UNIT 9 MEAL PLANNING FOR THE

INFANT AND PRESCHOOLER

Structure
9.1 Introduction
9.2 The Infant
9.2.1 Recommended Dietary Intake for the Infant
9.2.2 Meal Planning for the Infant
I 9.3 The Preschool Child
9.3.1 Recommended Dietary Intakes for the Preschool Child
9.3.2 Meal Planning for the Preschool Child
9.4 LetUsSumUp
9.5 Glossary
9.6 Answers to Check Your Progress Exercises

9.1 INTRODUCTION
I Growth and development are essential features of life. But the pattern of growth is
not always uniform. In the last unit you studied how life begins with a single cell. This
cell divides and multiplies into hundreds and thousands of cells to form the foetus.
I Imagine the rate of growth at this stage! Never again in life would the rate of growth
be as rapid as it is during the foetal stage. After the foetal stage the growth continues
to be rapid for the first year, but then slows down somewhat thereafter.
The present unit focuses on the pattern of growth inthe'first few years of Life -from
birth to six years. The first year of 1ife.i~
called the period of infancy and the period
1-6 years is referred to as the preschool years. Infancy and preschool pefiod together
are important in the child's life as they form the foundation for the future health of
the child.
The changes in the pattern of growth influence the nutrient needs. Because the child
is growing the nutrient needs are more. In addition, as the child grows, taste
preferences, food advertisements, parentdfriends will influcence what food they
consuthe. Feeding children, therefore, involves far more than knowing what are the
nutrients required, why we need them and which foods contain them. We need to
combine foods into a diet that would help meet the nutritional needs of children and
at the same time be appealing and appetizing.
The unit presents a detailed discussion on how to planlprepare balanced diets and
what dietary measures are to be kept in mind while feeding infants and preschoolers.
Reading t h o u & the unit you will find the answers t o several questions which are
often asked in connection with feeding young children -what is the right time to
introduce infants to solid food? Which food other than breast milk can be given to the
infant? How to provide nutritious meals to preschoolers keeping the likeddislikes in
mind? What are the best snackslfoodpreparations for the preschoolers?
Objectives
After studying this unit, you will be able io:
a describe the periods of infancy and preschool age
a explain why these periods are crucial for growth and development
a describe the nutritional needs of infants and preschoolers
a discuss the importance of breastfeeding and supplementary feeding (i.e.
introducing foods other than breast milk) and
a state the dietary considerations-to be kept in mind.while planning meals for infants
and preschoolers.

9.2 THE INFANT

The child in the first year is referred to as an infant. The first year of life is a period of
intense growth and development. Growth, as you already know, refers to the physical
increase in the size of the body. The infant at birth weighs approximately2.5-3 kg and
measures 50 cm in length. With the rapid growth taking place the infant doubles its
birth weight in five months and by one year the weight is three times the birth weight
(Figure 9.1). Consider the rate of growth! Starting trorn 3 kg the weight increases to 9
kg in a single year. At no other time of life hereafter the rate of growth would be so
rapid. The normal body length of 50 cm at birth also increases to about 75 cm by the
end of the first year.

At Blrth 2 Months 5 Months 8 Months 10 Months 12 Months

Flg. 9.1 Average body weight of infmts from birth to twelve months

Gain trt weighti'iqcrease in length are, therefore, the best indicators to assess the child's
growth. Weighing the child every month, for the first year would give you a good idea
of the pattern of growth.
The gain in heightlweight are further accompanied by changes in tissues / organs/
systems of the body during the first year. The muscles grow in size and strength. The
bones lengthen. The brain, kidneys, digestive system improve in their functional
capacity. In other words, the body undergoes a process of development. The
development of the digestive system, for example, enables the infant to handle more
and more complex food items starting from breast milk at birth to solid food by the
end of the first year.
Because of this extremely fast rate of growth/development infancy is a period of great
stress for the baby Obviously, diet plays an important role in promoting growth and
general well-being. Can you imagine what would happen if enough food is not
provided to the infant? Yes, of course, the infant would be susceptible to the effects
of malnutrition. In fact, the infant would be more proneJo infections and diseases
resulting in ill health.
The rapid growth and development of an infant creates a high demand for nutrients.
But, what nutrients are of particular importance during-infancy? How much of which
nutrient should be given to the infant? w e shall learn about-these aspects in the next
subsequent sectlon.

9.2.1. Recommended Dietary Intakes for the lnfants

In Table 9.1 you would notice that the RDls for Infants are given in two age
categories - 0-6 months-and 6-12 months. This is so because the age of the infant
influences nutrient need. Rapid growth takes place during the first six months, which
obviously necessitates a high nutrient intake.'
The recommended intakes for infants during the first six months are based on the
intake of normal growing infants fed on breast milk aione. What does this mean? This
means that if an infant receives on an average 850 ml of breast milk daily upto six
rqonths, his requirements as given in TaMe 9.1 are easily met. The requirements given
above are, therefore, basically guidelines for feeding infants \irho,'for some reason,
cannot receive breast milk.
 Table 9.1 MalR.nnBalforthe
Rccommtndd Dietary Intakes for BI Infant Mmt and Fmcboder

