ii Table of Contents Starting Solid Foods ............................................ 1 Getting Started............................................... 2 Tips for Successful Feeding ................................. 2 How Do I Start Solid Foods?................................ 3 What Should I Offer? ....................................... 4 Will There Be Any Changes in My Baby’s Bowel Habits? .. 4 Mealtimes ..................................................... 5 Allergies ....................................................... 5 Starting Solid Foods: Six to Eight Months .................. 6 What about textures?........................................ 6 What about amounts? ........................................ 7 Caution - Choking ............................................. 8 Infant Cereals ................................................ 9 Meat and Alternatives....................................... 10 Vegetables and Fruit ........................................ 12 Introducing Solid Foods: Nine to Twelve Months ............ 15 Grain Products ............................................... 15 Milk and Alternatives........................................ 16 Finger Foods ................................................. 17 Foods to Avoid ............................................... 18 Solids Feeding Guide ........................................... 19 Baby Food....................................................... 21 Homemade Baby Food ....................................... 21 Commercial Baby Food....................................... 23 Homemade Baby Food Recipe.................................. 24 Keeping Your Baby’s Food Safe ............................... 25 Common Questions.............................................. 26 Additional Information ......................................... 29 iii This handout provides information about feeding healthy full-term infants from age six to twelve months. Your baby needs healthy foods to grow and to develop properly. How your baby eats now will help build the foundation for healthy eating habits for life. Healthy eating is critical to good health. Children and adults who eat healthy have less chance of becoming overweight and have less chance of developing certain diseases. You will probably have many questions about feeding your baby. This handout provides answers to some of the questions you may have. For additional information, contact your health care provider. Please note: For simplicity, the baby is referred to as “she” in this booklet. Starting Solid Foods Babies’ eating habits change during the period of six to twelve months of age. Breast milk or commercial iron-fortified infant formula is still the main source of energy and nutrients, but babies need other foods to develop and grow properly. Babies gradually get used to family foods during the latter part of the first year. There is no need to rush solid foods. You should give your baby only breast milk or commercial iron-fortified infant formula for the first six months of life. Remember, you can breastfeed your baby for as long as you wish. Breastfeeding may continue for up to two years of age and beyond. Research shows that breast milk or formula is all that babies need for the first six months. Giving your baby solid foods too early can cause problems because: • Your baby may not drink enough breast milk or formula. • Your baby’s system is not ready to digest solid food. • Your baby’s risk of being anemic (low iron) increases. • Your baby’s risk of developing eczema (skin disorder) increases. • Your baby’s risk of developing allergies increases. • Your baby may choke if she is not ready to swallow solid foods. Studies show that giving babies solid foods will not help them sleep through the night. Getting Started How can you tell if your baby is ready for solid foods? Look for these signs. Your baby: • can sit up with very little help • can hold her head up • opens her mouth when food is offered • is able to take food from a spoon and swallow it • can turn her head to refuse food • is six months old. Tips for Successful Feeding Keep in mind that it is your job to provide the right food for your baby. It is your baby’s job to decide how much she eats. Help your baby be a successful eater. • Choose foods that suit your baby’s abilities and age. It is important to give your baby food which is the right texture (e.g. pureed, minced, chopped) and to introduce the right foods at the right age. • Feed your baby whenever she is hungry. Signs of hunger may include: o moving her arms and legs in an excited way o moving her head towards food o reaching towards food o opening her mouth when she sees food o crying. • Make sure your baby is sitting up. A high chair is best. Your baby will be able to explore foods better and will be less likely to choke. • Never leave your baby alone when she is eating. • Talk to your baby quietly while she eats. Too much noise may distract your baby from eating. 