Feeding Your Baby - Common Concerns • Back to Feeding Your Baby • Vitamin & Mineral Supplements • Fussy Babies (Colic) • Trouble With Burping • Spitting Up Milk • Night Feeds (Not sleeping through the night) • Teething • Baby Will Not Eat • Bowel Movements (Stools) • Diarrhea • Choking • Weaning • Switching to Regular Milk • Pasteurizing raw milk • Allergies • Peanuts and Peanut Butter • Honey & Corn Syrup Vitamin & Mineral Supplements The vitamin and mineral supplements your baby needs depends upon two things: your child’s age and what he/she is eating. Not all babies and toddlers need vitamin supplements! If you give your child supplements, make sure that your doctor knows about it. Carefully follow the directions on the label. Too much of any vitamin or mineral supplement can be harmful to your baby’s health. Vitamin D A vitamin D supplement may be suggested for babies who are exclusively breast-fed from birth until they are weaned. This is because babies generally do not get enough exposure to the sun in order that their bodies make enough vitamin D. It is not because breastmilk does not have enough nutrients. A vitamin D supplement is available in drug stores. Ask your pharmacist about the recommended dose. Formula fed babies do not need a vitamin D supplement. This is because the vitamin D is already added to the formula. Iron After 6 months of age, your baby needs extra iron. Give this iron in the form of iron-fortified infant cereals and other iron-rich foods. After 6 months of age, if your baby does not eat iron-fortified infant cereal or other iron rich foods, he/she may need an iron supplement. Talk to your doctor first. Iron supplements can be very dangerous if too much is taken. Fluoride Supplementation with fluoride is not suggested for infants less than 6 months of age. For infants between 6 months and 2 years of age living in areas where household water is low in fluoride, a fluoride supplement may be recommended. Talk to your dentist for information about the correct dose. For those infants living in areas with fluoridated water supplies, supplementation is not needed. Call your local health unit for general information on fluoride. To the top Fussy Babies (Colic) All babies have fussy times, sometimes during the evening, night, or day. A “colicky” baby cries or screams for hours every day. Experts are not sure about the cause of colic. There are many theories and myths. If you are concerned about your baby’s crying, talk to your doctor or a public health nurse. They can provide some advice on coping with a colicky baby. Here are a few things you may want to try: Take a late afternoon nap with your baby to give yourself a boost. Try the age-old treatment of walking or rocking the baby. To take some of the load off your tired arms, use a front carrier. The combination of body contact, swaddling and motion often puts babies to sleep. Do not worry about picking up your baby too often. You will not spoil a baby by comforting him/her. Take your baby for a car ride in his/her car seat. Often, the motion of the car puts babies to sleep. Try some of the over-the-counter remedies in drug stores. Ask your doctor about these products before using them. Give your baby a warm bath. You may have to deal with a few minutes of screaming at the beginning, but often a bath brings relief to a colicky infant. Never shake a baby, no matter how frustrated you become. Ask someone to come and give you a break. Shaking a baby can cause serious injury and may be fatal. To the top Trouble with burping Some babies burp easily, others do not. Try to burp your baby once during a feeding and then again at the end of a feeding. Also, burp your baby when he/she seems uncomfortable or if he/she falls asleep too soon. Air in your baby’s stomach can cause pain. If your baby has difficulty burping, try changing the baby’s position to raise the air bubble in his/her stomach. Here are three ways to burp babies: Hold baby at your shoulder and gently pat the middle of his/her back. Sit with baby in a sitting position on your lap. Put one hand under his/her chin and the other on his/her back; gently pat his/her back. Place your baby on his/her tummy for a few seconds, then bring him/her to your shoulder and gently pat his/her back. To the top Spitting Up Milk Babies often spit up small amounts of milk during the first 4-6 months, especially while burping. If your baby spits up a lot, it may be because your baby is drinking too fast or too much, swallowing air while sucking or having too much activity after feeding. If you are worried, talk to your doctor or a public health nurse. To the top Night Feeds (Not Sleeping Through The Night) It is normal and healthy for young