Transcript Slide 1

Infant Nutrition Presentation
A few questions before we start
1. What should a baby less than 6
months old eat?
A. Water, juice, milk, breastmilk and
formula
B. Breast milk or formula
C. Strained or pureed foods, breast
milk, and infant formula
D. Table foods that the rest of the
family eats
Questions Continued…
2. Which of these foods is safe for a baby over
6 months to eat?
A. Popcorn
B. Grapes cut into four pieces
C. Raisins
D. Honey
E. Peanuts
Questions Continued…
3. When should a baby start to eat solid foods?
A. From 4 to 6 months
B. 6 months
C. 9 months
D. 12 months
Questions Continued…
4. I would feel comfortable teaching others in my
community about infant nutrition.
Disagree
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Agree
After this session, you should be able to:
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Explain the importance of breast feeding
Explain the risks of infant formula
Explain when a baby should start eating solids
Explain what foods are good for baby
Explain how much and how often baby should eat
Explain how to tell if baby is getting enough to eat
Teach others about infant nutrition
A Story
Nicole is 19 years old and expecting her first baby in a
couple of months. She is trying to decide whether to
breast feed or not. She has heard that it is the best
way to feed her baby, but isn’t sure if she can do it or
that she wants to. She came to the health centre for
some help deciding what to do.
Feeding Your Baby From 0 to 6 Months Old
Breastmilk provides food, protection and
emotional nurturing for your baby.
Breastmilk ensures normal growth and
development of your baby.
Health Canada recommends that babies
receive only breastmilk till 6 months with
continued breastfeeding for 2 years and
beyond.
Importance of Breast Feeding
Breastfeeding is the natural way of feeding your baby
• Made to meet baby’s needs
• Traditional way to feed baby
• Bonding between mom and baby
• Inexpensive and convenient
• Natural child spacing (not birth control)
• Weight loss
But…breastfeeding can be hard
Preparing for a good start
Feed baby on cue
• Most babies feed 8-12 times per day
• For the first few days, mom produces only colostrum
• Milk takes between 2-4 days to come in
Baby is hungry if he:
• Is making sucking motions with the mouth
• Is looking around with an open mouth
• Puts fingers in the mouth, cries
You can tell baby is full when he:
• Let’s go of breast
• Sucks slower, stops sucking
• Is happy, relaxed or sleeps
Who is likely to need extra help
• Most women, if they are only breastfeeding, will be
able to produce enough milk for their baby, even for
twins
• Some women may need extra help and support
• Breast reduction surgery
• Low thyroid, polycystic ovarian syndrome, Reynolds’s
disease
• C-section, epidural or traumic birth experience
• Diabetes
• Teenager
• Smoke
• Overweight
Is There Ever a Time When Mom
Shouldn’t Breastfeed?
There are a few situations when a mom should not
breastfeed her baby:
• Mom is HIV positive, baby is HIV negative
• Mom has active tuberculosis (TB)
• Once she has been treated for TB and she is no longer at
risk for passing it on to baby, she can breastfeed again
In these cases, it is best to use an iron fortified infant
formula
What if mom drinks?
Heavy and long-term drinking while breastfeeding may:
• Change baby’s nursing and sleeping patterns
• Affect mom’s ability to care for baby
• Cause behaviour and growth problems in baby
• Occasional light or moderate drinking is okay while
breastfeeding
• Wait 1-2 hours after drinking before breastfeeding if possible
• It is still best to continue breastfeeding even if mom drinks
moderately
• Ref: Nutrition for Healthy Term Infants, draft.
Drugs and Herbal Remedies
Drugs:
• Most prescription or over-the-counter drugs are safe
during breastfeeding
• Some illegal drugs may harm baby
• Check with a pharmacist, doctor or
www.motherisk.org to be sure.
Herbal remedies:
• Some ingredients in herbal remedies may harm baby
• For advice on herbal supplements, call the Medication and
Herbal Advice Line (1-888-944-1012)
But What If….
• I can’t make enough milk for my baby?
• This is often cited as the #1 reason why women stop
breastfeeding
• If mom is exclusively breastfeeding (hasn’t introduced
even 1 bottle) and is feeding on cue, it is uncommon
that she can’t produce enough milk
• However, there are situations where mom doesn’t
produce enough milk
• If you are concerned that the baby is not gaining
weight, contact a nurse, lactation consultant or doctor
But What If….
• My breast milk doesn’t provide enough nutrition for
my baby?