'rlunients RDIs
..
Age group
0-6 months 6 1 2 months

* e w (Kc4 loekg 98M

Protein(g ) 2.051Irg 1.65kg
Calcium (mg ) 500 MO
Iron erg) 7'"kg 7mg
Vitamin A (pg)
Retinol 350 350
or
Carotene 1200 1200
?hiamine (Clg) 5% 5Wg
Riboflavin (pg) m g
Niacin ( p g ) 7lWg 6 m g
Ascorbic acid (mg) 25 25
Fo'olicacid (lrg) 25 25
Vitamin BIZ(pg) 0.2 0.2

9o9m:Nuaient Requirements and RecommendedDietary Allowances for Indians, ICMR (1M)

Further, if you look at Table 9.1 carefully, you would notice that the RDls foca few
-
nutrien'ts -energy, protein, iron curd B vitcunins are given in terms of per kg body
weight and not as a tot01 inake Fgure. Can you suggest why this is so? This is because
the needs for these nutrients per kg body weight are substantially different within the
specific age category. The total amount of the nutrients required by the infant may
seem much smaller as compared to the adult but when expressed in terms of per kg
body weight, the need is over twice as much for most nut1ients.a~can be seen in
Figure 9.2. To understand this better let us compare the energy needs of a five month
old infant with that of an adult. An adult sedentary man (weighing 60 kg), you know,
requires a t b t a ~of 2425 Kcal. This, when expressed in terms of per kg body weight
works out to apprgximately 40 Kcalflrg body weight. (This is considered 100 per cent
RDI, for energy in Figure 9.2). The requirement of the infant (per kg body weight),
on the other hand, is much higher i.e. 108 KcaUkg body weight, which you notice is

1190

Key:
Kji -RDls for adult
Sedentary man
Sedentary

m -RDls for 5 months

infant

Vitamin C Retinol Iron Calcium Proteins Energy

Fig. 9.2 Nutrltnt needs of infants as compared to thosc of an adult man
more than twice as much as that of an adult. The total amount of energy required,
however, works out to be much lower (i.e. 108 X 5 = 540 kal) since a five-month
infant weighs only about 5 kg.

The RDI for protein 6nd certain protective nutrients like calcium, iron, vitamin C and
vitamin A are also high. Why? You know that the tissue growth and body-building
ai3ivity.h wnsiderable during the first year. This necessitates a high intake of protein
and vitamin A. The bones and skeletal system develop rapidly and calcium is
deposited in them, hence the requirement for calcium is high. The blood volume
increases and therefore, iron is required for the synthesis of haemoglobin in the blood
-cells,
Check Your Progress Exercise 1
1) Fill irr the blanks.
a) Infancy is the period in the life of an individual from ........................to
...................... year.
b) The infant ............................ his birth weight in five months.
c) The growth of the infant can& assessed by measuring ............................
and ................................
d) The RDIs for ..............................and .............................. per kg body
weight are considerably high during infancy.
e) By growth we mean an increase in body size as a result of an increase in cell
..............................and ...................................
2) State whether the following statements are true or false. Give reasons for your
answers.
a) RDIs for certain nutrients are expressed per unit body weight in the case of
infants. ( TruefFalse)

b) The requirement for iron (per kg body weight) is the Kast during infancy?
('TrueIFalse)

c) The infant should be weighed once in six months during the first year of life.
(True/False)

d) The infant increases comparativel~more in length than in weight during the

first year. ('I-rue/False)

e) RDIs for infants during the first six months are guidelines for feeding infants
w h o for some reason cannot receive breast milk. (True/False)

9.2,2-Meal Planning for the Infant

It is clear that the nutrient requirement is considerably high during infancy. The
crucial aspect to consider then is how to meet these requirements. What are the foods
that should be given to the infant that would help meet the requirement? This section '

presents a detailed discussion on these aspects.

You know that the first food normally given to the infant is breast milk. Breast milk
supplies all the nutrients needed by the baby for the first few months. It is the best
food for the baby. But after four to six months, breast milk alone is not sufficient to
 ncet the growing needs of the infant. Certain other foods need to be provided along Meal PlaMiDg for tbe
Mmt .adRcscbder
with breast milk so as to supplement the shortfall in the nutrients. This process of
introducingfoods other than breast milk in the diet of the infant ir called supplementary
feeding. It is also referred to as weaning.
Supplementary feeding is a gradual process which begins from the moment pther
foods(1iquid food preparations and solid food preparations) are started and continues
till the time the child is completely taken off the breast. Any food other than breast
milk given to the infant is referred to as a supplement or supplementary food. But
what are supplementary foods that can be given to the infant? What is the right age to
introduce these supplementary foods? Which food would be easily accepted and
tolerated by the infant? How much of these foods should be given? You will find the
answer to these questions in this section.
The specific considerations one should keep in mind in addition to those mentioned in- I
the margin are discussed below:
Whom are we planning for?
What is the stage of infancy -0-4 months, 4-6 months, 6-8 months or 9-12 months?
What is the expected body weight of the infant at that particular age?
t
What is the income level of the family to which the infant belongs?
Where does the infant live (region)?
Information on these aspects will help you decide on the RDIs and kind and amount
of food to be served to the infant. Based on the information first list the RDIs for the
infant.
Which are the nutrients of particular importance?
The need for the following nutrients is considerable during infancy:
energy-giving nutrients (carbohydrates and fats)
protein
calcium
iron
vitamin A and
vitamin C

Which foods to select?

