英訳協力：勤医協札幌病院小児科の先生方、みんパピ英訳チーム

Complementaryfood

What should you give your child?
1st Cooking burden

2nd Swallowing without chewing

3rd Low appetite, picky eating
it means“baby food” 4th Diﬃculty in feeding(National nutrition survey on preschool children
conducted by Japan Ministry of Health Labor andWelfare, 2016)

Complementary food is a diet that makes up for nutrition that breast milk can t give.
It is proposed by WHO as an alternative word to baby food. It s nothing out of the ordinary.
Give nutritious meals that you usually eat at home to your baby.
You need to smash, chop and soften them according to the baby s ability to bite and swallow.
Your baby will adjust to meals at home through this process.
Enjoyable mealtime is the most important thing for you and your baby.

Complementary food makes up for nutrition that breast milk can t give.
Particularly, breast milk contains less iron. Stored iron that a baby receives from their mother is used up by
six months after birth.This is why you need to give complementary food to your child.
Is it necessary to startwith white fish?

IronZinc

There is no nutritionalevidence to start withwhite fish. Rather, it isimportant to feed both
red meat and red fish
to give iron.

Meat
Especially red meat

Lean ﬁsh, etc.

When to start?

LiverBonito, sardines, tuna, etc.

□ Your child can sit by himself/herself with support.

Vitamin A□ Your child doesn t push out food with their tongue.

ChickenFish ,shellﬁsh

Yolk

Liver

Vitamin C

Calcium

FruitsDairy products□ Your child shows interest in normal meals.
5 - 6 months old is a rough indication under normal conditions.

AfterUntil

5-6

5 or 6months
old,Feeding breast and/or
formula milk is suﬃcient.
Consult yourpediatrician forconcerns!

monthsold,point1

breast/formula milk＋

complementary foodComplementary foods are
expected to containcarbohydrate, protein,micronutrient( iron, zinc,calcium, vitamin A,vitamin C, folic acid).

No need to reduce breast and formula milk

©佐久医師会

Vegetables

Spinach, broccolis

Baby foodTogather withother foods

Combine with other foods

to encourage complementary food?

It is diﬃcult to give iron, zinc,calcium and other nutrients withstaple foods (porridge) alone.
Side dishes area great addition.

Porridge paste
does not need tobe diluted

point 2

Breast and formula
milk digest in anhour. Babies caneat meals one hour
after having milk.

Do not feed low-calorie porridge!

Note that watery porridge is low
in calorie content.
A baby's stomach is small (about200ml) and they can t get enoughcalories from watery porridge.

Fish that can be eatenwith bones and all
Small ﬁsh, canned, etc.

Green peppers, broccoli,cauliﬂower, spinach, etc.

point 1

Do you need to reduce breast and formula milk
You don t need to decrease breast andformula milk. Reduction of milk to yourbaby sometimes stalls their growth. Giveyour baby as much milk as he/she wants,and whenever they want.

Green vegetables

Staple foods

after starting complementary feeding.

1 hour2

Citrus fruits, strawberries, etc.

Liver, etc.

Breast and formula milk are still responsible fora large portion of your baby s caloric needs
after starting complementary feeding.
Breast milk contains many immune substancesthat protect your baby from infection.

point

Yolk , yellow vegetables
Carrots, pumpkins, sweet potatoes,
Yellow and red bell pepper

toodilute

子どもが病気 ! など、いざという時役に立つ「教えて ! ドクター」無料アプリも Android・iPhone で配信中 ! お問い合わせ：佐久医療センター小児科外来

Try commercially available baby food as apart of your family menu .
●You don't have to be concerned withmaking soup stock from scratch.
●Sometimes it may be diﬃcult to sharethe family menu with your baby.

Caution!

When using commercial baby food, store it
carefully after opening the package. It is
strictly forbidden to give leftovers!

I don t likeforced feeding.... .

How come you
didn t eat yourmeal? I put somuch effort
into thisTEL.0267-62-8181 https://oshiete-dr.net 2019.5

英訳協力：勤医協札幌病院小児科の先生方、みんパピ英訳チーム

Gradually introduce complementary foods
Babies like to eat with their hands;
according to your child’s growth and comfort self-feeding
It is a big change for your baby to go from breast / formula milk to solid
food. Your baby needs practice.
There is no need to rush, as progress varies among individuals.
It is important to support and watch your child when they try new things.
Pay attention to your baby s expression and reaction,
Don t be too worried if your baby does not always eat the recommended
amount described in childcare books.

