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Infant feeding (ages 0 - 2)Formula feedingDaily communication with families can helpan infant’s overall health and well-being. Askfamilies about their feeding preferences; workwith them to develop a feeding plan for theirinfants; and discuss which foods have beenintroduced at home.For mothers who are not breastfeeding, ironfortified infant formula is the next best choice.Infants who are fed formula should continue tohave formula until they are nine months to oneyear old, at which time they may be ready forwhole cow’s milk (3.25% MF).BreastfeedingBreastfeeding is the ideal way to feed a baby.Health Canada recommends breast milk as theonly food babies should consume until they aresix months old, with continued breastfeeding fortwo years, or longer.Support breastfeeding mothers and theirchildren by: welcoming breastfeeding mothers intoyour facility offering them a quiet and comfortableplace to sit and feed their children encouraging them to send expressedbreast milk from home, if possible10DID YOU KNOW?You should NEVER give any type of honeyto infants 12 months old and younger.Feeding babies honey before they are oneyear old has been linked to a rare, butserious, form of food poisoning calledInfant Botulism.

Introducing solid foodsWhen infants are six months old, they areusually ready to start eating small amountsof solid foods containing iron. Solid foodsprovide nutrients and textures needed forhealthy growth and development. At this time,breast milk and/or formula with iron shouldstill be baby’s main food.SIGNS AN INFANT IS READY FOR SOLIDFOODSThey: sit up with very little help hold their head up open their mouth when food is offered turn their head to refuse foodFeeding tips Choose foods and textures that suit baby’sskills and age. It is important to try different textures.This helps baby to learn to chew, swallowand enjoy the same food other children areeating. Babies do not need to have teeth to eatsolid foods. If using store-bought baby food, check theexpiry date on the jar or package. Do notuse past the expiry date. Use a small bowl or plate for feeding baby.Do not feed babies from the jar. Any food left over should be thrown out asgerms can spoil the food. When warming baby food, stir and test it tomake sure it is not too hot. Put a small amount of food in front of babyand see what happens. They may play withit, taste it or not eat it at all. Start with one or two teaspoons of foodand gradually increase according to baby’sappetite. Let baby decide how much to eat. Start with one meal a day and graduallyincrease to three meals a day and snacks. Babies do not need sugar, sweeteners orsalt added to food. Try only one new food at a time. Waitat least two days before trying anothernew food. This helps you find out if afood causes an allergic reaction. Talk tothe family about what foods are beingintroduced at home. Work closely with families to create a planfor introducing new foods.(adapted from Feeding your Baby: 6 Months to1 Year, Healthy Child Manitoba ding.pdf)11

BeveragesMilk Whole cow’s milk(3.25% MF) can beintroduced after ninemonths of age. Reduced-fat milk(2%, 1% or skim) andfortified soy beveragescan be introduced aftertwo years of age (discusswith family beforechanging the type ofmilk served). Children who drink more than 3 cups ofmilk a day may not be hungry for foodand therefore may not be getting othernutrients their bodies need.Water Once an infant is six months of age, watermay be introduced as a beverage. Water given to infants (for drinking and/orpreparing food and other beverages) mustbe clean and safe from contamination. Offer water to satisfy thirst.DID YOU KNOW?Infants over one year of age do not need touse a bottle or “sippy cup” (cup with a lid).A regular (open) cup is the best choice toencourage development of mature drinkingskills, a healthy diet and good dentalhealth.12Fruit juice Fruit juice is not recommended for infantsunder six months of age. Vegetables and fruit should be offeredmore often than juice. If juice is served to children or infants aftersix months of age:-- offer only a small serving (about 60 - 125ml or ¼ - ½ cup)-- the daily amount should not exceed125 - 175 ml (or ½ - ¾ cup); keep in mindthat they may be drinking juice at home,too-- offer in a cup, not a bottle-- only offer as part of a meal, or snack-- offer only 100% fruit juice-- never serve un-pasteurized juice Do not serve beverages called “fruitcocktail,” “fruit punch” or “fruit drink.”They are not a food-group choice and arehigh in added sugar. Too much fruit juice will fill a child’sstomach, making them less hungry fornutrient-rich breast milk, infant formula,milk and healthy foods.Sweetened drinks Sugar-sweetened beverages like pop/softdrinks, fruit punch, flavoured water, icedtea, lemonade, sports drinks, and drinkssweetened with artificial sweetener, are notrecommended for children. When children fill up on these beverages,there is little room left for nutritious foodand drinks.

