Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
CHCCN305A: Provide care for babies
Respond to cues and needs of babies/infants
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Contents
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Respond to babies/infants in an unhurried, gentle and sensitive way to promote a relationship of trust
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Monitoring infants’ needs and well- being Babies and infants communicate with their carers in a variety of ways. Much of their communication is non-verbal, i.e. they use facial expressions and body posture to express their feelings. We can tell if a baby is content if they are gazing steadily at us with a relaxed body posture. As an infant grows, they will start to smile, gurgle and laugh. We need to build a trusting relationship with the babies and infants in our care by ‘tuning in’ to their cues—those signals that tell us how the baby/infant is feeling.
Activity 1
During physical care routines, be aware of changes to the infant’s cues and adapt caregiving in response to these cues. If infants begin to cry during nappy change, settle and soothe them first and then finish the change rather than rush the change through quickly. When infants cry, they have a need that should be addressed, not ignored or left for later.
Monitoring needs and well-being
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Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Fostering infants’ emotional well-being
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Establishing successful routines Successful routines are those that allow the physical care tasks to be accomplished in a caring and responsive manner. This happens when the caregiver is aware of the individual needs and rhythms of the child and reflects these within the routine.
There is a need to be flexible so if infants are hungry before the normal feed time, then they should be fed. The feeding routine should be unhurried and carried out in a respectful manner. Infants should not be made to feel that they are in the way or disrupting the general flow of the room.
A successful and quality infant program will endeavour to ensure that all physical care routines are carried out according to the individual child’s needs and rhythms and not to the needs of the adults in the room to set up and get the next part of the day ready.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Identifying ways to improve routines Here’s an interesting story of how staff in an infants’ room had to reconsider the general routine of the room.
Staff had been having problems with unsettled and whingy children, some of whom were also responding aggressively to the other infants. Staff were also finding it a very stressful room to work in and, as a result, were rushing even more through the physical care tasks so they could get outside as quickly as possible where there were staff from the other rooms to help.
At a room programming meeting, the staff decided this situation could go on no longer as they were feeling exhausted. They carefully considered the routine of the room to see if they could see how they could ‘speed’ the routine tasks along.
During this time, a staff member suddenly noticed that they were concentrating on the needs of staff and not the infants’ needs. Somewhere in the minds of the workers, a ‘light’ came on and they remembered a teacher, from their training days, talking about the need to plan around the children’s routines and not the staff’s.
The staff began a process of serious reflection and discovered that the more stressed they felt, the more they tried to hurry things along and wanted the infants to conform.
Everyone agreed that they needed to change the approach. So they spent two weeks carefully gathering information on the infants’ individual routines and rhythms. They gathered information through observations and discussions with parents. They then used a programming meeting to plan a new general routine for the room—a routine that reflected the individual infant’s needs and rhythms and still allowed for a little flexibility.
Bravely, the next week they put the routine into practice. Staff genuinely found that it was difficult to change their own behaviours but at the end of the week they felt less stressed and had noticed a marked difference in the temperament of the infants. One person even enjoyed the week.
The room leader was so pleased with the transformation and how it came about that she used it as an example of the importance of individual routines and the need for flexibility. She made sure every student who spent time in the room heard about it.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Another important aspect of successful routines is to be consistent. Routine tasks need to be carried out the same way each time as it allows infants to predict what is happening next. This is vital if we are trying to establish a feeling of trust and security.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Encouraging autonomy Another aspect of emotional well-being is the establishment and growth of a positive self-concept. Allowing infants and toddlers the opportunity to begin doing some tasks for themselves brings with it a sense of ‘I can do it’ and provides them with positive, intrinsic feelings of success. This sense of independence or beginning autonomy allows the child to feel good about their skills and to attempt to care for their own physical needs.
