Homemade Baby Food

Monika Pis, PhD, CPNP

Preparing baby foods at home helps to integrate preparation of your infant’s meals into preparation of meals for the rest of the family. By making baby foods yourself, you will be in control of the quality of nutrients that your child eats, and you will also be able to provide her diet with a greater variety of healthy foods that taste much better than any jar baby food available at your local supermarket. While having a tremendous sense of satisfaction from having an impact on your baby’s health, you will also save money!

Essentials you need:

 food processor or blender
 veggie/fruit peeler
 stainless steel saucepan and steamer (avoid copper as it robs food from vitamin C)
 paring knife
 colander (for rinsing and draining)
 fine mesh strainer
 ice cube trays or muffin tins
 pen and labels or masking tape
 small freezer bags
 instant-read meat thermometer


Fruits & Vegetables
With the exception of bananas and avocado, all fruits and vegetables have to be cooked. Cooking tenderizes them and kills bacteria that may be present on their surfaces. While cooking in water is the easiest way to prepare fruits and vegetables, it’s not the healthiest, as it depletes many nutrients. To preserve all or most vitamins and minerals, steam your fruits and vegetables instead. Other healthy ways to prepare your foods are roasting and baking. You may roast or bake apples, winter squash, broccoli, cauliflower, and sweet potatoes. Dry heat will preserve all their nutrients and bring out their natural flavor.

Meat & Poultry
Roasting or baking meat or poultry are healthier methods than frying, broiling, or grilling. Frying leaves the food too greasy and fatty, while broiling and grilling can cause formation of carcinogens, the cancer-triggering substances. Always check if your meat is done with the meat thermometer.

You do not need to add salt to your baby’s food. Also, refrain from adding spices in the baby’s first year of life, as her delicate digestive system may not ready to handle them.

Freezing
Spoon your cooked and cooled baby food into a clean ice cube tray (~ 2 Tbsp of food), or muffin tin for older infants. You want to leave room for fluid expansion during freezing. Cover tightly with plastic wrap and place in the freezer. When frozen, transfer baby food cubes into small freezer bags. Label them with the name of food and the date of preparation. You may store the frozen cubes up to 1-2 months.

Thawing
Defrost the desired amount of baby food in the fridge overnight. You may microwave it for ~30 seconds per cube if you need the food right away. However, check the food’s temperature before you serve it to your infant to prevent burns! Discard leftovers. Also any baby food left at room temperature for an hour or more needs to be discarded.


Sample Recipes

BANANA

1 small ripe banana
breast milk or formula

Break banana into pieces. Blend with a blender or food processor. Add breast milk or formula to thin it out.


CARROTS

½ lbs peeled and washed carrots
breast milk or formula

Steam carrots until tender (~10 minutes). Cool for ~ 10 minutes. Blend. Add breast milk or formula to thin it out.


MEAT/POULTRY

2 oz cooked and chopped chicken, turkey, beef, or pork
breast milk or formula
Blend the meat. Remove chunks. Add breast milk or formula to thin it out.

Jaundice of the Newborn

Monika Pis, PhD, CPNP

Hyperbilirubinemia, also known as jaundice, is a common condition in newborns, as it is observed in 60% of full-term and 80% of pre-term infants. In most cases, jaundice is a benign condition. Nevertheless, symptoms must be recognized and treated appropriately to prevent the neurological toxicity called kernicterus (see below). 

In utero, infants rely on oxygen supply from the mom’s bloodstream. In order to transport as much oxygen as necessary to the developing vital organs, unborn babies have an extra amount of red blood cells (RBC) that carry oxygen where it’s needed. After birth, those additional RBC are no longer necessary and start to break down, producing bilirubin, the yellow pigment that accumulates in the skin and eyes, called jaundice.

The so-called physiological jaundice occurs in more than 50 percent of newborns. The bilirubin levels rise on day 2-4 of life and are caused by the slow processing of bilirubin by the immature liver. The physiological jaundice may last for 1-2 weeks and the levels of bilirubin that are reached are harmless.

About 5-10 percent of breastfed newborns may have breast-feeding jaundice. This type of jaundice is caused by inadequate intake of breastmilk, thus dehydration and inadequate caloric intake. It appears around day 2-4 of life and lasts for 1-2 weeks.

