In this interview with FUNMILAYO AREMU-OLAYEMI, the head of the Nutrition and Dietetics department, FMC, Jabi, Abuja, Cosmas Ugwu, speaks on appropriate nutrition practices for infants and children.
WHAT are the key nutrients that are crucial for the healthy development of babies, and toddlers?
The major nutrients –vitamins and minerals, proteins, and carbohydrates– must be adequate in children’s diets. Parents must make sure their children’s diet is balanced and contains adequate nutrients so that the child can meet the required weight at their age and also help all the vital organs and tissues to develop well. The age range of zero to five years is the normal period for a child’s vital organs to develop. If there is a lack of one or more nutrients, there may be a delay in the development of vital organs, or in the mental development of that child.
Can you explain the importance of breastfeeding and/or formula feeding for infants in their first year of life?
In an ideal situation, there is what we call exclusive breastfeeding, which is between zero to six months. Breast milk contains all the vital nutrients required for the development of the baby. Because of this, mothers need not add any other thing, even water, except if the child is sick and has to take prescribed medications. Breast milk contains all the nutrients the baby needs, especially the first breast milk a mother produces which contains colostrum. This colostrum is rich in secretory immunoglobulin A (IgA) which helps to protect the baby from infection and contains nutrients required for the baby’s development. This is why exclusive breastfeeding is very essential for babies. It helps prevent babies from developing health challenges and provides immunity against diseases. The quantity of water a baby requires is already provided in the breast milk. It contains 70 to 80 per cent water, so there’s no need to give water to babies under exclusive breastfeeding. Despite exclusive breastfeeding, it is recommended to breastfeed babies for up to two years. After six months, parents can introduce solids to their infants but breastfeeding is expected to continue for two years. That is the standard for babies to meet up with healthy growth and development.
On the issue of formula, it will be introduced after six months and that is the type/brand of formula your baby tolerates, because the best one for you, might not be the best for another. There are vital nutrients that are needed and must be present, the level of iron, proteins and others that are required for normal development.
What are the common misconceptions parents have about the introduction of solid foods to babies, and how can these misconceptions be addressed?
Some parents erroneously believe that their babies need water before six months and that breast milk may not contain enough water but as I have explained, breast milk has enough water required for babies. Some people are sometimes confused that breast milk is not enough for the baby, not knowing that it is the method of feeding that makes the baby unsatisfied. If you don’t know how to make your baby latch properly, there will be a challenge and also the mode of feeding. If a mother doesn’t allow the baby to exhaust the first breast before transferring to the second one, what the baby is being fed with is more of water and vitamins. Once the baby urinates, he/she starts crying. But if you exhaust the first breast, the baby gets all the water, fat, vitamins and carbohydrates that will sustain him/her to lie down or sleep for a longer period and get the energy to grow.
After six months, some people will say their babies have refused to take the food that they are introducing, but the challenge there is that many of them don’t do it the right way. They may be giving the child breakfast, lunch and dinner and some babies may not like it that way. Under that condition, parents should feed their babies on demand or play with the child while feeding, do not force-feed. Under that condition, you’ll see that the child will start taking the food and parents should not just concentrate on doing a lot of preparation at a stretch. You introduce foods one by one in a single form. You may introduce blended carrots, for instance, which is very colourful for the first time and study how the child tolerates it, give it a trial for some days before you change it and you can now introduce another food, like pap or fish. Study the child and take note of the food the child tolerates and which one he/she adapts to. Make sure to not confuse the baby with different foods at a time because the child may get confused and start rejecting your offer.
How do you recommend introducing allergenic foods to infants?
The issue of allergy is relative because it may be a result of hormonal problems or in-born error metabolism in that child who has allergies. All children are not born to be the same. If a child happens to have an allergic reaction to a particular food, you ought to remove it. Find out what food causes the allergic reaction and eliminate the food from the baby’s diet.
What role does variety play in a child’s diet, and how can parents ensure their child receives a diverse range of nutrients?
Well, if not because of the economic crunch in the country, we have to go back to nature by combining the simple things we have in the community. But if you’re thinking of exotic foods, most of them are very expensive. So, you can cook eggs, or you can homogenise and blend them into pap to beef up the protein quality of the food. You can make a combination of roasted groundnut, with carrots because of the vitamin A present in carrots, and produce pap, you can introduce rice pap combined with something like cooked liver, if you want it in pap form, it is of good advantage to infants. There are lots of formulations that you can do, even Irish potatoes can be introduced in the form of pap, you can also have blended corn pap, but make sure it is a balanced diet.
