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Feeding Suggestions for our Littlest PHA Patients

Birth to 6 months:
Breast is best: Breast milk for the first year is recommended but cow’s milk protein based formulas are a nutritious alternative when breast is not possible.

Vitamins:
Vitamin D 400IU dropper vitamins to be started at a few days of life and continued throughout childhood.
Poly-vi-sol with iron exclusively breast fed babies after age 6 months.
Fluoride supplement by prescription after age 6 months if not getting any fluoridated water (ie: well water).

Solids

Age 4 – 6 months:
May introduce complementary feedings at 4-6 months when developmentally ready.
Baby should be fed by appetite and allowed to turn away when he/she has had enough.  Typical serving size might be 2 TBLSP and should be given from a spoon.  Typically babies will have one meal a day at this age.
Introduction of solids prior to age 4 months increases the risk of obesity.
Avoid processed juice because it is sugared water without nutritional value.

Begin single ingredient purees (Stage 1) of vegetables, meats, fruits and cereals, in any order, to allow baby to become accustomed to diverse flavors.
Balance foods to adjust to bowel habits (rice, bananas may make stool solid, “P” fruits loosen stools (prunes, pears, peaches, plums).

Introduce one new food every 3 days observing for reactions (for example: a rash).

These small servings are meant to introduce healthy foods and flavors, hoping that early introduction of a variety of foods might decrease the incidence of food allergy.

Important nutrients:
Iron and zinc: meats and fortified infant cereals, lentils, prunes, kidney or white beans
Vitamin C: to improve absorption of iron.  Found in: cantaloupe, mango, strawberries, broccoli

Cereals:
Limited quantities, on spoon mixed with breast milk or formula, not in bottle.
Infant iron fortified wheat cereals, oats, barley and multigrain.
Rice: due to arsenic concerns, may be included but not exclusively.

Age 6-9 months
Add scrambled eggs, cow’s milk yogurts, cottage cheese, melted cheeses, nut butters: peanut, cashew, almond butters (mixed into vegetables), pureed lentils and beans, meatballs.
Continue three days with each new food observing for reactions.
Increasing texture is important at this age when babies are more willing to accept new things than they will be after age 9 months.
Peanut butters in children without severe eczema or egg allergy: freely introduced in age appropriate forms when other complimentary foods are introduced, after 6 months.

Age 9 months:
Begin finger food: steamed broccoli and carrots, shredded chicken and cheese, fish and shellfish.

Avoid choking foods until age 3: popcorn, raw vegetables, and nuts.

Avoid processed foods: aiming to introduce and present healthy natural food, not factory produced foods (ie: Puffs, Cheerios, Goldfish, Teething biscuits).

Age 12 months:
Whole milk and honey can be introduced.
May begin whole milk (16-24oz per day) after assessment in our office for anemia.  Water as the supplemental beverage.  Beverages should be offered in a sippy cup, no juice.

Emphasis on natural, unprocessed foods and whole grains.  Avoid empty calories and hidden sugar found in processed foods.  (Examples: mac and cheese, white breads, boxed cereals, fruit snacks, cereal bars, yogurts with factory added fruits).

No sweets — cakes, cookies, ice creams — until 2.

Healthy snack food examples: cut fruit, pieces of cheese, peanut butter on whole wheat crackers, hummus, hard boiled eggs, guacamole, yogurt fruit or vegetable smoothies.  Fruits and veg should be offered at every meal in order to reach goal of 5-6 servings per day.

Children will eat what is offered to them and develop and retain a varied and healthy palate if this is what is presented to them.  If processed food creeps in, it is very difficult to go back.

Avoid entertainment food, snacks and grazing can easily take the place of a healthy appetite for meals.

The first 2 years are your opportunity to create a healthy lifelong eater.

Dr. Patricia Eagan