The third type of jaundice is breast-milk jaundice that occurs in 1-2 percent of babies who are breastfed. This type of jaundice is related to an enzyme secreted in breast milk. This enzyme is responsible for increased absorption of bilirubin from the intestines. The breast-milk jaundice starts on at 4-7 days of life and may last for 3-10 weeks.

If your infant was born jaundiced or jaundice occurred within the first 24 hours after birth, she may have jaundice related to blood incompatibility. If the mom and the baby have different blood types, the mom may start to produce antibodies that destroy the newborn’s RBC. This causes sudden buildup of high levels of bilirubin that is evident within the first day of life. Should that happen, the infant will be placed under special lights (phototherapy) that will help her bilirubin levels decrease rapidly. Very rarely, when the levels of bilirubin do not decrease with desired speed, the baby may require a blood transfusion to prevent kernicterus.

Treatment 

To make sure that your infant is healthy and safe, always follow the advice given to you at the hospital or at your health care provider’s office. Determining the cause of jaundice and assessing the level of bilirubin in your newborn is always very important in order to prevent possible serious complications.

If your health care provider decides that your baby has physiological jaundice, you will need to feed you infant frequently (every 1-2 hours) and place her by the window, so that she is exposed to daylight. Frequent feedings will promote frequent bowel movements with which bilirubin will be excreted. In addition, resting in a sunny spot will help your infant’s body breakdown bilirubin more readily--thus jaundice should improve faster!

If your newborn is diagnosed with breast-feeding jaundice, your health care provider may suggest more frequent feedings, or alternating breastfeeding and formula bottles. And if breast-milk jaundice seems to be the problem, you may need to stop breastfeeding for 48 hours and supply your infant with formula during that time.

Whatever the cause of your newborn’s jaundice, if you are uncomfortable with how she looks or acts, NEVER hesitate to contact your health care provider for advice.

What is Kernicterus?

Kernicterus is a neurologic syndrome resulting from bilirubin accumulationg in brain cells. The duration of exposure to higher levels of bilirubin to produce toxic effects is unknown. Kernicterus is usually associated with bilirubin levels >20mg/dL. The initial sign and symptoms are lethargy, poor feeding, and loss of Moro reflex. Progressively, the infant may start to appear very ill, experience respiratory distress, convulsions, and produce a shrill high-pitched cry. Survivors of kernicterus may experience mental retardation, deafness, and spastic quadriplegia. To help prevent this condition, always follow-up with your health care provider as directed at the hospital or in the office.

Language Development: 12 to 24 Months

Monika Pis, PhD, CPNP

Language development is intricately woven together with cognitive development. Often an infant’s gestures are a part of their emerging language. For example, a 1-year-old may point to a bottle of juice and grunt, letting her parent know that she wants it. Symbolic gestures at 13 months are highly correlated with future language ability. Children who have a rich gesture communication system in toddlerhood are likely to develop normal linguistic skills even if they are late bloomers.

The acquisition of new words between 12 to 18 months is slow. By 18 months of age, a toddler should say at least 5 words and understand more than 50.

2-year-olds start to show an understanding of the rules of language by putting words together. At this age the child produces more than 50 words, follows 2-step commands, points to objects and names them, and uses words to request things. She also develops new words daily, and may get confused if adults talk to her like a baby.

Receptive language is always ahead of expressive language, thus children will always understand more than what they are able to say. This usually results in moderate frustration due to inability to express feelings and desires, and temper tantrums might emerge. To prevent these kinds of temper tantrums, read to your child daily from birth. Reading together is a quality family time, and studies show that by making a habit of it, you will assist your child in early language acquisition. 

Developmental Milestones: Birth to 6 Months

Monika Pis, PhD, CPNP

Babies develop at all different rates but here's what to look for from newborn to 6 months of age.

Newborn to 2 months
The first two months of your baby’s life is a time of adjustment into her new environment. She will learn new sounds and become comfortable with her surroundings. This period is also the time for new parents to get to know their newborn.

From the very first days, your newborn knows how to communicate with her bodily movements, facial expressions, and sounds. Observe and listen to her carefully and in a very short time, you’ll be able to distinguish a hungry, tired or bored cry. Also, you’ll know when your baby needs a break from what she is doing because she will look away, arch her back, frown, or cry.

