Feeding Infants

Good Nutrition for Good Growth

Infants need special feeding care. Parents and child care providers must work closely to ensure consistent care in this most important growth period. Parents should establish a regular routine of feeding their baby according to the recommendations of a pediatrician.

BREAST MILK OR FORMULA FEEDING

Babies grow more rapidly in the first year of life than at any other time. A baby doubles his birthweight in the first 4 months of life and triples birthweight by the first birthday.

Infants need the same nutrients as children and adults: protein, carbohydrates, fat, water, vitamins, and minerals. Infant foods must also contain enough calories to allow normal growth and development at this critical time.

Parents may choose to breastfeed their infants or to provide commercial infant formulas. Either type of feeding contains the calories and nutrients infants need for the first 4 to 6 months. Appropriate amounts of either frozen breast milk or commercial formulas may be brought to a child care provider each day. The following tips will aid in the proper handling of infant feedings:

• Label all infant feedings with the baby's name.
• Store bottles of commercial infant formula in the refrigerator. Store frozen breast milk in the freezer until feeding time. Then thaw it under cool, running water. Do not warm bottles on the stove, which may cause the milk to curdle. Do not warm bottles in the microwave. Uneven heating may cause hot spots, which can burn baby's mouth. Cover all bottles during storage.
• Wash hands carefully with soap and water before preparing any infant feeding. Do not touch nipples with your fingers.
• Prepare commercial infant feedings according to instructions. Add the right amount of water to ensure that the infant gets adequate calories and nutrients.
• Throw away any breast milk or formula left in a bottle after feeding.
• Clean reusable bottles and nipples thoroughly after each use. Bottles and ,nipples may be washed in a dishwasher in very hot water or washed by hand and boiled for five minutes before refilling.

Breast milk and infant formula are the only foods recommended for the first 4 to 6 months of life. Vitamin and mineral supplements usually are not necessary and should be given only when recommended by a physician.

BEGINNING SOLID FOODS

Although breast milk and infant formula continue to be an important part of baby's diet, solid foods may be introduced at about 4 to 6 months. These foods provide extra calories and nutrients for the older baby.

At 4 to 6 months, babies learn to control head movements and to keep food in their mouths rather than pushing it out with their tongues. They also learn to sit up, making feeding with a spoon possible. Wait for the baby to develop these skills before you begin solid foods.

Follow these tips when introducing solid foods:

• Start slowly. Only 1 or 2 spoonfuls of food are needed in the beginning.
• Introduce one new food at a time. Add another new food after 4 or 5 days. Waiting allows the baby to get used to new flavors and allows you to identify problem foods easily if allergic reactions occur.
• Start with rice cereals. Rice is less likely than other grains to cause an allergic reaction . Mix it with breast milk or infant formula to provide a good balance of protein, carbohydrate, and fat and to serve as a good source of iron.
• Hold the baby during feeding. Babies need to be reassured that this new experience is safe.

Vegetables may be introduced after cereals, at about 7 months. The baby may begin to make chewing motions at this time. At this stage, cereal may be made with less formula or breast milk, and mashed vegetables may be added to encourage chewing.

Babies with one or two teeth can eat some lumpy foods. Foods served to the other children may be offered to the baby. Easily mashed foods, such as potatoes and carrots, bananas, or canned fruits, work well. Remember, though, that babies do not need added sugars or salt.

Offer soft finger foods as soon as a baby can grasp. Any food that will not fall apart between the plate and mouth is appropriate as a soft finger food. Soft finger foods are messy at first, but the mess will decrease with practice.

Meat, egg yolks, and small amounts of cheese and yogurt may be added to baby's diet between 10 and 12 months. Babies should not be given egg whites before the first birthday.

Honey and corn syrup are not recommended before 12 months. Some honey and corn syrup contain botulism spores. These are not harmful to children and adults but may produce poisons that can be fatal to babies. Infants' digestive systems cannot destroy these spores.

