Kidstuff Kidstuff By Paul L. Marz, M.D.
Welcome to the world of parenting.
You have this wonderful bundle of love and joy and there is no tech manual to cover maintenance. You have very little time to prepare as feeding begins within hours of birth. Breast milk is best, as it is fresh, warm and right at hand when needed. It also possesses other benefits including increasing the baby’s resistance to infection and includes all the nutrition that the baby will need for the first few months. We like to offer this food for the first few months of life.
However, considering our current fast-paced lifestyle, or for other reasons, formula may be the best choice for you and your baby. Most hospitals have this choice available for you when the baby is born.
Different opinions exist on this next step, but for myself, the introduction of solid food starts around four months. From the baby’s point of view, the breast milk/formula food is great, but as babies get larger, they need more calories. Breast milk and formula have about 20 calories per ounce. Solid foods can run as high as 60 to 80 calories per ounce. In this way the baby may eat less volume, but enjoy more calories per day.
I like to start off with plain rice cereal. In America, we enjoy a mostly wheat-based diet. As we introduce solids foods, we are always on the lookout for the baby’s reaction to the foods. If our baby develops an allergy to rice, it is relatively easy to structure the diet to avoid rice in the future.
I’ll also mix the cereal with white grape juice or pear juice. This type of mixture has a lower pH that makes it easier for the baby to absorb the iron from this first solid food.
So, now we are doing just great on cereal twice a day, morning and night. The baby understands the spoon concept and is doing well.
But, if this is not the case, let’s review. Introducing solids is a new experience for you, but to the baby it is an earth shattering revelation. Yes, there are other options to this hunger thing. Please do not introduce it at feeding time. When babies are hungry, they believe that familiar nipple thing is the only cure available for their pain. Attempting to introduce a spoon at this time is usually a frustrating experience for both baby and parent. I suggest that you try things out 30 to 45 minutes before the expected wail of hunger starts. At this time baby is awake and interested in playing, but not yet beyond a new experience. So now we are doing just great on cereal twice per day, morning and night.
This brings us to time to introduce other solids. I discussed the food allergy possibility, so when we try another cereal, or add a new vegetable, wait a few days with this new factor in place to see how the baby tolerates the food. After three days or so, if all is well, move that food to the regular menu and continue to experiment.
Which foods to offer first? I recommend at least 10 different vegetables before introducing fruits. Most parents love fruits because baby is so ecstatic with the flavors. As a word of caution, breezing past the list of vegetables to fruits may make the introduction of peas wait until high school. If you add a food that your baby is just not enjoying without any sign of allergy, just keep offering until this new food become familiar and the baby may soon grow to appreciate this new flavor. Remember, it can take up to 10 or 15 introductions for your baby to accept a new food.
As the menu grows, the schedule becomes more complicated. Consider this format for feeding baby:
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Now remember that this pattern is suggested and it may take weeks to convince the baby that this is easiest for the parents to follow. The minimum goal for formula is 16 ounces a day. Your physician may recommend some variation of this pattern. Remember that food allergy thought? I recommend that introducing protein as in meats should wait until after six months of age. If your baby is thirsty between feedings, water should suffice.
Some time after six months your little eater is starting to move around. Make sure you are then ready to deal with the care and feeding of toddlers.
(Special thanks to Richmond Nutrition & Associates.)
(Dr. Marz, a board certified pediatrician, is supervising physician for the Town of Barnstable school system. He practices with Bass River Pediatrics in South Yarmouth.)