In the first two months of life, mutual gaze is a powerful form of socialization. Let you baby watch your face and exchange looks. Show your infant a colorful toy and slowly move it from side to side, allowing her gaze to follow the toy. Interaction with your baby will strengthen your bond, as well as help strengthen the eye muscles. 

Studies show that reading to you infant from a very young age allows for early acquisition of language skills. Therefore, spend a few minutes every day reading to your baby. You can also talk to her about your day and even sing--it makes for good family time and above all, your baby will love to listen to your voice!·

Milestones you should look for:

1-2 weeks:
- Responds to noise
- Looks at your face
- Tries to lift head when placed on the belly

2 months:
- Responds to noise
- Makes baby sounds
- Smiles back at you
- Follows people with her eyes
- Holds head up 45 degrees when placed on the belly

Things to do to enhance your baby's development:
- Read daily to your baby
- Observe to learn your baby's needs
- Respond to cries. It teaches your baby trust and that she is loved.

Age 2-6 months

Infants between 2 and 6 months of age are very interactive. They love to imitate anything that helps them learn new skills. For example, if mom sticks her tongue out, baby will usually do the same. This game teaches the infant the art of communication. Babies this age love to discover their voices, so you may hear your baby coo or babble frequently. As she coos and babbles, talk and babble back to her, as if you both understand each other very well. This exercise also teaches your baby how to communicate and, at the same time, lays groundwork for developing extensive vocabulary later on. 

At about 3-4 months of age, babies start to laugh out loud, they can sit with support, and grasp a rattle. Soon, at about 6 months of age, they’ll be reaching out for objects. Since infants learn by looking at, holding, and putting objects into their mouths, keep all small objects out of your baby’s reach. It’s good to remember the toilet paper roll rule: objects that can fit through a toilet paper tube, including plastic bags and deflated balloons, are too small for children younger than 3 years.

Closer to 5-6 months, babies start to have a better control over their bodies. They will be able to roll over, pull up to sit without a head lag, and transfer objects from hand to hand.

Milestones to you should look for:

4 months:
- Rolls over
- Sits with support (keeps head steady)
- Grasps a rattleLaughs out loud
- Holds head up 90 degrees when placed on the belly
- Looks around 180 degrees

6 months:
- Reaches for objects
- Transfers objects form hand to hand
- Bears weight on legs when standing up with support

Things to do to enhance your baby’s development:
- Talk and babble with your baby back and forth
- Read daily
- Lay baby on back and hold brightly colored toy over her chest to promote reaching
- Introduce one toy at the time to allow for exploration

Language Milestones: Birth to 6 Months

Monika Pis, PhD, CPNP

Developing language skills and the growth of cognitive abilities allow children to interact with the surrounding world. 

Language development begins before birth as the baby perceives the sounds of the womb. There is evidence that the baby possesses receptive language ability well before birth. She can hear and respond to environmental sounds and start to develop memories of them.

Expressive language development also begins early. Cooing, which is when the baby produces vowel sounds, begins in the first two months of life. Increased volume in cooing begins to develop around one month of age, and pitch variability can be noticed between two and four months of age. During that time, when you converse with your infant, you should notice some variation in tone. These “conversations” are a great exercise that teaches your baby the art of conversing.

By six months of age infants should start to babble. The ability to babble requires coordination of muscles on the pharynx. When babbling begins these muscles get exercised, and your infant discovers her ability to talk. By nine months of age you should hear your baby say “mama" or "dada." Often “dada” is heard first, because the nasal sound “m” is harder to produce than the “d” sound. But don’t worry, she will say “mama” pretty soon--especially if you practice with her!

Between 9 and 12 months your baby will start to point to objects. This is a very important language milestone, as it proceeds the naming of objects. By the age of one year, a child usually has learned one other word besides “mama” and “dada” and is able to follow one-step commands.

AGE Newborn: By 3 months: By 6 months: By 9 months: By 12 months:

LANGUAGE MILESTONES The baby turns to soft voices, especially the voices of his/her parents. The baby produces cooing sounds and smiles responsively. The baby turns to familiar sounds, laughs, and coos. The baby babbles "mamama," "bababa," and knows his/her name, and turns when called. The child has learned one word other than “mama” and “dada” and follows one-step commands.