All infants can be encouraged to begin self-care from the simple task of putting their arms up so a shirt can be pulled off to alerting adults to their needs, such as pointing to a cup of water when thirsty. We need to provide unhurried time for older infants and toddlers to participate in physical care routines.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Providing physical comfort Babies and toddlers need cuddles. Skin-to-skin contact is important for attachment. It’s a fact that infants who are deprived of physical comfort and affection may fail to ‘thrive’ and have developmental delays in many areas of development.
From birth, a new-born baby will respond to being held close or being touched, stroked, patted and rocked. They will mould their body to yours as you hold them.
The older infant will lift their arms up to the carer for a cuddle; a toddler with enough language skills may even ask for a cuddle if they recognise that as their need. As caregivers of very young children, our hearts as well as our arms should always be open to the babies in our care.
Affection even enhances learning and enables the infant to build up trusting relationships with others as well as providing a solid foundation for their self- esteem.
Evidence from neuroscience, based on the study of infants’ brains as they interact in secure and playful relationships, tells us that infants are laying down pathways in their brain during interactions that form a basis for strong cognitive and emotional development throughout life.
To learn more about infant brain development and the effect that consistent, warm, playful interactions and lots of physical touch and comfort have on the developing brain, have a look at this site on the internet: http://www.zerotothree.org
It is not enough for caregivers to respond affectionately only when the child is crying or distressed, or only in order to distract them when they are distressed. Spontaneous affection also has an important role in building up relationships. It gives babies in our care the message that they are important and that we love them and that they are a pleasure to be with.
Activity 2
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Cuddles—are they always appropriate? Are cuddles always appropriate? They are in most situations but consider, for example, of an infant from a cultural background different to yours and who looks quite different from you. To them, you look not only unfamiliar, but different to everyone they may have met before. Over-enthusiastic cuddles may overwhelm the child and distress them more. Also, what is appropriate physical comfort may be culturally-determined. For example, in some cultures touching the top of the child’s head is taboo (some cultures consider this as where the person’s ‘life essence’ resides). It is always crucial to talk to parents about how they comfort and show affection to their children and whether they would be comfortable with you demonstrating affection.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Remember—every infant needs a cuddle Now think of infants who are very secure with you, are used to being in care and do not demand much attention. These infants should not be forgotten when we think about offering comfort. We often think that the infant has to be distressed for us to offer them comfort, but offering comfort can also be about reminding the secure infant that you are still there for them. A spontaneous hug and a tickling game may reinforce their security and also provide valuable opportunities for learning.
Tickling games (such as ‘Round and round the garden’) provide great opportunities to engage an infant in an affectionate interaction, not to mention the value of learning to anticipate what is coming next.
Activity 3
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Closely monitor babies/infants for signs of hunger, distress, pain and tiredness, and signs that they are ready for solids
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Signs of distress in infants Responsive, ‘tuned-in’ childcare workers carefully monitor the needs of the children in their care at all times. By being aware of each individual child’s cues and signs of distress they are able to respond quickly and appropriately, adjusting their responses as needed.
A crying baby
Those of you who have had any kind of extended contact with an infant will probably be able to make a list of some of the signs of distress. Obviously, crying comes straight to mind but try to think of some others—for instance, body language.
Activity 4
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Reasons for distress
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Why do infants get distressed? Numerous reasons probably came to your mind—from hunger and being left alone to experiencing a fright from sudden noise. Babies will exhibit obvious differences in what distresses them. The reactions will also vary. This means that a boisterous game involving lots of tickling and fast movements may have some infants laughing joyously, while those who may not be used to such games would get very scared.
Infants can very easily pick up on the emotions of the adults who care for them. If carers are suffering depression or having an anxious time or are just sad for some reason, it will have an impact on children in their care. Infants and toddlers can be astute judges of character and of feelings, so being cared for by adults who have a genuine love and respect for them is important.
