Weaning Your Child From Breastfeeding

Weaning Your Child From Breastfeeding

Weaning is a natural stage in your baby’s development.   It is the gradual process of giving your baby other foods while continuing to breastfeed.

  • Breastfeeding as long as you can is the best thing for your baby.
  • As you introduce your baby to new foods, you can continue to breastfeed.
  • It’s easiest for you and your baby if weaning is gradual.
  • The right complementary food will depend on your baby’s age when you start to wean.

Weaning can come with a lot of mixed emotions. You may feel excited at the new independence you and your baby can both enjoy, as well as some sadness as your baby moves to another stage in her life. This is completely normal.

Breastfeeding as long as you can is the best thing for your baby. You can continue to breastfeed until your child is 2 years of age and beyond.

At about 6 months, your baby will be ready for other foods. He will also need other foods to meet his growing nutritional needs. As you introduce your baby to new foods, you can continue to breastfeed.

You’ll know baby is ready to start other foods when he:

  • Seems hungry earlier than usual.
  • Can sit up without support, and has good control of his neck muscles.
  • Holds food in his mouth without pushing it out on his tongue right away.
  • Shows interest in food when others are eating.
  • Opens his mouth when he sees food coming his way.
  • Can let you know he doesn’t want food by leaning back or turning his head away.

Weaning can be either natural (child-led) or planned (mother-led). Natural weaning or “child-led weaning” happens when your baby starts to accept more—and different types—of solid foods while still breastfeeding on demand. With this type of weaning, you watch your baby’s cues and wean at her pace. Babies who are weaned naturally usually stop breastfeeding completely sometime between 2 and 4 years of age. 

Planned weaning or “mother-led weaning” happens when mothers decide to start the weaning process. A “partial wean” means substituting one or more feedings with a cup or bottle and breastfeeding at other times. This can work well if you are going back to work or school, but still want to breastfeed. Early morning, evening and night feedings can continue even if you are separated from your baby during the day.

Your weaning experience is up to you and your baby. Try to follow your baby’s cues whenever possible. If you feel your baby is not taking what you think is enough other foods or liquids, see your doctor.

When you and your baby are ready to wean, there are few things that can help make the experience a more positive one for both of you:

  • It’s easiest for you and your baby if weaning is gradual – over several weeks, months or even longer. A sudden, abrupt wean should only be considered in extreme circumstances such as maternal illness.
  • Start by substituting one feed. When one feed is going well, substitute another feed, and so on.
  • Continue this way, substituting one feed at a time. The pace is up to you and your baby, but in general, the slower the better.
  • Someone else, such as your baby’s father, may need to offer a feed for your baby to accept it. You can start with a liquid (such as expressed breast milk) in a bottle or cup or a complementary food after about 6 months of age. 
  • Follow your baby’s cues. She’ll tell you when she’s had enough.
  • Hold and cuddle your baby if you are feeding from a bottle. This extra closeness will help both of you during the weaning process. Never prop a bottle. Bottle propping can put your baby at risk for choking and causes early childhood caries.

Watch the cues you give to your baby. If you sit in the same chair you usually use when you’re nursing, he’ll likely want to breastfeed

If possible, avoid an abrupt wean, which can be uncomfortable for you and upsetting for your baby.

  • If you have to take a medication, talk to your doctor. There are very few medications that require you have to stop breastfeeding. 
  • If you are very sick, or if you and your baby have to be separated or a long time, try some of the suggestions for caring for your breasts described below. If your breasts get uncomfortable, express your milk to avoid blocked ducts, mastitis or a breast abscess.
  • Babies who are sick should NOT be abruptly weaned. You can pump and store breast milk until your baby can take it again.

What complementary foods can I give my baby?

At about 6 months, you’ll start to introduce solid foods into your baby’s diet. When this happens, your baby will begin to take less breast milk.

Introduce solids one at a time and in small amounts at the beginning. Some babies get very constipated if they are given too much solid food early on.

You can also offer your baby small amounts of water once or twice a day, usually after 6 months of age. It’s best not to offer juice at this age. Too much juice can lead to dental caries, obesity or even poor weight gain and diarrhea.

If you give your baby water, or alternate milks, offer it in a cup instead of a bottle. Breastfed babies easily learn to drink from a cup as early as 6 months of age. You can also try this with expressed breast milk.

After 12 months of age, your baby should not take more than 16 to 24 ounces (500 mL to 720 mL) of milk per day. Otherwise, she’ll fill up and won’t want to eat solid foods. Also, she may develop iron deficiency anemia. If your baby has a milk allergy, talk to your doctor about what to use for substitute feedings.