During the first few months after birth, breast milk alone provides most of the
nutrients required by the baby. Thereafter, in addition to breast milk, one should
introduce supplementary foods. What are the supplementary foods that can be given?
Before we go on to discuss this, let us first learn about the importance of breast milk.
For your convenience the discussion in this subsectiorl is given under three headings.
Importance of breast milk
When to introduce supplementary foods?
What kind of supplementary foods should be given?
Importance of breast milk: Breast milk is the best and the only food for the infant for
Lhefirst few months after birth. It contains most of the nutrients the baby needs. As
soon as possible after birth, the ?nfant should be put to the breast, since sucking
stimulates milk production. But before milk is secreted colostrum is produced by the
breast. Colostrum should be fed to the baby as it is good for growth and general well-
being. What is colostrum? #Whyis it important to feed colostrum to the baby. You will
find the answer'to these auestions in Highlight 2.

Brcast m i l k is secreted from the third or fourth day onwards. It is the nlost nutr~tious
and balanced food. It supplies most of the nutrientsneeded by the infant, i;l the
correct amounts and proportions. Table 9.2 gives a comparative list of nutrients
present in various milksJ100 ml.

Table 9.2: Comparison of Nutrient Composition in Varlous MUkd100 ml

- - - - -

M i Energy Protein Fat Carbohydrate CPMum

(Kd) 0 (s) (g) (ms)
Human 65 1.1 3.4 7.4 28
Cqw's 67 3.2 4.1 4.4 120
Ass's 48 2.1 1.5 6.5 ' 80
Buffalo's 117 4.3 6.5 5.0 210
Goat's 72 3.3 4.5 4.6 170

Source: Nutritive Value of Indian foods by C.Gopalan, B.V.Rama Shastri and S.C.Balasubramanian; re-
vised and updated by B.S.Narasinga Rao, Y..G.Deosthale and K.C.Pant, National Institute of Nutrition
(1989)

Compare the nutrient composition of human milk with that of other milk given
in Table 9.2. What do you notice ? Yes; breast milk does have a low
concentration of certain nutrients as compared to other animal milks (i.e. cow's,
buffalo's, goat's). So, how do we say that breast milk is nutritionally adequate?
We say so because the amount and proportion of nutrients present in breast
milk is ideal for supporting the growth of the infant. All nutrients are present in
just the amounts required by the baby. A high protein and mineral content as
seen in buffalo's, cow's milk is not good for the baby as it imposes a great strain
on the excretory capacity of the infants immature kidneys. Bre"astmilk, on the
other hand, suits the baby's tender digestive system and it gets easily assimilated
in the body. Breast milk, however, has a high content of carbohydrates
(specially lactose), essential fatty acids and certain protective nutrients like
vitamin A, and vitamin E which are beneficial for the infant.
Besides nutritional adequacy, breast milk has other advantages as well which
are listed in Figure 9.3.

BREAST MILK IS THE BEST FOOD

'FORTHE INFANT

Fig. 9.3 Importance of brenst mUk

Check Your Progress Exercise 2

1) Explain the following statements in two to three lines. '
a) Breast milk is nutritionally adequate.
.........................................................................................................
........................................................................................................
..........................................................................................................
b) Breast milk has protective functions.
.........................................................................................................
.........................................................................................................
.........................................................................................................
c) Colostrum has life-saving properties.
.........................................................................................................
.........................................................................................................
When introduce supplementary foods: In inany families you would have noticed
that the introduction o f ssdid food is associated with a religious ceremony commonly
known as 'Anna Prashna'. This ceremony takes place at around 6 months in some
communities and in some as.Iate as one year. But, what is the right time for
supplementary feeding? The right time to start with supplements is between f o u ~to
six months. If you start too early you fisk diarrhoea and if you start too late you risk
malnutrition. Hence introduce supplementary foods only around 4-6 months. But
continue breastfeeding.
What kind of supplementary foods should be given: In general, based on the age of the
infant, one could vary the texture and consistency of the supplemerrts as follows:
(a) Liquid Supplements at - 4 6 months
(b) Semisolid to solid supplements -well cooked and mashed between 6 - 8 months
(c) solid supplements - chopped or lumpy between 8-12 months
Let us learn what liquid and solid supplements can be given.
a) Liquid Supplements: T o begin with, at about 4 months, along with breast milk,
cerraln liquid supplements like juices, soups or other milk substirutes (like animal
milk) can be given (Figure 9.4). Juices of seasonal fruits such a s oranges, musambi
and grapes provide protective nutrients (likely vitamin C) which are not present in

troduce clean and strained juice or soup at 4-6 months.

