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Pediatric Nutrition

Initial Consult

Initial consult to include in-depth health and medical history intake which will involve comprehensive assessment of pregnancy, labour, breastfeeding/formula feeding, sleep, lifestyle habits, gut health, infants’ overall behaviour from birth until appointment while looking to identify subclinical challenges as well as assessing family goals when it comes to introduction of solids, family history of allergies/sensitivities, family set up (multiple children, meal team expectations).

One hour consult $150

Follow Up Appointment

Follow up appointment will happen the following week after assessment of data and creation of an individualized protocol is complete. This appointment will serve as an overview of your protocol which will include first foods to introduce and dietary recommendations, food combining and importance of nutrient dense foods, baby lead weaning vs purees, how to incorporate breastmilk/formula into new plan, how sleep is affected and subsequent lifestyle recommendations.

45 minute follow up $80

Signs Your Baby is Ready to Start Solid Food

Mom with baby in waiting roomWhether you breastfeed, bottle feed or a combination of them both, eventually your baby will need to start eating solid foods. It’s an exciting transition. But can also be stressful and leave you feeling unsure of the when and how to start. Recommendations seem to always change and old school advice from well-meaning loved ones can add to the uncertainty. Here are some current guidelines as well as some practical tips to help with this new stage.

The World Health Organization, as well as the Canadian Paediatric Society both, recommend breastfeeding exclusively for the first six months of your baby’s life. Of course, that doesn’t always work out as planned and so a commercially prepared formula is a safe and sufficient alternative. The rationale behind the six-month recommendation has to do with the maturity of your baby’s digestive tract. If you start solid foods before your baby is ready it may lead to digestive tract upset (gas, constipation) and your baby may not be able to absorb the nutrients from the food well. Your baby may also be more susceptible to illnesses if solid food is started too soon.

There are also several developmental signs that your baby is ready to start solid foods. These include:

  • Baby can sit up on their own
  • Baby is ready to chew
  • Baby has lost the tongue-thrust reflex and will not automatically push food out of their mouth
  • Baby can pick up items using their thumb and pointer finger (pincer-grasp reflex)
  • Baby is interested in mealtimes and may try to grab food off your plate

Some babies may reach this stage before or after the six-month mark. So what do you do? The recommendation is still to wait until six months due to the development of the digestive tract. So if your five-month-old is really interested in mealtimes there are several things you can do to keep them involved and interested. These can include letting them sit at the table with you, giving them a sippy cup of water and giving them baby spoons, forks and plates to play with at the table. Alternatively, if your seven-month-old is still not showing any interest in solid foods, not to worry. As long as your baby is continuing to grow and develop, breastmilk or formula do continue to meet the dietary needs of babies until about a year old.

No matter when you do start giving your baby solid foods start small and work your way up. Start with easy, bland food (bananas, avocado) and slowly increase the texture and variety of foods you offer. Ideally iron-rich and nutrient-dense foods will make up a large portion of the foods you offer. Some babies really like pureed food and others just liked diced up soft food (whatever you are having). It takes some time and some trial and error but ultimately you want mealtimes to be an enjoyable time for everyone. Breast or bottle feeding should also continue to be a major source of nutrition for your baby.

5 of Our Favourite Baby Food Recipes

Feeding your baby and toddler can be overwhelming at times especially on those weeknights when you get home from work and everyone is hungry and tired. Be prepared for your toddler to have big swings in their eating habits. Some days they can literally eat the entire cupboard and then the next day but interested in nothing – this is totally normal and will even out. If you are concerned about your child’s eating habits, please speak to your doctor. I’ve included some of my top tips for making mealtime less stressful for you and successful for your toddler and 5 of Our Favourite Baby Food Recipes.

  • Introduce a variety of foods and textures to you’re your baby/toddler as early as possible (starting solids is recommended at 6months of age)
  • Start with small serving sizes and allow your toddler to ask for more
  • Make mealtimes playful family time. Sitting down together to eat is a great time for connection and allows you to model eating habits.
  • Be prepared for picky phases. Even an easy-going eater has picky phases and it’s not personal to you or your cooking. Pickiness generally comes from wanting to exert control and uncertainty about what they are eating. A great way to deal with this is to acknowledge that it isn’t a favourite food or unfamiliar and find a way together to make it work.
  • Incorporate the 5 senses. Toddlers are not that different from us – food is so much more than just taste. Make a smiley face out of their lunch plate – let your creativity take over and have fun!

Here are 5 great recipes your toddler and baby are sure to enjoy!

Avocado & Egg Toast

This recipe is easy peasy and quick! Toast a slice of their favourite bread, mash up a ripe avocado and spread it on the toast. Slice a hard-boiled egg and arrange on top. You can even mash the egg with the avocado together for little fingers.

Pumpkin Blender Muffins

In a blender add 1 cup rolled oats, 1 ripe banana, ¼ pumpkin puree, 1 egg, 3 tablespoons maple syrup, 1 teaspoon cinnamon, ¼ teaspoon each of nutmeg & allspice. Blend on low for 30 seconds, scrape down the sides and add 1 teaspoon baking powder, 1 teaspoon baking soda, and a pinch of salt. Continue to blend until oats are broken down. Preheat oven to 350F and grease a mini muffin tray. Scoop mixture into muffin tins to 2/3 full and bake for 8-10 minutes. You can omit the pumpkin and spices and add in whatever flavour you wish.