• Breast milk is made for baby and fully meets baby’s needs
• It is best to eat a healthy diet while breastfeeding, but even if
mom doesn’t, breastfeeding is still better than formula
• The Canadian Pediatric Society recommends that babies in
Canada receive 400 IU vitamin D every day to ensure they
are getting enough
But What If….
• I get sick and can’t breast feed my baby?
• Most moms are able to breastfeed when they are sick
• It hurts to breastfeed my baby?
• It may pull a bit when first starting to breastfeed but
breastfeeding should not hurt.
• If it does hurt, mom should continue to breastfeed and seek
help from Nurse or Lactation Consultant immediately
• I smoke and am not ready to quit?
• It is best not to smoke while breastfeeding, but even if mom
does smoke, breastfeeding is still the best choice for baby
Is Baby Getting Enough?
The best way to know if baby is getting
enough is if he is growing well
• Be sure to have baby’s nurse follow
his weight regularly
What About Formula?
• Iron fortified infant formula is the only adequate
alternative to breastmilk
• It is important to know that there are health risks for
baby associated with formula:
•Ear infections
•Chest infections
•Diarrhea
•Asthma
•Leukemia
•SIDS
•Allergies
•Celiac disease
•Ulcerative colitis and Chrone’s
•Lower IQ and cognitive
development
•Obesity in childhood and
adulthood
•Infection from food born
illness (E.Sakazaki)
•Improper preparation
Other milks
• Evaporated cows milk formula, cows milk, soy milk,
coffee whitener are not nutritionally complete and are
harmful to babies
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Low in iron
Cause intestinal bleeding
Iron deficiency anemia
Hard on the kidneys
Lacks essential fats
There are risks to mom as well
Not breastfeeding can increases mom’s risk of:
• Breast cancer
• Ovarian cancer
• Post-partum depression
• Endometrial cancer
• Osteoporosis
Breastfeeding and diabetes
Breastfeeding is particularly important for babies at risk
of diabetes
• Formula increases baby’s risk of developing type 1 and type
2 diabetes and becoming obese
Breastfeeding is particularly important for women with
gestational diabetes or pre-existing diabetes
• Prevent or delay the onset of type 2 diabetes
• Lower insulin requirement
• Better blood sugar control
How you can support breastfeeding
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Mention breastfeeding at every prenatal class
Show a video in the Health Centre reception area
Show a video at prenatal classes for moms and dads
Invite Elders to prenatal classes to talk breastfeeding
Invite breastfeeding mothers to prenatal classes
Buddy new moms up with other experienced moms
Talk to moms about the risks of infant formula
Run a postnatal group
Talk to moms about what to expect at the hospital
Do numerous and regular post-natal visits
WHO/UNICEF’s Baby Friendly Initiative
The baby friendly initiative was established in 1991 to
promote, protect, and support the starting and
continuation of breastfeeding
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Have a written breastfeeding policy
Train all health care providers
Inform pregnant moms about the benefits & management
Support mothers to establish and maintain BF for 6 months
Encourage BF beyond 6 months
Provide a welcome atmosphere for BF families
Promote collaboration between health care providers and
breastfeeding support groups
Where Can Moms go for Help?
Here are some helpful resources you can direct mom to
if she needs help or support:
• Local Canadian Prenatal Nutrition Program (CPNP)
• LaLeche League Canada
• Visit: http://www.lllc.ca/
• Or call:
• Edmonton: 780-478-0507
• Calgary: 403-242-0277
• Red Deer: 403-348-1829
• Lethbridge: 403-331-1003
• LaLeche League International
• http://www.llli.org/
Where Can Moms go for Help?
Alberta Health Link
• Edmonton: 780-403-LINK (5465)
• Calgary: 403-943-LINK (5465)
• Toll-Free: 1-866-408-LINK (5465)
Non-Insured Health Benefits covers the cost of seeing a
lactation consultant or attending a breastfeeding
clinic
What Should Mom Eat When Breastfeeding?
Mom’s should eat a healthy, balanced diet
based on Eating Well with Canada’s Food Guide
First Nations, Inuit and Métis version
Breastfeeding increases a woman’s nutrition
needs
•Breastfeeding mom’s should eat an extra 1-2 Food
Guide servings every day to meet these needs
•For example: one cup (250 ml) milk and ½ cup mixed
berries
What About Prenatal Vitamins When
Breastfeeding?
