Power of nutrition for the first 1000 days by jess 06082016 slideshare

TBAN – GIFT OF LOVE
2016
Power of nutrition in the
first 1000 days
Wong Hui Juan (Jess)
Nutritionist, IBCLC
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OUTLINE
• Theory
• Q&A Session
• Food Display
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OBJECTIVE
• To have knowledge and skill on how to eat healthy during pregnancy and
lactation
• To have a better understanding about complementary feeding.
• To know why, how and what to do when starting solid.

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SITUASI
PEMAKANAN
SEMASA DI
MALAYSIA
BERLEBIHAN BERAT BADAN & OBES
1:2 dewasa
(48%- NHMS 2011)
Kanak-kanak Sekolah
(NHMS 2015)
7-12 tahun – 31.8% (1:3)
13 -17 tahun- 24.4% (1.4)
PENYAKIT TIDAK BERJANGKIT
Diabetes Mellitus – 17.5%
Hipertensi – 30.3%
Hypercholesterolemia – 47.7% (NHMS 2015)
KEMENTERIAN KESIHATAN MALAYSIA
MINISTRY OF HEALTH
PENGAMBILAN BUAH & SAYUR YANG TIDAK
MENCAPAI SARANAN
• 92.5% dewasa (>18 tahun) TIDAK mencapai saranan
pengambilan 5 sajian sayur dan buah sehari
(NHMS, 2011)
• 93.7% remaja dan 81.7% dewasa TIDAK mencapai
saranan pengambilan 3 sajian sayur sehari
• 51.7% remaja dan 85% dewasa TIDAK mencapai saranan
pengambilan 2 sajian buah sehari
(Malaysia School Based Nutrition Survey, 2012, MANS, 2014)
PENGAMBILAN SUSU & PRODUK TENUSU YANG
TIDAK MENCAPAI SARANAN
•76% dewasa, TIDAK mencapai saranan 1-2 sajian
•(Malaysian Adults Nutrition Survey (MANS), 2014)
•81.5% remaja TIDAK mencapai saranan pengambilan 1-
3 sajian sehari
(Malaysia School Based Nutrition Survey, 2012
KEKURANGAN ZAT MAKANAN
Taraf pemakanan kanak-kanak <5 tahun
•Underweight – 12.4%
•Stunting – 18.5%
•Thinness – 8.0%
• 331,659 (19.5%) warga emas >59 tahun
(NHMS 2011)
KEKURANGAN MIKRONUTRIEN
•50.7% kanak-kanak di Semenanjung
Malaysia mempunyai masalah IDD
(Survei IDD Kebangsaan, 2008)
•9.1% ibu hamil mengalami anemia
(HIC, MOH 2014)
•4.4% kanak-kanak; Kekurangan
Vitamin A
•47.5% kanak-kanak; Kekurangan
Vitamin D (Seanuts, 2013)
Bahagian Pemakanan, KKM
Similar situation in Malaysia

COMPREHENSIVE
IMPLEMENTATION PLAN
ON MATERNAL, INFANT &
YOUNG CHILD NUTRITION
WORLD HEALTH ORGANIZATION
WHO/NMH/NHD/14.1

• Micronutrients deficiencies (preschool-age population)
• 47.7% (293 million) children anaemia5
.
• 33.3% (190 million) children vitamin A deficient6
.
• Child overweight (preschool-age population)
• Globally 43 million preschool children in developing & developed countries
were overweight & obese7

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In Malaysia
2 October 2015 Wong Hui Juan, Jess, Power of nutrition in the first 1000 days

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In Malaysia
2 October 2015
Reference: Reten PSI 201B, 2014
31.1%
44.9%
47.1%
42.6%
43.6%
48.4%
59.3%
59.3%
60.5%
43.1%
43.4%
42.1%
42.4%
24.0%
35.7%
55.2%

Leave the workforce Not breastfed
Using unfriendly spaces Find a friendly workplace
Choices working moms have to make

