Online Learning: Early Nutrition

See Feeding Your Baby – 6-12 Months – Horizon Health Network
See Guide and recipes for introducing solid food – Vitalité Health Network

Infant Feeding Recommendations

• Exclusive breastfeeding is recommended for the first 6 months
• Around 6 months, start offering solid foods and continue breastfeeding for 2 years and beyond.
• Breastfed and partially breastfed babies need to receive 400 IU of vitamin D daily via supplement
• If baby is not breastfed, a commercial cow’s milk based infant formula is recommended until 9 to 12 months of age.

Around 6 months, look for signs your baby is ready for solids:

• They are able to sit in a highchair with or without support.
• They show interest in what you and your family are eating.
• They watch the spoon and open their mouth when the spoon is coming.
• They pick up food and try to put it in their mouth.
• They keep food in their mouth and swallow it instead of pushing it out.

• Offer your baby iron rich foods first, such as iron-fortified infant cereal, finely minced meat or fish, mashed cooked egg, mashed beans, or tofu.

• Add soft vegetables and fruits.

Introduce common allergenic foods safely.

Common allergenic foods include peanuts, tree nuts, soy, eggs, wheat and dairy. Waiting to give common allergen foods will not prevent food allergies and may promote allergy development.

• Add one new allergenic food at a time.
• When introducing common allergenic foods for the first time give a small amount. For example, offer smooth peanut butter that has been diluted in hot water (cooling after mixing) or mixed with a previously tolerated food (breastmilk, infant cereal, yogurt, etc.). Offer it on the tip of a spoon, directly in the mouth, and wait 10 minutes. If no symptoms develop, feed at the infant’s usual pace of eating.
• Give priority to introducing peanuts and eggs around 6 months
• Offer the tolerated allergenic food 2-3 times per week

• Start by offering pureed or mashed foods around 6 months
• Gagging is a natural reflex when learning to chew and swallow new foods.
• Between seven to nine months, based on your baby’s feeding cues and abilities, progress quickly to soft minced or diced foods, regardless of how many teeth your baby has.
• Allow baby to eat with their fingers and from a spoon.
• Safe finger foods:
  • Pieces of soft, cooked vegetables
  • Soft ripe fruit, such as bananas
  • Finely minced, ground, or diced cooked meat
  • Deboned fish, chicken, or turkey
  • Grated cheese
  • Bread crust or toast
• By 12 months, your toddler can eat a variety of healthy foods with various textures, continue to modify the texture of food as needed.

See video: Offering A Variety Of Textures To Your Baby (UnlockFood.ca)

You can make your own baby food at home with a few basic kitchen tools: Fork or potato masher, grater, toaster, blender or food processor, and a good cutting knife.

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Cooked protein foods
These can be chopped, minced, grated, or cut up. You can purée or mash them in water, breastmilk, or the liquid you cooked them in. If you are formula feeding, you can use formula.

• Beef
• Pork
• Chicken
• Turkey
• Fish – See: Consumption Guideline: Fish and Mercury (GNB.ca) and Mercury in Fish (Canada.ca)
• Egg
• Dried peas, beans and lentils

Vegetables and Fruit
Fresh, frozen, and low-sodium canned vegetables and fruit offer many choices. If you can’t find canned low sodium vegetables or fruit in water, just rinse the food before you serve it.

• Cook, then mash, purée, chop, mince, grate, or cut up your fruit and veg.
• Vegetables should be cooked, but very soft fruits – like ripe bananas or avocados– can be served raw and just cut up or mashed.

Whole Grains
Smooth, plain/single ingredient infant cereals with iron can be prepared according to the directions on the package. You can mix breastmilk or formula and other fruit.

Some good whole-grain finger foods:

• Pieces of toasted bagel
• Dry toast strips
• Rice
• Quinoa
• Roti
• Noodles
• Cooked pasta
• Flatbreads
• Cereal
• Unsalted crackers

Honey
Babies should not have honey at all until they are 12 months old. This includes baked or cooked foods that contain honey. This is due to a risk of botulism- a serious type of food poisoning.

