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Introduction

Ayurveda aims at maintaining good health in a healthy person and aims to cure the person who is diseased or sick.Bala (Kaumarbhrityatantra) is the branch of Ashtang Ayurveda that deals with the diagnosis and treatment of diseases related to  preconception, childbearing (Pregnancy),Childbirth and diseases of the children. Here in with reference to Pediatrics Recommendations given below:

Vayvibhajan according to Ahar1:

1] Kshirap – Upto to 1 yr- who drink only milk

2] Kshirannad - Upto age 2 yrs- who consume both milk and solid food.

3] Annad Awastha- who eat only solid food.

               With reference to Pediatrics,Ayurveda lays emphasis on Child’s growth and development since Intrauterine Period. Fetus is getting its nourishment from the ‘Rasa’, which is derived from mother’s Ahar and remains alive and develops in uterus.  Ahara Mool of human being but it also varna and oja of all individual.2 Here it depicts that Varna and Oja are also dependent on Ahar. According to Ayurveda the living human body and diseases that afflict it is both the product of Aahara. Aahara is considered as one of the key pillars (Upsthambha) of life in Ayurveda.3 For Sharir  poshan and Swasthya  Rakshanarth, Ahar is main content. The Anna/Ahara is a Dravya which is swallowed and through which  Dhatuposhan takes place.4   Now a days,through various means,healthy lifestyle is being compromised by promoting healthy eating habits,as aired them on TV or adverstisements. This led to less intake of Homemade Satvik food items. Deprived of appropriate Ahar if Proper Poshana does does not takes place,it may lead to onset of  Phakkarog,Balshosha, Parigarbhik, Karshya and various Dhatukshayajanya Roga. In case of more Quantitative intake of Ahar sevan leads to Sthoulya,Prameha,Hrudaya roga. Whereas Dushit Ahar may cause Udarshool, Krimiroga, Balatisar etc.5 Childhood phase is considered as Kapha Kala.6

With Reference to role Role of Ahar in Kaumarbhritya Acharya Kashyapa,in Kashyap Samhita  states that Ahar said is to be cause of stabiltity for living beings. There is nothing else except diet for sustaining the life of living beings.7 Any other medicament just like Diet is not available.One is able to make man disease-free only with the congenial diet.8 One is not able to sustain life without diet even of endowed with medicine.Thats why Ahar is said to be Mahabhaishajya.9

Aim: The study aims the importance of Ahar from the point of view of promoting good

health, Growth and Development.

Objective: To evaluate the data available for Factors responsible on large measure for the

rate of Growth and Development advocated in Classics.

Materials & Methods:

To remain healthy, in context to Ahar many rules and regulations are given in Ayurveda by Acharyas.The food we eat is digested and assimilated in the body and used for its maintenance and growth. Growth denotes a net increase in the size or mass of tissues.10 Development specifies maturation of functions. It is related to the maturation and myelination of the nervous system and indicates acquisition.11 Infants and children have higher requirements of nutrients than adults. While adults need nutrients for maintaining constant body weight and functions, infants and children require nutrients not only for maintenance but also for promoting and supporting their rapid rate of growth and development.12

Ahar as a  responsible factor for Growth:

Aharsaoushthavam13 -excellence of properties of food.

Aharsampachya14-Excellence of ingested food -factor responsible for promotion of strength.

After birth food alone is considered the most important factor for the development, and it is considered as BahyaPrana.“Aharamekatva Shareera Vriddhikaro Bhavanti” Kashyapa says that there is no better medicine than the food,to make the body free from any disease. It can keep the individual healthy. Among  Shareera Vruddhikara Bhavas, the Ahara is of prime importance, and it is mainly responsible for the body growth and development.15

Role of Agni:

Ayurveda has described an important factor of digestion and metabolism in our body as Agni.Digestion is a process that is characterized by a specific sequence of events following the ingestion of foods.These events allow food to interact with the various secretions such as enzymes,emulsifying agents,acid,or  alkaline substances thereby facilitating  the breakdown of complex molecules into simpler molecules under optimum Ph.16 Ingested food is to be digested, absorbed and assimilated, which is unavoidable for the maintenance of life, and is performed by Agni. In Ayurveda, the term “Agni” is used in the sense of digestion of food and metabolic products. The major  foods on which the body lives can be classified as carbohydrates,fats and proteins.Thay generally cannot be absorbed in their natural forms through the Gastrointestinal (GI)mucosa and for this reason ,they are useless as nutrients without preliminary digestion.17 Agni converts food in the form of energy, which is responsible for all the vital functions of our body. Therefore, Ayurveda considers that Dehagni is the cause of life, complexion, strength, health, nourishment, lusture, oja, teja (energy) and prana (life energy).18

