Infant nutrition

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Without a doubt the “vegan diet” (avoidance of all animal based foods) seems to be one of the more popular of our time. Whilst some follow this diet out of concerns for animal welfare or the environment, many people follow it for it’s nutritional benefits. A vegan diet has been shown to reduce the risk of ischaemic heart disease, type 2 diabetes, obesity and certain types of cancer. In 2016 the American Academy of Nutrition and Dietetics updated their statement on Vegetarian and Vegan diets, stating that they are safe to follow at all stages of the life cycle when appropriately planned (including in infants, children and pregnant and lactating women). 

A good vegan diet requires more effort than just pasta and sauce, especially for children, who have very particular nutritional needs. If you are going to embark on a vegan diet, having a thorough understanding of the nutrients that are at risk and having a plan for how you will meet them, is key. Below is a summary of the key nutrients you need to consider for children following a vegan diet.

Energy (calories) – The vegan diet can be lower in energy because of the large number of vegetables consumed. Whilst this might be a good thing for adults looking to lose a bit of weight, for children who are growing rapidly it can be a problem. Balancing the vegetables in a meal with good quality wholegrain carbohydrates (eg rice, pearl barley, quinoa, wholemeal pasta) and a protein source, will help ensure each meal has adequate energy. 

Protein – If a wide variety of plant food is eaten and energy intake is adequate, then it is generally agreed that protein intake will meet your child’s needs. Without adequate amounts of protein and energy, children can fall behind with their growth. The key here is eating from a wide range of plant based foods. Unlike animal foods, not all plant based foods contain the “complete” range of amino acids required by our bodies. By eating a wide variety of different plant based foods, a complete range of amino acids will be consumed. Good sources of plant based proteins include: soy products, beans, legumes, nuts and seeds. These higher protein plant foods should be consumed at each and every meal.

Iron – Iron from plant foods (called non-haem iron) is not as well absorbed as animal sources. Phytates and polyphenols (naturally occurring compounds in vegetables) inhibit the absorption of iron, whilst the presence of vitamin C (naturally present in many fruits and vegetables) can help improve absorption. Over time the human body is able to adapt to a diet with low iron availability ( a measure of how well iron can be absorbed from foods). Inadequate iron in pregnancy can have serious affects on the developing infant, for this reason it’s advised that an iron supplement should be used. Breastmilk provides adequate iron to meet the needs of infants up until 6 months of age. Beyond 6 months of age, good vegan sources of iron include hummus, cooked mashed legumes and lentils as well as tofu.Whole grain cereals are higher in iron. Fortified foods such as weetbix, should be used regularly in the diets of young children to help achieve adequate iron. Infants who are not breastfed should use a soy formula under 1 yr of age. 

Calcium  Calcium absorption from plant foods high in oxalate is generally poor (eg spinach). White beans, tahini, chia, calcium set tofu and almonds are all reasonable sources of calcium.

For children their most reliable source of calcium will be from a calcium fortified plant milk such as soy milk.  Under 6 months of age, breastmilk or soy formula will provide your child’s calcium requirements. Between 6 months and 1 yr breastfeeding or soy formula should be continued and calcium fortified soy milk can be used in cooking and to make up breakfast cereals. (see note below on suitable milks for children).

Iodine – Good sources of iodine for Vegan’s include sea vegetables (eg nori sheets) and iodised salt. Pregnant women should always take an iodine supplement to ensure the adequacy of their diet. In Australia all commercial bread products that are not labelled as “artisan or organic” must be fortified with iodine. For most children using these fortified products together with iodised salt in cooking should be sufficient to meet their needs. For infants under 1yr salt shouldn’t be used in cooking. Breastmilk or formula provides sufficient iodine. 

Vitamin B -12 – B12 is not found in plant foods. Pregnant and lactating women need to pay particular care to ensure their diets are adequate. As breastmilk will provide the sole source of B12 during the first 6 months of age it is vitally important that breastfeeding mothers regularly eat or drink foods fortified with B12, or take supplements. B12 fortified foods in Australia include soy milk, soy burgers and alike, as well as some yeast spreads. Checking the ingredient list of these products will tell you whether they are fortified or not. The nutrition information panel will tell you how much B12 is present in the food. A pregnant or lactating Mum drinking 650ml of fortified soy milk each day (eg Sanitarium So Good) would have an adequate intake of B12. 