Foods with added sugar
Babies and young children have no room in their diet for added sugars. Foods high in added sugar will leave little room in baby’s small stomach for the foods they need to grow and develop such as iron rich foods, vegetables, and fruit.

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Foods with added salt
Salt should be limited in baby’s diet because their kidneys are not fully developed and are not able to process large amounts of salt. Babies exposed to salty foods may develop a preference for these types of foods

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Foods that can cause your baby to choke

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Division of Responsibility

Parent’s role: What, when, where food is offered

Baby’s role: if and how much food is eaten

Developing a healthy relationship with food starts with encouraging your baby to follow their own hunger cues.

How to tell if your baby is hungry:

• Turns towards food
• Opens mouth when they see food
• Gets excited when they see food or when they hear things like “let’s have lunch” or “time for a snack”

How to tell if your baby is full:

• Turns their head away
• Closes their mouth when food is offered
• Spits out food
• Covers their mouth with their hands
• More interested in playing with food or throwing it on the floor

See Video: Responding To Baby’s Cues (UnlockFood.ca)

Healthy Eating Habits

Mealtimes are a chance to connect with your baby as a role model.

• Include your baby in family mealtimes
• Limit distractions. No toys or TV/ electronics at meal and snack time.
• Be patient. Babies will make a mess as they learn to feed themselves.
• Encourage but do not pressure
• Avoid using food as a punishment or reward
• Serve a variety of healthy foods, even if you do not like them.

• Use Canada’s Food Guide for what foods to offer.

• Some foods may need to be made more toddler friendly by changing the shape and texture – see the Is There Anything I shouldn’t Feed my Toddler tab on foods that can cause choking and how to make food safer.
• Include: fruits and vegetables, protein, and grains

Vegetables and Fruit
Fresh, frozen, and low-sodium canned vegetables and fruit offer many choices. If you can’t find canned low sodium vegetables or fruit in water, just rinse the food before you serve it. Offer fruit instead of fruit juice, as fruit juice can be higher in sugar and lacks the fiber that fruit contains. You can offer water to drink instead of juice. Here are a few examples of vegetables and fruits:

• Carrots, grated or cooked to soften
• Celery, cut into small pieces
• Bell peppers, cut into strips
• Broccoli, cooked to soften
• Strawberries, diced
• Blueberries, cut in half
• Bananas, cut into pieces

Protein foods

• Nut and Seed butters
• Peas, beans, and lentils
• Hummus
• Meat (beef, pork, chicken, turkey)
• Fish – See: Consumption Guideline: Fish and Mercury(GNB.ca) and Mercury in Fish (Canada.ca)
• Eggs
• Milk
• Cheese
• Yogurt

Whole Grains

When checking to see if a product is made with whole grains, look for the words “whole grain”, “whole wheat” or “brown __” on the package labels.

• Whole grain bread
• Cooked pasta
• Cereal
• Quinoa
• Oats
• Unsalted crackers
• Rice

Although you may offer something from each part of the CFG plate at your meals, your toddler may choose not to eat all of it. That’s ok too!  Remember, they are learning.

We also want to acknowledge that the best healthy eating patterns include foods that reflect your preferences for taste, your culture, budget, and your lifestyle.

See: Healthy eating for parents and children – Canada’s Food Guide

Milk

If breastfeeding, continue until age 2 and beyond.

• Milk provides protein, fat, calcium and vitamin D, as well as other important nutrients. Offer pasteurized whole cow’s milk (3.25%) or pasteurized full fat goat milk fortified with vitamin D.
• Other types of milk, such as soy, almond, coconut, rice or hemp are not a suitable alternative to drinking cows/goats’ milk or breastmilk as they don’t contain comparable amounts of fat, protein and energy
• If included, offer 2-3 cups (500-750ml) of milk per day.
• After age 2, you can switch to a lower fat milk.
• If your family does not drink cows’ or goats’ milk, then a fortified soy beverage is the recommended plant-based alternative.
• Offer about 1/2 cup of milk at a time (for example at each meal and at bedtime).

