Children also require varied diet

Question:

Dear Dr. Donya,

My son is a year old. However, to date he can only take porridge (twice a day) instead of rice and he needs at least an hour to finish a half bowl of porridge. I used to put all the ingredients into a slow cooker and cook it for approximately 10 hours. Old people suggested not to let him have the meat as it is tasteless and contains no vitamins. He has milk 2-3 times a day, and fruit once. I give him Seven Seas Cod Liver Oil, Grape Water, Vidaylin-L, A-D Plex alternatively. I would like to seek your advice on the following: 1. What age is it proper to start taking rice? 2. Is it good to let him have the meat/liver after it has been cooked for so long? 3. When should I change to a new bottle nipple? 4. What should I give him so he can have a better appetite? 5. Are the above vitamins necessary for him? 6. When should he get the varicella immunization? Is it necessary?

Thank you for your valuable advice.

Best regards,

-- Kim C.

Answer:

Dear Kim,

Your questions are interesting but I am concerned about your baby's diet, as I understand it to be only porridge and milk. So I am going to focus mostly on feeding tips to help with his nutrition and appetite. 1. When to take rice? Rice is a carbohydrate and infants have the enzyme to digest rice at around three months of age. Steamed rice can be started when the infant has teeth and needs solid food to stimulate his growing jaws and teeth. Ten to 12-month-old infants love chewing, you can give them a little rice along with other nutritious foods; protein, fat, vegetables and fruit. 2. Should you give your son long cooked meat or liver? No, I don't think so. When you cook meat too long, the vitamins and minerals will be lost into the soup. 3. Your son needs basic and also varied foods. A one-year-old infant should weigh at least eight kilograms and his height should be 75 centimeters. A typical day's food might be: an early morning drink of fruit juice, or porridge with pork and egg, or cereal with milk. Banana or other fruit, chopped fish, potatoes, peas, fried rice, rice with vegetable soup or chicken, yogurts or fruit juice, cheese on toast with tomato and a milk drink.

For a better appetite I would recommend you change his meals to have more variety. A well-balanced diet of protein, fat, carbohydrates and minerals: * Protein: fish, meat, peanut butter, eggs, cheese, liver, peas, beans, also bread, potatoes, grains, nuts and Soya products. * Fat: found in cheese, butter and milk * Carbohydrates: bread, rice, cereal, root vegetables, biscuits (he can take them in unsweetened form). * Minerals: Calcium in milk, iron in liver and egg yolk. Most other minerals are only needed in tiny quantities. A normal diet will provide all that he needs. * Vitamins: if he is taking milk (500 ml/day), eggs, vegetables, fruit and meat, he has all the vitamins he needs.

Also as he grows, it is fun to let him eat with the family and feed himself. When he reaches the dropping stage, just put a plastic sheet under his chair to catch the mess. Let's try right now to change his diet to a variety of foods and letting him feed himself, also let him hold a biscuit, a piece of fruit, a carrot with his own hand and eat his meals with the family. 4. Are vitamins necessary for him? Yes, if his foods are only porridge and some milk. 5. Bottle nipples have S, M and L sizes, usually S to M is for around six months old, and M to L is for 12 months old. 6. The varicella vaccine can be given to children from 12 months on. Is it necessary? I would say that it is not routinely recommended in normal healthy children. It is only used for high- risk groups i.e. in cases of leukemia and immunodeficiency (weak immunity) where there is a tendency to develop severe diseases and complications from varicella infection. Usually I recommend the varicella vaccine in children 10-12 years old because: a. More than 50 percent of the children get chicken pox or varicella zoster before this age and usually only have mild symptoms and get better without scars. This compares to adolescents and adults who tend to have more severe symptoms and scars after infection. b. When children get a natural infection they will have life-long immunity whereas vaccinated children get 95 percent immunity that persists around eight to 20 years. The vaccine is not 100 percent effective so children have a chance of getting infected but the symptoms will be mild with fewer lesions. c. The vaccine dose for under 13 years old is a single injection but children of more than 13 years old and adults need two injections four to eight weeks apart. Hence, more injections mean more expense.

Adverse events following vaccination are minimal. Within a month of immunization, a mild vaccine-associated rash or varicelliform (small blisters)-like rash develops in around 7 percent of children with two to five lesions at the site of injection or elsewhere. Transient pain, tenderness or redness at the injection site is also found in approximately 20 percent of the children.

-- Dr. Donya