Weaning advise

WEANING What is weaning? Weaning your baby from the breast or the bottle starts from about 4-6 months. From about 4-6 months old, your baby needs more iron and other nutrients like Vitamin D and Vitamin C that milk alone cannot give. The idea of weaning is the process of gradual introduction to a wide range of 'non milk' foods so that by age of one, your baby will be joining in family meals. When do I start weaning? Weaning is a transition form breast milk or formula milk to solid foods. It is divided into the following stages: • Stage 1: Babies are usually ready to start on solid foods between 4-6 months. • Stage 2: 6-9 months. • Stage 3: 9-12 months. Begin with smooth textures, mashed, minced, chopped, finger foods and finally family foods. From 4-6 months: During the first couple of weeks of weaning, your baby needs to learn that foods have different textures and taste, and that it doesn't come in continuous flow. You can start off with: • Baby should be still having 600ml of breast or infant formula milk daily. • Starchy foods: Initially cereal is used such as baby rice or sago (sabudana). • Mashed, pureed, starchy vegetables are also suitable e.g.- potato, carrot, sweet potato, yam (suran). Try combining some of these foods together. • Vegetables and fruits: soft cooked pureed vegetables and fruits are suitable e.g.: apple, banana, pear, mango and chickoo. (Do not add sugar) • Non fibrous vegetables e.g. cauliflower, pureed spinach, lauki (bottle gourd, dudhi) Remember: 1. The aim is to get the baby used to taking food from a spoon-Start with teaspoonful (quantities will be small) and milk will still be major sources of nutrients) 2. Foods should be not be salted or sweetened. 3. Don't press food on your baby-If the food doesn't seem to be wanted, wait and try again another day. 4. To try the food after a milk feed or in the middle of one 5. If food is hot, you make sure you stir it and test it again From 6-9 months: Gradually increase amount of food you give either before or after milk feed. • Continue 500-600ml breast or infant formula milk • Dairy products: Cow's milk may be used to mix solids. Cheese may be given as finger foods. • Starchy foods-2-3 servings daily: introduce wheat based cereals- khichri (gruel of rice and pulses) -sooji halwa/porridge -nachni mixed with milk (porridge). • Vegetables: 2 servings Raw soft fruits and vegetables may be given as finger foods e.g. -soft cooked strips of carrot, Cooked green beans, soft banana and pear, Apple stew, Spinach and tomato soup. Other cooked vegetables and fruits may now be coarser in texture. • Meat and alternatives- 1 serving. Meat, fish, pulses may be coarsely pureed. Chopped hard cooked egg may be used as finger foods. Remember: 1. Introduce lumpy foods by 6-7 months 2. Introduce feeding from the cup. 3. Encourage different textures and stronger tastes. 4. Food should not be salted or sweetened 5. Encourage a savoury preference to sweet Some meals to try: Breakfast: porridge of rice or suji (rava) or nachni or dahlia or mashed banana Lunch: minced chicken with vegetables and potato or khichri (gruel of rice and dal with vegetables and potato) or soft ripe peeled pear or apple. Dinner: mashed boiled sweet potato with carrots with cauliflower. 9-12 months: • Continue 500-600ml-breast milk or infant milk formula daily. • Dairy products: To continue to use cows milk to mix with solids. Hard cheese used as finger foods. • Starchy foods: 3-4 servings daily May be normal adult texture. • Vegetables and fruits: 3-4 servings Encourage lightly cooked or raw foods. Chopped or finger foods is suitable, e.g. pear, apple, chickoo, banana and melon. • Meat and alternatives: to try mixture of different vegetables and starchy foods, dal and rice or rice and chicken or rice cheese. Remember: - Encourage self-feeding. Some meals to try: Breakfast: • Nachni khir • Rice khir • Sooji halwa/upma • Boiled egg and bread finger • Stewed apple with curd/yoghurt • Mashed banana with milk Lunch: • Khichri • Spinach curry or spinach and tomato soup • Mashed rice with yoghurt/curds • Mixed seasonal vegetables soup (carrot, spinach, tomato, lauki (bottle gourd/dudhi) and potato • Stewed fruits with custard. Dinner: • Same as for lunch After 1 year: Minimum of 350 ml milk daily or 2 servings of dairy products e.g. curd, paneer. • Dairy products: Whole cows milk may be now used as a drink. • Starchy foods: minimum 4 servings daily. • Vegetable and fruits: minimum 4 servings daily Remember: Your child may now take almost all that you cook for your regular meals. Hints for successful weaning: • Allow plenty of time for feeding, particularly at first. • Choose time of the day when you both are relaxed. • Start with small amounts of food and more frequently • Introduce new foods mixed with familiar foods • Try not to get upset if your baby refuses food. Take the food away and try again later. Go at your baby's pace.

