Feeding babies and young children during the COVID19 outbreak - WHO
Proper nutrition is vital in the first two years of a child’s life. It helps to ensure healthy growth, strengthen their immune system and improve their cognitive development. It also reduces their risk of becoming overweight or obese, getting ill with infectious diseases, or developing chronic diseases later on in life.
So give your child the best possible start. Breastfeed them exclusively for the first 6 months of their life, then complement breastmilk with a variety of fresh and unprocessed foods every day to give them all the vitamins, minerals, dietary fibre, protein and antioxidants they need. A diverse diet with a colourful mix of fruits and vegetables as well as grains and proteins (beans, nuts, seeds, meat, chicken, fish, eggs) will help keep your child’s immune system strong. Dark green leafy vegetables and orange/yellow coloured fruit and vegetables are especially good for their immunity.
Make sure your child drinks enough water, and stay away from sugar, fat and salt to significantly lower their risk of overweight, obesity, heart disease, stroke, diabetes and certain types of cancer.
And if you or your baby or young child has suspected or confirmed COVID-19, follow the basic protective measures outlined below to protect against this and other viruses such as cold and flu.
Exclusively breastfeed your baby
You should start breastfeeding your baby within 1 hour of birth and continue to breastfeed them exclusively during the first 6 months of their life.
Carry on breastfeeding your child until they are at least 2 years old.
From 6 months of age, complement breastmilk with a variety of adequate, safe and nutrient-dense foods. Make sure you do not add salt and sugar to these complementary foods.
If you have confirmed or suspected COVID-19, use a medical mask when near your child, wash your hands thoroughly with soap or sanitizer before and after contact with your child, and routinely clean and disinfect any surfaces you touch.
If you are severely ill with COVID-19 or suffer from other complications that prevent you from caring for your baby or continuing to breastfeed them directly, express milk to safely provide breastmilk to them.
If you are too unwell to breastfeed or express breastmilk, explore the possibility of relactation (restarting breastfeeding after a gap), wet nursing (another woman breastfeeding or caring for your child), or using donor human milk. Which approach you use will depend on your cultural context and personal preferences and the services available to you.
Give your child fresh and unprocessed food
Give your child fruit, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice or starchy tubers or roots such as potatoes), and foods from animal sources (e.g. meat, fish, eggs and milk).
For fruit, toddlers between 2 and 3 years old need about 1 cup of fruit per day. Children between 4 and 13 need 1.5 cups of fruit per day. Girls between 14 and 18 need 1.5 cups of fruit per day, and boys that age need 2 cups.
For vegetables, toddlers between 2 and 3 need about 1 cup of raw or cooked vegetables per day. Children between 4 and 8 need 1.5 cups of vegetables per day. Girls between 9 and 13 need 2 cups of vegetables per day, and boys need 2.5 cups. Girls between 14 and 18 need 2.5 cups of vegetables per day, and boys need 3 cups. Vary vegetable consumption to include leafy greens, brightly coloured red and orange vegetables and legumes.
For protein, serve 2–3 portions per day (3 for a vegetarian toddler). Fish should be served at least twice per week and one of these should be oily fish (e.g. salmon, sardines, mackerel or trout). Nuts are considered protein, and they are recommended for children above 5 years old.
For milk, serve 3 portions per day. Children under 2 should have whole milk or yogurt. Those eating well can be given semi-skimmed milk after 2 years. Skimmed or 1% milk is not suitable as a drink for children under 5. Products fortified with vitamin D can make a useful contribution to intakes.
For fruit juice and dried fruit, children under 6 should have no more than half a cup of juice per day – and make sure it is 100% fruit juice, not a juice drink with added sugar. After age 7, keep juice consumption below 355 ml per day. Half a cup of dried fruit is equivalent to a whole cup of regular fruit. Fresh fruit is the best choice.
For snacks, give your child raw vegetables and fresh fruit rather than foods that are high in sugar, fat or salt.
Make sure you do not overcook vegetables and fruit as this can lead to the loss of important vitamins.
If you use canned or dried vegetables and fruit, choose varieties without added salt or sugar.