Striving for a perfect balance:
Life, Work and Breastfeeding

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Returning to work

Off to A Solid Start
• Complementary feeding: What is it?
Feeding your child, foods in addition to milk
• Start at six month or older
• Why complementary feeding should not start before six month?
• What about milk after 6 months?
• Breastfeeding – still great for your baby
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What is your baby first solid food?
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Possible relationships between intake of
energy from complementary foods and
breastmilk
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Maintenance of Breastfeeding
• Breastfed children at 12-23 months of age whose intake is similar to
the “average” amount of breast milk consumed at that age (about 550
g/d in developing countries; WHO/UNICEF, 1998) receive 35-40% of
total energy needs from breast milk (Dewey and Brown, 2002).
• Because it has a relatively high fat content compared to most
complementary foods, breast milk is a key source of energy and
essential fatty acids. Its fat content maybe critical for utilization of
pro-vitamin A carotenoids in predominantly plant-based diets.
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ENERGY
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Energy Requirement According to Age
From 6 months onwards, breastmilk alone cannot provide all the energy baby needs.
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Age Total energy
requirement
(kcal/day)
Energy from milk
intake
(kcal/day)
Energy from food other
than milk
(kcal/day)
6 to 8 months 615 413 200
9 to 11 months 686 379 300
1 to 3 years old 945 346 500 hingga 600
4 to 6 years old 1315 300 900 hingga 1000
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Iron
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Five Golden Rules
• Start from 6 months onward
• Give enough food to meet his energy needs
• Give a variety of nutrient-rich foods for his growth & development
• Increase the frequency of your baby’s feeding according to his age
• Vary food preparation methods as your baby grows older
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Signs that your baby is ready
• Can control his tongue and neck movement better.
• Start to make up-and-down munching movements.
• Can sit up with minimal support.
• Likes to put things into his mouth.
• Show interest in what you are eating.
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Tips
• Start with just a few teaspoons and increase the amount slowly.
• If your baby is not too keen to try new food, try adding express breast
milk to baby food. This will help baby get used to the taste.
• Can I add salt?
• Can I add sugar?
• Can I add oil?
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Food Texture
Baby Led according to their neurology system development
(rooting reflex, tongue thrust reflex, suck-swallow pattern, gag reflex dan bite reflex).
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Age Food Texture
6 to 8 months Liquid, puree, blended, mashed & soft food.
9 to 11 months Chopped, diced & nutritious finger food.
12 months & above Family Food
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Tips to prevent baby from choking
• Always supervise baby when he is enjoying his finger
food.
• Vegetables like carrots, celery can be cooked until soft.
• Remove all bones from fish properly
• Avoid giving :-
• Small, hard food such as candies & nuts
• Soft and sticky foods such as peanut butter
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Amount of Food
Increase the amount gradually as your baby grow.
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Age Amount of food
6 to 8 months ½ cup of porridge.
9 to 11 months 1 cup of porridge.
1 to 3 years old ½ cup of rice.
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When to feed?
Feeding and eating should be enjoyable.
Increase the frequency of feeding gradually.
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Age Breakfast Lunch Dinner
6 months and below Breastfeeding on demand (BF)
6 months and
above (1st
week)
Starting solid BF BF
2nd
week Starting solid Starting solid BF
3rd
week Starting solid Starting solid Starting solid
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Tips
• It is common for your baby to eat only a small amount of food (such as
one teaspoon) when you first begin to complementary feed.
• This is normal especially in the first week.
• DON’T Force feed.
• Your baby’s appetite will grow as time pass
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When to feed?
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Age Main meals Snack
6 to 8 months 2 to 3 times
1 to 2 times9 to 11 months 3 to 4 times
1 to 3 years old 4 to 5 times
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Nutrients & Food Sources
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The Art of Feeding
•As you feed, smile & talk to your baby. He will be encourage to
try out new food by your soothing voice.
•Inculcate healthy eating habits in your baby – Vegetables & Fruits
•Make mealtimes fun. Pretend the spoon is an aeroplane flying to
deliver food to baby’s mouth.
•Use attractive serving plates, bowl and cutlery to stimulate baby’s
interest in food as well as encourage them to self-feed.
•The joy of eating together.
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Food Allergy
• If your family has a history of food allergy, introduce new food to your
baby gradually.
• One food at a time.
• Some signs of possible food allergy:-
• Severe skin rash after a meal
• Vomits most of the food recently eaten
• Produce loose and very watery stools
CONSULT YOUR DOCTOR AT ONCE IF YOU HAVE WORRY OR
DOUBT.
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Why Won’t Your Baby Eat?
Possible reason What you can do
Your baby is simply not hungry. Avoid giving snacks or milk to your baby
too near to the meal times. Opt for at
least 1 to 2 hours before meals.
Your baby is distracted. Minimise mealtime distractions (e.g:
switching off TV or putting away baby’s
toys).
Your baby is too tired. Perhaps he had a long & tiring day/
missed a nap. Let him have his nap.
Regular nap times can minimise this
problem.
Your baby is feeling unwell. Check for signs of possible illness (e.g:
high temperature) and consult your
doctor.
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When your baby is ill
• Keep breastfeeding often.
• Give more water and other fluids.
• Offer his favourite food.
• Choose soft food for easier digestion.
• After baby recover, let him eat more frequently, give a little more food
each time. This will make up for the nutrients and weight he had lost
during his illness.
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Is Your Baby Full?
• Since your baby can’t speak, he communicates with you using sounds
and gestures.
• Knowing these cues will help you determine whether your baby has
eaten enough:-
• Closing mouth as spoon approaches
• Show signs of wanting to leave the table or chair.
• Becomes distracted by his surrounding.
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Is Your Baby Eating Enough?
• Many parents are worried that their baby may not be eating
enough.
• Every baby eats and grow at his own rate.
• The best way to be sure is to monitor his growth rate.
• You can consult your health care professional if:-
• Baby’s weight is not within the normal range.
• Notice a sudden weight gain or weight loss drastically.
• There is no increase in weight over period of two to three
months
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Obese
Overweight
Normal
Wasted
Severe
wasted
Risk of overweight

