Updated Date: 07.07.2024

What is Supplementary Nutrition?

The period of life that begins at birth and continues until the age of two is a very critical period when the need for nutrients is high, 90% of brain development is completed, and the natural environment (microbiota) of the intestines takes on an adult form due to the rapid growth. Nutrition during this period is very important.

The baby should be fed with breast milk alone from birth until the end of the sixth month. Complementary foods should be started in addition to breast milk at the end of the sixth month. Complementary food is the food given to the baby along with breast milk in the second 6 months of life. Complementary nutrition is the giving of other foods appropriate to the baby's age and needs in addition to breast milk.

Complementary feeding is not a substitute for breast milk, but rather a supportive feeding along with breast milk.

When to Start Complementary Feeding?

Complementary feeding should be started at 6 months. The period of getting used to complementary foods is between 6 and 8 months. Different tastes and textures increase the baby's biting and chewing skills. If this critical period is missed, it takes a long time and is difficult for babies to get used to eating grainy foods. The main source of nutrition for babies between 6 and 8 months old should be breast milk. Starting complementary feeding early or late causes some problems.

Why Should Complementary Feeding Not Be Started Before 6 Months?

• Early initiation reduces the production of breast milk.
• It increases the risk of exposure to infectious agents and infections.
• The baby does not grow better because it is started early.
• In the first months, the tongue thrust reflex is strong, so spoon feeding is difficult.
• Since the ability to swallow grainy/granular foods is not developed, the risk of food getting stuck in the trachea increases; additional foods may cause choking.
• It causes obesity and diabetes to occur more frequently in the baby's later life.
• Starches and proteins cannot be broken down sufficiently. This can increase the risk of digestive problems as well as allergies and immune system diseases.
• The composition of breast milk is ideal for babies. When complex foods are given before the kidneys are mature enough, the kidney load increases.

Why Shouldn't Complementary Foods Be Started Late?

• The energy and nutrients the baby needs cannot be met.
• The baby's growth slows down or stops.
• Since the baby cannot receive the necessary nutrients, anemia, developmental delay, vitamin deficiency diseases and mental developmental delay may occur.
• Your baby may be delayed in learning to chew.

What should be the first complementary foods I give to my baby?

It should be rich in energy and nutrients, have an appropriate consistency, and be clean and safe in terms of microorganisms, harmful chemicals and poisons. It should be locally available, easy to buy and prepare, and seasonal. It should be foods that can be found at home, that the baby will like and can be easily eaten, and that are not too hot/cold/spicy.

What should be the first complementary foods I give to my baby?

• The first food to be given to the baby may be yogurt fermented at home. 
• Easy to digest seasonal fruits (such as apples, peaches, bananas, pears) can be given as juice and then puree using a glass grater.
• Seasonal vegetable purees (with pulp, not just juice) can be given.
• Egg yolk; Start with one eighth of the amount. Depending on the allergy, it can be given by increasing if no allergy occurs.
• When preparing pudding, molasses or small pieces of fruit can be used instead of sugar.
• Pasteurized, desalted cheese and kefir can be given.
• It is important to add meat to prepared foods (lean ground meat or meat puree). Meat broth and bone broth are not recommended due to their high salt content.
• Traditionally recommended in our country, the starter vegetable puree is made from potatoes and carrots, which are available in every season. If it is summer, green zucchini can be added, if it is winter, pumpkin can be added, and it is enriched with rice or semolina. Bulgur, which is consumed as widely as rice in our country, is a grain that increases its nutritional value and can be added to vegetable purees.

What Should I Pay Attention to When Starting Complementary Foods?

• The transition to complementary foods should begin with a single type of food and the transition to a new food should be at least 3 days apart.
• Each food that is started should be recommended in the amount of one teaspoon on the first day, one dessert spoon on the second day, and one tablespoon on the third day.
• On the fourth day, the new food can be given along with the old one.
• The baby's stomach capacity is about a tea glass (100-125 ml) at 6 months. Stomach capacity should be taken into account when preparing the amount to be given at one time.

What are the consistency, content and amount of foods that can be given to my baby according to his/her month?