Vitamin D – as most vitamin D is obtained from sunlight, vegan infants and children will generally receive sufficient amounts so long as their skin is exposed to sunlight each day. Breastmilk is a poor source of vitamin D. For breastfed vegan infants a supplement may be required, especially during the winter months or if the mother’s own stores are low. Your GP or paediatrician can advise on this. 

Fatty acids  EPA and DHA are n-3 fatty acids that are important for brain, eye and heart health. 

Seafoods such as oily fish (eg salmon) are some of the best sources, whilst meat and eggs provide lesser amounts. ALA is a plant based n-3 fatty acid that our body can convert into EPA and DHA. ALA is found in nuts and seeds, with flaxseed, chia and walnuts all being good sources. Olive oil is also a good source. 

Choosing the right plant based milk for your child is critical to ensuring they are getting enough energy, protein and calcium in their diet. A calcium fortified milk soy milk is the best choice for vegan children. Ideally chose a soy milk that contains at least 100mg of calcium per 100ml and preferably one that is also fortified with vitamin B12. Depending on how much of this milk your child drinks, they may not need additional B12 supplements. Soy milks have some of the highest protein contents of plant based milks and are therefore ideal for growing children. Other plant based milks include almond, rice and coconut. These milks however, tend to be lower in energy and protein and therefore are not the first choice for vegan children. If your child has an allergy to soy products speak with an accredited practising dietitian about the best choice of alternative milk that will tick all of their dietary needs.  

Vegan Meal Plan for a toddler or pre-schooler

Breakfast:

2 weetbix with 1/2 cup so good essential soy milk

To serve: sprinkle 1 teaspoon of chia seeds and 2 TBS stewed apples

1 cup (200ml) so good essential milk

Morning Snack:

wholegrain crackers with 2 TBS peanut (or cashew/almond) butter and 1 TBS sultanas

Lunch:

Wholegrain toast fingers (1- 2 slices) with vegan margarine and 2 TBS hummus

Kale chips (made with olive oil and a sprinkle of iodised salt) and cucumber sticks

Smoothie made with 200ml so good essential milk, 1/2 banana, 2 TBS coconut yoghurt, 1 teaspoon chia seeds, 1 teaspoon pure maple syrup and cinnamon to taste

Afternoon snack

Roasted seaweed sheets and cut up grapes

Dinner:

chickpea, broccoli and tofu curry in a mild coconut sauce served with 1/4 cup cooked basmati rice

Dessert:

soy life soy yoghurt with a sprinkle of toasted muesli (vegan variety)

This example meal plan meets a 2 -5 yr old’s needs for calcium, iron, iodine, vitamin B12 and protein. 

Notes: Analysis is based on using So good regular soy milk which is fortified with both calcium and vitamin B12, Helgas wholemeal bread with grains which is baked with iodised salt and soy life calcium fortified yoghurt.

 

Julia @Bloom


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There have been rumblings of concern for a while now about the safety of plastics and food chemicals and many consumers would have no doubt noticed the trend towards “Bisphenol A (BPA)” free plastic products.

The American Academy of Paediatrics (AAP) recently released their “Food Additives and Child Health” Policy Statement, which for the first time makes recommendations about how we store and chose food products that we feed our family.

The AAP have classed food chemicals of concern as those either added directly to our food supply (specifically the preservatives nitrates/nitrites and some food colourings) or those which enter our food via indirect contact from packaging or the processing of food (BPA, phthalates, perfluroalkyls (PFCs), and perchlorates).

BPA (used to stiffen and harden plastic products) and phthalates (used in soft plastic products such as clear plastic food wrap) can both potentially  interfere with the metabolism of carbohydrate and fat and have anti-androgenic effects. There is therefore concern that both chemicals could have a role to play in obesity as well as reproductive development. PFCS and perchlorates can interfere with the production of thyroid hormones, and nitrate and nitrate preservatives have been linked to the production of cancer causing compounds. Some artificial food colourings have been linked to hyperactive and aggressive behaviour.

