Iron-Rich Foods

iron-rich-foods

I have good news. People are hearing that babies should have iron-rich foods as first foods. I’ve been talking this up for almost 10 years now and I’m super happy that the message is starting to be commonplace.

Yes, we recommend offering your baby iron-rich foods twice a day. From the very start. Then introduce a wide range of other healthy foods.

Why? Because iron is needed for growth and development. Iron is also needed during this critical time for brain development. This critical period extends from infancy through to about 5 years old.

That bad news is that people have misunderstandings of what foods are good sources of iron. So, they think that they are feeding their babies iron-rich foods. But they aren’t.

Avocado, broccoli, sweet potato, and quinoa are all foods that people commonly think are good source of iron. Incorrect. Myth.


Foods that are Good Sources of Iron:

  • Meat*
  • Poultry (e.g. chicken, turkey)
  • Seafood
  • Beans and lentils. Particularly the lentils.
  • Nuts and seeds. Particularly the seeds.
  • Iron-fortified baby cereal.
  • Tofu
  • Eggs

*While liver is a very high source of iron, it also contains extremely high amounts of vitamin A. So much vitamin A that it’s not recommended that you offer liver as a first food, and only offer it on rare occasions to toddlers and preschoolers.

Not All Iron is Equal

Iron comes in two different forms in food – heme and non-heme. Heme iron is better absorbed by our bodies and is found in meat, poultry and seafood. Non-heme iron isn’t as well absorbed by our bodies. So, when looking at lists of foods with iron that just list the number of milligrams, you need to recognize that you’re comparing apples and oranges.

There’s a great hack for increasing the body’s absorption of non-heme iron. It’s to eat a food with vitamin C at the same time. May fruits and some veggies are good sources of vitamin C. So serve your lentils in a tomato sauce and stir some strawberries into that baby cereal.

Here’s a more extensive list of iron-rich foods (from a trusted source): https://www.healthlinkbc.ca/healthlinkbc-files/iron-foods

Low Iron Foods

You’ll notice that a number of foods that are commonly thought of as containing iron aren’t on my list above. Certainly there are a number of other foods that have a little bit iron. Some vegetables and fruit do contain a small amount. But I wouldn’t consider them good sources of iron. You’re likely surprised that spinach isn’t on the “high-iron” list. That’s because while spinach does contain a decent amount of iron, most of that iron is bound to another molecule, called oxalate, that prevents us humans from absorbing it. While most of the anti-nutrient content on the internet is making a mountain out of a mole hill, the oxalates in leafy greens are noteworthy enough to not count these foods as a source of iron.

Dairy foods aren’t a source of iron. In addition, they can prevent the absorption of iron from other foods. This is why we recommend delaying the introduction of cow’s milk until 9 – 12 months of age. And, once you have introduced cow’s milk, limiting it to 2 – 3 cups per day.

Grains aren’t a source of iron. Yes, even quinoa. That’s why iron is added to infant cereal and breakfast cereals (that’s what the word “fortified” means in “iron-fortified infant cereal).

Check out my Youtube channel for videos on how to prepare baby food versions of iron rich foods (puree and finger foods- Baby Led Weaning).

Photo credit: James Sutton

When Can I Give My Baby Eggs?

When_Can_I_Give_My_Baby_Eggs

I'm often asked by parents "When can I give my baby eggs?". The old advice of waiting to introduce egg whites until babies are 1 year old has changed. But there are some important age considerations when preparing eggs for your baby. Here are all the do’s and don’ts when it comes to feeding eggs to your baby.

Eggs are an excellent first food. Yes, right from about 6 months onwards. The current advise for introducing solid foods is to offer iron-rich foods first. Then build up a repertoire of other foods, such as vegetables and fruit. Eggs are an iron-rich food. Eggs are also an excellent source of protein. So good is the protein in eggs that they are the standard that’s used to measure the quality of protein found in food.

You may be thinking “Wait, but aren’t eggs a high risk allergy food?” Yes, it’s true that eggs are a common food allergen. The latest research is suggesting that this is exactly why you should introduce them earlier rather than later. There is some evidence that waiting until 12 months or later to introduce higher allergen foods may increase the risk for an allergic reaction. Or, stated the other way around, introducing common food allergens as soon as you start introducing foods (at about 6 months) may help prevent food allergy. There isn’t sufficient evidence yet that introducing higher allergenic foods before about 6 months offers any protection. The good news is that this is an active area of research so perhaps in the next few years we’ll know more about how to prevent food allergies.

There are a few more details about eggs that you need to know to introduce them. These are steps to take to ensure food safety – to prevent food poisoning. Babies are more susceptible to food poisoning so it’s recommended to follow these guidelines.


When To Give Baby Eggs

Age

Guideline


Safe Examples

About 6-12 months

Serve only eggs with both hard yolks and whites

Hardboiled eggs, eggs in cooked foods (e.g. baking), eggs scrambled well-done, firm omelets, fried eggs over-hard, hard poached eggs.

1 – 5 years

Runny yolks are okay. Avoid raw eggs and eggs with runny whites.

All the examples from 6 – 12 months. And, over-easy fried eggs, sunny-side up fried eggs (with whites fully cooked), soft-boiled eggs (also known as eggs and soldiers, dippy eggs), eggs poached medium.

