Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0021/00213.txt

Text File | 1993-06-21 | 24KB | 413 lines

$Unique_ID{PAR00213}
$Pretitle{}
$Title{6 Months to 1 Year:  Nutrition and Feeding}
$Subtitle{}
$Author{
Editors of Consumer Guide
Mendelson, Robert A
Mendelson, Lottie M
Meyerhoff, Michael K
Ames, Louise Bates}
$Subject{6 Months to 1 Year Nutrition Feeding sterilize sterilizing bottles
formulas powdered formula powder supplemental vitamins vitamin supplement
supplements A C D fluoride fluoridated teeth cary caries cavity cavities cup
cups two-percent milk bottle wean weans weaning chubby juice juices food
cereal vegetables meats fruits snack snacks dessert desserts meals feeding
feedings pure pureed foods food-reaction allergic reaction egg whites honey
infantile botulism nuts popcorn raisins peas apples pears melon meat poultry
choke chokes choking hot dogs taste sweets loose stools stool water diet bowel
movement movements sugar cereals Mealtime Mealtimes mess messes messy wash
washing clean cleaning play plays sucking teething SOLID FOODS}
$Log{
Preparing Homemade Baby Food:  Steps 1, 2, and 3*0021303.tif
Preparing Homemade Baby Food:  Steps 4, 5, 6, and 7*0021304.tif
At this age, as long as he enjoys eating, he is doing fine*0051901.tif
Your baby will let you know that he's hungry at this age by gesturing*0052601.tif
Babies need to be able to practice feeding themselves*0052701.tif
For uninterrupted meals, you might feed the baby before feeding the family*0052801.tif}

The New Parents' Question & Answer Book


6 Months to 1 Year:  Nutrition and Feeding


     Do I still need to sterilize my baby's bottles?

     The answer to this question varies from area to area and from
pediatrician to pediatrician, but for this age group, you probably don't.
Most city water supplies are safe and clean and could probably be used at any
age, but many pediatricians prefer that bottles, water, and formula be
sterilized for the first two to four months (see "Nutrition And Feeding," of
the Birth To 6 Months section for instructions on sterilizing bottles).  For
households that use well water, it is generally recommended that the water be
boiled for ten to 15 minutes or that distilled water be used instead for the
first six months.  If you have any doubts about your water supply, check with
your pediatrician to find out whether you should still be sterilizing.


     What's the safest way to carry formula when I'm away from home with my
ten month old?

     When you're away from home, you can carry the formula in one of two ways.
If you'll be able to use the formula within a couple of hours or if you have a
way to refrigerate the bottle, you can pour ready-to-feed formula directly
from the can to the bottle before you leave.  The remainder should then be
refrigerated until the can is empty.  An equally good alternative, and one
especially suited for extended trips away from home, is to use the powdered
form of the formula.  The powder can be mixed with water on the spot in the
exact amount needed for one feeding.  If there is a question about the local
water supply, you should use distilled water, which is safer and is generally
available in any drug store in inexpensive gallon containers.


     How long should I give my baby supplemental vitamins?  What kind is best?

     Breast-fed babies are usually started on supplemental vitamins A, C, and
D in the first month of life (along with fluoride, if it is not already in the
drinking water).  Babies receiving formula don't need added vitamins since the
vitamins are already added to the formula.  Most pediatricians stop the extra
vitamins during the second year of life.  After that time, a nutritious diet
should provide the necessary vitamins.


     Do I still need to give my baby fluoride drops?

     Pediatricians and dentists recommend supplemental fluoride for all
children who do not live in areas where the drinking water is fluoridated.
The fluoride supplement is usually started in drop form at the first pediatric
checkup and is continued into the teen years or until all of the permanent
teeth are formed.  The additional fluoride strengthens the teeth and makes
them more resistant to caries (cavities).  In appropriate doses, there are no
negative side effects to the supplemental fluoride.


     How and when should I try to get my baby to drink from a cup?