It’s important to note that much of the studies done to date are animal based studies or epidemiological studies which don’t necessarily point to a “cause and effect” in humans. Within the scientific community there is still a lot of contention as to how much of these chemicals humans are exposed to, and what level of exposure is harmful. Nonetheless, with children being exposed to proportionally more of these chemicals than adults, the AAP feels its prudent to start reducing our exposure. 

The AAP have made the following recommendations:

  • Where possible choose fresh fruits and vegetables and wash those that cannot be peeled
  • Avoid canned foods as these can be lined with BPA (note: there are some BPA free canned products in Australia)
  • Avoid plastic storage containers in favour of glass or stainless steel 
  • Purchase PBA and phthalate free products (note: In Australia we have many BPA  free plastic options. BPA has been replaced with other chemicals about which little is known. Because of this it might be a better option to avoid plastics altogether where possible, although there is no evidence to support this)
  • Avoid clear plastic wraps (Phthalates) and baking paper (PFCS)
  • Avoid Microwaving food and beverages (including breastmilk and formula) (heat causes the chemicals to leach out from plastic)
  • Avoid putting plastic products in the dishwasher, hand wash them
  • Limit or avoid processed meats (nitrate and nitrate preservatives are used in small goods such as ham and bacon)
  • Limit processed foods 
  • Avoid artificial food colourings

Whilst there are certainly things we can do everyday at home to reduce our exposure to these chemicals, the reality is that it will take a “whole of food supply” approach to truly remove these chemicals from our environment. Sure, you can decant your dry goods into glass jars or buy your grocery items in bulk or from markets, however, many of these products were probably stored or transported in plastic prior to being placed into barrels or boxes at your point of purchase. 

In the meantime I’ve taken baby steps at home to start reducing my family’s exposure. For a while now I’ve been using glass storage containers in my pantry (there’s the added bonus that they look nice), I hand wash my lunch boxes each day (these are BPA free), and the lunch boxes I pack are generally free of plastic wrap and packaging (bento style boxes are a great option to help you do this). 

If you’d like to read more about this topic head to:

http://pediatrics.aappublications.org/content/early/2018/07/19/peds.2018-1408

https://www.pehsu.net/_Phthalates_and_Bisphenol_A_Advisory.htmlhttp://www.foodstandards.gov.au/consumer/chemicals/bpa/Pages/default.aspx

 

Julia @ Bloom


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If you’re concerned about your child’s diet, chances are that you’ve probably already started them on a multivitamin. But what are in these vitamins, and is this the answer to your concerns about fussy eating?

These days there are a wide variety of vitamins aimed at kids that come in a multitude of preparations such as “gummies” (a sort of a soft chewable lolly), capsules with liquid centres, crushable tablets, and of course liquid preparations. The other major variety of vitamin supplement on the market for children, are those that are made into milkshake type drinks, think toddler formulas and more specialised pharmacy products like Pediasure or Sustagen.

The majority of multivitamins on the market are made up of mostly B vitamins. Nearly all will include a good dose of vitamin C, and possibly some minerals like iron and zinc. Some will include vitamin D and E, most do not contain vitamin A or iodine, or larger minerals such as calcium. If they do, it’s usually in small amounts. I’m aware of at least one product on the Australian market that is a multivitamin and Omega-3 fish oil preparation, but you will usually need to purchase a separate supplement if it’s fish oils you’re after. 

Milkshake type supplements offer a more comprehensive range of nutrients and are complete with protein and energy.

But what does your child actually need? 

Most people that make their way to see me are worried because their toddler/pre-schooler/older child is fussy and not eating a wide variety of foods. If I really drill down to what parents are concerned about, two food groups come to mind: vegetables and meat (usually red meat). Most of us are familiar with some sort of population based recommendation as to how we should eat. In Australia, we have the “Australian Guide to Healthy Eating” (AGHE)(https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating). The pictorial below demonstrates the proportions of each food group we should be aiming to eat across the day. For those of us that remember the old food pyramid, Nutrition Australia has revamped it and it now represents current recommendations (see below). Both the AGHE and Food Pyramid are based upon recommendations outlined in our Australian Dietary Guidelines. 

