This section hopes to guide you through the first few weeks of your baby’s life. Tips on feeding, introducing solid foods, breastfeeding, sleep, safety, and more can be found here. If your baby is premature, this information still applies but your doctor can give you extra advice when required.
In April 2014, Health Canada, Dietitians of Canada, the Canadian Pediatric Society, and the Breastfeeding Committee for Canada together released updated guidelines for feeding infants aged 6-24 months. Below is a summary of the key points regarding introducing solids to your baby. You will find new recommendations in bold.
The best time to introduce solids may be a few weeks before or after 6 months, based on the readiness of your baby and recommendations from you health care provider.
Breastfeeding (or formula feeding) is the primary source of calories and nutrition for babies, so don’t stop!
Daily Vitamin D supplement (400IU) is recommended for infants and young children who are breastfed ONLY.
Introduction of solid food at around 6 months of age (or 6 month corrected age*) is recommended.
The first foods introduced to your baby should be iron rich foods; single-grain iron fortified infant cereal (oatmeal, rice, or barley) and well-cooked, pureed, minced, mashed, or shredded meat or poultry, low-mercury fish, legumes (beans, lentils, and peas), tofu, or eggs. (NOTE: If your baby was born prematurely, speak to your doctor as they may need an iron supplement). After iron rich foods are introduced and your baby is eating them on a regular and daily basis, you can then introduce fruit, vegetables, grain products and dairy products (with the exception of milk)
There is no recommended order for introducing foods after iron rich foods are introduced.
Offer one new food at a time.
Wait 3-5 days between offering new foods.
Foods can be introduced using a variety of soft textures. *Past advice was to start your baby on pureed food, however, at 6 months of age, babies are able to handle a variety of textures.
Potentially allergenic foods should be part of the first foods offered to babies; this includes eggs, milk, peanuts, seafood, sesame, soy, tree nuts, and wheat. *Contrary to past advice, in order to decrease the likelihood that your baby will develop and allergy, introduce the above foods early (as recommended) and serve them often.
This applies to all babies, including those with a family history of allergies. If you have a strong family history of food allergies, talk to your health care provider about introducing potentially allergenic foods in a safe manner.
There are only 2 exceptions to the “try everything” approach:
MILK: homogenized milk can be introduced to breast or formula fed babies from 9-12 months.
HONEY: avoid honey and all products made with honey until at least one year of age due to risk of botulism.
Toss the sippy cup!
The use of sippy cups is no longer recommended.
The use of regular “open” cups (at 6+ months) is now the gold standard.
The reasoning is that “open” cups support the development of feeding skills.
*corrected age (used for premature babies) = actual age in weeks minus weeks premature.
Circumcision in the newborn is a surgical procedure that is not medically necessary. Historically, circumcision has been practiced by those of Jewish and Muslim faiths for religious reasons. Circumcision for non-religious reasons has gone through various stages of favour and disfavour. There is evidence to suggest that circumcision reduces the risk of urinary infections in boys to 1/12 of what it would be otherwise. This potential benefit must be weighed against the fact that urinary tract infections in male infants are rare to begin with. The overall benefits and risks are so evenly balanced that the Canadian Pediatric Society does not recommend routine circumcision.
Your decision with the knowledge of the potential risks and benefits must be based on personal, religious and cultural factors. If you are concerned about the boy looking different from other children or his father, remember that the implications of circumcision or non-circumcision are no greater than other natural physical differences such as hair colour, build, or size.
Choosing not to circumcise The advantage of choosing not to circumcise are mainly the avoidance of the risks of circumcision as a surgical procedure; specifically bleeding, infection, and surgical trauma. At birth, the foreskin is tightly attached to the head of the penis, and normally cannot be pushed back. The foreskin of many children spontaneously goes back by the age of 5 years. Pushing the foreskin back before it is ready and breaking down the adhesions may cause significant infection and could cause tightening of the foreskin around the head of the penis. It is therefore not recommended that the foreskin be pushed back. The penis should simply be washed daily without pushing back the foreskin.
Choosing to circumcise Circumcision is the surgical removal of the foreskin, or prepuce. This procedure is performed at the clinic, and takes about ten to fifteen minutes. Using a freezing technique called “dorsal penile nerve block” a small amount of local anesthetic is injected under the skin at the base of the penis, to numb the area. The technique uses the Mogen clamp, which is fast and protects the head of the penis.
Risks Most babies exhibit little discomfort after their circumcision. As with any surgery, there is a risk of bleeding or infection. If your baby has a congenital malformation of the penis (i.e. hypospadias) this may not be evident until after the circumcision. Rarely, part of the glands may bleed following this surgery. The incidence of complications of circumcision in published articles varies from 0.2% to 2%. Most complications are minor but occasionally serious complications can occur. Premature babies, those with bleeding problems, deformities of the penis, or other major medical problems should not undergo circumcision.
Preparing for circumcision Bring extra diapers, soother, and 1 tsp. sugar. There is evidence that having a baby suck on a sugar-coated soother is a great distraction during the operation.
After the circumcision Instructions to look after the surgical site will be given to you after the circumcision. The tip of the penis will look angry and raw, and this is normal. With every diaper change, you will apply a generous amount of Vaseline over the area. A little bleeding is not unusual and can be stopped by applying gentle pressure with a clean gauze or cloth.
Cost Circumcision is not a benefit covered by OHIP or any other health insurance. The fee is payable by cash, cheque, Visa, or Master Card and is due at the time of the surgery. The receptionist booking this visit will advise on fees.
Behind the Smile: My Journey Out of Postpartum Depression Marie Osmond, Marcia Wilkie & Judith Moore Postpartum Depression and Anxiety: A Self-Help Guide for Mothers (available at the Parent Resource Centre) Pregnancy and Postpartum Anxiety Workbook Pamela Wiegartz When baby brings the blues: Solutions for Postpartum Depression Dr. A. Dalfen