Planned Nutrition

A dietary prescription for babies and children

By Lucio Victor Jr.

Dr. Brian Wharton, director general of the British Nutrition Foundation once remarked: "Food is essential for all reproductive processes from the formation of gametes through delivery of a healthy baby at term, and to his health in childhood and adult life." Clearly, the proper nutrition Dr. Wharton imposes is one that is "not of excess or deficiency."

    But for a fast growing baby, what will be the appropriate diet and at what stage of the development?

     In most cases, recommendations are mainly based on anthropometric measurements like weight, height, and head circumference. Although recommendations usually come hand in hand with certain breakthroughs in research, more attention is being paid at the moment to the growth and functional outcomes of the breastfed infant as the standard.

    Dr. Jean Rey, neonatologist at the Department of Pediatrics at the Hospital "Enfants Malades" in Paris notes a marked decline in breastfeeding in most parts of the world since the 1960s. Although he admits that there recently has been an upswing in the practice, many mothers usually stop breastfeeding and shift their infants to a follow-on formula at six months .

    In Western Europe in 1975, Dr. Bertil Lindquist of the European Society of Pediatirc Gastroenterology and Nutrition (ESPGAN) coined the term "follow-on formula" to describe a formula that forms part of a mixed feeding scheme intended for babies at four to six months of age. In Europe, follow-on formulas are popularly used from four or six months up to 12 months before the babies are shifted to a ready-to-feed formula intended for older children (one to three years old).

    The Philippine Society of Pediatric Gastroenterology and Nutrition's Dietary Prescription: Food Pyramid Guide for Filipino Infants and Children was developed to help caregivers provide healthy diets for children of all ages.

    The guidelines encourage breastfeeding eight to 12 times per day for newborns, at an interval of two to three hours, or as the baby becomes hungry. Complementary feeding is introduced ideally at six months. Water, rice gruel, mashed fruits and vegetables, eggs, meats, and other protein sources like legumes and soybean curd (taho) are slowly initiated into the baby's palate.

    The recommendations suggest maintaining a healthy range for each recommended food group, increasing their amounts as the child grows.

    Water for instance should be no more than one cup at six months, then increased to two cups at nine months and to three cups at one year. Breast-feeding, on the other hand, may be reduced to six to eight times a day at six months to one year if it is supplemented with a standard infant milk or follow-on formula of three to four cups per day. This will ensure that the baby gets enough hydration without giving more water than necessary.

    Semisolid foods like rice gruel (lugaw), mashed potatoes or root crops, and cereals are introduced gradually. At six months, a baby can have one-half cup of rice gruel per day or half a potato (mashed) twice a week. At nine months, a baby can have two cups of rice gruel per day or one piece mashed potato twice a week.

    Mashed fresh fruits or cooked vegetables (about five tablespoons per day) may also be added to the diet beginning at six months, and increased to six tablespoons per day at nine months and to eight tablespoons at one year. One-half cooked egg yolk may be added to the diet thrice a week at six months, and increased to one egg yolk thrice a week at nine months. Cooked beans or taho (one-fourth cup) may be given thrice a week at six months, and increased to one-half cup twice-weekly at nine months.

    Fish, pork, beef, and chicken must be well cooked and minced or flaked. Two tablespoons may be given beginning at six months, three at nine months, four at one year. Butter, margarine, fats and oils should be kept at one to two teaspoons per day at six to eight months, then increased to two to three at nine months and five at one year.

    At two years of age, babies may be shifted to follow-on or growing-up formulas or whole cow's milk if they are not hypersensitive. Two cups will be enough per day.

    Since the child can now tolerate solid foods, three cups of rice per day or one piece of cooked root crop thrice weekly may be added to the diet. Other sources of carbohydrates like bread, noodles (fresh noodles or pasta) and cereals are highly encouraged at one year.

    One-year-olds may be given one-and-a-half pieces or two regular slices of fresh fruits and three-fourths cup of cooked vegetables daily.

    The guidelines discourage consumption of high-sodium, high-calorie, high-carbohydrate junk foods like chips and instant noodles. Dr. Rebecca-Abiog Castro, former president of the PSPGN stresses that giving children the right food in the right amounts at the right time will ensure good health (MEDICAL OBSERVER, Sept. 2000).

    The PSPGN hopes that the Food Pyramid Guide will help bring forth a healthier nation.