 

Most parents know that their child should be eating roughly 5 serves of veggies and 2 serves of fruit each day along with the above recommendations. If your child’s not eating like this then there’s usually concern about whether they are getting enough vitamins and minerals. Some parents may also be worried about protein if their child isn’t eating meat.

What I know after more than 15 years of practice and analysing hundreds of children’s diets, is that there is more than one way to eat that will meet a child’s requirements. 

Most fussy eaters that I have worked with are reluctant vegetable eaters, they probably eat some fruit but prefer a predominantly carbohydrate based diet (cue crackers, bread, pasta and noodles on repeat!). Sound familiar?

Diets rich in grains and cereals are generally adequate in B vitamins, the major component of most multivitamins. Iodine is worth pointing out as it is not included in most multivitamins and recent studies have shown low to moderate levels iodine deficiency in Australian children. Iodine is important for brain development and deficiencies can lead to mental and intellectual problems. Simple changes to your child’s diet like using iodised salt in cooking, using bread that includes iodine (a mandatory requirement since 2009 in Australia) and including seafood and eggs regularly, will ensure iodine requirements are met without the need for supplements.

Fruit contains a similar range of nutrients to vegetables, so if they are eating some fruit, it’s more than likely they’re getting nutrients like beta-carotene (a form of vitamin A), vitamin K, folate as well as minerals such as potassium and magnesium that are also found in vegetables. A child who is a reluctant meat eater (particularly red meat), may be lacking in Iron, however, there are other non meat sources of iron in ours diets (for example wholegrain, fortified breakfast cereals as well as beans and legumes), and if your child consumes these regularly, their iron intake may well be adequate. Vitamin C requirements are generally adequate if your child eats two serves of fruit each day.

Dairy products are not usually something I see parents of fussy eaters struggling with. In fact many fussy eaters over consume dairy (particularly milk), so calcium is not generally an issue. Some parents are worried their child isn’t going to get enough protein if they don’t eat meat. This is rarely a concern. Protein is found widely in our diet (although the quality varies), including in dairy products and breads and cereals. I usually find that protein intake from dairy alone is sufficient to meet a growing child’s needs. In fact most fussy eaters I deal with, usually exceed their requirements for protein. 

What do I recommend?

For most children that I see I don’t recommend a vitamin supplement and rarely would I recommend a milkshake type supplement (I reserve these for children with extreme fussy eating who may also need to gain weight, but this is very much on a case by case basis). One of the major drawbacks of using milkshake type supplements  is that you are using this product to fill your child up, and not actually making any headway with them eating real food.

Whilst your child may not be eating ideally, it’s highly likely they are still getting what they need to grow. If I do use a multivitamin preparation then I would aim for one that includes iron. The other nutrient that IS usually a concern with fussy eaters is fibre. Fibre is NOT included in vitamin preparations but there are some fibre supplements on the market which can be used for children.

What your child is missing out on if their diet is low in vegetables are phytonutrients. Phytonutrients are thought to be one of the reasons that diets rich in vegetables (and fruit) might help to protect us against chronic diseases such as some types of cancer. Examples of phytonutrients include lycopene, known for cancer prevention, and leutin, important for eye health. Let’s not forget small oligosaccharides and resistant starches (collectively known as prebiotics) that are found in plant foods either. These are very important for optimal gut health and with more and more research pointing towards the importance of gut health for the prevention of chronic disease, we can’t overlook the need for a diet high in prebiotics. Phytonutrients, and prebiotics aren’t included in vitamin preparations. 

So you may be starting to get the idea that a multivitamin isn’t really the answer to fussy eating and possibly not even necessary.  As always, my main aim when working with clients is to identify nutrients that might be of concern and find ways to increase these nutrients in your child’s diet using real food, not supplements.

 Our population based guidelines above are “ideal” ways of eating that are associated with maintaining a healthy body weight and avoiding chronic disease as we age. It’s what we want to be aiming for with our children long term and what we as dietitians can help you achieve, but it’s not the only dietary pattern that will give them all the vitamins and minerals they need each day. 