2 How Do I Start Solid Foods? • • • • • • Wash your hands and your baby’s hands before each feeding or meal. When introducing each new food, start with only one teaspoon to make sure the food agrees with your baby. Gradually increase the amounts according to your baby's appetite over time. Offer only one new food at a time, at least three to four days apart, so you can see if your baby is allergic to any new food (see page 5 for more information on allergies). The new food should be one single type of food, not a food which is a mixture of different foods. Be patient with new foods. Do not force new foods. If she turns down a food, wait a few days and try again. Sometimes a baby may need to try a food 10 or more times before she knows that she likes it. Throw away any leftover food which either your baby or your baby’s spoon has touched. This helps to keep your baby’s food safe. Let your baby take the lead with eating. Remember, it is your job to provide the food and it is her job to eat the food. o Let your baby open her mouth before you feed her. o Let your baby touch her food – in the dish or on the spoon. Allow her to feed herself with her fingers as soon as she shows an interest. o Feed your baby at her pace. Do not try to make her go slower or faster than she wants to go. o Stop feeding when your baby shows she has had enough. Do not force your baby to finish her food. A baby who is full will close her mouth, turn her head away, cover her mouth with her hand, shake her head “no”, or cry. o Do not put any food into your baby’s mouth without her permission. Avoid playing games which trick your baby into eating. What Should I Offer? • • • • • A variety of foods so your baby can learn to enjoy many different tastes. Your baby may even like foods you don't. Plain vegetables, fruits and meats without added salt or sugar. Serve foods separately (for example, don't stir meat and vegetables together) so your baby can learn to like different flavors and textures. Do not give your baby store-bought baby food dinners which combine different foods. Foods without added sugar. Babies do not need custards and desserts. Plain foods without sauces or gravies. Your baby should be able to taste the food and does not need sauces or gravies. Will There Be Any Changes in My Baby’s Bowel Habits? Changes in bowel habits are normal when there is a change in a baby’s food. You may notice a change in the colour, size and consistency of your baby’s bowel movements. She may have bowel movements more or less often. If you have any questions, contact your health care provider. Remember These are general guidelines. No two babies are exactly alike. Don't compare your baby with others as to how much she eats, or when she accepts a new food. 4 Mealtimes Eating is more than just consuming food. The social part of eating is also important. Your baby should eat with the family. Your baby will learn new eating skills best in a happy atmosphere, so try to make mealtimes pleasant and unhurried. Set a good example by what you eat - children are great imitators! Children start to learn eating habits at an early age. Keep your baby safe by keeping hot tea, coffee, soup and other hot foods out of your baby's reach. Allergies When introducing a new food, it is important to look for signs of an allergy. Signs of an allergy can occur within a few minutes or a number of days after eating a certain food. Signs of an allergic reaction may include hives, swelling, wheezing, stuffy nose and itchy watery eyes, eczema, nausea, vomiting, cramping and diarrhea. Signs of a severe anaphylactic reaction may include hives, swelling, difficulty swallowing or breathing, skin color changes and dizziness/fainting. A baby may also pull or scratch at her tongue and talk or cry with a hoarser or squeakier voice. Get immediate medical attention if these severe symptoms occur. If a baby experiences any of these symptoms or any other reaction while eating a food, stop feeding the food you think caused the allergy until you can talk to your baby’s doctor or health care provider. If your family has a history of allergies, consult your health care provider for specific advice about introducing foods to your baby. Starting Solid Foods: Six Months to Eight Months Iron-rich foods should be the first foods given to your baby. Start with iron-rich infant cereals and meat and alternatives. Next, introduce vegetables and fruits. What about textures? Choosing the right texture of solid foods is very important. Giving a baby texture that she is not ready for (too lumpy, hard or chewy) could cause choking. On the other hand, feeding a baby pureed or soft food for too long can delay the development of chewing skills. Solid foods should be introduced to most babies at six months. Gradually add more texture to your baby’s food as your baby develops. Use the following table as a guide. Do not worry about how many teeth your baby has before you introduce new textures. Babies do not need teeth to chew and eat soft foods. Introducing textures has more to do with a baby’s development than the age of the baby or how many teeth she has. By twelve months most babies should be eating what the family is having. Talk to your health care provider if you need more information or if you are not sure what to do. Developmental Stage Sits with help or support Sits without help Beginning to crawl and walk Texture • • pureed foods soft mashed foods without lumps Gradually change the texture of the food in the following order: • soft mashed foods with tiny soft lumps • ground foods • foods with a soft texture • coarsely chopped foods • foods with a moderate texture (not hard) • finger foods • baby bite-sized pieces of food Adapted from Butte, et al. The start healthy feeding guidelines for infants and toddlers. JADA;104(3):442-454. 