Formula, breast milk, juices, and water may be given from a cup after 10 months. Hold the cup and serve only small amounts of liquid. Only an adult should feed an infant. By the first birthday, the baby should be able to handle the cup alone.

Avoid serving foods that may choke an infant. Serve only foods that are soft or that will soften in the mouth. Avoid raw carrots, nuts, popcorn, unpeeled fruits and vegetables, hard candies, pickles, hot dogs, and other hard foods.

If you are in the Child and Adult Care Food Program (CACFP), refer to their infant meal pattern guidelines for information on specific foods and appropriate amounts. Discuss feeding infants with your sponsor, and remember that you must have on file a medical exception if other than the required foods are to be reimbursed.

PREPARING INFANT FOODS

• Wash hands with soap and water first.
• Handle infant foods carefully. Pour out a small portion of strained food, or mix a small portion of cereal in a serving dish. Do not feed an infant directly from a baby food jar, as saliva from the spoon will contaminate the remainder of the food in the jar.
• Remember that contact with your skin will contaminate the infant's food. Do not touch the nipple or rim of the cup. Do not put a spoon with strained food onto your arm to test temperature and then into the baby's mouth. Do not stick your finger into the jar of baby food or test it with the tip of your tongue. Test by the temperature of the container or of a sample dripped onto your wrist or inner elbow.
• Do not warm baby's food in the microwave oven. Microwaving may leave hotspots in the food, so that one spoonful of food may be cold, while the next spoonful may burn baby's mouth. Babies accept cold or room temperature foods, making warming unnecessary. If you do need to warm food for babies, do so carefully, and stir the food to even the temperature.

BOTTLE TOOTH DECAY

Always hold an infant for feeding. If an infant falls asleep while feeding, and an adult is not present to remove the bottle, milk may remain in the mouth during sleep. The sugar naturally found in this milk can cause cavities in new or forming teeth. Teeth with cavities may hurt or break, making it difficult for a child to chew. Inability to chew makes it difficult for children to get the calories and nutrients they need.

Do not allow toddlers to carry bottles of milk, juice, or soft drinks while playing. Sugars in these liquids also contribute to bottle tooth decay. Damage to the teeth can be long-lasting, and eating may become more difficult as the child grows.

In addition to bottle tooth decay, children who carry bottles may share sips with other children. By sharing sips, they also may share infections.

TEETHING

Teething infants can find some relief from chewable toys, including some made for teething children. Avoid giving brittle crackers, raw vegetables, and any substance that might cause the infant to choke, but do give bits of foods that infants can eat with their fingers.

BREASTFEEDING - HOW YOU CAN HELP

Some mothers may wish to continue breastfeeding while their children are in child care. They may choose to adjust their work schedule so that they can come and nurse the baby at your home, collect and store breast milk for you to use while they are away, or use formula during the day but continue nursing at home. The following information about breastfed babies can help you if you happen to care for one.

• Breastfed babies need to eat frequently. Expect to feed infants approximately every 2-3 hours.
• Some mothers may ask you if they can come to your home and nurse the baby at lunch time. They also may wish to nurse their baby before they go home. Breastfeeding mothers may feel quite comfortable nursing the baby while visiting with you and the other children, or they may wish to go to a quiet corner or another room.
• Occasionally, breastfed babies may have trouble accepting the bottle. This may be because babies suck the breast nipple and the bottle nipple in different ways. A breast-shaped nipple may help solve this problem. A long, soft nipple may help the younger baby get more milk. An older baby may takea cup with a narrow plastic spout on the lid.
• Be sure to shake breast milk that has been refrigerated or frozen and thawed. Breast milk is not homogenized, and the cream separates out and rises to the top. Also, breast milk does not look like cow's milk or formula. In spite of its thin appearance and blue color, breast milk is rich and nutritious.
• Breast milk will last up to 48 hours in the refrigerator and up to one month in the back of a freezer that stays at zero degrees.
• Frequent daily stools that are loose are normal for breastfed babies inthe first 2 months. Stools look like cottage cheese and mustard.