Pureed Foods For Spoons (Stage 1 or First Foods)

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The development of self-feeding skills is an important aspect of your child's maturing relationship between self and the surrounding environment. An early exposure to a wide variety of fruits and vegetables helps to familiarize your child with some of the mainstays of the PKU diet. As finger coordination improves your child will gradually progress from easily gripped fist foods to finger foods. To encourage finger coordination, offer smaller pieces of fruits and vegetables as well as dry cereals. As more teeth come in, foods that can be gnawed or chewed, as well as crisper foods for munching, may be offered. Cutting foods into different shapes and sizes helps to further develop eye, finger and tongue awareness of foods. To prevent choking it is important that your child be able to sit upright and have good head control before solid foods are offered. Be sure to watch your child when solid foods are eaten. Food is an adventure for your child and offers important and exciting developmental lessons. For additional reading on developmental stages around food and food related behaviors: Child of Mine: Feeding with Love and Good Sense By Ellyn Satter RD, MS, MSSW, Bull Publishing Co., Boulder, CO, 2000.

Exploration through touching, feeling, and tasting is the beginning of a whole new exciting world for your child. When your child is able to sit up alone and when your child starts to put everything into his or her mouth, offer soft foods from a spoon. Choose foods very low in phe. Foods from a spoon offer "experience" rather than "nourishment." Pureed Foods For Spoons (Stage 1 or First Foods) Consult the Low Protein Food List as there are small differences in the phe content between brands Applesauce Bananas Peaches Pears Pears Carrots Squash Low protein porridge (provided by PKU Clinic) Remember to introduce one new finely pureed fruit or vegetable at a time. Wait about a week to watch for allergic reactions before introducing another. STRAINED VITAMIN C ADDED

When your child is skilled at sucking from a spoon and is beginning discrete lip and tongue movements, offer soft and mealy foods cut into fist sized slices and chunks. Peeled Fruits and Vegetables Weight (gm) mg phe Applesauce 10 1 Banana chunks 10 4 Cantaloupe chunks 10 3 Fresh Strawberries 10 2 fresh or canned Peaches 10 2 Pears 10 2 Plums 10 2 fresh or canned Carrot coins or sticks 10 7 Asparagus spears 10 8 Summer squash, seeded 10 4 Winter squash, cubed 10 4

After your child is able to munch on foods instead of sucking them and can pick them up between thumb and forefinger, introduce delicious crunchies. Cut them into interesting circles, cubes, or other shapes. Fruits Amount Weight (gm) mg phe fresh, canned or frozen Blueberries 1/ 4 c. 36 9 Cranberries 1/ 4 c. 24 9 Figs, medium 1/ 4 fig 13 3 Grapefruit segments fresh, with skin 1/ 4 c. 43 10 Guava, medium 1/ 3 guava 30 2 Kiwi, medium, peeled 1/ 2 kiwi 38 17 Mango, sliced 1/ 4 c. 48 9 Orange segments 1/ 2 orange 90 19 Payapa, cubed 1/ 4 c. 35 4 Blueberries 1/ 4 c. 36 9 Pineapple chunks fresh 1/ 4 c. 38 7 canned 1/ 4 c. 45 7 Raisins, seedless, dark 1 Tbls. 9 13 Raspberries fresh 1/ 4 c. 62 22 frozen 2 Tbls. 63 10 Tangerine segments 1/ 2 tangerine 42 8

Vegetable Amount Weight (gm) mg phe Fresh, frozen or canned, cooked Beans, green or wax 1/ 4 c. 34 24 Beets, sliced 1/ 4 c. 43 20 Broccoli strips 1/ 8 c. 11 13 Cauliflower 1/ 8 c. 14 Cabbage shreds (green) 1/ 4 c. 29 9 Cucumber slices, peeled 1/ 4 c. 36 11 Lettuce 1/ 8 c. 7 4 Mushrooms 1/ 4 c. 18 15 Bell peppers, 1/ 4 thick slices 2 38 16 Pickles, dill slices or sticks 3 32 5 Tomatoes, raw 1/ 4 c. 40 11 Turnip sticks or cubes 1/ 4 c. 33 6 Remember that many different kinds of fruits and vegetables help your child learn color awareness and familiarity with low phe foods.

Also offer foods with interesting shapes and texture. Low protein products Cereals Amount Weight (gm) mg phe AND... Amount Loprofin Cereal Loops 2 Tbls. <1 Loprofin Fusilli (dry) 2 Tbls. 1 Loprofin crackers 1 <1 Dietary Specialties graham 1 1 cookies Puffed Rice 2 Tbls. 2 8 Rice Chex 2 Tbls. 4 11 Trix 2 Tbls. 2 9 Kix 2 Tbls. 2 9 Rice Krispies 2 Tbls. 3 11 Corn Chex 2 Tbls. 4 13 Amount Pepperidge Farm Goldfish (original) 10 goldfish 20 Mini-marshmallows 1 Tbls. 2 *Low Protein Applesauce Muffins p.124 1 1 *Low Protein Cinnamon Graham Crackers p.96 1 1 *Low Protein Pretzels or Breadsticks p.92 1 1 * Recipes from Schuett, V. Low Protein Cookery for PKU 3rd ed. 1997 mg phe mg phe

Developed by Cristine M. Trahms MS, RD, Carla Cox MS, RD, Pamela Luce MS, RD and Deborah Padgett ARNP, MN Illustrations by Teresa Strom pdf files by Greg Owen PKU Clinic Center on Human Development and Disability Box 357920 University of Washington, Seattle WA 98195-7920 Supported in part by MCH Grant No. MCJ-539159 and the Washington State Office of Newborn Screening University of Washington, 1997 revised, 2003, 2013 http://depts.washington.edu/pku