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Table of Contents
Nutrition during Pregnancy 1 Breastfeeding 4 Formula Feeding 6 Introducing Solid Foods 7 Homemade & Store Bought Baby Foods 11 Feeding the Older Infant 13 Feeding the Toddler & Preschooler 17 Infant Growth Charts 21 A Guide for your Childs Nutritional Needs 23 Nutrition & Feeding: Frequently Asked Questions 25 Who to Turn to for Advice 27
Thats a critical question as nutrition is the cornerstone of good health. Good early dietary habits are important for your childs development and growth, and are also the key to a lifetime of good eating habits and health.
Providing your baby with a balanced diet is actually not that difficult. Its just a matter of giving your baby the right food at the right time. Thats where this booklet can help. "Starting Right" was first developed in consultation with the Canadian Pediatric Society in 1996 to address the principal issues concerning your child's diet and to give you some practical guidance regarding what is best for your child. Since then there have been changes to the recommendations. The current version has been revised to reflect current recommendations. We hope you will find the information helpful. Good nutrition is an ongoing process - and the sooner you get your children started on the road to proper eating, the better. Idamarie Laquatra, Ph.D. Director-Global Nutrition H.J. Heinz Company
First trimester
The beginning is very exciting! Physical changes are not apparent but your body is undergoing drastic hormonal changes.These changes do not affect all women, but you may experience morning sickness as a result. Also, you may have cravings for certain foods and beverages due to hormone changes that affect your sense of taste and smell. As long as you meet your nutrient needs, its okay to eat, in moderation, the foods you crave. During the first 3 months of pregnancy, you need extra food energy, but not too much -- an additional 100 calories/day is all. In addition, you need 5 g more of protein every day. Eating somewhat larger servings of meat and meat alternatives, fish, seeds, nuts and, or legumes will give you the extra protein your body needs.
Second trimester
Your baby is growing fast and you can see changes in your body. You may still have sudden food cravings. You may also experience heartburn, as the growing fetus puts pressure on the stomach. To prevent heartburn, you should eat frequent small meals and relax while eating. Eat slowly, chew your food completely, and avoid spicy or greasy foods. Eating an extra serving from each of the four food groups or eating nutrient-dense foods will provide the additional 300 calories/day that are needed at this stage. In addition, you need 15 g more of protein. On average, you want to gain only one pound per week during the second trimester.
You should visit your family physician regularly to ensure that you are healthy and your pregnancy is progressing well. The doctor will monitor your diet and weight gain to ensure that youre gaining sufficient weight to support a healthy baby.
Third trimester
This stage is critical for the health of your newborn baby and its also when you gain most of your weight.You should maintain a weight gain of one pound per week. Doctors recommend that you continue to take an additional 300 calories/day over what you were consuming before pregnancy. It is always wise to consult your doctor/dietitian and have them assess your diet and nutrient intake, and to monitor your weight gain.
Breastfeeding
The most complete food
Breast milk is the most complete food you can offer your baby. It has just the right level and quality of nutrients that your baby needs. It is safe and easy to digest which means fewer feeding problems for your baby. Its also a special time for you to build a close and comforting bond together.
Calcium
An additional 500 mg/day of calcium is recommended for fetal bone development and to maintain your bone strength. This can be easily achieved by adding 2 cups of milk and other dairy products to your diet. Soy milk and soy products with added calcium, canned sardines with their soft bones, cheese, etc. are also good sources.
Iron
You need a large supply of iron to support the increased blood volume required during pregnancy. An additional 18 mg/day is recommended during the second and third trimester. Diet alone wont supply this so iron supplements are recommended during this part of your pregnancy.
Folic acid
It is extremely important that you get enough folic acid before and during pregnancy to help reduce the risk of serious brain and spinal cord birth defects. Fruits, orange juice, green leafy vegetables, and fortified cereals products are good sources of folic acid
TIP
Keeping fit and staying active will make you feel better throughout your pregnancy and help you during labor and delivery. Build up your strength and endurance by participating in regular low-impact activities in cool conditions. Be sure to drink plenty of water before and after exercise.
Your diet
Your diet affects the quality of your milk so make sure youre eating nutritiously. Eat according to the Canadas Food Guide To Healthy Eating and have the recommended daily servings of fruits and vegetables.
Formula Feeding
Choosing the right formula
Breastfeeding is best for your baby. But if you choose to bottle-feed your newborn, a commercial iron-fortified infant formula is an acceptable alternative because it provides similar amounts of energy (calories), protein, vitamins and minerals to those normally found in breast milk. Breast milk or formula is recommended in the first year of life. Most infant formulas need to be mixed with water, but you can also find formula that is ready-to-serve. Cows milk-based formulas are the most commonly used and are best for non-breastfed babies with no family history of allergies. Ask your doctor about which formula is best for your baby.