     Like many other steps in development, the time to introduce a cup varies
according to your baby's size and motor development.  Some babies are ready to
start "playing" with a cup as early as six months of age, while others are not
ready until ten to 12 months of age.  Most breast-fed babies who nurse until
the age of nine months can be weaned directly to a cup without using a bottle
in between.  Most formula-fed babies wean from bottle to cup between ten and
15 months.  As mentioned above, at first your baby will probably spend most of
the time playing with the cup.  Then you can give her a few sips from a mostly
empty cup (to avoid major spills) while you hold it for her.  Once she
realizes that she can get nourishment in some way other than sucking, she will
experiment by taking more and more liquid from the cup.  Soon she will try to
hold the cup herself and eventually will be able to get more of the liquid
into her mouth than on herself.  Allowing her to use a plastic, no-spill baby
cup with a lid and small spout may help make the transition easier and less
messy.  After that, it will only be a matter of time (and much parental
tolerance) before your little one is handling her own cup or glass efficiently
This may occur as early as nine to ten months of age or as late as 15 to 18
months of age.


     If my baby drinks from a cup at mealtimes, should I still offer her a
bottle?

     This is another good way to start the transition from bottle to cup; you
can try it at about nine to 12 months of age.  At mealtime, along with baby
food or finger foods, offer the baby a cup with two-percent milk in it, rather
than the bottle.  After the meal, you can offer her a bottle containing the
amount of formula that she needs to complete her caloric intake for that meal.
Gradually, she'll take increasing amounts from the cup while decreasing the
amount she takes from the bottle.


     When I begin the weaning process, should I put formula in my baby's cup?

     There's a very good trick to use in this situation that really helps wean
a baby from bottle to cup.  Never put formula in the cup or milk in the
bottle.  When you think your baby is ready to begin weaning from bottle to
cup, offer her small quantities of two-percent milk in a cup.  The two-percent
milk tastes better to most babies than the formula does so it helps make the
transition even easier.  Offer the cup first and the bottle containing formula
after.  Make sure that the total daily amount of milk and formula doesn't
exceed 30 to 35 ounces.  Gradually increase cup use and decrease bottle use.
When you feel that your baby is ready to totally give up the bottle, don't
just take it away.  Give her a bottle filled only with water, and she will
give it up on her own when she no longer needs to suck (usually between 12 and
18 months of age).


     My ten month old still wakes me up for a bottle at night.  Isn't she too
old for this?

     Assuming your baby is developing and growing normally and is taking an
adequate amount of formula during the day, yes she is too old to be waking
you for a bottle at night.  Babies, like adults, generally wake up a few times
every night.  They check on their surroundings, shift positions, and usually
go back to sleep.  Sometimes, babies wake up because they are wet and need to
be changed.  Sometimes, they wake up if they are hungry.  At other times,
however, they may just want the comfort of a bottle or a cuddle with Mom or
Dad.  If your baby is taking 30 to 35 ounces of formula daily, that should be
sufficient.  If she still seems to get hungry at night, you might try giving
the last bottle later in the evening and perhaps even moving her bedtime back
a bit.  You might also need to add a little cereal to her diet as a filler
(ask your pediatrician if this would be appropriate).  If she continues to
wake you up at night, hunger probably has little to do with it; it's
comforting and attention that she wants.  In that case, when she wakes you up
at night, minimize the time you spend with her by changing her diaper and
putting her back to bed immediately.  If she won't settle for this, give her
water to drink, preferably from a cup, before you put her back down.  It's
also a good idea to leave a low-watt night-light on in her room so that she
can see that everything is alright when she awakens at night.  If, over the
course of several nights, you gradually diminish the attention she gets at
these nighttime wakings, she'll probably give up on them.  A little crying or
anger won't hurt her, just let her know you love her but that it's time for
sleeping.


     My eleven month old is still taking a bottle, eats everything, and is
chubby.  Should she be getting skim milk?

     You should not give your baby skim milk in place of formula because a
diet containing skim milk may not provide enough fat to promote adequate
growth.  If your baby is getting 30 to 35 ounces of formula a day and is
chubby, offer her water to quench her thirst or satisfy her need to suck.  If
you are in the process of weaning her from bottle to cup, be sure to use the
bottle for formula and the cup for two-percent milk.  This way, she will
gradually wean from bottle to cup and from formula to two-percent milk at the
same time.  During this transition, the total amount of milk plus formula
should remain the same--a maximum of 30 to 35 ounces daily.


