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Active Living
Full Listing with story descriptions
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Ask the Doctor
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My Doctor Says I Need a Test
Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
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Delaying Motherhood
Blue after Baby or Postpartum Depression
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High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
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Low Birth Weight Babies
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Prenatal Classes
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Planning a Pregnancy
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Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
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Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
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When Baby Comes Home
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Introducing Solid Foods
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Not Just Baby Fat
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Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
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Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
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A Healthy Mouth
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Seniors Oral Care
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The Smile You Want
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Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
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Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
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Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
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Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
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Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
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Diabetes in Cats
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Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
Insulin Pumps
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Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Blood Transfusions
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Carpal Tunnel Syndrome
Check-Up
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Contact Lenses
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Cost of Doctor's Visit
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Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
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Family Doctor
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Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
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How to Talk to Your Doctor
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Medical Digital Technology
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Win by Losing
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Get Active!
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Have Health, Will Travel
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Skin Over 50
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Travel Tips for Snowbirds
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Modern Living
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Aging and Memory
Alcohol and Your Health
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Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
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Diabetes Epidemic
Discipline
Diseases from Pets
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Mature Student
Melamine in Food
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Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Schizophrenia
Smokeless Tobacco
Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
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Travel Comfort Tips
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Whiplash
Wind Chill Index
Workplace Drug Testing
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Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
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Sports-Minded Nutrition
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Survive and Thrive
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Understanding Food Biotechnology
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Weight Wise Tips
Pharmacy Care
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After a Heart Attack
Adverse Drug Reactions
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Allergy Attack
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New Anticoagulant Medications
Inhaled Asthma medications
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Biologics
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Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
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Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
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Emergency Contraception
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Expanding Role of Pharmacies
Eye Protection - Sunglasses
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Generic or Name Brand?
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Heart Health
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Kids and Cold Medications
Medication Questions?
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Natural Medicines
New Blood Thinners
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Obesity Medication
Over-the-Counter Drugs
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Over-the-Counter Drugs and Pregnancy
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Packing Medications for Travel
Pharmaceutical Studies
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Research Studies
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Sports & Nutrition Supplements
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Take as Directed
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Viagra
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Yeast Infections
Your Best Shot
Your Medicine Cupboard
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Full Listing with story descriptions
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Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
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Caffeine
Cell Phones and Driving
Childhood Obesity
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Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
E-cigarettes
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
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Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
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Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
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Should You Immunize?
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Teens, Drugs and Driving
Travel Health Considerations
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Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
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Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
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Contraception for Mature Women
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Estrogen's Effect on the Brain
Fear of Fracture
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Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
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Menopause
Menstruation Myths
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Third Generation Birth Control Pills
Osteoporosis
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Your Pelvic Floor
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Family Health Magazine - CHILDHOOD

Introducing Solid Foods
A step-by-step guide

Few things in life are more exciting than having a baby. Along with the delight, many parents question whether they are making the right decisions for their child. Health care providers are often asked when and how to introduce solid foods into a baby’s diet. Many well-meaning people have opinions, from grandmas and aunties to neighbours and even strangers. The guidelines outlined here are based on the latest evidence, and are flexible enough that most families can follow them.

1Before solids, breastfeeding is best

5 No-nos

Honey is not safe for children under age one, because of an illness called infant botulism. Avoid hard, small, round, smooth or sticky foods. For instance, nuts, grapes, hot dog pieces and hard vegetables can all be choking hazards. Stay away from raw or undercooked meats, eggs or fish, and unpasteurized milk or milk products.

Do not offer children sugary beverages like pop or juice. Juice has lots of sugar and very little nutrition. Drinking it can lead to diarrhea and tooth decay. In general, select foods with little or no added sugar or salt. Keep in mind that fats are an important source of energy for young children. Low fat and diet foods are not appropriate.

Until solids are introduced, it is strongly recommended that a baby be exclusively breastfed. Breastfeeding gives important early immunity to your baby, and allows an excellent bonding opportunity with mom. It is also the best balance of the nutrition your baby needs, and costs zero dollars. Supplement exclusively breastfed babies with vitamin D drops. Once solids are introduced, breastfeeding is still encouraged until two years of age.