babies to wake up during the night for at least one feeding, and maybe more. Their small stomachs cannot hold enough milk to last through the night and they get hungry. Frequent feedings at night help to prevent Sudden Infant Death Syndrome (SIDS). Breastfed babies do not get into as deep of a sleep and tend to wake more often, therefore decreasing the risk of SIDS. Babies may wake for night feedings whether they are fed breastmilk or formula. Every baby is different. Usually, when baby is several months old, he/she is able to go without a feeding for 5 to 6 hours at night. This is true except when your baby is going through a growth spurt or is teething. If your baby is going through a growth spurt or teething, they may wake up more often, even if they have been sleeping well until that point. It is important to offer a feeding at these times. It means that the baby needs more breastmilk or formula, not that they need to have solid foods introduced sooner. When your baby is ready, they will begin to sleep longer again. Every baby does this at a different age. Offering pablum at bed time either from a spoon or in a bottle mixed with formula is not the solution to get baby to sleep through the night. This may actually make the sleeping situation worse if baby is not ready for solid foods. If you do this and baby starts to sleep through the night, it is coincidence. Babies will sleep through the night when they are developmentally ready. To the top Teething Teething can make your baby fussy. To comfort your baby, use a safe teething ring. Make sure the teething ring is clean, not worn out, not leaking and cooled in the fridge, not frozen. Try dry toast or bread crust. Cold cooked foods may also help. Teething biscuits can be high in sugar, which can lead to tooth decay, so read the labels first. Always watch your baby closely when he/she is chewing on food, and clean their teeth and gums (even if they don’t have teeth yet!) after they eat or drink. Talk to your doctor or pharmacist about teething ointments and follow the directions. Ointments should be used with caution as they will numb more than just the gums if used too often or if too much is applied. Never squirt ointment directly in baby’s mouth. Always wash your hands first, put a dot of the ointment on your finger, and rub on baby’s gum. It is possible to overlook real illness in a child by blaming fevers, vomiting and other symptoms on teething. If your child seems sick or has a fever, talk to a doctor. To the top Baby Will Not Eat Children are good judges of how much they can eat. Too often parents force their child to eat more and it backfires! In this case, no one looks forward to mealtimes. Parents are responsible for providing a variety of healthy foods. Children are responsible for deciding how much they will eat. A child’s appetite changes from day to day. As long as your child is healthy and gaining weight, he/she is probably eating enough. To the top Bowel Movements (Stools) For the breastfed baby: During the first month, breastfed babies usually have 2 or more soft or loose stools each day. After the first month, it is normal for the breastfed infant to have a loose stool with each feeding or to have a stool only once a week or even less often. This is because at about one month of age, a baby’s digestive system becomes much more efficient and produces less waste with breastmilk, so they sometimes have less bowel movements. This stool will be soft and you may be surprised by the large volume. Babies have different bowel patterns; so watch what is normal for your baby! For the formula fed baby: Just because he/she has not had a bowel movement for a day or two does not mean your baby is constipated. If your baby has true constipation, he/she will be having a difficult time passing small, hard stools. True constipation is very rare. Make sure your baby is gaining weight and soaking at least 6 diapers a day. For true constipation, use ¼ teaspoon of sugar in 2 oz. of water. Do not use honey or corn syrup—see page 34 for more information. Add sugar only until normal stool returns. Do not dilute formula with more water – this will decrease the concentration of nutrients in the formula. For an older baby over six months who is ready for these foods, you can add more fibre and fluids to the diet. Try: Whole grain breads or muffins Adding bran to baby/toddler cereals More fruit and vegetables More diluted fruit juice, especially prune juice. More peas and beans as meat alternatives (after 7 months) To the top Diarrhea Diarrhea is a common childhood problem. In most cases, it is mild and brief. It can be, but is not always, an early sign of illness, food poisoning, food allergy or food