Causes of distress are many. Appropriate reactions to distress may vary among different cultures. It is important always to examine our own backgrounds and beliefs about child-rearing practices. The ‘Western way’ is definitely not the only way, and certainly not the only appropriate way. It is important to communicate with the child’s family to find out the ways that they calm and comfort their child.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Monitoring for and responding to signs of distress Be aware of the cues and signs used by individual infants in your care and ensure that other staff are aware of these. It is very useful when an infant first starts care to speak to the parents about how their children behave when they are distressed, frightened, upset, hungry and so on. This will help you pick up on the signs quickly. Also discuss how these cues are responded to at home so a consistent approach can be used to reassure the infant that his or her needs will be met.
We need to be observant, use empathy, and respond promptly to signs of distress.
Activity 5
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Attending quickly to distress cues Whilst it is important to respond in a timely and appropriate manner to infants it is vital that we attend to needs quickly at times of distress. This distress might be the result of pain, loneliness, a fright or separation. When an infant is hurt or in pain, a responsive caregiver will pick up the child, comfort him or her and then act to ease the ‘hurt’. Sometimes a cuddle is all that is needed while on other occasions we may need to wash a graze or apply a bandage.
Activity 6
Giving comfort
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Provide babies/infants with physical comfort as appropriate
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Settling techniques We have already discussed many aspects of being a responsive caregiver. The following techniques are practical strategies you may wish to employ when trying to settle distressed infants, or just things you may like to incorporate into your care of infants to help them form relationships with their primary caregiver at the service or other carers.
The main point is that distressed infants need physical comfort. Hold infants close, rock them and soothe them with song—this is often very appropriate. But how exactly should we hold them?
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Holding the infant The following is meant as a guide only. You should always gather information about the infants from their main caregivers.
You will get to know the infants in your care and quickly be able to discern what sort of comfort or relaxation methods they enjoy.
Some things to consider when holding infants are outlined below.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Hold them when you are relaxed Don’t try to comfort an infant when you are feeling stressed or angry. If you are stressed or angry, try to hand the infant on to a relaxed adult and take a break to calm down.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Hold them with confidence Hold infants with confidence. Always support the head and back of a young infant, as well as give them support under their buttocks. For the safety of the infant as well as your safety, it’s best to carry the infant in your centre of gravity, ie, close and towards your middle.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Wrap them up Some young babies enjoy being wrapped quite firmly. In the colder months, ‘bunny rugs’ or ‘receiving blankets’ are good for this. Tuck their arms in. Sometimes flailing arms can startle the very young baby and add to their distress.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Pat them if they have wind If you think the baby has wind, and they are under three or four months, you could lay them across your arm or lap on their tummy with their head raised and pat them rhythmically.
If they don’t seem to like this, try holding them in a sitting position with their back against your tummy. Their head should be just under your chin. Place one hand over their tummy and one under their buttocks for support.
Another good remedy for wind is to lay the infant on their back, their head raised with a pillow or cushion and gently ‘pump’ their legs holding their feet, ie, push their feet up so the baby’s knees come up to their tummy and down again.
Holding a baby 1 Holding a baby 2
The ‘over-the-shoulder’ hold is also quite soothing for infants of most ages, where their head rests on your shoulder and their tummy is against your body.
Gentle rocking and a soothing voice along with some of the above techniques will soon soothe the distressed infant.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Relaxation Some babies may not seem distressed but may be tense. Signs of this are:
If the baby is over three months old, their fists are constantly clenched.
They do not seem to curl into you when held; instead they hold their body stiffly.
The following are some ideas to help babies relax.
Play soothing music. Perhaps lay the baby under a mobile in a quiet place while soft music plays.
If ratios permit, take a few moments to remove them from the hustle and bustle of the centre. If everyone is inside, go out for a few minutes or if everyone is outside, go inside for a while.
Some babies respond well to a deep bath. The water should be warm to relax them.
Sing a lullaby.
Put them in a pram or stroller and go for a walk around the centre.
Baby massage is very helpful but you can’t really do this if the baby is distressed or too tense. Ironically, the baby needs to be able to relax a little for this to be successful, so it’s often a good thing to do after the relaxation bath.
