Sunday, December 19, 2010

First foods: Which weaning foods to introduce when

Written for BabyCenter Philippines

Very first foods 

The Department of Health, through its Promotion of Breastfeeding Program, encourages exclusive breastfeeding in the first six months after birth. After six months, breast milk alone may not provide your baby with enough nutrients, in particular iron, so other foods are needed. 

Waiting until your baby is 6 months old to introduce solid foods into her diet helps to minimize the risk of her developing adverse reactions to foods and allergies. This is particularly important if you have a family history of allergies, as the incidence of adverse food reactions, allergies, and celiac disease does decrease if you delay weaning until this time. 

If you feel your baby needs to start solids before 6 months, do discuss it with your pediatrician first. This is particularly important if your baby was born prematurely. Experts recommend that solid foods should not be introduced before the end of your baby's fourth month (20 weeks). 

One of the first things your baby has to learn when weaning begins is how to swallow "non-fluids." So that your baby doesn't have to cope with new flavors as well as using different muscles, bland baby rice mixed with baby's usual milk is the most common first food. However, there's no reason why you can't try vegetable or fruit purées first. Introduce one food at a time and give it for three days before introducing another type of food. This way, you can tell if your baby reacts adversely to something in particular. In time, you may want to mix baby rice with, for example, apple or carrot purée. 

Try: 

• Purées of vegetables such as cooked carrots, potato, kamote (sweet potato),kalabasa (squash), sayote (chayote), or cauliflower 

• Purées of fresh ripe fruits in season, such as cooked apple, peach, pear, mango, papaya, avocado, or mashed banana 

• Lugaw (rice porridge) or gluten-free baby cereals, such as iron-fortified baby rice or maize flour, mixed with baby's usual milk. 

The next stage 

Once your baby is happy eating from a spoon, increase the range of foods you offer to include: 

• Purées of lean meat or poultry 

• Purées of lentils or split peas 

• Purées of mixed vegetables with potatoes or rice 

• Purées which include green vegetables, such as peas, cabbage, spinach, pechay(Chinese cabbage), kangkong (water spinach), talbos ng kamote (sweet potato tops), malunggay (horseradish leaves), or broccoli 

• Try to limit the number of sweet or cereal purées to one a day, and always include a vegetable purée. Gradually make the food a thicker consistency. 

•Experts recommend that you avoid giving cow's milk or milk products (cheese, yogurt, fromage frais), fish and shellfish, soya beans, citrus fruit (including orange juice), or eggs, until your baby is 6 months old. 

• If your family has a history of allergies, such as eczema, asthma, or food allergies, your baby should avoid nuts and sesame seeds up to the age of 3 years. 

• The risk of developing celiac disease is reduced by avoiding foods containinggluten, such as wheat, rye, and barley-based foods. That includes bread, flour, pasta, some breakfast cereals, and rusks until 6 months old. Oats are best avoided until 6 months old, too, in case they contain traces of gluten. 

• Avoid follow-on milk until your baby is 6 months old. 

• Don't add salttoyo (soy sauce), patis (fish sauce), or other food seasoning. Also avoid adding sugar, honey, or other sweeteners to your baby's food. 

From 7 to 9 months 

From now, your baby's ability to join in with family meals increases enormously. You should offer him a wide range of foods to fulfill his nutrient requirements, and to get him used to eating different flavors. There are also fewer foods to avoid. 

If you are buying commercially-produced food, the ranges normally go from 4 to 7 months, and 7 months upwards. In fact, there's no nutritional reason why a baby of 6 months can't eat jars of food labeled seven months plus (although the consistency may need adjusting). 

Now's the time to introduce: 

• Mashed or minced food, not purées. Be sure to include some lumps. 

• A wider range of starchy foods -- rice, bread, couscous, pasta, baby breadsticks, breakfast cereals, oats, in addition to cornmeal, potatoes, rice, and millet. Give two to three servings a day of starchy foods. 

• Cooled boiled water from a beaker with a soft spout, when she is thirsty, in addition to her daily breast milk or 500-600mls / 17-20oz of formula. If you do choose to give fruit juice, keep it to mealtimes only and dilute it 1 part juice to 10 parts of cooled boiled water, and use a beaker or feeding cup, not a bottle. Keeping juice to mealtimes helps with iron absorption and reduces the risk of damage to emergingteeth

• Citrus fruits, such as oranges, dalandan, and calamansi (Philippine lemon). 

• Eggs which are well-cooked, fish and shellfish can be added to the other protein-rich foods in her diet -- lean red meat, poultry, and lentils. Aim for one serving of protein-rich food a day. 

• Nut butters are fine for babies who don't have a family history of allergic diseases. Use unsalted smooth versions, or make your own. 

• Dairy products, such as fromage frais, yogurt, and cheese. Although you should wait until your baby is 1 year old to introduce cow's milk as a drink, you can use it in cooking or in your baby's breakfast cereal, so make a cheese sauce to add to vegetables or pasta. 

• Follow-on formula can be used, if you wish. 

• Finger foods are great once your baby can hold things, and allow her a degree of control. Try cooked green beans or carrots, cubes of cheese, slices of banana, or soft pear. 

From 10 months 

Meals should be more adult-like now. They should be chopped or minced and follow a two to three meal a day pattern, along with one or two snacks and 500-600mls / 17-20oz of breast milk or formula milk. At this stage, your baby should be having: 

• three or four servings of starchy foods, such as rice, bread, pasta, or potatoes, a day 

• one serving of meat, fish, eggs (completely cooked), or two of pulses (lentils, peas, beans) or nut butters 

• one to two servings of cheese, fromage frais, or yogurt as well as breast milk or formula milk. 

What should babies under 1 year old avoid? 

• Still keep off salt, sugar, honey, and artificial sweeteners. Try sweetening desserts with mashed banana or a purée of stewed dried fruit if possible, or use expressed breast milk or formula milk. 

• Avoid the temptation to add a little tea to baby's bottle. The tannin in tea interferes with iron absorption, and the caffeine it contains is not recommended for children. 

• Avoid giving fruit squashes or diet drinks to your baby. Artificial sweeteners are not suitable for babies and young children. 

• Avoid foods which may carry a risk of food poisoning, such as soft mold-ripened cheeses (brie, camembert), liver pâté, and eggs that are raw, soft-boiled, or fried sunny-side up. 

• Don't give cow's (or goat's or sheep's or carabao's) milk as a main drink to babies under 1 year. 

• Skimmed and semi-skimmed milks, low-fat spreads, yogurts and reduced-fat cheeses. Always offer your baby the full-fat versions -- they need the calories. 

How much fat should babies and toddlers have? 

Up to the age of at least two, fat is an important source of energy for your baby, so full-fat versions of milk, cheese, yogurt, and fromage frais are important. When she is two, and only if she is growing well, and eats a well-balanced diet, you can gradually introduce lower-fat versions. By the time she is 5 years old, only about a third of her energy should be provided by fat. 

How much fiber? 

Be cautious about introducing too many wholegrain foods and pulses for babies and young children. These tend to be bulky and can fill up a small tummy, leaving little space for other higher energy foods. So give your baby and toddler a mixture of white and wholegrain cereals and breads. If your toddler regularly eats pulses and lentils as part of a vegetarian diet, make sure that she has some white bread, rice, and pasta as well.

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