From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
National Food Service Management Institute The University of Mississippi Spring 2003
From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Table of Contents Purpose Objectives Time Definitions Materials Trainer’s Tips Icebreaker Activities Evaluation Techniques General Coaching Tips References Content Outline with Trainer’s Tidbits Handouts Pretest Posttest Test Keys Transparencies Not Numbered
This lesson has been corrected to meet the new 2009 Food Code and the USDA Kitchen Companion. Regulations may vary from state to state; please check with state agency for the most current information and regulations before presenting this material.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Purpose: To help providers understand their role in a successful feeding relationship.
Objectives: The provider will be able to describe the relationship between food and health. The provider will be able to identify an infant’s eating cues. The provider will be able to demonstrate proper techniques of bottle-feeding.
Time: 30 Minutes
Definitions: Eating Cue—the way an infant tells you he/she is full. Expressed Milk—breast milk a nursing mother has pumped from her breast for later use.
From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Trainer’s Tips:
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Find out something about your audience before the program. Use examples that apply to your audience. Don’t plan to reuse any food samples for a later program.
Icebreaker: If you were a crayon, what color would you be? Focuses on how personalities of caregivers and infants blend. Use Handout 1.
Activities: Group Activity: Feeding Infants. Hold a baby doll and pretend to feed it. Show different facial expressions like happy, sad, mad, nurturing, warm, frustrated etc. Ask participants to guess how you are feeling. Ask participants what message the baby is receiving from the caregiver. Group Activity: Bottle Feeding. Demonstrate the correct technique for bottle feeding. Group Activity: Burping Baby. Demonstrate the correct technique for burping.
Evaluation Techniques: Use the following to assess participant knowledge: Pretest is given following the Icebreaker. Use Handout 2. Discuss answers using Test Key. Posttest is given at the end of the training session. Use Handout 5. Discuss answers using Test Key.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
General Coaching Tips:
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5
Be prepared to answer questions your participants may have about: ƒ How to deal with fussy babies. ƒ How to safely handle breast milk. ƒ How to encourage breast feeding. Plan activities that work within your setting. ƒ Groups: ¾ ALWAYS do an icebreaker. ¾ Select activities. ¾ Remember that groups usually like to discuss and work together. ¾ Games are great ways to reinforce new concepts. ƒ One-on-one instruction: ¾ Be prepared to provide direction and assistance to complete activities. ¾ Use content from group activities in one-on-one discussions.
References: Fromer, J. & Berman, C. (1997). Meals without squeals: Child care feeding guide and cookbook (2nd ed.). Palo Alto, CA: Bull Publishing Company. National Food Service Management Institute. (2001). Child care mini-posters. University, MS: Author. National Food Service Management Institute. (2001). Child care tips poster. University, MS: Author. Shelov, S. P. (1998). Caring for your baby and young child: birth to age 5 (Rev. ed.). New York, NY: Bantam Books. United States Department of Agriculture, Food and Nutrition Service. (1993). Breastfed babies welcome here! Washington, DC: Author. United States Department of Agriculture (1994). What’s in a meal? Chicago, IL: Food and Consumer Services.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
References: (cont.) United States Department of Agriculture (2001, December). Feeding infants: A guide for use in the child nutrition programs (rev. ed.). Retrieved January 10, 2003 from: http://www.fns.usda.gov/tn/Resources/feeding_infants.html. United States Department of Agriculture (2002, May 28). 7CFR Parts 210, 220, and 226 Amendments to the child nutrition infant meal pattern. Retrieved January 9, 2003 from: www.fns.usda.gov/cnd/care/Regs&Policy/InfantMeals/amendments.pdf.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
1. Icebreaker Handout 1: Icebreaker Transparencies 1 - 2
1. Icebreaker – Use Handout 1 and a box of crayons. Ask participants to describe their personality as the color of a crayon. Make a list of personality traits on a flip chart or overhead transparency. Ask participants to describe the infants they care for as the color of a crayon. Coaching Tip: There are no “right” or “wrong” answers. We all perceive colors differently. One color may seem upbeat to one person but not to another. What happens when you mix two different colored crayons? A new color is created. When caregivers feed infants, feelings are communicated. Sometimes feelings are friendly and positive – but not always. Think about how your personality color blends with the personalities of the infants. Your color changes with each infant. Be sure the blending of the two colors conveys a warm, nurturing atmosphere.