Vitamin D

• Health Canada recommends a vitamin D supplement of 400 IU for breastfed or partially breastfed babies/toddlers until the age of 2.
• It is understood that after age 2, children are likely eating adequate food sources of vitamin D on a daily basis and do not require a vitamin D supplement. These food sources may include milk, egg yolk, fatty fish, and soft margarine.

See: Vitamin D – Canada.ca

Foods with added sugar

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• Some foods contain higher amounts of sugar and should be offered less often
• We suggest offering small portions of sweets in a neutral way, not as a ‘treat’ or as a reward. They could be offered at a meal instead of at the end (they may choose to eat the “dessert’ first sometimes and that’s perfectly ok.)

Foods that can cause choking

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See: Loving Care – 1 to 3 years

Meal Routines and Family Meals

• Toddlers do best when there is a routine with their meal and snack times, so they know what to expect.  We recommend keeping to a schedule of three meals and two to three snacks each day at about the same time.
• Enjoy eating with family and friends as much as possible and avoid distractions
• Your toddler should be seated in a highchair or booster seat and supervised during meals and snacks.

See: Healthy eating for parents and children – Canada’s Food Guide

See: Loving Care – 1 to 3 years

Developing a healthy relationship with food starts with encouraging your child to follow their own hunger cues.

• The parent’s role includes controlling what foods are offered, when they are offered and where they are offered at mealtimes and
• The child’s role includes controlling how much, and whether or not to eat the foods that are offered to them.
• See: Food Tips for Children and Parents – Southwestern Public Health

• Toddler behaviours can often be mistaken for picky eating. These behaviours may include eating very little one day and a shocking amount the next; liking a food one day and disliking it the next; going through a phase of only liking a handful of the same foods; saying they’re full at mealtimes then being hungry shortly after; and varying in their love for eating.
• Toddler eating habits likely start at around 18 months. Your baby that was once open to exploring and trying new foods will start developing new behaviors around feeding.
• They are also learning to process their emotions, test boundaries or they may want to assert control of situations.
• These behaviors are often temporary and will go away over time as your toddler continues to grow and develop. When you spend time eating as a family and modelling the eating behaviors you’d like to see, your toddler will learn to participate and adopt these new behaviors over time.

Too Distracted

When your toddler is too distracted to eat here are some tips:

• Have sit-down meals & snacks.
• Keep to a schedule.
• Remove the distraction (toys, tv screen).
• Keep mealtimes short and sweet.

Throwing Food

If you toddler starts throwing food during mealtimes here are some tips:

• Stay Calm & Neutral when it happens.
• Give them 1 or 2 more chances to correct the behavior and if throwing food continues, remove the food.
• Prepare to take the hint your toddler is finished eating.
• Introduce the “No” bowl – This is especially useful for toddlers that tend to get overwhelmed when they have food in front of them that they don’t want. The “no” bowl is a designated place where your toddler can put the food that they have said no to. This gives them the control to choose between the options put in front of them and keep the items they DO want while putting the foods they DON’T in a designated place that isn’t all over the floor.

Food Refusal

If you toddler is refusing foods during meal or snack times here are some tips:

• Resist the urge to pressure, bribe or force them to eat the food.
• Let them explore unfamiliar foods at their own pace.
• Pair new foods with familiar ones.
• Keep offering the rejected foods.
• Switch up the serving style (For example instead of potato wedges, try serving the potatoes cut into fries or mash them up.)
• Include them in prep/cooking the food.
• Eat the same foods as a family.
• Resist the urge to hide, sneak or trick your toddler into eating vegetables and fruits.
• Tone down strong vegetable flavours with seasonings, herbs, sauces/gravy, or breadcrumbs.
• Tone down ‘weird’ fruit textures by making them into a sauce/jam or choosing canned vs fresh.
• Be prepared to accept when your toddler simply doesn’t like it.

