The month of September is celebrated as Poshan Maah every year, focusing on nutrition. The objective is to ensure community mobilisation and bolster people’s participation in addressing malnutrition among young children and women. It aims to raise awareness about health and nutrition among people. Every Anganwadi in Maharashtra celebrates Poshan Maah by providing nutritious food to children, organising cultural programs, inviting parents, etc.
Dr Pranali Kothekar, a health professional from the Maharashtra government-led Aarambh Team, Sevagram, writes about why nutrition is important for children and how parents, families and communities can contribute to it. The Aarambh project started in 2010 with a goal to provide nurturing care towards enhanced brain development, improved infant and young child feeding and school readiness for children aged 0-3 years. The focus on health and nutrition ultimately leads to good learning outcomes in school and higher levels of education.
"Why isn't my child eating properly? Why does she prefer only junk food? Why is her eating so selective? Why does he always want a screen during meals? Why is she averse to eating fruits? Why is she still demanding to be fed at the age of 3?" These are common queries posed by new parents. They're fraught with uncertainty because these questions lack definitive solutions. Each child is unique, as are their parents and the dynamics of their interactions. However, the solution to these queries can be found within the concept of 'Responsive Feeding.'
What is responsive feeding?
Responsive feeding is a mutual relationship whereby the parent notices the child’s cues and responds appropriately to the cues. This practice nurtures the establishment of a solid bedrock for a trusting relationship that promotes the child's growth and development. The way a child is nourished leaves a lifelong impact on their life.
Importance of responsive feeding
Prior to birth, the fetus experiences a continuous supply of nutrients through the placenta. For various elements, when the fetal nutrient levels decrease, the placenta facilitates an influx of those nutrients from the mother's system. Newborns, when placed on the mother's abdomen, instinctively crawl to the breast, drawn by its familiar aroma and the comfort of her heartbeat and warmth. This close contact nurtures a strong mother-baby bond, making the mother's chest a secure haven. This interaction equips early optimal natural stimulation to the infant's sensory organs and brain, potentially aiding in their long-term sensory-neural development.
Although many parents strive to establish feeding routines for their infants, the best outcomes arise when babies are allowed to feed according to their individual needs. This dynamic mirrors the inherent design of babies and mothers. Babies learn that their cues prompt parental responses to fulfill their needs. When parents observe and respond to early cues, the need for distressed cues, like crying, diminishes as a means of gaining attention and response. When babies' hunger cues go unanswered, they learn the insignificance of cues and stop signaling, resulting in undernutrition. If parents control feeding, overeating may result in disregarding natural fullness cues. This can establish overeating as the norm, ignoring inborn satiety mechanisms.
How do you practice responsive feeding?
Parents can demonstrate their positivity through smiles, eye contact, and encouraging words directed towards the child while feeding. When feeding the baby, they should do so gradually and patiently while maintaining a cheerful and pleasant atmosphere. Experimenting with a variety of healthy food options, flavors, and textures can give the baby a sense of empowerment in making food choices and nurturing good eating habits.
Practicing patience is key; parents should wait when the baby stops eating and then offer more food. Providing finger foods encourages the baby to explore self-feeding. During mealtimes, parents should stay engaged and attentive, remaining present with the child. It's also important for parents to set a positive example by showcasing good eating habits and behaviours.
Hunger and fullness cues
There is a pattern of hunger cues that most newborns exhibit after birth. These cues progress from crying to a state of relaxation, followed by awakening, salivation, mouthing of hands, preparing to crawl, and then advancing through arm and leg movements. Subsequently, the baby explores the breast through actions such as licking, mouthing, touching, and gently massaging with their hands. This process leads to self-attachment and suckling, and then sleep. In response, the mother engages by softly communicating with and gently touching her baby, initiating breastfeeding. As the baby is full, their body relaxes, and their arms rest at their sides. They release the breast, although some babies prefer to continue light sucking until they fall asleep.
When hunger cues are overlooked, the baby might progress to a full cry. Their tongue is up and back rather than reaching forward and downward towards the breast. Attempting to feed a crying baby is challenging for both the mother and the baby. It places their entire system under stress and exhausts energy reserves, potentially contributing to inadequate weight gain. In an appropriate response, parents learn to recognize the early hunger cues of the baby and promptly respond to them.
Family meal: why not only quantity and frequency?
The second half of the first year is a time to learn the skills of eating the foods from family meals. Observing cues and responding suitably during the exclusive breastfeeding phase can actually enhance a parent’s ability to observe appropriate cues for complementary feeding at 6 months of age. During this phase, babies might show cues indicating readiness for foods other than milk. Smiles and patience are needed as the baby learns this new skill. Consider feeding as an opportunity to engage with the baby rather than concentrating solely on the quantity of food consumed.
Including the baby in family meals, allowing them to explore and eat the same food, and observing others' eating skills are very critical. Progress at the baby's pace and stop feeding when cues indicate fullness. Avoid forcing the baby to eat. Ensure constant presence while the baby is eating. The process of eating should be a source of love and fun.
Role of father and family members
Fathers, along with other family members and friends, can significantly shape the attitudes and beliefs of the family. Especially in cases where fathers aspire to play an active role in their newborn's life, they might experience a sense of exclusion during breastfeeding. However, they often display an eagerness to engage in conversations about how they can enhance their support for the mother. Fathers contribute to this journey by attentively observing, sensitively noting, exhibiting patience, and offering care and warmth to the mother, accompanied by reassurance. This collaborative effort can contribute to nurturing more joyful meal experiences for families.