Vayavibhajan into three groups according to Ahar :

1]Kshirap Awastha:

In Kshirap awastha Acharya Charak has stated ,first of all the child should be given honey and ghee impregnated with mantra prescribed for this purpose in the Vedas. Thereafter ,following the same procedure ,milk from the right breast should be given to the child at first19.Honey is said as pacifying Kapha and pitta20 and ghee used as alleviating vata and pitta.21 Milk is said to be Jeevaniya.22

Acharya Vaghbhat only mother.s milk is to be given to newborn for Balvriddhi.23 Acharya Kashyapa told that Stanyapana results in good growth, strength, longevity and good health of child as well as not causing any trouble or diseases to child.24 The benefits of Stanyapana are Jeevaniya (longetivity), Bruhaniya (overall growth of child)25 Balakaraka (develop immunity), Satmya (congenial),26 Sthairyakara (stability), Dehavriddha27 (aids digestion), Dosha Shamana (maintains Dosha Samyata), Vrisha (Harsha). Mothers’ own milk is considered to be the best source of infant nutrition28 It is desirable that the baby should be breast fed whenever this is practicable,and that cow’s milk should be  used only when the mother cannot .All varieties of milk are not forbidden for use by all living beings, because of its habituation by birth29 If an infant is provided only breast milk and no additional foods ,water,or other liquids (with the exception of medicines, if needed) upto the sixth month of life,then that infant is considered to be exclusively breastfed. Extensive evidence has shown that breast milk contains a variety of bioactive agents that modify the function of the gastrointestinal tract and the immune system, as well as in brain development. Thus, breast milk is widely recognized as a biological fluid required for optimal infant growth and development. Recently, studies have further suggested that breast milk mitigates infant programming of late metabolic diseases, particularly protecting against obesity and type 2 diabetes.30

Acharya Kashyapa have told about “Lehan” for the Children of “Aksheera (nonlactating mother) and Alpksheera Janani” (less lactating mother). A child’s happiness and misery depends completely on this “lehan”. He also used the term “Suvarnaprashan” for the lehan.31 The concept of Lehan to enhance body growth,intellect,immunity besides serving above purposes also fulfil the nutritional requirements. Acharya Kashyap prescribed recipes of Lehan like Ghrita boiled with Brahmi, Mandukparni, Triphala, Chitrak, Vacha etc. herbs, Kalyanak Ghrita, Panchgavya Ghrita and Brahmi Ghrita for Medhavardhan,aids also for achieving developmental milestones.32

2]Ksheeranad Awastha

In accordance with Selection of Diet for Children, the diet consume by the pregnant woman becomes wholesome to the child, therefore only those articles should  be offered to that child. Place ,time and digestive capacity should not be transgressed.33 Although growth rate slows in toddlers, their activity levels are high and appetite and food intake tends to be erratic.34 With regards to energy requirements, after six months of age, breast milk is not enough to make an infant grow well. Complementary feeding, is started at six months of age, while continuing breastfeeding. According to Kashyapa, Phalaprashana (fruit juices) should be advised at the age of 6th month while in 10th month or after eruption of teeth, Annaprashana (feeding of cereals) should be indicated.35 According to Sushruta, the child at the age of six months, should be given food light and Hitkar (appropriate wholesome food). According to Vagbhat on the 6th month, solid food should be given to the child gradually as much as he required as he goes on and breast feeding should be gradually discontinued.36