6 What is gradually? Gradually means changing the texture of the food you are feeding your baby over time. Babies develop gradually and so the texture of foods should change gradually. Watch your baby’s development for signs. Is your baby showing signs of a new milestone? Is she sitting without help or starting to crawl? Then it is probably time to change the texture of her food. But don’t compare her to other babies. Remember, babies all develop at different rates. What about amounts? There is no set amount of food that your baby should eat. Start with just one teaspoon of any new food in case your baby has an allergy to the food. If your baby does not show any signs of an allergy to the food, you can increase the amount of food the next time you offer it. Over time, increase the amount of food you offer gradually, using your baby’s appetite as a guide. Signs that your baby may want more food could include opening her mouth when she sees the food, moving her head towards the food and reaching towards the food. A baby who is full will close her mouth, turn her head away, cover her mouth with her hand, shake her head “no”, or cry. When feeding more than one kind of food, do not let your baby fill up on one kind of food before you offer the next kind. Instead, offer a spoonful or two of one kind of food and then offer a spoonful or two of another kind of food. Keep repeating this pattern until your baby shows that she is full. This lets your baby decide how much of each food she wants to eat and lets her try all the foods you are providing. Talk to your health care provider if you need more information or have questions about the amounts of food to feed your baby. Caution - Choking Babies can choke or suffocate easily since they do not have the teeth and chewing abilities of an older child or adult. • Babies should eat sitting upright with an adult present. Babies should never eat while alone or while moving around. • Certain foods can be a choking hazard for children before they reach four years of age. Choking hazards include foods that are: o hard (such as nuts, seeds and raw carrot pieces) o hard to chew (such as corn, shellfish, popcorn, candy, raisins and other dried fruits). Avoid these foods that can cause CHOKING These foods should be avoided until your child is at least four years old: • raisins, gum, candies, popcorn, nuts and seeds • fish with bones • snacks using toothpicks or skewers These foods are safer for infants and young children when they are prepared as described • • • • 8 Hard vegetables or fruit - grate carrots, remove pits in fruit, cut grapes in quarters lengthwise with seeds removed, and soften raw vegetables by cooking so that they are easier to chew. Wieners or hot dogs - to make safer cut in quarters lengthwise and then into bite-sized pieces. Note: Hot dogs and wieners are not good choices as they are high in fat and salt. Peanut butter and melted cheese given alone (i.e. from a spoon) are hard to swallow and could get stuck in the throat and block air flow. To make these foods safer for young children, spread thinly on a cracker or bread. Foods which can be hard to chew - cut these foods into baby bite-sized pieces. Infant Cereals Infant cereals are fortified with iron and are an important source of iron for the first 18 months. What kind of cereals should I feed my baby? • • • Choose plain infant cereal with iron, not regular cereal. Start with infant rice cereal. Next, offer barley, oatmeal, corn and then wheat cereal. If these cereals are tolerated, add a mixed grain infant cereal. Use only one kind of cereal for three to four days before trying a new kind of cereal. That way you can watch for signs of an allergy. Infant cereals which contain added fruit and vegetables are not necessary for your baby. If you do choose to give your baby these cereals, you should wait until your baby is older and you have introduced all the ingredients in the cereal to your baby. Some infant cereals which contain added fruit and vegetables also have added sugar which is not necessary for your baby. Read the labels carefully. How do I make infant cereal? • • • • Read the label on the cereal box carefully. Some brands of cereal have added formula and some do not. Follow directions for mixing. Mix dry cereal with recommended liquid to make it runny like thick soup. As time goes on, use less liquid to make thicker cereal. This helps your baby learn how to chew and swallow. Do not add sugar or sweeteners to the cereal. How much cereal do I feed to my baby? • Start with 1 teaspoon (5 ml) of cereal. Increase the amount according to your baby’s appetite. When do I feed cereal to my baby? • Offer infant cereal to your baby at mealtimes. How do I feed cereal to my baby? • • Always feed cereal from a spoon. This helps your baby learn to chew. Never put cereal in a bottle. This can cause choking. Meat and Alternatives Meat, poultry, fish and alternatives are good sources of protein and iron. What kind of meat and alternatives should I feed my baby? • • • • • • Suggested foods are beef, pork, veal, chicken, turkey, fish, tofu, liver, lamb or well-cooked legumes (peas, beans, lentils) and egg yolk. Add one meat or alternative at a time. Wait three to four days before you add a new one. Game, such as moose, caribou and rabbit, are also good choices. But, do not give moose or caribou liver or kidney to your baby. Do not give ham, salt meat or salt fish to your baby because these foods are high in salt. Processed meats such as bacon, wieners, salami, pepperoni, bologna, and sausages are not good choices because they are high in salt and fat. How do I prepare meat and alternatives? • • • • • 