Infant Eye Color

Monika Pis, PhD, CPNP

Have you ever wondered what eye color your child will have? Many parents, seeing their newborn’s blue eyes, hope they retain that deep blue hue forever. But they might be in for a surprise!

Eye color is determined by the brown pigment, melanin. Depending on the concentration of melanin in the iris, your child ends up with blue, green, or brown eyes. All newborns have blue eyes because at the time of birth, their irises have not started producing melanin. The real eye color settles in between 6-9 months of age and is mainly determined by genetics.

Research has identified many genes that are responsible for our permanent eye color, but there are two that are best understood. I'll call them gene A and gene B. Each of these genes has 2 variants: A-brown and A-blue, and B-green and B-blue. Our eye color depends on which combination we inherit from our parents. This model provides the best understanding of how eye color is inherited, but it does not provide an explanation for the occurrence of gray eyes, or shades of blue, green, or brown. So these eye colors still remain a mystery.

Brown is the most common eye color in the world. In many populations, brown is the only eye color present. Brown eyes contain the most amount of melanin, and they are common in Africa, Americas, and Asia. Brown eye color is rare in countries such as Germany, Poland, Finland, or Sweden.

Green eyes are among the rarest eye color, and they are common in Northern and Eastern Europe. A study published in Preventive Medicine reports that almost 90% of the Icelandic population has either green or blue eyes. Another study of Icelander and Dutch adults found that green eyes are much more prevalent in women than in men. 

A geneticist wrote a program, called the eye color calculator, founded on the principle of probability. This program allows you to predict your child’s eye color based on the closest approximation of the eye color of people in your family tree. You can check it out here: Eye Color Calculator. Since we don't yet know how eye color is exactly determined, use this eye color calculator only for fun.

Whether your child ends up with blue or brown eyes, remember to love them for who they are. Eye color does not determine personality or inner beauty!

Diaper Rash or Yeast Infection?

Monika pis, PhD, CPNP

The diaper area is dark, moist, and warm. Therefore, by the virtue of wearing diapers, infants are prone to develop diaper rashes and even yeast infections in the diaper area. It's important to learn how to prevent diaper rashes, as well as how to tell a diaper rash from a yeast infection, to protect your baby’s skin integrity.

Prevention Is Key
You can keep your infant’s diaper area healthy by frequently changing her wet and soiled diapers, applying barrier ointments, such as petroleum jelly (Vaseline) or A & D ointment, and allowing the area to air out after every diaper change. Using cloth diapers decreases your infant’s risk for diaper rashes, because the air can circulate better through cloth than though a synthetic diaper.

Diaper Rash
If you notice redness or pinkish red pimples in the diaper area, your infant has developed a diaper rash. You need to reach for over-the-counter zinc oxide cream like Desitin. Apply a thin layer to the diaper area 3-4 times daily, and then cover it with a thin layer of a barrier ointment. Continue to air out the area after each diaper change.

Yeast Infection
If the redness in the diaper area has spread to the bends of the legs and looks very red and shiny, most likely it is a yeast infection. You might have already tried the zinc oxide cream at this point without any results, so it is the time to consult with your infant’s health care provider. The best treatment for yeast infections in the diaper area is an anti-fungal cream applied 3-4 times a day for 7-10 days.

Contact your child’s health care provider if your infant has a rash and develops a fever, the rash is spreading, or you are concerned in any way with how the diaper area looks.

Introducing Solid Foods to Infants

Monika Pis, PhD, CPNP

When an infant doubles her birth weight, weighs over 13 pounds, lifts and supports her head, may seem to be hungry after 8-10 breast-feedings, or ingests over 40 ounces of formula a day, she may be ready to start eating solid foods. Typically, the readiness to begin eating stage 1 baby foods takes place between 4 and 6 months of age.

Always talk to your health care provider before starting solid foods, as she may recommend waiting. For example, physicians may recommend a delay in solid foods for infants with an extensive family history of food allergies.