Age What to offer
6 to 12 months
  • Breast milk
  • Iron-fortified infant formula
  • Begin introducing solid foods
12 to 18 months
  • Breast milk
  • Whole cow’s milk (3.25%)
18 to 24 months
  • Breast milk
  • Whole cow’s milk (3.25%).
  • 2% milk is okay if your child is growing well and eating a variety of foods
2 to 5 years
  • 2% milk
My baby is refusing the breast. Does that mean he’s ready to wean?

No, it doesn’t necessarily mean your baby is ready to wean. Sometimes babies go on a “nursing strike” and suddenly refuse to breastfeed. There can be many causes, such as teething, an ear infection or other illness, the onset of your period, a change in your diet, soap, or even deodorant.

Here are some tips to encourage your baby to start breastfeeding again:

  • Make feeding time special and quiet; try to limit distractions. Sometimes, as babies get older, they are more interested in looking at the things happening around them then focusing on nursing.
  • Cuddle and soothe your baby as much as possible.
  • Offer your breast when your baby is very sleepy or just waking up.
  • If possible, try using different nursing positions, alternate sides, or nurse in different rooms.
  • If you can’t figure out the reason for your baby’s nursing strike, see your doctor or talk to a lactation consultant. Don’t get frustrated or angry. Remember that a nursing strike does not mean your baby is rejecting you.

If this happens, be sure to pump your milk so you don’t develop a blocked duct and that you continue to produce enough breast milk for when your baby is ready to nurse again.

Should I care for my breasts when I start to wean?
  • If your breasts are uncomfortable while weaning, try expressing some milk. Over-the-counter pain relievers like acetaminophen or ibuprofen might help. Cold compresses or gel packs applied to your breasts can also be of some comfort.
  • Don’t bind your breasts or drink fewer fluids while you’re weaning.
  • Check your breasts regularly to make sure you aren’t developing a blocked duct. A block duct will feel like a firm, tender area (the size of a pea) of the breast. Sometimes you can clear it with gentle rubbing or by putting a little bit of pressure on the area. If it’s painful, see your doctor or lactation consultant. This is more likely to occur during an abrupt wean.
What is mastitis?

Mastitis is an infection that causes breast pain, swelling, warmth and redness on your breast. It can also cause fever and chills. If you have these symptoms, call your doctor. Your doctor will most likely prescribe an antibiotic to clear up the infection. You can continue breastfeeding if you have mastitis.

Where can I get more information?

You probably have many questions about breastfeeding and your baby’s nutrition. There are many sources of information, including your paediatrician, family doctor, a community health nurse, breastfeeding clinic, and lactation consultant.

Vitamin D

Vitamin D

Babies need vitamin D for healthy growth and development. Babies who are breastfed should get 400 IU (international units) per day.

Babies in northern communities (north of 55° latitude, which is about the level of Edmonton) or who have other risk factors (such as dark skin) should get 800 IU per day between October and April, when there is less sunlight.

Babies need vitamin D for healthy growth and development. It helps them build strong, healthy bones and teeth. Babies who don’t get enough vitamin D are said to have a deficiency. If the levels are low enough, they are at risk of getting rickets, a disease that affects the way bones grow and develop.

You can make sure your baby has enough vitamin D by giving a daily supplement (a dose of drops every day). This should start as soon as your baby is born.

    How do we get vitamin D?

    Vitamin D comes from different sources:

    • Sunlight: Vitamin D is formed naturally when skin is exposed to sunlight. Because Canada is located so far north, sunlight isn’t enough at certain times of the year and in certain places. Also, sunscreen and clothing, which protect babies from the harmful effects of the sun, won’t allow vitamin D to be formed.
    • Foods: Some foods—like salmon, tuna, and liver—are good sources of vitamin D.
    • Vitamin supplement: For babies, it comes in liquid form and is given daily with a dropper. It’s important to give your baby a supplement that is meant for babies. Read the instructions carefully to be sure you give your baby the right amount.  If you are unsure, talk to your pharmacist.
    How do I know if my baby is at risk of vitamin D deficiency?

    Babies are most at risk of vitamin D deficiency if:

    • They are breastfed.
    • Their mothers don’t have enough vitamin D.
    • They have darker skin.
    • They live in northern communities.

    All breastfed babies should get a daily supplement of vitamin D.

    How much vitamin D should my baby receive?

    • Babies who are breastfed should get 400 IU (international units) per day.
    • Babies with risk factors should get 800 IU per day, when there is less sunlight.