Fig. 9.4 Liquid supplements for infants
suilicient amourits in breast milk. Alongwith fruit juice, soups of green leafy
vegetables may be given. The soup can be prepared by boiling the vegetable in
minimum water and a little salt and then straining it through a sieve. The liquid
obtained may then be fed to the baby. In addition, thin dal soup can also be given.
Now, what we need to know is how much of these liquid supplementi should we give
to the infants? In the early stages fruit juices can be diluted with equal amounts of
boiled water and only a couple of teaspoons can be fe'd. Thereafter, the amount can
be gradually increased and at the same time the dilution can be cut down. In a few
weeks the baby can,be given 3 ounces or 85 ml (a little less than half glass) of orange
juice or the soup.
A word of Caution: Juices, soups when diluted with excess water and strained may not
be able to provide adequate nutrients. Hence, it is advised to use minimum of water
for dilution. Similarly mash the dal with the water used for cooking and feed it to the
infant instead of serving 'dal ka pani'.
b) Semisolid and Solid Supplements: As the child grows, the kind and quality of food
given changes. From liquid supplements there is a gradual transition to
semisolid/solid foods (Figure 9.5). The first solid food commonly offered at 5-6
months is a soft thin, liquidy porridge madefrom the staple food of the community.
The porridge can be prepared by cooking the cereals (i.e. whkat, rice, semolina etc.)
with milk and sugar. Such a preparation is called the basic mix i.e. when the staple
(cereal) has one food (usually a protein source) added to it. A common basic mix
served to the infants in the south is 'ragi kanjee' and in the north 'suji kheer'. A few
other common examples of basic mix with the method of preparation is given in
Annexure 3 at the end of the block.
A staple porridge can be made with any cereal flour - maize, jowar, sago, semolina
etc. The addition of just one-fourth to half a teaspoon of germinated wheat flour to
the porridge will ensure that it does not thicken at all and will be in a form that the
baby can swallow easily. What is this 'germinated wheat flour'? Why are we
suggesting the use of this in the porridge? What is its role in making thick porridges
thin? Information on this new interesting concept is given in Highlight 3.

t
Serverthin, llquidy porrldge and,mashed trults/vegetables at six month*.

Fig. 9.5 Semidid supplements for uifaots

Other than the porridge, starchy fruits and vegetables which are cooked well and
mashed can be given round 5-6 months. Roots and tubers, vegetables that can be
given in the mashed state include potatoes, sweet potatoes, yam, carrots, green leafy
vegetables. It is advisable to boil these vegetables in minimum water till tender and
then to mash them properly. The mashed vegetable can be fed as such or with a little
salt or!and ghcelbutter could be added to provide more energy. Remember, only the
pulp of vegetables is to be given. The skin and seeds, if any, and other fibrous matter
is to be discarded.
 .d%iauaaioru a p l ~ o i d01 pappe
aq o s p ue3 (iaiinq -a'!) iq jo iunome IIeuxS .aisei 01 pappe aq ue3 'qes L LON
.spp paqsem pue paqoo3 [[am '(auoq inoql!~)qsg paqseru 'ieaw paqoos pue pmu~ru
6laug '3% palloq -p~eqe jo ylo6 a p n p u ~ua+% aq plnos q q m siuamalddns i a q i o
-8uwas aiojaq sl!ruj aq4 JO spaas 'utqs piesstp 01 iaqruauxax .paAias %u!aq
aiojaq paqsem pue (iapuai iee%nspue iaiem aliiq e u! paI!oq 'a'!) pamais isi!~aq
01 paauena s a q ~ e a d'alddeaurd aqq sl!ru;l iaqio 'seaisqm ' q ~ n sse u a ~ @
pue paqseru
aq p(no3 I!IUJ leuoseas iaqio Lue l o sao%uem'ekeded 'seueueq -s1g1.1~aql%uomy
small pieces befor4 being served. For instance, vegetables like potato and carrots
could be boiled and cut into small pieces. Minced meat and fish could be boiled and
served as such instead of mashing. Soft cooked rice or sri.lal1pieces of chapaties may
also be introduced at this stage.
As the infant ,is teething, it isbeneficial to give more of crunchy foods like a hard
biscuit or a piece of toasttrusk or a slice of raw earrot or a fruit segment (seeds and
skin removed) which would be ideal for the child to chew. These foods would aid in
teething and provide exercise to the gums.
In addition to this, thick porridges can be prepared and served to the infant. Earlier
you studied about the basic mix i.e. cereal pomdges prepared by adding milk and *
sugar. Now other than milk, foods like pulses, animal foods, green leafy vegetables,
other vegetables can also be added to the staple to form a multimix (Figure 9.7).
When the staple i.e. the cereal has morefoods added to it, (protein source plus
vitamidmineral source) we call it a multimix. A commonly used multimix in the north
is 'khichri' and 'pongal' in the south. Multimixes can be prepared by mixing the
following food items:
(a) Cereal + pulse + green leafy vegetable
or
(b) Cereal + pulse + milk
or.
(c) Cereal + pulse + vegetable + curd
or
(d) Cereal + animal food + green leafy vegetable
or
Ce) Cmxli milk + fruit '+ nuts (finely ground)
or
(f) Cereal + animd food + green leafy vegetable
or
(g) Cereal + animal food + orange yellow vegetable (carrot, pumpkin etc.)