See your child's
expressions andreactions rather thanreferring to childcare
books.

If you are in a hurry and forcing your child to eat, he/she may be morereluctant to eat.
You don t have to rush.
It s a good idea to give your child the opportunity to eat by hand at theirown speed.

1

2

3

4

Horizontal

against the roofof my mouth.

When the child closes theirlips, pull it out horizontally(do not scrape it against
the roof of their mouth).

boiledvegetables,
meat, fish,etc.

出典：神奈川県立こども医療センター 偏食外来パンフレットより一部改変

Complementary food is the initial step toenjoy meals with family
Complementary food (baby food) is nothing out of the ordinary.
Complementary diet is a step towards being able to eat the same meals as your family s.

I want you to
eat as muchas possible.

I don't want foodto be scraped on theroof of my mouth.

Horizontal

出典：神奈川県立こども医療センター 偏食外来パンフレットより一部改変

参考文献 1）WHO（著），（2000）戸谷誠之（監訳）（2006）．補完食― 母乳で育っている子どもの家庭の食事 ,JALC 2）神奈川県小児保健協会資料
http://www.kanagawa-syounihokenkyoukai.jp/cat111194 神奈川県立こども医療センター 偏食外来パンフレット 3、チャレンジ編「いつから・なにをどのように食べる？」 3）日本ラクテーション・コンサルタント協会（2015）．
母乳育児支援スタンダード 第 2 版 , 医学書院 4）WABA( 著 )（2005），母乳育児支援ネットワーク（訳）（2005）母乳育児と家庭の食事― 健康的で愛情たっぷり（世界母乳育児週間パンフレット），母乳育児支援ネットワーク 5）
UNICEF/WHO( 著 )，BFHI2009 翻訳編集委員会（訳）（2009）．
UNICEF/WHO 赤ちゃんとお母さんにやさしい母乳育児支援ガイドーベーシック・コース「母乳育児成功のための 10 か条」の実践 医学書院

©佐久医師会

Beware ofsuffocation

Prepare vegetablesticks about 7˜8cm
long, so that adults
can pull them out.

Then, you can give your child boiled vegetables,
meat, ﬁsh, etc. in 1 cm cubes that are softenough to chew with their back gums.
Your child should be supervised by adults.

Don't putthe spoonin the backof mouth.

Stop just beyond the lips or at the tipof the tongue. Do not force beyond
Don t scrape
the first 1/3rd of the tongue.

7˜8cm

child can snap food with their gums
2 □□ YourYour child can pick things up with two ﬁngers

Use a spoon for infant.
(with a shallow bowl and a long handle)

Place a small amount of food on thespoon, hold it horizontally, and put itin the middle of the mouth.

Start practicing with hard, unchewable
vegetable sticks at ﬁrst.（i.e. raw carrots,celery. You can even put some food pasteon the tip of an edible stick

STEP

Don't worry about it alone. Ask for help!

1

The picnic sheet willkeep the floor clean.

Start practicing with hard
STEP

However, if your child does not accept any food other than breast milk orformula after 9 months of age, you need to have your pediatrician checkhis or her growth, development, and nutritional status such as irondeﬁciency.

Tips onhow to give
paste foodwith spoon

Children feel comfortable eating with
their hands, so we should respect this.
When your child reaches for a toy andputs it in his or her mouth, he or she isready to start practicing self-feeding.

When yourchild reaches
for a toy andputs it in hisor her. mouth

Separate and smash ingredients
before seasoning for adults(ex.simmered vegetables andother ingredients used for
miso soup) so that your baby
can enjoy the same menu as
your family s.
What is most important foryou and your baby is an
enjoyable mealtime
experience.Don t put too mucheﬀort into making
complementary foods.

子どもが病気 ! など、いざという時役に立つ「教えて ! ドクター」無料アプリも Android・iPhone で配信中 ! お問い合わせ：佐久医療センター小児科外来

TEL.0267-62-8181 https://oshiete-dr.net 2019.5