    If you aren’t sure about the right amount to give your baby, talk to your health care provider.

    Why do breastfed babies need a vitamin D supplement?

    Breast milk is the best food you can offer your growing baby. Even when your baby starts eating other foods, you can continue to breastfeed until 2 years of age and beyond.

    But breast milk has only small amounts of vitamin D (4 to 40 IU per litre), which may not be enough to meet your baby’s needs. That’s why babies who are breastfed should receive a daily supplement of vitamin D from birth until they get enough from their diet.

    If I am breastfeeding and I eat foods rich in vitamin D, do I still need to give my baby a supplement?

    Yes. Although some foods are good sources of vitamin D, they won’t provide enough vitamin D to enrich your breast milk to the level your baby needs.

    If you are breastfeeding, talk to your doctor about whether a supplement of 2000 IU/day is right for you.

    Do babies who are formula-fed need extra vitamin D?

    Since vitamin D is already added to infant formula, most full-term babies who are formula-fed don’t need a supplement. However, formula-fed babies with risk factors should receive a supplement of 400 IU/day when there is less sunlight to ensure they have enough vitamin D.

    Should pregnant women take vitamin D supplements?

    How much vitamin D you get while you’re pregnant will affect how much vitamin D your baby has at birth. A baby born to a mother who is vitamin D deficient is more likely to have a vitamin D deficiency.

    You are more likely to be vitamin D deficient if:

    • you don’t use products like milk and margarine, which  are fortified with vitamin D.
    • you do not have much exposure to the sun, or if your skin is covered much of the time.
    • you do not take vitamin D supplements.

    If you are pregnant, talk to your doctor about whether a supplement of 2000 IU/day is right for you.

    Iron needs of babies and children

    Iron needs of babies and children

    Iron is a mineral that babies and children need for good health and development.Red blood cells contain hemoglobin, a protein that carries oxygen to all cells in the body. Our bodies need iron to make hemoglobin. Iron gives red blood cells their colour. When you don’t have enough iron, red blood cells become small and pale. They can’t carry enough oxygen to your body’s organs and muscles. This is called anemia.

    What are the symptoms of iron deficiency?                                          Babies and children need iron for their brains to develop normally. Babies who don’t get enough iron (“iron deficiency”) may be less physically active and develop more slowly. They may also show these symptoms:

    • slow weight gain,
    • pale skin,
    • no appetite, and
    • irritability (cranky, fussy).

    Iron deficiency can affect how older children do in school. Low levels of iron can make it hard for children to concentrate and cause them to feel tired and weak.

    How much iron do babies and children need?

    Full-term babies are born with a reserve of iron, which comes from their mother’s blood while they are in the womb.

    For the first 6 months of life, breastfed babies will get what they need from their mother’s milk. However, waiting too long after 6 months to introduce other foods increases your baby’s risk of iron deficiency. If breastfeeding is not an option, use a store-bought iron-fortified infant formula for the first 12 months. The formula should be cow’s milk-based.

    Once babies start eating solid foods, the amount of iron they need depends on their age. The Recommended Dietary Allowance (RDA) is the amount a person needs every day to stay healthy.

    Age

    Amount of iron per day (recommended daily allowance)

    7 to 12 months

    11 mg

    1 to 3 years

    7 mg

    4 to 8 years

    10 mg

    9 to 13 years

    8 mg

    14 to 18 years

    11 mg (for boys)
    15 mg (for girls)

    What foods are good sources of iron?

    There are two different types of iron:

    • Heme iron is more easily absorbed by the body. It is found in meats.
    • Non-heme iron comes from plant sources like legumes, vegetables and cereals.

    Foods that are rich in iron include:

    • Meats: Beef, lamb, veal, liver, chicken, turkey.
    • Fish
    • Eggs
    • Grains and cereals: Iron-fortified cereals, whole grain breads, enriched bread, pasta and rice.

    Other sources of iron include:

    • Legumes: Chick peas, lentils, dried peas and beans.
    • Vegetables: Spinach, broccoli, Brussels sprouts, green peas, beans.

    To help the body absorb iron, combine these foods with good sources of vitamin C, such as oranges, tomatoes and red peppers. For example, serve an iron-fortified breakfast cereal with orange slices. Or top spaghetti with a meat and tomato sauce.

    Is cow’s milk a good source of iron?

    No, cow’s milk is not a good source of iron. Even though cow’s milk has about as much iron as human milk, the body doesn’t absorb it well.