Vitamin D
If you are breastfeeding your baby, a daily vitamin D supplement of 400 I.U.fg (10 g) is recommended.
Iron
Breastfed babies will need extra iron at around six months. They should have 7 mg of iron per day, which can be obtained from iron fortified infant cereals or an iron supplement
Vitamin B12
If you are a strict vegetarian and are breastfeeding your baby may need a vitamin B12 supplement. Your doctor, once aware of your diet, will recommend an appropriate supplement.
Weaning
You are going to hear a lot of different advice about when to wean your baby. Nursing for six months or more is best for your baby and most doctors recommend continuing longer if the baby is healthy and growing well.
Wash your hands. Wash the bottles thoroughly and remove all milk residue from the bottle and nipple with a brush. Immerse the bottles in boiling water for five minutes to sterilize. Allow bottles to dry before filling. Prepare formula according to the instructions on the package, place in clean bottles and refrigerate immediately. Do not reuse leftover formula after a feeding
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Introducing Foods
When to start
When your baby is around six months of age, you can start introducing complementary foods. Your baby will start showing interest in food or become dissatisfied with only breast milk or formula.
Do not force feed. As long as your baby is healthy and achieving normal growth, respect your babys cues about the types and the amounts of food he eats. If he rejects a food, try the food again a few days or a week later. If your baby still does not want it or like it, let it be. If you force your baby to eat, you may be setting the stage for poor eating habits and creating negative associations with food and mealtimes.
Infant cereals
Most doctors recommend beginning with a rice cereal, as it is the least likely to cause an allergic reaction such as a rash, diarrhea, tummy ache or frequent crying. Once this is well accepted by your baby for at least one week, you can progress to another single grain cereal such as Barley. Do not give your baby mixed grain cereals until you are certain your baby can tolerate the different grains. Infant cereals are fortified with iron. Therefore, if your baby has been taking a standard iron supplement, it will no longer be necessary once your baby begins eating infant cereals regularly. Iron-fortified infant cereals are particularly good first solid foods because they are also enriched with calcium, phosphorus and vitamins B1, B2 and niacin which your baby needs for healthy growth and development.
Introduce solid foods gradually, one at a time. This way your baby will learn to appreciate each new taste and texture and you can easily identify any food allergies. Your baby may spit the food out the first time, so try offering it a few more times on different days.
TIP
Rice More complex grains (barley, oatmeal) Multi-grain cereals Cereals with fruit
Preparing cereal
Prepare infant cereal by combining the recommended amount in a bowl, with lukewarm breast milk, formula or water. Make the consistency such that your baby can swallow easily. The consistency of the cereal mixed with breast milk, formula or water should be thinner when your baby is just starting cereal. Begin by offering a bit of breast milk or formula first to take the edge off babys hunger. Then offer one teaspoon of cereal mixed with breast milk, formula or water at each meal and slowly increase the amount at your babys own pace. At first you may put cereal on your finger or just place the spoon up to the lips, not in the mouth. Allow baby to suck on the spoon and become familiar with the feel of the spoon until baby learns to take food from the spoon. The texture of cereals can be thickened as your baby develops chewing skills.
Lunch
180 - 240 mL Breast milk or formula feeding 1 - 2 tbsp Pureed single vegetable
Dinner
180 - 240 mL Breast milk or formula feeding 1 - 2 tbsp Infant cereal 1 - 2 tbsp Pureed single fruit
Snacks
180 - 240 mL Breast milk or formula feeding
* Around 6 months babies are usually eating 6-7 breast milk or formula feedings of 150-180 mL each per day. Around this age you may choose to introduce small amounts of infant cereal at breakfast and dinner; begin with 1 tsp and gradually increase amounts to 1-2 tbsp.
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Store bought foods are as wholesome, nutritious, and safe as properly prepared homemade baby foods. They are commonly referred to as strained and junior foods. Baby food manufacturers demand that quality and safe standards are maintained in a number of areas. Here are things to watch for: Ingredient purity: Ingredients do not include any salt, additives, preservatives or modified food starch Nutritional purity: Fruits and vegetables are pureed in the water they are cooked in so that valuable nutrients are retained Process purity: the best jarred baby foods are tested for quality, safety, and nutritional content before they are vacuum-packed and safety sealed
Lunch
3-5 tbsp Strained meat 4-6 tbsp Strained vegetable 2-3 tbsp Strained fruit
Dinner
3-5 tbsp Strained vegetable/ meat combination 2-3 tbsp strained fruit
Snacks
180-240 ml breast milk or formula feeding 3-5 tbsp Infant cereal
180-240 ml 180-240 ml breast milk or formula breast milk or feeding formula feeding
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Egg white is highly allergenic and shouldnt be given to babies under one year. Only offer egg yolk to your baby before that age.