5 years and older

Eggs with runny yolks and runny whites as well as raw eggs, prepared safely, are okay.

Soft scrambled eggs, eggs poached soft, French-style omelets, sauces made with raw eggs e.g. home-made Caesar salad dressing, home-made mayonnaise.


Do Babies Need Teeth for Finger Foods?

babies need teeth for finger food

At workshops I’m often asked by new parents whether babies need teeth to eat finger foods. The short answer is: no. Whether you’re choosing to start with purees or to follow Baby Led Weaning (BLW), we recommend starting to offer your baby finger foods by 7 months. Many babies won’t have any teeth at that age. And, most babies won’t have molars then. Our molars are the teeth that we use to chew food. We use our front teeth to bite and tear.

Babies’ gums are surprisingly strong. They can use them to eat finger foods. It’s the presence of things along their gums that helps them move their gag reflex from the young infant position to the mature position. And, it’s with practice that babies learn how to co-ordinate the chewing, swallowing, and breathing that are involved in eating. That’s why at this age babies put everything in their mouths – they’re practicing.

Introducing a wide range of tastes and textures before 9 – 12 months can help lessen picky eating in toddlerhood. You’ve got a developmental window of opportunity when babies are interested in tastes and textures. Use it!

What makes good finger foods?

  • Pieces of soft cooked vegetables
  • Ripe soft fruits (skins and pits removed)
  • Grated raw vegetables or hard fruits
  • Finely minced, shredded, ground or mashed cooked meat
  • Deboned fish and poultry
  • Bread crusts or toast

Some finger food examples:

  • Tortillas cut in narrow strips and thinly spread with nut butter
  • Omelet cut in to narrow strips
  • Salmon crumbled into small pieces
  • Grated carrot and grated apple
  • Extra-firm tofu steamed and cut in to skinny fingers

Looking for more finger food ideas (including iron-rich finger food ideas)? Check out my video on Youtube.

How Much is Enough Food?

baby w fruits & veg Rarely do I give a workshop on introducing solid foods to babies or feeding toddlers and preschoolers (including picky eaters) where a parent doesn’t ask how much food they should feed their child. It’s quite an easy question for me to answer. And, the answer applies to any meal or snack for a child of any age:

As much as they are hungry for.

If this answer surprises you, you’re not alone. This answer usually is met with confused faces. So, let me expand. As the adult, it’s your role to provide opportunities to eat 5 or 6 times a day. It’s your child’s role to choose how much to eat.

I recognize that it’s difficult to trust them to know how much to eat. But it really is best to do so.

We’re born being able to know when we are hungry and when we are satisfied. Over time, through social pressures, we learn to not listen to our bodies and instead look to external cues for how much to eat. This is associated with higher rates of eating disorders and obesity.

Studies show that when kids are raised in households where they’re told to stop eating before they’re satisfied (i.e. because the adult believes that their child has “had enough”), they learn to sneak food and gorge on food when they get the opportunity.

On the flip side, when kids are forced to eat more than they are hungry for, they learn to over-ride their bodies’ signals and they learn to overeat.

Instead, trust your child to listen to their bodies and eat as much as their bodies tell them. Expect this to vary from day-to-day. Some days they’ll eat so much that you don’t know where they’re putting it all. Other days they’ll eat so little that you won’t know where they’re getting their energy from. I recommend serving a very small portion. If kids want more, allow them to have seconds.

You’ll know that your child is getting enough to eat when they have lots of energy and their growth is tracking along their curve on their growth chart.

My kid used to eat just about everything…

My kid used to eat just about everything

Does this sound familiar?

“My kid used to eat just about everything and anything but she stopped eating meat all of a sudden. She's now 2.”

This, hands-down, is the single most common question that parents come to me wondering. Well, it’s not always meat that their children suddenly won’t eat. It may be vegetables, fruit, or most foods (i.e. they’ll only eat something like 5 foods).

If you’ve recently experienced this, the good news is that you’re not alone!

Most (but not all) kids will happily eat almost everything when you’re first introducing solid foods. From about 6 months onwards, these happy babies keenly gobble up most foods you put in front of them. In fact, they’re delighted with all the different textures, shapes, and tastes that you introduce to them.

Then, all of a sudden, something changes. This change can happen as young as 9 months, and most commonly happens somewhere between 18 months – 2 years.

Welcome to the picky eating stage.

It’s a completely normal developmental stage that most kids go through.

No, you didn’t cause your great little eater to suddenly “hate” foods that she loved previously. If you’re like most of the parents I’ve worked with, I know that I need to tell you to turn down the volume of the Mommy-guilt (or Daddy-guilt) voice in your head that’s telling you that it’s all your fault, that you did something wrong to cause this. That you “broke” your child. Let me tell you definitively: you didn’t.

The science doesn’t tell us why kids all of a sudden become picky. Some scientists have theorized that it’s a protective thing. From back when we lived in caves. At this age infants become toddlers and start wandering away from parents. It would be evolutionarily protective to have kids become scared to put random (i.e. potentially poisonous) plants in their mouths. It’s an interesting theory but who knows if this is true.

