Regression - A Guide To The Developmental Stages

Chapter 13
Development - Feeding 0-1 Year

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Chapter Description: The first year of life is a time of more rapid growth and development than any other time of life. A baby usually doubles its birth weight within the first four months and triples birth weight by the first birthday. A 70-pound 10-year-old who did this would weigh 210 pounds at age 11.

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The first year of life is a time of more rapid growth and development than any other time of life. A baby usually doubles its birth weight within the first four months and triples birth weight by the first birthday. A 70-pound 10-year-old who did this would weigh 210 pounds at age 11.

For this amazing growth, the infant requires an adequate intake of calories and essential nutrients. Good nutrition alone will not guarantee normal development, but a loving environment is incomplete without proper feeding.

Your baby needs the same nutrients you do: protein, carbohydrate, fat, water, vitamins, and minerals. Over 40 different nutrients are needed by your baby for healthy growth and development.

Full-term babies are usually born with enough reserves of nutrients, especially water, to last the first few days. By the second or third day, your baby needs calories, water, and nutrients.

BIRTH TO 4 MONTHS

BREAST MILK OR FORMULA?

Although breastfeeding is best for most babies, this may not be possible for all families. Your baby’s nutritional needs will be safely and adequately supplied whether you choose to breastfeed or use commercial infant formula. The choice is yours. Each has its advantages and disadvantages, as shown in the chart below.

New mothers who want to return to work have often been able to combine breastfeeding with formula-feeding, especially after the first few weeks, when the milk supply has been well established.

The nursing mother usually needs an extra 500 kilocalories per day, along with 20 more grams of protein and 400 more milligrams of calcium. This can be supplied by adding a glass of milk, a slightly larger serving of meat, and an egg or a slice of bread. Drinking plenty of water will help provide the needed liquid.

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TABLE 1: BREASTFEEDING

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ADVANTAGES:

- Breast milk contains an optimum combination of nutrients for your baby.

- In the first few weeks your baby has little resistance to disease. Breast milk contains factors that help protect your baby from viruses and bacteria. (Even if you only breastfeed for two or three weeks, you may be helping your baby.)

- Breastfed infants have been shown to be protected from many gastrointestinal upsets and diarrhea.

DISADVANTAGES:

- Babies can receive harmful substances from a mother’s milk. Medications, alcohol, caffeine, pesticides, and lead can appear in breast milk. (However, mothers can easily limit their use of caffeine and alcohol and only use medication on the advice of their doctor.)

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TABLE 2: BOTTLE-FEEDING

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ADVANTAGES:

-Commercial formulas are sterile and safe when prepared properly.

DISADVANTAGES:

- Feeding your baby using commercial formula can cost 1/3 to 1/2 more than breastfeeding.

- It is easy to prop the bottle in the baby’s mouth while doing something else rather than give the baby the love and attention it needs.

- "Bottle-mouth" is a serious problem that can result when babies are routinely put to bed with a bottle. Baby may fall asleep with the bottle still in the mouth. Extensive tooth decay can result because there are natural sugars in the milk that dribble onto the baby’s teeth as she sleeps.

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FEEDING TIMES

The stomach of a newborn infant has a capacity of less than 1/4 cup. At 12 months the baby’s stomach will be able to hold about 1 cup or 8 ounces. Because babies can eat very little at one time, they eat every two or three hours. Babies get hungry at irregular times during the first few weeks. As they grow, they will become more regular and will be able to go longer between feedings.

Feeding-on-demand has become more popular although some parents still prefer to set up regular schedules that are convenient for them and their babies. Each family must choose what’s best for them.

WATER

Just like older children and adults, babies need water as well as milk. These daily fluids are necessary for the formation of urine to help remove wastes from the body.

Babies need about 1/3 cup of fluid per pound of body weight up to 18 pounds. At heavier weights, fluid needs are smaller. A 12 pound baby, for example, needs about 4 cups (1 quart) of fluid a day. Most of this should come from breast milk or formula.

Many babies may want additional water, especially in hot weather. If your baby cries soon after eating and you can discover no reason, try feeding a little water in a clean bottle (but make sure you boil then cool the water first). Be careful not to give so much water that the baby fails to get

enough milk.

VITAMIN AND MINERAL SUPPLEMENTS

Breast milk and commercial formulas contain adequate amounts of vitamins and minerals for normal infants. Although breast milk and formula contain very small amounts of vitamin C, it is enough to meet a baby’s needs. Giving the baby extra vitamins and minerals is probably unnecessary under normal conditions and can be dangerous if excessive amounts are given.

Generally the vitamins and minerals in breast milk are in forms that are especially well absorbed and used by an infant. For example, there is little iron in breast milk, but it is present in a very usable form. In addition, a full-term baby from a well-nourished mother is born with iron stores large enough to last nearly six months.

Fluoride is known to be important for development of healthy teeth, but little research has been done to show how important fluoride is in the first six months of life. Formula-fed babies will get adequate fluoride from the water (if it’s fluoride-treated) that is mixed with the formula. In areas where the water is not fluoride-treated, the American Academy of Pediatrics recommends a fluoride supplement of 0.25 mg per day for both breastfed and bottle-fed babies. Supplementation should begin two weeks after birth.