One of the reasons I don’t often recommend vitamin supplements is because it’s usually adding another layer of “work” for parents, remembering to 1. offer it and 2. get your child to take it. I’d rather parents put their energy into using practical strategies to try and change their child’s diet. We know that food habits and preferences are formed in childhood, so if we want our children to eat a diet rich in vegetables, fruit and other plant based foods, along with quality proteins, we need to work towards it NOW. Sure, their choices at the moment may not make them deficient in anything, and they may still grow, but for optimal health as they mature, we want to get the dietary foundations and patterns of eating right in childhood. 

If you’re concerned about your child’s diet make an appointment to see an Accredited Practising Dietitian who specialises in children.

Angela and I are working on some exciting strategies to help you in your journey to feed your family real food and optimise your intake of plant based foods. Make sure you sign up to our newsletter so you can be kept in the loop as well roll out our new tools that will make feeding your family easier!

The advice in this blog post is of a general nature only and may not be right for your child. If you are worried about your child’s diet we suggest your consult with an Accredited Practising Dietitian.

 

Julia @Bloom


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We all know buying fruit and vegetables in season makes good sense. Food is fresher, tastes better, and is more economical. But with so many fruits and vegetables available out of their natural season, it can be confusing to know what to buy right now.

Below is a guide to whats available in the southern states in Autumn for March/April/May.

Autumn fruits –
apples, blackberries, cumquats, figs, feijoas, grapes, honeydew, limes, mandarins, valencia oranges,

passionfruits, pears, persimmon, plums, pomegranates, quinces, raspberries, rhubarb, rockmelons, strawberries, watermelons.

Autumn vegetables –
asian greens, beetroot, broccoli, brussels sprouts, cabbage, capsicums, carrots, celeriac, celery, cauliflower, eggplant, jerusalem artichoke, kale, kohlrabi, leeks, onions, parsnip, peas, potato, pumpkin, shallots, silverbeet, spinach, swede, sweet corn, turnip, chicory, zucchini.

Nuts –

chestnuts, pistachios.

(Seasonal Guide with thanks to Adelaide Farmer’s Market)

And what to do with these autumn offerings?

While the weather is still warm in the beginning of autumn, fresh foods served simply, like BBQs, salads and shared platters and outdoor eating remain at the top of the family meal list.

As the weather cools down, consider preserving some of the warmer weather’s fruits and veg for the coming winter. Getting chilly? Start ramping up the roast and soup rotations to help meet the family’s 2 & 5 goals for fruit and veg. Leftovers are great for lunchboxes too!

Remember, if you’ve got a fussy eater in the family, providing both new and familiar options of fruits and vegetables in a buffet or family style offering encourages children to try new foods.

Enjoy!

Angela @ Bloom 🌿

 


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Today I’m continuing our series of questions and answers and in the process, inviting you to send your question into us! Today’s question comes from a Mum in my exercise class who is soon to return to work and is stressed that her baby is refusing to take a bottle.

Milly is 10 month’s old and has only ever been breastfed. Milly’s lovely Mum Esther is returning to work 2 days per week in 2 months time (when Milly turns 1) and despite how hard she tries, she simply won’t take formula or expressed breast milk from a bottle.

Esther’s experience with Milly is a very common concern amongst breastfeeding Mum’s who need to provide an alternative when they are going to be apart from their baby. It’s a concern that isn’t always easy to address, and can be a hugely stressful experience for any Mum planning to return to the workforce.

The first point I’d make is consider the age of your baby and how regularly you’re going to be away from them. Milly is going to be one when Mum returns to work 3 days per week. In this case there is really no need for her to be offered formula or breastmilk or even cow’s milk. Many parents are surprised to hear that milk is not an essential part of a toddler’s diet. By age one, babies can get enough energy and nutrients from the food they are eating. So long as they are eating other calcium rich foods (for example yoghurt and cheese and perhaps milk added to porridge or cereal), they will meet their calcium requirements. Offering water throughout the day will provide enough fluid. This is a revelation to many parents who are sure their babies need to progress to toddler formulas or cow’s milk if they are ceasing breast feeding.