    • Be sure your baby is getting other sources of iron and vitamin C before you start to offer cow’s milk. Wait until your baby is 9-12 months old before introducing whole cow’s milk.
    • Drinking too much cow’s milk can lead to iron deficiency.
    Should I give my child an iron supplement?

    • Full-term babies who are breastfed or who get iron-fortified infant formula from birth do not need an iron supplement.
    • Preterm babies should get an iron supplement by the time they are 8 weeks old until their first birthday. Talk to your doctor about the right amount.

    Children over a year old don’t need an iron supplement unless they aren’t eating enough iron-rich foods. Talk to your child’s doctor if you think this is the case

    Food allergy vs. food intolerance

    Food allergy vs. food intolerance

    What is the difference and can I prevent them?

    • There is no evidence that avoiding certain foods will prevent allergy in your child.
    • There is no evidence that soy-based formula will prevent your child from developing an allergy.
    • It isn’t recommended that you delay introducing a food beyond 6 months of age to try to prevent an allergy.

    An allergy happens when a person’s immune system treats a substance (allergen) like an inappropriate invader. The body will try to protect itself by releasing a chemical into the body called histamine. This chemical is what causes the symptoms that are unpleasant or even dangerous. The reaction can start very suddenly, even after being exposed to a small amount of the allergen.

    Allergens can get into the body in different ways. They can be:

    • inhaled (such as dust or pollen),
    • ingested as food (some common ones are nuts, eggs or shellfish),
    • ingested as medication (such as penicillin),
    • injected by an insect sting (like a bee or wasp venom), or
    • absorbed through the skin (such as poison ivy).

    What is food intolerance?

    Food intolerance is different from an allergy. It is not caused by an immune reaction. Food intolerance will cause discomfort but it’s not dangerous to your child.

    How can I tell if my child has food intolerance?

    Your child may experience bloating, loose stools, gas or other symptoms after eating a specific food. Even though this reaction is not dangerous, if it causes your child discomfort you might want to avoid those foods in the future.

    What is lactose intolerance?

    Lactose intolerance happens when the body doesn’t produce enough of the enzyme lactase to fully break down the sugar (lactose) found in most dairy products. It is rare in young children and usually only develops after 3 years of age. While some young children adjust to the lack of this enzyme, some will have problems for life.

    If your child is lactose intolerant, you can give her the calcium she needs by offering lactose-free or lactose-reduced milk.

    While none of these items will provide enough calcium on their own, it’s also healthy to offer:

    • fortified soy milk,
    • yogurt,
    • canned salmon and sardines with edible bones,
    • oranges or fortified orange juice,
    • broccoli,
    • almonds, and
    • pinto beans.

    Many of these foods do not provide enough vitamin D. Talk to your doctor about whether a supplement of vitamin D would be right for your child.

    When should I call the doctor?

    It is hard to diagnose food allergies. If your child has a reaction to a food, you will need to see your doctor. Your doctor will refer you to an allergist for the right testing.

    If the allergy is confirmed, your doctor may prescribe a medication (e.g. EpiPen or Allerject), a needle that will protect your child right away if he is exposed to the allergen.

    What foods are common allergens?

    Any food can trigger an allergic reaction, but the most common are:

    • peanuts
    • tree nuts
    • eggs
    • shellfish
    • fish
    • milk
    • soy
    • wheat

    Are there any foods I should avoid while breastfeeding to prevent my child from getting allergies?

    You don’t need to avoid milk, egg, peanut or other foods while breastfeeding. There is no evidence that avoiding certain foods will prevent allergy in your child.

    Is there a particular formula I should use to prevent allergies?

    If breastfeeding is not an option or if you choose not to breastfeed, use a store-bought iron-fortified infant formula for the first 9 to 12 months. The formula should be cow’s milk-based. There is no evidence that soy-based formula will prevent your child from developing an allergy

    Should I wait to offer common food allergens to my baby for the first time?
    • It isn’t recommended that you delay introducing a food beyond 6 months of age to try to prevent an allergy. This applies even to children who are considered at high risk of developing an allergy (who have a parent or sibling with an allergic condition).
    • However, once you offer these foods to your child, it’s important to continue to offer them on a regular basis.
    • If you have concerns, speak to your health care provider.

    How will I know if my child has a food allergy?

    Most often, your child will have to eat a food more than once before you know he’s allergic. For example, the first time your child is exposed to nuts, there will probably be no reaction. If he develops an allergy to nuts, the next exposure could be more serious.

    What are the signs of an allergic reaction to food?