There are some good videos available about baby massage and you may find these helpful. Johnson and Johnson have a video called A Whole New Life which covers many things on caring for new babies, and includes both relaxation bathing and baby massage.
Massaging a baby
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Meet needs of babies/infants for consistent and secure care, in a timely manner
In order to feel emotionally secure, babies and infants need to develop a sense of trust in their caregivers and in their environment. Erik Erikson, a respected human development psychologist, believed that babies need to be cared for in a ‘consistent and warm manner’ in order to develop a sense of trust. If they are cared for in an inconsistent or emotionally cold manner then they may develop a sense of mistrust in others which can affect their emotional wellbeing.
Prompt and responsive caregivers can help develop the baby’s sense of trust by responding positively and consistently to their cues. This helps the baby to form a secure attachment to their caregiver or caregivers. It is recognised that it is vital for young children’s emotional wellbeing to develop attachments to their primary caregiver/s both at home and in care.
The Attachment Curriculum has been developed to foster attachment in child care settings. It consists of five parts:
Separation from Primary Caregivers (i.e. parents/family)
Links Between Home and the Child Care Centre.
Physical Contact with the Infant.
Handles for Attachment.
Routines and Rituals (Hutchins, 1995, pp 46-47).
Let’s examine each of these five parts of the Attachment Curriculum more closely:
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
One: Separation from primary caregivers The first part of the day in care revolves around the infant separating from the parent or primary caregiver. When the separation is positive and the infant is provided with lots of support and reassurance during this transition, then the day ahead is less stressful to the infant and the child will feel more secure in care. If the separation is stressful and the infant is not provided with adequate support, then the day ahead is more likely to contain difficulties.
Building a trusting relationship with each infant in our care is vital to allow the infant to feel secure. Caregivers who are consistently responsive to the infant’s needs will establish this trust much more quickly than a caregiver who responds inconsistently.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Two: Links between home and the child care centre Spending time on establishing relationships and feelings of trust with the infant’s parents will also contribute to establishing feelings of trust with the infant. The time put into ensuring positive parent/ caregiver partnerships at the beginning of care will pay off quickly as the infant will settle faster than when the parents are still unsure about the care setting.
Child care workers need to talk to the parents to help establish consistent arrival routines to make the transition to care easier. Also establish visual links between the home and the child care setting through the use of family photographs to facilitate familiarity.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Three: Physical contact with the infant Humans rely on touch and physical contact as part of the way we form and affirm relationships and attachment. We need to give infants as much physical contact as possible and an attachment curriculum provides continued opportunities to hold and cuddle infants. When infants are distressed and we pick them up and hold them to provide comfort and reassurance, this physical contact will build and strengthen secondary attachments. The level of physical contact given by caregivers should be appropriate and sensitive to the infant’s needs with caregivers using words to describe their actions and asking the infant’s permission, e.g. ‘Hello, it’s so good to see you are awake. Did you have a good sleep? Would you like me to pick you up? Come on up and have a cuddle.’
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Four: Handles for attachment These are not what you might imagine—we don’t attach handles to the infants. It is more a figure of speech—handles make it easier to hold onto, attach to things. What we need is to form a handle or bridge to help the infant’s transition from home to the child care setting. Handles for attachment refer to games, toys, special items and activities we use to help the child settle into care. Simple handles that are used by caregivers everyday are:
reading a favourite story book.
playing a peek-a-boo game.
looking in the mirror.
a push on a swing.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Five: Routines and rituals By establishing a consistent way of arriving at the centre and being greeted by staff we are able to foster security for the infant. Infants respond positively to consistent methods of care.
It is important that staffing in the babies room of a centre is consistent as far as practicable so that the infants are seeing familiar faces and beginning to form secondary attachments with one or two of the child care professionals.
Activity 7
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Respect and fulfil rituals of babies/infants
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Rituals in child care Rituals are set patterns of behaviour that generally allow the infant to feel more secure and in control of a situation.
