Ohh I’ve been itching to blog for a long time now. Between my (first and best priority) 10 month-old son, work, and family stuff, my writing goes neglected, but not forgotten in my mind. Adventures in Matthew-land have been wonderful as the funny guy is now eating better, much more mobile (eeek..), and so jibber-jabbery. The eating thing, however, has been a journey to say the least. For those of you who don’t know me well or haven’t read my post on the whole MSG intolerance fiasco, it has been an uphill battle, mainly because of evil reflux. After trying everything under the sun, baby Prevacid has been our hero. As a dietitian who is not real fond of medication at this early stage, I’m hoping he won’t need it too much longer. I am SO thankful, however, that it works, and he is comfortable now (and eating!)
Pediatric nutrition has always been daunting to me. As a registered dietitian who has always worked with the opposite end of the spectrum with the elderly, I have often felt silly not knowing exactly what to do in this department. I have felt silly when the pediatrician asks me what I do for a living, and then I ask her about food introduction. I have felt silly ciphering through internet junk at 2 am trying to find answers to my many, many questions. I have learned so much in the past 10 months that makes me scoff at how little I knew before. But…live and learn. From what I have learned from my own experiences, from other dietitians, and through the latest scientific research is what I would love to share. What I wouldn’t have given to have some of this laid out for me on day one. Although many Moms may already know a lot of this, I hope that it may help (even a little bit) the baby, grandbaby, nephew/niece, etc in your life.
Nutrition Tips for Baby (under 1 year)
When to start solids?
The latest research suggests 6 months. Why? Usually by this time baby has doubled their birth weight and their little digestive systems are more mature to better handle food. Requirements for several nutrients, especially iron, increase at this point. Prior to 6 months, exclusive breast feeding remains the “gold standard.” Some pediatricians still recommend starting food at 4 months, however this is an old recommendation and may be a bit early. Every baby is different however, so signs that your baby is ready include being able to sit up in a high-chair, has good head control, doesn’t immediately push food out with their tongue, and seems interested in what you’re eating.
What to start?
Before it was drilled in that you must start with a single-grain cereal, then move on to vegetables and then fruit. The latest research indicates you can start with anything. A first food choice should be a low-allergy risk (no eggs, fish, nuts, wheat, soy), be one that your baby would likely enjoy, and prepared in an easy-to-eat way (like pureed). Still remember the 3-day rule before trying another new food to be able to determine any possible allergies.
New recommendations support starting allergic foods early to reduce risk of allergies later in life. This is not to say that you should plop a piece of salmon or egg in front of baby as their first food. If baby is tolerating less allergenic foods well and there is no strong family history of allergies, the American Academy of Pediatrics recommends that there is no benefit of waiting. Make sure you try new foods at home and monitor for reactions, which usually appear immediately or within hours. Do the 3-day rule. If there is a family history of allergies or if you have any doubt, consult your pediatrician before trying anything.
There’s a lot of concern with high levels of inorganic arsenic found in infant rice cereal. Rice very readily absorbs any arsenic in the soil. While there is natural organic arsenic in soil, it is the inorganic arsenic present in pesticides that is being linked to long-term health problems including cancer. Some doctors are recommending limiting your child’s intake of rice for this reason. Gerber issued a statement that their rice only comes from California, which has the lowest arsenic levels in the U.S. All that being said, I personally chose oatmeal for my son’s first cereal and skipped rice cereal all together.
Organic or not?
Although buying 100% organic would be nice, it is not always available or cost-efficient. I pay attention to the “dirty dozen” and the “clean 15.” For the complete lists look here: http://www.pbs.org/wnet/need-to-know/health/the-dirty-dozen-and-clean-15-of-produce/616/ The “dirty dozen” fruits and vegetables, such as peaches, strawberries, and apples are ones you should definitely try to get organic as they test positive for the most chemicals when conventionally grown. The “clean 15” are considered safe to buy non-organic as they contain little to no traces of pesticides.
What foods are off-limits?
The latest research still supports NO honey until after baby’s first birthday because of botulism risk. No cow’s milk until baby’s first birthday because of the low iron content which often can cause anemia at this stage. Milk products like yogurt, cheese, are OK before one though. No choking hazards such as raw vegetables, sausages, whole nuts/seeds, popcorn, whole grapes, nut butters, chunks of cheese or meat.
When starting foods, when and how often do I give breast milk/formula?
This was a big one for me. Right around the time we started solid foods is when Matthew’s reflux kicked in full force and getting both breast milk and food in together was a horrible struggle. Around 6 months baby should still be getting 28-32 oz of breastmilk/formula per day. The best thing I found was to space it out the best I could. Nurse first, then wait an hour, then food. Yes, I was spending almost every other hour nursing or feeding, but his was the only way it would work for us.
Traditional puree feeding vs. Baby led weaning:
Today many parents are trying a new approach, baby-led weaning, in which baby eats appropriate finger foods from the dinner table and skip traditional purees all together. This is in hopes to make the child a more relaxed and less picky eater. A concern with baby led weaning is they may not get enough food in themselves at first as they are learning to pick up things with their fingers. Another concern is choking risk and the extra precautions you must take. Pediatricians still recommend beginning with traditional purees. What worked for my baby was to start with purees and then continuously upgrade the texture overtime. Every baby is different, and neither approach should be considered right or wrong itself, but you must be sure whether it is right or wrong for YOUR baby. Exposing your baby to variety of foods and of different textures as they grow is key.
Can my baby have water?
Baby does not need additional water while exclusively breastfeeding and in fact, can be dangerous as it can cause electrolyte imbalances. When baby starts food, breastmilk or formula should continue to be their primary beverage, but they can have small amounts of water in cups with meals.
Juice is not recommended before 6 months of age. It is not recommended by the Australian government and Health Canada before 1 year of age. Aside from lacking nutrition, it can cause tooth decay and stomach upset. If you do give juice before 1, dilute with water and only offer in a cup. After age of 1, do not give more than 6 oz/day.
So these are some tips based off the latest research per the World Health Organization, American Academy of Pediatrics, National Institute of Health to name a few. For anyone interested in continuing education hours, I got much of this information from a great presentation from DietitianCentral.com, Update on Infant Nutrition: New Practices for Starting Solids by Natalie Weiss, RD, LDN. Please feel free to contact me with any other questions you may have and I will see if I can help you, or if not, we will learn together!
Bonus! Got a teething baby? For moms that are as displeased as I am about how much junk are in store-bought teething biscuits, here is a great homemade recipe I found from Pinterest. It calls for rice cereal but I think I’m going to try oatmeal next time I make them. http://sweettreatsmore.com/homemade-teething-biscuits-3/ It was a major hit in this house. Nom, Nom, Nom. Until next time!