    An allergic reaction can affect many different body parts. Symptoms can include:

    • itchy mouth and throat when eating certain foods,
    • hives (raised red, itchy bumps on the skin),
    • stomach trouble (diarrhea, cramps, nausea, vomiting),
    • swelling of the face or tongue, or
    • trouble breathing.

    What is anaphylaxis?

    Allergic reactions can be very serious, even life-threatening. In rare cases, a child may have a rapid and severe reaction to an allergen. This is called anaphylactic shock or anaphylaxis. It can happen within minutes or up to 2 hours of being exposed to an allergen.

    What are the symptoms of anaphylaxis?

    A severe allergic reaction can cause:

    • difficulty breathing,
    • swelling of the face, throat, lips, and tongue (in cases of food allergies),
    • rapid drop in blood pressure,
    • dizziness,
    • unconsciousness,
    • hives,
    • tightness of the throat,
    • hoarse voice,
    • light headedness.

    If any of these happen to your child, go the nearest emergency department or call an ambulance immediately.

    Do children outgrow food allergies?

    Many children outgrow food allergies, especially if the allergy started before age 3. Allergies to milk, for example, will usually go away. However, some allergies, like those to nuts and fish, probably won’t go away

    Feeding your baby in the first year

    Feeding your baby in the first year

    Feeding your baby in the first year of life is an exciting adventure for parents and babies alike. It’s about development, nutrition, curiosity, sharing and learning. Attachmentalso grows as you go about your daily routine with your baby. You can help your baby develop a lifetime of healthy eating habits with the right start.

    The first 6 months

    For the first 6 months of life, breastfed babieswill get what they need from their mother’s milk.

    • Breast milk has the right amount and quality of nutrients to suit your baby’s first food needs.
    • It is easiest on her digestive system, so there’s less chance of constipation or diarrhea.
    • Breast milk also contains antibodies and other immune factors that help your baby prevent and fight off illness.
    • Babies who are exclusively breastfed should get a daily supplement of vitamin D, which is available as drops.

    If breastfeeding is not an option, use a store-bought iron-fortified infant formula for the first 9 to 12 months.

    • Formula should be cow milk-based.
    • Homemade formulas made from canned, evaporated, whole milk (cow or goat) are not recommended as a breast milk substitute. 
    • Homemade formulas can contain harmful germs and lack important nutrients that can make your baby sick.
    • Soy, rice or other plant-based beverages, even when fortified, are not appropriate as a breastmilk substitute as they are nutritionally incomplete for infants.  There is no evidence that soy-based formula will prevent your child from developing an allergy. 
    • Soy-based infant formulas should only be used as an alternative to cow milk-based formula if your baby has galactosemia (a rare disorder that will affect how your baby’s body processes simple sugar) or if your baby cannot consume dairy-based products for cultural or religious reasons. 
    • Talk to your doctor if you are unsure which formula is best for your child.
    Introducing solid foods

    At about 6 months, most babies are ready for other foods. Along with other foods, you can continue to breastfeed until your baby is 2 years and beyond.

    You’ll know baby is ready to start other foods when he:

    • Seems hungry earlier than usual.
    • Can sit up without support, and has good control of his neck muscles.
    • Holds food in his mouth without pushing it out on his tongue right away.
    • Shows interest in food when others are eating.
    • Opens his mouth when he sees food coming his way.
    • Can let you know he doesn’t want food by leaning back or turning his head away.

    Remember that all babies are different. Some babies may be ready a few weeks before or just after 6 months. However, waiting too long after 6 months to introduce other foods increases your baby’s risk of iron deficiency.

      What foods should we start introducing our baby to first?

      There are many ways to introduce solid food. The first foods usually vary from culture to culture and from family to family.

      • Start with foods that contain iron, which babies need for many different aspects of their development. Meat, poultry, cooked egg yolk and well-cooked legumes (beans, lentils, chick peas) are good sources of iron. Store-bought iron-fortified infant cereals such as rice or barley are also common first foods because they are good sources of iron.
      • There is no special order to introduce new foods to your baby. The CPS does not recommended delaying any food (such as peanuts, fish or eggs) beyond 6 months of age as a way to prevent your child from developing allergies. This applies even if your child is at high risk for developing an allergy (a child is considered high risk if a parent or sibling has an allergic condition). Talk to your doctor if you are unsure.
      • When introducing foods that are common food allergens, try offering no more than one per day. Wait two days before you introduce another. This makes it easier to identify a food that may have caused a reaction.