Most people have small rituals that they perform each day often without being aware of them. Some of the interesting rituals I have seen are:
Putting tea into the teapot and then adding boiling water followed by turning the pot three times in the clockwise direction and then five times anti- clockwise.
Stirring the sugar into coffee (or tea) in the clockwise direction eight times and then tapping the spoon twice on the rim of the cup.
Rituals are fine to have; the majority of people have set patterns or ways that they complete a task but the world doesn’t fall apart if the ritual is incomplete. Rituals generally don’t cause us huge amounts of stress if we can’t complete them but their completion helps us to feel secure. There is a sense of security in familiar actions and patterns.
Think about your life and any rituals you may have, eg, the order in which you do things when you wash your hair, take a shower or wash clothes. Do you have a set pattern of behaviour or ritual that you follow in new situations? How do you feel if you are unable to complete this ritual? You may want to log onto the OLS forums and discuss your answers with others.
Most people have one or two rituals that allow them to feel more secure in unfamiliar situations. Infants and young children are the same.
Rituals are very important in the lives of infants as they are often placed in many unfamiliar situations and environments and need to have a successful way of comforting themselves and promoting feelings of security.
Activity 8
The importance of rituals in the arrival routine will be discussed in detail in the topic Settle new arrivals.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Rituals at sleep times It is very important to establish a sleep ritual that signals to the infant that it is time to sleep in a secure and comforting way. We should try to replicate the infant’s sleep ritual that is used at home so communication with family members is crucial. Some of the ways that families may put their infant to sleep could be:
wrapping them
patting or stroking them
giving them a dummy
rocking them
playing soft music
singing a lullaby.
The infant may have been fed a bottle of expressed breast milk or formula before sleep but we should never lay a baby down with a bottle, even if this is the practice at home. Putting infants down with a bottle is a dangerous practice as the child may choke, or the milk may enter their middle ear passages leading to otitis media (glue ear).
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Rituals at transition times Rituals can be a familiar way to signal a change for the young child. For example, clapping our hands for the child to imitate while we sing ‘Now it’s time to play outside, play outside, play outside’ to the tune of ‘Here we go round the mulberry bush’. We can add in verses such as ‘Now we need to put on our hat, put on our hat etc…’
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Importance of rituals Infancy can be a stressful time, especially when infants have to cope with new people and situations. Having an understanding of the role that rituals and transition objects play in children’s lives can make these situations easier to cope with. Working closely with parents is one way to ensure that we learn as much as possible about the rituals, transition objects and handling techniques that will make these times easier for all.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Provide for meeting the nutritional needs of babies
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Feeding Infants do have very special dietary requirements. Breast milk or formula is all they need for the first six months of life. Other foods must be introduced very gradually and certain foods and drinks should not be given at all during the first year of life.
Activity 9
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Bottle feeding Infants are fed expressed breast milk or infant formula in child care. This is a routine that is best carried out one-to-one according to the infant’s own feeding schedule and hunger on a particular day. As you can see from the exercise above, feeding infants in the first year or two of life is a gradual transition from a diet made up entirely of milk (breast or formula), with the very gradual introduction of solids, through to a diet very similar to that of older children with a wide range of solid foods.
Bottle feeding is a time during which you can hold, caress and talk gently with infants. Many infants fall into a drowsy state during bottle feeding and will often sleep afterwards. You should make sure you are sitting in a comfortable position so that you can relax and enjoy the experience too—if you are tense and want to rush, the infant will sense this and it may affect their feed.
Try to visit the website of the Children’s Hospital at Westmead and take a look at guidelines for making up a bottle of formula: http://www.chw.edu.au/parents/factsheets/pdf/formula.pdf.
If this link is no longer active do your own internet search through a search engine such as Google and assess reliable sources, such as government or hospital sites.
It would be useful to keep these guidelines for reference.
Be careful to take steps to avoid nasty accidents when boiling and heating water and milk. Below are some basic safety measures.
While you’re boiling water, make sure children are not close by. Turn the pot handle towards the back of the stove. Also use the back hotplates (not the front ones as little hands can reach for the pot handles).
Do not use the microwave to heat milk. Microwaves heat unevenly, and the hot milk can burn the baby. Instead, reheat the bottle by immersing it in a container of warm water or using a bottle warmer.
Always test the temperature of the formula before feeding it to the baby.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Breast-feeding Many infants and toddlers in care are still breastfed at home while happily feeding from bottles at the centre. This practice has many advantages for both the child and the mother (both nutritional and emotional), and should be supported by childcare staff for as long as possible.
Below are some of the reasons mothers may want to continue breastfeeding as long as possible.
Breast milk is a perfect food for infants and provides all their nutritional requirements for the first six months of life, and is a valuable supplement to solid food after six months.
Breast milk contains substances which protect infants against allergies and infections.
Breast milk is free.
Mothers and babies are in close physical contact while the baby is breastfeeding, and many find it an enjoyable and intimate experience.
Some parents may want to bring in expressed breast milk to be bottle fed to the child in care. Expressed breast milk should be treated with respect—it is a valuable resource that usually takes both commitment and determination to extract.
Freshly expressed breast milk can be stored in a refrigerator for up to three days without spoiling. Breast milk must never be heated in the microwave as essential nutrients can be compromised.
Some mothers and infants will want to breastfeed as soon as they are reunited at the end of the day in the centre, so provide a comfy chair in a quiet part of the room where mothers can breastfeed and reconnect with their infants and toddlers.
Mothers who work very close to the centre may want to come in through the day to breastfeed their infants.
For information that will help you to support mothers who wish to continue breastfeeding while in the paid workforce, you may wish to look at the following website: http://www.breastfeeding.asn.au/bfinfo/canwork.html.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Introducing solids
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
When to introduce them You will find a lot of different opinions among parents about when to introduce solids and what should be the first solid food given to an infant. Of course, it is the parents’ decision and you will need to work with their wishes and fit in with the foods that are being introduced at home.
Many parents will look to you for advice and guidance in this area however, as they may be getting conflicting messages from family members and medical professionals such as their doctor and early childhood nurse.
The reason for this conflict in advice is that solids were introduced much earlier to infants in the past; some believed that introducing solids in the first few months of life made babies sleep for longer and made them stronger and healthier.
We now know that waiting until the infant is about four to six months of age is best for their long-term health, and that breast milk or formula provides all of their nutritional requirements in the first four to six months of life. You need to be aware, however, that many parents may be under pressure from grandparents and older relatives to introduce solids. Giving them accurate information and support is helpful at these times, and there are many informative websites on the subject.
Have a look at the following website from the Children’s Hospital at Westmead. You might wish to keep this worksheet as a reference: http://www.chw.edu.au/parents/factsheets/fobabyj.htm
If this link is no longer active do your own internet search through a search engine such as Google and assess reliable sources, such as government or hospital sites.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
What to introduce first A common first solid food in Australia is rice cereal, as it is less likely to cause allergies than most other foods and it are high in iron. You will come across families that introduce first foods such as mashed avocado, mashed cooked kumara (sweet potato) and mashed banana.
Baby's first solid meals
The very first solid meals are often a mixture of the first food thinned with breast milk or formula to a runny consistency. This is given to the infant on a small feeding spoon. The infant is more likely to suck than eat this mix. Over a couple of weeks, this mix can be made gradually firmer as the baby gets the idea of eating from a spoon. Never mix solids into a bottle—babies need to learn the difference between eating and drinking.
A recommended sequence for introducing solid foods is clearly illustrated in the above website (ie, the website of the Children’s Hospital at Westmead). Take special note of their recommendation to take a slow, watchful and relaxed pace to introducing a variety of foods, and to allow each individual child to set the pace.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
How to introduce new foods New foods must be introduced in very small quantities one at a time, and it will be several days before another new food can be introduced so that you are sure there has been no allergic reaction.