     My baby loves juice and drinks it all the time.  Could this be harmful to
her?

     Almost all juices consist of about ten percent sugar, water, and little
else except flavoring.  Therefore, they should not be an important part of any
child's diet.  Often they are substituted, for the sake of convenience, for
more nutritious foods.  In addition, allowing the baby to go to bed with a
bottle of any sweetened liquid (even milk) can cause decay of newly erupting
teeth.  The juice tends to pool in the baby's mouth as she sleeps; as it does,
it is converted to a weak acid that can damage the teeth.  For these reasons,
it is recommended that juice be given sparingly or reserved as a special
treat.


     What foods, and in what amounts, are important for babies in this age
group?

     Between six and 12 months of age, your baby should be introduced to a
large variety of foods in the form of store-bought baby food and/or food
processed at home (see "Preparing Homemade Baby Food" below for instructions).
In fact, by the time she's a year old, she should have tried most of the foods
that she will be eating the rest of her life.  You can discuss with your
pediatrician the order in which you should introduce foods, or you can check
Suggested Introduction Of Solid Foods below for suggestions.  Since even at
one year of age she will still be getting more than 80 percent of her calories
from milk, the amount of various foods should be determined by her appetite.
In an average day, she should receive between 16 and 32 ounces of milk, two
servings of cereal, two of vegetables, and two of meats, with fruits and
juices used as snacks and desserts.  Most children at this age eat three main
meals each day plus snacks or smaller feedings.  Snacks are usually offered at
midafternoon, bedtime, and sometimes, midmorning.  Her appetite will be
determined by her rate of growth and physical activity so it can vary a great
deal, even day to day.  Let her appetite and desires be your guide.  If you
limit anything, limit the milk to the amounts mentioned above.


     Can I make baby food for my baby instead of buying it?

     You can make homemade baby food whenever your baby is ready for solids.
It's preferable, however, to process your own foods only after you've
introduced the baby to most baby foods.  Using store-bought jars of baby food
in the beginning can make it easier to introduce a variety of pure foods
without much waste.  When you do begin making your own baby food, you'll want
to be discriminating about content and amount.  Don't make more than enough
for one or two meals unless you plan to freeze individual servings for later.
Both store-bought baby food and homemade baby food require careful handling
and refrigeration; opened jars of the store-bought variety as well as freshly
processed homemade baby foods should be kept refrigerated, and neither should
be kept for more than two days.  Spoon only small amounts into your baby's
dish and keep the rest in the refrigerator.  If the baby requires more,
retrieve the jar, put a small amount in the dish, and immediately refrigerate
the remainder.  In terms of content, any cooked vegetable or cooked, soft
meat, poultry, or fish (carefully deboned) can be processed and offered to
your baby.  If the food isn't liquid enough for the processor, add a small
amount of water or broth.  Cooked potatoes, squash, beets, carrots, and peas
can all be mashed or pureed in small amounts for your baby.  Applesauce, pear
sauce, mashed bananas, and cooked, mashed peaches are good choices as well.
Babies like a variety of tastes and eventually can be offered many foods from
your menu.  Do not, however, add salt, sugar, seasonings, or any other
ingredients (other than water or broth) to your baby's food.  If you intend to
process food for the baby using a food that you'll be serving to the rest of
the family, separate the baby's portion before adding seasonings for the rest
of the family's meal.


     What are the first table foods I should offer to my baby?

     After you have cautiously introduced most baby foods to your baby, you
can offer many of the foods you eat.  Mashed potatoes; mashed sweet potatoes;
soft or pureed cooked vegetables; and cooked pureed fruits are all fine fare.
Many parents take small portions from what they're serving that day and put it
into the food processor to soften it for the baby.  You can even offer pureed
chicken, meat, and fish.  Babies can have scrambled egg yolks or, when they're
ready, pancakes made with the yolk only.  Babies can also eat smooth, cooked
cereal, but the baby cereal with added iron may still be the better choice at
this age.  Plain yogurt or yogurt with small pieces of soft fruit can be a
favorite food for this age group as well.  Be sure to read the following
question for information on foods to avoid during this period.