Fig. 9.7 Sdid supplemcnta (multimlxes) for Manta

Multimixes can be introduced as early as 6-7 months of age. You could add MulRuJlrkirtbe
I d m t n d Rcaebookr
one-fourth of a teaspoon of ARF powder to the multimix to make it thin and easy to
swallow. Some of the multimixes or infant foods that can be prepared daily for the
infants are given in ~ n n e x u r e4 at the end of the block.
What foods to give at 12 months i.e. one year? By the age of one year (i.e. 12months)
the baby can take all solid foods. In fact, the infant should be eating foods prepared
for the family, for example riceldal; chapatildal; ricelfish; chapatilsubji. A chapati can
be crumpled into small pieces and softened with milk, dal or curd and salted or
sweetened according to the baby's taste and served. Rice can be served with dal and
vegetable all mixed well. Attempts should be made to get the infant slowly on to the
family meal pattern. Along with these foods breastfeeding should be continued. But if
breast milk has ceased, then the child can be given half a litre of animal milk per day
either as sukh or as curd, cottage cheese or milk pudding or porridge.
Along with the supplementary foods, one should provide plenty of water/Juids to the
infants. Small amounts of boiled and cooled water should be given 2 to 3 times a day
or more often, depending on the need. More water needs to be given during hot
seasons and especially if the baby has diarrhoea.
What should be meal pattern?
The type and quality of food given would depend on the age of the infant. Consider
the meal patterns A, B, C and D.

Meal Pattern A M q l Pattern B Meal Pattern C Meal Pattern D

0-4 months 4-6 months 6-8 months 8-12 months
Birth-Zm: On waking- . On waking- On waking-
~ r e a s milk
t Breast milk Breast milk Breast milk
7-8 times a 8 AM-Fruit juice 9 AM-Mashed 9 Am-Multimix
day fruithegetable
11 AM-Fruit cut
into pieces
10 Am-Mashed banana 11 Am-Breast milk 1 PM-.Multimix
From 2m-4m: 12 PM-Breast milk 1 PM-Porridge 4 PM- Breast milW
Breast milk other milk
6-7 times 2 PM-Dal soup 4 Phf-Breast milk 6 PM- RusWBiscuitl
a day a slice of bread
4 PM%reast milk 6 PM-Porridge 8 PM-Multimix
6 PM-Vegetable soup 8 PM-Breast milk 10 PM-Breast milk
10 PM-Breast milk
8 PM-Breast milk
10 PM-Breast milk

From hirrh ro four month only breast milk is to be given. There is no rigid rule for the
'number of times the inhnt should be fed each day. Feeding on a self-demand
schedule is recommended. However, roughly 6-8feeds can be given during the first
few months which can be reduced slowly. By the age of 6 months babies should be
given some ~taplebased porridge about twice a day. One to two teaspoonfuls are
enough to st;rrt with, followed by about 3-6 large spoonfuls at each feed subsequently.

The frequency o f breastfeeding should be gradually reduced. In fact, by the time the
child is 12-18 months, attempts should be made to take the baby off the breast. By one
year, the child is capable of eating and digesting a variety of foods. The child is ready
to eat the family food i.e. chapati, dal, rice, vegetables etc. But the child may not be
able to eat much at one time. On the other hand, the child's energy needs, are greater
than is indicated by its size. So the problem is how to provide enough energy food to
the child. The answer is:
feed the child frequently -five to six times a day in addition to breast milkland
enrich the child's food with a little oil or fat.

Simple tips on infant .feeding are listed in points to remember.

From our discussion so far you would have got an idea about infant feeding. Now
consider the case of Lata. Lata had a baby two weeks back. Like most mothers she
started breastfeeding her baby right from day one. But to her dismay, she found she
was unable. to feed her baby because of the inability to secrete adequate breast milk.
Lata was very womed. She consulted her doctor. The doctor diagnosed her condition
as Lactation Failure. Lactation failure refers to the inability of the mother to secrete
breast milk. There is either a deficient supply of milk or at times there is no milk
secretion. Under such circumstances what should Lata do. We are already aware
about the high nutrient need during infancy. How should Lata meet the needs of her
growing baby? She need not worry. For her and for many women like her here is a
detailed discussion on Infant feedine in lactation failure in Hiehlieht 4.
Check Your Progress Exerdsc 3
1) What do you understand by supplementary fee ling?

2) Fill in the blanks.

a) Supplementary feeding should begin around. ......................months.
b) ................. and ................... foods should be given at 6 months.
c) 'When the child starts teething ..................and .....................foods
should be given.
d) Infants cannot eat much at one time. They need ..............and
........... ..feeding.
e) Along with supplementary feeding ...........................should be
continued.
f) In case of lactation failure ......................... milk is best suited f6r the
baby.
3) Note down some of the staple porridges or multimixes used in your community.

9.3 THE PRESCHOOL CHILD

Who is a preschool child? Here we will consider a child in the age group 1-6 years as
a preschool child.
From the growth and development standpoint,the preschool child, like theinfant is
extremely vulnerable. A preschooler grows rapidly, but when compared to infancy,
the rate of growth is somewhat slower and more gradual. The average gain in weight'
during the preschool age is only about 2-2.5 kg each year as can be seen from
Figure 9.8. It is, however, interesting to note that the preschool child gains
comparatively more in height than in we~ght.By three years the child is about 93 cm
tall and by four years about 100 cm tall. Because of this the child gives an appearance
of being tall and thin as compared to the roiind and chubby appearance characteristic
of infancy. .Another characteristic feature of .the preschool child is the increased
physical activity. The infant from being dependent on the mother moves on to
becoming independent especially in terms of gaining control over the body. The
increased physical activity and the growth taking place during the preschool stage
necessitates a higher intake of nutrients.