10 You can cook and then puree, grind or mash these foods, depending on the texture your baby needs. Once your baby is ready for more texture, mix cooked ground meat with pureed meat. This will help your baby learn to chew. Do not add salt. If warming food, stir it thoroughly. Taste the food to make sure it is not too hot. Do not put the tasting spoon back into the food. If you use commercial baby food: o Choose plain meats, instead of “dinners” or other combinations. o Always check the expiry date on the jar. Do not use food past this date. o Do not feed your baby directly from the jar. Put a portion in a small bowl or plate so you are not putting germs from your baby’s mouth into the jar while feeding. o Opened jars of meat and poultry should be stored in the refrigerator and thrown out if not used within 48 hours. How much meat and alternatives do I feed my baby? • Start with 1 teaspoon (5 ml). Increase the amount according to your baby’s appetite. When do I feed meat and alternatives to my baby? Offer meat and alternatives to your baby at mealtimes. What about eggs? Eggs are a good source of protein, vitamins and minerals. Give your baby only egg yolks when you introduce eggs. Start by offering mashed cooked egg yolk. Caution: egg whites and whole eggs may cause an allergic reaction if given at an early age. Wait until your baby is one year of age to introduce egg whites and whole eggs. What about peanut butter and nuts? If there is no family history of allergies, peanut butter can be given once grain products are introduced. Peanut butter should never be given alone, such as on a spoon. Peanut butter is a choking hazard if it is given alone or if it is spread thickly on another food, such as bread or crackers. To serve peanut butter safely to a baby, the peanut butter should be spread thinly on bread or crackers. Nuts should be avoided until your child is at least four years old (see section on choking on page 8). If your family has a history of allergies, speak with your health care provider before you give your child these foods. What about mercury and fish? Fish is a healthy part of your baby’s diet and an important food for growth and development. But some fish have high mercury levels which can be unhealthy for your baby. Health Canada provides advice for limiting exposure to mercury from certain types of fish. Refer to www.healthcanada.gc.ca for the latest information or check with your health care provider. Vegetables and Fruit Vegetables and fruit can be introduced once infant cereal and meat and alternatives have been introduced. Vegetables and fruit have vitamins, minerals and fibre. Vegetables and fruit add new tastes, textures and colour to your baby’s diet. What is the best way to introduce vegetables? • • • • • • Offer pureed or mashed vegetables. Try one vegetable at a time. Wait three to four days before trying a new vegetable. Offer vegetables separately. Do not mix them. Let your baby learn the taste of each vegetable. Offer plain fresh or frozen vegetables or commercial baby food. For mashed vegetables, you can also use unsalted canned vegetables. Don’t puree canned vegetables as they become “soupy”. You can make your own baby food. It’s easy! See page 21 for instructions. How much vegetables do I feed my baby? • • Start with 1 teaspoon (5 ml). Increase the amount according to your baby’s appetite. When do I feed vegetables to my baby? Offer vegetables to your baby at mealtimes. 12 What is the best way to introduce fruit? • • • • • • Offer pureed or mashed fruit. Try one fruit at a time. Wait three to four days before trying a new fruit. Offer each fruit separately. Do not mix them. Let your baby learn the taste of each fruit. Use fresh fruit, frozen or canned fruit (in juice, not in syrup) or commercial baby food. Cook hard fruit before pureeing or mashing it. How much fruit do I feed my baby? • • Start with 1 teaspoon (5 ml). Increase the amount according to your baby’s appetite. When do I feed fruit to my baby? Offer fruit to your baby at mealtimes. How do I feed vegetables and fruit to my baby? • If warming food, stir it thoroughly. Taste the food to make sure it is not too hot. Do not put the tasting spoon back into the food. • If you use commercial baby food: o Always check the expiry date on the package. Do not use food past this date. o Do not feed your baby directly from the jar. Put a portion in a small bowl or plate so you are not putting germs from your baby’s mouth into the jar while feeding. o Opened jars of fruit and vegetables should be stored in the refrigerator and thrown out if not used within 72 hours. Note: the storage time for opened jars of meat and poultry is different than vegetables and fruit (see page 10). What about juice? Babies do not need juice to quench thirst. They get all the fluid they need from breast milk or formula. Think of juice as a food and not as a drink. But remember, juice does not have fibre like fruit. Fruit is a better choice. When choosing juice, you should: • Choose 100% unsweetened fruit juice or reduced sodium (salt) vegetable juice. You do not need to buy special baby juice. • Give your baby no more than 2 oz (60 ml) of juice a day. Too much juice will fill your baby up. • Serve juice in a plastic cup, not a bottle. Your baby may keep the bottle in her mouth for too long which can cause tooth decay. • Do not give your baby fruit drinks or pop because they are not good sources of nutrients. Products labeled as fruit beverages, fruit drinks, fruit crystals, fruit “ades”, fruit cocktails or fruit punches are not 100% unsweetened fruit juices. • Remember, you can give your baby water to quench her thirst once she is six months old. Give your baby no more than 2 oz (60 ml) of water at one time and no more than 4 oz (125 ml) of water a day. Too much water will fill your baby up. See page 27 for more information about water. 