Little Sapling Toys Blog

Nutrition in the First Year of Life for the Breastfed Baby

Guest Post by Laurel Kimball, RDN, LDN

Breastfeeding baby.

Choosing to breastfeed your little one may be one of the first decisions you make regarding the health and nutrition of your baby. It is a wonderful choice—the benefits are extensive for you and your little one. But the decision making doesn’t end there. There is still more to know about feeding an infant, and it can be especially confusing when mom is telling you one thing and sister another.  However, you can be confident you are making the best nutritional choices for your baby, by reading this blog with the most current recommendations and information on the basics of nutrition for your baby during their first year of life.

Nutrients to Consider

The nutritional and health advantages of human milk and breastfeeding are numerous. Your breast milk gives your baby the most superior nutrition available. For the first 4-6 months of life, it will be the baby’s primary source of nourishment. There are, however, a few vitamin of concern recommended for supplementation during this time, including vitamin K and D.

Vitamin K is given as a single dose at the time of birth. It protects infants from hemorrhagic disease.

Vitamin D: The American Academy of Pediatrics (AAP) recommends supplementing all newborn infants with 400 IU vitamin D per day from the first few days of life until the baby transitions to drinking vitamin-D fortified milk (11-12 months of life). Vitamin D protects against Rickets, infection, and is important for the utilization of calcium in the body for the development of bone.

The first transition in the infant’s diet begins around 4-6 months of life. At this time, solid foods and infant cereals should be introduced for nutritional and developmental purposes. Nutrients of concern at this time for exclusively breastfed infants are iron, zinc, and fluoride, and also to be considered is DHA.

Iron: Full term infants usually have adequate iron stores until 6 months of life, but then require additional iron (11 mg per day until 12 months of life). This is met most often through the introduction of iron-fortified infant cereals and meats. Maintaining adequate iron status will decrease the risk of the baby developing anemia and will protect against cognitive and motor skill impairments.

Zinc: The zinc present in breastmilk is not sufficient to meet the needs of the baby after 6 months of life. 3 mg per day is recommended at this time, and like iron is met through fortified infant cereals and meats. Zinc is vital for normal growth and development, a proper sense of taste and smell, and plays a role in immune and cellular functions.

Fluoride: The AAP recommends daily supplements of 0.25 mg fluoride for infants over 6 months of age who live in areas where the water supply contains less than 0.3 ppm of fluoride, and/or are at high risk developing tooth decay.

DHA: Docosahexaenoic acid is an omega-3 fatty acid important for brain and eye development. Sources for infants include salmon, tuna, and fortified eggs. Current recommendations are 10-12 mg per kilogram of body weight.

Feeding baby nutritionally.

Getting Started with Solids

Introducing solids into your infant’s diet is an exciting, and for the most part, enjoyable, a milestone. These complimentary foods will expose your infant to a variety of flavors and food textures that will influence life-long eating habits. There is no nutritional benefit to adding solids to your baby’s diet before 4 months of age, and the latest recommendations from the AAP, the World Health Organization, and the United Nations Children’s Fund encourage waiting until closer to 6 months of age.

Since all infants develop at different rates, it is important for you to look for signs of readiness in your baby and not get caught up in comparing your baby’s progression with those of another baby. Physical signs of readiness include baby being able to sit independently and maintain balance while using hands to reach and grasp for objects. They have good head and neck control. It is equally important to look out for the psychological signs of readiness. These are expressions of feelings, for example, an infant may indicate hunger by leaning toward the food and opening their mouth, or leaning back and turning away from the food to show disinterest or satiety. Respecting these expressions can reduce the anxiety that sometimes accompanies feeding a baby and will also prevent against overfeeding. It will also aid in building the foundation for self-regulation, which is very important for lowering the risk of obesity.

First foods, for nutritional reasons already discussed, are fortified infant cereals thinned to a semi-liquid consistency with breast milk. These should be introduced on a small spoon and not through a bottle or sippy cup.  Pureed meats are another good first food, along with pureed vegetables and fruits. The most current AAP recommendations state that there is no need to wait a long time between introducing new foods, that 2 days is sufficient. Once a variety of single ingredient foods have been introduced and tolerated, a combination of these foods can be offered. Your baby may still have a sensitive gag reflex until about the age of 7 to 9 months, so don’t let excessive spit up alarm you. Choking, however, may indicate your baby is not quite ready for the transition inconsistency.

The introduction of solid foods does not mean the consumption of breast milk becomes any less important. The number of feedings at the breast will slowly decrease as baby’s consumption of solid foods increases between 6 to 12 months of life, but breast milk will still be the primary source of your infant’s nutrition and calories. So continue to breastfeed your baby!