      Healthy foods that your whole family is eating  are the best choice for your baby. Make sure they are plain, with no added salt, sugar or spices. You can use commercial baby foods, but read the label to ensure there is no added salt or sugar.

       

      6 to 9 months

      9 to 12 months

      Grain products

      Offer up to 30 to 60 mL (2 to 4 tbsp.) of iron-fortified infant cereal, twice a day. Then try other grain products such as small pieces of dry toast.

      Offer other plain cereals, whole grain bread, rice and pasta.

      Vegetables

      Offer puréed cooked vegetables—yellow, green or orange.

      Move to soft, mashed cooked vegetables.

      Fruit

      Offer puréed cooked fruits, very ripe mashed fruits (such as bananas).

      Try soft fresh fruits, peeled, seeded and diced or canned fruit, packed in water or juice (not syrup).

      Meat and alternatives

      Offer puréed cooked meat, fish, chicken, tofu, mashed beans, eggs.

      Mince or dice these foods into very small pieces.

      Milk and milk products

      Between 6 and 9 months, you can offer dairy foods like yogurt (3.25% fat content or higher), cottage cheese or grated hard cheese.

      Introduce whole cow’s milk (3.25%).

      After 12 months of age, your baby should not take more than 16-24 ounces (500-720 mL) of milk products per day. Too much milk can lead to iron deficiency anemia.

      Follow your baby’s cues for how much to feed. Start by offering a teaspoon or two. Don’t rush. Some babies need to try a food many times before accepting it. If she’s not hungry, she’ll turn her head and close her mouth. If she’s hungry, she’ll get excited and open up.

      Never trick or coax her to eat more by playing games or offering sweetened foods. Babies who are allowed to follow their own hunger cues are much less likely to overeat later in life.

      Try foods with different tastes and textures to help your baby learn how to handle foods in her mouth.

      Babies who are exclusively breastfed don’t need extra water. When your baby begins to eat other foods, you can start to offer water occasionally.

      • Babies and children don’t need to drink juice. Too much juice, especially apple juice, can cause diarrhea and can fill up small stomachs, decreasing your baby’s appetite for nutritious foods. Too much juice can also cause early childhood tooth decay.

      • Offer water to babies and young children between meals and snacks if they are thirsty. If you choose to offer juice, be sure it is only 100% fruit juice. Always offer it in an open cup, and as part of a meal or snack. Limit juice to 125 to 175 mL (4 to 6 oz.) per day.

      • Babies shouldn’t be offered sugary drinks or foods, such as candies, soda/pop or energy drinks.
      • Don’t give honey to babies under 1 year old, as there is a risk of infant botulism (food poisoning).
      • There is no reason to delay the introduction of common food allergens (such as eggs, fish or nuts) beyond 6 months of age. Once you do, it’s important to continue to offer these foods to your child regularly.
      • If you have concerns, please speak to your health care provider.

      Is there anything else I should know about feeding my baby?

      • Always wash your hands before breastfeeding and your baby’s hands before he eats.
      • Wipe your baby’s gums with a soft, damp cloth twice a day for good oral health.

      Young children don’t know how to chew food into tiny pieces. And they haven’t learned how to bring a piece of food back up when it gets caught going down. Foods most likely to cause choking are small, round or cylindrical in shape, like hot dogs, whole grapes, carrot slices, seeds and hard candy.

      To protect your baby:

      • Always supervise your children while they are eating.
      • Make sure your child is sitting down to eat.
      • Grate raw vegetables such as carrots to make them easier to chew.
      • Cook hard fruits and vegetables to soften them.
      • Slice round foods such as hot dogs or grapes lengthwise.
      • Remove pits from fruits.
      • Chop or scrape stringy meat and add broth to moisten it.
      • Spread sticky foods like fruit butters thinly on a cracker or toast rather than bread.
      • Don’t feed your baby whole nuts, popcorn, gummy candies, hard candy, or fish with bones.

      Your baby’s development

      How often to feed

      Type of food

      Sits with support

      2-3 times a day*

      Puréed, mashed food and semi-solid foods

      Sits on own

      2-3 times a day*

      Family foods, small amounts of soft mashed foods
      without lumps

      Crawls

      3-4 times a day*

      Family foods, ground or soft mashed foods with tiny soft lumps; crunchy foods that dissolve, such as whole grain crackers

      Walks

      3 meals and 2 snacks a day*

      Coarsely chopped foods; foods with more texture; toddler foods; bite-sized pieces of food; finger foods