14 Introducing Solid Foods: Nine to Twelve Months To help your baby eat a variety of foods, you should gradually begin introducing other types of foods, such as grain products, milk and alternatives and finger foods at around nine months. Some babies may be ready for grain products and finger foods before nine months. See the information about textures on page 6. By one year of age, most babies should be eating a variety of foods from all four food groups of Canada’s Food Guide: • Vegetables and Fruit • Grain Products • Milk and Alternatives • Meat and Alternatives Grain Products Grain products contain fibre, vitamins and minerals and are a good source of energy. Infant cereal is a grain product which is started at six months of age. Other grain products can be started at around nine months of age. Examples of grain products include bread, unsweetened regular cereals, crackers (unsalted top), pasta and rice. • Choose whole grain bread, crackers and pasta at least half of the time. • Choose brown rice more often. • Choose unsweetened whole grain cereals as finger foods. Continue to offer infant cereals. • Check the ingredients of the grain product. If one of the ingredients is a new food for your baby, start with a small amount of the grain product. Continue feeding the new food and wait three to four days before you add another new food. How much grain products do I feed my baby? • • Start with a small amount, such as 1 teaspoon (5 ml) of cooked rice or cut-up cooked pasta, a finger-sized piece of bread or a small cracker. Increase the amount according to your baby’s appetite. Milk and Alternatives Milk and foods made with milk, such as yogurt and cheeses, are typically high in protein and calcium. Milk is also a good source of vitamin D. These foods add variety to your baby’s menu. Begin including milk and alternatives once your baby is eating a variety of cereals, other grain products, vegetables, fruits and meat and alternatives. Milk and alternatives should not replace breast milk. Milk • • • • • • Breastfeeding has many benefits and cow’s milk should not replace breast milk. The number of times a day you breastfeed should not decrease when cow’s milk is introduced. Mothers who breastfeed may choose to wait longer than 9 to 12 months of age before introducing cow’s milk. Whole cow’s milk (3.25% MF) can be given to your baby when she is 9 to 12 months old as long as she is eating a variety of other solid foods. Introduce whole cow’s milk gradually. For formula-fed babies, the change from iron-fortified infant formula to whole cow’s milk should be completed by around one year of age. At this time, a formula-fed baby should be consuming a healthy diet, including two cups of milk a day, to meet her vitamin D needs. For information about vitamin D needs for breastfed babies, see page 27. Continue to give your child whole milk until she is at least two years old. Do not give her 2%, 1%, .5% or skim milk. Soy beverage, rice beverage or other vegetarian drinks (even if they are fortified) should not replace breast milk, formula, or whole milk in the first two years. These beverages do not contain enough protein or calories to help your baby grow. Yogurt • • • Give plain, unsweetened yogurt. Start with 1 teaspoon (5 ml) and increase the amount according to your baby’s appetite. Do not give your baby yogurt containing artificial sweeteners. Cheese • • • • 16 Start with a soft cheese like cottage cheese. Start with 1 teaspoon (5 ml) and increase the amount according to your baby’s appetite. Slowly add other types of cheese like cheddar or mozzarella. Hard cheeses can be grated or cut into thin slices. Finger Foods A finger food is any small piece of food that can be picked up from the high chair tray and brought to the mouth using fingers. Offering finger foods helps babies learn to chew and feed themselves. Your baby is ready for finger foods when she is able to hold food in her hand and bring it to her mouth. Other signs that your baby is ready for finger foods are that she is grabbing the spoon and learning to crawl. Most older babies enjoy eating with their hands. Be ready for some fun and for a mess! Finger foods should be offered as snacks and with meals. Finger foods should be healthy foods. What are some examples of finger foods to give to my baby? • • • • • • • • • • Soft, ripe, peeled fruit cut into very small baby bite-sized pieces or strips (e.g. bananas, pears, peaches, plums, cantaloupe or kiwi). See choking section on page 8. Strawberries and grapes do not have to be peeled but should be cut into small bite-sized pieces. Blueberries do not have to be cut or peeled. Cooked vegetable pieces (baby bite-sized pieces or cut into strips) Dry toast strips, bread crusts and unsalted crackers Unsweetened cereals Shredded cheese, cheese cubes or cut-up cheese sticks Cooked tender meat, cut up finely or ground Cut-up cooked pasta Cooked beans and other legumes Foods to Avoid There are some foods which should not be given to babies during the first year including: • honey (It can make your baby very sick with botulism, a type of food poisoning. Honey is safe for older children and adults). • candies and chocolate • soft drinks (pop), fruit drinks, sport drinks • tea, coffee, herbal teas • salt, pickles • foods sweetened with artificial sweeteners • fried foods • high fat snack foods (e.g. cheese snacks, corn chips, potato chips) • processed meats such as ham, bacon, wieners, salami, pepperoni, bologna, and sausages • salt meat and salt fish • sweets • cake, cookies • sugar-coated cereals • jelly/gelatin desserts • gravy • salad dressings and mayonnaise. 