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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 Babys 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 Babys Food Safe ............................... 25 Common Questions.............................................. 26 Additional Information ......................................... 29
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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.
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 babys system is not ready to digest solid food. Your babys risk of being anemic (low iron) increases. Your babys risk of developing eczema (skin disorder) increases. Your babys 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.
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.
Remember
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 babys 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.
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.
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.
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 babys 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 dont compare her to other babies. Remember, babies all develop at different rates.
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).
These foods are safer for infants and young children when they are prepared as described
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.
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Fish is a healthy part of your babys 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.
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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.
Milk
Breastfeeding has many benefits and cows milk should not replace breast milk. The number of times a day you breastfeed should not decrease when cows milk is introduced. Mothers who breastfeed may choose to wait longer than 9 to 12 months of age before introducing cows milk. Whole cows 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 cows milk gradually. For formula-fed babies, the change from iron-fortified infant formula to whole cows 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 babys 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 babys 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.
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.
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Solid foods should add to, not replace, breast milk or commercial iron-fortified infant formula, which are nutritionally superior for young babies. Let your babys appetite guide how much food you provide.
Age
Birth
Foods
Breast milk or iron-fortified formula
Comments
Amount varies depending on age and babys appetite. See Breastfeeding Your Baby and Infant Formula Feeding pamphlets for additional information. (Available from your health care provider) Infant cereal: Start with 1 teaspoon (5 ml). Increase amount according to your babys appetite. Try one new cereal at a time. Wait 3 to 4 days before you try another kind of cereal.
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.
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 babys 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: Start with 1 teaspoon (5 ml). Increase amount according to your babys appetite. Try one new vegetable or fruit at a time. Wait 3 to 4 days before you try another vegetable or fruit.
Age
Nine to Twelve Months Continue with breastfeeding or formula. Wait 3 to 4 days between the introduction of each new food. Feed solid foods three to four times per day.
Food
Grain Products Bread, pasta, crackers (unsalted tops) and rice Whole grain unsweetened cereals as finger foods. These cereals do not replace infant cereal.
Comments
Infant cereal: Continue to provide and increase amount according to your babys appetite. 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 babys appetite. Meat and Alternatives: Continue to provide and increase amount according to your babys appetite. Vegetables and Fruit: Continue to provide and increase amount according to your babys appetite.
Milk and Alternatives Whole cows milk (3.25% MF) Plain cheese, unsweetened yogurt, cottage cheese
Whole milk can be introduced once your baby is eating a variety of foods from all food groups. Introduce small amounts of cheese and yogurt such as 1 teaspoon (5 ml). Increase amount according to your babys appetite. Introduce different foods in small amounts such as 1 teaspoon (5 ml). Continue to provide and increase amount according to your babys appetite. Continue to give whole milk until your baby is two years old. Continue to provide healthy foods according to your babys appetite. Contact your public health nurse or health care provider for a copy of Feeding Your Toddler.
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.
Egg white may be offered. A variety of nutritious foods from the four groups of Canada's Food Guide.
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Both home-prepared foods and commercial baby foods are acceptable choices for babies.
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 babys acceptance of new textures because the flavour stays the same as the texture changes. Helps your baby get used to family foods.
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
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. Dont 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).
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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.
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 babys 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 familys food.
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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.
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.
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 babys 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
What about snacks?
Here are some questions which parents and caregivers often ask:
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 babys 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.
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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.
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).
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 babys teeth.
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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:
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2007