7 Things your paediatric nutritionist wants you to know about your baby's diet
Baby nutrition is confusing. Some people claim that breast milk or formula provides infants with all of the nutrients they need and anything else is just for fun. Others warn that babies need a well-balanced diet of fruit, vegetables, protein and carbohydrates from the moment they start solids. So which is true? What, how much and when does a baby really need to eat to be healthy? I asked the experts to set the record straight.
1. Food before one is NOT just for fun
If you're the parent of a baby, you've probably heard the "food before one is just for fun" rhyme about a thousand times. However, while the experts agree that food should be a fun experience for babies, they stress that after the age of six months breast milk and formula alone are no longer sufficient.
"While babies should be encouraged to play and have fun with their food, it's important that they're provided with essential nutrients (foods) plus a variety of tastes and textures that will set them up for their lifelong food journey ahead," explains accredited nutritionist and founder of Tracie Talks Health, Tracie Hyam Connor.
"The stages of going from exclusive breast milk or formula to eating family foods at about one year of age is (sic) very important for setting the stage for a positive feeding environment. It isn't just for fun," adds Family Food Works paediatric dietician, Eve Reed. "From a nutrition point of view, at about six months of age, infants need an additional source of iron apart from milk (breast or formula). They need to be offered iron-rich solids from this age."
She adds that babies also need to eat food in order to develop the correct eating skills.
2. But it should be fun
While food is nutritionally and physiologically important that doesn't mean you should approach mealtimes with the rigour of boot camp. The most important lesson for babies, according to the experts, is that eating is fun.
Paediatric dietician and registered nutritionist, Judy More, specialises in child nutrition and stresses that making meals sociable and happy for babies, rather than trying to coerce them to eat, should be the key focus.
"We want to make the experimentation with foods an exciting and enjoyable experience, rather than a stressful one, so yes, remember to keep it fun," agrees accredited practising dietician from Health Victory Nutrition Experts, Katherine Baqleh, adding that force-feeding sets up a negative atmosphere which makes consequent meals even harder.
Expanding on the point, Reed explains that mealtimes shouldn't involve a power play where the parent is dominant and the baby is merely a passive recipient.
"It is very important that a positive feeding relationship between the parent and child is established in the first year of life," she says. "In the first six months or so the parent is responsible for deciding what to feed the infant (breastmilk or formula) and the baby decides when and how much to eat. As the infant transitions to family food and from then on, the parent is responsible for the what, when and where of feeding and the child for the how much and whether to eat. When parents follow this division of responsibility in feeding, children learn to be competent eaters."
3. Don't stress the quantity
Parents tend to get hung up about the quantity of the food their babies eat. This makes sense. It's a measurable, tangible thing that remains somewhat in your control. So what's wrong with that?
Well, according to More, it can create unnecessary stress for parents while not being conducive to raising a well-nourished baby.
"I think the problem of most mothers is that they get hung up on the quantity of food that their babies eat. What's more important is that a baby experiences a wide range of tastes and textures," she says, adding that weaning should be viewed as a learning experience rather than purely from a quantitative standpoint.
"There are no hard and fast rules about how much babies eat or drink; it's about allowing them to eat to their appetite," she says.
Babies vary how much they eat based on the development of their feeding skills, their needs, their mood and even how they're feeling so there's no need to worry even if they don't appear to be getting much.
"If they're not feeling well or teething or they've got pain, they won't eat as well. Then, when they feel better, they'll increase their intake again, so it's about trusting your baby," she clarifies.
Reed agrees, reassuring parents that: "If you offer three to four different foods at each meal, a baby will eat the right amount."
4. Instead focus on quality
Providing quality and a balanced diet is a far better place to direct your energies because that's where the experts say it counts.
A variety of textures and tastes is important, says Baqleh, and should progress and grow with the baby.
"Textures should move from puréed to lumpy to normal by 12 months," she says. "Start with a few mouthfuls one to two times a day after breastfeeds then increase it."
Aside from textures, babies should also receive a good, balanced variety of nutrients. But what does that mean exactly?
"You need to include all of the four food groups," says More. "Once the baby is on three meals a day, you want to make sure that they are having meats, fish, eggs, pulses or nut butters for two of the meals, a starchy food like potatoes, rice, pasta, quinoa or couscous at each meal, fruit and vegetables at each meal and then some dairy products, like cheese or yoghurt."
The reason for this, Reed explains, is that the iron found in meat and iron-fortified cereals is important for brain development, immunity and energy. Zinc, also found in those foods, helps with growth, while fruit, vegetables, grain foods and dairy take care of all the other vitamins and minerals (except vitamin D).