18 Solids Feeding Guide Solid foods should add to, not replace, breast milk or commercial iron-fortified infant formula, which are nutritionally superior for young babies. Let your baby’s appetite guide how much food you provide. Age Foods Comments Birth Breast milk or iron-fortified formula Amount varies depending on age and baby’s appetite. See Breastfeeding Your Baby and Infant Formula Feeding pamphlets for additional information. (Available from your health care provider) Six to Eight Months Infant cereal Introduce one type of grain at a time. Start with rice; then try barley or oatmeal; then corn, wheat and mixed grain infant cereal. Infant cereal: Start with 1 teaspoon (5 ml). Increase amount according to your baby’s appetite. Try one new cereal at a time. Wait 3 to 4 days before you try another kind of cereal. Meat and Alternatives Pureed or ground up meat, fish, poultry, meat alternatives (beans, peas, lentils) and egg yolks. Meat and Alternatives: Start with 1 teaspoon (5 ml). Increase amount according to your baby’s appetite. Try one new meat or alternative at a time. Wait 3 to 4 days before you try another kind of meat or alternative. Vegetables and Fruit Pureed or mashed vegetables and fruit. Vegetables and Fruit: Start with 1 teaspoon (5 ml). Increase amount according to your baby’s appetite. Try one new vegetable or fruit at a time. Wait 3 to 4 days before you try another vegetable or fruit. Continue with breastfeeding or formula. Feed solid foods two to three times per day. Age Nine to Twelve Months Continue with breastfeeding or formula. Wait 3 to 4 days between the introduction of each new food. Food Comments Grain Products Bread, pasta, crackers (unsalted tops) and rice Infant cereal: Continue to provide and increase amount according to your baby’s appetite. Whole grain unsweetened cereals as finger foods. These cereals do not replace infant cereal. Grain Products: Introduce different grain products in small amounts, such as 1 teaspoon (5 ml) of cooked rice or cooked cut-up pasta, a finger-sized piece of bread or a small cracker. Increase amount according to your baby’s appetite. Meat and Alternatives: Continue to provide and increase amount according to your baby’s appetite. Feed solid foods three to four times per day. Vegetables and Fruit: Continue to provide and increase amount according to your baby’s appetite. Milk and Alternatives Whole cow’s milk (3.25% MF) One year of age Breastfeeding can be continued until two years of age or longer. Nutritious snacks may be provided one to two times per day. 20 Whole milk can be introduced once your baby is eating a variety of foods from all food groups. Plain cheese, unsweetened yogurt, cottage cheese Introduce small amounts of cheese and yogurt such as 1 teaspoon (5 ml). Increase amount according to your baby’s appetite. Finger Foods See list on page 17. Introduce different foods in small amounts such as 1 teaspoon (5 ml). Continue to provide and increase amount according to your baby’s appetite. Egg white may be offered. Continue to give whole milk until your baby is two years old. A variety of nutritious foods from the four groups of Canada's Food Guide. Continue to provide healthy foods according to your baby’s appetite. Contact your public health nurse or health care provider for a copy of Feeding Your Toddler. Baby Food Both home-prepared foods and commercial baby foods are acceptable choices for babies. Homemade Baby Food • • • • • Can be cheaper. Allows you to control the texture as you do the mashing and chopping. Allows a greater variety of choices. May increase your baby’s acceptance of new textures because the flavour stays the same as the texture changes. Helps your baby get used to family foods. What do I use to make my own baby food? • • • • • • You can use a blender, food mill, food processor, fork, or potato masher. If you use a processor or blender, note that vegetables puree best in large quantities and meats in small ones. Food, hands and equipment must be clean. Fresh foods should be cooked just until just tender and processed quickly. Do not add salt, butter, oil, margarine, seasonings, spices, sugar or sweeteners. If you feed your baby what you are feeding the family, separate out your baby's portion before you add salt, butter, oil, margarine, seasonings, spices, sugar or sweeteners. Once your baby is used to the taste of the food, you can add the spices which you add to your family’s food. When cooking, don't put the tasting spoon back in the food. How do I make the different types of baby food? You can make different types of baby food using the following tips and recipes: Meat and Alternatives • • • • • Choose lean cuts and trim the fat before cooking. Take the skin off poultry. Do not give your baby salt fish, salt meat, bacon, or other processed or smoked meat. These are high in fat and/or salt. Roasted, broiled or stewed meat, poultry or fish that has been prepared