CHAPTER ONE This Is Not Your Mother's Kitchen Your food choices are more complex now than at any other time in history. When your great-grandmother went shopping, she had only nine hundred food items to choose from at the local market. Your supermarket, on the other hand, is likely to carry forty-five thousand items. Some additions have been positive, including a greater variety of fruits and vegetables and certainly more whole grains and even organic food. But it is the addition of what I call inferior foods that is alarming. Over the past decade the snack food market has increased by 25 percent, with more than $60 million in sales. The baby food aisle alone contains mini granola bars, ready-to- eat meals, and snack treats. High-fructose corn syrup, an ingredient in almost all of those snack items, was created in 1960; according to an article in the American Journal of Nutrition, its use has increased by 1,000 percent per capita--and, I fear, permanently altered young people's desire for sweet-tasting food. Parents often don't believe me when I say food is cheaper today, but it is. According to the Nutrition Action Healthletter, Americans spent, in the 1950s, 21 percent of their disposable income on food, while in the year 2000 only 11 percent of our disposable income was spent on food. Cheaper food means that in order to make money, the American food industry must get us and our children to overeat. The American food industry daily produces 3,900 calories' worth of food for every man, woman, and child in the country, an amount that is almost double what the average adult actually needs and way above what a young child requires. How we eat has changed, too. The number of meals that families eat together has declined, snacking has replaced real meals, and the microwave has become a part of almost every home. The impact of these changes has been a dramatic increase in childhood obesity, an accompanying rise in disease, and a potentially reduced life span. You and your child are at risk of poor food choices and the resulting health risks because of advertising, the wide availability of food, and our innate biology. For example, in 2004 Kraft Foods spent $26 million just on advertising the children's deli meat product called Lunchables--a truly inferior food because of its excessive sodium content and lack of vitamins and fiber. Coca-Cola spends $1 billion each year advertising its products. These products (and others like them) are in your child's future. The combination of ubiquitous advertising, wide availability, and low price makes food flavored with salt, sugar, and fat almost impossible for a child (and her parents) to self-limit. In addition to all the societal factors, human beings are simply "wired" to eat them. Our ancestors learned a very long time ago that foods with fat had more calories and would keep them alive, foods with a sweet taste were not likely to be poisonous, and salt--a nutrient essential to health but so hard to find in nature--was to be consumed whenever available. All human beings --including you and your child--are physiologically designed to covet these tastes. The food world in which you are raising your child is different because of all these products, but also because the American family eats away from home more often. On any given night only 58 percent of us are eating at home, and many of those meals include take-out restaurant food or store-bought convenience products. Pizza, burgers, and Chinese are the most popular take-out foods, and they will soon be part of your child's diet, too. You might think that the world I describe above does not yet apply to your baby; babies are perceived to live in this rarefied bubble that protects them from the world of adult concerns. Say the words "baby food" and you are likely to picture tiny bowls of smooth warm oatmeal and creamy orange carrots. Those images may be accurate for some babies, but not for all. There is a discrepancy between what babies need to eat and what babies actually are being fed. Half of all seven- to-eight-month-olds are eating dessert daily; the dessert replaces the recommended fruits and vegetables they actually need. One-third of seven-to-twenty-four-month-old babies eat no vegetables at all, and by fifteen months french fries become the most popular vegetable. The Feeding Infants and Toddler Study (FITS), published in 2004, was a study sponsored by the Gerber Products Company to update our understanding of the food and nutrient intakes of infants and toddlers in the United States. The survey asked parents or caregivers about the feeding habits of their children age four months to twenty- four months. It gives us a look into what real families are feeding their kids and is useful because it illustrates how quickly parents are forced to make decisions about how and what they feed their child. The survey also covered food choices, feeding practices, growth and development, and nutrient intake. The results were mixed. The FITS data suggest that most babies have been introduced to solid foods by four to six months. At this early age children are just learning to eat and become familiar with food, so a "balanced diet" isn't an issue since formula and breast milk are the true nutritional safety net. The majority of babies have had some sort of grain product (usually infant cereal) by six months, and about 40 percent are eating a little fruit and vegetable. Less than 1 percent have had a dessert or sweetened beverage. By eleven months, the majority of babies (98 percent) are eating grains (cereal, bread), and over 70 percent have fruits, vegetables, and meats in their menu. Few infants are getting plain meats; instead, parents are opting for baby food combination dinners. Few children are eating the recommended servings of dark green vegetables, and once they move to table food, potatoes become the vegetable of choice. Eleven percent of eleven-month-olds have been served soda or fruit-flavored drinks, and by twenty-four months the proportion of babies consuming sweetened beverages jumps to 44 percent, 60 percent eat a baked dessert, and 20 percent get candy. Children given more sweetened drinks early in life are likely to consume more sweet drinks later. Sweetened drinks are so easy to consume in excess, crowding out other more nutritious foods, that the American Academy of Pediatrics (AAP) now recommends only 6 ounces of 100 percent fruit juice per day and no fruit drinks or soda. Apple juice and apple-flavored fruit drinks are popular baby beverages, and for many children fruit drinks and soda replace milk by age two. At this age some infants are drinking little or no milk, possibly leading to low calcium intake if non-milk sources are not consumed as alternatives. The FITS survey shows that the trend of not meeting the recommendations for fruit and vegetables starts as early as nine to eleven months. As babies transition to table food, 25 percent of nineteen-to-twenty-four-month-olds are consuming chips or other salty snacks on any given day. This is significant because the foods introduced in the early years can impact a child's preference for life. These trends make it important for you to examine your own eating and drinking habits. Your child will want to eat what you are eating, and if Mom and Dad are having french fries and sweetened drinks, most