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Dangerous foods
Even under your watchful eye, your baby should not be offered any of the following foods, which can cause choking: Raw, hard fruits and vegetables Fruits with seeds/ pits such as cherries Dried fruits, except raisins that are small and seedless Hot dogs, popcorn, nuts, seeds, whole grapes, chips or small round hard or chewy candies that can get stuck in the airway.
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Lunch
4-6 tbsp Junior meat 6-8 tbsp Junior vegetable 3-4 tbsp Junior fruit
Dinner
Snacks
8-10 tbsp 150 ml Junior formula/breast vegetable/ milk meat combination 3-5 tbsp Infant cereal 1/2 slice Whole wheat toast 3-4 tbsp Junior fruit 150 ml formula/breast milk
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To prevent choking, ensure your baby is always seated and supervised during feeding
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Poor eaters
At some point in their young lives, children are likely to assert their independence by rejecting the food you offer. Do not take it personally. There are some techniques for encouraging poor eaters to change their ways. Older infants and toddlers with small appetites often get turned off by large amounts of food on a plate.Try giving your child just a spoonful or two at a time. Occasionally, a poor appetite is the result of boredom. Offer your child a wide variety of appetizing foods. Some children show a distinct dislike for certain vegetables or other foods. Try to find a nutritionally sound substitute that your youngster likes. When your picky eater is old enough, you can let him/her help you select foods at the supermarket and help prepare at home. Do not force your child to finish a meal, but be firm about no snacks or desserts in between meals if these interfere.
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Make sure your child has a good source of iron such as iron-fortified toddler cereals, red meats, liver, legumes and egg yolk.
Snacks
150 mL Whole milk
1 cup iron 30 ml fortified Meat (Mild Infant/Toddler cheese or egg) Cereal mixed 1 /2 -1 slice with whole bread milk 90 ml Juice 150 ml Whole milk 1/2 slice Whole wheat toast
/4 cup
/4 cup
Fruit
/4 cup
Fruit
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Growth Chart
52 50 48 46 44 42 40 38 36 34 CM 8 7 6 KG 14 13 12 11 10 9
Boys Infant
Growth Chart
52 50 48 46 44 42 40 38 36 34 CM KG 13 12 11 10 9 8 7 6
Girls Infant
HEAD CIRCUMFERENCE
HEAD CIRCUMFERENCE
Name:
Name:
WEIGHT
4 3 2
WEIGHT
4 3 2
Date of Birth:
1 0
Date of Birth:
1 0
MONTHS
MONTHS
The blue areas indicate a normal rate of growth. Measure head circumference above the eyebrows and around the back of the head, for maximum circumference. Measure your babys weight using an infant scale. Consult your doctor if either head circumference or weight differs significantly from the graph.
The pink areas indicate a normal rate of growth. Measure head circumference above the eyebrows and around the back of the head, for maximum circumference. Measure your babys weight using an infant scale. Consult your doctor if either head circumference or weight differs significantly from the graph.
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In the beginning breast milk and formula will offer your baby all the essential vitamins and minerals needed. As your baby continues to grow, you will start introducing foods from the different food groups (described by Canadas Food Guide for Healthy Eating). As soon as your baby is eating from all four food groups, planning nutritionally balanced meals is easy. Choose foods from each of the food groups every day.The foods will work together to give your child all the energy and nutrients needed for healthy growth and development.
Around 6 months
Around 6 months
From 6 months
From 7 - 9 months
From 10 - 12 months
Introduce Mild cheese/yogurt
From 12 - 24 months
Introduce Whole milk
Introduce Bread/Toast Introduce Combination fruits, vegetables & juices Strained meats, Meat Vegetable Combinations
Fruits & Vegetables Meat, Fish, Poultry & Alternatives The first months: It all begins with milk Rice, or Barley, single-grain before mixed varieties
Increase variety
Note: The pace at which your child eats solid foods and rate of growth are unique. This chart provides a guideline on when to introduce various foods to your childs diet. It should be used only as a guide.
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Q& A
Q. Why do leftover baby foods sometimes become watery? A. If youre feeding your baby directly from the jar, your babys saliva
will probably get transferred from the spoon to the jar. Saliva contains an enzyme which breaks down carbohydrates in baby foods creating a watery consistency. Use a clean spoon to remove each portion to a bowl and feed your baby from the bowl.
Q. When should I start feeding solid food to my baby? A. The Canadian Pediatric Society of Canada Nutrition Committee
recommends that Infants should be introduced to nutrient-rich solid foods with particular attention to iron at six months.*
Q. What should I start with? A. The most common first food for babies is infant cereals.
Try rice cereal first, as your baby is least likely to be allergic to it. Infant cereals are fortified with iron which is depleted in the body by this time.
* Canadian Paediatric Society, Dietitians of Canada and Health Canada. Nutrition for Healthy Term Infants, Minister of Public Works and Government Services, Ottawa, 2005.
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