How Do I Safely Feed My Child?
When your child is showing all the developmental signs that he is ready for feeding, it is time to begin. It is such an exciting time in your child's life. You, as a parent, get to introduce them to a whole new part of life — eating solid food. It is important that you do this in a safe manner.
Choking
Choking is a concern for every parent, but there are steps that you can take to prevent choking. Always watch your child when he is eating or playing around food. Do not allow your child to run around with food in his mouth. Your child should be seated and supervised for all meals and snacks. Make sure all items that your child could choke on are out of reach. And, most important, learn how to help your child if he is choking. Most community hospitals teach parents' first aid and CPR classes.
According to the Center for Disease Control and Prevention, thousands of children visit the emergency each year due to choking. In fact, in the year 2000, there were 17,500 visits to the emergency room due to choking. Sixty percent of those visits were caused by children choking on food.
There are a handful of foods that are dangerous due to the high likelihood that your child could choke on them. The American Academy of Pediatrics recommends that all children under the age of four years old should avoid the following food items:
- Hot dogs
- Nuts and seeds (they recommend children be seven years old for nuts)
- Chunks of meat or cheese
- Whole grapes
- Hard, gooey, or sticky candy
- Popcorn
- Chunks of peanut butter
- Raw vegetables
- Raisins
- Chewing gum
Allergy Prevention
A food allergy is a reaction by your body's immune system to a food that it thinks is a threat. It is an “overreaction” of the immune system. The specific reactions range from rashes or hives to trouble breathing.
Research presented in the Journal of Pediatrics indicates that 4 to 6 percent of children have documented food allergies. Food allergies appear to be on the rise. More and more families are adjusting their dietary habits due to food allergies. These changes can be minor inconveniences or major life changes depending on the number and severity of food allergies.
The eight most common food allergies are milk, egg, peanut, wheat, soy, tree nuts, fish, and shellfish. Some people have allergies to more than one of these top allergens. It is possible for your child to outgrow their allergies by the age of three. The only preventive measure to take for food allergies is total avoidance of the allergen; the only treatment is medication to help if a child is accidentally exposed to allergenic food.
There are steps that you can take to potentially decrease the chance that your child will develop food allergies. The current recommendation from the American Academy of Pediatrics is to exclusively breastfeed for the first six months of life to decrease their exposure to allergens. If breastfeeding is not possible, the recommendation is to exclusively formula feed and delay introduction of solids until the age of six months.
In addition, it is recommended to not introduce cow's milk or egg yolks before the age of one year. If there is a family history of food allergies or atopic disease (e.g., hay fever, asthma, eczema) the recommendation is to further delay the introduction of eggs until the age of two and to wait until the age of three to introduce peanuts, tree nuts, fish, and seafood.
I think my child has a food allergy. What should I do?
You and your pediatrician will need to decide how you are going to limit your child's exposure to high-allergen foods. If you suspect allergies in your child, see a pediatric allergist who is trained to identify true food allergies in your child.
Some families, after consulting with their pediatrician, will begin to introduce solids to their infant as early as four months of age. This cookbook does include recipes for infants at this age to show how to introduce solids appropriately. If you start solids at this age, your child should be meeting the developmental milestones to support taking in solid foods. Take your time introducing food to your child. Eating is a new experience and there is no need to rush into offering a huge variety of foods to a very young infant.
Your child's first food should be a prepared iron-fortified infant rice cereal. This is a very hypoallergenic food. Take your time introducing new foods to look for signs of a food allergy. It is important to only introduce one new food at a time. It is recommended that you wait four to seven days after introducing one food before you introduce another. In those four to seven days, you should be watching your child for signs of food allergies. Look for signs such as itching, burning around mouth, runny nose, skin rash, hives, diarrhea, vomiting, and trouble breathing. Once your child has tolerated a food, it is then acceptable to mix that food with another food that has also been established to be tolerated.
