Supplementation and weaning
The introduction of food other-than breast milk reflects both cultural and economic differences. Early introduction of semi-sold food is very common among rural families in Thailand, Indonesia, China and Burma. Chewed rice,rice paste or gruel or banana are usually given to the baby. It is customary in Thailand to give the baby thick, sold feeda as a supplement to breast milk at an early age.If supplemental feeding is started within the first three months of life almost invariably consists of a mixture of mashed a chewed boiled rice and banana, especially the cheap and easy to get banana of kleuy namwa(Musa sapientum) variety is used for this purpose. When supplemental feeding is begun at a leter age there is more choice; vetetable soup, egg yolk, meat broth and the like; these are given together with the rice, and other fruits are offered in combination with banana. At the age of about one year,the supplement will consist of the family food, but for the baby it is always wellminced and left unseasoned.
In the Northern and Northeastern part of the country, the rice consumed is glutinous rice(Oryza glutinosa), in the Central and Southern part it is Oryza sativa (Table3). In the Southern part the first solids introduced sometimes consists of a thick cornflour porridge, called sojee, but with this too, banana is also given. Over all about 40% of the babies receive solid foods at the age of one month and about 60% at three months. In the Northern and Northestern part supplemental feeding with solids is frequently introduced early as the first week.
Supplemental feeding in the first week of life stands more chance of doing harm than of serving any useful purpose, and therefore it should be avoided. In general, amylase activity in the duodenal fluid of young infants during the first one or two months of life, is so low that it is almost unmeasurable, however it gradually increases as the child grows older. The study of the glucose level in the blood of infants, aged one to three months, whose regular food intake includes rice and banana, evidently increases after rice soup is given instead of milk. The result indirectly indicates that amylase activity in the intestines of those children increases in reponse to the stimulus of the early introduction of rice or banana(6). A study of the composition of carbohydrate in the ripe banana (Musca sapienta) shows more mono and disaccharide than starch (Table 4). The amount of starch in rice that is converted to sugar after being chewed for 5 minutes is 12.82% in the case of plain rice and 19.2% for glutinous rice (Table 5). The study of showed that the introduction of rice and banana at the age of one month did not do any harm from a digestive point of view. However, food supplement should not be given to the very young infant because it would reduce the sucking activity of the infant and this would lead to a decrease in the secretory function of mother’s breast. Beri-beri is common among pregnant and lactating women in the North and Northeastern part due to the fact that fresh food is taboo and the basic, common food: fermented fish contains thiaminase. The amount of banana which is given to the young infant varies from about 50-100 g. its universal use as a food in early infancy may well furnish the explanation why, in a country where beri-beri is so common, clinical infantile beri-beri is fairly rare(7).
WHO collaborative study on breastfeeding in India and Sri Lanka showed that complementary feeding occurred as late as one year. In Sri Lanka, the delay is often due to a ritual rice eating ceremony which is traditionally arranged around the eleventh month. There is therefore reluctant to offer rice earlier(8).
When the child approaches the weaning age (from the age of 4 months onward), the infant receives the local weaning foods vary from country to country. Almost of the traditional weaning foods are insufficent calories and inadequate essential nutrients, especially protein and fat as well as needed vitamins and minerals.This is the cornerstone for preschool malnutrition in Asia.