What I do know is that picky eating is a developmental stage. Kids become wary of foods. They honestly become scared to try things (yes, even if they’ve eaten them before). They don’t have the language skills to tell you that they’re feeling trepidatious about trying that food. So they simply say “I hate it!” (before they’ve even tried it.

The good news is that you don’t just have to wait until your daughter or son grows out of this stage. You can support them to be confident enough to try new foods, to increase the range of foods that they’ll eat, and to get the good nutrition that they need.

The bad news is that I can’t solve your question in 1 short and snappy blog post. I can, however, point you in the right direction.

As first steps, I encourage you to:

  • Continue serving your child small servings of every food that you eat in your household.
  • Role model eating these foods by joining your child at as many meals and snacks as possible.
  • Plan meals and snacks that include both familiar and challenging foods.

And of course, keep your eyes on your peeled for other strategies I'll share to help your picky eater transition smoothly through this difficult phase (while ensuring that they’re meeting their nutrition needs).

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What’s the Right Age to Start Solid Foods?

age-to-start-solid-foods

Parents have been sending me a lot of questions lately asking what is the right age to start introducing their baby to solid foods. They’ve heard 6 months before. Now they’re hearing 4 months from other health professionals. And, some places online say 4 – 6 months. They’re right to be confused with all this conflicting information. If you’re wondering what age to start your baby on sold foods, here’s the scoop…

The recommendations haven’t changed. The World Health Organization recommends 6 months¹. In Canada the recommendations from Health Canada, the Canadian Pediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada say 6 months². The American Academy of Pediatrics recommends “around 6 months”³.

I suspect that reports from a new, and important, study on preventing peanut allergy are behind the advice that these health professionals are giving parents. Now I’m not in the doctor’s office when the parents are being given this advice, so this is a best guess. But the study is being talked about a lot in the health provider community, which is why I’m suspecting it’s behind the advice that parents are receiving. Unfortunately the researchers chose to use a phrase that I’m suspecting is creating some of this confusion.

The research study found a significant decrease in peanut allergy with their intervention⁴. What was their intervention? To introduce, and regularly feed, peanuts to children starting as babies versus waiting until they were 5 years old. Giving peanuts to the babies reduced the incidence of peanut allergy. But here’s where I suspect the misunderstanding comes in. The children in the “early” introduction of peanuts group were between 4 – 11 months old. Because this is “early” versus introducing peanuts at 5 years old. The article doesn’t compare introducing peanuts at 4 months versus 6 months. However, I suspect that busy health professionals could have glanced at articles describing the study and mistakenly concluded that the “early” group meant introducing peanuts at 4 months versus 6 months of age. Especially, since the researchers didn’t report the older children’s age as 5 years, but as 60 months.

The reality is that the scientific and health communities still don’t know anything definitive about the perfect age to introduce solid foods to minimize food allergy.

What we do know is that babies start to run low on the iron that they’ve stored in their bodies at approximately 6 months of age. And so it’s at this time that we need to start introducing iron from a new source, i.e. solid foods. Iron is important for brain development in babies and young children.

And, babies show the signs of being ready to start solid foods between 4 – 6 months. Just like every other developmental stage, babies arrive here at slightly different ages. The signs of readiness for eating solid foods are:

  • The disappearance of the extrusion reflex.
  • The ability to sit up (with support) and hold their own head up (without support).
  • Can visually track your movement.
  • Becoming fascinated with watching people eating.

As we learn more about what causes food allergies and how to prevent them, the recommendations may change. There are some fantastic studies underway that I can’t wait to get the results from. Until we know more, I still recommend starting solid foods at about 6 months. If your little one is between 4 – 6 months, you’re seeing all the signs of readiness, and you’re keen to start – go ahead. If you enjoy the simplicity of breast or bottle feeding or you’re not yet seeing the signs of readiness in your child, hold off until 6 months of age. My advice for the last 7 years has been “start solids at about 6 months”. I’m not changing my advice yet.

References:

  1. http://www.who.int/nutrition/topics/complementary_feeding/en/
  2. http://healthycanadians.gc.ca/healthy-living-vie-saine/infant-care-soins-bebe/nutrition-alimentation-eng.php?_ga=1.150740528.74375254.1447739252
  3. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx
  4. http://www.leapstudy.co.uk

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1 Simple (and Overlooked) Step to Get Picky Eaters to Eat More

get picky eater to eat more

There’s a very simple technique to get picky eaters to eat more. It’s something that I always look for when working with individual families. I can’t tell you how often it’s missed by parents. Let’s just say a lot. So, what’s this super simple tip? Make sure your child has their feet resting on something solid. Kids eat best when they have something solid to rest their feet on. Take a peek at your child’s feet when they’re sitting in their highchair or booster seat. Are their feet dangling? If you want your child to eat better, get them something on which to rest their feet.

Have you ever sat at a bar stool that didn’t have a footrest? Did it feel unsettling to have your feet dangling? Likely, yes.

This is something that I’ve looked for since I started my practice in 2008. But I never knew why kids ate best when their feet are supported. Then last month I attended a workshop and learned why. The reason is that while eating is a priority for our bodies, there are two priorities that supersede eating: 1) breathing; and, 2) staying upright (i.e. not falling on our heads). When your child’s feet aren’t resting on something solid, their bodies are required to focus on not falling over. This takes away from the focus on the task of eating. Babies and young children under 3 years of age are still novice eaters and they need to pay full attention to the task of eating. By providing a solid footrest, you’re removing a big source of distraction.

