Child nutrition

Good nutrition during the first few years of a child’s life helps to protect against illness and is crucial for good growth and development.

Communities have an important role to play in supporting the nutrition of mothers and their infants. This includes recognising the need for pregnant mothers to rest, eat a variety of nutritious food and drink plenty of safe water. 

Once the baby is born, new mothers need to continue to rest and eat well, and they may need additional help as they learn how to breastfeed their baby. Support groups for new parents can be helpful, as well as peer-to-peer advice and home visits by local midwives or community health volunteers.

In emergency or conflict situations, providing safe, private spaces for mothers to breastfeed can help them continue to feed their babies without worrying about what is happening around them. These can also be spaces where mothers can talk about their worries, helping to protect the health and wellbeing of both themselves and their children. 

Breastfeeding

Breastmilk is the best food for babies. It is safe and clean, and it provides all the energy and nutrients that a baby needs for the first few months of life. 

Breastmilk helps babies to develop strong immune systems. As a baby comes into contact with different diseases, saliva from the baby causes the mother’s body to produce very specific antibodies in her milk. These antibodies provide protection against disease and help the baby to recover when they become unwell.

Mothers often worry about whether they can make enough milk. However, the more their baby feeds, the more milk is produced, so babies should feed as often as they like – both day and night. This is especially important in the first few days after birth.

The World Health Organization recommends:

• skin-to-skin contact between mother and baby immediately after birth and initiation of breastfeeding within an hour of birth
• exclusive, on-demand breastfeeding for the first six months. This means letting the baby feed as often as they want and not giving them anything else to eat or drink, unless medically necessary
• introduction of nutritionally balanced, safe solid foods at six months, together with continued breastfeeding up to two years of age or beyond. 

Antiretroviral drugs mean that mothers with HIV can breastfeed their babies until at least 12 months of age with very low risk of HIV transmission.

Alternatives

If the mother is not able to breastfeed, or has passed away, a relative or friend can breastfeed the baby instead. Any woman of child-bearing age can start breastfeeding or increase current milk supply by taking a baby to her breast. In many communities there will be people who have experience of doing this who can provide advice. 

If formula milk is the only option:

• wash hands with soap and water and ensure that all feeding items, such as cups, are very clean
• use formula that is in date and suitable for the age of the baby
• follow the instructions on the container very carefully
• use boiled, safe water and then allow the milk to cool to body temperature before feeding
• keep the container tightly closed to avoid contamination
• use a cup rather than a bottle: bottles and feeding nipples are very difficult to clean properly
• only prepare as much formula as you need for each feed and use it within one hour.

Complementary feeding

At about six months of age, a baby’s need for energy and nutrients begins to exceed what is provided by breastmilk, and complementary foods are needed to meet those needs. 

Key principles:

• Continue frequent, on-demand breastfeeding until two years of age or beyond.
• From six months, offer small amounts of soft, local food such as mashed fruits and vegetables, several times a day.
• Between six and nine months, gradually increase the quantity and variety of foods, avoiding salt, spice, or bones that can cause choking.
• Gently encourage the child to eat, but do not force them, and allow them to start feeding themselves when they want to.
• During illness increase fluid intake, including breastmilk, and offer soft, favourite foods.
• Offer plenty of safe water to drink.
• Wash hands frequently and make sure all feeding utensils are clean.
• When the baby is one year old they can start eating the same food as the rest of the household, alongside breastfeeding.