• Use Canada’s Food Guide for what foods to offer.

• Include: fruits and vegetables, protein, and grains

Vegetables and Fruit
Fresh, frozen, and low-sodium canned vegetables and fruit offer many choices. If you can’t find canned low sodium vegetables or fruit in water, just rinse the food before you serve it. Offer fruit instead of fruit juice, as fruit juice can be higher in sugar and lacks the fiber that fruit contains. You can offer water to drink instead of juice. Here are a few examples of vegetables and fruits:

• Carrots
• Celery
• Bell peppers
• Broccoli
• Strawberries
• Blueberries
• Bananas

Protein foods

• Nuts, Seeds and their butters (ex. peanut, almond, or sunflower butter)
• Peas, beans, and lentils
• Hummus
• Meat (beef, pork, chicken, turkey)
• Fish – See: Consumption Guideline: Fish and Mercury(GNB.ca) and Mercury in Fish (Canada.ca)
• Eggs
• Milk
• Cheese
• Yogurt

Whole Grains

When checking to see if a product is made with whole grains, look for the words “whole grain”, “whole wheat” or “brown __” on the package labels.

• Whole grain bread
• Cooked pasta
• Cereal
• Quinoa
• Oats
• Unsalted crackers
• Rice

We also want to acknowledge that the best healthy eating patterns include foods that reflect your preferences for taste, your culture, budget, and your lifestyle.

See:

• Make healthy meals with Canada’s food guide plate – Canada’s Food Guide
• Food guide kitchen – Canada’s Food Guide
• Healthy eating for parents and children – Canada’s Food Guide

When packing your child’s school lunch, it can be helpful to think in sections. Choose foods from each of these sections every day:

• Vegetables
• Fruit
• Whole Grains
• Protein

A bonus section can be left occasionally for ultra-processed foods. These are foods that contain higher amounts of sugar, sodium or fat. They should not be offered every day, but can be included in small portions on occasion. Examples include: yogurt drinks, cookies, chips, chocolate and candy. Check out the How to balance offering nutritious and ultra-processed foods tab for more tips on how and when to include these foods.

If packing a school lunch is still a struggle, try following a theme each day to help you decide what to pack. For example:

See:

• Peanut-free Lunches and Snacks – Unlock Food
• Healthy eating at school – Canada’s Food Guide

Using the food labels on packaged food can help you know what foods to choose for your child.

Follow these 3 steps to make decisions at the grocery store easier:

Find the amount of food: The numbers on the Nutrition Facts table will be based on the serving size listed at the top of the table. Helpful Hint: If you or your child plan to eat more than the suggested serving size then adjust the numbers on the facts table accordingly to match the new serving size.

Use the % daily value (DV): 5% DV or less is a little, 15% DV or more is a lot.

• Choose packaged foods that have a lower daily value for sugar, sodium, and saturated fats.
• Choose packaged foods that have a higher daily value for fibre, protein, and vitamins/minerals.

Read the list of ingredients: Ingredients are always listed in order of weight. This means that the list starts with ingredients that weigh the most, and ends with ingredients that weigh the least.

• Choose packaged foods with a shorter ingredient list. This often means that the product has been less processed because less ingredients and stabilizers have been added to the food’s raw form.
• Choose packaged foods with less refined flour (white flour), sugar and hydrogenated oils. This means that these ingredients are listed further down the list or not listed at all.