Some highchairs are adjustable. These are my favourites. Don’t have an adjustable chair? Not to worry, just MacGyver a footrest for your child. Inexpensive footstools (usually used at the bathroom sink) work well. As do a stack of phone books – although these are getting harder to come by.

The perfect height for your footrest is the height where your child’s feet are 90 degrees from their legs. In other words, your child is resting flat-footed.

Remember, check your footrest every couple of months. Kids grow!

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1 Simple Tip to Help Your Baby Gagging Less During Feeding

baby gagging

Pretty much all babies gag sometimes when then they first start eating solid foods. But, some babies gag more than others. Baby gagging can be very frightening for moms and dads and I get a lot of questions about it when I lead my Introducing Solid Foods workshops. I know that you are busy and exhausted so you like my blog posts short and to-the-point. If you’re really nervous about introducing your baby to solid foods, and/or are looking for a more fulsome description of gagging versus choking, I recommend coming out to one of my in-person workshops or getting in touch with me to find out more!

The focus of this post is on how to help babies who gag a lot to become less gaggy so that they can be more successful at eating solid foods.

For this tip, I’m assuming that you’re starting solids in that ‘just right’ window of about 6 months old. And, that your health professional has ruled out any medical cause for your baby’s gagging.

It’s often said that some babies have a “sensitive gag reflex”. But for most babies this isn’t the case. It’s not that their reflex is too sensitive, it’s that it’s in the wrong place.

You see, babies and adults have different mouth physiology. In adults, the majority of our tastebuds are on the tip of our tongues and our gag reflex is way in the back of our mouths. A fun way to test this is to place food in different parts of your tongue and notice how differently it will taste.

In babies, the majority of their tastebuds are at the very back of the mouth and their gag reflex is at the front of their mouth. This makes sense because for the first months of life babies are nipple-fed (either breastfed or bottle). To feed, babies place nipples to the very back of their mouths. So Mother Nature has the tastebuds at the back, where baby will taste their breastmilk/formula. The gag reflex is at the front of the mouth where it’s out of the way for nipple-feeding and where it protects babies from putting items in the front of their mouths that they could choke on.

Starting at about 4 – 6 months, the gag reflex and tastebuds migrate in opposite directions to swap places into the grown-up positions.

Most gaggy babies don’t have overly sensitive gag reflexes. Instead, their gag reflexes are still too far forwards.

What stimulates the gag reflex to move backwards? Having things in your baby’ mouth. Particularly things that your baby can stick towards the back.

So, your baby sticking their hands (and feet) in their mouth is really them working to move their gag reflex backwards. So is mouthing Sophie the Giraffe and other chewable toys that babies can stick deeper into their mouths. Toys like teething rings that stay at the very front of their mouths won’t help because it’s the presence of things ever deeper into your baby’s mouth that stimulates the backwards movement of their gag reflex.

So what’s the 1 tip to help baby gagging?

Let them play with toys they can safely stick in their mouths.

Now to be clear, I’m not recommending that you allow your baby to chew on things that they can choke on. I said “safely stick in their mouths”. What I’m recommending is to allow your baby to play with chewable toys and other objects that can safely go further back in their mouths. You want to look for long things that your baby can’t get a bite off of. Examples include:

  • Their own hands (and your fingers).
  • Sophie the Giraffe.
  • Toy key rings.
  • The spoon that you feed your baby with.
  • Whole, big, raw carrots or parsnips (big enough in diameter that your baby can’t bite off a chunk).
  • Ice cubes in a mesh feeding bag (I only recommend plain water ice cubes, not frozen foods).

Given the opportunity, babies will do lots of chewing on these objects. Know that they’re not just playing. They’re playing with a purpose. Playing is their job at this age. Your baby is playing with the purpose of developing the skills to eat.

How Much Should You Focus on Your Child’s Table Manners?

Before I chat about child table manners, I want to explain this photo. Yesterday I had the opportunity to see Ellyn Satter speak live. Ellyn's work is the foundation for mine. She's easily the most influential person in my career. And while I've thoroughly studied her work and used it with families for more than 7 years, I had never met her. By the time that I was finished university, had started to pay down my student loans, and could afford to travel to a US destination for her in-person training seminars, she retired. But yesterday she came out of retirement to present in Vancouver. You bet that I was going to be there - I may have been the first to register :) The table manners question was asked of her, and it was fantastic to see that she responded with the same answer as I give parents.

Table manners, like most matters of etiquette, can cause a strong reaction in us - really getting under our skin. When it comes to table manners, parents usually approach me in two ways (which really are about the same thing). Either they ask about how to best teach kids to have good table manners. Or, they’re embarrassed about their child’s messy eating and apologize to me for it.

When it comes to table manners, the best course of action is to not sweat about it. Like many other things, your actions speak louder than words. Kids naturally have an internal drive to master things and grow up. Eat together with your child on a daily basis. Use good table manners yourself – use utensils, a napkin, say “please” and “thank you” when you ask someone to pass you the pepper, don’t get up and down from the table like a jack-in-the-box. Your child will pick up your good habits.