      * Plus breast milk, formula, or whole cow’s milk, depending on your child’s age

      Developmental milestones related to feeding

      Age

      Physical milestones

      Social milestones

      Birth to 4 months

      • opens mouth wide when nipple touches lips
      • sucks and swallows
      • recognizes source of milk by about 10 weeks

      4 to 6 months

      • sucking strength increases
      • brings fingers to mouth
      • socializes during feeding

      6 to 9 months

      • drinks from a cup held by an adult
      • eats soft food from a spoon
      • begins rotary chewing (in a circular motion)
      • enjoys holding food and finger-feeding
      • loves to be included at the table for meals
      • begins to show likes and dislikes for certain foods

      9 to 12 months

      • tries to use a spoon
      • starts to finger feed with a more advanced grasp
      • feeds at regular times
      • is aware of what others do
      • imitates others

      12 to 18 months

      • grasps and releases food with fingers
      • holds spoon but use is awkward
      • turns spoon in mouth
      • uses a cup but may dribble
      • wants food that others are eating
      • loves performing
      • understands simple questions and requests

      18 to 24 months

      • appetite decreases
      • likes eating with hands
      • likes trying different textures
      • is easily distracted
      • prefers certain foods
      • ritual becomes important

      Breastfeeding

      Breastfeeding

      Breast milk is the best food you can offer your new baby. At about 6 months, your baby will be ready for other foods, but you can continue breastfeeding until your child is 2 years of age and beyond.

      Breast milk:

      • Is naturally and uniquely produced—by each mother for her own baby. So your baby is less likely to be exposed to foreign allergenic material.
      • Contains antibodies and other immune factors that help prevent illness.
      • Has the right amount and quality of nutrients to meet your baby’s first food needs.
      • Is easy on your baby’s digestive system, so there is less chance of constipation or diarrhea.

      Breastfeeding offers your baby the best start, but it’s not always easy. Problems are common. Don’t be afraid to ask for help and support.

      Breastfeeding burns a lot of calories so it is important that you eat a variety of nutritious foods and drink plenty of fluids. You don’t need to avoid milk, egg, peanut or other foods while breastfeeding. There is no evidence that avoiding certain foods will prevent allergy in your child.

      You should avoid dieting while you are breastfeeding.

        Colostrum is the first milk produced in the early days after your baby is born. For some women it is thick and yellowish and for others it is thin and watery. Colostrum is very rich in proteins, vitamins, minerals and infection-fighting antibodies that are found only in breast milk.

        You will know that your colostrum is changing into breast milk when it becomes milky white in colour and your breasts feel full. This is known as your milk “coming in”. The amount of time it takes for milk to “come in” varies from mother to mother. If your milk hasn’t come in within 72 hours of your baby’s birth, it is a good idea to talk to your doctor.

        The milk at the beginning of each feeding is called foremilk. Foremilk is watery to satisfy your baby’s fluid needs.

        As the feed continues, foremilk is gradually replaced by rich, fatty hindmilk. Hindmilk will satisfy your baby’s hunger and provide the calories he needs.

        How do I know when it’s time for a feeding?

        At first, you will feed your baby on demand, which means feeding her whenever she’s hungry. This could be as often as every 2 to 3 hours. Typically, you can expect to breastfeed 8 to 12 times over a 24-hour period. Let your baby set the pace.

        Sometimes babies  want to feed more frequently and for very short periods of time. This is called “cluster feeding” and often happens in the evening. “Cluster feeding” is normal and might  mean your baby is going through a growth spurt.

        When should I express breast milk?

        If your breasts are engorged (large, sore, and feeling extremely full), your newborn may have difficulty latching on. Express some milk by gently massaging or pushing on your breast with your hand or a breast pump. This may help your baby latch on.

        If you will be away from your baby during feeding time, you can express your breast milk. This will allow your baby to drink breast milk from a cup or a bottle when you are not available.

        Expressed breast milk is also a way to keep breastfeeding while your baby is in child care. Make sure the centre or home has a refrigerator. Breast milk has to be kept chilled until feeding time.

        Are there ever reasons not to breastfeed?

        Rarely are there reasons not to breastfeed. If you are receiving chemotherapy (especially cyclosporine, methotrexate, bromocriptine, cyclophosphamide, doxorubicin), have HIV disease, or take street drugs (especially PCP) talk to your doctor. You may be advised not to breastfeed.

        If you have a medical condition or take prescription medications, always talk to your doctor before nursing your baby. With most prescription medications you can continue to breastfeed because only small amounts will pass through your breast milk.

        How will I know if my baby is feeding well?

        Feed your baby from each breast for as long as she wants and alternate the breast you begin with at each feeding.