Breastfeeding moms should also keep taking prenatal
multi-vitamins to make sure they are getting enough
nutrition
Getting Dad Involved
Even though only mom can breastfeed baby, dad can
play a very important role in feeding baby. Dad can:
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Attend birthing, breastfeeding, and parenting classes
Help with household chores
Bring baby to mom for feeding
Bring mom snacks and water while breastfeeding
Bond with baby by bathing, changing diapers, and playing
with him
• Skin-to-skin contact
• Bottle feed baby mom’s breast milk while mom is away
One of the most important things dad can do is simply
support and encourage mom in her choice to
breastfeed!
Our Story Continued
When Nicole comes to the health centre for your advice
because she isn’t sure if she wants to breastfeed or
not, what do you do to encourage her to breast feed?
A. Tell her that breastfeeding is the best way, and
you’re not sure why she is even thinking about using
a formula.
OR
B. Explain to her why breastfeeding is the best way to
feed her baby, and talk to her about why she wants to
use a formula instead.
What Would You Do?
If you said:
A. Nicole feels like you aren’t listening to her concerns,
and feels like she is being judged for not wanting to
breastfeed her baby. After this appointment she
never comes back to the clinic.
What Would You Do?
If you said:
A. Nicole feels like you aren’t listening to her concerns,
and feels like she is being judged for not wanting to
breastfeed her baby. After this appointment she
never comes back to the clinic.
What Would You Do?
I you said:
B. Nicole explains that she has heard some moms can’t
make enough milk for their babies, and Nicole
worries this will happen to her too. She also worries
that breastfeeding will be painful and uncomfortable.
You explain to her all of the benefits of breastfeeding
and you clear up some common false ideas about
breastfeeding. Nicole decides that she will give
breast feeding a try!
What Would You Do?
I you said:
B. Nicole explains that she has heard some moms can’t
make enough milk for their babies, and Nicole
worries this will happen to her too. She also worries
that breastfeeding will be painful and uncomfortable.
You explain to her all of the benefits of breastfeeding
and you clear up some common false ideas about
breastfeeding. Nicole decides that she will give
breast feeding a try!
Remember… It is always mom’s (and dad’s) choice to
breastfeed or not. It is your job to teach her about the
different ways to feed her baby so that she can make
an informed decision.
Whatever she decides, she should not be judged, and
should be supported in her decision!
Our Story 6 Months Later
Nicole gave birth to a healthy baby boy and named him
Jason. With your help and the support of her family
and community, she breastfed Jason with no
problems. Jason is about to turn 6 months old, and
Nicole knows it is almost time to start feeding him
solid foods, but doesn’t know how to tell if he is ready
and worries about what foods to give him.
Feeding Your Baby from 6 Months and Up
At 6 months, baby is ready to learn to eat solid foods
At this age:
• Baby is hungrier
• Baby’s body is ready for solid foods
Why Wait Until 6 Months?
Before he is 6 months, baby is not ready for solid foods
because:
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His tummy isn’t ready to handle solid foods
He may be at greater risk for allergies if he eats solid foods
Baby is ready for solid foods if he:
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Is watching what others are eating
Is reaching for food
Can sit up on his own
Can hold his head up without help and turn it side to side
Seems hungry or is not as full after breastfeeding
No longer pushes his tongue out of mouth over and over when
foods other than liquids are given
Just because baby doesn’t have teeth doesn’t mean he
isn’t ready for foods!
Introducing Solid Foods
The first food baby should eat is an iron-rich food:
• Red meats (beef, elk, moose, venison, buffalo, etc)
• Chicken, turkey, and fish with no bones
• Iron-fortified infant cereals (rice cereal, oat cereal, wheat
cereal)
• Beans (kidney beans, lima beans, lentils, etc.)
• Egg yolk
Introducing Textures
Different textures are safe for baby at different ages.
From about 6-7 months, foods should be:
• Smooth
• Strained
• Pureed
• Mashed
From about 8-9 months, foods should be:
• Lumpy
• Grated
• Minced
• Diced
From about 9-12 months, foods should be:
• Soft
• Finely chopped
• Finger foods
• Dissolve or soften
easily in baby’s mouth
Introducing New Foods
Introduce one new food at a time, waiting 2-3 days
before introducing another new food
• This makes it easier to notice if baby shows any signs or
symptoms of food allergies
Go slowly when introducing new foods:
• You may have to offer some foods to baby many times
before he tries them
• It is important to be patient
• If baby does not want to try a food at first, try offering
it again a few days later
• Never force baby to eat
Healthy Food Choices for Baby
Once baby is eating a variety of foods every day, try to
include 3 to 4 food groups at each meal
Source: Feeding Baby Solid Foods From 6
to 12 Months of Age, Alberta Health and
Wellness
Choose Foods from all Four Food
Groups for Baby
Vegetables and Fruits:
• Examples: carrots, squash, yams, sweet potatoes, peas,
bananas, peaches, applesauce, canned vegetables and
fruits labelled “unsalted” and packed in water
• Start with pureed vegetables and fruits, moving to mashed,
then soft cooked vegetable pieces and soft cut up fruit.
