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2. Dr Nahed Al nagger Assistant Professor of Pediatric Nursing Umm Al Qura University 1430-1431 H

3. Intended Learning Outcomes (ILOs): Define weaning. Recognize aim of weaning. Identify the best time of weaning. Mention principles of weaning. Explain the effect of premature weaning. Describe technique of weaning. List hazards of weaning. Identify the role of the nurse in weaning.

4. Definition Weaning is the process during which the infant change from full dependence on breast milk to complex independence from it.

5. Definition Weaning is the gradual decrease of breast feeding and gradual increase of semi- solid food.

6. Aims of Weaning The child can not tolerate more than one liter of fluid per day so, with his increase needs for energy more solid foods should be added. To train GIT to digest starch and other solid foods.

7. Aims of Weaning With growth, the baby requires more food items, minerals and vitamins, which cannot be all supplied by milk alone. To educate the child independence by using spoon and cup.

8. Best time of Weaning Breast milk contains high level of immunoglobulin antibodies (IGA), which protect the immature gut wall, thus weaning should be delayed for 6 months of infant’s life.

9. Principles of Weaning 1.Weaning should be gradual to prevent GIT disturbance, sudden weaning may also cause psychological trauma to the young infant. 2.Weaning should be not in summer because of the high susceptibility to gastroenteritis.

10. Principles of Weaning 3.Weaning should be not start during convalescence from any disease. 4.Weaning should be not start if the infant is under weight to avoid gastrointestinal disturbances.

11. Effect of Premature Weaning 1. Early weaning has been implicated as cause food allergy, indigestion, constipation or diarrhea. 2. Weaning too early is not tolerated due to immaturity of gastrointestinal tract, liver, and kidney.

12. Effect of Premature Weaning 3.Excessively early weaning avoided because it may result in fat or trigger allergies. 4.Early introduction of food and the early discontinuation of breast feeding are associated with increase risk of diarrhea also excessive rate of morbidity from infectious disease.

13. Technique of Weaning 1.Weaning start at the age 6 months by replacing milk feed by semi – solid food. 2.This should be continued gradually by replacing other milk feeds by foreign food until all food is replaced at the age of 1-2 years.

14. Technique of Weaning 3.The new food is given gradually and in small amount at first if accepted by the baby, the amount can be increased,  Never force the infant to takes a new food.

15. Technique of Weaning 4.The presentation of food is important so, better use colorful attractive spoon and plates to stimulate babies interest and appetite. 5.Introduce solids when the infant is hungry.

16. Technique of Weaning 6.New food item should be introducing one at a time usually intervals of 4-7 days to allow for identification of food allergies.

17. Technique of Weaning 7.As the amount of solid food increase, decrease the quantity of milk to prevent overfeeding. 8.Do not introduce foods by mixing them with the formula in the bottle.

18. Time Schedule of Introduce New Foods 6 MonthFruits, juice, orange, cereal food. 7 MonthStarch food, rice, mahalabia (spoon). 8MonthVegetable, soup, cereal stained. 9 MonthEgg yolk (in winter only) beans, custered, cheese. 9 MonthBiscuit, bread, dry toast, chicken liver, and finger food. 10-12 M 12-15 Chicken, rabbit. Red meat (food as adult total)

19. Marasmus and Kwashiorkor are the most common malnutrition disease. If weaning is postponed, the child may become anemic. When weaning occurs too abrupt, the infant may show sign of discomfort ( anxiety, sleeplessness and irritability). Hazards of Weaning

20. Diarrhea is the most dangerous hazard occurs during weaning period. Side effect occur during weaning they may be include: - Gastroenteritis. - Colic due to excessive CHO. - Allergic reactions. Hazards of Weaning

21. Assist parents in their individual approach to weaning their infant. Role of the Nurse

22. Factors to be considered as this process is discussed with the parents as : - Developmental readiness - The baby sucking needs. - Parent’s believes and feeling, finance, and nutritional requirements. Role of the Nurse