Optimizing the introduction of complementary foods in the infant's diet: a unique challenge in developing countries.

Being one of a series of technical support papers pertaining to the South African paediatric food-based dietary guidelines, this paper specifically deals with two of the guidelines proposed for the age group 6-12 months regarding the introduction of complementary foods in the infant's diet. Studies have shown that most of South African infants receive solid foods at the age of 4 months or earlier while only a small percentage are breastfed exclusively until 6 months. The untimely and inappropriate introduction of complementary foods have been shown to be risk factors for both under- and over-nutrition with resultant under- or overweight, stunting and micronutrient deficiencies. Optimal timing for the introduction of complementary foods will depend on the infant's physiological and developmental status. Small, frequent meals of easily digestable, smooth, semisolid nutrient- and energy-dense complementary foods should initially be offered while gradually increasing variety in both the type and texture of food. Protein and carbohydrate intake should increase with the infant's age while preference should be given to foods rich in micronutrients. It should be observed that certain foods, such as fresh cow's milk and egg white, because of their allergenic properties, as well as fat-free and high-fibre foods, excessive fruit juice and low nutrient value drinks such as tea are not recommended. Timely introduction of appropriate complementary foods is vital for the immediate and long-term health of the infant and caregivers should be accordingly advised on feeding at this age.

Feeding the 1 to 7-year-old child. A support paper for the South African paediatric food-based dietary guidelines.

Young children embark on a transitional nutritional journey, progressing from total reliance on caregivers to independence, autonomy and self-determination. Appropriate nutritional intake in young children is a diverse concept, incorporating suitable nutritional choices and feeding behaviours. Lessons learnt in childhood will have long-term effects on the individual and society overall. Since South African children are raised in a country where under- and over-nutrition exist simultaneously, a careful balance should be achieved in any national public health message. The South African paediatric food-based dietary guidelines for children younger than 7 years strive to facilitate the education of carers of young children in the adoption of healthy eating practices. The guidelines address issues regarding variety in the diet that has been shown to improve both micro- and macronutrient intakes. Specific reference is made to starchy foods, vegetables, fruit and water along with protein sources, which should be consumed regularly. Milk, has been emphasised in these guidelines because of the poor calcium intake in South African children. The only guideline that limits intake is the sweet treats or drinks message, because of public health concerns such as obesity and dental caries. Other messages pertaining to eating habits take cognisance of the child's physiological limitations in gastric capacity and suggest small regular meals. Clean, safe drinking water is the beverage of choice. Non-food-based guidelines are also included, which recognize the importance of active play, for developmental and health purposes, as well as regular clinic attendance.