See:

• How to use food labels to make healthier choices – Canada’s Food Guide
• Prepare meals and snacks using healthy ingredients – Canada’s Food Guide

The foods we eat can be broken down into 3 main categories:

• Whole Foods: Foods that are in their most natural state. Examples include:
  • Fresh veggies and fruits
  • plain meat, poultry, or fish
  • milk
  • nuts and seeds
  • whole grains

• Nutritious Processed Foods: Foods that have undergone some form of processing but still contain beneficial nutrients and just a few ingredients. Examples include:
  • canned veggies or fruit
  • canned fish
  • cheese
  • bread

• Ultra-Processed Foods: Foods that have been processed and packaged by food companies using many manufactured ingredients, rather than whole foods. These often contain additives like artificial colors, flavors, and preservatives, and are typically high in fat, sugar, and salt. Examples include:
  • chips
  • Hotdogs
  • frozen dinners
  • sweet treats

Ultra-processed foods can have a place in an overall healthy eating pattern. When included, these foods should only be offered to children in small portions and occasionally.

Here are some tips on how to offer ultra-processed foods to your child:

• Offer them with a meal or snack on occasion. Ultra-processed foods should be offered infrequently enough so they are not expected, but frequently enough so they don’t feel too restricted. Having a meal or snack with them will make sure your child won’t fill up only on the ultra-processed food.
• Offer them in a neutral way. Remove any bright flashy packaging before offering them with other nutritious foods. Do not pressure or force your child to eat the nutritious foods first. They may choose to eat the ultra-processed food first sometimes, and that’s ok!
• Do not use them as a bribe or reward. When food is given as a reward, it becomes more special than the other foods a child is given throughout the day.
• Do not closely monitor intake of ultra-processed foods during special occasions and celebrations. Let your child enjoy, get their fill, and learn to regulate their intake during special occasions. In general, allowing your child to indulge during special events will not have a huge impact on their overall growth and development. Once the occasion is over, simply return to your regular meal and snack routine then continue to follow the other tips provided in this list.
• Take notes on how your child acts when given ultra-processed foods. Adjust your approach to offering them accordingly. For example, if your child gets too excited about the food or is caught trying to sneak it, consider how frequently you are offering that food. If you suspect your child feels it is too restricted, try offering it a little more often to help them feel more neutral about it.

• Throughout the school-aged years, your child is still growing and developing at a rapid rate. They are using more brain power with learning and socializing at school. That is why we recommend keeping to a schedule of three meals and two to three snacks each day at about the same time each day.
• Enjoy eating with family and friends as much as possible. Children who have family meals have been shown to eat better, feel better about themselves, get along better with others, and do better in school (Satter, E. 2018. Feeding with Love and Good Sense: 6 through 13 years).

See: Eat meals with others – Canada’s Food Guide

The focus of raising a competent eater should be on how you feed your child and how your child behaves at mealtime, not on what your child eats. The focus should be on family meals and the positive relationship your child has with food rather than on what or how much your child eats.

A competent eater means:

• They feel good about eating; They enjoy food and join in happily with family meals.
• They enjoy meals and behave nicely at mealtimes; They feel good about being included at meals and do their part to make mealtime pleasant.
• They pick and choose from the food provided; They are relaxed when offered food, they say “yes, please” and “no, thank you”. They can ignore the food they don’t want and can make do with what’s available.
• They eat as much or as little as they need; Because you trust them to eat as much as they need, they trust themselves. You both understand that your child is growing and developing into the body intended for them. They do not try to adjust how much they eat to get heavier or thinner.
• They learn to take care of themselves and to respect food; They manage their snacking and schedule to arrive at family meals on time and hungry.

The Division of Responsibility:

The Division of Responsibility is a model that is research based for feeding children. It can be used at every stage of your child’s growth. It’s a great way to address feeding concerns and set your child up for a positive relationship with food. Both parents and children have roles:

• The parent’s role includes controlling what foods are offered, when they are offered and where they are offered at mealtimes and
• The child’s role includes controlling how much, and whether or not to eat the foods that are offered to them.