For babies between 9 and 12 months it really depends on how often and for how long you’ll be leaving them. I’d usually recommend leaving either breastmilk or formula with the caregiver/ child care staff, but for many it quickly becomes apparent that bubs is going to do little more than take a few sips at best. Worse, continuing to force a bottle at a child that doesn’t want it, can be an unpleasant experience for all. You don’t want your baby making unpleasant associations with their caregiver or new place of care. If you’re only leaving your child for 1 or 2 days per week, I’d suggest you drop the worry and simply let the caregiver offer more food and water on those days. Breastfed your baby in the morning, as soon as you pick them up and then again before bed, and they’ll be just fine.

Between 6 and 9 months ideally you’d leave some expressed breastmilk or formula for baby, but as you inch closer to 9 months and depending on how regularly you need to leave your baby, the above advice may still work. Certainly under 6 months of age you’re going to need your baby to take something from a bottle.

My top tips for getting young babies to drink from a bottle include: Make sure they are sufficiently hungry and offer the bottle at their regular feed time, having allowed at least 3 hours between feeds (2 hours if the baby is very young and seems hungry). Bottles with teats that “mimic” the shape of the nipple are often better accepted than others. I like the Tommy Tippee range which you can find here:https://www.tommeetippee.com.au/product/closer-to-nature-baby-bottle

Some babies will actively refuse the bottle no matter what you do. I have occasionally had success getting such babies (over 6 months of age) to drink from an open cup. This is messy and slow, but can be an option if you really need it.

Ideally someone other than the Mother should offer baby a bottle. As soon as baby is placed with Mum, they are going to want the familiar routine of a breastfeed.
Introducing a regular bottle early on (generally not before 6 weeks of age as during this time babies and Mums are still learning to breastfeed) can be helpful in getting them to accept a bottle long term. If you know you’re returning to work I’d suggest offering a regular bottle once or twice per week to get baby happily accepting a bottle long before it’s required.

In reality, persistence is the key. If you really need your baby to take a bottle, I’d put aside a whole day (perhaps a weekend day when the other parent is around offer it) to work on it. If they have refused the first time it’s offered. Wait an hour and try again. Be prepared to offer a large number of distractions and entertainment during this time as baby is likely to be getting hungry and cranky! The hungrier they get, the more likely they will give in and take what is offered. I won’t lie, this can be the most stressful of exercises, and if it all gets too much for you or your baby, put it aside and try again another day. The vast majority of babies eventually take enough to get them by at childcare and a good breastfeed before and after pick up, will help make up for any shortfall.

I’ve breastfed all four of my kids and have had mixed experiences trying to get each to accept a bottle. When my first child was four months old I returned to work 2 days a week for a short contract lasting a couple of months. Despite all my knowledge, pumping from day 1 and trying to introduce a bottle early, my little boy did not want a bar of it. The closer my return to work date loomed, the more stressed I became. My husband generally had more success with the bottle than I did, although my little boy took small amounts at best, and I generally returned home to a hysterical baby and distraught husband. With no other option, I returned to work and crossed my fingers that he would be okay. Luckily my Mum had volunteered to look after my little boy and her patience combined with my absence, resulted in him taking moderate amounts of expressed breastmilk on the days I was at work. He was never unhappy or stressed and I’m sure he made up for any difference with me breastfeeding him on demand when I returned home (ok so I may have run into the house on those nights peeling my clothes off as I did to feed him 😀).

I found the whole experience of trying to get my first child to take a bottle so stressful that by the time my second child came along I knew I didn’t want to repeat it. I wasn’t planning such an early return to work and so I simply didn’t worry about introducing a bottle in the early months. When he was 8 months old I returned to work 1 day per week. This time I made no plans or great attempts to get the bottle in before I started. I did leave some expressed breast milk with our nanny but after the first few weeks it was clear he had no interest and I was wasting my time. He was clearly happy with food and water and so I just left it at that. I continued to feed him morning and night and on demand as per usual on the other days of the week. Happy baby, happy Mum and his nutrition did not suffer as a result of the 10 hours each week where he got slightly less breastmilk than normal.
With my third and fourth children I planned longer maternity leaves and simply didn’t worry about introducing a bottle. For simplicities sake if I needed time away from them when they were very little, I did a mad dash between feeds. As they got older I used solids and water to stretch them out if I wasn’t going to make it home in time for their feed.

