Fuelling underweight children


  • Health
  • Sunday, 19 Jan 2003

BY REKHA NAIDU

A child needs plenty of energy to grow and develop healthily.Cereals (carbohydrates) like wheat or oats and foods containing protein can be introduced from eight to 10 months during the 'weaning' period  

BABIES not putting on enough weight is a concern to many parents, but usually in most instances, it is not a major problem. In the United Kingdom, underweight babies represent 2% to 5% of the population and affects all socio-economic groups and cultures.  

Normally, a baby or child is underweight due to insufficient energy, which is commonly seen in the first two years, but this can be rectified in most cases by giving additional energy in the form of extra glucose, glucose polymer, or additional supplements in food. 

Unfortunately with the concerns about obesity, it is sometimes forgotten that glucose is the primary fuel used by most cells and is essential for the functioning of the human body. It is the smallest unit that comes from the breakdown of the carbohydrate group of foods that include rice, bread, fruits, chocolates, etc. 

What does it mean 

Usually, birth weight and length are important factors used to monitor the development of a baby. Doctors and clinics normally use height and weight percentile to assess the progress of a baby. Hence, always check with your doctor or health clinic nurse if you are concerned about the growth of your child. 

Growth and body composition 

During the first year of life, a normal infant triples his/her weight and doubles in length. Refer to the chart to determine your baby’s growth. Height and weight are proportionate to the baby’s birth measurements. 

According to the UK experts 

Weight faltering means that a baby’s weight is not proportionate to his/her height and there is a low weight for height, or that a baby may have been born with a low birth weight and is not able to increase his/her weight.  

The root cause of faltering growth is attributed to inadequate calorie intake and a number of factors may be associated with this. 

·Inadequate content or frequency of meals. 

·Interaction difficulties between parents/carers/maids and children at meal times. 

·Oral-motor dysfunction such as difficulty chewing or swallowing food or drinks. 

·Developmental difficulties. 

·Illness (most parents realise that when a child is ill, his/her weight often goes down). 

·Abuse/neglect. 

·Pyscho-social causes. 

Faltering growth can be easily rectified or prevented with a foundation of good nutrition set in the early years of life, especially the first year. 

Mother’s milk is an excellent source of energy and all nutrients essential for the health, growth and development of a baby for the first six months of life. The energy is provided by the milk sugar lactose, which is converted into glucose by the body.  

The complementary feeding challenge  

The term weaning is no longer used and has been replaced with the term complementary feeding (semi-solid and solid). It means changing from milk to semi-solid and solid food, which usually takes a period of 12-15 months.  

This is a learning process for both baby and parents. Weaning should be started at six months as recommended by a recent medial review in March 2001. This is because a baby’s organs are not fully developed prior to that and can lead to an increased strain on the kidneys, allergies and obesity.  

Which food should you give your baby first 

It is usually traditional to give rice porridge or bubur cair or congee with nothing else added. In the beginning, try offering two to three teaspoons mixed with breast milk or infant formula. But do not be surprised if your baby spits it out.  

The second week, try a new food like banana during another feed – teatime. Offer a new food every three or four days and observe your baby’s reactions. Between six and eight months, offer fruit, rice porridge with vegetables, and tau foo. Cereals (carbohydrates) like wheat or oats and foods containing protein should be introduced from eight to 10 months. A matchbox size of meat contains about 7g of protein plus the minerals iron and zinc. By 12-15 months, your baby should be eating a variety of adult foods without excess salt and sugar.  

Should there be a problem with weight gain during any of these stages, a doctor or dietitian will recommend increasing the energy intake, which may mean adding a teaspoon of butter, margarine or glucose to the food after assessing food and drink intake.  

Another way would be to add a teaspoon of glucose into a fruit puree, giving your child an extra 20kcal.  

Alternatively, making some milk jelly with glucose as a snack will boost the energy of a toddler not taking enough calories in a diet.  

This article is contributed by consultant dietitian Rekha Naidu, and brought to you by Glucolin. 

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