Feeding And Nutrition For The Baby
A newborn gets all of his nutrition from breast milk or an iron fortified infant formula until he is four to six months old. Supplements with water, juice or cereal is not required at this time. By this time, the baby is now on a more predictable schedule and will probably be nursing or drinking 5-6 ounces of formula every 3-4 hours.
Feeding practices to avoid during this time are putting the bottle in bed or propping the bottle while feeding, putting cereal in the bottle, feeding honey, introducing solids before 4-6 months, or heating bottles in the microwave.
Low iron formulas should also be avoided at this time because they are nutritionally inadequate to meet the needs of a growing infant. This can put the baby at risk for developing iron deficiency anemia (which has been strongly associated with poor growth and development and with learning disabilities). Iron fortified formulas do not cause colic, constipation or reflux and a low iron formula should not be given to the baby if he has one of these problems.
By this time, iron fortified cereals can be given to the baby each day along with the continuation of the breast milk and the iron fortified formula. The baby can be given well-cooked, strained, or mashed vegetables or commercially prepared baby foods. Start with one tablespoon of a mild tasting vegetable, such as green beans, peas, squash or carrots and gradually increase to 4-5 tablespoons one or two times each day.
Start fruits about a month after starting vegetables and again, gradually increase to 4-5 tablespoons one or two times each day. 4-6 ounces of 100% fruit juices can also be given. Start by mixing one part juice with two parts of water and offer it in a cup only. Delay giving finger foods or meat and other protein foods until infants are eight to nine months old.
To avoid having to supplement with fluoride, prepare powdered/concentrated formula with fluorinated tap water. The baby may need fluoride supplements in case ready-to-feed formula or bottled or filtered water is used. The baby will probably have given up middle of the night feedings by this age. If not, slowly reduce the bottle content each night and gradually stop this feeding all together.
Feeding practices to avoid are putting the bottle in bed or propping the bottle while feeding, putting cereal in the bottle, feeding honey, using a low-iron formula, offering juice in a bottle or heating bottles in the microwave.
More protein containing foods can be given to the baby by this time. These include well-cooked, strained or ground plain meats (chicken, beef, turkey, veal, lamb, boneless fish, or liver), mild cheese, peanut butter, or egg yolks (no egg whites as there is a high chance of allergic reactions in infants less than 12 months old. Start with 1-2 tablespoons and increase to 3-4 tablespoons once each day. If your baby doesn't seem to like to eat plain meat, then you can mix it with a vegetable that they already like.
Offer soft table foods and finger foods at this age. Give soft, bite-size pieces of food, such as soft fruit and vegetable pieces, pastas, graham or saltine crackers, and dry cheerios, but do not give these foods if the child is going to be unattended in case of choking. Over the next three months the baby's diet will begin to resemble that of the rest of the families, with 3 meals and 2 snacks each day. 4-6 ounces of 100% fruit juice can also be given to the baby.
Feeding practices to avoid are changing to regular milk before the child is twelve months old, putting the bottle in bed or propping the bottle while feeding, feeding honey, using a low-iron formula, offering juice in a bottle or heating bottles in the microwave.
The baby can now be offered homogenized whole cow's milk. Do not use 2%, low fat, or skim milk until the child is 2-3 years old. Limit milk and dairy products to about 16-24 oz each day (in a cup or bottle) and juices to 4-6 oz each day (offered in a cup only) and offer a variety of foods to encourage good eating habits later.
By this time the child want to feed himself with his fingers and a spoon or fork and should be able to drink out of a cup. The next few months will be time to stop using a bottle. Remember that the baby's appetite may decrease and become pickier over the next few years as his growth rate slows.
Feeding practices to avoid are giving large amounts of sweet desserts, soft drinks, fruit-flavored drinks, sugar coated cereals, chips or candy, as they have little nutritional value. Also avoid giving foods that the child may choke on, such as raw carrots, peanuts, whole grapes, tough meats, popcorn, chewing gum or hard candy.
How to prepare an infant’s formula?
Infant formulas are available in many different forms, including those that are ready to feed, which comes in 32oz cans and requires no preparation. Once opened, ready to feed formula must be refrigerated and used within forty eight hours.
Formula can also be concentrated in 13 oz cans, and require dilution with water on a 1:1 basis (one ounce of water for one ounce of concentrated formula). Powder formulas are prepared by mixing one scoop of formula with two ounces of water. Powder formulas are usually the least expensive.
Boiling water or sterilizing the bottles and nipples isn't necessary incase the running water is properly sanitized. The water out of the tap can be used directly and bottles can be washed in hot soapy water or in the dishwasher. However, it is better to boil the water for minutes before preparing formula.
Discard any formula in the bottle that is not finished during the feeding.
The baby may accept formula prepared with cold water, or he may prefer to have the formula warmed. Warm the formula by placing it under hot running water, using a bottle warmer or on the stove. Do not warm formula in the microwave, as it can produce hot spots in the bottle that can burn the baby. And always test warmed formula before feeding it to your baby.
In case of using ready to feed formula or preparing concentrated or powder formulas with bottled or filtered water, then the baby should be given fluoride supplements when he is older. Consult the doctor regarding this.
Introducing Solid Food to the Baby
Solid food can be introduced to the baby any time between 4 and 6 months if the baby is ready. His digestive system simply isn't ready for solids until he nears his half-birthday. Until then, breast milk or formula provides all the calories and nourishment the baby needs.
When the baby is ready for the solid food intake?
The baby gives clear signs when he's ready to move beyond liquid-only nourishment. These include:
• Head control. The baby keeps his head in a steady, upright position.
