The Complementary Feeding Challenge

Ma'am, let's start with the transition itself.

Why is the period when a child moves from exclusive breastfeeding to complementary food such an important nutritional window? What is actually happening in a child's nutritional needs around six months that makes this transition so critical?

Thank you for asking that, Shreya.

I think it's very, very important to put things in perspective.

And for that, let me start with a statistic, something which will blow our minds, uh, especially those who do not do this on a daily basis.

Do you know how many kids are born in India per hour? There are 3,000 kids.

Every hour, we are producing 3,000 kids in India.

That's about 27 million babies per year.

That's a huge cohort of these young sort of lives which, uh, require very important nutritional, um, needs, uh, to be fulfilled and then convert to productive, optimal, uh, citizens in some ways.

And at any time, this cohort of over 50 million children under two years old is, uh, therefore very dependent on the caregivers' feeding practices.

The UNICEF report which came out in 2021, which was titled "Fed to Fail," also emphasized that children require higher nutrition per kilogram of body weight between six months and two years than any other life stage.

So therefore, complementary feeding becomes so, so critical at this particular point in time.

Around six months, which is at 180 days, roughly, breast milk alone cannot keep up, you know, with the body's, uh, rapidly growing needs, surging energy and nutrient demands.

And therefore, it's very important to add appropriate foods, which are also called complementary feeding, uh, therefore.

Not stopping the breast milk.

WHO advises that we should continue till at least two years, uh, because that continues to provide vital immune protection and nutrients.

Uh, rapidly growing infants actually face critical gaps in iron, zinc, vitamin B12 if the diets are solely relying on thin staple cereals, which is often the case in an, in Indian scenarios.

Um, according to the NFHS 6 data, in fact, ala- only about 15% of our kids were between six and 23 months were getting an adequate diet.

Uh, this looks like a English term, but it's also very scientific because it's made up of two things, which is the frequency and the diversity.

If the frequency, the number of times the child is fed, and the diversity the, uh, you know, parents or caregivers introduce for the child, those two are very, very important, and that becomes MAD, which is minimum adequate diet.

Okay? So that MAD statistic is only 15%, so 85 out of 100 kids are not getting that.

So that's again huge, um, in terms of highlighting that missing this window directly leads to irreversible growth faltering, stunting, and wasting.

Uh, there are several guidelines, our own Indian guidelines, as well as WHO, which emphasize that introducing diverse nutrient-dense foods, especially like eggs, dairy, local mashed family foods, right from six months onwards prevents chronic malnutrition and also supports rapid brain development.

There have been positive significant relationships which are found between diet quality and cognitive development, uh, between minimum dietary diversity Uh, and l-lower risk of developmental delays, about 39% in fact, uh, lower risk of developmental de-delays if you are meeting the minimum dietary diversity.

And in Nepal, a study from Nepal also showed that additional-- each additional day of consuming at least four food groups was associated with 33% reduction in the odds of a, you know, a low score, um, in mental and motor score for, for small babies.