Could you provide examples of age-appropriate portion sizes for toddlers and young children?
It depends on the baby’s energy requirements, the weight of the baby at that particular period and the health condition of the baby. There is no way to standardise food portions for babies because a malnourished child in recovery may demand more food. In order not to affect the gastrointestinal tract (GIT), a good dietician would have to calculate the way the child eats, and the quantity of protein the baby is eating so that they develop another adverse effect.
How do you advise parents to handle picky eating behaviours in young children while still ensuring they receive adequate nutrition?
Picky eating in children, most of the time, is supposed to be controlled, especially in children of affluent and wealthy people. It will tend to produce obese children because many of them will prefer sweetened foods to healthy foods. Parents should reduce the quantity of these foods in their children’s diets. They should be cautioned and informed of the dangers.
Minimise the sweetened foods in their diets so that they do not become obese because if they get obese, there is a chance of them becoming diabetic in the long run, it may not appear on time, but in some cases, it may come up as type 2, some may be type 1. This is why macrosomic babies (newborns with excessive birth weight) are likely to become diabetic or hypertensive in life. Those pregnant women who eat haphazardly during pregnancy, it is not advocated for.
How does nutrition during the early years impact children’s health long-term?
Early nutrition has a huge part to play in the health of a child and the child’s lifetime. If a child is abused with food in the early stage of life and the child becomes obese, there is a high tendency to have metabolic syndrome diseases like diabetes and high blood pressure. The only thing that can save that child is having a very good parent who will monitor and manage the child’s eating habits and lifestyle. If this is not in place, the child might have metabolic problems, it could be high blood pressure, high cholesterol, stroke, cardiovascular diseases and the rest of them in the long run. So, early childhood nutrition plays a huge role in the health of an individual. In pregnancy, healthy feeding is advised because if a pregnant woman doesn’t eat healthy, it can affect the baby. If babies are not well fed, from the age of zero to five as you may say, the beta cells of that child may not develop properly and that creates a possibility of the child developing diabetes. So that is why early childhood nutrition is important in health management except in Nigeria where most people do not prioritise nutrition.
What are your recommendations regarding limiting the intake of sugary beverages and processed foods in young children’s diets?
The issue of limiting sugary and processed foods, soft drinks, juices and the rest of them, they have a lot of adverse effects on child development. It induces obesity which can lead to diabetes and high blood pressure and other complications can arise from there. If there were to be a very good road map on nutrition, it would have to be manned and controlled by experts but these things are not found in Nigeria because everybody is politicising and looking for money, even in the health sector, so for that reason, everything is wobbling. There is a need for nutrition and health education to reduce the cost of management of patients in the country. To reduce the standard of suffering, and improve the health and life of the masses. We’re still hoping the government does the needful and recognises the importance of nutrition. A country with a poor nutrition profile is already in a ditch.
Do cultural and socioeconomic factors influence the dietary choices and nutritional status of young children?
A child has no choice but to eat whatever is provided by his/her parents, so, it can affect the nutritional status of children. There are no universal methods and there is no health and nutrition education at the community level. So, it is basically what they have been doing that they will continue to do. But if there is a good nutrition road map as I said earlier, there would be a way to educate people on how to modify certain things they have in their locality. They may have certain food items in their locality but they do not know how to use them for their babies. Some people, based on what they know, feed their babies with only corn pap which is made up of only starch and at the end of the day, the child may develop kwashiorkor or Marasmus. But if there were to be an organised road map on nutrition as it is in advanced countries, there are a lot of things that can be modified. We can decide to modify the groundnut paste with cooked fish, with carrots. Carrot contains pro-vitamin A, fish contains protein, and rice has carbohydrates. These food items contain basic nutrients needed for brain development, so, combine all these things. Many people have these items in their locality but do not know how to combine these things. The cultural stance of the community may affect the nutrition of a child. When you give a baby pap with a little sugar, the end product of both food items is the same thing, there is no vitamin, mineral, or protein, only carbohydrate components.
ALSO READ: APC calls for cancellation of LG poll in Oyo
Source: