ON FEEDING BABY FROM NEWBORN TO TWELVE MONTHS Your Baby Feeding EASY HELPFUL ADVICE . ofessional. YourBaby , magazines.... Revised October 2006 Feeding Deciding how to feed your baby can be confusing. This guide may help you sort out what is best for you and your baby found The following information is based on feeding recommendations "-Statement of the Joint in the document "Nutrition for Healthy Full Term Dietitians of Canada and Health Canada, 2006. Canadian Paediatric Society, Group: Working This booklet gives general guidelines for healthy babies. health pr If you have specific questions, contact your doctor or regulated Relax and Enjoy Your Baby! Relax and Enjoy Your Everyone seems to have advice - your family, friends, your doctor Everyone seems to have advice - your family, 01 YourBaby Feeding Sample Menu for 6-9 Months Own Your Making Baby Your Foods to Table Introducing Sample Menus for 9-12 Months Baby Your Safety and Baby Your Diarrhea and Constipation, Nutrition Book Recommendations Help References Choosing Foods for Baby Baby Food and Formula in the Microwave Warming Baby Your and Decay Tooth Early Childhood Up and Vomiting Spitting 21 22 23 24 25 26 27 28 29 29 30 31 32 33 02 03 04 05 06 07 08 09 10 12 13 15 16 17 Iron Fluoride Weight Gain Weight Food Allergies Feeding Formula Benefits for Baby Benefits Storing Breastmilk Storing Preparing Formula Preparing Breastmilk is Best Benefits for Benefits Table ofTable Contents Your Breastfed Baby Breastfed Your Weaning Vitamin D for Breastfed Babies D for Breastfed Vitamin Introducing Solid Foods to Your Baby Your Introducing Solid Foods to How to Know if Baby is Getting Enough Your Baby Feeding Health Canada recommends exclusive breastfeeding for the first 6 months of life or longer -- even beyond The longer you breastfeed, the more benefits 2 years. there will be for your baby and you. Breastfeeding for any length of time is better than not breastfeeding at all. YourBaby Breastmilk is the best food for your baby. your for Breastmilk is the best food Your Baby’s First Baby’s Food Your Feeding Breastmilk 02 03 YourBaby Feeding Colostrum (early breastmilk) and breastmilk contain many different substances Colostrum (early breastmilk) and breastmilk contain many different to help prevent and fight infections. For babies with a family history of allergies, exclusive breastfeeding for 6 months may protect your baby from developing allergies. There is growing evidence that breastfeeding may also reduce the incidence of childhood obesity. Benefits of Breastmilk Baby: Breastfed babies have fewer illnesses than formula fed babies (e.g., colds, diarrhea and ear infections). Breastfeeding may help protect against Sudden Infant Death Syndrome (SIDS). . Soy, lactose-free Soy, Pricing in Windsor-Essex Note: and special formulas are usually more expensive. County, 2005 County, Windsor-Essex County, 2005 Windsor-Essex County, Nutritious Food Basket Data, * ** $ 495.71 $ 539.03 $ 170.11 $1512.93 __ ** amount of money saved in 1 year: $651.20 *______YourBaby Breastmilk is convenient, available, safe, fresh and always the right temperature. Many women who breastfeed find it easier to return to their pre-pregnancy weight. can save money by breastfeeding your baby You Breastmilk costs very little. Benefits of Breastfeeding Feeding Average Cost of Regular Cow's Milk-Based Formula Average for first 6 months of life, for a healthy term baby of average weight Powder ______Liquid Concentrate ______Ready-to-Use ______Estimate of minimum Breastfeeding ComparedBreastfeeding to Formula Feeding cost of additional food that mother needs for 6 months Average of breastfeeding Breastfeeding helps the uterus return to its normal size more quickly. who breastfeed may have a lower risk of developing cancer and cancer of the ovaries. Women Mother: 04 tion 05 fe. YourBaby . 88 IU 80 IU 25 IU 25 IU Feeding 100 IU 103 IU formula per day. s milk in the first two years of li International Units of Vitamin D* If baby is taking breastmilk your and formula, vitamin D supplementa Food Health Canada recommends that all breastfed, healthy term infants receive a daily vitamin D For Breastfed Babies Breastfed For Egg yolk, one milk (fortified), 250 ml **All cow’s (fortified), 250 ml Margarine (fortified), 1 tsp Salmon, cooked, 1 oz ***Fortified plant based beverage, 250 ml Vitamin D Most Common Canadian Dietary Sources of Vitamin D* (Health Canada, 2004) Most Common Canadian Dietary Sources of Vitamin * 1µg (microgram) = 40 IU of vitamin D milk is not recommended before 9 to 12 months of age. **Cow’s beverages are inappropriate alternatives to breastmilk, infant formula or cow’ ***Vegetarian supplement (400 IU or 10 µg). Supplementation should begin at birth and continue until the baby's diet includes at least 10 µg (400 IU) per day of vitamin D from other dietary sources (see chart below), or until the breastfed infant reaches one year of age. should continue until the infant is drinking moreshould continue until the infant than 1000 ml of to your doctor or pharmacist for a vitamin D supplement that is right for your small BM’s 6 Weeks to 6 Months 3-4 per day or 1 large BM per week soft Yellow, & seedy 5 Weeks 4 Weeks 3 Weeks 2 Weeks 7 Day 6 Day per day, the size of a quarter or larger per day, 5 in a dry . in a dry diaper. Day At least 6 heavy wet 3+ Many babies have a bowel movement (BM) after each feeding. daily Some small & large BM’s soft & seedy Yellow, *A heavy wet diaper feels like at least 3 tablespoons or 45 ml of water 4 Guidelines for Breastfeeding Babies Breastfeeding Guidelines for 4* Day per day, 3 3* Day the size of a quarter or larger Brown, green or yellow & soft 3+ 2 2 Day 1-2 YourBaby Newborns (birth to 6 weeks) eat often because they have small stomachs. Many newborns is Getting Enough Breastmilk 1 1 Day Black or dark green & sticky Feeding Age # Wet Baby’s Diapers Minimum Diapers # Soiled & Colour per 24 hrs of Bowel How to Know if to Know How Baby Your nurse 8 to 12 times in a 24-hour period in the early stages. They may also feed more often during growth spurts. nurse 8 to 12 times in a 24-hour period in the early stages. make sure your baby is getting enough breastmilk, check these guidelines. If your baby is not meeting these To guidelines, contact your doctor or a regulated health professional. (See Breastfeeding Help on page 32.) 06 Movement 07 . You can You . . Your baby's Your . YourBaby Feeding You can talk to your doctor You , according to their appetite. Remember 15 to 225 grams) per week. The average baby 15 to 225 grams) per week. . and Your Baby and Your Newborns should not lose more than 7 percent of . Typical weight gain by day 5 Typical Newborns should not lose more than 7 percent of birth weight. Weight Gain Weight is 2/3 to 1 ounce or 20-30 grams per day. Breastfed babies usually return to their birth weight in 10 to 14 days. is 2/3 to 1 ounce or 20-30 grams per day. Formula fed babies may regain their birth weight more quickly Babies often experience growth spurts at around 2 to 3 weeks, 6 weeks, 3 months and 6 months of age. During these growth spurts, your baby may feed more often. (Solid foods are not recomended before 6 months of age.) More frequent breastfeeding increases the breastmilk supply to satisfy your baby's hunger normal feeding pattern will return in a few days following each growth spurt. gain is the best way to tell if your baby is growing well. Each baby's growth rate is different. Weight doctor will mark your baby's height and weight on a growth chart. Your about how your baby is growing. From birth to 6 months, typical weight gain is 4 to 8 ounces (1 If your baby is not gaining weight, or doubles birth weight by 5 to 6 months and triples birth weight by 1 year. talk to your doctor or regulated health professional. you think your baby is gaining weight too quickly, A simple guide for feeding babies is to feed them when they are hungry Do not force your baby to eat. Babies will that babies cry for many reasons, not only when they are hungry. indicate when they are full by clamping their mouths shut, turning their heads or pushing food away help your older baby grow into a healthy weight by encouraging active and providing nutritious foods. To warm To Always mark the date Never use a microwave to defrost . Length of Storage Time Thaw frozen breastmilk in the fridge 2 weeks 3 months 6 months Do not thaw frozen breastmilk at room temperature. Once breastmilk is thawed, it can be refrigerated for up to 24 hours and should not be Storage Space YourBaby Breastmilk Fresh, unfrozen breastmilk can be stored in the fridge for up to 8 days. Feeding Freezer inside fridge Separate freezer above fridge Deep freezer Mohrbacker & Stock (2003). breastmilk for your baby, place the container in a bowl of very warm water breastmilk for your baby, or heat breastmilk. Throw away unused breastmilk after storage time has passed. refrozen. that the milk was expressed on the storage container before storing. or by placing the container under cool, running water and gradually adding warmer water until the milk is thawed and becomes room temperature. Storing 08 09 YourBaby by are Ready. Feeding (such as unexpected hospitalization of mother) flexible. There are now 2 formula feedings per day. There are now 2 formula feedings per day. flexible. feedings. Baby should be weaned gradually over several weeks. Replace 1 daily breastfeeding with a bottle or cup of iron-fortified formula. Replace another feeding with formula after 3 or more days. Mother can be Continue this process until all breastfeedings are replaced by formula To Fully Wean Your Baby: Your Fully Wean To 1. 2. 3. Unplanned Weaning: should be pumped regularly to avoid engorgement. Follow above weaning schedule. Getting your baby used to drinking breastmilk from a bottle is a good idea if you expect If you are returning to work, you don't have to give up breastfeeding. The Best Time for Weaning is When You and/or Your Ba and/or Your is WhenThe Weaning You Best Time for Your Breastfed Baby Breastfed Your Continue to breastfeed when you are at home. You will adapt to fewer feedings per day by making less milk. You You can pump breastmilk while at work and store in a fridge. Use that breastmilk for the next day's bottles. You can nurse your baby during your hours at home and give iron-fortified formula while you are at work. You Weaning Weaning Returning to Work: 1. 2. Introducing a Bottle: to use a bottle as a back-up now and then. By 4 to 6 weeks you and your baby will likely be comfortable with This is a good time to introduce a bottle. Plan ahead and express some breastmilk for bottle-feeding. breastfeeding. OR , like a or sibling, has allergies. Wheat Coughing Blood in stools Breathing problems Irritability Poor growth Sneezing Vomiting Corn Soy Eggs Shellfish Milk and milk products YourBaby and Your Baby and Your An allergy is an abnormal reaction of the immune system to a protein in food. Food allergy can Feeding Abdominal pain Diarrhea Feeding problems Hives or skin rash Itchy and watery eyes Runny nose Swelling of the mouth and face Citrus fruits Fish Peanuts & other nuts Foods that cause most food allergies cause most food include: that Foods Food Allergies Food also be called food hypersensitivity. also be called food hypersensitivity. about 1 to 8% of babies. Many allergies may go away before school age. Some babies Food allergies affect are more likely to develop food allergies if an immediate family member Some symptoms of allergies include: 10 11 YourBaby Talk to your to your Talk doctor about introducing new foods when immediate family members allergies. food have Feeding . When there is a family history of food allergy, babies may benefit if you delay introducing citrus fruit, berries and tomato until Delay peanuts after 1 year. until 2 years of age or later. Some regulated health professionals recommend waiting even longer before introducing these foods. give egg white until after 12 months of age. When introducing cereals, start with single-grain Do not Breastfeed exclusively for 6 months. cereals like rice, oat or barley. Introduce small cereals like rice, oat or barley. amounts of new foods one at a time, several days apart. Lower the Risk ofLower Allergy Food Intolerance is differentFood allergythan a food It is an unpleasant reaction to food without a response from the immune system. Food intolerances are often seen with lactose (milk sugar) and many food additives, preservatives or colouring agents. Food intolerances can have many of the same symptoms as food allergies. AllergyFood or Intolerance? to your doctor if you think your baby has had an unpleasant reaction to food or if there is a history of food Talk doctor will advise you if your baby needs to avoid certain foods or change formula. Your allergies in your family. Removing foods from your baby's diet without your doctor's knowledge may cause problems with growth and development. Once you learn that your baby has a food allergy or intolerance, you may need to talk to a Registered Dietitian to help plan a healthy diet for your baby Always talk to your doctor before changing formula. Some babies who are allergic to cow's milk-based formula will also be allergic to soy-based formula. It often takes It often takes months several your before baby sleeps through the night. Total Amount of Total Formula Per Day Formula Per no less than 18 oz (540 ml) 18 to 30 oz (540-900 ml) 20 to 40 oz (600-1200 ml) 25 to 40 oz (750-1200 ml) 18 to 35 oz (540-1050 ml) 18 to 32 oz (540-960 ml) in Each Bottle in Each Amount of Formula 1.5 to 3 oz (45-90 ml) 3 to 4 oz (90-120 ml) 4 to 6 oz (120-180 ml) 5 to 7 oz (150-210 ml) 6 to 7 oz (180-210 ml) 6 to 8 oz (180-240 ml) Per Day Per Number of Bottles 7 to 12 6 to 10 5 to 8 5 to 6 3 to 5 3 to 4 Age If you are not breastfeeding, feed your baby iron-fortified formula until baby is at least 9-12 months of age. to Your Baby to Your 1 week to 1 month 1 month to 3 months 3 to 6 months 6 to 10 months Birth to 1 week 10 to 12 months YourBaby Your baby may drink Your Feeding How Much Much How Formula is Enough? Feed your baby on demand. He knows when he is hungry and how much he needs to eat. If you are worried about the amount of formula your baby is drinking, check the following guide- lines or contact your doctor or regulated health professional. These general guide- lines can also be used for expressed breastmilk. 12 Feeding Formula Feeding more or less than the amounts of formula suggested, depending weight and activity on baby’s baby will drink less Your level. formula as he begins eating more solid foods (6-12 months). NOTE: 13 YourBaby 2 minutes. It is also Feeding for at least . Health Canada recommends s formula. Boiled water can be stored rolling boil Carbonated/soda water Distilled water Mineral water Softened water It is common practice to sterilize bottles for breastmilk or formula until your baby is at least 3 to 4 months of age. Waters that are not good for formula include: Waters for Your Baby Your for water for feeding infants less that 4 months of age to a all Preparing Formula important to follow the manufacturer’s instructions in preparing your baby’ in the refrigerator in a closed sterile container for 2 to 3 days. It can be stored for 24 hours at room temperature in a closed sterile container. Water Used in Formula Preparation Water Municipal tap water and commercially bottled spring water are the safest to use in formula preparation. water can be safe but must be tested for bacteria and nitrates regularly Well bringing , fork and tongs in a large pot 1 1/2 hours. YourBaby Feeding for 5 minutes to sterilize them. They are now ready for expressed breastmilk or formula. Let them air dry. to the manufacturer’s instructions. Cool the water before making the formula. Pour formula into sterilized bottles. Read formula label. Do NOT reuse leftovers because bacteria will now be in the bottle. Take bottles and other items out of boiling water with tongs and place on a clean surface. Take If you are using a powdered or concentrated formula, boil water for the formula according Follow the manufacturer’s directions carefully when you make formula. Prepared formula can be kept in the refrigerator for up to 24 to 48 hours. Wash your hands. Wash Rinse well. all equipment with a brush in hot, soapy water. Wash Formula manufacturers recommend boiling bottles, , can opener Throw away leftover formula or breastmilk after your baby has finished eating. Do NOT leave formula or breastmilk out of the refrigerator for more than 4. 5. 6. 7. Making Bottles for Baby Making Bottles for 1. 2. 3. 8. 9. 14 15 YourBaby 6 months family dentist Feeding If you use bottled water to make your baby's formula, call the manufacturer to learn the fluoride level. with your dentist to learn if this amount of fluoride Talk much fluoride can be harmful Too is safe for your baby. and can stain your baby's teeth with white or brown spots. and Your Baby and Your Fluoride in water is needed for healthy teeth and to lower the risk of your baby developing Fluoride of age. Your dentist will decide if your baby needs to receive a fluoride supplement. Your of age. cavities. Fluoride is present in different levels in your local water supply, well water and many bottled waters. levels in your local water supply, cavities. Fluoride is present in different Extra fluoride is not needed before 6 months of age. It is important to talk with your to learn if your water supply has the right amount of fluoride once your baby reaches , learning abilities YourBaby Make sure your baby is getting enough iron in his diet. Iron helps to prevent anemia and Your Baby and Your Feeding Iron as well as your baby's immune system. Breastmilk provides all the iron your baby needs until 6 months of age. Iron in breastmilk is easy for your baby to absorb. Babies who are not breastfed or who are weaned from the breast should be given iron-fortified formula until at least 9 months of age. At 6 months of age, infant cereals, pureed meats and meat alternatives can be introduced so that your baby can get the extra Iron from meat is better absorbed than iron iron needed to grow. from non-meat sources. Cow's milk is low in iron and can cause blood loss through a young intestines. Whole milk should only be given to babies who baby’s are over 9 months old and are eating a variety of foods that Baby on page 26). Your contain iron (see Milk and (low iron in baby's blood). Anemia can interfere with growth, development, behaviour (low iron in baby's blood). 16 17 YourBaby age. Feeding Your baby needs to learn to pull Your when spoon is coming Watches spoon and opens mouth Watches Closes lips over spoon Too Late Too Iron deficiency anemia (low blood iron) Difficulty chewing food Difficulty Slow to accept solid food to Your Baby to Your Most babies are ready 6 months of to begin at solid foods Sits alone or with little support others eat Watches Too Early Too Food allergy or intolerances Not enough breastmilk or formula Hard on kidneys and digestive system baby is ready your to trySigns that solids: Not enough nutrients to grow and develop properly Choking Introducing Solid Foods At first your baby's tongue may push food out of the mouth. This is normal. At first your baby's tongue may push food out of the mouth. the food to the back of the mouth. Gagging is also normal; it protects your baby from choking. to your doctor or regulated health professional if you have concerns about when your baby is ready to start Talk solid foods. Health Canada introduced new infant feeding guidelines in 2006. Health Canada introduced feeding new infant After 6 months of age, your baby can Before 6 months of age, your baby is not able to bite and chew properly. If solid foods are started too soon or too late, there is a greater chance of problems. digest solids better. , if your baby has a food allergy her head away, leans back/away or loses interest in food, her head away, baby may need to try Your then try it again in 2 to 3 days. a food up to 20 times before she decides to eat it. If your baby is on a vegetarian or special diet, consult a Registered Dietitian. Fruit juice is not recommended before the age of 6 months. Do not force your baby to eat a new food. If your baby turns YourBaby Feeding or intolerance, it will be easier to know which food is causing it. that can also be introduced at this stage (Health Canada, 2006). at eating solids. When your baby is older and eating more solid foods, baby will gradually take less breastmilk or formula. Start with a single-grain iron-fortified infant cereal. Meat and meat alternatives are iron-containing foods Solids can be given at the beginning, middle or at the end of liquid feedings. baby should be upright and facing you. Your Feed your baby in a sitting position. That way Introduce new foods 1 at a time and at least 3 days apart. very small amounts (1 to 3 tsp or 5 to 15 ml) of food at first. Offer mashed foods, as your baby gets better Begin with pureed foods at 6 months and progress to lumpier, Tips for Introducing Solid Foods Tips for 18 19 YourBaby Commercial mixed dinners are low in meat; it is better to buy meats and vegetables separately and then combine them on your own. Gradually increase Feeding single-grain cereal (barley or oatmeal) Adding cereal to bottles may cause choking and overfeeding. with the same cereal, you may introduce another at least 3 days Do not give the egg white to baby until 12 months of age because it may cause an allergic reaction. Do not add cereal to bottles. Start with a single-grain cereal such as rice; it is easy to digest and is low risk for causing allergies. Mix as per instructions on package. Begin with small amounts 1 to 3 tsp (5 to 15 ml). After Spoon-feeding is an important part of your baby's development. Serve only 1 to 3 tsp (5 to 15 ml) of pureed meat at first. Introduce 1 new meat every 3 to 4 days. Gradually increase the amount of meat as per sample menu page 22. the amount of prepared cereal as per sample menu page 22. and finally introduce mixed-grain cereals. First Foods - Cereals,First Foods Alternatives and Meat Meat They have the iron Iron-fortified infant cereals are usually the first solids. your baby needs at a time when iron stores in the body are running low, at 6 months. It is recommended to continue with iron-fortified cereal until your baby is over 2 years of age. Meat and meat alternatives also contain iron. These foods can also be introduced at 6 months. Iron from meat sources is better absorbed than iron from non-meat sources. Cereals: Meat and Meat Alternatives: and Meat Meat fish, cooked egg yolks, and meat alternatives such as chickpeas, The foods in this group include meats, poultry, pinto and other beans as well as tofu. lentils, kidney, . Commercial fruit "desserts" are not pure fruit and contain added sugars; it is best to offer pure fruits that are pureed or mashed. fered. fer vegetables Use water to quench thirst. Use unsweetened fruit juices instead of fruit beverages, drinks and punches. Save money by buying regular juice instead of buying "baby juice". Limit juice intake to 4 ounces (120 ml) or less in one day. Milk products such as cottage cheese, shredded cheese and yogurt can be introduced after vegetables and fruit. Other grain products such as bread, pita, crackers, rice and noodles next. can be offered Gradually move from pureed meats to ground meats, then to strips of tender Limit processed meats. Keep meats moist because they are easier to swallow. meats such as bacon, wieners, bologna or sausage. Processed meats have higher fat, higher salt and more preservatives. Fruit juices can be given when fruits are already on the menu. If you choose to give juice, offer it in a cup and never in a bottle YourBaby Feeding peas, squash and sweet potatoes, before moving on to mixed vegetables. Fruits such as pureed peaches, apricots, pears and bananas may also be of Make a gradual change in texture from smooth purees to mashed to chopped. Begin with mild tasting individual cooked vegetables such as carrots, green beans, Second Foods - Vegetables and Fruits - Vegetables Second Foods Once your baby is eating cereals and meat/meat alternatives of may be accepted better if introduced before fruits. and fruits. Vegetables 20 Choosing Foods Based 21 On What Your Baby Can Do Typical Age Feeding Capabilities Type of Feeding Suggested Foods

Birth to Cuddles -feeding Breastmilk 6 months Roots for nipple or iron-fortified formula Sucks YourBaby Swallows 6 Begins to sit Spoon-feeding Iron-fortified baby rice months Follows food with eyes of semi-solid food or barley cereal Opens mouth for spoon Pureed meat/meat

Closes lips over spoon alternatives, vegetables Feeding Moves semi-solid food and fruit to back of tongue Swallows semi-solids 6 to 8 Moves tongue to sides Spoon-feeding Pureed foods months of mouth and finger-feeding of thicker, Fork-mashed vegetables Positions food in mouth lumpier food and fruit Delays swallowing Cup drinking Mashed potatoes Munches by chewing Soft, diced fruit up and down Sticky rice Grasps food Chopped noodles with palm of hand and other pasta Scrapes food from hand into mouth Drinks from a cup

7 to 10 Bites off food Finger-feeding of lumpy food, Cut-up cooked months Chews with rotary pieces of soft food vegetables movement Cup drinking Diced, cooked or canned Moves food side-to-side fruits (in juice) in mouth, pausing Grated fresh fruit in the middle Tender ground meats Curves lip around cup Casseroles Uses thumb and forefinger Crackers to grasp food Dry, unsweetened cereal Toast 9 to 12 Becomes more skillful Finger-feeding Pieces of soft, cooked months with hands of table foods foods from family table Finger-feeds Cup drinking Tender meats that are Improves chewing cut/chopped finely Improves cup-drinking across the grain Is interested in food Pieces of soft, raw fruit Becomes more sociable (like bananas or peaches) at family table Crackers and toast Dry, unsweetened cereal, cheese, egg yolk, and legumes

Adapted from: Canadian Paediatric Society, Dietitians of Canada and Health Canada (2005); Satter (2000). than . Amounts are This menu is to be used as a general guide based on the average weight baby may Your of a healthy baby. eat or drink more or less the amount of formula and food suggested, depending on the weight and activity of your baby. Note: 8 to 9 months Progression of Solids Depends on amount of solid food baby eats. 27-32 oz (810-960 ml) 7-8 oz (210-240 ml) breastmilk or formula 7-8 oz (210-240 ml) breastmilk or formula Tbsp (45-75 ml) infant cereal 3-5 Tbsp (15-30 ml) fruit 1-2 3-4 oz (90-120 ml) breastmilk or formula Tbsp (45-90 ml) vegetable or fruit 3-6 Tbsp (30-75 ml) meat/meat alternatives 2-5 Tbsp (30-60 ml) fruit 2-4 in a cup Water Dry cereal like Cheerios ® Tbsp (15-30 ml) vegetable or fruit 1-2 3-4 oz (90-120 ml) breastmilk or formula Tbsp (45-75 ml) infant cereal 3-5 Tbsp (45-90 ml) vegetable or fruit 3-6 Tbsp (30-75 ml) meat /meat alternatives 2-5 * 6 to 7 months Introduction of Solids Depends on amount of solid food baby eats. YourBaby 3-4 oz (90-120 ml) breastmilk or formula 3-4 oz (90-120 ml) breastmilk or formula Tbsp (15-45 ml) infant cereal 1-3 Tbsp (15-30 ml) vegetable 1-2 Tbsp (15-30 ml) meat/meat alternatives 1-2 6 -7 oz (180-210 ml) breastmilk or formula Tbsp (15-30 ml) vegetable or fruit 1-2 Tbsp (15-30 ml) meat/meat alternatives 1-2 6 -7 oz (180-210 ml) breastmilk or formula 6 -7 oz (180-210 ml) breastmilk or formula Tbsp (15-45 ml) infant cereal 1-3 Tbsp (15-30 ml) fruit 1-2 6-7 oz (180-210 ml) breastmilk or formula 7-8 oz (210-240 ml) breastmilk or formula 30-36 oz (900-1080 ml) * Feeding Feeding Early Morning Breakfast Lunch Snack Dinner Evening breast- Total milk or iron- fortified formula for the day Sample Menu:

22 Cut out and place on your fridge for reference. for fridge your on place and out Cut spices, sugar, honey or molasses to recipes. spices, sugar, pork, turkey or veal) may be easier to puree than other meats. or fruit can be pureed. and fruit before processing. or "drop" spoonfuls on a cookie sheet and freeze. Once frozen, put in labelled freezer bags for storage. Freeze up to 4 weeks. TIPS start, you Before hands your wash and all equipment. salt, herbs, sauces, gravy, Do not add butter, Cooked, ground meats (ground beef, chicken, Cooked, fresh, frozen or canned vegetables Remove seeds and tough skins from vegetables Do not refrigerate pureed food longer than 3 days. For freezer storage, place puree in ice cube trays Thaw only the amount of puree needed for a meal. Once Thaw frozen baby food in the refrigerator. thawed, heat cubes in a double boiler or transfer to a bowl to be put in a hot water bath. Never refreeze thawed puree. 1/3-1/2 cup (75-120 ml) 1/3-1/2 cup (75-120 ml) 1/3-1/2 cup (75-120 ml) ". Follow these basic 3 Tbsp (45 ml) water 3 2 tsp (10 ml) fruit juice or water Tbsp (60 ml) water 4 or formula or YourBaby Baby Food Making your own baby food can save Food Liquid Yield Liquid Food Feeding Cooked vegetables 3/4 cup (200 ml) Cooked fruit 1/3-1/2 cup (75-120 ml) Cooked meats 1/2 cup (120 ml) Making Your Own Making Your recipes but adjust the liquid if necessary to get the right texture. Begin with smooth textures and progress lumpier textures, as your baby gets better to thicker, at eating solids. you money and can help you give your baby a greater variety of foods than what is available in jars. Some babies may also like homemade food better than prepared food. As a general Be sure to cook and store food properly. rule, be "Clean and Quick 23 Microwaves heat foods and liquids unevenly and can create hot spots that can burn your baby. Be sure to stir the food and test the temperature before serving it to your baby. The back of your hand can be used to be sure the food is warm, but not hot. Baby Food Transfer food to a microwave-safe dish. Transfer Heat on low to medium setting. Food often heats unevenly; therefore, mix it well before testing the temperature. rates. If heating more foods heat at different Different than one type of food in a divided dish, test the temperature of each food separately. Warming Warming Baby Food and Formula in the Microwave Be very careful if you choose to heat your baby's food in the microwave. SAFEST WAY Formula A hot water bath is the to warm bottles, jars or containers of food. YourBaby for Baby for Feeding Heat 4 oz (120 ml) or more and shake bottle well to get rid of hot spots. Use microwaveable bottles. Do not microwave bottles with disposable inserts/liners. Remove nipple and cap to allow heat to escape. Formula should be cool to the touch, not hot. Warming Food Warming Food 24 . are . . Babies need to explore their Canada's Food Guide to Healthy Eating For safety reasons, keep an eye on your baby while feeding. Once your help to see if he is still hungry baby gets tired of feeding himself, offer Don't forget to eat with your baby to be a good role model. fine for your baby. Give your baby a wide variety of foods from each food fine for your baby. group. Over time, increase the lumpiness of the foods and give your baby foods from the family table that have been prepared with little or no seasoning. Safe finger foods include bread crusts, pieces of soft cooked vegetables and fruit, soft ripe fruit such as banana, cooked meat and poultry and shredded cheese. Limit foods that contain a lot of fat, salt or sugar. Help Babies Learn Themselves! to Feed food and learn how to feed themselves. Make mealtimes fun. Let your baby feed himself and play with the food. Give your baby his own spoon or fork if you can both feed baby! This way, he is reaching for the one you are using. "Practice makes perfect" but it also makes a mess, so be prepared! Once babies eat pureed or mashed foods well, slowly introduce softer table foods YourBaby to Your Baby to Your Feeding Introducing Table Foods Introducing Table (usually between 8-12 months). Even if they have few or no teeth they can learn how to chew Introduce new textures gradually. Offer small amounts of soft or lumpy foods that your baby has already had Offer Introduce new textures gradually. in a pureed or mashed form. Many foods from the 4 Food Groups of If lumpier foods are introduced too late, it may be hard to get your baby to try them 25 s milk is recommended until , learning abilities as well as your baby's should not be used until your baby is at least 2 years do not have all the nutrients that your baby needs. If there contains bacteria that can seriously harm your baby. contains bacteria that can seriously harm your baby. YourBaby Breastmilk or iron-fortified formula is recommended for the first 9 to 12 months of age. and Your Baby and Your Feeding is a , it is recommended that infant formula be used until 2 years. is a milk allergy, Never feed your baby unpasteurized milk. of age. Babies need the higher fat in the whole milk for proper growth and brain development. Lower fat cow's milk 2%, 1% or skim milk Unpasteurized milk (cow or goat) Goat's milk and soy/rice beverages Types ofTypes Recommended Milk That Are NOT Milk Cow's milk is NOT recommended before this time. Cow's milk does not have all the nutrients that young babies It can also cause anemia (low iron in baby's blood) because it may cause blood loss from need to grow properly. the intestine. Low iron can interfere with growth, development, behaviour immune system. Whole (homogenized 3.25% fat) cow's milk may be introduced between 9 to 12 months of age in a cup once your baby is eating a large variety of foods. Whole (3.25% fat) cow’ at least 2 years of age. 1. 3. 2. 26 Sample Menus for 9-12 Months 27 Meal Type of food Day 1 Day 2

Breakfast Breastmilk/formula/ 6-8 oz (180-240 ml) 6-8 oz (180-240 ml) whole (3.25 M.F.) milk Breastmilk/formula/ Breastmilk/formula/ whole (3.25 M.F.) milk whole (3.25 M.F.) milk Infant cereal 4-6 Tbsp (60-90 ml) 4-6 Tbsp (60-90 ml)

Oatmeal infant cereal Mixed infant cereal YourBaby Fruit pieces 1/2-1 Chopped kiwi 1/4-1/2 Sliced banana Snack Variety of finger foods 3-4 Tbsp (45-60 ml) 4 Tbsp (60 ml) Yogurt from 4 Food Groups Chopped canned pears 1 Arrowroot cookie 1-2 Soda crackers, unsalted Feeding Lunch Breastmilk/formula/ 4 oz (120 ml) Breastmilk/ 4 oz (120 ml) Breastmilk/ whole (3.25 M.F.) milk formula/whole (3.25 M.F.) formula/whole (3.25 M.F.) milk (in a cup) milk (in a cup) Grain product 3-5 Tbsp (45-75 ml) 1/4 slice Whole wheat Homemade macaroni bread with margarine & cheese Meat or alternative -- 2-3 Tbsp (30-45 ml) Canned tuna Vegetable or fruit 3-5 Tbsp (45-75 ml) 3-5 Tbsp (45-75 ml) Cut green beans Cooked carrot pieces

Snack Water or fruit juice 4 oz (120 ml) Juice Water in a cup in a cup 2-4 Soda crackers, Variety of finger foods 3-5 Tbsp (45-75 ml) unsalted Dry Cheerios® 1/2 -1 oz (15-30 g) Chopped or grated cheese Supper Breastmilk/formula/whole 4 oz (120 ml) 4 oz (120 ml) (3.25 M.F.) milk Breastmilk/formula/whole Breastmilk/formula/whole (3.25 M.F.) milk (in a cup) (3.25 M.F.) milk (in a cup) Meat or alternative 2-3 Tbsp (30-45 ml) 2-3 Tbsp (30-45 ml) Chopped meatloaf Chopped baked chicken Grain product 1/4 slice Whole wheat bread 1-2 Tbsp (15-30 ml) rice with margarine Vegetable 3-5 Tbsp (45-75 ml) 3-5 Tbsp (45-75 ml) Mashed potatoes Broccoli casserole Fruit 3-4 Tbsp (45-60 ml) 3-4 Tbsp (45-60 ml) Peeled apple pieces Cantaloupe pieces Evening Breastmilk/formula/ 6-8 oz (180-240 ml) 6-8 oz (180-240 ml) Snack whole (3.25 M.F.) milk Breastmilk/ formula/ Breastmilk/ formula/ whole (3.25 M.F.) milk whole (3.25 M.F.) milk Note: This is just an example of the types and amounts of foods babies may eat at this age. Menus will vary depending on your baby’s appetite and whether your baby has been introduced to these foods yet. Gradually move to ground meats, then to strips of tender meats. Keep meats moist because they are easier to swallow. The following foods are not safe for infants for are not safe foods The following under 4 yearsand children of age: popcorn, hard candies, gum, cough drops, raisins, peanuts or other nuts, sunflower seeds, fish with bones, and snacks using toothpicks or skewers. Some foods can be made safer by preparing them ways. For example, dice or cut wieners in different lengthwise, grate raw fruits or vegetables, and cut grapes into quarters. Poisoning Food prevent botulism (a form of food poisoning), do not To use honey before 12 months of age. Salmonella food poisoning can be avoided by making sure that egg yolks are cooked completely and by not using foods that contain raw eggs. Do not feed your baby fresh or frozen tuna steaks, swordfish, shark, marlin or tilefish These fish are high in steaks, muskellunge or walleye. Choose "light" canned tuna instead of "white" mercury. canned tuna for your baby. YourBaby and Your Baby and Your Mark the date the jar was opened on the lid Feeding has not been broken. or covered and in the refrigerator for no longer than 3 days. to help keep track. bacteria from your baby's mouth into food that is left in the jar. Make sure the plastic safety seal on the jar Listen for a "popping" sound when jar is first opened. Keep opened jars of commercial baby food sealed This can place Do not feed directly from the jar. Do not eat food from jars that do not make this sound. Safety Safety Commercial Baby Food When buying and serving commercial baby foods: Choking Babies should always be sitting and supervised when they are eating. Foods that increase the risk of choking Large are hard, small and round, or smooth and sticky. cheese cubes, pieces of raw vegetables and some dry cereals may also cause problems. 28 29 omiting a large YourBaby This is caused by Feeding from too often and Vomiting with a damp washcloth twice a day, especially with a damp washcloth twice a day, Tooth Decay Tooth Dental decay can happen if your baby drinks Spitting up a small amount is common for breastfed and formula fed babies. Early Childhood Spitting Up If your baby vomits often or has been vomiting for more than four hours, see your doctor or go to a clinic. drinking too fast, overfeeding, swallowing air while sucking and too much activity after feeding. V amount once in 24 hours is not a reason for concern. a bottle or training cup filled with liquids that contain sugars. When breastmilk, formula, milk, fruit juice or any other sweetened liquid stays in the mouth and is not washed away by natural saliva or cleaning, severe tooth decay may Clean gums and teeth occur. water alone if your baby needs a bottle to go to sleep. at bedtime. Offer fruit juice, soft drinks or other sweetened liquids in a bottle. Do not offer do not dip it in sweeteners, like corn syrup If your baby uses a pacifier, before placing in baby's mouth. or honey, & Babies Over 6 Months: Constipation Constipation to increase the amount of water and other fluids Try your baby drinks. Sips of apple, pear or prune juice a variety of foods higher Try with meals. can be offered in fibre like grain products, vegetables, fruits (prunes or pears) and cooked legumes. Call your doctor if constipation continues or you notice blood in the stools. Do not use suppositories without talking to your doctor. Diarrhea baby may Your Occasional loose stools