Nitrates
What are nitrates? Nitrates are molecules that are comprised of nitrogen and oxygen. They are naturally found in the produce and in the water that people drink. As part of a balanced diet in adults, these products are not harmful. Nitrates can be harmful to young infants. The American Academy of Pediatrics (AAP) cautions parents about the risks of nitrate poisoning in infants.
Nitrate poisoning causes your baby to have high levels of methemoglobin in their bodies. Why is this a problem? If there is too much methemoglobin in the blood, oxygen has a hard time reaching your baby's cells. Cells need oxygen to function. This syndrome is sometimes called “blue baby” syndrome since baby's skin turns slightly blue due to lack of oxygen. Although rare, this can be a serious and life-threatening condition.
The highest risk for babies to develop nitrate poisoning is from well water with high levels of nitrates. Do not use well water unless it has been tested for nitrates. The concentration should be should be less than 10 parts per million (ppm). Another risk factor involves certain types of produce that can be high in nitrates due to the soil that they are grown in. These vegetables are spinach, beets, broccoli, and carrots. The AAP cautions parents against making their own baby food using these vegetables for infants under six months of age. Many commercial makers of baby food voluntarily screen their vegetables for nitrates to ensure the supply is safe. If you are feeding any of these higher-risk vegetables to an infant under six months, it is safest to purchase commercially prepared and screened infant food. Infants over six months should be able to tolerate the nitrates that might be in these vegetables.
Food Safety
In the first few months of your baby's life, it is important to sterilize items that may come in contact with her in order to minimize her exposure to bacteria and viruses. However, once your baby is a little mobile and begins to explore the world with her mouth, it is not necessary to sterilize everything in her environment except bottles and nipples.
The most important way to decrease the risk of a food-borne illness is follow safe food handling practices. Safe food handling practices for infants and children are no different than for adults. Hand washing is the first step to every adventure in the kitchen. Here are some quick tips for food safety from the United States Department of Agriculture Food Safety and Inspection:
Frequently clean the areas where you prepare food.
Separate meat and poultry from other foods; do not cross contaminate.
Always cook food to proper temperatures.
Refrigerate your food right away so bacteria cannot grow on it.
Cooking and preparing food safely involves following guidelines that help decrease the chance that bacteria can grow in your food. These recommendations help ensure that your baby will not get food poisoning due to unsafe kitchen practices.
Once you purchase or cook your food, you need to safely store it. The rule is to always put perishable food in the refrigerator within two hours. If you live in a hot climate or the temperature is over 90 degrees, that time decreases to only one hour. Cook or freeze chicken, fish, or ground meat within two days. If it is heartier meat like beef, veal, lamb, or pork you can wait three to five days before freezing. Store your uncooked poultry, fish, or meat separately from fruit, vegetables, or any other raw food to help stop cross contamination. Refrigerators should be at 40°F or below, and freezers should be at 0°F.
In food preparation, use separate cutting boards for raw meats so that they won't contaminate the fruits and vegetables that you are preparing. Wash cutting boards thoroughly in hot, soapy water after each use. There are three ways to thaw frozen meats. You can place them in the refrigerator to thaw; you can submerge the meats in cold water in the sink and change the water every thirty minutes; or you can use the microwave to thaw frozen items. It is not safe to thaw foods on the counter at room temperature. Letting meat sit out at room temperature allows bacteria to grow on the food.
Once food is thawed, it is possible to refreeze it without cooking it first, but only if you thawed it in the refrigerator. If you thaw it in the microwave or in cold water, you need to cook the food and then refreeze it. It is recommended that you go through this cycle only once and not continue to freeze and thaw the same food over and over again.
When cooking foods, make sure that you cook meats to the proper temperature. Use a meat thermometer to tell if the food has reached the proper temperature. Beef, veal, lamb, roasts, and chops all need to reach 145°F. Pork and ground meat (beef, veal, and lamb) need to reach 160°F. Poultry, such as chicken and turkey, needs to reach 165°F.