Fruit juices provides adequate amount of Vitamin C which is deficient breast in milk of mother, cow or any other milk.37  Fruit juices provide the required amounts pf Vitamin C .The organic acids presents in fruit juice help to lower the curd tension of milk and thereby aid in the digestion of milk proteins and in the absorption of calcium.38 Freshly prepared juices are always better than packaged juice, which are full of extra sugar, additives and may cause dental caries.39 The fruits Strengthen a child’s immune system and help fight illnesses. There is strong evidence to show that the nutrients found in fruits can prevent chronic diseases such as cardiovascular diseases. The high-fibre content can aid in the proper function of the digestive system and prevent constipation. The fruits, which are rich in Vitamin C, which is absent in mother’s milk.Strained vegetables and fruits are added to diet ,providingiron,vitamin c and small amounts of indigestible carbohydrates. The latter may help to prevent constipation.40 Precooked enriched cereal foods are generally fortified with iron so that they meet the iron requirements of the infants. There is increasing evidence that infants who receive small amounts of  cereals foods thrive better than those who do not.  When food is first time introduced, a small amount and soft food should be given and gradually increase in amount. Acharya Kashyapa mentioned food preparation as below.

Licking of the cooked liquid made with husk-free well washed Sali or sasti rice specially old rice, mixed with oleaginous substances and salt is promoter of nourishment of child; the powder(flour)of wheat and barley should be given according to congeniality as it also possess same property.41 Rice is considered to a very low allergen food and ideal for child. Rice is rich in carbohydrates and good source of Vit B complex, Easy to digest, rejuvenates body when used with milk. Wheat is good supply of carbohydrates for energy. Good sources of vitamins and minerals, act as a good natural laxative. Barley is a nutritious and has good amount of dietary fibre, strengthens bone. Acharya Vagbhata has prescribed various nutritional supplements in the form of Modaka (sweet balls) to cope up with the nutritional deficiencies and other gastrointestinal related disorders arising during weaning period. These are preparations specially developed to meet the nutritional needs of the infant as the usual family diets in our country are often inadequate for proper growth of the child.  Priyala majjadi modaka :This weaning food can be used for improving infant’s nutritional status and is prepared by using powders of priyala majja (Buchanania lanzan), yasthimadhu(Glycyrrhiza glabra ,laja(rice pops), sitopala (sugarcandy) and madhu(honey). It is easily palatable and is rich in nutrients. Both Priyala and Yashti are sweet in taste and pacify vata-pitta. They have nourishing properties of all tissues and promotes strength. It is called as Preenana Modaka. Like Dhatakyadi modak, Balabilwadi modak, Deepan modak preparation also mentioned.42

Hence while factors be to be considered whiles Planning Food for the Child,it is important to give small energy dense feeds at frequent intervals to ensure adequate energy intakes by the child.Amount fo feed to be increased gradually,appropriate food suitable for age to be given.Good hygiene and proper food handling is to be taken care of.43

3]Annad Awastha

Annad awastha, comes under Swatantra bala category because, a Child of this Age group can express himself.In this phase, growth and development of the Child is in progress.

The Dhatus are in Vivardhamana Awastha.

Between 2 to 5 years children seem to eat less with appetite fluctuations during growth spurts. Older children and adolescents should consume plenty of milk to fulfil the high calcium requirement, oil / ghee should be consumed.44 oodness of ghee is mentioned by Acharya Kashyapa in Sutra Sthans?s Sneha addhyay that Incorporate ghee in child diet, ghee helps in improving memory, concentration, boosts digestion, relieves constipation, strengthens immunity, complexion, colour. Acharya Sushrut also tells the same benefits of consuming ghee.According to Agnibala

fruits

CATEGORIZATION OF BASIC FOODS IN AYURVEDA

Ayurveda classifies food (ahara) into 12 basic categories based on source, method of preparation and utility; such as

1.Sukandhanya (corns with bristles)

2. Samidhanya (pulses)

3. Mamsa (meat)

4.Saka (vegetables)

 5.Phala (fruits)

6.Arita (salads)

7. Madya (fermented drinks)

8. Ambu (water)

 9.Gorasa (milk and milk products)

10. Iksuvikara (products of sugar-cane)

 11.Krtanna (food preparations)

12. Aharayogi (accessory food articles).

Ayurveda emphasizes the material quality of food but places even greater emphasis on the selection of food, its processing and cooking, and rules for healthy eating. Thus, the Ayurvedic approach to food and dietetics is very different from the conventional Western approach. Charaka samhita describes the eight principles of Ahara vidhi i.e., (1) Prakriti (nature of food articles) (2) Karana (preparation) (3) Samyoga (combinations) (4) Rashi (quantity) (5) Desha (habitat and climate) (6) Kala (time factor) (7) Upayogasamstha (rules of use) (8) Upayokta (the user)45

