Infant Nutrition Presentation

Infant Nutrition Presentation

A few questions before we start • 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… • I would feel comfortable teaching others in my community about infant nutrition. • Disagree 1 2 3 4 5 Agree

After this session, you should be able to: • 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 • 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 • 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 • 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: • 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? • 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: • 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: • 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 • From about 8-9 months, foods should be: • Lumpy • Grated • From about 9-12 months, foods should be: • Soft • Finely chopped • Finger foods • Pureed • Mashed • Minced • Diced • 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 Plain, 2.5% Milk Fat Yogurt Homogenized Milk Breast Milk

Meats and Alternatives: • 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. Chicken Cut Into Small Pieces Minced Chicken Pureed Chicken

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: • Sweet desserts, jell-o • Cookies • Processed meats • Hot dogs • Sugary cereals • Gravy, butter, margarine, • salad dressings • Coffee, tea • Fried foods • Pickles, olives • Pop, sugary drinks • Canned soups • Candy • Chocolate • Ice cream

Some foods are choking hazards for baby: • Baby should not have these foods • Hard candies • Popcorn • Nuts and seeds • Raisins • Fish with bones • Chewing gum • Snacks made with skewers

Infant Nutrition Presentation