The Critical Window of Early Feeding

Did you know that the first 1000 days in a child’s life (conception to age 2) are critical to a child’s health, and potentially his future? What a mother and infant eat during these days can impact the child’s behavior, neural development, and even food preferences. In addition, proper feeding during this period can improve school-readiness and risk of chronic disease later in life. I attended a sponsored session earlier this year, presented by research dietitian Keli Hawthorne discussing the important nutrients of concern and how meat can be a first food once baby is weaned.

Meatballs are a perfect first food for baby.

Nutrition During Pregnancy

What you eat, and how much, are both important during pregnancy. As soon as you know you are pregnant you’ll want to pay extra attention to your diet. First off, no alcohol. If you smoke, now is the time to get support to quit.

Fifty percent of all women gain too much weight during pregnancy! You may sometimes hear “You’re eating for two!”. False! You are not eating for two. In fact, weight gain should be managed during pregnancy, with a recommended weight gain of about 25-35 pounds. Gaining too much or too little can be harmful for the baby and for mom. This can vary from woman to woman, and women who are overweight at conception should try to limit weight gain to 20 pounds. If you’re underweight, a 30-40 pound weight gain is okay. Of course if you’re pregnant with multiples, you’ll gain more. Talk to your doctor about what’s appropriate for you.

There are also some nutrients that become extra important, and you do need about 250-300 more calories per day. That’s not a lot. It basically means just adding one or two healthy snacks per day. Here are a few examples of high-calcium snacks that can provide those extra calories. Choose two:

  • One string cheese with an apple
  • A cup of low fat or non fat yogurt with fruit
  • A glass of milk and 6 crackers with peanut butter
  • Half a turkey sandwich on wheat with a glass of milk
  • 1 cup low fat cottage cheese with fruit
  • A strawberry-banana smoothie (banana, 4 ounces milk, 4 ounces plain yogurt, 1/2 cup strawberries)

Folic acid and iron are two nutrients that are important during pregnancy, as well as calcium (if you don’t take in the calcium, the baby robs it from your bones and teeth). Your doctor will prescribe a prenatal vitamin-mineral supplement to take daily, in addition to eating a balanced diet. You can learn a lot more about exactly what to eat from my colleague Elizabeth Ward. 

Breast or Bottle

Whether a woman chooses to breast or bottle feed, it’s important to pay attention to the baby, and track her growth and weight gain. While breast milk is highly nutritious and may support immune strength, some women and their babies have a more challenging time than others. That’s okay! It’s her choice to do what she can, and what’s comfortable for her.

I do encourage moms to give it a go however. Some research has shown there’s a 4% reduction in childhood obesity for each month a baby is breastfed, so even if you only breast feed for a month or two, it’s all good. And whether you breast feed or not, babies age birth to 12 months should only be drinking breast milk, infant formula, or water. There’s no need for other beverages. After age 1, cow’s milk can be introduced as a beverage, and I encourage milk with meals, and water in between. Your child can enjoy soda or juices occasionally when she is a teenager, small children don’t need them (neither do teens, but that’s another story).

Introduction of Solid Food: Baby Led Weaning

The American Academy of Pediatrics recommends introducing solid foods at around 6 months of age, and the World Health Organization recommends the same, with meat, poultry, fish or eggs eaten daily or as often as possible. From age 6 to 18 months, a critical period of growth happens, which is why it’s so important to understand how to offer solid foods. Iron is often a nutrient of concern and breastfed babies should be supplemented with iron at age 4 months, but they often aren’t. The 6-18 month window is also an opportunity to instill healthy eating habits by introducing a variety of foods.

Consider these statistics: Twenty percent of 1-2 year olds eat no fruit, and 30 percent eat no vegetables. Worse, 75% of 12-month olds are drinking sugar sweetened beverages daily. This is not a good trend!

“Provide nutritious foods starting at 6 months of age that are high in iron and zinc such as meat. The iron in infant cereals like rice cereal is not as well absorbed by your baby’s body compared to the iron from meat, and some cereals don’t contain any iron at all. 1 in 4 toddlers don’t get enough iron in their diet which is important for brain development.” says dietitian Keli Hawthorne. 

Even though vegetarianism and veganism are trendy right now, infants will have a much more difficult time meeting nutrient needs by eating a vegetarian diet without proper supplementation. So if you aren’t already vegan, offer a variety of foods, including meats, to your infant. Using recipes that the whole family can enjoy makes meal time easier.

Wait. Meat? When I had my children, iron-fortified cereal was a typical first food, and it was common advice to “offer veggies first” so that they will “accept them”, and then fruit, and later meat. First foods were pureed. We now know there is really no evidence to the order of introducing foods to baby, and since meats are nutrient dense – beef in particular is an excellent source of iron and zinc (two important nutrients for infants and toddlers) – it’s a healthy first food.

Hawthorne says, “Most parents don’t start meat until about 9 months of age, but the recommendations are to actually start them much earlier, at 6 months of age, because of the important nutrients they contain. There’s no evidence that foods should be offered in any certain order – including starting with rice cereal or vegetables before fruits. However, all foods should be introduced individually for at least one time to monitor for any signs of reactions or allergies.”

You may choose to use processed baby food for convenience, and that’s fine. Parents can puree beef and other meats when first staring solids if they like. Or you may choose to try  “baby-led weaning”. This technique simply encourages parent to offer the same foods that they are eating, and allow the infant to self-feed. Hawthorne suggests that those who want to do baby led weaning can skip purees and offer meatballs, a short rib, or chicken drumsticks – something that the baby can grasp easily at 6 months of age (of course babies and toddlers should be monitored for choking when eating).

Dietitian and author of Born to Eat, Wendy Jo Peterson, says, Baby Led Weaning (BLW) is a good fit for your family if you prefer to eat with your child, share the same family foods, and embrace the messiness of exploring foods. Here are her tips for success:

“To kick start the BLW journey it’s vital to understand the difference between gagging and choking and identify proper textures that support success with BLW foods. Most families are nervous initially, but once they see their baby navigate whole foods from their first bite they gain confidence in their baby’s abilities. Blenders have not existed for very long, and babies have thrived long before electricity. Have confidence that this is a viable choice that many families have done for centuries.”

There’s no one right way to feed your baby, but you do need to include wholesome nutritious foods daily. It’s still fine to choose to purchase packaged baby food, however, as with other packaged foods at the supermarket, marketing tactics and facts don’t always match up. In the case of baby food, some brands use “stages”, and there’s really no evidence for that. They may also include the ages on the package labeling. For instance, the ‘stage 1’ foods often don’t include meat. Rather than allow the food labels to educate your choices, ask your pediatrician if you can meet with a dietitian, or find a book written by a registered dietitian (RD or RDN).

One More Thing

You also may be concerned about food allergies when introducing foods. According to Hawthorne, more research has been done lately on reducing allergy risk. “We used to think we should delay introduction and even completely avoid potential allergy foods like peanuts, but more current science shows the opposite. It’s better to introduce foods even as early as 6 months of age just like any other food as the best strategy to reduce later food allergy risk”. Peanut allergy is an example. New research now shows that early introduction of peanut products in infants actually reduces future allergy.

There is a lot to know about the first 1000 days, and early feeding – prepare yourself with the facts, and find support to give your baby a good head start in life.

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