Soft Cooked Vegetables
Grain Products:
• Start with an iron-fortified cereal (like rice, barley, oats,
wheat)
• Always feed baby cereal with a spoon, not in a bottle
• Start with a single grain cereal before feeding baby a
mixed grain cereal
• Progress to other grain products that are soft like cut-up
pasta, rice, couscous, unsweetened breakfast cereals, toast,
plain, unsalted crackers)
Cooked Whole
Grain Macaroni
Noodles
Milk and Alternatives:
• Breast milk is still the main food in the first year
• After baby has been introduced to a variety of iron-rich
foods, cereals, and vegetables and fruits, he can have plain
yogurt and cheese cut into small cubes or grated.
• Whole (homogenized, 3.25% milk fat) milk can be started
between 9 to 12 months old
Homogenized Milk
Plain, 2.5% Milk Fat
Yogurt
Breast Milk
Meats and Alternatives:
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Meat: chicken, wild meat, turkey, beef, lamb, pork, fish
Beans: kidney beans, chick peas, lentils
Egg yogs
Tofu
Nut butters: almond butter, sunflower seed butter, peanuts
Start with smooth, pureed meats, moving to minced and soft
meats, and then meats cut into small pieces.
Pureed Chicken
Minced Chicken
Chicken Cut Into
Small Pieces
Some foods are less healthy choices for baby:
Baby does not need sugar, salt, or added fats
These foods are not healthy choices for baby:
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Fried foods
Pickles, olives
Pop, sugary drinks
Canned soups
Candy
Chocolate
Ice cream
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Sweet desserts, jell-o
Cookies
Processed meats
Hot dogs
Sugary cereals
Gravy, butter, margarine,
salad dressings
• Coffee, tea
Some foods are choking hazards for baby:
• Baby should not have these foods
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Hard candies
Popcorn
Nuts and seeds
Raisins
Fish with bones
Chewing gum
Snacks made with skewers
• Some foods are choking hazards, but can be made
safe for baby to eat:
• Stringy or chewy foods (meat, long pasta, cheese toppings)
• Cut into small pieces for baby
• Smooth or rounds foods like grapes or cherries
• Cut into quarters and remove pits
• Hard foods like raw vegetables or fruit
• Cook to soften or grate into tiny pieces
• Long foods like wieners and hot dogs
• Cut into bite-sized pieces
Some foods can make baby sick:
• Baby shouldn’t eat honey until he is at least one year old
• This is because of the risk of botulism (a type of food borne
illness)
• To reduce the risk of allergies, baby shouldn’t eat egg white until
he is at least one year old
• Egg yolks are a good choice for baby to eat
Some foods can make it hard for baby to get enough
good nutrition:
• Baby shouldn’t have any milk other than breast milk or
formula until he is at least 9 months old
• After this, baby should have whole milk
• Skim, 1%, and 2% milk don’t have enough fat to meet
baby’s energy needs
• Baby doesn’t need water until he is at least 6 months old
If baby has these before he is ready, it can decrease
the amount of breast milk he drinks
Juice
Baby does not need juice
• Give baby whole vegetables and fruits instead of juice
• Water is best for baby after 6 months
• Juices have a lot of sugar and can cause cavities or baby
bottle syndrome
• Drinking juice means baby may be too full at meal times to
eat healthy foods
• If you do decide to give baby juice:
• Give unsweetened juice, dilute to ½ juice - ½ water
• Give less than ½ cup (125 ml) of juice a day
• Give baby juice in a cup, not in a bottle or sippy cup
How Much Should Baby Eat?
Things to remember:
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Breast milk is still baby’s main food throughout the first year
Breast feed baby before feeding him solid foods
Never force a baby to eat
Every baby is different!
• Some babies will be more interested in food than others,
and every baby will eat different amounts of food, and
their hunger can vary from day-to-day
How Much Should Baby Eat?