Premature babies

Born Too Soon.. Babies born before the 37th week of gestation are considered premature and are sometimes referred to as “Preemies” (more than 3 weeks before the "due date").More than 1 in 10 babies are born preterm, affecting families all around the world. 15 million babies are born premature every year. Over 1 million children die each year due to complications of preterm birth. Many survivors face a lifetime of disability. Sub-categories of preterm birth, based on weeks of gestational age: Extremely preterm (<28 weeks) Very preterm (28 to <32 weeks) Moderate to late preterm (32 to <37 weeks) Late preterm (35 and 37 weeks) Causes Often, the cause of preterm labor is unknown. About 15% of all premature births are multiple pregnancies (twins, triplets, etc.). Health conditions in the mother, such as diabetes, heart disease, and kidney disease, may contribute to preterm labor. Symptoms and signs- The infant may have trouble breathing, feeding and keeping a constant body temperature. A premature infant may have signs of the following problems: • Neonatal respiratory distress syndrome due to surfactant deficiency in lungs • Newborn jaundice • Anemia • Bleeding into the brain or damage to the brain's white matter • Infection • Low blood sugar • Patent ductus arteriosis • Severe intestinal inflammation (necrotizing enterocolitis) Why do premature newborns need special care? Premature babies have underdeveloped parts that include the lungs, digestive system, immune system and skin. Thankfully, medical technology has made it possible for preemies to survive until they are strong enough to make it on their own. This may take weeks to months depending severity of baby’s prematurity. Treatment When premature labor develops and cannot be stopped, the mother may be moved to a center that has set up to care for premature infants in a neonatal intensive care unit (NICU). After birth, the baby is admitted to a NICU. The infant is placed under a warmer or in an incubator. Monitoring machines track the baby's breathing, heart rate, and level of oxygen in the blood. The baby may need support for breathing on ventilator or CPAP machine. Premature babies may also need intravenous nutrition and antibiotics to fight infection. The baby may have a feeding tube placed through the nose or mouth into the stomach. Once the baby’s respiratory system is stabilized it can begin breastfeeding. Most babies born 35-37 weeks can go straight to breastfeeding. Infants need special nursery care until they are able to breathe without extra support, eat by mouth, and maintain body temperature and body weight. What is Kangaroo Care? Kangaroo care is a technique where the premature baby is placed in an upright position on its mother’s bare chest allowing skin to skin contact. Kangaroo care has been shown to help premature newborns with maintaining body temperature and gaining weight. It also improves breastfeeding and increases intimacy & bonding between baby and mother. Outlook (Prognosis) The survival rate depends on the quality of NICU care available. Sevenhills Hospital offers tertiary level Neonatal care for babies born in the hospital and surrounding areas. The more premature an infant and the smaller the birth weight, the greater the risk of complications. Possible Complications- • Chronic Lung disease(BPD) • Growth and development delay or disability • Retinopathy of prematurity, vision abnormalities Prevention The best ways to prevent prematurity are to: • Be in good health before getting pregnant • Get prenatal care as early as possible in the pregnancy • Continue to get prenatal care until the baby is born Premature labor can sometimes be treated or delayed by a medication that blocks uterine contractions. Betamethasone (a steroid medication) given to mothers in premature labor can make some prematurity complications less severe.