intolerance. Call Your Doctor Right Away If: There are signs of dehydration: Sunken eyes; Lack of tears when crying; Dry mouth and tongue; Sunken soft spot (fontanelle) on baby’s head; Gray skin colour;Weight loss; Less than 6 wet diapers in 24 hours, after one week of age; Your child starts to throw up and is still throwing up after 4-6 hours; Your child has bloody or black stools or if diarrhea continues for more than 3 days. The most important treatment for diarrhea is to make sure your baby drinks enough fluids to prevent dehydration. If your baby is breastfed, continue nursing. If your baby is formula fed and your doctor recommends clear fluids, you can buy products like Pedialyte and Gastrolyte from the drugstore. Check with your doctor before offering these to baby! They are costly, but are usually used for only 24 hours. Home remedies like pop, fruit drinks and jello are not suggested. If your child is older than six months and has diarrhea, continue to offer regular food. Keep in mind that your child may not feel like eating, but it is important that he/she drink as much as possible. Frequent small meals may be easier. To the top Choking Since your baby is just learning to eat, there will be times when some food goes down the wrong way and comes right back up again. This is a normal part of learning to eat. Always watch your baby while he/she eats. There are some foods, which should be avoided because they may cause severe choking. These include whole grapes, popcorn, nuts, raw vegetables, berries, small candies and wieners. Hot dogs and grapes can be sliced in half, lengthwise to decrease the danger. Also, peanut butter, cheese and meat spreads should be spread thinly. (See caution on peanut butter) Know what to do if your child is choking. Call the Health Unit to find out where to take a Child Safe Course. To the top Weaning If and when you should wean your baby is a personal decision. Breast milk is recommended for babies beyond the second year of life. If you have questions when trying to decide what is right for you and your baby, call the Health Action Line at 1-800-660-5853. To the top Switching to Regular Milk Homogenized cow’s milk can be introduced after nine months of age, when your baby is eating a variety of solid, iron-rich foods (including cereal, vegetables, fruit and meat). Offering cow’s milk before nine months of age can cause problems, such as blood loss from the gut, anemia, and an improper balance of protein, carbohydrates and fat. Skim, 1% and 2% milk are not recommended for babies under two years of age. The amount of fat in these lower fat milks is not enough for a baby’s growth and brain development. Dietary fat is an important source of energy and the only source of essential fatty acids for infants and toddlers. To the top Pasturizing Raw Milk Once your child is ready to progress to whole cow’s milk, commercially pasteurized milk is recommended. If you choose to use milk from your own animals, you must pasteurize it. Pasteurization  is a heat treatment that kills germs, which can cause serious health problems and even death. Before you try to pasteurize your own milk, contact the local Health Unit and talk to a Public Health Inspector. To the top Allergies Food allergies are more likely to happen in babies who have relatives with asthma, food allergies, and seasonal allergies. They are more common in babies and often go away before school age. Symptoms of a food allergy may include diarrhea, vomiting, skin rashes or hives and breathing problems. If you think your baby has a food allergy, contact your doctor. Tips to protect your baby against food allergies are: Feed only breast milk for at least 6 months. Delay the introduction of solid foods until 6 months of age. There are specific foods to delay to certain ages. Wait until 1 year of age to introduce egg white. Wait until after 2 years of age to introduce shellfish and nuts. If there is a family history of allergies it may be necessary to delay offering other foods as well. Contact your public health nurse or dietitian for more information on diet and food allergies. Peanuts and Peanut Butter Peanuts, peanut butter and other nuts may contribute to an allergic reaction if introduced too early in a child’s diet. Avoid peanuts and other nuts until after 2 years of age. If there is a family history of peanut or other nut allergies, it may be necessary to wait until after 3 years of age or more. To the top Honey & Corn Syrup Honey should not be fed to infants before 1 year of age. Honey contains spores that cause infant botulism, which can make your baby very sick. There is also a risk with corn syrup—avoid this as well until after 1 year of age. To the top