Regular weight gain is the most important sign of the child's overall health and
num.tiona1 status. Weighing the child once every three month, during the second year,
and subsequently once a year, till the child goes to school, would give a good indication
of the child's growth. Any subnormal growth or growth failure can be easily detected
and corrected. It is important to mention%ere that it is during the early years of
childhood i.e.O-6 years, that "catch-up" growth is possible. What do you mean by
"catch-up" growth? To understand this, consider a case of growth failure i.e. a child,
whose heighttweight is considerably lower as compared to other children of his age.
Now, if during infancy and preschool years right inputs i.e. good diet and clean, safe
hygienic living conditions are provided, it will be possible for the child to make up for
the earlier deficit in growth and development. From this standpoint, therefore,
preschool period is very crucial. Diet plays an important role in promdting good
health. Let us now study the influence of above mentioned factors on the nutrient
needs of a preschool child.
9.3.1 Recommended Dietary Intakes for the Preschool Child
The recommended dietary intake that would support optimum growth aqd
development of the preschool child is given in Table 9.4.
Fabk 9.4: Rcavnmenatd Dkt.ry Intakes for the Pmwhool chUd
Nutrients RDIs
Age P U P
1-3 years 4-6 years
-
Energy (Kcal) 1240 1690
Protein (g) 22 30
Calcium (mg) 400 400
Iton (mg) 12 18
Vitamin A (pg)
Retinol 400 400
or
Carotene 1600 1600
Thiamine (mg) 0.6 0.9
Riboflavin (mg) 0.7 1 .O
Niacin (mg) 8.0 11.0
Ascorbic acid (mg) 40 40
Folic acid lpg) 3"
0.2-1 .O
40
0.2-1.0
Vitamin B,,(pg)
Sauce: Nutrient Icquirements and Recommended Dietary Allowances for Indians. ICMX (1990)
.he preschool years represent the age from approximately 1year to 6 years. It is
obvious that at any given age the nutrient need would vary depending on the level of
growth and physical activity. This is the reason why the nutrient need of the prtschool
child is given under two categories - 1-3years and 4-6 years in Table 9.3.
The total energy requirement of the preschooler increases with age,but if you were to
calculate per kg intake you would notice that in comparison to early infancy ((M
months), the requirement is markedly 1 k . This of cowse is attributed to the gradual
and slower rate of growth typical of preschool years.
The requirement for other nutrients (in proportion to body size) is also high but fhe
need for a few nutrients like protein, calcium, vitamin A and iron is the most. This is so
because these nutrients support the growth and development of the body. A
preschool child is more prone to infections and diseases hence pmtective nutrients,
especially vitamin A and iron are particularly important. The diet of the pre@mA
-
child must provide sufficient amount ofthese nutrients.
Check Your Pci-.1@6% htercLce 4
1) Fill in tllz b l a ~ ~ k s .
a) The preschool stage is the period from.. ...........to ...:........ ...y i:ars.
h) As compared l o infancy. growth during the preschool diige 4s ...,.............
ar~dmore ....................
c) Thc preschool stage is characterized by increased ..................activity.
d) The dietary requirement for .................. and ......................is high in
the case of the. preschooler.
e) A preschooler increase more in .................... than in .......................
f) The gain in weight during the preschool vears is ~ r : l y................. kg each
- year. --
9.3.2 Meal Planning for the Preschool Child
The preschool years are the time to establish good eating habits in children. ~ tthe '
sane time the influen- of parents, friends, television, activities associated with food,
help to shape the child's food habits. Providing an adequate diet for the child is,
therefore, a challenging task. What dietary measures should one keep in mind while
planninglpreparing a diet for children? How to plan balanced meals keeping the
Likes/dislikes in mind? How much of which food item should be included? These are
some of the questions which are often asked in the context of feeding preschoolers. In
this subsection, you will find the answer to these questions.
We begin meal planning for the preschool child by taking into consideration the basic
four factors listed in the margin. The other considerations include:
Whom are we planning for?
Is the child in the 1-3year age group or in the 4-6 year age group?
a What is the income of the family to which the child belongs?
Which region does this child belong to?
Information on these aspects would help us select the right kinds of foods (in the right
amounts and proportions) that would be included in the day's diet. Based on the
information the RDIs can be listed.
Which are the nutrients of particular importance?
Some of the nutrients which are crucial for the growth and development of a
preschool child include:
Energy-giving nutrients (carbohydrates and fats)
a Protein
Calcium
Iron and
Vitamin A
Which fodds to seled?
The diet of the preschool child must include at lea@one food item from each of the
three major food groups namely energy-giving, body-building and protective /
regulatory. But you are also aware that the need for energy, protein, calcium, iron
and vitamin A is considerable during the preschool age. ~ e n c einclude
, more of
eaergy-rich foods,spciJk$",-oeraals;protein-rich foods such as pulses, meat, egg;
calcium-rick'b~dspwticul&Iy'mi~ and milk products and iron-rich foods such as
meat @artrculatiy liver) pulses and green leafy vegetables in the diet. A list of food
items rich in energy, protein, calcium and iron is given in Annexure 1: You could
consult it and ~eleetfood items a g r d i n g to the likes/dislikes of the child and
availablity of the food item. As for the vitamin A-rich food sources one can select one
or two of the fobwing foods as indicated in Figure 9.9.