Choking hazardsAs infants and young children learn to eat, they should always be supervised and seated inappropriate, child-sized chairs to reduce the risk of choking. Remember that children move throughstages at their own rate. By watching children closely, you will be able to judge when they are ready forcertain foods.The foods below cause the greatest risk of choking for children under four years old. Therefore, thesefoods should either be altered to a safer shape or texture, or avoided altogether.Choking hazardHow to make it saferWhole or large pieces of raw vegetables,fruit and breadGrate raw vegetables or fruit.Kabobs (on a skewer or toothpick)Cook to soften.Remove pits and large seeds.Cut into very small pieces – about 1 cm (½ in) diameter.Cut up vegetables and fruit and serve them on a plate,rather than on a skewer or toothpick.GrapesCut into quarters, lengthwise, and remove seeds.Foods with fibrous or stringy texturessuch as celery or pineappleFinely chop these foods.Raisins and other dried fruitDo not give to children under four years old.PopcornDo not give to children under four years old.Seed and nut butter spread thickly orserved on a spoonSpread thinly on a cracker or breadWhole nuts and seedsDo not give to children under four years old.Fish with bonesCarefully remove all bones.Wieners or sausagesCut into quarters, lengthwise, then into bite-size pieces(or do not serve).Gum, marshmallows, hard candy andcough dropsDo not give to children under four years old.Provide first aid and call 911 if a child is choking.13

Protecting children with food allergiesHow will caring for children with foodallergies affect the way I do things?Caring for a child with a food allergy requiresextra attention.If your facility provides food: be sure all staff are aware of the foodallergy, and what is being done to avoidexposure to the allergen (substances thatcan cause allergies in some children) pay very close attention to food labelswhen shopping (see appendix for moreinformation on reading food labels) focus your menu on whole, fresh foods andhomemade sauces, seasonings and dips,to help avoid allergens communicate with all families about foodallergies present in the facilityIf families are providing food for their children: make sure all families are aware of the foodallergies at your facility inform families about how to avoidbringing food allergens into the child carefacility, and what the possible risks are ifthe allergic child is exposedAlso keep food allergies in mind when: planning activities (ex: avoid using foodfor art) organizing special events and field tripsWhat steps can I take to protect a child whohas food allergies?If a child in your care has a known food allergy,there are many important steps you can take tohelp protect them:1. Read food labels very carefully. Make sure you check the label every timeyou buy a product!-- Manufacturers sometimes change theingredients in products.-- Different varieties and sizes of the samebrand may contain different ingredients,so check the label on every product youbuy.14

Most packaged food products mustidentify major food allergens on the label.Read ingredient lists and look for thefollowing cautionary statements/warnings:-- “contains.”-- “may contain ”-- “manufactured in a facility which alsoprocesses ”Note: Less common food allergens donot have to be identified in a cautionarystatement. Look for them in the ingredientlist. Avoid buying food from bulk bins, asingredient lists may not be available andthere is a risk of cross-contaminationbetween bins.See appendix for more information on readingfood labels.2. Avoid cross-contaminationCross-contamination happens when an allergenaccidentally comes into contact with a foodproduct that doesn’t normally contain thatallergen. Cautionary statements on food labels warnthat foods could have accidentally beenexposed to an allergen some time duringthe manufacturing process, and are notsafe for those with food allergies. Even if a food does not contain the foodallergen, it still might have been in contactwith the allergen through things likeutensils (ex: forks, knives) and cookingpans. To avoid cross-contamination in yourfacility, you could consider eliminating allfoods containing the known allergen.3. DO NOT take chancesWhen in doubt, don’t serve it! Avoid serving food products that contain,or may contain, an allergen a child in yourcare is allergic to. Avoid serving food products that contain awarning statement naming an allergen ofconcern. Avoid serving food products that don’t listtheir ingredients.Where can I find more information aboutfood allergies?See the list of helpful websites on page 4.DID YOU KNOW?Substitutes for peanut butter include:soy butter (ex: WowButter ), pea butter,sunflower seed butter (ex: SunButter )and nut butters (ex: almond, hazelnut).These products provide similar amounts ofprotein and fat as peanut butter, and havea similar taste and texture.Before allowing these foods into yourfacility, check with families for allergiesto the ingredients in them (ex: soy, nuts).Also, some of these foods may have comein contact with peanuts during processing.Be sure to read the food labels every time!15