COLIC

Many babies go through stages of inconsolable crying after feeding. Some may even vomit. Colic may be a result of something baby has eaten or something mother has eaten that appears in her milk. Although most babies get fussy or appear colicky at times, it may be worth seeing if some type of food is causing it. Also, practice some comforting techniques, such as rocking your baby or talking or singing softly to her.

LOVING ENVIRONMENT

Babies grow well in a variety of situations. It is most important for parents to make decisions that are right for the family. Whichever feeding method is chosen, the baby needs to be fed in an atmosphere of love. The baby should be nestled close, touched, rocked, and talked to during feeding times. Without this tender physical contact, babies often fail to grow and develop. Although friends and relatives will share their experiences, the decision of how and when to feed your baby will depend on your baby’s and your own needs. Even small babies can sense when a parent is tense rather than relaxed.

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TABLE 3: 0-4 MONTHS

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FOODS GOOD FOR BABY:

Breast milk

Formula

FOODS NOT GOOD FOR BABY:

Cow’s milk

Solid food

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4-6 MONTHS

Baby’s main food will continue to be breast milk or formula.

Early experiences with food may have an impact on later eating habits. Learning to accept a variety of flavors and textures is important. Research shows that flavors from the food mother has eaten appear in her milk. A baby exposed early to a flavor that appears in it’s mother’s milk will probably continue to enjoy that flavor when it appears in food. One study suggests that breastfed infants are more likely to try new flavors later in life. However, parents should be careful not to impose their taste preferences on the baby.

INTRODUCING SOLID FOODS

For several decades parents were told to introduce solid foods early. In some cases babies were started on cereals as early as three weeks after birth. The current recommendation is to wait until the baby is 4 to 6 months old. Here are some reasons why waiting is advised:

• Until the age of three months, babies have a natural reflex to push outward with the tongue. This is useful in sucking but prevents a baby from moving solid foods from the front of the mouth backward for swallowing. Around age 4 to 6 months, babies gain control of the head and can sit upright more easily. Both of these developmental milestones show that a

baby is ready to eat from a spoon.

• A baby does not need the nutrients in solid foods before age 4 to 6 months. By this time the baby will have doubled its birth weight and will be becoming hungrier. The baby will need more food.

• Some pediatricians and nutritionists believe that early introduction of solid foods teaches a baby to overeat. It is easy for parents to urge babies to eat more than they really want; most babies do not know how to resist.

Well-intentioned grandparents may be placing pressure on you to introduce solid foods early. It can help them to know the reasons for waiting and that pediatricians and nutritionists agree.

HOW TO INTRODUCE SOLID FOODS

1. Go slowly. One or two spoonfuls will be enough.

2. Introduce only one new food at a time. Give the baby a few days to get used to it before adding another. This approach will make it easier to identify problem foods if allergies are present.

3. Start with rice cereals. Some pediatricians recommend iron-fortified infant rice cereal mixed with breast milk or formula as a first solid food. This gives your baby a good source of iron, as well as a good distribution of calories between carbohydrates, protein, and fat. Rice is less likely to cause allergic reactions than other grains.

4. Touch is still important. Your baby may need reassuring when you first introduce solid foods. Hold your baby to let him know that this new experience is all right.

MICROWAVE HEATING

Care must be taken when using a microwave oven to heat baby food. Microwaves can heat a food unevenly, forming hot-spots. One spoonful of the food may be cold, yet the next spoonful could burn the baby’s mouth. Babies accept room temperature and cold food, so warming is not really necessary. Most health and child care professionals recommend against using a microwave oven to warm baby food. If you do warm in a microwave oven, use extreme caution, and stir the food well before feeding baby to ensure the food is at an even temperature.

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TABLE 4: 4-6 MONTHS

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FOODS GOOD FOR BABY:

Breast milk

Formula

Water

Iron-fortified cereals

FOODS NOT GOOD FOR BABY:

Cow’s milk

Honey or sugar

Eggs

Meat

Powdered soft drink mix

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6-9 MONTHS

ADDING SOLID FOODS

Here is a general guide for adding solid foods:

Cereals: 4-6 months

Vegetables: 7 months

Fruits: 8 months

Meats: 10 months

Cheese and Yogurt: 10-12 months

Egg yolks: 10 months

Vegetables and fruits follow cereals at around 7 months. These provide vitamins A and C. If your baby starts to show some signs of chewing, you may want to give her some mashed vegetables or thick cereal to work on to improve chewing skills.

An 8- to 9-month baby will have one or two teeth and can probably handle lumpy foods. If you have not begun to do so, begin now to offer the baby foods prepared for the family. Go easy. Start with easy-to-mash foods such as cooked potato or carrot, banana, or canned fruits.

If any nutrient is going to be in short supply, it is iron. Many pediatricians recognize this problem and recommend iron supplements. Iron-fortified cereals are especially good sources of iron.

Infants do not need added sugar or salt. Babies have a strong sense of taste and do not need the flavor enhancers favored by adults.