babies will, too. The rise in childhood obesity should be no surprise, as it mirrors adult issues. Those in the lower socioeconomic brackets are hit the hardest. The rate of obesity for middle- and high-income American adults is 29 percent, but the rate for low-income Americans is 35 percent, and low-income kids have a similarly high percentage of being overweight. Overweight in adults is defined as having a Body Mass Index (BMI) between 25 and 30. Over 30 is considered obese. In children a BMI above the ninety-fifth percentile for the child's age is considered overweight. Combine the fact that adults have complex food choices with the phenomenon of the "picky eater" and you have a source of real stress for new parents. As many as 50 percent of babies four to twenty-four months of age are described by their parents as picky eaters. A picky eater can grow up in any family, and it is not an indicator of good or bad parenting. It is so common it must be normal. That doesn't mean nothing can be done to prevent it. Most parents offer a food three to five times before deciding their child does not like it, but that may not be enough--children may need eight to fifteen tries before accepting a food. Don't give up--the more variety you give your child, the more you may influence the flavors and textures he actually accepts. Read more about the picky eater on page 46. The good news is that despite the introduction of dessert, sweetened beverages, and salty snacks, children are not deficient in nutrients. Surveys consistently show adequate intake of nutrients, in part due to the fortification of foods. That is not the same as saying babies and children are eating well, because the bad news is they are not eating enough fruit, vegetables, and good calcium choices--foods containing unique substances that prevent illness and promote good health. Not eating sufficient amounts from the recommended food groups is significant because poor nutrition contributes to high blood pressure, diabetes, heart disease, and obesity--disease processes that all begin in youth. I am not trying to scare you, but I do want to impress on you that the food you choose really matters. You have to be your child's advocate because your baby is growing up in a food world that many nutritionists describe as "toxic." The news about food is not all gloomy. Most Americans eat a home- cooked meal almost five times per week, and while fruit and vegetable consumption is not where it should be, the latest food surveys find fresh fruit consumption is on the rise, particularly in families with young children. Concerns about health affect food choices. Parents look for foods described as healthy, "light," and even organic. More than 70 percent of you are breastfeeding your baby for at least part of the first year because you know it is the best way to feed your infant. If we encourage these trends, we'll be off to a much better, healthier start. HOW TO START OFF RIGHT Children do not need to be taught how much to eat, but you must support this by showing them how to recognize feelings of hunger and satiety and by feeding them when hungry and allowing them to stop eating when they indicate a sense of fullness. Never force or bribe a child to eat. You do need to choose good food for children because they can't do that on their own. Babies never need a low-fat or reduced-calorie diet. In the first year of life adult feeding guidelines that encourage low-fat choices do not apply to infants. But that is not the same as saying babies need a menu of high-fat foods. As soon as you start feeding your baby solid food, you will be forced to make decisions that can affect your child's future health. These food choices are not trivial. Between 75 and 95 percent of major chronic disease is linked to poor nutrition. Good nutrition and activity can prevent chronic illness, and feeding exposures early in life can make a difference. I want to reassure you that selecting food is not complex. It means getting back to basics, recognizing that food choices matter, and knowing how to distinguish the good from the bad. TWO The Easy Year Given all the changes that a baby brings to a parent's life, you might be surprised to hear me refer to your child's first year of life as the "easy year." But when it comes to food, the first twelve months really are easy. In the beginning the only feeding choice you make is whether to breastfeed or give formula, and if you are reading this book at home with your newborn by your side, that decision has already been made. Your next decision will be when to add solids and which foods to choose. If you stick to traditional baby food items, either homemade or jarred, the choices are not too complex, either, at least in the beginning. But new parents worry about a lot of things. When I brought my babies home I worried about what it meant when they cried, and I worried about when to start real food and if they were getting enough to eat. The truth is there are no hard-and- fast rules. Breast-fed babies should be offered the breast on demand-- as much as ten to twelve times a day in the first month; settling into five to ten times per day later on--and in the first few months a baby on formula can drink 18 to 32 ounces divided into four to eight feedings. It is in these early days that you will want to learn to trust your child's innate ability to self-regulate and know how much he or she needs to eat. Your job is to provide the food in a relaxed and secure environment; if you feed your baby on demand, she will consume exactly the amount she needs. In this early phase I think breastfeeding moms have it easier because they can't see their breast empty of milk in the same way a parent can see a formula bottle empty. Parents feeding with a bottle may think it is their responsibility to teach a child to finish the bottle, but the real job is to allow the child to take what she needs and only finish the bottle if her hunger tells her to do so. The child who falls asleep, refuses the nipple, or stops sucking is indicating that she is no longer hungry. Now is the time to practice trusting your child to consume enough food based on what she needs and not on the amount that fits into a bottle. It is the same skill your child will need when she begins eating from a plate. CRYING Please don't let well-meaning friends or family members discourage you from responding to your baby when he cries. Crying is an effective way for a baby to communicate hunger and discomfort, and I believe strongly that the parent who responds to a crying child with a change of diaper, a warm blanket, food, or a gentle cuddle is absolutely not creating a spoiled child but is instead helping the child to feel secure, strong, and important. Babies do not cry because they are trying to manipulate; they cry because they can't talk. You will learn very soon to distinguish a hunger cry from a sick cry, a scared cry, or a pained cry, and you will know what to do. As your baby gets older, routines and a flexible schedule regarding feeding and naps and diaper changes will help you and your baby create a family rhythm that makes you more confident and the baby more secure. Excerpted from The Baby Food Bible: A Complete Guide to Feeding Your Child, from Infancy On by Eileen Behan All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
