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Family Health Magazine - CHILDHOOD

Feeding Your Baby
Introducing healthy eating step by step

Feeding your baby can be an exciting and challenging experience. During the first 12 months of life, your baby is learning new skills, such as how to chew food with different textures and how to drink from a cup. As with other aspects of parenting, you will hear all sorts of advice. It can be hard to know the right thing to do. Do you start solids at two weeks, three months or six months?

Do solids really help babies sleep through the night? Does fruit come before vegetables or vegetables before fruit? So much to remember! Feeding a baby solid foods is a sign of development, and parents sometimes want to rush things along. Relax and be patient. Your baby will tell you when he or she is ready.

If you are exclusively breastfeeding your baby, try to wait until around six months before introducing solids. If you are giving your baby infant formula, solids can be introduced between four to six months. Continue to give breastmilk (or formula) in addition to solid foods.

Infant feeding guidelines vary slightly between provinces and countries. Generally, in Canada, the following order is recommended for introducing solids.

  • First – iron fortified infant cereals
  • Second – vegetables and fruit
  • Third – meats, finger foods, cheese and yogurt
  • Fourth – whole milk (homogenized) after nine months, and egg whites after 12 months

Breastmilk – your baby’s first food

Breastmilk is the natural and healthiest choice for your baby. You may choose to breastfeed directly or give expressed breastmilk using a specialized cup or bottle. Breastmilk is easy to digest and provides all the nutrients your baby needs for about the first six months of life. Breastfeeding also strengthens a baby’s immune system. It helps protect against and fight illness and infection including ear, respiratory and gut infections, allergies, and Sudden Infant Death Syndrome (SIDS).

In the early weeks and months, expect to feed your baby about eight to 12 times in 24 hours. Why so often? Babies have small tummies and since breastmilk is so easy to digest, your baby will want to feed often. You know your baby is getting enough when he or she is growing well and has six to ten wet diapers and two or more dirty diapers per day. If you have difficulty breastfeeding or worry that your baby may not be getting enough milk, contact a breastfeeding (lactation) consultant, public health office or your family doctor for advice. Breastfed babies may need a vitamin D supplement. Contact your doctor or public health office for guidelines and amounts.

Infant formula

If you choose not to breastfeed, iron-fortified infant formula is the next option. For the first four months of your baby's life, be sure to boil water at least two minutes before using it to prepare infant formula. If your baby has problems with infant formula, contact your doctor or public health office. Do not switch formulas on your own. Specific guidelines can help you decide if your baby needs a formula without added iron, or a specialty formula such as lactose-free or soy.

Why Wait Until
Four to Six Months Before Introducing Solids?

Nutrition is a science that constantly includes new information and research. Although past generations did not always wait until four to six months to introduce solids, there are a few reasons why it is suggested that you delay this step.

  • Breastmilk (or formula) is all your baby needs for the first four to six months. Feeding solids too early may reduce the amount of breastmilk your baby is drinking, also limiting the amount of iron absorbed from breastmilk.
  • Your baby is less likely to choke if you wait.
  • Your baby is less likely to develop allergies if you wait.
  • Before six months, your baby’s body cannot handle a substance called nitrates found in certain vegetables.
  • Younger babies don’t have the head or tongue control to cue parents when to start and stop feedings.
  • Feeding solids early does not help a baby sleep through the night!

When is my baby ready for solid foods?

When your baby gives you the following cues between four to six months, you can try introducing solids. Your baby:

  • can sit up with little support
  • can hold up the head
  • can control head and neck muscles
  • watches the spoon and opens mouth when food is offered
  • can close lips around a spoon and does not push food out with the tongue

How to introduce solids

Sit your baby straight up in a well-supported position (not in a car seat). Always feed solids from a spoon and not from a bottle. Hold the spoon in front of your baby’s mouth. If your baby’s mouth opens, it is a sign that he wants the food. If he pulls back or turns away, he does not want it, so try again later. To prevent food-borne illness, throw away any uneaten food that has been in contact with the feeding spoon or your baby’s mouth.

Introduce each food separately, and wait about four days before introducing another new food. This way, if your child has a reaction, you know which food has caused the problem. Signs of a food allergy vary but may include a rash, vomiting, diarrhea, stomach pain or breathing problems. Stop feeding your baby the problem food and seek medical attention.