If you’ve got tips on how you got your child to take a bottle, we’d love to hear them!

Julia @ Bloom

This post is not sponsored


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Given that I spend my life around other Mums, it’s not surprising that as soon as people find out what I do for a job, they inevitably have a question for me.
Today’s question was one that I have answered time and time again, and given our soaring temperatures here at the moment, I suspect it’s something on a lot of parent’s minds. So I thought I’d share my answer with you all and extend the offer for you to ask us anything! If you’ve got a burning question, pop it in the comments section below, send us a message on Instagram or FaceBook or just drop us a line over email.

Anyway, onto today’s question which was “ My baby is 10 months old, she’s only ever been breastfed and isn’t taking much water. I’m worried she’s not getting enough fluids, especially in the heat”.

On Further questioning Mum said she had introduced water around 6 months of age but noticed that her baby drank very little of it. Mum had also tried (multiple times!) to get her baby to take either expressed breast milk or formula from a bottle but she had always outright refused. The baby was still breastfeeding 3 times a day and taking about 1/2 a sippy cup of water throughout the day.

It’s perfectly normal for babies to take very little extra fluid beyond what is offered via either breastmilk or formula. Baby’s first foods (be they pureed or mashed) have a high fluid content and this combined with the fluid they are naturally getting from breastmilk or formula will be enough for most babies. I always recommend introducing water from around 6 months (or the time that you introduce solids), but I wouldn’t expect a baby to get through more than about 1/4 of a sippy cup a day until they are 9 – 10 months old. As they start moving onto more solid food (and the fluid content of their meals drops and they also start reducing their breast or formula feeds), their intake of water will naturally increase. Most 12 months old babies will be taking close to a sippy cup (ie around 250ml) of water across the whole day. If your baby is taking less and you’re concerned, check their nappies. If they’re wet enough that you need to change them several times per day and they are also passing regular bowel motions, then that’s generally a sign that your baby is getting enough fluid. Their lips should also appear moist, not dry and cracked.

My top tips for encouraging babies to drink water include: persistence – don’t give up just because you think they aren’t drinking much. Many parents panic and start to introduce dilute juice as a way of tempting babies to drink. This only leads to the expectation that beverages should be sweet, and usually in my experience, further exacerbates the problem. Your baby will most likely to be thirsty immediately after eating, so always have water available at the end (or during) every meal or snack that is offered. Many babies are also thirsty when they wake from sleep. If you’re not going to be offering them a breastfed or formula, it’s a good time to try some water.
It’s worth remembering that breastfed babies under 6 months of age don’t need any extra fluid, just feed them on demand. Formula fed babies may be offered some cooled boiled tap water if they seem thirstier than usual (eg on a hot day). All babies can be offered tap water from 6 months of age. You may like to first offer water in a baby bottle, but I would suggest moving him or her onto a sippy cup after a few months (we like the Tommy Tippee range of adapters for baby bottles here: https://www.tommeetippee.com.au/product/weaning/cups). These are good all rounder cups/bottles if your baby is breastfed.

There are a large variety of sippy style cups on the market and the drinking style needed will vary from brand to brand. For example, some sippy cups require more of a “bite” to get water out style, others require sucking from a straw (generally babies won’t be ready for this until closer to 9 months) and others will require a suck somewhat similar to breastfeeding. Some come with valves to regulate the flow and others the water will simply pour straight out. If you’re really confused about cups and have a baby who’s really reluctant to take one, I would suggest consulting a paediatric speech pathologist who specialises in infant feeding. Another option would be to try an open cup but this will obviously be messy!

So my advice to this Mum today? Her baby was getting enough fluid and she just needed to hang in there offering water regularly as per my recommendations above. I had a feeling he was probably about to take off on the water as Mum was actively reducing breastfeeds, and his diet was expanding considerably. The other thing that’s worth remembering is that babies do have the ability to regulate their own thirst so long as the water is being offered regularly. It’s only in rare circumstances that babies won’t do this, usually as the result of a medical condition, or infants with extreme feeding disorders and food refusal. These babies are special cases that warrant individual assessment and advice.

Julia @ Bloom

This is not a sponsored endorsement