are normal. have diarrhea if there are more bowel movements than usual, stools are less formed and more watery. Diarrhea can be dangerous and can lead to dehydra- can You tion if baby loses large amounts of water. prevent dehydration by continuing to give baby fluids. Do not give sugary drinks like fruit juices or fruit drinks, Kool-Aid®, soft drinks, sports drinks or sweetened tea. Contact a doctor immediately or call Telehealth Ontario 1-866-797-0000 if diarrhea continues. & Breastfed Babies: & Formula Fed Babies: and Your Baby and Your Less often than usual Hard and dry or painful to pass. Difficult Constipation, Diarrhea Constipation Constipation is rare. Baby is not constipated just because he has not had a bowel movement for a day or two. Many young babies will grunt, groan, have a red face and appear to push hard, but this is not necessarily constipation. Baby may just be learning how to have a bowel movement. Constipation occurs when bowel movements are: Constipation Constipation They Breastfed babies rarely become constipated. can have one bowel movement every 1 to 7 days once they are over 6 weeks old. If your baby does become constipated, put to breast more often. Constipation If constipation occurs in a formula fed baby under 6 months of age, try feeding more often. 31 YourBaby Feeding Dr. Jack Newman’s Guide to Breastfeeding Jack Newman’s Dr. Pitman, 2003 Jack Newman & Teresa Dr. up-to-date advice on every aspect of breastfeeding. Answer Book The Breastfeeding La Leche League International, 2003 guidance and essential information for breastfeeding based on reliable research. Recommendations Nutrition Book Better Baby Food Daina Kalnins & Joanne Saab, 2000 nutrition information for infants with sample recipes for different stages of your child's development. Child of Mine: Feeding Love &With Good Sense 2000 Ellyn Satter, nutrition information for infants and young children and overview of how to establish a healthy feeding relationship. Support Groups La Leche League www.lllc.ca 1-800-665-4324 Mother to mother breastfeeding information and support. Association of Multiple Births www.pomba.windsor-canada.com Breastfeeding support services, group meetings. Sandwich Community Health Centre 519-258-6002 Breastfeeding support for current clients of Sandwich Community Health Centre. Breastfeeding Care Total 519-973-1124 RN, IBCLC Sharon Butler, (for babies up (by appointment only 254-5577 ext. 52231 Hospitals Leamington District Memorial Hospital Newborn Clinic 519-326-2373 ext. 4131 Line, ext. 4131 24 hr Warm Regional Hospital-Met Campus Windsor Maternal/Newborn Clinic 519- for babies up to 6 weeks of age). Information Lines Motherisk Long distance charge: 1-416-813-6780 (information about medicines and illnesses when pregnant or breastfeeding). www.motherisk.org Ontario Telehealth free: 1-866-797-0000 Toll Registered Nurses are available to answer your questions 24 hours 7 days a week. a day, to & including 6 weeks of age). In Windsor County & Essex Breastfeeding Help Breastfeeding YourBaby Feeding 258-2146 ext. 1340 32 Your Baby Windsor-Essex County Health Unit www.wechealthunit.org County Health Unit Windsor-Essex Breastfeeding Help Line 519-258-2146 ext. 1350 (Mon. to Fri. 8:30 am - 4:30 pm). County Health Unit Windsor-Essex Breastfeeding Clinic Information 519-258-2146 ext. 1350 (for times and locations). County Health Unit Windsor-Essex Prenatal Breastfeeding Classes 519- Feeding 496-506. Ottawa, ON: Toronto, ON: Toronto, eastfeeding. Schaumburg, IL: Schaumburg, , 115(2), Retrieved June 20, 2006, Retrieved June 12, 2006, from Retrieved June 12, 2006, from , Nutrition for healthy full term infants. . Palo Alto, CA: Bull Publishing. eastfeeding & the use of human milk. (3rd ed.). Manchaca, TX: LactNews Press. (3rd Clinical guidelines for the establishment of exclusive br Breastfeeding: Fundamental concepts – A self-learning package. The breastfeeding atlas The La Leche League International: The breastfeeding answer book. Health Promotion/Prevention: -infant formula. Frequently asked questions: How can I tell if my baby is getting enough? Child of mine: Feeding with love and good sense from http://www.lalecheleague.org/FAQ/enough.html http://www.lalecheleague.org/FAQ/enough.html from La Leche League International. Minister of Public Works and Government Services. Minister of Public Works Registered Nurses Association of Ontario. Registered http://www.dieteticsatwork.com/pen/ (members only). http://www.dieteticsatwork.com/pen/ Raleigh, NC: International Consultant Association. call the Intake Nurse at the Windsor-Essex County Health Unit at 519-258-2146 ext. 1350, call the Intake Nurse at the Windsor-Essex Monday to Friday 8:30 am to 4:30 pm If you have a question or need information about feeding your baby References: Mohrbacher, N. & Stock, J. (2003). Mohrbacher, Registered Nurses Association of Ontario. (2006). Registered K. (2005). B. & Hoover, Wilson-Clay, Dietitians of Canada. (2006). Satter, E. (2000). Satter, Canadian Paediatric Society, Dietitians of Canada and Health Canada. (2005). Canadian Paediatric Society, International Association. (2005). American Academy of Pediatrics. (2005). Policy statement: Br La Leche League (2006). YourBaby Feeding Revised October 2006 Produced and distributed by: Produced County Health Unit The Windsor-Essex www.wechealthunit.org Office Windsor 1005 Ouellette Avenue Ontario N9A 4J8 Windsor, 519-258-2146 Essex Office Suite 215 W., 360 Fairview Ave. Essex, Ontario N8M 3G4 519-776-5933, Ext. 3100 Leamington Office E. Street 215 Talbot Leamington, Ontario N8H 3X5 519-326-5716