The first solids – infant cereal

In Canada, plain iron-fortified infant rice cereal is recommended as a first food. The iron is necessary since the iron stores your baby was born with are used up by around four to six months. Mix infant cereal with breastmilk, water or formula to make a pasty texture.

Start with one or two spoonfuls and gradually work your way up to about four to eight tablespoons (60 to 125 mL) divided throughout the day. Read labels carefully, as some types of cereal have formula, skim milk powder or other ingredients added. Some brands have more iron than others. Once your baby has tried rice cereal, you can move on to infant barley or oatmeal cereals. Mixed infant cereal should be the last one you introduce. If your baby refuses to eat cereal, talk to your doctor or public health office about other sources of iron.

Vegetables and Fruit

Vegetables and fruit can be offered next. You can easily adjust the texture from smooth to lumpy, mashed or diced. There are so many types of vegetables and fruit to choose from that you can introduce your baby to all sorts of different flavours. Start with a few spoonfuls and work your way up to four to 10 tablespoons (60 to 150 mL) per day by seven to nine months, and around one cup (250 mL) of vegetables and fruit by one year.

Feed your baby tender, cooked vegetables or soft fruit with skins removed. Mashed, grated or minced pieces of vegetables and fruit give your baby practice chewing. Your baby can eat the same cooked vegetables and soft fruit the rest of the family is eating if you prepare them without adding salt, sugar or fat.

You may want to mash extra vegetables or fruit to keep in the freezer for days when you are eating things your baby has not yet tried. Wait until your baby is six months or older before offering home-prepared beets, carrots, turnips and spinach. For more information on preparing homemade baby food, contact your local public health office.

Jarred baby foods are expensive but can be ideal for travelling and when offering your baby foods you don’t typically eat at home. However, jarred foods have limited textures and the age recommended on the jar may not always meet current health recommendations. Read labels carefully to ensure you are getting plain vegetables and fruit and not ‘desserts’ with extra starch and sugar added.

A word about juice and water

Babies do not need to drink juice. Soft and cooked vegetables and fruit are the best choices and provide fibre along with the same vitamins and minerals as juice. If you decide to serve juice, limit it to two to four ounces (60 -125 mL) per day so it doesn’t replace breastmilk or formula. Make sure you serve 100 per cent unsweetened fruit juice. You do not need to buy special baby juice. Fruit punch, fruit cocktail, lemonade, iced tea, pop or juice crystals are not recommended. These are mostly sugar and water and do not contain the nutrients your baby needs. For good dental health, juice should only be served from a cup and not from a bottle.

Breastmilk or formula provide all the water your baby needs from birth to six months. Extra water is not needed at this age and might interfere with your baby getting enough calories. Small amounts of water may be offered once infants are eating solid foods.

Meats and finger foods

After your baby is eating infant cereal and a good variety of vegetables and fruit, you can offer ground, minced or finely cut meat and poultry. Start with a few spoonfuls and work your way up to six to eight tablespoons (90 - 125 mL) per day. Avoid salty or fatty processed meats, as these are not nutritious choices for your baby. Other protein-rich options include starchy beans such as kidney beans or beans in tomato sauce (rinsed), lentils, cooked egg yolks, tofu and fish without bones. Yogurt and cheese can also be offered now.

By this age, your child likely wants to feed himself. Let your baby pick up, play with and explore food. This is a normal, although messy, stage of development. It can be an ideal time to introduce finger foods like unsweetened cereal, toast, crackers, macaroni, rice and bread. You might also place a little breastmilk, infant formula, water or juice in a cup to give your child practice holding, tipping and drinking.

One year

Due to the risk of allergies, wait until your baby is one year old before offering egg whites. Whole (homogenized) pasteurized milk can be introduced at nine months, although waiting until one year is ideal. Whole milk is recommended over lower-fat milks, because it includes extra fat and calories babies need. By the age of one, your baby should be eating soft, diced table foods along with the family.

Feeding your baby is an exciting experience. Follow these guidelines to be sure your baby is getting all the nutrition he or she needs. For answers to other questions or for more detailed information on introducing solid foods, contact your local public health office.

FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specifid medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physican promptly. Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1  [CH_FHb04]
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