That is, as long as they aren’t staring at a screen during the meal (iPad, phone etc).

Don’t sweat your child’s messy eating. It’s normal for kids to use a combination of utensils and fingers into the school-age years, depending on the food and how hungry they are. And like all things, some kids learn to use utensils faster than others.

The most important factor for kids to learn to love healthy eating is to enjoy eating at the table. This requires the table to be a pleasant place. Constant nagging about table manners (“elbows off the table”, “use your fork”, etc) can really get in the way of kids enjoying meals.

It takes a lot of effort to organize yourself to plan and prepare meals and snacks and to have an adult sit down with your child to eat together. Congratulate yourself for accomplishing this and know that over time your child will learn good table manners.

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Can Kids Have Too Much Fruit?

baby w fruits & veg

Here’s what a Mom recently asked me: "I have what may be a silly question. Should I be concerned with my 8 month old getting too much fruit? In other words, can kids have too much fruit?

Can Kids Have Too Much Fruit?

In a word: yes. Let me expand with 2 key points.

  1. All of us (i.e. adults too) can get diarrhea from eating too much fruit at once. If your child’s stools are getting loose, then it's a sign of too much fruit.
  2. Of course, fruit is a healthy food. But human beings need a wide variety of foods from all the food groups to meet our nutrition needs.

In particular, for babies, toddlers and preschoolers, iron is a key nutrient that we’re looking to provide through food. Fruit is low in iron. It’s recommended that you offer iron-rich foods twice a day.

It’s normal for kids to have food preferences. However, kids aren’t at a developmentally ready to understand that human beings can’t survive on a favourite food alone until they’re well into their school-age years.

How to Make Sure Your Child Doesn't Get Too Much Fruit

If you notice that your child will always choose one or two favourite foods, I recommend starting a technique that I call “controlling what’s on the menu”.

Here’s how. You choose what foods you will offer, i.e. what foods are on the menu, at meals and snacks. Your child gets to choose what they’ll eat from what you’ve provided. And, they get to control how much of each food they eat (yes, including zero bites).

This way you are creating a situation where your child eats a balance of food groups throughout the day. And, your child gets to express themselves by controlling what they eat from what you’ve provided. You’ve created an environment where you’re making sure that your child is getting good nutrition at the same time as your child’s personal boundary with their body is respected.

For example, for this mom’s 8 month old, at one solid food time each day serve an iron-rich food either on it’s own, or with another food that isn’t fruit – maybe it’s a vegetable or a grain. Feel free to offer fruit at the other solid food time where you’re offering the iron-rich food. If your child eats a particularly huge amount of fruit one day and you notice that his stools are loose, hold off offering fruit for a day or two. Create balance by offering vegetables, protein foods, and grains.

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When to Ignore Messy Eating. When to Nip it in the Bud.

Messy Eating Child

I’m often asked about kids' messy eating. Parents often wonder what’s normal and at what age kids will learn to use utensils. Recently I received this question from a Mom:

My question is regarding messy eating.  My daughter (just turned 4) often eats with her hands and then has food obviously all over her hands but also on her face from ear to ear.  She also plays with her food a bit (ie:  bites a few holes in her bread and then pauses to see what shape she has made).  How much emphasis should I put on eating neatly with a fork and spoon and how do I do this or should I just be happy that she’s eating?

It's normal for preschoolers (3 - 5 year olds) to eat with a combination of their hands and utensils. Most are still working on the dexterity involved in using utensils. They're curious about the world, so yes, they'll likely explore their food too (like the example you give with the bread).

As long as her behaviour is coming from a place of eating and interest in her food, don't sweat this mess. Because we want her to continue feeling confident with eating. We don't want to make her feel self-conscious about the way that she eats.

Teach through role modelling. Have an adult join her at as many meals and snacks as possible. Her internal drive to grow up will motivate her to copy your use of utensils and other actions at the table (e.g. wiping your mouth with your napkin when you finish eating).

In the meantime, go ahead and start teaching other manners like saying please and thank you, taking turns to speak during a conversation, asking to have someone pass you the peas, and asking to be excused when finished eating.

On the other hand, pay close attention to see if her behaviour is motivated by naughtiness. That is, if she's acting out and purposely taking actions to get negative attention. You'll recognize this right away. If so, then do nip the behaviour in the bud and explain that we don't play with our food.

How do I Help My Baby Feed Himself/ Herself?

Help My Baby Feed Himself

I’m often approached by parents of babies between 9 months and 12 months old who are concerned that their children aren’t learning to self-feed as quickly as other babies. Here’s an example of what one parent asked me: “My son is 9 months and has been eating finger foods since about 7 months however he will not feed himself. Is there something I can do to help this? Or will it just come to him? How do I help my baby feed himself” Without doing a full assessment of a child, I can’t say for certain what’s causing a child to learn self-feeding slower than their peers. But I can share the common causes that I see and their solutions.