See: 10 Tips to Help Your Child Have a Positive Relationship with Food and Their Body

Here are some solutions to help you with these mealtime struggles:

• Keep to a schedule.
• Remove distractions (TV, pets, toys, radio, etc.)
• Avoid pressuring, bribing or forcing your child to eat the food.
• Include your child in meal planning and cooking.
• Check out the *Toddler Nutrition Class* tab for more solutions to common mealtime struggles

Untouched packed lunches

Foods not eaten from packed lunches can be one of the mealtimes struggles often seen for school-aged children. Some reasons can include:

• Not being hungry
• Being overwhelmed (with number of kids, new cafeteria, noise, etc…)
• Not liking the food
• Feeling embarrassed about what’s in the lunchbox
• Liking what peers have in their lunchbox better
• Being too chatty (with friends)
• The food is not at the temperature that the child likes (hot or cold)
• Not being able to open packages
• Short lunch breaks (not enough time to eat)

Here are a few tips to help you manage foods not eaten from a packed lunch:

• Have a conversation with your child to find out why the food hasn’t been eaten.
• Make sure your child can open the packaging or containers.
• Make sure there is something your child likes in their lunchbox.
• Cut foods into smaller portions. This makes it easier for children to eat.
• Include your child in cooking and lunchbox preparation.

Only wanting the same few foods

Liking only the same foods means your kid has “safe foods”. A safe food is a reliable and consistent food item for a child. They may choose these items more often. This is typically a phase of development, and your child will grow out of it.

Here are a few tips to help your child build a bigger net of accepted foods:

• Build on the safe food. Instead of removing items, build on what they actually like. For example, if your child likes chicken nuggets, try adding a vegetable.
• Add variety. Try changing the cooking style (roasting vegetables instead of boiling them) or the serving style (having ingredients for tacos in the middle of the table instead of having the tacos already made).
• Modify the safe food:
  • Change the toppings (serve peanut butter on an English muffin one day and pizza sauce with cheese the next).
  • Changing the shape (serve shredded carrots instead of long pieces of carrots).
  • Changing the cooking method (serve raw carrots instead of cooked carrots).
  • Adding a dipping sauce.

Sneaking food

Finding out that your child is raiding the pantry behind your back or secretly stockpiling goodies can be upsetting. You may start noticing food wrappers under your child’s bed or missing food from the fridge or cupboards. You may feel angry, confused or concerned and may want to address it right away and discipline your child right away. This is the perfect time to help your child develop a healthy long-term relationship with food without feeling as though they need to sneak food.

Here are a few solutions that may help:

• Have a conversation with your child. Approach your child gently and lovingly. Try and avoid approaching your child during meal or snack time. Ask them why they are sneaking food.
• Sticking to a meal and snack routine. Keeping consistent with meals and snacks will help with hunger.
• Moving food items around in your cupboard and putting “sometimes” foods in a less accessible location. By continuing to offer the “sometimes foods” regularly, they will not feel the need to reach for these items.
• Come up with a solution together. Having your child have a say in the solution will make them feel like they are being listened to and will develop a healthy relationship with food.

See:

• When your child is a picky eater | Caring for kids
• Cooking with Kids of Different Ages – Unlock Food
• Involve kids in planning and preparing meals – Canada’s Food Guide
• Simple Lunch Solutions for your Kids – Unlock Food

Pressure to eat

Pressure can be beneficial in some circumstances, but pressure when it comes to nutrition is not beneficial. It can have various forms:

• It can seem positive; praising, rewarding, playing games and bribing.
• It can be negative; restricting amounts, punishing, begging and withholding desserts.
• It can also feel like you’re doing the right thing; reminding them to eat or at least try, warning them that they will be hungry after the meal or making special food or a second meal.
• … it always backfires.

Here are a few solutions that may help build a no pressure, positive environment for eating:

• Depend on structure. Don’t concern yourself with what and how much your child eats of the foods you provide.
• Avoid restriction. Allow your child to have a wide variety of foods.
• Don’t reward or praise them for eating. When food is given as a reward, it becomes more special than the other foods a child is given throughout the day.
• Remember the Division of Responsibility. Trust and let your child decide how much they will eat.