For a number of reasons, breastfeeding may not be possible. If this is true for you, offer commercial infant formula instead. Cow’s milk based formulas are recommended. True cow’s milk allergy is rare, and soy, rice or other plant-based beverages may not be appropriate. If you think your baby is not tolerating cow’s milk based formula, discuss alternatives with your doctor before using a substitute. Once solids are introduced, continue with formula until 12 months of age.

2Solids at six months

Once your baby is about six months old, complementary foods are needed to support growth, satisfy hunger, and supplement energy and nutrient needs. Some infants will be ready to try solids a few weeks earlier. Others are not ready until a little after the six-month mark.

Watch your child for signs of readiness. Key things to look for include better head control and the ability to sit up and lean forward. By this age, the baby might be showing interest in what others are eating. She may be reaching, grasping, and trying to put food in her mouth. Between four to six months, babies typically stop using their tongues to push food out of their mouths. They develop the coordination to move food from the front of the mouth to the back for swallowing. Put a little bit of baby cereal on a spoon and see where it goes — right back out or down the hatch? As well, after six months caregivers are better at reading baby’s signals of fullness. For instance, your infant may turn her head away and refuse further food.

Introducing solids too early will not solve some of the many challenges faced by new parents. Starting with cereal earlier than four months will not help a baby sleep through the night. It may do harm, since the baby is not developmentally ready for solids. As well, it will do little to manage bowel function like constipation, soft stools or regurgitation (spit up). Babies have a wide variation in what is ‘normal’ for poops and spit up. If you have concerns, discuss them with your care provider before changing your baby’s diet.

3 Iron-rich foods first

When your baby shows interest in food and appears ready to swallow solids, it is important to start off with iron-rich foods. After six months, breast milk can no longer provide enough iron. Since it is needed for brain development and other functions, a good source of iron is the best choice for a first solid food. Consider soft meat and alternatives like eggs, legumes, tofu, or iron-fortified cereals.

Introduce one food at a time. Allow a few days in between new additions. Gradually increase the number of times new foods are offered, while continuing to breast or formula feed.

It is not necessary to avoid certain foods to prevent allergies. In fact, foods like eggs, fish, wheat and soy should be introduced early in order to develop ‘immunologic tolerance’. This allows the body to get used to these foods. When your baby is about a year old, offer cow’s milk. It should be 3.25 per cent milk fat (homo or whole milk). Offering cow’s milk before this time can lead to iron deficiency. The baby will fill up on the milk and not get the nutrition needed from other whole foods.

Once iron-rich foods are tolerated well, continue introducing a variety of nutritious foods. Use the same food for your baby that you make for the rest of the family. Modify a family meal by mashing, blending, and later cutting up food into small pieces. This strategy adds variety, and you avoid becoming a short order cook. Sharing the family meal with a baby also helps in making wise nutritional choices that set a good example. Everyone begins to consider food groups and portion sizes. Meat and fish, vegetables and fruit, grains, and dairy should be a part of every family member’s diet.

Some families have food restrictions, such as celiac disease or being vegetarian. In this case, talk with your care provider about how to meet your baby’s dietary needs. Adult restrictions are not always appropriate for a child.

In addition to deciding what to feed your baby, consider how to deliver the choices. Vary textures as well as tastes. Offer lumpy food textures no later than nine months, or your baby may refuse to eat them. Encourage self-feeding by offering finger foods once your child is eight to ten months old. Examples include soft fruits, bits of pasta, or small chunks of cheese. Use open cups to teach coordination, with help at first. Of course, some of these suggestions will mean a messier baby and kitchen. You must decide on your priorities and what you are able to tolerate.

4 Enjoy the adventure and do not stress

Many parents worry about whether their baby is eating enough and eating right. Routinely monitoring your child’s growth is the best way to assess health and nutrition. Visit your care provider regularly. Relax and remember that eating meals together is good for baby and the family. Encourage exploration, avoid power struggles, and enjoy what can be a very fun (and funny) learning process.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [CH_FHab15]
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