Starting Solids
I think Dr. Gilgoff is a mind-reader. I was going to start Willow on solids this weekend and I chickened out. Nursing is just sooooooo easy. No mess, no cooking, bottles to recycle, endless laundry…. He gave me inspiration to buck up and do it this week.
Introducing Solids To Your Newborn
by Dr. Gilgoff
This is an exciting time for you and your baby! She is now close to 4 months old, and with a curious look and half a smile she is eyeing your food as you eat! At the same time, her muscles of mastication are maturing– she is acquiring the ability to coordinate her swallowing. But how and when should we start to give solids?
With a definite rise in food allergies, we thought a delay until 6 months might be a good idea. Especially for the breastfeeding mom, the answer seemed obvious – why give anything else, when breast is indeed best. While delaying solids remains a very good option, there have been excellent studies by the top allergists in 2008 that showed that introduction of solids between 4 and 6 months old does not increase the risk of food allergy.
So whenever you begin – whether it be 4, 5 or 6 months old – the same questions remain: what, when, and how! The babies first food should be the easiest to digest – and this is baby cereal mixed with her milk (breast milk ideally, or formula). You should mix two tablespoons of cereal (usually rice is first, but oat or barley are also great) with two ounces of milk and go for it! She’ll likely need a few different tries before she can coordinate her tongue, so don’t get frustrated if she looks like she can’t do it, or doesn’t like it!
You can give the cereal any time you want, but it is nice to slowly develop some sort of a schedule. After two weeks of cereal, I would offer a vegetable. You can boil and then puree or mash up the vegetable yourself, or you can just buy it from a jar. Organic is always a nice but expensive option, and while I think there are some benefits of organic meats, for fruits and vegetables, it’s up to you (and your wallet!). You can indeed add some milk to the vegetable if it seems too thick, but never add any sugar.
Start with squash or sweet potato. Then go to carrots (and don’t stress if her skin almost looks a little orange after a lot of carrots!), and eventually the peas and beans. The fruits are generally sweeter and rarely refused, so establish the vegetables first for about 4 weeks before getting to them. The first fruits would be apple sauce, bananas and pears.
Give each new food three days without adding any new food, so you can observe for any allergic reaction. This could be hives (swollen red blotches) or diarrhea. As you add new foods, you can keep giving the already established foods at other times in the day.
As for the best times, I really think that it depends on your schedule. As boring American adults, we tend to have three big meals a day, with a few snacks in between. Often, your baby will develop a similar schedule, and eat either before or during your attempts to quickly wolf down your own meal. The first few months of solids are only a gradual introduction – a fun mellow beginning – so treat it as such. Don’t worry if the cereal fully “replaces” a normal feeding (whether breast milk or formula). The amount of calories in a full milk feed far outweighs what you’ll get from a little jar of carrots, but you’ll likely notice a decrease in the amount of milk your baby needs as they increase their solids. In order to have the best chance of success with your baby’s first foods, make sure you let them develop a little appetite. Waiting 3-4 hours since the last feed (whether bottle or breast) will make it more likely that your little one will be open minded to a new food and a different sensation. But don’t wait another 4 hours to give some milk – they’ll likely need some more calories within an hour or two in the beginning.
Many people give cereal in the morning, then a vegetable around lunch time and then a fruit for dinner. But before you know it, your baby will be 7, 8 and 9 months old. At these ages, it becomes appropriate to have yogurt (plain, or “baby”), grains of rice, beans, avocado, tiny pieces of pasta (pastina) and bread, and soups. The stage 2 and 3 jarred foods have pureed meats in them, but I would wait until 9 months to have real cooked chicken or meats or fish.
Depending on your family history of allergies, you may choose to delay seafood, eggs and berries. Most family’s wait until one or even two years old for peanut butter, but the truth is that delayed introduction of foods does not necessarily decrease your odds of having an allergy. Likely, a child is going to be allergic or not, and while a strong reaction in a younger child may indeed look scarier, I think it’s ok to try eggs and nine months and peanut butter at one years old. If you want to be on the safe side, give these allergenic foods in the morning (so you can bring them in to the doctor if need be) and have a little children’s benadryl close by. If you are dealing with a strong reaction, such as hives all over and any breathing problem –this could be a sign of anaphylaxis, and you must go immediately to the ER.
Make sure you make food fun for your child and never force them to eat. Kids develop so many bad habits around food, and it starts at a young age. Unless your doctor is worried about the baby being underweight, or “failure to thrive”, you should remember that these little ones are people – and people will show signs when they are hungry. Each baby is different, and some are indeed picky and finicky. But if we can remain positive and cheery, and never forceful or stressed, the introduction of solids (and eating on the whole) will be a fun, albeit messy endeavor!
***Dr. Gilgoff will be speaking about a host of pediatric issues at Families First – a wonderful community resource on Baltic, b/w Court and Clinton, on February 14th, at 10am. Please contact them for more information.
Families First, Inc.
www.familiesfirstbrooklyn.org
250 Baltic Street
Brooklyn, NY 11201
(718) 237-1862
Dr. Gilgoff has his own page of Expert Advice on this blog, check it out here for all his articles.
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