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Dinner time!

New guidelines offer healthy tips for feeding your baby

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Winnipeg Health Region
Wave, May / June 2014

Like most parents, Autumn Anderson had a lot of questions when it came time to transition her baby from breast milk to solid food.

A mother of three young children, Anderson has attended her neighbourhood Healthy Baby Community Support Program with the birth of each child and says she always learns something of value.

"It's great to learn new things, because everything is always changing. Healthy Baby has been really helpful," she says.

Now, Healthy Child Manitoba Office, Dial-a-Dietitian, Healthy Start for Mom and Me, and the Winnipeg Health Region have teamed up to update guidelines that provide parents with the information they need when transitioning their babies to solid food.

The new-and-improved resource comes in two booklets - Feeding Your Breastfed Baby, Six Months to One Year and Feeding Your Baby, Six Months to One Year.

Anderson says she often refers to the resource when she has questions.

"I look to see which finger foods are good for him. I knew iron was important. I just didn't know how much, so I tried giving my son kidney beans and he likes those a lot," she says. "I also didn't know that feeding one food for two days so the baby gets used to it was so important."

Coralee Hill, Clinical Lead of the Dial-a-Dietitian program, says the guidelines were designed to help parents like Anderson who can be anxious about giving their infant solid food for the first time and may have a lot of questions about feeding their baby.

"Parents always want to do the right thing for their children. You want to help your child develop lifelong healthy eating habits."

Good nutrition is essential for babies, as the minerals and nutrients they take in will help them grow to be healthy and strong. "The habits we teach our babies stay with them for life," says Tamara Hes, Program and Policy Consultant with the Healthy Baby Community Support Program. "Every facet of the development of our body is impacted by what we take in."

Most of the information in the two booklets is based on long-standing advice that has been around for decades. For example, the guidelines still recommend transitioning your baby to solid iron-rich food at about six months of age. Babies at this age need more nutrients, such as iron, that can be provided through solid food in addition to breast milk or formula.

Most babies show signs of being ready for solid food at the age of six months, but every child is different. The most common signs of readiness include mouthing objects, opening the mouth when food is offered, and mimicking their parents' motions of eating.

"Usually at about six months, babies show an interest and ability to eat food in addition to breast milk and formula," says Rosemary Szabadka, a registered dietitian with the Winnipeg Health Region. "Babies are usually sitting and their tongues can start to bring food back, and when a spoon is offered, they can take the food off the spoon. You will have a better food relationship with your baby if you're both enjoying the feeding process."

Iron-fortified infant cereal is an easy food to introduce first, but it is a good idea to also introduce other iron-rich foods, such as meat (beef and chicken) and meat alternatives (beans and lentils), to prevent iron deficiency anemia.

Babies' iron stores start to run low around six months of age, so it's important to focus on iron-rich foods and continue with these foods every day, says Lana Pestaluky, a registered dietitian with the Winnipeg Health Region. At seven to eight months, your baby will be ready to move to mashed, minced, grated and finely chopped foods that would include grains, grain products and vegetables and fruit. By nine to 12 months, you can try diced and cubed table and finger foods from all four food groups. "Babies need pureed foods only for a short time. It may be harder for babies to accept different textures if they are not exposed to them," says Pestaluky.

Szabadka says parents needn't be hesitant about transitioning their baby to solid foods. "A lot of parents don't want to progress to food with texture because they're nervous about choking or about the mess, but if a child doesn't learn to guide a spoon, the parent will still be doing the feeding at age two or three," says Szabadka. "It may be messy, but it's all part of learning. Everything takes time. Once you relax, you'll be amazed at what your child can accomplish in a year."

Szabadka recommends trying just one new food for two days to see if your child has an allergic reaction to it. Signs of a possible reaction include rashes or hives, difficulty breathing, stomach pain, diarrhea, and vomiting.

"It takes babies up to 20 tries to decide whether they like a food. You don't force it. Just introduce the foods to them," says Hes. "You want them to have many experiences with food so they're eating a variety of things."

But the booklets also include some new recommendations based on the latest research. For example, the new guidelines say that it's no longer necessary to avoid foods like eggs, fish, wheat, nuts and products like peanut butter during your baby's first year.

"In the past, there was a belief that delaying the introduction to these foods would prevent the child from developing allergies, but there is no evidence that delaying these foods has a preventive effect," says Hill.

There is also new emphasis on the importance of Vitamin D for breastfed and formula-fed babies. While formula is Vitamin D-fortified, some infants, especially partially breast-fed infants, will not get the recommended daily allowance of 400 IU.

"Babies need to be drinking one litre of formula during the day to be getting adequate amounts of Vitamin D," Hill says. "Even beyond the age of one, there are still some benefits to Vitamin D supplementation."

Infants cannot be given honey in the first year of life due to the risk of botulism. Foods with added sugar and salt are not recommended, and parents should also avoid low-fat or reduced-fat products, which usually don't contain enough nutrients for a growing baby.

"You brought this little one into your life, so let's start him off right. The relationship you are building and the food that is eaten is the groundwork for the future," says Szabadka.