     My eleven month old is eating a variety of soft table foods.  What foods
should I avoid feeding to her?

     It sounds like your baby is right on schedule and doing fine in the
soft-food department.  Even if you've followed the conservative program of
introducing only one new food every five to seven days, and your baby has not
had any food-reaction problems, you should still put off feeding her egg
whites for another month because of the potential for allergic reaction.  One
other definite food to avoid prior to one year of age is honey, because of the
danger of a disease called infantile botulism.  Some professionals also advise
against offering citrus fruits and orange juice until the baby is nine to 12
months old.  Since your baby can't really chew as yet (molars come in after 12
months, and the ability to chew or grind with them comes much later), she
won't be able to handle any foods that don't dissolve in her saliva.  Table
foods that need to be chewed should be pureed before being served to your
baby.  You should also avoid giving her any food that might chunk or break off
in pieces of a size that might cause choking.  Dangerous foods include nuts,
popcorn, raisins, whole peas, raw vegetables, and chunks of apples, hard
pears, or unripe melon.  Chunks of meat or poultry can also cause choking.
Indeed, hot dogs are the most common cause of choking accidents in young
children and shouldn't be offered for a few years.  You'll also want to try to
educate your baby's taste away from sugary and salty foods, since she doesn't
need them; doing so now may help her make healthier food choices as she grows.


     Is it possible to educate a baby's taste for certain foods?

     We certainly think it is.  If you and your family eat a nutritious
variety of foods every day, your baby will grow up eating them, too.  Indeed,
part of the reason for introducing fruits later and avoiding the addition of
sugar and fruit to cereal is to let the baby get acquainted with
less-sweet-tasting foods first.  We're all born with a taste for sweets; it
doesn't need to be encouraged.  When you introduce table foods to your baby,
your first choices should be nutritious ones.  Although your baby needs more
fat in her diet than you do and she needs to be offered a variety of foods,
she definitely doesn't need foods that are deep fried, fried in butter, or
highly seasoned.  Like the rest of the family, your baby doesn't need very
salty foods either.  By introducing nutritious foods from the very start,
you'll be educating your baby to make wise food choices in the future.  You
should also be cautious about using foods as a pacifier or reward.  You want
to impart a healthy attitude toward eating in general as well as toward
specific food choices.  Too many young children look to food or sweets for
comfort and consolation.  Babies and children should eat when they are hungry,
not when they're bored or in need of other kinds of nurturing.  When you do
offer her snacks, choose nutritious items, not junk food, sweets, or fried
foods.


     My nine month old eats baby food well, but she's having two loose stools
a day.  Could the baby food be causing the loose stools?

     Two loose stools a day is an entirely norma] pattern for a nine month
old, as is one formed stool every other day or three to four loose stools
daily.  In other words, there is wide variation in the stooling pattern of
normal babies.  The number and consistency of stools is related to many
factors, including illness, water intake, and, of course, diet.  Some of the
foods that cause bowel movements to be on the loose side are fruits, juices,
and anything else that contains a lot of sugar.  Foods that make stools firmer
include cereals, milk (not formula), cheese, and many grain products.  If your
child is growing and developing normally and is having no symptoms other than
the two loose stools, there is no cause for concern.  If the problem increases
or begins to bother your baby or you, discuss it with your pediatrician.


     My 12 month old likes her high chair and eats pretty well, but she's a
mess.  When she's finished, she doesn't like to be wiped.  Do you have any
helpful hints?