More adds that, in conjunction with a balanced diet, U.K. infants under one — particularly if they are breastfeeding —should also receive a vitamin D supplement. "This is particularly important if the mother did not take vitamin D during her pregnancy," she says.
If parents choose to give their babies pre-made baby food they should pay attention to what's inside, adds Hyam Connor.
"Ingredients are always listed in descending order (i.e. largest to smallest), therefore opt for baby foods that list the first ingredients as vegetables, fruits or meats. Avoid added sugars [including those in fruit juice], salts and preservatives or any ingredients listed as a number (i.e. chemical additives)," she says.
When preparing their own purées or finger foods, Hyam Connor advises parents not to add sugar or salt and to avoid honey before their baby reaches 12 months of age.
5. Read the baby's cues
Sorry mum but your baby knows best. Even though it can be hard to relinquish control, especially if you're worried that your baby is not eating enough, babies really do know what they're doing.
"At every age, a child needs to determine the amount of food eaten at each meal," says Reed. "A child's appetite will vary from meal to meal and the carer needs to follow the child's cues. Usually children make clear signs when they have had enough to eat."
"Be alert and sensitive to their cues of fullness such as turning away, becoming frustrated, spitting food out," adds Baqleh. If the baby says stop then stop.
But what if your baby didn't finish his bottle or barely touched her plate?
"Stop feeding and wait until the next meal," says Reed. "All healthy babies will eat the amount of food they need over the day."
If you are a bit concerned and would like to increase your child's chances of eating more a good way is to give your baby a bit of autonomy at mealtime.
"Put three or four foods in front of the child and let them decide what to eat from what is on offer," advises Reed.
According to More, it's also possible that, on some occasions, babies might not be quite finished but may need to take a little break. She suggests parents who suspect their baby isn't full give their little one a short break and then offer a second course. However this needs to be done responsively so, if the baby is still uninterested, it means they're done.
6. Don't take it slow
Often parents get told to introduce food slowly to allow for signs of allergies to develop. However, while this is good practice in the case of typically allergenic foods, you don't have to wait it out with the rest.
"You don't need to offer all the firsts one at a time. You don't need to be careful about things like potato, rice, vegetables and fruits," says More. "The foods you need to offer once are fish, nut butters or egg or something with soya in it and milk, if you've been breastfeeding, because formula-fed babies would have already shown a reaction to milk."
"Different cultures introduce different foods at varying ages and, providing that nutritional requirements are met, there are no adverse consequences," adds Baqleh. "First solid foods should be iron-containing foods, including iron-enriched infant cereals, puréed meat, poultry and fish, cooked tofu and legumes. There are no other recommendations for the order of introducing foods and slow introduction of solids is not necessary."
Even with the scary foods it's better to bite the bullet and move fast. Hyam Connor says that fearing the reaction and delaying the introduction of typical allergen foods, such as eggs and nuts, is one of the biggest mistakes that parents make.
While parents should take precautions when introducing these foods, by offering them one a time, waiting a couple of days in-between and watching for reactions, the experts say earlier is better than later.
If you're particularly nervous More suggests putting a little of the food (such as peanut butter) on your baby's leg or arm to see if it reddens. If that doesn't initiate a response you can then rub a bit on your baby's lip to see if it swells. If it doesn't, but you're still worried, you can offer a tiny amount to try.
7. Don't give up!
Babies are people too and sometimes it takes them a little longer to warm up to a particular food. They need to think about it a bit and get used to new flavours and textures — it is their first time after all — so be patient and don't give up.
"Babies take a while to learn to like new tastes so, if they do seem to reject the food, it's important that you keep re-offering it to give them the opportunity to learn to like it," says More. "The younger the baby is, the quicker they learn to like it, but at any age it's important that mothers don't stop offering the food."
"Persistence and offering a food up to 20 times is important," Baqleh concurs. "Babies enjoy exploring and playing with their foods and if they're fussy or suspicious over meals, it is normal. Make feeding time fun. If they are not keen on a food, leave it for a week then try again."
Presentation is key and babies are clever, she adds so, if you're not having much luck, try to disguise previously-refused ingredients. But no matter what you do — keep on keeping on.
An additional note:
While most babies are absolutely fine, if you are feeling worried about your baby not gaining enough or gaining too much weight, or simply feeling overwhelmed, the help is out there.
"Parents have so much on their plate with a newborn and growing baby, and they shouldn’t have to sit in silence when help is needed. If you have concerns about the health and welfare of yourself or your baby at any time, speak with your accredited nutritionist, health nurse or paediatrician," says Hyam Connor.