2. Pretest Handout 2: Pretest
2. Pretest Use Handout 2. Discuss answers using Test Key.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
2. Food and Health Transparency 3
2. Food and Health
A. Patterns of Eating
A. Eating patterns and attitudes toward food develop early in life and affect health later on.
B. Food Likes and Dislikes
B. The food choices you make before age 20 determine in part how healthy you will be at age 40 and beyond.
C. Outcomes of Poor Food Choices
C. Remember that your body is made up of food. It is affected by all you have eaten in a lifetime. A lifetime of poor eating habits usually has a negative impact on health. Many deaths in the United States are related to eating habits: • Heart disease • Hypertension • Some cancers • Diabetes These are chronic diseases that develop over a lifetime.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
3. Infants and Food A. Feeding Conveys the Feelings of the Caregiver Transparency 4
3. Infants and Food A. The way feeding is handled affects an infant’s view of the world. The feelings and attitudes of the caregiver are conveyed to the infant during feeding.
B. Examples of Ways Feelings are Expressed Transparency 5
B. Examples of Ways Feelings are Expressed Group Activity: Feeding Infants. Ask participants to guess what you are feeling based upon your facial expressions. Hold a baby doll and pretend to feed it expressing a variety of positive and negative feelings. Ask participants to discuss how you are feeling and what messages the infant is receiving. Does the baby see the world as friendly and nurturing or cold and frustrating? Discuss how you think the infant will respond to the different facial expressions.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
4. Developmental Milestones Handout 3: Developmental Milestones in Feeding Transparency 6
4. Developmental Milestones – Infants develop on different timetables but they all go through these stages of development. Nutrition and food are a part of each developmental stage. Use Handout 3.
A. Attachment
A. Attachment to Primary Caregiver – Infant sees self as part of caregiver. Infant needs stable care. Infant may refuse to accept feeding from strangers.
B. Trust
B. Trust – Infant is dependent on caregiver to meet nutrition needs. Caregiver needs to look for infant’s cues of hunger and satiety.
C. Exploration
C. Exploration – Infant puts everything into his/her mouth. Infant uses the mouth to explore the environment. Protect infant from hazards associated with choking and from poisonous substances.
D. Independence
D. Independence from Caregiver - Infant needs to be allowed to set the pace in feeding. Infant may refuse food in an attempt to get a response from caregiver.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
5. Feeding Techniques
5. Feeding Techniques – Feed infant when he/she is hungry. Cries, wiggles, and fussiness do not always mean hunger. Ask participants why infants cry, wiggle, or act fussy. Some answers include: • Wet or dirty diaper • Needs to be burped • Needs to change position • Needs some company • Teething • Ear Infection • Diaper rash
A. Bottle-Fed Infants Transparency 7
A. Bottle-Fed Infants - Discuss the correct method of bottle feeding. • Always hold a baby when giving a bottle. • Hold the head higher than the rest of the body. This way the milk does not flow into the inner ear and cause an infection. • Tip the bottle so the milk fills the nipple and air does not get in. • Wait for baby to stop eating to burp. Group Activity: Bottle Feeding. Demonstrate using a baby doll and baby bottle.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
5. Feeding Techniques (cont.) B. Burping Infants
5. Feeding Techniques (cont.) B. Burping Infants • Wait for the infant to stop eating before burping. • Many techniques can be used to burp a baby. Some examples include: ¾ Rub the back gently while the baby rests on your shoulder or sits (supported with your other hand) on your lap. ¾ Have the baby sit in your lap supporting the head while gently patting on the back. ¾ Lay the baby across your lap (the baby’s head should be higher than the chest) and gently rub or pat the back. Group Activity: Burping Baby. Demonstrate burping using a baby doll.