As always, when feeding your baby, it's important to sit at the table with the infant in a highchair. Szabadka recommends starting with one meal that is part of the regular family schedule. Incorporate your infant into the family's normal routine as much as possible.

"Create a safe environment and bring mealtime back to the table. Let your child be in charge of their eating. It's your job to provide food, but it's their job to eat," she says. "It really revolves around respect. Don't do anything to your kids that you wouldn't want done to you."

When it comes to feeding your baby, the experts agree that it's best to let your child take the lead. "Right from birth, a baby knows when he's satisfied and has had enough. Let the baby's cues and appetite be your guide," Hill says. "Recognize those cues. Often a child will turn away, push food away, or close his mouth or cry when he's finished eating. Trust the child's ability to know when he's had enough and when he wants more."

Holli Moncrieff is a Winnipeg writer.

***

What's new in the Feeding Your Baby guidelines

Here are some of the highlghts contained in the Feeding Your Baby guidelines:

  • A new emphasis on the importance of Vitamin D for breastfed and formula-fed babies. While formula is Vitamin D-fortified, some infants, especially partially breast-fed infants, will not get enough. Health Canada recommends that all breastfed, healthy term babies receive 400 IU (International Units) of liquid Vitamin D supplement each day. Speak to your health-care provider about your baby's needs.
  • At six months, your baby should start with iron-rich foods because your baby's iron level is becoming low. Iron is important for healthy red blood cells and for brain development.
  • Research now shows it is not necessary to delay giving fish, eggs, or any food to your baby to reduce or prevent allergies to these foods.

***

Solid foods

When your baby is ready to eat solid foods, try these:

Avocado

Smooth and creamy when mashed and full of healthy fat needed for baby's growth.

Beef

A good source of heme-iron and helps to ensure adequate levels of zinc and protein. Choose ground, stewed or roast cuts.

Blueberries

Packed with vitamins and antioxidants. Unsweetened fruit is a great finger food for your baby.

Canned tuna

Convenient, inexpensive, and a source of iron. Just drain, rinse and prepare into the texture your baby needs.

Chicken and turkey

Both are sources of iron. Dark meat from chicken and turkey has more iron than white meat.

Cooked barley

A great food for baby as it is a whole grain full of nutrients. Barley can be cooked into soups and stews and blended into a cereal.

Eggs

The whole egg can be given to babies starting at six months of age. The yolk is packed with iron. Hard boil then blend, mash or cut up into bite- size pieces.

Iron-fortified infant cereal

A traditional first food for babies that can be added to muffins and pancake recipes as baby grows.

Kidney beans

A good source of iron, which your baby needs. Try pureed kidney beans at six months of age.

Sweet potato

Loaded with Vitamin A and potassium, plus a good source of fibre. Easy to bake in the microwave.

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More information on feeding your baby

Help your baby be successful with eating

  • Make sure baby is sitting up during meal times - in a highchair is best.
  • Include your baby in the family mealtime routine. Feed your baby while other family members are eating.
  • Stay with your baby when she is eating. Talk quietly and encourage her while she eats.

Signs of hunger

  • Excited and smacks lips when placed in high chair.
  • Opens mouth when offered food.
  • Leans forward and reaches for the food.

Signs of fullness

  • Shuts mouth when offered food.
  • Turns or pushes the food away.
  • Cries to get out of high chair.

Let your baby take the lead with eating

  • Let your baby open his mouth before you feed him.
  • Let your baby touch her food - in the dish, on the spoon, or on the tray.
  • Allow her to feed herself with her fingers as soon as she shows interest.
  • Feed your baby at his pace. Do not try to get him to go faster or slower than he wants.
  • Stop feeding when your baby shows that she has had enough. Do not force your baby to finish her food. A baby will eat when she is hungry and stop when she is full. Remember a baby's appetite can change from day to day.
  • Be patient when offering new foods. It may take 15 to 20 tries of a new food before your baby likes it.
  • Have fun!

Feeding tips

At six months of age, breast milk should still be your baby's main food. But now it is time to add solid foods. Solid foods provide nutrients and textures needed for your baby's healthy growth and development.

Here are a few tips for introducing solid foods:

  • Choose foods and textures that suit your baby's skills and age.
  • It is important to try different textures. This helps baby to learn to chew, swallow and enjoy the same food the family is eating.
  • Babies do not need to have teeth to eat solid foods.
  • If using store-bought baby food, check the expiry date on the jar or package. Do not use past the expiry date.
  • Use a small bowl or plate for feeding your baby. Do not feed your baby from the jar.
  • Any food left over should be thrown out, as germs can spoil the food.
  • When warming baby food, stir and test it to make sure it is not too hot.
  • Put a small amount of food in front of your baby and see what happens. Your baby may play with it, taste it or eat it all.
  • Start with one or two teaspoons of food and gradually increase according to baby's appetite. Let baby decide how much to eat.
  • Start with one meal a day and gradually increase to three meals a day and snacks.
  • Your baby does not need sugar, sweeteners or salt added to food.
  • Try only one new food at a time. Wait at least two days before trying another new food. This helps you find out if a food causes an allergic reaction. Stop feeding the food if the baby has a reaction. Talk to your healthcare provider. Call 911 or emergency services if your baby is having trouble breathing.

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