When you and your health care provider come to an agreement that it is safe to start solid foods, start slowly and enjoy the process! Start with single-grain cereals (rice, then oatmeal, and then barley), then move to vegetables and fruits. Introduce one new food at the time. Preferably, offer a new food to your baby 4-5 days in a row, so that you can observe her for allergic reactions (i.e. hives, abdominal pain, vomiting, etc.). Once you establish that the new food is safe, add a new one to your baby’s menu and repeat the steps.

After introducing cereals, you can start vegetables. Begin with green vegetables, as they are not as sweet as the yellow ones, and your infant may learn to like them faster. Remember that it may take several tries before your baby accepts new food, so don’t give up after the first rejection!

At about 6 months of age, you may start to feed your child meats and introduce juice (only for flavor!). Remember that juices are full of sugar (empty calories); therefore, it is a good idea to dilute them with water, and offer no more than 2-4 ounces per day.

Guidelines to introducing solid foods to infants

Infants are ready for stage 2 foods when they can sit independently, roll over, and can hold a small object in their hands. These milestones occur around 6-7 months of age.

Some sources recommend moving on to stage 3 foods when infants begin to crawl and pull themselves up to stand (at approximately 9 months of age). However, I never recommend that. Stage 3 foods can be tricky, as they are a mixture of smooth and chunky textures. Since it takes a coordination of several muscles in the mouth to chew and swallow foods, and your baby is learning the process, stage 3 foods may increase your baby’s risk for choking. To keep that risk as low as possible (prevention is the best medicine!), when your child begins to crawl and pull herself up to stand, start her on table foods. At that point, she can eat almost everything you are eating with some small exceptions and baby food is no longer necessary.

Foods to avoid in the 1^st year of life

Honey
Karo Syrup
Cow’s milk
Peanuts
Peanut butter
Strawberries
Citrus products
Tortilla chips
Popcorn
Hard candy

Avoid honey and Karo syrup before your child’s 1st birthday, as they may contain spores of botulism (see below). Feed your baby breast milk or formula until she turns one. Afterwards, you may introduce cow’s milk. All she will need is 16-24 oz. per day. Until the second birthday, whole milk is preferred, as it contains just the right amount of fatty acids that are necessary for the proper development of the nervous system. After the second birthday, you can switch to whatever milk the rest of the family drinks. Also, do not rush your child into eating highly allergenic foods, such as peanut butter and citrus products. By delaying their introduction until your child’s immune system is a little stronger, you decrease your child’s chance to develop allergic reactions.

When feeding your baby, remember that she learns from you. If you want her to eat a certain food, do not wrinkle your nose! She will learn very quickly that you do not like that food and think that she should do the same. Also, respect your infant's ability to know when she is full. When she is done eating, she may turn her head away, cover her face with her hands, or simply spit the food out of her mouth. Watch for these clues and do not force her to eat more. Overfeeding may lead to overweight later in life, and we all know that it is easier to prevent it than to deal with it.

Overall, have fun introducing solid foods to your baby. It is a good way to interact and learn about each another.

What is infant botulism?

Botulism is rare but a very serious disease. It is caused by toxins released by a bacterium called Clostridium botulinum. Signs and symptoms begin after 18-36 hour after ingestion and may lead to death. The first sign of infant botulism is often constipation. Other signs and symptoms include: floppy movements due to muscle weakness, droopy eyelids, trouble breathing, weak cry, tiredness, difficulty sucking and feeding, and paralysis. Paralysis and other symptoms are caused by the toxins ability to disrupt the nerve function.

Pregnancy Book

By Sandra Sexton

If you are expecting, you might have a lot of questions about what to expect during your pregnancy.  I would like to suggest a book for you: You & Your Baby: Pregnancy by Dr. Laura Riley, OB/GYN.

Dr. Riley is an author, the medical director of labor and delivery at Massachusetts General Hospital in Boston, and a mom to two daughters.  In her book, she talks about how a mom's-to-be body changes week-by-week and what symptoms expecting moms can experience.  She also offers advise on how to deal with the morning sickness, mood swings, and lower back pain. 

You & Your Baby: Pregnancy gives moms-to-be a good overview of the amazing journey that pregnancy is.  She suggests exercise programs, healthy diet, addresses safety issues in preparing women to progress through the pregnancy as healthy as possible, and helps them to conquer childbirth fears.

It is a great read full of very good information.