C. Distractions to Feeding Transparency 8
C. Distractions to Feeding – Ask participants to identify things that may distract or may upset an infant during feeding. Some examples include: • Noise, loud music, or loud TV • Too much burping • Too much wiping • Too much bouncing and jiggling • Too many changes in position
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
5. Feeding Techniques (cont.) D. Cues of Fullness Transparency 9
5. Feeding Techniques (cont.) D. Cues of Fullness – Ask participants to identify ways an infant tells us he/she is full. Some answers include: • Closed lips • Stop sucking • Spit out nipple • Turn head away • Cover mouth with hands • Cry • Bite the nipple Remember, infants like to pause during the meal. This is a good habit for adults, too. Offer the nipple again. If it is refused, the infant is probably full. Resist the temptation to make the infant finish the little bit of formula left in a bottle. When an infant conveys fullness, discard what is left.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
6. Breast-Feeding Infants Transparencies 10-11
6. Breast-Feeding Infants
A. Advantages
A. Breast-Feeding offers the infant many advantages: • The right balance of nutrients • Immune factors • Special bonding with Mom • Recommended by doctors • Less likely to develop food allergies
B. Challenges
B. Challenges – Breast-Feeding moms who work outside the home have a special challenge.
C. Managing Breast-Feeding
C. Ways to manage breast-feeding: • Pump breast milk and put in sterilized bottles or nursing bags for the child care. Ask Mom to label each container with the child’s name, date, and time milk was collected. • Mom can nurse at child care during breaks from work. Note that the meal is not reimbursable by CACFP if the mother nurses the infant at the child care facility. • Infant can be fed formula while in child care and breast fed at home.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
6. Breast-Feeding Infants (cont.) D. Tips to Support Breast-Feeding Moms Transparency 12
6. Breast-Feeding Infants (cont.) D. Tips to Support Breast-Feeding Moms If Mom will be nursing during child care: • Make the infant’s last feeding 1 to 1 ½ hours before Mom arrives. This way the infant will be hungry enough to nurse. • Offer Mom a comfortable chair and a cozy, private place for nursing.
7. Food Safety Handout 4: Think Food Safety
7. Food Safety – Think about food safety when feeding infants. Infant formula and breast milk will spoil if left out too long. Here are some tips to keep milk safe.
A. Handwashing Transparency 13
A. Handwashing • Be sure to wash your hands and the infant’s hands before and after feeding.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
7. Food Safety (cont.)
7. Food Safety (cont.)
B. Keeping Breast Milk Safe Transparencies 14 - 16
B. Breast Milk: Handout 4 If breast milk comes in bottles from home: • Store breast milk in the refrigerator at 40oF or lower for up to 48 hours from the time it was collected. • Freeze breast milk for up to 3 months. • Do NOT allow breast milk to sit out at room temperature. • Expressed milk should be stored in sterilized bottles or disposable plastic nursing bags. • Ask Mom to label each container with child’s name, date, and time collected. • Do NOT warm breast milk in the microwave. • If frozen, thaw by running under cool, then very warm water. Shake gently to mix. • Once breast milk is thawed, use within 24 hours and do NOT refreeze. • Discard unused portions.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Content Outline
Trainer’s Tidbits
7. Food Safety (cont.) C. Keeping Infant Formula Safe Transparencies 17-18
7. Food Safety (cont.) C. Keeping Infant Formula Safe • Store in refrigerator at 40oF or lower for up to 48 hours. • Do not allow prepared formula to sit at room temperature. • Warm under running water. • Do NOT warm in the microwave. • Discard unused portions.
8. Review for Understanding Transparency 19
8. Bottle feeding or breast feeding can provide babies the nutrients needed for growth. Remember, the caregiver’s attitude and feelings are conveyed to the baby. Use feeding time as a way to give the baby a positive view of the world.
9. Posttest Handout 5: Posttest
9. Posttest. Use Handout 5. Discuss answers using Test Key.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Handout 1: Icebreaker 1. If you could be a crayon, what color would you be? Color Box 1 the color that best describes your personality. For example: yellow = warm, blue = cool, hot pink = cheerful. There are no “right” or “wrong” answers. We all perceive colors differently. 2. Below Box 1, list two to three words that best describe your personality. 3. Think about three different infants you care for. If each infant was a crayon, what color would he/she be? Color Boxes 2 - 4 the color that best describes each infant’s personality. 4. Below Boxes 2-4 list two to three words that best describe each infant’s personality.
Box 1: Me
1. 2. 3.
Box 2: Infant
1. 2. 3.