Working with caregivers
• With both parents working full time becoming increasingly common,
more babies are cared by:-
• Maids
• Grandparents
• Baby sitters
• Discuss early about how to feed.
• Help them understand your decision better.
• Play your part in ensuring that baby is feeding well by providing the
ingredients needed to prepare baby’s food.
• Let them know if your baby has allergy or special dietary
consideration.
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Cooking for Your Baby
• Home-cooked or commercial baby foods?
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Home-cooked is better
• Your know exactly what you are feeding your baby.
• You can introduce a wide variety foods with different tastes and
textures to baby.
• You baby gets to taste local and natural flavours of food.
• It is usually cheaper to prepare food at home.
• Home-cooked complementary food makes it easier for him to get used
to eating family food when he grows older.
• You can control the safety and cleanliness.
• No added sugar, preservatives and food additives.
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Storing and keeping baby’s food
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Storing and keeping baby’s food
• Clean the ice cube tray with warm soapy water.
• Pour the puree into the ice cube tray.
• Cover the tray with plastic wrap.
• Place the tray in freezer.
• If you run out of space in the ice cube tray, pop out the cubes and
keep them in bag.
• To thaw the “baby food cubes” place the required number of cubes in
a small bowl and place this bowl in a bigger bowl containing hot water.
Cubes will be thawed in 10 – 20 minutes.
• Avoid cross contamination with raw food.
• Do not feed directly from the container and discard any left over that
has baby’s saliva.
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Accessories
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Questions & Answer
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THANK YOU
•Email : wonghuijuan@gmail.com
•Facebook :
https://www.facebook.com/Nutrilact/
•Blog : Jess Nutrition Blog
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Food Display
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REFERENCES &
ACKNOWLEDGEMENT
• Complementary Feeding of Young Children in Developing Countries: A
Review of Current Scientific Knowledge, WHO/ NUT/ 98.1.
• Baby’s First Bites, Complementary Feeding with Confidence, Nutrition
Society of Malaysia.
• Nutritionists’ Choice Cookbook, Vol.1, Nutrition Society of Malaysia.
• Garis Panduan Perancangan Menu di TASKA, Bahagian Pemakanan,
KKM.
• Panduan Pemakanan Kanak-kanak Berkeperluan Khas (untuk ibu bapa
dan penjaga), Bahagian Pemakanan, KKM.
• Modul Latihan Pemakanan Bayi dan Kanak-kanak, Bahagian
Pemakanan, KKM.
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C
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