FINGER FOODS

Once your baby begins to be able to take hold of things, you may offer finger foods that will help develop coordination. (At this stage, a finger food is anything soft that holds together long enough for baby to get it from plate to mouth.) This may be very messy at first, but as baby’s skills develop, the mess decreases.

TEETHING

Rusks make a good finger food when baby starts teething. You can make a hard teething bread by baking any bread in a very low (150-200 degrees F) oven for 15 to 20 minutes. Also, cold fruit mixtures (pureed canned or soft fruit) are very refreshing to baby’s gums during teething.

SOME THINGS TO WATCH

Honey is not recommended for infants under the age of 12 months. Honey may carry botulism spores. The digestive system of children and adults can destroy these harmful spores but a baby cannot. The spores may remain active in the stomach and produce their deadly toxin. Even baking may not destroy the spores that occur in honey. Not all honey contains botulism spores, but because babies do not need honey, there is no reason to take the risk.

Beets and spinach have high concentrations of naturally-occurring nitrates that can reduce the ability of the baby’s hemoglobin to transport oxygen. These foods should be used in moderation or not at all until the baby reaches his first birthday.

MILK FOR THE OLDER BABY

Until the age of six months, babies need either breast milk or commercial formula as their main source of nutrients even though babies will begin to eat other foods. Babies and parents who are satisfied with breast milk or commercial formula may continue to use either one until 12 months. The use of breast milk or commercial formula until 12 months is recommended by the American Academy of Pediatrics. Cow’s milk should not be used until after 12 months.

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TABLE 5: 6-9 MONTHS

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FOODS GOOD FOR BABY:

Breast milk, formula, water

Cereal

Unsalted mashed vegetables

Unsweetened fruits & juices

Finger foods

Unsalted crackers

Rusks

FOODS NOT GOOD FOR BABY:

Cow’s milk

Honey or sugar

Eggs

Meat

Powdered soft drink mix

Soft drinks

Salt

Sweets

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10-12 MONTHS

ADDING MEAT, EGGS, AND CHEESE

By 10 months your baby is probably eating and enjoying a variety of cereals, vegetables, and fruits. Now it is time to introduce meats. Although meat is a good source of protein, most babies get plenty of protein from milk. The most important contribution meat can make to a baby’s diet is iron.

Around 10 to 12 months, eggs can be added to the diet. Although egg yolks can be added to the diet around 10 months, egg whites or whole eggs should not be given to your baby until the end of the first year. This is because egg whites often cause allergic reactions if introduced too early.

Cheese and yogurt in small amounts may be added to the diet now.

MORE FINGER FOODS

Babies are now ready for more finger foods. Good choices are banana slices, dry toast, ready-to-eat unsweetened cereals, crackers, meatballs, and small cubes of cheese.

To protect your baby from the danger of choking, offer only foods that are soft or will soften in the mouth. Avoid raw carrots (unless they are grated), nuts, popcorn, unpeeled apples, and other hard foods.

EATING ROUTINE

By this age, a baby’s eating behavior will have settled down into a fairly predictable routine. The baby will still need to eat more frequently than other family members, with mid-morning, mid-afternoon, and evening snacks as well as regular meals.

DRINKING FROM A CUP

At around 10 months the baby may begin to drink from a cup with an adult helping to hold the cup. Around 12 months of age most babies can handle a cup alone. Milk, water, and juice may all be given in a cup instead of a bottle. Do not expect the baby to take much liquid from the cup at first. Offer just 1 or 2 ounces (1/8 cup), and gradually increase the amount.

Some babies are ready to give up nursing or the bottle around this age. Many will want to continue to nurse or have a bottle for a few more months.

WEANING

Babies are generally weaned by the end of the first year. As a baby learns to drink more milk from the cup, bottles or breast feedings can be discontinued gradually.

A baby who continues to drink large amounts of milk may not be eating enough solid foods to meet his or her increasing nutritional needs. By the age of 1 year a baby should be eating a variety of foods and drinking only about 2 cups of milk a day.

SOME THINGS TO WATCH

RAW EGGS AND RAW MILK are not appropriate for babies. These foods may be

sources of infections that can be dangerous to infants.

NO-NO FOODS for babies include desserts, carbonated beverages, caffeine-containing beverages, and candy. They provide calories with few nutrients. If they take the place of nutritious foods and beverages, they can be harmful. Powered soft drink mixes sweetened with sugar or NutraSweet(TM) are not good for babies. NutraSweet(TM) is considered safe in moderate amounts for children and adults, but safety for babies is not yet fully established. Besides, babies need calories for growth and development.

National Network for Child Care - NNCC. Part of CYFERNET, the National Extension Service Children Youth and Family Educational Research Network. Permission is granted to reproduce these materials in whole or in part for educational purposes only (not for profit beyond the cost of reproduction) provided that the author and Network receive acknowledgment and this notice is included:

Reprinted with permission from the National Network for Child Care - NNCC. Schafer, E., & Fradgley, N.K. (1995). *Feeding your baby (Pm 862)*. Ames, IA: Iowa State University Extension.

 

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