        Your baby is feeding well when:

        • You hear short swallowing sounds (making a “K” sound) which gradually become longer and deeper as your milk is released.
        • He is content after feeding.
        • The nursing process isn’t painful.
        • Your breasts feel full before and empty after.

        How will I know if my baby isn’t feeding well?

        Your baby isn’t feeding well when:

        • You hear a lot of lip smacking.
        • She isn’t content after a feeding.
        • The nursing process is painful.
        How will I know if my baby is getting enough to eat?

        Signs that tell you your baby is getting enough to eat include:

        • Six or more wet diapers in a 24-hour period.
        • Stools that are yellow, soft and seedy. Early on, these may come after every feeding. After the first month, stools may not be as frequent (1 bowel movement every 2 to 7 days), but they should be soft and yellow.
        • Weight gain (your baby’s doctor will check at each visit).

        What else should I know about breastfeeding?

        • Wash your hands before breastfeeding.
        • If you experience cracked or sore nipples, try exposing them to the air after each feeding, allowing them to dry naturally. You can also apply lanolin cream. You can buy a lanolin product at your local pharmacy.
        • Avoid using soap on your nipples. Soap will wash away your breasts’ natural lubricants.
        • Some women get mastitis, a serious bacterial infection which causes painful swelling of the breasts, and sometimes fever. If you have these symptoms, see your doctor. Mastitis is treated with antibiotics. You can continue to breastfeeding during treatment.
        How should expressed breast milk be stored?

        Expressed breast milk should be kept in a clean container, such as a glass bottle or milk bags for breast milk, with the date marked on it. Plastic polyethylene bags, such as commercial bottle liners, and containers made of bisphenol A (BPA) are not recommended because they can affect the quality of your milk.  

        Breast milk can be stored for:

        • 6 to 8 hours at room temperature (no warmer than 25°C [77°F]),
        • up to 5 days in the refrigerator (at a temperature of below 4°C [<39°F]),
        • 2 weeks in your refrigerator freezer (not in the door),
        • 3-6 months in the freezer compartment of a refrigerator with separate doors, or
        • 6-12 months in a separate chest-type freezer (at a temperature below -20°C [-4°F]).

        Never mix fresh breast milk with chilled or frozen breast milk because it can cause bacteria to grow and lead to food poisoning

        How do I prepare expressed breast milk for a feeding?

        • Thaw frozen milk in the refrigerator and keep it there until you’re ready for it. Do not use a microwave to thaw or warm frozen expressed milk because it can affect the quality of the milk. .
        • Prepare clean bottles and nipples.
        • Put the thawed milk into a feeding bottle or cup. You can warm the milk by placing the bottle of expressed milk into a container of warm water before the feeding.
        • Shake the bottle of breast milk well to mix any separated layers.
        • After each feeding, throw away any leftover milk.
        • Do not refreeze breast milk once it has been thawed or partially thawed.

        Does my baby need anything else besides breast milk?

        Since breast milk has only small amounts of vitamin D, babies who are breastfed should receive a daily supplement, which is available as drops.

        What do I feed my baby when I cannot breastfeed?

        If breastfeeding is not an option, use a store-bought iron-fortified infant formula for the first 9 to 12 months.

        • Formula should be cow milk-based.
        • Homemade formulas made from canned, evaporated, whole milk (cow or goat) are not recommended as a breast milk substitute. 
        • Soy, rice or other plant-based beverages, even when fortified, are not appropriate as a breastmilk substitute as they are nutritionally incomplete for infants.  There is no evidence that soy-based formula will prevent your child from developing an allergy. 
        • Soy-based infant formulas should only be used as an alternative to cow milk-based formula if your baby has galactosemia (a rare disorder that will affect how your baby’s body processes simple sugar) or if your baby cannot consume dairy-based products for cultural or religious reasons. 
        • Talk to your doctor if you are unsure which formula is best for your child.

        Since vitamin D is already added to infant formula, most full-term babies who are formula-fed don’t need a supplement. However, formula-fed babies in northern communities should receive a supplement of 400 IU/day from October to April to ensure they have enough vitamin D.

        At about 6 months, you can begin to introduce solids to your baby’s diet.

        Who should I ask if I have questions about breastfeeding?

        Although breastfeeding is the natural way to feed your baby, you may find it hard in the beginning. This is normal and like most aspects of motherhood, you’ll learn through experience. Don’t be afraid to ask for help or advice from health professionals or experienced friends and relatives.

        Your doctor or midwife can counsel you about the principles and practice of breastfeeding

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