for the family can be used. Do not add sauces or salt until your baby's portion has been taken out. Remove bones before cooking or choose pieces of meat away from the bone to process. Cook meat thoroughly and process quickly. Do not let cooked food stand at room temperature for long periods of time. If storing, refrigerate immediately. Vegetables • • • • • • 22 Use fresh or frozen vegetables. Don't use regular canned vegetables because they contain more salt than babies need. For mashed vegetables, you can use unsalted canned vegetables. Don’t puree any canned vegetables as they become "soupy" when blended. Clean fresh vegetables. Cook fresh or frozen vegetables until just tender. Don't overcook them. Baking or steaming retains the most nutrients. If you boil, use as little water as possible. Choose a variety such as carrots, turnip, broccoli, cauliflower, brussels sprouts, peas, squash, parsnip, sweet potato, green or yellow beans, cabbage, and tomatoes (strained). Fruit • • • Use unsweetened cooked, frozen or canned fruit or ripe bananas. If using canned fruit, the kind packed in water or fruit juice is the best choice for your baby. When using fresh fruit, wash it and remove skin, pits and large seeds before cooking. Commercial Baby Food If you buy commercial baby food, remember... • Baby foods are nutritious but most don't teach chewing skills. Move on to mashed table foods when your baby is ready. • Read labels - ingredients are listed in order of quantity. The ingredient listed first is present in the largest amount. Make sure that the first few ingredients are not fillers, but the actual foods you want to give to your baby. • Choose foods without added sugar, fat and salt. • Do not serve fruit products that are labeled “dessert”. • Choose separate jars of meats and vegetables, not combination dinners which may have fillers and lower nutrient contents. • Check the expiry date on the package. Do not use food past this date. • Do not feed your baby directly from the jar. Put a portion in a small bowl or plate so you are not putting germs from your baby’s mouth into the jar while feeding. • Keep your baby’s food safe. Opened jars of meat and poultry baby food should be stored in the refrigerator and thrown away if not used within 48 hours. Opened jars of vegetables and fruit should be stored in the refrigerator and thrown away if not used within 72 hours. Homemade Baby Food Recipe Ingredients 1 cup (250 ml) Diced or chopped cooked food 2-4 T (30-60 ml) Liquid (breast milk, formula, water or unsweetened juice). Additional liquid may be needed for meat, poultry and fish. Directions 1. 2. 3. 4. Wash your hands. Use clean cooking utensils and dishes. Cook fresh food until just tender. For pureed foods, add liquid to cooked food and put into a blender or food mill. Add extra liquid if a thinner puree is needed. Only use breast milk, formula, water or unsweetened juice. 5. For mashed foods, moisten cooked food with liquid as needed. Mash with a fork or potato masher. 6. For chopped food, either use a food processor or cut with a knife and fork until food is the right texture. Moisten with liquid as needed. Yield: Varies depending on how much liquid is used. Tip Take small portions of the healthy meals you are making for your family and use these foods to make your baby’s meal. Choose foods which are appropriate for your baby. Use a blender, food processor or knife and fork to create the right texture. Do not add salt, butter, oil, margarine, seasonings, spices, sugar or sweeteners during cooking or before serving. Once your baby is used to the taste of the food, you can add the spices which you add to your family’s food. 24 Keeping Your Baby’s Food Safe The following steps help to keep food safe: Preparing Food • • Wash your hands before preparing food and during food preparation. Washing hands is especially important if you have touched raw meat, poultry or fish. Use clean utensils and dishes. Refrigerator Refrigerate food immediately after preparation. • Do not store food in refrigerator for more than two to three days, depending on the type of food. Opened jars of meat and poultry baby food should be stored in the refrigerator and thrown away if not used within 48 hours. Opened jars of vegetables and fruit should be stored in the refrigerator and thrown away if not used within 72 hours. • Store food in a plastic or glass container and cover tightly. • For Freezing • • • Spoon food into ice cube tray(s) and chill in refrigerator. Cover tray(s) and place in freezer until food is frozen hard. Remove food from tray(s) and place in freezer bag. Remove air from bag with a straw, seal bag and label with type of food and preparation date. Maximum storage times in freezer or deep freeze • • Homemade baby food may be frozen and stored in the freezer of the refrigerator for up to two months. Homemade baby food may be frozen and stored in a deep freeze for six to eight months. Thawing and Heating • • • • • Frozen cubes should be thawed in the refrigerator or over hot water or in a microwave; not at room temperature. Heat only one meal portion at a time. Do not save leftovers for another meal. Do not refreeze food. When using a microwave oven, hot spots can be created in the food which can burn your baby’s mouth and throat. To prevent your baby from getting burned, stir food thoroughly to make sure that food reaches an even temperature throughout. Taste the food to make sure it is not too hot. Do not put the tasting