“Picky” eater at the tableTry not to label a child as a “picky” eater; theyare simply learning to eat. Many children gothrough stages where they refuse to eat some, orall, of the food offered to them. Learning to bean adventurous eater takes time and patience.Remember that if children are growing andsleeping well, and are happy and healthy, theyare probably getting the food they need. If youhave concerns, try some of these ideas:1. Work closely with families. Communicate regularly about successesand challenges concerning food andeating. Work with families to apply the samestrategies at home and at child care, toprovide a consistent and reliable message. Try to have discussions about food andeating challenges when children are notpresent.2. Create a positive eating environment. Be role models and encourage healthyeating habits. Children learn by imitation. Give children about 10 to 15 minutes noticebefore the meal or snack is going to start. Allow children as much time as they needto eat. Sit at the table with the children, and eatthe same food (when possible). Allow children to serve themselves, whenthey can. Give them the opportunity tochoose how much, or how little, of eachfood they would like. Allow them to haveanother helping if they are still hungry. Keep mealtimes as pleasant and relaxed aspossible (ex: start up conversations). Limit distractions at the table. Children willfocus better on eating without other thingsgoing on like the television, telephone,computer and toys. Avoid entertaining children duringmealtime (ex: singing songs, readingbooks).DID YOU KNOW?It can take at least eight to ten exposuresbefore children try a new food. Continue tooffer a food even if it’s not accepted the firsttime.16

3. Try to make sure children come to the tablefeeling hungry. Offer only small snacks halfway betweenmeals or, if possible, two hours beforemeals. Offer only water in between meals andsnacks (ex: don’t leave out a bowl of cut-upfruit, dry cereal or crackers for the childrento munch on). Include physical activity throughout theday.4. Other tips The amount of food eaten at each mealand snack will vary day to day, dependingon the child’s appetite, activity level,growth, and whether they are excited ortired. Trust children to know when they arehungry and when they are full. Try to serve food in a variety of differentways. For example:-- Add vegetables to soups, casseroles andsauces; or try them raw, shredded, baked,mashed or with a dip.-- Try adding meat (ex: beef, pork) orpoultry (ex: chicken, turkey) – choppedinto small, bite-size pieces – to acasserole, soup or sandwich. Also tryground meat or poultry in a sauce. Offer new foods with familiar foods. Be open about the ingredients inmixed food dishes (ex: spaghetti sauce,meatloaf). Don’t try to hide or disguisevegetables or other ingredients. This cancause the child not to trust you. Involve children in meal planning andpreparation, according to their abilities.When they have been involved in preparingthe food, they are more likely to taste it.See pages 22 - 23 for informationabout involving children in foodpreparation. Make only one meal but try to include atleast one food you know all the childrenwill eat. Sit children together in small groups. Theymay be more likely to try new foods if theirfriends are eating them.DID YOU KNOW?Eighty (80) per cent of five-year-oldchildren are thought to be “picky” eaters,but by seven years of age, only 23 per centremain “picky”. Be patient!17