Flg. 9.9 Preschoolers need foods ricb In Vitamin A

What should be the meal pattern?

Always remember that a regular meal pattern should be maintained. Too long or too
short an interval between successive meals should be avoided. The preschool child
may not be able to eat much at one meal. Hence, smallfrequent meals need to be
given. A preschool child would benefit from three small meals plus 2 to 3 snacks
in-behveen meals per day. The meal pattern adopted would actually depend on the
age of the preschool child. Consider the list of meals given under A and B.
- - - -

A B
Early Mnrninp Early morning
Br$akfa\t Breakfast
Mid-mrwn~ngmc.;~l Mid-morning meal
Lunch Lunch
Mid-afternoon mclrl Tea
Tea Dinner
Dinner Bed Time
Bed Time

A) is likely to be adopted for a 1% year old child, The child needs to be given food
every 3-4 hours. Alteast.2-3 milk feeds (early morning, tea, bed time) should be
given. In addition foods of high protein and energy content should be given 4-5 tinits
a day.
B) is likely to be adopted for a 3-5year qld child. In addition to 2 rn~lk.feeds.a11d
three main meals (breakfast, lunch, dinner) other nutritious foods. snacks and fuod
preparations should be served in-between meals.
What are the fwd prep~rationdsnackssuitable fur the presehcol child? -mh-bg~r*
Any snack/food preparations bascd on the common locally available cereals and -4-
pulses can be prepared. The snack should provide on an average 300-400 k d s . But,
ensure that the bulk of the preparation fed to the child is not vdry large. A child will
remain healthy and well nourished provided food/snacki of high energy / proteini
calcium / vitamin A content are given (without increasing the bulkhrolume). Snacks
should supplement not substitute the main meals. Snacks should be such that are easy
to prepare and should be in a form easily handled by the child. A few ideas for snacks
for preschool children are given in Annexure 5.
What are the other specific considerations?
i) Mealtime for children should be relaxing and enjoyable. Children learn to enjoy
food when they are allowed to feed themselves. It is easier for the child to feed on his
own if food is cut into bite-sized pieces that can be readily handed and lifted to the
mouth. Children like foods that can be eaten with the fingers (Fig 9.10).

Fig. 9.10 Children enjoy finger foada

ii) When introducing-new foods to the child, offer one at a time. Give only smalI
amounts at first. Let the chiid make the decision of liking or disliking the food. Never
make an issue of food acceptance. Forcing the child to eat a particular food may
establish an unfavourable attitude towards that food. If the food'is rejected, wait for a
few weeks and then try again.
iii) Children of preschool age develop very strong likes and dislikes for certain foods.
They might avoid eating one or more essential foods. For example, green leafy
vegetables, milk are usually disliked by children. In such situatioris, therefore, it is
advisable to change the form of the food and then serve it to the child rather than
totally omit it from the diet. Fewer difficulties are likely to be encountered if foods
which are disliked by children are given when the child is hungry.
iv) Children are easily influenced by the parents attitudes towards food. Parents
should, therefore, be extra careful of not to express their likes and dislikes in front of
children (Figure 9.11). Rather they should eat a variety of food and encourage the
child to do the same.

v) Foods served to children should be warm and not too hot or too cold.
vi) Children usually have a very high taste sensitivity. They do not enjoy highly
flavoured foods. Only mildly flavoured foods should be included in the.diet.
vii) The digestive tract of the preschool child is easily irritated by spicy food, very
swekt or fried foods. Hence, such foods should be avoided. Further consuming
excessive amounts of fibrous food also irritates thetender digestive tract. It is,
therefore, advisable to use a minimum of fibre-rich foods for preschool children.
viii) Preschool children are almost constantly active. Their interest is readily diverted
from food. Hence, it is essential to prepare meals that look colourful, attractive and
catch the attention of the child and motivate them to eat.
 Fig. %1k Wren& a(tihdcs inflwaee ehlldrcn's food W t s

ix) It is important that the child eats a good breakfast. ~reakfastshould supply upto
one-third of the day's energy reqirement. A good nutritious breakfast served in the
morning would help increase physical and mental efficiency of the child.
Simple tips on how to provide adequate and satisfyin'g meals for preschoolers are
listed below in pointi to remember.

1
NOTE: REFER TO THE PRACTICAL MANUAL - PART I (SECTION 6)
FOR DIETS FOR INFANTS AND PRESCHOOLERS.
Check Y w Progress Excereise S
1) State whether the following statements are true or false. Give reasons for your
answers.
a) When supplemel9tary feeding has been delayed, the child does not a e p t
food easily at one year of age. (TtueIFalse)

b) Srnall frequent meals should not be given to thc preschooler. (TrueFalse)

c) Fibre nch food like whole grain cereals, whole pulses should be totally
avoided for older preschool children. ('TndFalse j

...................................................................................................
d) Foods disliked by preschoolers should be avoided. (True~Falsc.)