Common Causes for Baby Not Self-Feeding:

  1. Medical conditions or developmental concerns. Because you didn't mention it, I'm assuming that your son doesn't have any medical conditions or developmental concerns that would affect his dexterity/ motor control.
  2. Missing role models. Kids learn from watching others - particularly older kids and adults. If no one else is eating there isn't anyone to act as a role model for how to do it. Also, eating is a social activity for us human beings. Kids of all ages eat better when adults join them at the table.
  3. Temperament (also known as personality). Some little ones are what I call "outsourcers". They're happy to sit back and let others do things for them instead of doing the hard work of figuring it out themselves. Because learning to self-feed does take work at this stage.
  4. Over-helpful caregivers. Sometimes parents (and other caregivers) have such strong desires to help their little ones that they jump in and "help" instead of sitting back and allowing their little one figure things out for themselves. This can sometimes also be fuelled by impatience and/or anxiety about your little one getting enough to eat. The result is a learned helplessness.

Solutions to Help Baby Feed Himself:

If the cause is #1 then working with an Occupational Therapist can be a great help.

The solution to #2 is to sit and eat with your child. Ideally, eat the same foods too. This way you're sending a message loud and clear that you want him to eat what’s in front of him. And, you’re creating the social environment that’s most conducive to eating and learning.

The solution to #3 and #4 is the same. Resist the urge to jump in and "help". You're actually being more helpful by holding off and allowing him to learn the skills himself.

Take Home for How to Help My Baby Feed Himself:

Note that the most common cause that I see are # 3 and 4. In other words, a combination of a child’s natural temperament and parents who are either overly anxious or keen to help.

It’s a classic case of fantastic intentions inadvertently taking things in the wrong direction.

Thankfully, it’s super easy to fix! Babies this age are compelled to master the skills that they see others doing. Just like learning any new skill, kids learn to feed themselves with finger foods at different rates. They want to learn how to self-feed, we just need to create the environment that supports them in mastering it. When you do, they’ll learn this new skill in their own timing that’s perfect just for them.

When Can I Give My Baby Soy Milk and other Plant-Based Milks?

little child drinking soy milk

{Expert Guest Post for Love Child Organics: www.lovechildorganics.com} In last month's post I promised that today I’d talk about when to give baby soy milk and other plant-based milk alternatives.

In the last number of years there’s been an explosion of plant-based milks – soy, almond, oat, hemp, coconut, rice, quinoa, and more.  Many of us adults use them in our smoothies, on our cereal, and in our coffee. So it’s no wonder that parents are wondering when they can introduce them to their babies.

Recently in Canada, the Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee of Canada* provided some guidance around plant-based milks for babies and young children. They recommend waiting until 2 years for using soymilk as a replacement for breastmilk or formula and don’t recommend other plant-based milks (they didn’t give an age for introduction).

I haven’t seen any guidance from US organizations on introducing plant-based milks.

Personally, I find it difficult to give clear advice that I’m certain of. Here’s why:

  1. I believe that there are many healthy eating patterns – we don’t all need to be vegan, or vegetarian, or eat meat to be healthy. Many cultures around the world traditionally don’t include cows’ milk. And, many cultures do traditionally include cow’s milk. So I don’t see how we needs to or need not to introduce cows milk to babies’.
  2. We may use cow’s milk or any of these plant-based milks in similar ways (they’re wet and white). However, they are actually quite different foods. They each contain very different nutrients, such as fat, protein, vitamins and minerals. They aren’t equivalent substitutions for each other. So, it’s difficult to give one recommendation that covers so many different beverages.
  3. This is the first generation of kids where these milks have been widely available (soymilk has been widely available for the longest) so we just don’t have the evidence to see the long-term impact on kids’ health and growth.

That being said, if you’re not planning to introduce your baby to cows milk, here’s what I recommend:

  • Continue breastmilk or formula as the primary milk source until your baby is 2 years and older.
  • Introduce a wide variety of foods, so that your baby is getting the nutrition that they need from the foods that they’re eating – such as fat, protein, iron, other minerals, and vitamins.
  • Think of plant-based milks as a “big kid” food. In other words, serve them in an open/ lidless cup, not in a bottle. Offer them only very occasionally under 2 years of age. If your child is eating a good amount of a wide variety of solid foods, after 2 years of age (or be extra careful and wait until your child is 3 years old), slowly increase the frequency that you offer plant-based milks. Stay well under the limit of 3-4 cups per day (which is the recommended limit for cows’ milk).
  • At all ages, choose unsweetened, vitamin and mineral fortified plant-based milks. The “original”, vanilla and other flavoured varieties can have a lot of sugar.

http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-eng.php

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When Can I Stop Boiling Water for My Baby?

Stop Boiling Water for My Baby

“Can you tell me when I can stop boiling water for my baby (formula)? And when I can stop sterilizing her bottles? Seems silly since she puts everything else in her mouth.” Thank you to the parent who asked me this question.  Parents also often ask me a related question: whether they need to boil water when they’re teaching their babies how to drink from a lidless cup or sippy cup. So I’ll answer all these water-related questions together here.