Culture, religion and foodChildren in your care may come from a varietyof cultural and religious backgrounds. Trying tounderstand and include children’s cultural andreligious food traditions or restrictions (foodsthey don‘t eat) will help them feel accepted andvalued.The role of food in cultural and religiouspractices is not simple – it varies amongindividuals and communities. It’s not possibleto know every cultural or religious traditionor celebration that involves food. The mostimportant thing you can do is learn from thefamilies of the children in your care. Here aresome steps you can take to learn about, andsupport, all children in your care: Do not assume that all children from aparticular culture or religion follow thesame traditions. Ask children and theirfamilies to tell you about any cultural orreligious food traditions or restrictions thatthey follow. Ask families to share a couple of theirchildren’s favourite cultural recipes withyou. Learn how to cook them and includethe ones made with whole, fresh food inyour regular menus. Accept that some children may not want totry traditional Canadian foods, and othersmay not want to try foods from differentcultures.18 Participate in some of the children’scultural celebrations by buying or preparinga special dish or snack. Always make sure there are suitablechoices for all children. See the section called Helpful Websites/Resources in appendix for recipe ideasfrom a variety of different cultures.

Vegetarian dietsWhat about vegan diets?The term “vegetarian” means different thingsto different people. Typically, vegetarians don’teat animal foods, including meat, fish, seafoodand poultry; however, they may eat dairy andeggs. Children and families follow vegetariandiets for a number of reasons – they includeenvironmental, cultural, religious, ethical orpersonal choice. It is important to supportchildren and families in their choices. Find outfrom families which foods can be included intheir children’s diet.A vegan diet is the same as a vegetarian dietbut does not include foods of animal origin (ex:meat, poultry, fish, eggs, milk, cheese, dairyproducts). A vegan diet can be healthy if foodsare chosen wisely to support a child’s growthand development.Like all children, children following a vegetariandiet need to eat a variety of foods for growth anddevelopment. The nutritional needs of thesechildren are the same as those of non-vegetarianchildren. Follow the recommendations inCanada’s Food Guide, using meat alternativesinstead of meat.In addition to replacing meat with meatalternatives (listed here), for vegan diets you willalso need to replace milk and milk products withalternatives such as fortified soy beverages. Talkto the family to find out what is served in thehome.Also, consult with families to determine whichingredients to be aware of when reading foodlabels and choosing acceptable packaged foodproducts. See appendix for more information onreading food labels.Meat alternatives include: peanut butter and other nut butters nuts and seeds pulses (ex: dried or canned beans, peas,chickpeas or lentils) tofu soy-based meat substitutes (ex: meatlessburgers, meatless ground round) fish * eggs **Some vegetarians do not eat fish or eggs.Check with the family before serving these foodsto children who are vegetarian.If possible, avoid making separate meals forvegetarian children. Instead, replace meat withalternatives or find vegetarian choices the wholegroup can enjoy.19

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Food and Nutrition:Putting it into PracticeWhat is your role?Child care providers play an important role inyoung children’s experiences with food andeating. By setting a good example, creating apleasant eating environment and providingnutritious choices, you can strongly influencechildren’s overall health and well-being – nowand into the future.Here are some things you can do: Be role models for healthy eating. Childrenare more likely to enjoy a variety of foodand try new foods if they see you doing it. Be aware of food allergies and what couldtrigger allergic reactions, and share theinformation with everyone who needs toknow. Respect families’ individual needs andpersonal choices (ex: medical – allergies,celiac disease; religious or cultural foodrestrictions; vegetarian diets). Create relaxed and pleasant mealtimes thatprovide an environment for social learningand positive interaction. Offer a variety of foods, including foodswith different colours, textures, flavours,sizes, shapes and temperatures, as well asdifferent ethnic choices. Hold infants during bottle feeding – look atthem, talk to them and cuddle them. Actively involve children in mealtimeactivities (ex: setting the table, servingfood, cleaning up). Sit with children in small groups duringsnack and mealtimes whenever possibleand start conversations. Encourage communication a

Food and Nutrition: What You Need to Know 9 Important facts about nutrition and children 9 Portion sizes 9 Infant feeding (ages 0 - 2) 10 Beverages 12 Choking hazards 13 Protecting children with food allergies 14 “Picky” eater at the table 16 Culture, religion and food 18 Vegetarian diets 19 Food an