Additional water is not necessary during the first year of life. Even in hot months, a baby will obtain adequate amounts of free water from breast milk. Consult your doctor on additional fluid intake if your baby experiences severe vomiting or diarrhea. The AAP strongly encourages the avoidance of juices in the first 6 months of life. Never add honey, sugar, or salt to baby food in order to entice your baby into eating it. Recent research shows that avoidance or late introduction to common allergenic foods (such as dairy products or foods made from peanuts/other nuts) may actually increase your baby’s risk for developing food allergies rather than preventing them. Yogurt can be introduced as early as 6 months, cheese around 8 months, and cow’s milk around 11-12 months of life. Peanut-containing products, eggs (yolk and white), and citrus fruits can be introduced into baby’s diet, even high-risk infants, between 4 to 11 months, but shouldn’t be the first solid foods a baby gets.

Baby in highchair eating a carrot.

Feeding Progression

Time moves quickly, so don’t get too comfortable with the feeding stage your baby is in. Before you know it, it will be time to move onto the next step. Yes, babies do progress at different rates, but it is important to keep moving forward. Here is a general outline for age appropriate food consistencies and progression.

4-6 months: Progress from a thinned, watery texture to a pureed, smooth texture.

6-8 months: Progress from pureed texture to mashed, lumpy texture. Start practicing self-feeding skills with soft finger foods.

8-10 months: Progress from mashed, lumpy foods to soft, chopped finger foods. Just because a baby doesn’t have all their teeth doesn’t mean they can’t chew! Don’t be afraid of messes, let your baby start to play with the spoon and explore their foods. Let baby start to learn to drink from a cup by using a training cup.

10-12 months: Progress to eating mainly chopped table foods and eating with the family. Encourage self-feeding, even if it means a big mess to clean up afterward. Continue to offer a wide variety of foods. Repeated exposure will lead greater food acceptance.

Taking care of baby’s nutritional needs and leading their progression during their first year of life can be a roller coaster. Don’t get discouraged; just do your best. Try to be patient when things don’t go as planned and be sure to celebrate the victories. Together, you and baby can make the whole eating experience into a fun adventure.

I am NOT sorry

 

Grocery store shopping with two babies.

Dear woman in the grocery store,

I had a life-changing realization after our short interaction.  I was having a bad day with my two little chickens (i.e. my 5-year-old and 8 month old), tantrums, seemingly never ending screaming, throwing breakfast, and resistance to doing anything I wanted from my 5-year-old and wanting to be held all the time from my 8-month-old.  My older one had woken up early (like 3 am early).  I felt like a zombie but I steeled myself for my busy day.  I had so much to get done and by 8 am my patience was already wearing thin.  Whoa, was I in for it.  I had to sit in the bathroom chanting internally, I can do this... I can do this...  Show no fear, they smell fear.  

Finally, by some miracle, I was able to get out the door to do some much-needed grocery shopping, which I usually pawn off to my husband because shopping with my little darlings sometimes feels like wrangling cattle.  I nervously pulled up to the grocery store and went to take out my older daughter out of the car and discovered that she didn't have any shoes on and they were not to be found anywhere in the car.  

How did she get her firmly strapped on sandals off so fast before we left? How could I have overlooked her bare tootsies as I buckled her in?  It was the last thing I did before I left.  UGH...  With the hot pavement, walking wasn't an option so I grabbed her, my enormous purse/diaper bag in one arm and my baby carrier my other arm and wobbled into the store grunting with effort until I was able to load them in the cart.  Let's just say I barely made it into the store because there was not one cart in the parking lot I could just grab.  It was just not my day.

Just imagine me trying to shop as my baby is screaming and I am haphazardly trying to get her to take a bottle, all while chasing after the older one who is running everywhere inside the store with her bare feet.  My hair is in disarray and I am pleading with my 5-year-old to stop, not touch that, don't knock that over, etc.  To anyone seeing me I must have looked like "one of those moms."  I am used to looking like "one of those moms."  You know, the ones where you think "geez get some control over your kid" or that my sweet daughter is a brat and I am an indulgent pushover.  

I pushed those negative thoughts from my mind.  No one really cares or takes the time to notice me and my seemingly unruly girlie and screaming baby who wants to be held NOW.  I was wrong.  I discovered people were noticing me and that judgmental inner dialog was re-affirmed that day as I saw a woman approaching me.

She looked to be in her mid-fifties, thin, and fashionable.  Before she said anything I hoped she was coming to lend me a hand or give me a kind word like, "I have been there, keep your chin up."  But no.  As she got closer I saw her lips pursed into a thin line and I knew then that this wasn't going to be good.  