Sterilizing Baby Bottles

It’s safest to always sterilize bottles before using them. As long as you’re using bottles (for any liquid), do continue to sterilize them. Breastmilk and formula are both rich foods for babies, and unfortunately for germs too. Bottles, nipples, lids, etc have so many nooks and crannies that they’re difficult to scrub clean. Sterilizing is the best way to make sure that you’re keeping your baby safe. Use a sterilizer or boil all parts in a pot of boiling water. Household dishwashers aren’t able to truly sterilize bottles. For more directions check out: http://www.healthlinkbc.ca/healthfiles/hfile69a.stm

Boiling Water for Baby Formula

If you’re feeding your baby powdered or liquid concentrate formula, always use water that has been boiled. There is no age to stop using the boiled water. There are thorough step-by-step instructions available at this great resource: http://www.healthlinkbc.ca/healthfiles/hfile69b.stm

Boiling Water for Baby (Drinking)

Any time after you’ve started introducing solid foods, you can start providing your baby the opportunity to learn how to use an open/ lidless cup and a sippy cup (yes, even as young as 6 months). As long as you have safe drinking water, you can use water from your cold tap. There’s no need to pre-boil this water. What do I mean by “safe drinking water”? I mean that you live in a city or town with a municipal water system and you’re using the water that’s intended for drinking (sometimes the term “potable” is used). Or, you’re on a well system that you’ve had tested recently and know is safe. If you haven’t had your well tested in a long time, this is a great reason to get testing done.

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AHH the Pressure! Is my baby ready for solids or should I wait?

is my baby ready for solids

{Guest Expert blog post for Modern Mama } Many moms contact me wondering if their baby is ready for solid foods. Usually this comes from two places:

  1. Worry that their baby isn’t getting the nutrition that they need from breast milk/ formula.
  2. Pressure from family or friends to introduce baby food.

Here’s the latest scientific-evidence based information on how to know when your baby is ready for solid foods. Use it as ammunition against your under-slept, worrying mind and any well-intentioned advice from others.

Is my baby ready for solids?

Babies are ready for solid foods at about 6 months of age. At this age, babies start running out of the iron that they stored in their bodies while they were in your womb. Breast milk is naturally low in iron so you need to provide your baby with iron from another source – solid foods. Iron is used in overall growth and development. It’s especially important for little one’s brain development – for babies to reach full their cognitive potential. While iron isn’t as much of a concern for babies fed formula, they’re still developmentally ready for you to start feeding them first foods.

Like any developmental stage, babies become ready for first foods at slightly different ages. You will see the following signs in your baby anywhere between 4 and 6 months of age. Your baby is ready for you to start feeding them solid foods when you see the following:

  • Extrusion reflex disappears. The extrusion reflex is when anything put in your baby’s mouth automatically causes them to stick out their tongue, thus forcing it back out again.
  • He can focus his eyes on food placed in front of him.
  • She can sit upright with minimal support.
  • He can hold his head up without support. This is important for safe swallowing.
  • She is very interested in watching people eat and the food on your plate. She may even be grabbing for people’s food, plates, cups etc.

Notice that the presence of teeth isn’t on the list above. You don’t need to wait until little ones have teeth before feeding them baby food.

If your baby was born prematurely or has developmental or health concerns, speak with your health professional about when your baby will be ready to start solid foods.

There is no benefit to starting solids earlier than about 6 months. In fact, there is some emerging scientific evidence that introducing solid foods before babies are 4 months old may increase the risk for food allergies.

There are several persistent myths about when to start feeding your baby solid foods that I want to bust:

  1. Big babies don’t need solid foods earlier. At this age, babies are experts at breast and bottle feeding. And, breast milk and formula are rich sources of nutrients. Feeding your big baby solid foods earlier isn’t necessary or beneficial.
  2. Small babies don’t need solid foods earlier. As I described above, at this age, babies are experts at nursing nutrient-rich breastmilk and formula. Feeding your small baby solid foods earlier isn’t necessary or beneficial.
  3. Feeding babies solid foods doesn’t make babies sleep through the night.While I understand grasping at anything that may get your baby (and you) to sleep through the night, this is a myth. The age that some babies start sleeping through the night happens to be the same age that you start feeding your baby solid foods. While they happen at the same time, it’s not that the one causes the other. Sorry.

In summary, your baby will be ready for first foods at about 6 months of age. There aren’t any nutritional benefits to starting earlier. Nor, will it help you get a decent night’s sleep.

Check out this post for information on choosing puree or Baby Led Weaning (BLW)

When Should I Introduce Dairy to my Baby?

little child drinking milk

{Guest Expert Blog post at Love Child Organics} Many parents ask me about when they can introduce dairy to their baby. The recent recommendation from Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee of Canada is*:

If parents and caregivers are introducing cow milk…delay until 9 – 12 months of age…limiting cow milk intake to no more than 750mL (3 cups) per day.”

A similar (but not exactly the same) statement from the American Academy of Pediatrics says **:

“Once your baby is past one year old, you may give him whole cow’s milk, provided he has a balanced diet of solid foods (cereals, vegetables, fruits, and meats). But limit his intake of milk to one quart (32 ounces or 946 ml) per day.”

These statements leave many parents asking me questions. Let me address the most common ones that I receive.

But first let me explain the reason behind the recommendations because I think that it will help you understand what to feed your baby. It’s not that there is something in dairy that’s unsafe for babies. The recommendation is related to iron. Iron is important for babies’ growth and in particular their brain development. There are 3 ways that dairy foods can be a concern with respect to iron:

  1. Dairy foods aren’t a source of iron.
  2. Many babies love drinking cow’s milk and eating other dairy foods. Thus, the dairy foods can crowd out iron-rich foods.
  3. Dairy foods can interfere with babies’ absorption of iron.