It is important for infants to be sitting upright when they are being fed solids.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Self-feed or spoon-feed? Some parents and caregivers will want infants to learn to feed themselves as soon as they can hold a spoon, will encourage the introduction of finger foods and will be very tolerant of the mess this makes.
Other parents and caregivers will prefer to spoon-feed infants right into the toddler years to avoid this mess and to ensure all the food is being eaten rather than played with. Like so many other aspects of child care, this is an individual choice to be made by parents and carers in collaboration.
However, it is important to support infants’ self-help attempts, so you will need to keep a watchful eye to ensure you respond to the child’s initiative to self-feed.
Some parents and caregivers are very tolerant of mess
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Joining other children for meals Once babies are eating a small variety of mashed and finger foods and can sit up without support, they may enjoy joining in on group snack times and mealtimes while they sit on a high chair.
There is much to be learnt from joining in on group mealtimes. Infants can watch older children eat a range of foods and handle cutlery and there is the social aspect of watching and listening to others, and joining in sometimes.
Try to obtain a copy of the following video:
Kolbe U (1995) Mia-Mia: A New Vision for Day Care, Part Two, The Infants’ Program (Under Twos, Summer Hill Films for the Institute of Early Childhood Studies, Macquarie University, NSW.
In this video, you will see a very positive mealtime for infants and toddlers.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
Guidelines for creating positive feeding and mealtimes with infants and toddlers Below are guidelines for creating positive feeding and mealtimes with infants and toddlers. Remember you should always take into account the physical and organisational aspects, as well as the caregiver’s attitude and manner.
Consult parents about their children’s food preferences, allergies, cultural or religious food beliefs and home feeding routines. Remember: Some allergies can be life-threatening so it is important to consult parents and nurses about children’s allergies—and make sure you know exactly what to do if there is an emergency.
Support breastfeeding. In fact, encourage mothers to breastfeed their children at the centre.
Be alert and responsive to signs of hunger and thirst. Meet these needs promptly.
Remember that children have individual schedules for feeding. Follow their schedules.
Make sure that mealtimes are always pleasant. Meals should be unhurried. Children and carers should be calm and relaxed. Children should not have to wait long for their meals.
Allow the children to leave the table when they have finished their meals.
Make sure the furniture in the dining room is comfortable. For example, the table height need to be slightly above waist height and the chairs should not be too high (children’s feet should touch the ground when they are seated).
Try to seat children in small groups. Make sure there is plenty of room between each child. Small groups are better than ‘whole’ group meal times. Whole group meal times are certainly not suitable for babies.
Make sure that cutlery and crockery are sturdy and are easy to use. Also, make sure they are clean and safe to use.
Try to make the food attractive. Vary the food so that they are not always eating the same type of food. Try to keep to foods that are familiar to the children (but do introduce new foods every now and again). Importantly, make sure the food is nutritious.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010
If children prefer small servings, allow that.
Encourage children to feed themselves. However, make sure you are there to offer help. Tolerate messiness and exploration.
Do not expect perfect table manners. Model good table manners—so children can learn. Remember, too, that the children in your care may be more familiar with other types of utensils at home or may eat with their fingers.
Encourage children to try new foods—but do not ever force them to try the food.
Children often need either a drink or some moist food (eg, custard, yoghurt or even fruit) to start their meal, especially if a sandwich is part of their lunch.
All courses of the meal should be valued and counted towards nutritional intake provision. No special order or sequence should be observed if the child chooses to eat one part of the meal before another.
Small groups for meal times
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You may wish to take a look at the following book for more information about feeding practices:
Greenman J and Stonehouse A (1997) Prime Times: A Handbook for Excellence in Infant and Toddler Programs, Addison Wesley Longman, Australia.
Certificate III in Children’s Services: CHCCN305A: Reader LO 9205 © NSW DET 2010