spoon back into the food. Common Questions Here are some questions which parents and caregivers often ask: What about snacks? Children less than one year of age do not usually need snacks. If snacks are provided, serve nutritious snacks to help your baby grow and develop. Choose foods which are appropriate for your baby’s age. Do not give your baby soft drinks, fruitflavored drinks, cheese-flavored snacks, chips, candy and bars. See the lists on pages 8 and 18 of other foods which should be avoided. What about convenience foods? Many convenience foods, such as canned pasta and canned soups, are typically high in salt. Choose convenience foods which are healthier choices, such as low sodium soups, or make your own casseroles and soups. Then, the food can be as healthy as you make it! These types of foods can be given to your baby once she has tried a variety of foods and can chew cut-up table foods. 26 Does my baby need to take vitamins? Babies who are being breastfed during the first year should receive a daily supplement of 400 IU of vitamin D until one year of age or until breastfeeding is stopped. Babies who are being breastfed after one year of age should receive a daily supplement of 200 IU of vitamin D, unless they are obtaining that amount of vitamin D from food. A healthy diet, including two cups of milk a day, provides approximately 200 IU of vitamin D. You can buy vitamin D drops at drug stores or at stores that have a pharmacy. The vitamin D drops should be placed directly in the baby’s mouth. Breastfed babies do not need any other vitamins or minerals. Babies fed commercial iron-fortified infant formula do not need any vitamin or mineral supplements. Vitamins should only be given to a baby if prescribed by a physician for special needs. Does my baby need fluoride drops? The use of fluoride drops is not recommended for babies less than six months of age. Some babies may need fluoride drops after six months of age. Fluoride drops should only be given to a baby upon the advice of a dental care giver. What about water? Babies who are less than six months of age do not need water to quench their thirst. Giving water during the first six months may affect a baby’s growth as it may reduce her intake of breast milk or formula. Water is a good choice for older babies. Give your baby no more than 2 oz (60 ml) of water at one time and no more than 4 oz (125 ml) of water a day. Too much water will fill your baby up. Use water from the cold water tap. Water from the hot water tap may have higher amounts of lead than water from the cold water tap. Lead and copper from the pipes is not healthy for your baby. Let the water run from the cold water tap for two minutes each morning to flush out any overnight build up of lead and copper in the water from the pipes. The only bottled waters suitable for babies are noncarbonated natural spring water from underground springs and non-carbonated treated water with a low mineral content. Bottled water should have less than 500 ppm or mg/L of total dissolved solids. Note: natural spring water which is not commercially bottled and has not been tested for safety should not be used. Health Canada recommends caution when using home water treatment equipment. Some water softeners increase the sodium content of the water, and charcoal filters can increase the silver content of water or may contaminate the water with bacteria. Health Canada also recommends caution when using well water for infant feeding (birth to 24 months). Well water may naturally contain high amounts of nitrates, nitrites, arsenic, fluoride, or other heavy metals. If you are using private well water for your baby, the water should be tested at least twice a year for these substances. Well water should also be tested for coliform bacteria. Contact your nearest Government Service Centre for information on free testing for bacteria. They can direct you to laboratories where you can pay for testing for the other substances. What about teething? • • Don't worry if teething upsets your baby's appetite. It should return to normal when the tooth comes through. Give your baby a teething ring or bread crusts - not teething biscuits that contain sugar and crumble easily (which may cause choking). How do I keep my baby’s teeth healthy? • • • 28 If your baby uses a pacifier, do not dip it in anything sweet as this may cause tooth decay. Never put your baby to bed with a bottle of milk, juice or any sweet liquid. This practice promotes tooth decay and is a choking hazard. Ask your public health nurse or dental care giver for information about the proper way to clean your baby’s teeth. Additional Information Giving your baby the gift of healthy eating habits is a wonderful thing to do. Remember, support and information is available from public health nurses, dietitians, doctors and other health care providers. Some public health nurses, Healthy Baby Clubs and Family Resource Centers offer information sessions about feeding babies. You can also check out the following websites: Health Canada www.hc-sc.gc.ca The Canadian Health Network www.canadian-health-network.ca Dietitians of Canada www.dietitians.ca Our thanks to Manitoba Health for permission to use original illustrations and adapt content in developing this resource. Thank you to the parents, caregivers and health care providers who provided insight and guidance in the development of this handout. Notes: 30 2007
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