Make sure your child drinks enough water every day
Water is essential for life. It transports nutrients and compounds in blood, regulates the body’s temperature, gets rid of waste, and lubricates and cushions joints.
Make sure your child has 8–10 cups of water every day. This includes water from all sources like other drinks and food.
Water is the best choice, but you can also give them other drinks (e.g. unsweetened milk), fruit and vegetables that contain water (e.g. cucumber, tomatoes, spinach, mushroom, melon, broccoli, Brussels sprouts, oranges, apples, blueberries), and avoid giving them sweetened fruit juices, syrups, fruit juice concentrates, fizzy and still drinks as they all contain sugar.
Make sure your child eats healthy fats
Make sure your child eats unsaturated fats (found in fish, avocado, nuts, olive oil, soy, canola, sunflower and corn oils) rather than saturated fats (found in fatty meat, butter, coconut oil, cream, cheese, ghee and lard).
Give your child white meat (e.g. poultry) and fish, which are generally low in fat, rather than red meat.
Do not give your child processed meats because they are high in fat and salt.
Do not give them industrially produced trans fats (found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads).
Limit your child’s salt and sugar intake
When cooking and preparing food for your child, limit the amount of salt and high-sodium condiments (e.g. soy sauce and fish sauce).
Limit the amount of salt you use daily to less than 5 g (approximately 1 teaspoon), and use iodized salt.
Do not give you child food (e.g. snacks) that is high in salt and sugar.
Do not give them soft drinks or sodas and other drinks that are high in sugar (e.g. fruit juices, fruit juice concentrates and syrups, flavoured milks and yogurt drinks).
Remember: fresh fruit is the best choice for your child, not sweet snacks such as cookies, cake and chocolate.
Cook at home
Cook your meals at home to improve the quality of your family’s diet. Home-cooked food is healthier and more nutritious for growing children than calorie-filled food from outside the home because you know exactly what you are adding to it. A lot of food produced outside the home is high in calories, salt, fat and sugar, which increases the risk of your child becoming overweight or obese, and developing chronic diseases such as heart disease, stroke, diabetes and certain types of cancer later on in life.
Also, taking children to eat out during this COVID-19 outbreak increases their contact with other people and their chance of being exposed to the virus. If you have to eat out, maintain a distance of at least 1 metre between your child and anyone who is coughing or sneezing. That is not always possible in crowded social settings like restaurants and cafes. Droplets from infected people may land on surfaces and people’s hands (e.g. customers and staff), and with lots of people coming and going, you cannot tell if hands are being washed regularly enough, and surfaces are being cleaned and disinfected fast enough.
So home-cooked food during this outbreak and beyond is the best choice for you and your child. Make it fun for them so they eat a healthy and nutritious diet rich in fruit, vegetables and whole grains. Get them to pick their own food, help out with the ingredients, and be part of the decision-making process.
Basic protective measures
If you or your baby or young child has suspected or confirmed COVID-19, follow these basic protective measures. It is important that each of you follows these measures before and after you have contact with each other.
Regularly and thoroughly wash hands with soap and water or clean them with an alcohol-based hand rub.
Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze, then dispose of the used tissue immediately. Teach your child to do the same.
Avoid touching eyes, nose and mouth (hands touch many surfaces and can pick up viruses).
If you or your child have respiratory symptoms such as shortness of breath, the affected person should wear a medical mask.
Stay at home if you or your child feels unwell, even with mild symptoms such as a headache and a slight runny nose, until fully recovered.
If fever, cough and difficulty breathing develop, seek medical advice immediately as this may be due to a respiratory infection or other serious condition. Call in advance – do not visit a clinic or hospital without calling first.
Stay at least 1 metre away from anyone who is coughing or sneezing.
Keep informed about the latest developments with COVID-19 and follow the advice given by health care providers to protect yourself and others from COVID-19.
Counselling and psychosocial support
During this COVID-19 outbreak, it may be harder to get nutritious food at home because of lockdowns, and there may be increased demands on parents and caregivers. If you feel overwhelmed with children and feeding responsibilities, seek counselling, basic psychosocial support, or practical feeding support. You may get support from appropriately trained health care professionals and also community-based lay and peer counsellors.