Offer small amounts of food to start with:
• Try 1 teaspoon (5 ml) of iron rich food once a day
• Slowly add more food as baby’s hunger increases
• Once baby is eating a variety of foods, he may eat from 1 to
5 tablespoons (15-75 ml) of each choice offered at a meal
As baby gets older, the number of meals he eats will
increase:
• At 6 to 8 months: offer 1 to 3 meals per day
• At 9 to 11 months: offer 2 to 3 meals per day and snacks
between meals
• At 12 months: offer 3 meals per day and snacks between
meals.
Source: Feeding Baby Solid Foods
From 6 to 12 Months of Age, Alberta
Health and Wellness
Is Baby Getting Enough?
The best way to tell if baby is getting enough after he
starts solid foods is still if he is growing well
• Baby’s weight should still be followed by a nurse
Is Baby Getting Enough?
Signs baby is hungry:
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Excited when put in high chair
Sucks or smacks lips
Opens mouth at sight of food
Puts hands/fist in mouth
Leans forward, reaches for food
Cries
Is Baby Getting Enough?
Signs baby is full:
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Turns head away from spoon
Closes mouth at sight of spoon
Covers mouth with hands
Fusses, cries
Falls asleep
It is important to remember that baby knows how much
to eat
• If baby is telling you he’s full, never force him to eat
Happy Mealtimes for a Happy Baby!
Here are some tips for successful mealtimes:
• Baby should enjoy meals at the same time as the rest of the
family
• Sharing family mealtimes with baby helps him learn that
mealtimes are a time for families to come together and share
• Sit face-to-face with baby and keep eye contact while you
feed him
• Let baby eat as quickly or slowly as he wants
• Let baby take the lead role when eating
• Wait for his mouth to open when you offer food
• Never force baby to eat
• Let baby make a mess as he explores new foods and learns
to feed himself
Be a Healthy Role Model!
Baby is just learning how and what to eat, and he is
learning from watching you!
• Baby wants to be just like you, so be positive about food and
make healthy food choices, and he will grow up to have a
healthy relationship with food
Food Safety Tips
• Wash your hands with warm, soapy water before
preparing baby’s food
• Clean all counters, tables, and cooking and storage
tools in your kitchen with hot water, soap, and a clean
cloth before and after preparing baby’s food
• Keep raw meat, fish, poultry, and eggs away from
other foods. Don’t use the same cutting board, knife,
dishes, or other tools for both raw foods and cooked
foods
• Make sure to cook food until it is very hot. Use a food
thermometer to be sure
Food Safety Tips
• Store foods in the refrigerator for 1 to 2 days
• Never leave food out of the fridge for more than an hour
• Never feed baby directly out of the storage container, put a
small amount of food in a bowl to feed baby
• Thaw foods in the fridge, microwave or in a sealed
container under cold water
• Do not leave foods on the counter to thaw
• Reheat food in the microwave or in a pot on the stove
• Always check the temperature of the food before feeding
• Microwave food using a glass plate or bowl rather than
plastic
What if Nicole came to you?
• Explain why breast feeding is important, and why it’s the best
way to feed baby
• Encourage her to breastfeed by talking some of the common
myths about breastfeeding
• Explain to her why it is important to avoid smoking, alcohol, and
illegal drugs while breastfeeding
• Explain how she can tell if baby Jason is getting enough,
whether he is breast feeding or eating solid foods
• Listen to her and support her in her decisions
What if Nicole came to you?
• Explain when and why baby should start eating solid
foods, and what foods to introduce first
• Explain what foods are and are not good choices for
baby
• Giver her some tips on how to create happy meal
times and foster Jason’s healthy relationship with
foods, and encourage her to be a healthy role model
• Provide her with information on food safety
Questions and
Discussion
Back to our questions from earlier…
1. What should a baby less than 6
months old eat?
A. Water, juice, milk, breast milk and
formula.
B. Breast milk or formula
C. Strained or pureed foods, breast
milk, and infant formula.
D. Table foods that the rest of the
family eats.
Questions Continued…
2. Which of these foods is safe for a baby to
eat?
A. Popcorn
B. Grapes cut into four pieces
C. Raisins
D. Honey
E. Peanuts
Questions Continued…
3. When should a baby start to eat solid foods?
A. 4 months
B. 6 months
C. 9 months
D. 12 months
Questions Continued…
4. I would feel comfortable teaching others in my
community about infant nutrition.
Disagree
1
2
3
4
5
Agree
Fax us your evaluation!!!!
780-495-7338