While considering Ahara matra, Acharya Charaka says that food is to be taken depending upon the power of digestion and metabolism (Agnibala and srotobala), which varies according to season as well as the age of the individual. The quantity of the food to be taken directly depends on the digestive strength of a person (Agnibala). The stomach capacity is divided into three portions and two portions should be filled with solid and liquid food and one portion should be left for easy gastric movements and air, to aid the digestion process. Processing of food results in the transformation of attributes of the dravya. Methods of preparing different types of food items like Manda (rice water which is the clear supernatant watery portion (without rice) in which rice is boiled) Peya (rice soup), Yavaagu (semi-solid meal thicker than Peya), Vilepi (thick rice soup which thicker than Yavaagu) Yusha (Lentil soup), are mentioned in the samhitas. The different Ahar kalpanas of the same dravya differ in their properties and digestibility. Processing of food results in the transformation of attributes of the dravya

Phalshruti:

Ahar consumed according to its forms by virtue of Pradipt Jatharagni,gets absorbed and digested in all Dhatus equally without accumulation in one dhatu ,thus resulting in Dhatuvriddhi.Alongwith promotes Bala,Varna,Sukh and Ayu.Hence in compliance with Prakriti Sharir Dhatu becomes Aha rod all Dhatus.ie.Dhatus are nourished by specific Dhatuvaha Srotas and Dhatvagni.When Ahar Rasa reaches to the Dhatu through their specific Srotas,Dhatvagni transforms and assimilates the required nutrients for the nourishment of Dhatu.The role of Dhatuvaha Srotas and Dhatvagni in tissue nutrition has been explained by various Dhatu Poshana Nyaya ie.Ksheer Dadhi Nyaya,Kedari Kulya Nyaya,Khale Kapot Nyaya,Ek Kala Dhatu Poshan Nyaya.

Discussion

Children are extremely vulnerable. They succumb readily where the diet is poor in quality and quantity and infectious diseases and infestations are widespread. This affect their growth and increase the requirements of various nutrients. The rate of Growth and Development of children depend to a large measure on the adequacy of diet consumed by them. Thus Ahar play an important role in context of nourishment. The body is the outcome of type of Ahar taken by and individual. Both quality and quantity of Ahar determines the proper nourishment of body. In accordance to agnibala, type of diet and stomach capacity. Human milk is universally regarded as the ideal food for feeding infants during the early months. As Acharya Vagbhatta rightly said ‘Maturev Pibet Stanyam..’considering the digestibility by the infants.

Exclusive breastfeeding has an overall effect on growth and development of children. Various studies have noted the effect of Breastfeeding habits on orofacial development including eruption of primary and permanent dentitions. It has been suggested that other growth factors present in human milk target the development and maturation of nerves and retina. Also Epidermal growth factor stimulates maturation of the lining of the infant’s intestines, so that it is better able to digest and absorb nutrients. In absence of Human Milk Cow’s Milk is advised. Here Milks of animals can be modified for feeding by adjustment of fat content to that of human milk by partially skimmed, by boiling it which brings physio-chemical changes in the milk and helps reduce markedly curd tension of milk and thirdly dilution with water. Food differ widely in their contents of various nutrients. Based on the analysis related to Edible Portion Ahar is well  defined by our Acharyas according to its Categories. It can be correlate by various nutrients broadly grouped under 3 heads from the nutritional point of view -

1]Energy-yielding foods

2]Body building foods and

3]Protective foods thus supplying all dietary essentials in the require amounts.

Conclusion

In parlance to Role of Ahar in Pediatric age group, its concept, utility, besides food contents, Samagni, Patent Srotas and regular excretion of Mala are factors determining ideal nutrition state of individual. Ahar is prana of human structure. Just as sharir is panchabhoutik so is food.Ahar is processed by agni leading to release of Poshak Ras which is ultimately responsible for Dhatu-Poshan. Ahar consumed methodically according to rules and guidelines advocated since very early times, also selection of foods best suited for promoting good health and nutritional status yields good results for the well being of an individual in all ages.

Ayurvedic dietetics does not follow the modern norms of fixing a constant amount of Ahara for all individuals in general but instead relies on the status of Agni Bala for each & every individual respectively. For optimal Growth and Development of Child, the appropriate dietary considerations synchronize physical, mental and spiritual health.