Consistency of foods; 

• Puree at 6 months, 
• Crushed, chopped, grated in the 7th-8th month, 
• In the 9th-11th months, chopped, cubed or finger foods, 
• In the 12th month, the food on the family table should be in its crushed or chopped form.

Due to babies' small stomach capacities, it is recommended to choose foods that are high in energy and contain sufficient protein and nutrients.

The stomach capacity is approximately 5 ml (1 teaspoon) at birth, 125 ml (a tea glass) at 6 months, and 200 ml (a glass) at one year of age.

What Foods Are Not Suitable for My Baby?

• Hard, round, membrane-bound foods (hazelnuts, grapes, round candy, raw carrots) can cause choking and should be given by crushing until the baby is 3 years old.
• Honey, broad beans, cow's milk and egg whites should not be given to babies until they are 1 year old.
• A vegetarian diet should not be given to infants and young children.
• It is necessary to avoid plant-based milks (like rice, almond, coconut milk) as they do not meet the nutritional requirements of the baby.
• Cow's milk should not be started before 12 months unless absolutely necessary, as it increases the risk of allergies and iron deficiency due to its high protein content. 
• Raw milk and cheese made from raw milk should not be given to children. 
• Complementary foods should be prepared without adding sugar or salt. Adding sugar or salt does not increase the acceptance of foods by babies. Avoiding salt and sugar during infancy is effective in lowering the threshold for these tastes in later years.
• Sugary drinks (tea, coffee, fruit-flavored drinks) should be avoided during infancy. Sugary drinks consumed during infancy also increase the risk of obesity in later years. These drinks also increase the risk of tooth decay.
• Foods that have been previously added with salt and spices or canned vegetables are not suitable for babies and young children.
• Foods that are difficult to digest (salami, sausage, fatty, fried and spicy foods)  are not given to babies.

When Can My Baby Eat Family Meals?

Once your baby turns 1 year old, he or she can sit at the family table.

The recommended foods during this period are healthy family meals that include a balanced mix of all food groups. Boiled water, ayran, freshly squeezed fruit juice, and cow's milk after the age of 1 can be given to the child as drinks.

Feeding time is also a time of love and learning. Supporting and encouraging your baby while he/she is feeding himself/herself will also make the meal enjoyable.

What Should We Pay Attention to During the Complementary Feeding Period?

The complementary feeding period is a period in which the child is both nourished and acquires eating habits. Failure to provide these two conditions together will lead to eating problems in the child in the future. Therefore, the following principles should be taken into consideration;

• Mealtime should be a special time when the child is hungry and not sleepy, and only the child is taken care of.

• Portions should be prepared considering the child's stomach capacity.
• The child should be seated in an upright position, the person feeding should sit at eye level, directly across from the child, and speak calmly and encouragingly.
• The child should be allowed to feed himself with his hand, and when he is ready, he should be given a spoon,
• The spoon should be held in a way that the child can see (the spoon should not be hidden, it should not come from behind),
• There should be no stimuli such as television, tablet, or computer that may attract the baby's attention in the feeding environment.
• The baby should be allowed to decide how much and how quickly to eat and when to stop feeding.
• Support your child to eat but do not force him/her,
• Food preferences and reactions to new foods should be respected.

Why is it important to continue breastfeeding during complementary feeding?

The primary source of nutrition for babies aged 6-8 months is breast milk. Half of the energy needs of babies aged 9-11 months are provided by breast milk. Between 12-24 months, breast milk provides 35-40% of the energy needs. In addition, breast milk;

• It has a high fat content and is a source of energy and essential fatty acids.
• Contains substances that protect against infections.
• During illness, the baby's appetite decreases. During illness, babies refuse other foods but continue to breastfeed. Therefore, continuing to breastfeed ensures that the child receives some of the nutrients he needs during illness and prevents dehydration. 
• Long-term breastfeeding has a positive effect on the child's bone development and height.

How to Prepare and Store Supplementary Foods Safely?

Cleanliness:  Hands must be washed before preparing and serving food. Kitchen utensils, plates and glasses used must be clean.

