicker. making daal thicker. adding sago or soya in addition to naachani. fruits should be easily palatable..





banana are best accepted. so do potatoes and tomatoes pulp to satisfy his chewing desires.





keeping a kheer cup handy to the child at home always improves frequency of feeds.





avoid unnecessary milk, as the current market milks hardly have nutritious elements , rather-- improve diet.





Let me suggets adding one wati sago in morning, reducing the formula quantity to half; and adding a banana at night with breaks.



and may be we will reasses your situation after a month for weight gain.





per feed quantity should not exceed weight into 15ml over 2 hours. feed slowly. in sitting posture.





respect the child when he refuses feeds.



check for full tummy or need to burp. maintain activity during / while feeding that will permit more intake.you may add khichri instead of dal rice, mash the feeds to improve acceptability.





get back to me if any further queries.when diet fails.. calorie and protein rich concentrated protein supplements may help . but not to be recommended as routine.









for a 9 kg child her daily intake of calories should bE around 900 calon an average, a good feed if preapared as per instructions contains around 100 calories per 100 ml, a full meal for a child of 9 kg will be around150 calories 6 times a day.

thanks dr,your suggestions are valuable to me as even i have a 1 yr old son. i was worried whether i am giving him diet enough to fulfill his requirements.his diet matches with the schedule given by you,only a bit of difference.thank again.

Tuesday, November 07, 2006 12:41:00 AM