So the recommendation was created to provide advice on how to include cow’s milk in a way that doesn’t interfere with babies’ need for iron.

Here are my responses to the questions that I’m frequently asked:

Question: Does this mean that I need to wait until 9 – 12 months to give my baby cheese and yogurt? What about foods that contain cow’s milk?

Answer: No. Any time from about 6 months onwards, feel free to introduce small amounts of yogurt and (pasteurized) cheese amongst the wide variety of foods that you’re introducing to your baby.  Just don’t make yogurt or cheese a food that you’re giving large amounts of, day after day. Make them a ‘sometimes’ food, not a ‘frequent’ food. The same goes for other foods that use cow’s milk as an ingredient, such as sauces and dips.

Q: 9 – 12 months is a big age range, should I wait until 9 months or 12 months?

A: The reason behind the age range is that you want your baby to be regularly eating a good amount of solid foods multiple times a day before you introduce cows’ milk. Like learning any new skill, some babies master eating solids quicker and some take longer to actually get any significant amount of food in them (as opposed to on their face and clothes, in their hair, and on the floor). If your baby is eating lots of solid foods (particularly iron-rich foods), feel free to start introducing small amounts of cows’ milk after 9 months. If your baby is slower to get the hang of eating solids (particularly iron-rich foods), wait until 12 months.

Q: Why do the statements give a limit per day?

A: It’s above 3-4 cups per day that we start to see the negative effects of cows’ milk on eating iron-rich foods and iron’s absorption. This can result in iron deficiency.

Check back to this blog next month when I’ll cover when to introduce cow’s milk alternatives such as soymilk, almond milk, etc.

http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-eng.php

** http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx

Vitamin D Kids - Sunshine and Beyond

vitamin D kids

{Guest post on Love Child Organics} All this sunshine that we’ve had lately has me thinking about Vitamin D. Vitamin D’s nickname is ‘the sunshine vitamin’ because our bodies make it from exposure to the sun. However, our bodies don’t make it when we wear sunscreen. So if you’re choosing to have your kids be sun safe, you need to rely on vitamin D kids from food and supplements. Our bodies also don’t make it at the latitude of Canada or the northern United States from September through March – even on a sunny day.

Vitamin D’s Role in Our Bodies

Vitamin D is involved in building and maintaining strong bones and teeth. You’ve also likely heard about how it’s being investigated by the scientific research community for a wide variety of other roles in our bodies. While there isn’t enough evidence yet of vitamin D’s involvement in all these other roles, the research strengthens the idea that we want to make sure that babies and kids (and us adults too) get the recommended amount of vitamin D.

Here are the current recommendations:

Age

Recommended Intake

Safe Upper Level

Birth to 6 months

400 IU

1000

6 to 12 months

400 IU

1500

1 – 3 years

600 IU

2500

4 – 8 years

600 IU

3000

9 – 70 years

600 IU

4000

Over 70 years

800 IU

4000

Pregnant + Breastfeeding

600 IU

4000

Vitamin D For Babies Less Than 12 months Old

Breastmilk is naturally low in vitamin D (yes, even if you’re taking vitamin D yourself). Therefore, if you’re breastfeeding your baby, it’s recommended that you give your baby 400IU of vitamin D drops every day.

Formula does have vitamin D in it. If your baby takes 1000mL (32ounces) of formula a day then you don’t need to give your baby vitamin D drops. If your baby takes less than 1000mL (32 ounces) of formula a day (for example, if you do both breastfeeding and formula), then it’s recommended that you give your baby 400IU of vitamin D drops per day.

Vitamin D - Kids and Teens

At 12 months, the recommendations increase to 600IU of vitamin D per day. This may be from a combination of food and vitamin supplements (e.g. drops, pills, gummies).

Vitamin D in Food

Vitamin D isn’t found in many foods. I have a number of the best sources of vitamin D listed below. Note that while fluid cows milk has vitamin D in it, most yogurts and cheeses are made with cow’s milk without vitamin D in it so they aren’t sources of vitamin D. However, some yogurts are starting to be made with vitamin D fortified cow’s milk. Read the labels to find out if the yogurt you like is made with vitamin D.

While many kids are happy to drink lots and lots of glasses of milk, this usually crowds out other foods resulting in an unhealthy balance and not enough of other important nutrients (such as iron). Because of this, it’s recommended that kids drink a maximum of 2 glasses of milk a day. Goat’s milk, soy milk, almond milk, and other alternative milks may or may not have vitamin D added to them. Read the labels to find out.

Food

How Much

Vitamin D

Cow’s Milk

1 cup

100 IU

Formula

1 cup (250mL or 4 oz)

100 IU

Fortified Soy Milk

1 cup

80 IU

Fortified Orange Juice

½ cup

45 IU

Egg Yolk

1

25 IU

Salmon, canned or cooked

75grams (2.5 ounces)

608 IU

Tuna, canned

75grams (2.5 ounces)

41 IU

Kids Vitamin D Supplements (Including Drops) 

Since sunshine and foods end up playing a small role in providing vitamin D, most kids need to continue to get vitamin D from a supplement.

The amount (i.e. number of drops) that you need to give your baby, child, or teen is different with the different types and brands of drops. Read the label on your package to find out how many drops you need.

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