Separate raw and cooked foods:   Different containers and tools should be used when preparing raw and cooked foods. If fruits and vegetables are to be eaten raw, they should be washed with plenty of water and, if possible, peeled before consumption.

Cooking well:  For food to be consumed safely, the cooking temperature must reach at least 70˚C. Foods such as meat, chicken, fish and eggs should be cooked well.

Storing foods at appropriate temperatures:  Foods should be prepared in small quantities and consumed fresh. If this is not possible, they should be stored below 10°C until the next meal. They should not be kept in the refrigerator for more than 3 days.

Safe water:  It is recommended to boil water for clean water.

What are the Age-Appropriate Nutritional Recommendations for Babies?

Period between 6-8 months:

• Fermented yogurt can be given daily at home
• Purees or juices of fresh seasonal fruits can be given.
• Pudding or rice pudding (when preparing pudding, molasses or small pieces of fruit can be used instead of sugar)
• Vegetable soups: Potatoes, rice, carrots, green zucchini in summer, pumpkin in winter can be cooked lightly, mashed with a fork and made into a rough puree, then served without salt with olive oil or a liquid oil added. Minced meat or meat puree can be added.
• Juicy meatballs can be made with minced meat, rice, bulgur, potatoes, carrots, and the meatballs can be mixed with water, crushed, and given as puree.
• Vegetable meatballs (zucchini, carrots, potatoes, onions, minced meat or chicken liver are cooked in oil, bulgur, chickpeas, eggs and flour are added, turned into meatballs and cooked in a pan without oil) can be given.
• Yayla soup (made with eggs, yoghurt and rice and pureed) can be given
• Tarhana soup can be prepared with minced meat and in a thick consistency.
• Stuffed zucchini, meaty vegetable purees can be given
• Lentils, rice, bulgur, carrots, potatoes, tomatoes, onions, soups prepared with oil and bread can be given.
• It can be given with pasteurized cheese (any soft, unsalted cheese), egg yolk, molasses, and bread.
• If the baby is thirsty, ayran, water, fresh fruit juice can be given before or during the meal.
• Foods are not consumed with water, as the stomach will be filled with water for no reason and the patient will not be able to get enough energy.

Period between 9th and 12th months:

• You can sit at the family table while continuing to breastfeed (home-cooked meals with little salt, little tomato paste, and no spices).
• In addition to what was taken before, whole eggs, chicken, fish, pasta, rice, legumes are added.
• Foods called finger foods such as boiled vegetables and pieces of meat, meatballs, cheese and bread are given.
• You can make fritters by adding eggs to grated zucchini, cheese and carrots.

Period between 12 months and 2 years old:

• Cheese, yogurt
• Vegetable dish (such as potatoes, zucchini, spinach) with minced meat (or chicken) prepared with liquid oil
• Legume dish prepared with liquid oil (such as beans, chickpeas) 
• Rice pilaf, bulgur pilaf, bread, pasta
• Dishes prepared with minced meat or egg yolk, vegetables, rice or bulgur (stuffed zucchini, stuffed peppers, juicy meatballs, etc.)
• Yogurt soups (tarhana, yayla) 
• Grilled Meatballs
• Menemen prepared with eggs, tomatoes, peppers, cheese and oil
• Omelette prepared with eggs, cheese (or tomatoes, peppers, potatoes, carrots, etc.) 
• Fresh vegetables and fruits according to the season
• As drinks, the child is given boiled water, ayran, freshly squeezed fruit juice, and cow's milk.

The period after two years of age:

• He eats the same food as his family three times a day.
• Adding red meat, chicken, fish, eggs, cheese, and oil to each given meal enriches the nutrients.
• Snacks are provided twice a day.
• As a snack; fresh vegetables and fruits (carrots, tomatoes, green peppers, cucumbers, apples, peaches) or cheese, bread and drinks such as ayran, freshly squeezed fruit juice, cow's milk are given.
• The amount of sweet foods (such as candy, biscuits, chocolate) given to the child is limited, and cola and similar acidic drinks are not given.