Box 3: Infant
1. 2. 3.
Box 4: Infant
1. 2. 3.
5. Now, create three new colors in Boxes 2 - 4 by blending the color that you chose as representative of your personality with the colors of your infants. Describe the way your personality blends with the personality of the infant. Do you feel the same toward every infant?
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Handout 2: Pretest Directions: Circle T for True or F for False.
T
F
1. The way an infant is fed impacts how he/she views the world.
T
F
2. Many deaths in the United States are related to eating habits.
T
F
3. Propping a baby’s bottle with a pillow is an acceptable way to feed a 5-week-old.
T
F
4. Spitting out the nipple is one way an infant tells you he/she is full.
T
F
5. Breast milk provides the right balance of nutrients for infants.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Handout 3: Developmental Milestones in Feeding Milestones Attachment
Trust Exploration Independence
Relationship with Nutrition Infant sees self as part of the caregiver. Infants need stable care. May reject strangers. Infant is dependent on the caregiver to meet nutrition needs. Look for cues of hunger or fullness. Infant uses mouth to explore the environment. Infant needs to set the pace in feeding. A pause in eating may not mean fullness.
Fill in the blanks: The correct way to bottle feed:
The correct way to burp a baby:
Eating Cues: Messages that tell you the baby is full. • Closed lips • Stop sucking • Spit out or bite nipple • Turn head away • Cover mouth with hands • Cry
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Handout 4: Think Food Safety Infant formula and breast milk will spoil if left out too long. Here are some tips to keep milk safe: Breast Milk 1. Store in refrigerator at 40oF or lower for up to 48 hours from the time it was collected. 2. Freeze breast milk for up to three months. 3. Do not allow breast milk to sit out at room temperature. 4. Expressed milk should be stored in sterilized bottles or disposable plastic nursing bags. 5. Ask Mom to label each container with child’s name, date, and time collected. 6. Do not warm breast milk in the microwave. 7. If frozen, thaw by running under cool, then very warm water. Shake gently to mix. 8. Once breast milk is thawed, use within 24 hours and do NOT refreeze. 9. Discard unused portions. Commercially Prepared Infant Formula 1. Store in refrigerator at 40oF or lower for up to 48 hours. 2. Do not allow prepared formula to sit at room temperature. 3. Warm under running water. 4. Do not warm in the microwave 5. Discard unused portions.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Handout 5: Posttest 1. If an infant ate 30 minutes ago, why might he/she be crying now?
2. Give three examples of things that might distract or upset an infant at mealtime. a.
b.
c.
3. Give two advantages of breast feeding. a.
b.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Test Key: Pretest Directions: Circle T for True or F for False.
T
F
TRUE
1. The way an infant is fed impacts how he/she views the world.
T
F
TRUE
2. Many deaths in the United States are related to eating habits.
T
F
FALSE 3. Propping a baby’s bottle with a pillow is an acceptable way to feed a 5-week-old.
T
F
TRUE
4. Spitting out the nipple is one way an infant tells you he/she is full.
T
F
TRUE
5. Breast milk provides the right balance of nutrients for infants.
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship
Test Key: Posttest 1. If an infant ate 30 minutes ago, why might he/she be crying now? Wet or dirty diaper Needs to be burped Needs to change position Needs some company Teething Ear infection Diaper rash
2. Give three examples of things that might distract or upset an infant at mealtime. a. b. c. d. e.
Noise, loud music, or loud TV Too much burping Too much wiping Too much bouncing and jiggling Too many changes in position
3. Give two advantages of breast feeding. a. b. c. d. e.
Right balance of nutrients Immune factors Special bonding with Mom Recommended by doctors Less likely to cause food allergies
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From the Trainer’s Tablet: Lessons for Family/Home Child Care Providers
Infants: Understanding the Feeding Relationship Participant’s Guide
Table of Contents Purpose PowerPoint Presentation Handout 1: Icebreaker Handout 2: Pretest Handout 3: Developmental Milestones in Feeding Handout 4: Think Food Safety Handout 5: Posttest Answer Key
This lesson has been corrected to meet the new 2009 Food Code and the USDA Kitchen Companion. Regulations may vary from state to state; please check with state agency for the most current information and regulations before presenting this material.