     At 12 months of age, your baby needs to be a mess.  If she's getting some
of the food into her mouth and enjoying it, then she's doing quite well, and
so are you.  Plan on a mess for quite some time.  Mealtime needs to be
enjoyable for her.  She needs to be able to practice and enjoy feeding herself
without being scolded for making a mess.  To make things a little easier for
yourself, put only a few to several bites of food on her tray at a time; this
way, there's less to distribute elsewhere.  Let her drink from a small plastic
cup with a lid and spout, and put only a small amount of liquid in it at a
time.  When the baby is playing more than eating, take her out of her chair.
Before she wanders off, use a damp cloth to gently but firmly wipe her face
and fingers.  Although you don't want to bathe her every day, you could
consider taking her directly from high chair to bathtub on her usual bath
days.  Your baby also might enjoy going to the sink and washing her own hands
and face with your help.  Although it's bound to be a little messy, it's one
way to help her feel more independent.  Try to make wiping her hands and face
a brief, pleasant experience.  To make cleaning up the eating area easier,
spread a sheet of plastic under her high chair before she sits down to eat;
after the meal, fold it up, take it to the sink, and wipe it off.  When it's
necessary to scrub down the high chair, you might consider placing it in the
shower and cleaning it there.


     My 12 month old plays with her food and drops it on purpose.  When I tell
her "no," she cries and wants out of her high chair.  Should I let her down?

     Your 12 month old, as you know, has little patience for sitting still for
any length of time.  She's in the usual moving mode for this age.  It's also
normal for her to mush her food, examine it, eat some, and drop some.  To make
this phase easier on you, you can try to offer her only a few bites at a time
and help her with her spoon.  If she thinks dropping food on the floor is a
game, try not to overreact.  If your reaction is strong enough, you reinforce
the game.  Try to get the message across that food is for eating not throwing.
Do it calmly and patiently.  If she persists and is no longer eating, take her
out of her chair.  Then, feed her later when she's hungrier.  At 12 months of
age, she can let you know that she's hungry by gesturing or going to her high
chair.  Offer her small portions of a variety of foods, and change the menu
daily to keep mealtime interesting.


     My teething nine month old is constantly sucking on things.  Her
favorites are teething biscuits and graham crackers.  Can these be harmful to
her?

     Teething biscuits and graham crackers are fine for snacks and for comfort
during teething as long as the baby can handle them and as long as they
liquefy in her saliva.  Graham crackers can sometimes break off and cause
choking before they liquefy, so you should try to break them up into smaller
pieces.  Allowing your baby to pick them up and put them in her mouth will
also give her some practice with finger foods.  You might try offering her a
teething ring instead of snacks on occasion as well.  Although gnawing on
biscuits and/or toys throughout this teething stage will make your baby more
comfortable, you should also try to provide her with other diversions, like
some cuddling time with you.


     Should my baby eat her meals at the same time as the rest of the family?

     There's no hard and fast rule here.  Whether or not you feed her at the
same time that everyone else sits down to eat will depend in part on timing.
If she has to wait for her dinner, she's likely to get cranky and impatient.
Likewise, helping your baby to eat is hardly conducive to a relaxing meal and
adult conversation.  Babies are notoriously poor dinner companions.  For
family harmony, you might feed the baby first most of the time, and, if she
wants to, allow her to sit in her high chair with small amounts of finger
foods while the rest of the family eats.  If you do decide to have the baby
eat with the rest of the family, you might want to plan special dinners for
you and your spouse on occasion, so that the two of you can have uninterrupted
mealtime together.  Although you want to remain flexible enough to accommodate
the baby's needs, you'll need to take care of your own needs and the needs of
other members of the family as well.


SUGGESTED INTRODUCTION OF SOLID FOODS

     You can start introducing soft or pureed solid foods when your baby is
four to six months old.  Begin with cereals unless directed otherwise by your
pediatrician.

1. Cereal:  Rice, then barley, then oatmeal
2. Yellow vegetables:  Carrots, then squash, then sweet potatoes
3. Green vegetables:  Peas, then beans, then spinach
4. Meats:  Lamb, beef, veal, poultry, pork, fish (order not important); then
   egg yolk
5. Noncitrus fruits
6. Noncitrus juices (only after nine months of age)
7. Citrus fruits (orange, tomato, grapefruit, etc.)
8. Citrus juices
9. NO EGG WHITE OR HONEY UNTIL AFTER 12 MONTHS OF AGE