• Losing the "extrusion reflex." To keep solid food in his mouth and then swallow it, the baby needs to stop using his tongue to push food out of his mouth.
• Sitting well when supported. Even if he's not quite ready for a highchair, the baby needs to be able to sit upright to swallow well.
• Chewing motions. To start solids, the baby should be able to move food to the back of his mouth and swallow.
• Significant weight gain. Most babies are ready to eat solids when they've doubled their birth weight (or weigh about 15 pounds) and are at least 4 months old.
• Growing appetite. The baby seems to be hungry even with eight to ten feedings of breast milk or formula a day.
• Curiosity about what others are eating. The baby may be eager to know what people around him are eating.
How to introduce the solid food to the baby?
Start with rice cereal, which is gluten-free and less allergenic than other foods. First, nurse or bottle-feed the baby. Then give him one or two teaspoons of dry cereal mixed with enough formula or breast milk to make a semi-liquid. Use a soft-tipped plastic spoon for feeding the baby, to avoid injuring his gums. Start with just a small amount of cereal on the tip of the spoon.
If the baby doesn't seem very interested in eating off the spoon, let him smell and taste the cereal or wait until he warms up to the idea of eating something solid. Don't add solid food to the baby's bottle or he may not make the connection that food is to be eaten sitting up and from a spoon.
Begin with a once-a-day feeding, whenever it's convenient, but not at a time when the baby seems tired or cranky. The baby may not eat much in the beginning, but give him time to get used to the experience. Some babies need practice keeping food in their mouths and swallowing. Once he gets used to his new diet, he'll be ready for a few tablespoons of cereal a day. As the amount he eats increases, gradually thicken the consistency of the cereal and add another feeding.
How to know the baby is full?
A strict accounting of the amount the baby has eaten isn't a reliable way to tell when he's had enough. If the baby leans back in his chair, turns his head away from food, starts playing with the spoon, or refuses to open up for the next bite, he has probably had enough. Sometimes a baby will keep his mouth closed because he hasn't yet finished with the first mouthful, so give him enough time to swallow.
Should the baby still be provided with the breast food or formula?
The baby will definitely need breast milk or formula until he's a year old. Both provide important vitamins, iron, and protein in an easy-to-digest form. Solid food can't replace all the nutrients that breast milk or formula provides during that first year.
How to introduce different types of solid foods to the baby?
Introduce other solids gradually, one at a time, waiting for at least three days after each new food. This will give enough time to know if the baby has an allergic reaction any of the food items introduced. Signs of an allergy may include diarrhea, a bloated tummy, increased gas, or a rash. In case of a family history of allergies or if the baby develops the allergic reaction, start waiting up to a week between new foods.
It'll take time for the baby to get used to each new taste and texture. Each baby will have unique food preferences, but the transition should go something like this:
1. Semi-liquid cereals
2. Strained or mashed fruits and vegetables
3. Finely chopped table foods, including meat and other protein sources.
When the baby has mastered digesting cereal, offer a few tablespoons of vegetables or fruit in the same meal as a cereal feeding. Good foods to start with include sweet potatoes, squash, applesauce, bananas, carrots, oatmeal, peaches, and pears. All food should be strained or mushy because at this stage the baby will press the food against the top of his mouth and then swallow.
In case of feeding from ready-to-eat jars of baby food, scoop some into a little dish and feed him from that. If the feeding spoon is dipped into the jar, it will introduce bacteria from his mouth into the jar. Also, throw away any baby food jars within a day or two of opening them.
And stay away from foods that might cause him to choke. If the baby turns away from a particular food, don't push. Try again in a week or so.
How many times a day should the baby is given solid food?
At first the baby will eat semi-liquid cereal mix just once a day. By around 8 months he should be eating solid food three times a day. A typical day's diet at 8 months should include a combination of:
• Breast milk or iron-fortified formula
• Iron-fortified cereal
• Yellow and green vegetables
• Small amounts of protein such as poultry, cottage cheese, tofu, and meat
Foods that can be unsafe for the baby:
All foods are not safe for your child. Some pose a choking hazard, and a few aren't good for the baby's still-developing digestive system.
Foods to avoid for newborn to 4 - 6 months-
All solid foods should be avoided at this time.
Foods to avoid for 4 to 12 months-
Honey: Honey can harbor spores of Clostridium botulinum, which causes botulism. An adult's intestinal tract can prevent the growth of these spores, but in a baby the spores can grow and produce life-threatening toxins.
Peanut butter: The sticky consistency of peanut butter and other nut butters can make it tough for a young child to swallow safely.
Cow's milk: Stick with breast milk or formula until his first birthday. This is because the baby can't digest the protein in cow's milk for the first year; it doesn't have all the nutrients he needs; and it contains minerals in amounts that can damage his kidneys.
Food items which can cause choking for the little one:
Large chunks of foods: Pea-size pieces of food are safest — they won't get stuck in the child's throat. Vegetables like carrots, celery, and green beans should be diced, shredded, or cooked and cut up. Cut fruits like grapes, cherry tomatoes, and melon balls into quarters before serving. Cut meats and cheeses into very small pieces or shred them.
Small, hard foods: Nuts, popcorn, cough drops, hard candies, raisins, and other small dried fruit and seeds pose potential choking hazards.
Soft foods: Soft foods like marshmallows and jelly candies can get lodged in the child's throat and cause choking.
Choking prevention tips:
- Avoid letting the child eat in the car.
- When using a rub-on teething medication, keep a close eye on the baby as it can numb his throat and interfere with swallowing.