Showing posts with label weaning. Show all posts
Showing posts with label weaning. Show all posts

Thursday, September 15, 2011

10 Tips for Starting Your Baby on Solid Food


10 Tips for Starting Your Baby on Solid Food

Starting solid foods is one of the major landmarks of a baby’s first year.  You play a very active role in your child’s experience with food, and your goal is to make that experience healthy, fun, and safe. 

Here are 10 tips to get you off to a good start.

1.     Start feeding your baby solids between 4 and 6 months of age.  There is currently a big debate in the pediatric community about exactly when babies should start solids, and it is particularly heated when it comes to breastfed babies.  The World Health Organization recommends that babies be breastfed exclusively for the first 6 months.  The AmericanAcademy of Pediatrics Committee on Nutrition uses more confusing language, stating that babies should be breastfeed exclusively for 4 months but preferably 6 months.  If you want to get a taste of the arguments for 4 months vs. 6 months, check out the paper published in British Medical Journal earlier this year by Fewtrell et al. (Six months of exclusive breastfeeding:  how good is the evidence?) [1], and scroll to the bottom of the page to see the 23 published responses to the article.  I love scientific debates, but this one quickly overwhelmed even me. 

After doing lots of reading and going through the process with my own baby, I concluded that the data aren’t really that strong one way or another.  Start solids at 4 months, and your baby is slightly more likely to get a GI infection, but wait until 6 months, and he’s slightly more likely to become anemic.  If you are worried about this decision, talk to your pediatrician, but also ask your baby what he thinks.  If your 4-month-old is trying to grab food off your plate and still seems hungry after breastfeeding, he’s probably ready to give solids a try.  After much deliberation, we started trying solids with BabyC at 5 months, but she really wasn’t interested in more than a few tastes until around 6.5 months. 

2.     You can skip the white rice cereal.  Yes, it is fortified with iron, and that is a good thing, and yes, it is easy to digest.  On the other hand, white rice cereal is basically pure starch (refined rice flour) and not that tasty or nutritious, except for the added iron.  Try whole grain baby cereals like oatmeal, barley, or brown rice cereal, which are also fortified with iron.  Just start with single-grain cereals so that you know the culprit if your baby has an allergic reaction (see #5) and avoid wheat (includes spelt) for the first month or so.  There is also no reason that cereal has to be your baby’s first food.  Whoa, you say, now you’re really blowing my mind.  I know, keep reading…

3.     Focus on meats, legumes, veggies, and fortified cereals.  Meat is a great complement to breastfeeding in older infants, because it is a good source of iron and zinc, both of which are low in breast milk [2].  However, there is a common misconception among parents that meat should not be used as an early food for infants.  In a 2008 survey of the dietary habits of infants and toddlers, only 8% of 6-9-month-old infants ate meat or poultry at least once per day (more ate those baby food “dinners” which contain some meat but also a lot of crap) [3].  There is no reason to wait on meat – you can make it one of your baby’s first foods.  Legumes are also packed with protein and fairly high in iron - try lentils, hummus, or mashed beans.  Vegetables are a great choice and are usually well received by your budding foodie.  Offer some fruits, but know that they don’t give you as much nutritional bang for your buck, being higher in sugar and water.  Including two servings of fortified cereal in your baby’s diet will help ensure that he is getting enough iron, but check out my recent post (Practical Ways to Increase Iron in Your Baby’s Diet) for other tips.  Dairy products such as cheese and yogurt are also fair game but should be fed in limited amounts.

4.     Wait until your baby’s first birthday to try high allergy foods.  If you have food allergies in your family, talk with your pediatrician, who will probably recommend waiting even longer.  High allergy foods include peanuts, egg whites, shellfish, fish, and tree nutsAlso avoid honey until your baby is one year old because of the risk of botulism.

5.     Wait 2-3 days between introducing new foods.  This gives you time to watch for symptoms of a food allergy, and if those symptoms should appear, you will know that they are likely due to the new food.  Common food allergies include wheat, cow’s milk, soy, citrus, and berries.  You can introduce these foods, but watch for symptoms of allergies, which include diarrhea, rash, and vomiting. 

6.     Experiment with different textures.  Your baby may prefer a thinner or thicker puree.  Or he may prefer to skip the purees altogether.  We tried giving BabyC purees for at least a month with very little success, but then we discovered that she loved finger foods and moved straight to those.  Soft fruits, avocado, cooked vegetables, and pasta were a big hit.  There is a movement called Baby Led Weaning that advocates for skipping purees all together.  We basically ended up following their method, though not by design.  I do think it is best for babies to take charge of their meals as soon as possible, so that they decide how fast and how much food to eat. 



7.     Do you know what to do if your baby starts choking?  Make sure you do.  Learn the baby Heimlich maneuver.  The Heimlich is easy enough, if you haven’t already, this is a good time to take an infant/child CPR class, which will include handling a choking emergency.  At this age, any number of things in your house and the world, including food, can be choking hazards, and you should be ready.  Obviously, avoid giving your baby foods that are small and firm such as raisins, popcorn, and nuts.

8.     Start slow.  Start with one solid meal per day, which may be just a tablespoon or two at first.  As your baby starts to show more interest in food, gradually increase the amount offered and the number of meals up to three solid meals per day around nine months of age.  Think of this time as a gradual transition towards more solid foods, but let your baby set the pace.  At first, your baby will not be eating enough solids to affect breast or bottle feeding, but you will gradually decrease the number of milk feedings as your baby gets more and more calories from solids. 

9.     Know that every baby is different.  Some babies will eat like a pro on day one.  Ours did not.  If your baby is slow to start solids, don’t worry and don’t rush him.  Just trust that he’ll get it eventually.  Meal timing may be important to your success.  If your baby is too hungry or too full, he may not be interested in solids.  Many parents find that nursing on one side, then trying some solid food, then returning to nurse on the other side, works well.

10.  Set your baby up for a lifetime of healthy eating by modeling healthy eating habits.  Your baby will reach an age when he wants to eat what is on your plate, so if there are french fries on your plate, that’s what your baby will want.  Babies are remarkably adept at recognizing hypocrisy when they see it.   Make an effort to sit down to eat as a family, with your baby included.  Make mealtime a social, pleasant time.  It should never be rushed or forced.  For more ideas, check out my recent post - Enjoying and Exploring Food with Baby.

I hope these tips help as you embark on your baby food adventure!  But like I said, every baby is different.  If you are just beginning this process, what other questions do you have?  Experienced mamas and papas – what did I leave out?


REFERENCES

1.  Fewtrell, M., D.C. Wilson, I. Booth, and A. Lucas. Six months of exclusive breast feeding: how good is the evidence? BMJ. 342: p. c5955. 2011.
2.  Krebs, N.F. and K.M. Hambidge. Complementary feeding: clinically relevant factors affecting timing and composition. Am J Clin Nutr. 85(2): p. 639S-645S. 2007.
3.  Siega-Riz, A.M., D.M. Deming, K.C. Reidy, M.K. Fox, E. Condon, and R.R. Briefel. Food consumption patterns of infants and toddlers: where are we now? J Am Diet Assoc. 110(12 Suppl): p. S38-51. 2010.