...................................................................................................
e) At each meal, large helpings of food should be given. (True/False)

2) List any three specific considerations that should be kept in mind while feeedirrg
preschoolers.

LET US SUM UP
In this unit you studied about infancy and the preschool stages.
Infancy refers to the first yearof life after birth. Infancy is a period of rapid growth
and development. To support the growth and development the nutritional needs are
considerable. The RDI for energy, protein, calcium and iron are particulary high.
The nutrient requirement of the infant for the first months can be easily met by
breast milk. After six months, however, breast milk done is not sufficient t o meet the
growing needs of the infant. Along with breast milk other food supplements (liquid,
semi-solid, solid) need to be given according to the age of the infant. By the age of
one vear the infant should be ready to eat the family food.
Preschool sfage i.e. 14 years, is also a rapid growth period. But compared to infancy
the growth is gradual and slow. The most characteristic feature of the preschool age,
however, is the increase in physical activity of the child. %use of the rapid growth
and increased physical activity, rhe nutrient requirement is high. To meet the nutrient
requirement of preschoolers, certain dietary considerations should kept in mind.
First, the meal shouid be balanced and nutritionally adequate. Regularity in the
feeding schedule sho.uld be maintained. Since the child cannot eat much at a time,
small but frequent meals should be given. Substantial snacks should be offered in
between the main meals -mid-morning or in the evening. Strongly flavoured or fatty
foods should be avoided. Meals served should be attractive and appealing to the eye
so that the child is motivated to eat 61
9.5 GLOSSARY
Food Allergy : It is the condition when the body reacts unfavourably to milk or
other food substances. Allergy might manifest itself in the form of
diarrhoea, skin rash or any orher such problems.
Malnutrition : It can be defined as a pathological state resulting from relative or
absolute deficiency or excess of one or more essential nutrient,
which can manifest into overnutrition or undernutrition.
Staple foods : The foods used frequently or daily in meal preparation. For
example rice is the staple food in south, and wheat is the staple
f w d in north.
: It reYers to below normal growth, for example when the height/
weight of an individual is considerably lower as compared to
other individual of the same age it is referred to as subnormal
growth.
Vulnerable : Refer to someone capable of being physicallylemotionaily hurt;
Susceptible to infectionsJdiseases.
Weaning : The gradual change in the infarits diet pattern from breast milk to
other liquid food preparation and cooked solid food preparation is
referred to as weaning.

9.6 ANSWERS TO CHECK YOUR PROGRESS

EXERCISES

Check Ywr Progress Exercise 1

1) a) birth; one b) doubles c) weight, height
d ) any two of the foliowing -~ner~y/~rotein/calcium/vitamin
A e) size;
number
2) a) True; the RDIs for some nutrients are expressed per kg body weight
because their requirement is substantially different within the
specific age category.
b) False; the requirement for iron is high during infancy because the blood
volume increases and, therefore, iron is required ior the synthesis
of haemoglobin in the blood cells.
c) False; an infant should be weighed every month during the first year, to
aisess the pattern of growth.
d) False; an infant gains comparatively more in weight than in height.
e) True; the RDIs for the first six months are only guidelines for feeding
infants who cannot receive breast milk. If an infant who is breast
fed, on an average, receives 850 ml milklday his RDIs are easily met.

Check Your Progress Exercise 2

1) a) Breast milk is nutritionally adequate as it contains all nutrients in the right
amount and proportion. The protein content of breast milk, as compared to
other milks, is low, but it is the right amount for the infants growth. The
carbohydrates and the essential fatty acids content of breast milk is high
which is beneficial for the child.
b) Breast milk contains certain substances which are protein in nature and
protect the infant's body from infections and diseases. These substances
thus prolong the body immunity.
c) Colostrum is life-saving as it has protective functions. It contains high
concentration of antibodies and white b l w d cells which protects the child
from infections.
Check Your Progress Exercise 3
1) The process of introducing foods other than breast milk (liquid foods, other
substitute milk preparation, cooked solid food) in the diet of the infant is called
supplementary feeding.
 hk.lPl8nnIngfathc
Idmt rud Rcseboolcr
(e) breastfeeding (f) co?'s
3) Answer on your own.
Check Your Progress Exercise 4

Check Your Progress Exercise 5

1) a) True; because the child is not familiar with the f w d and has not developed
a taste for it.
b) False; small frequent meals should be given to the presohoolers since, the
child may not be able to eat much at one time..
r) False; fiber-rich foods should be served judiciously since high fibre diet
would irritate ttie digestive system of the child.
d) False; foods disliked by the children shooid not be avoided infact they
could be served by changing the form of food.
e) False; small amounts of food shortld be serveitat &ch meal shce the

2) List any three of the following: ' . ,-+

Regularity in the feeding &hedu!e should berm&&d. - , -
Small frequent.feeding shouldbe given. -
All fried, spky and strongly flavoured foods should be avoided, whilst the
fibrous food should be reduced.
Serve more milk, green leafy vegetables, yellow and om& fruits and
vegetables and other vitamin A rich foods to the chiid.
Include nutritious snacks in-between meals.