She abruptly said, "You must be a horrible mother, your daughter is going crazy and isn't even wearing shoes."  

The next few moments felt like an eternity.  Did that really just happen? What do I say to that?  I felt rage.  Blinding, seeing red, rage.  She had no idea.  I wanted to yell some very choice words at her.  Who was she to judge me as a mother and my daughter after seeing us only in this inopportune moment?

As I sat there and debated all my options for a curt response, almost involuntarily I found myself saying, "Sorry, we are having a tough day."  To which she huffed and walked away.  Immediately, wished I could take back every syllable of those words.  

I have thought long and hard about what I would say if I could re-live that moment because I am NOT sorry. I am NOT sorry that my daughter's behavior bothered your peaceful shopping experience.  That looking at me and my little family bothered you enough that you thought what you said and did was ok. I am NOT sorry that my five-year-old, though she struggles with self-regulation and focusing, is the strongest, most pure, brave person that I know.  She battles with having so much to say and not being able to find the words to say it.

Can you imagine the frustration YOU would feel if you couldn't express your wants, needs, and emotions?  She wants so much to connect and make friends with other children but she doesn't know how, and yet she courageously continues to try after seemingly endless experiences of social rejection. Have YOU ever felt that way or experienced that?  

I am not sorry that my daughter's exuberance and energy bothers you, but in truth, she experiences a myriad of sensory issues daily (including hating the feeling of having shoes on), but still has the strength to go out and find joy in discovering new things. Can you say that you have conquered such challenges and still find happiness in life? I don't know, but you don't know either.  

Even though I was hurt, angry, and embarrassed that day I am grateful you happened. I realized something invaluable because of you.  I really am not sorry and I will not apologize that my daughter has autism.  

I am not sorry that she is mine because every day I am delighted in some small thing that marks her progress as she learns or says something new, something more.  Those moments are my rainbows after storms, my silver linings.  When her eyes brim with pride at her new accomplishment or when she kisses me good morning or rests her head on my shoulder as I try to engage her in a bedtime story.  

Mom reads to child next to the fireplace.

I am grateful to you, the judgemental lady in the store, for what I gained from that terrible interaction with you.  That I am not embarrassed or ashamed, I am not sorry, and I don't have to say it anymore.  Not ever, not for anyone.  I am proud of my daughter and proud to be her mother.  She will not learn from me that her sensory issues, which she cannot control, are something to be apologized for or embarrassed about. If only you could see what I see, that she has walked, inched, and clawed her way a million miles from where she came.

She will not hear me apologize anymore for any minor inconveniences she may cause people we meet.  She will know that no matter what, whether it is a stressful, off, or a great day that I accept her, love her, and have her back no matter what.  That is what I want her to grow up hearing and the mother I want to be.  I am NOT sorry.

Everyone Gives Advice to the New Mom

Guest Post by Chelsy Theriault

New mom loving her baby.

This probably happens to the majority of women who become mothers for the first time: they feel as if they really know nothing about taking care of a baby. Feeding, crying, sleeping – it's all a frightening mystery. Of course, older relatives and friends with children immediately appear as parenting experts and everyone is competing to give you the best advice. The amount of advice is huge and some sources may contradict others.

As time passes you start feeling you are on some kind of roller-coaster of parenting advice and you don't know who you should listen to first – it seems that everybody has nothing better to do than overload you with advice. Even mothers on the street will share their opinions regarding your baby.

The truth is, no matter how many books have been written or however many “experts” bless you with their advice, being a parent is a science forever growing and changing – sometimes in a trembling way. What was acceptable two or three years ago could be outdated and not recommended today. Recommendations about sleep positions, sippy-cups, introducing solids – it all changes. Those who have not raised children for a long time may imbue you with outdated advice.

At some point, you may lose your cool, but try to keep your patience. Those self-appointed advisers only mean well and want what is best for you and baby. In the meantime, you must claim your point-of-view and always stay in touch with your pediatrician. They are the trained and educated experts in the health of babies and children. Keep an open line of communication with health professionals and always ask questions; never feel embarrassed to clarify any confusion you may have about mothering and care for your child.

All of this can become extremely annoying. The “I've-raised-a-child-already-and-you-haven't!” attitude is tiring but there is one thing you have that these advice-givers do not – a deep, seeded bond with your little one. You have the instinct connected with your child, who is different and unique from everybody else's child. Once you give birth your mind immediately kicks into mother-mode and these instincts will seem to appear out of nowhere. You may not be an expert when it comes to babies – but you are the expert in everything related to your baby! You know and feel best what your child wants and needs.

Don't let the advice of others cause you to question your abilities as a mother. Trust those instincts – you are doing much better than you know!