Infant Nutrition

??????????Growth and development are more rapid during the first twelve months than at any other time. Infants generally double their weight in the first 4 to 5 months and triple their birth weight during the first year. A 1-year-old is expected to
increase birth length by 50 percent. Infants are totally dependent upon others to protect them from danger and provide nutritious, safe food needed for growth and development. Feeding infants in an age-appropriate manner is an important
role for parents and child care providers.

The interaction and communication that occurs between a parent or caregiver and the infant during feeding impact the infant’s ability to progress in personal feeding skills and consume a nutritionally adequate diet. To foster a
high-quality feeding relationship, the parent or caregiver should be responsive and sensitive to an infant’s feeding cues.

The Early Months

For the first four months, it is generally best to feed the infant on demand. Infants vary as to the amount of formula or
breast milk they will consume. Respond to infant cues. At least six wet diapers a day suggest the infant is receiving enough formula or breast milk. Until semi-solid foods are added, breast milk or formula should meet the water needs
of the infant. A thirsty baby acts much like a hungry baby. If the baby appears hungry a short time after feeding, water can be offered. In warmer climates, additional water may be needed.

Feeding should be a pleasant social time. Before feeding, talk and play with the infant. Hold the infant in a sitting position. Cuddle the infant and provide eye-to-eye contact. Do not hurry the feeding process. Infants require at least twenty minutes per feeding. Stop two to three times during feeding to burp the baby.

From Breast Milk or Formula to Solids

The American Academy of Pediatrics suggests that breast milk or iron-fortified infant formula be the ONLY food fed to infants less than 4 to 6 months. Avoid serving regular cow’s milk before one year of age. A pediatrician can advise on the best time to start solids. Introducing semi-solids before an infant is developmentally and physiologically ready is inappropriate. There is no proof that early introduction of solids helps infants sleep better.

Do not feed cereal mixed with formula or breast milk from a bottle, because:
  • The larger opening in the nipple can overwhelm the baby and cause choking.
  • It may interfere with the infant’s ability to learn to eat from a spoon.
  • It may cause overfeeding. Because bottle-feeding is faster than spoon-feeding, infants may not have that “full” feeling until after they “drink” too much cereal.
  • It may lower nutritional intake. Providing too much cereal and not enough formula or breast milk leads to a lowered nutritional intake.

 

Signs of Readiness for Solid Food

Trying to feed an infant who is not developmentally ready can be frustrating for both you and baby. Don’t force it. Babies are adept at reading facial expressions. If you are anxious, expect your baby to be anxious also. Baby is ready for solid food when:

  • He can sit well with support.
  • His tongue thrust reflex has largely disappeared.
  • He is interested and watches the spoon.
Introducing Semi-Solid Foods

Around 5 to 6 months, the infant’s digestive system can begin digesting complex carbohydrates and proteins. At the same time the iron stores from birth are gone. It is time to begin the introduction of semi-solid foods such as iron-enriched cereals and pureed fruits and vegetables. By 6 to 7 months, the infant’s kidneys are sufficiently developed to handle the nitrogen-containing wastes from the addition of high-protein meat products.

Introduce semi-solid foods slowly by offering a few baby spoonfuls 1 or 2 times daily. Iron-fortified infant cereal usually comes first. Start with rice or barley cereals because they are less likely to cause allergies. Thin cereals with formula or breast milk. Follow cereals with the introduction of vegetables, fruit and then meat. Initially offer individual foods rather than mixtures so that the source of allergies or sensitivities can be readily identified should they occur. It is best to offer a new food for 3 to 5 days to rule out a potential allergy.

Involve the Infant In Self-Feeding

Infants move toward self-feeding around 6 to 7 months. Allowing infants to hold an infant spoon or a cup during feeding encourages eventual self-feeding. The infant mimics the caregiver’s activities. Babies at this age use a palmer grasp, an early gross motor skill, using the entire palm to pick up items. This allows them to hold large items like a teething biscuit. Picking up small pieces of food is difficult, but allow the infant to try. Encourage the child to experience feeding with as many senses as possible. As the sense of touch is heightened, much exploration occurs through the mouth. Encourage exploration and expect messiness.

Around 8 months the infant has more manual dexterity. The child may use the pincer grasp, using fingers to manipulate items. This indicates readiness to handle finger foods and that the infant can participate in feeding. Parents and caregivers need to monitor the eating so the infant does not choke. By 9 to 12 months, more nutrient needs are being met through semi-solid foods. Ideally the child is demonstrating beginning proficiency with both a cup and spoon. Limited self-feeding has begun and should be encouraged. If the texture is soft and the pieces are small, many table foods are now appropriate for the child. Continue to watch for potential allergies and foods which are choking hazards (see below).

Foods to Avoid Entirely
  • Common allergens should be avoided for the first year: cow’s milk, yogurt, peanut butter, egg white, citrus fruits and shellfish.
  • Choking hazards such as meat sticks, hot dogs, sausages, breaded fish products, nuts, seeds, raw carrots, popcorn, large chunks of meat and cheese, whole grapes, chunks of peanut butter, raisins, chewing gum and hard, gooey or sticky candy should be avoided.
  • Honey should not be offered for the first year due to the possibility of contamination with botulism spores. This includes honey that has been baked in products such as Honey Graham Crackers and Honey Nut Cheerios.
  • Jarred baby food dinners and desserts and jarred or dry infant cereal with fruit are nutritionally inferior to single ingredient foods.
  • Juices are not necessary for baby and should not be offered until at least 6 months. Limit juice to 4 ounces and serve only in a cup.