Corn & Spinach Fritters

Pulse 1 cup of corn, 1 small handful of spinach, 1 small clove of garlic crushed, 1 green onion chopped, ¼ cup + 2 tbsp flour, 1 egg, ½ teaspoon baking powder, and 50ml of milk in a food processor/blender until fairly smooth. Heat a frying pan with cooking oil of your choice and drop dollops of the mixture into the pan. Cook for 1-2 minutes each side until cooked through.

Minestrone Soup

Heat oil in a large non-stick skillet over medium-high heat. Add the 1 cup chopped carrots, ½ cup chopped celery, ½ cup chopped onion, 2 cloves of garlic minced and sauté until tender about 15 minutes. Add remaining broth (1 carton), 1 large can (128oz) tomatoes, pureed beans (puree 1 can of white beans with 1 cup of broth from carton), salt and pepper. Add the 1 sprig rosemary, 2 bay leaves, 2 tbsp of basil and parsley, cover and cook on low for 30 minutes. Add spinach and chopped zucchini and simmer for 10 minutes. Serve with cooked pasta.

Applesauce

Chop 5 large apples, removing the skin if you wish. Add chopped apples, pinch of cinnamon and ½ cup water to a pot. Simmer on the stove until apples are soft. Remove from the heat and puree or mash apples to the texture of your choice.

Starting solids can be such an exciting time for your family, and also a big leap for your little babe. It may also be somewhat of an uneasy time as the amount of information and resources can be very overwhelming. When to start solids? What method is the best way to start? What foods should you introduce first? What to do if your child is not loving solids? There are so many different approaches and opinions when it comes to introducing food. I’m here to tell you that it will be okay. You got this! And we are here to help. Enjoy the excitement of this milestone! It is an adventurous and fun stage.

Sample Schedule for Introducing Solids to Your Baby (Food Compliments Milk)

While following guidelines safely, do what works for you and your babe. Not every babe is the same, therefore what works well for one child may not work the best for another. Take things at your own pace. Some babies do really well with purees and need a very slow, gradual change to new textures. Other babes prefer mashed or lumpy textures. Watch how your child responds and follows their cues.

When should you start solids?

The World Health Organization, as well as the Canadian Paediatric Society, both recommend breastfeeding exclusively for the first six months of your baby’s life. They both state that from six months on, other foods should complement breastfeeding for up to two years or more. Alternatively, if you are not breastfeeding, a commercially prepared infant formula is safe. At 6months old, solids do not replace breastmilk/formula but rather compliment them. Therefore, you will continue to breastfeed and/or give formula as usual.

“The rationale behind the six-month recommendation has to do with the maturity of your baby’s digestive tract. If you start solid foods before your baby is ready it may lead to digestive tract upset (gas, constipation) and your baby may not be able to absorb the nutrients from the food well. Your baby may also be more susceptible to illnesses if solid food is started too soon.”

How should you start solids?

Yes, it’s true! There is more than one way to introduce solids to your child. There is the traditional method of offering purees and gradually modifying the texture to soft, diced foods. And then there is an alternative approach called Baby Led Weaning. Baby-led weaning is all about letting your baby take charge. You bypass the purees and spoon feeding while offering finger foods in a safe manner.

Make sure that your little one isn’t coming to the table tired and starving. It’s best to offer solids after their nap. At first, start with offering solids once a day roughly 60minutes after breastfeeding. I know this may sound like you have to schedule your day around your babe eating but it’s easier when explained. As Mama Coaches we use the MAMA method. When babe wakes you give them Milk- breastfeed or give formula. Allow them to have some time of Activity-what ever is appropriate for your child’s age. Then offer them their Meal. Prior to starting solids, this would have been the second M for Milk-breastmilk or formula but now it will be solids. After they finish with their meal, give them a small amount of time for an activity prior to going down for another nap.

What foods do you start with?

No matter what approach you take to introducing solids, we must always remember to introduce iron-rich foods first. Your baby was born with a supply of iron, but by 6months it is nearly used up and that is why it is so crucially important that you begin with iron-rich foods. Pick one new food. Observe your child for any redness around the mouth, hives, vomiting, diarrhea, increase in gas pain, or crying. If there are no signs of an allergic reaction then move onto a new food and let your child experiment with it. Once they have tried a variety of foods that you know are safe for them, you can mix flavours together. After you have introduced a few other solid foods, offer the common food allergens one at a time while observing for signs of a reaction. Always be sure that you never give your baby honey under the age of one as they are at increased risk for botulism.

  • Iron-Rich Foods:
  • Well Cooked/Pureed Meats, Poultry, Fish and Eggs, Legumes-beans, lentils, chickpeas
  • Iron-fortified Cereals
  • Tofu

Begin with one tablespoon at a time and increase the quantity and frequency as your child becomes accustomed to eating.

What if your babe isn’t interested in solids?

Don’t worry Mama! This is completely normal. This developmental milestone is a big leap. Not every babe is quick to eat everything that is put in front of him. Introducing solids at this age is a fun and experimental time in your little one’s life. The transition to solids doesn’t happen overnight and to be honest, is sometimes quite the process.

Have fun with things! There are SO many recipes out there. Be adventurous and experiment with different flavours.

 

Check out our “Baby’s First Solids” Tracker. Write down your baby’s age, food with texture, and comments/reactions of how your baby responded to that food. Put this in their baby book.

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Pediatric Nutrition in South Ottawa, ON | (613) 260-8828