Hello my dears. I loved getting your feedback after last week's post. The gist of your comments can be summed up as follows: starting solids can be complicated. And there are lots of right answers, depending on the kid, the family, the pediatrician. I'll cover a couple of discrepancies brought up in your comments, and several more things that I left out of last week's post.
- The first thing I need to clear up is about when to start solids. I did not realize how confusing the answer to this question was until I started hearing your feedback and looking into it a bit more myself. Look, for example, at the AAP's advice page about starting solids. In one paragraph, it says to start solids between four and six months. Then a few paragraphs later, it says they recommend exclusive breastfeeding until about six months. Clear as mud? Thought so.
We know that breastfeeding has many proven benefits. And we know that exclusive breastfeeding for a prolonged duration can maximize those benefits. And we know that healthy babies definitely don't require any complementary foods before four months if they are breastfeeding well. So then we enter the gray area: just how long should babies be exclusively breastfed to receive the maximum benefit? Basically, even the big dogs don't know. They think that four months is a good place to start. And they think that six months could be even better. Since the studies don't give a conclusive answer, the big dogs maintain their recommendation because there is a "lack of clear evidence to either support or refute a change from current recommendations for exclusive breastfeeding for six months." They also maintain that "Study results to date suggest that there is no significant harm associated with introduction of complementary foods at four months of age..."
So there you have it. If your baby is thriving on your breastmilk (or formula) and has no need for solids from a developmental or growth standpoint, it's fine to wait until six months to introduce solids. It's also fine to start earlier if your pediatrician recommends it.
Whew. Sorry this was so confusing. I hope that clears some things up...
- Here is an interesting article about a link between obesity and starting solids before four months.
- I had one question about the "White Out" campaign being popularized by Dr. Alan Greene. The idea is to stop giving white rice cereal to infants for the same reason we grown ups try to avoid white grains: they are often stripped of their nutrients during processing and end up being purely carbohydrate. He theorizes a link between the prevalence of white rice in infant's diets and the prevalence of childhood obesity.
I had never heard of Dr. Greene or his theory before lovely Beth Ann brought it to my attention. There is probably some truth to this idea, but I have never seen a study to prove it, nor has it been endorsed by the big dogs. I don't think there would be a problem simply using white rice cereal to get your baby used to textures, and then switching to other grains after that. Oatmeal is a good option. You can try brown rice cereal or other whole grain cereals too. Jonathan hated cereal so we didn't even have to address the issue--ha! Thanks Beth Ann for the tip! :)
- Should I offer my baby liquids besides milk? You can. Once she is six months, it's safe to offer her water. The big dogs don't recommend more that 4-6 oz of juice in a day for kids under age five. And I recommend watering down the juice with at least 50% water. It's also a good idea to do juice or water only from a cup or sippy cup, which can make bottle weaning easier later. Personally, I like offering J some sips of water or very diluted juice throughout a meal. Sometimes when he seems sick of eating, a few sips will make him in the mood to take a few more bites of food. But if you are not regularly offering your baby other liquids, that's ok. Your baby doesn't really need water or juice if she is getting enough hydration through milk throughout the day. It's especially important to make sure water or juice don't take the place of that milk, since sometimes babies start preferring those.
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- The first thing I need to clear up is about when to start solids. I did not realize how confusing the answer to this question was until I started hearing your feedback and looking into it a bit more myself. Look, for example, at the AAP's advice page about starting solids. In one paragraph, it says to start solids between four and six months. Then a few paragraphs later, it says they recommend exclusive breastfeeding until about six months. Clear as mud? Thought so.
We know that breastfeeding has many proven benefits. And we know that exclusive breastfeeding for a prolonged duration can maximize those benefits. And we know that healthy babies definitely don't require any complementary foods before four months if they are breastfeeding well. So then we enter the gray area: just how long should babies be exclusively breastfed to receive the maximum benefit? Basically, even the big dogs don't know. They think that four months is a good place to start. And they think that six months could be even better. Since the studies don't give a conclusive answer, the big dogs maintain their recommendation because there is a "lack of clear evidence to either support or refute a change from current recommendations for exclusive breastfeeding for six months." They also maintain that "Study results to date suggest that there is no significant harm associated with introduction of complementary foods at four months of age..."
So there you have it. If your baby is thriving on your breastmilk (or formula) and has no need for solids from a developmental or growth standpoint, it's fine to wait until six months to introduce solids. It's also fine to start earlier if your pediatrician recommends it.
Whew. Sorry this was so confusing. I hope that clears some things up...
- Here is an interesting article about a link between obesity and starting solids before four months.
- I had one question about the "White Out" campaign being popularized by Dr. Alan Greene. The idea is to stop giving white rice cereal to infants for the same reason we grown ups try to avoid white grains: they are often stripped of their nutrients during processing and end up being purely carbohydrate. He theorizes a link between the prevalence of white rice in infant's diets and the prevalence of childhood obesity.
I had never heard of Dr. Greene or his theory before lovely Beth Ann brought it to my attention. There is probably some truth to this idea, but I have never seen a study to prove it, nor has it been endorsed by the big dogs. I don't think there would be a problem simply using white rice cereal to get your baby used to textures, and then switching to other grains after that. Oatmeal is a good option. You can try brown rice cereal or other whole grain cereals too. Jonathan hated cereal so we didn't even have to address the issue--ha! Thanks Beth Ann for the tip! :)
- Should I offer my baby liquids besides milk? You can. Once she is six months, it's safe to offer her water. The big dogs don't recommend more that 4-6 oz of juice in a day for kids under age five. And I recommend watering down the juice with at least 50% water. It's also a good idea to do juice or water only from a cup or sippy cup, which can make bottle weaning easier later. Personally, I like offering J some sips of water or very diluted juice throughout a meal. Sometimes when he seems sick of eating, a few sips will make him in the mood to take a few more bites of food. But if you are not regularly offering your baby other liquids, that's ok. Your baby doesn't really need water or juice if she is getting enough hydration through milk throughout the day. It's especially important to make sure water or juice don't take the place of that milk, since sometimes babies start preferring those.
- What are the nutritional requirements for iron and zinc for my baby? The big dogs emphasize iron and zinc as two elements to be watchful of in the early feeding months. I don't want to give you specific numbers for iron and zinc (unless you really want to know--then you can ask me) because you will drive yourself crazy trying to do food math to figure out if your kid is getting enough. Don't go crazy. Just make sure your baby is getting good sources of these elements a couple times a day: meats, iron-fortified cereal, whole grains, cheese, legumes.
- How many calories should my baby consume in a day? We don't talk a lot about calorie requirements for babies, but I thought you might be interested in some numbers:
I read a couple other questions about food allergies, which I would like to cover later since it is such a big topic... Thanks so much for all your feedback. See ya next week!
- How many calories should my baby consume in a day? We don't talk a lot about calorie requirements for babies, but I thought you might be interested in some numbers:
- 0-2 months: 520 Cal/day
- 3-5 months: 662 Cal/day
- 6-8 months: 784 Cal/day
- 9-11 months: 950 Cal/day
- 12-23 months: 1170 Cal/day
Please note that these are estimated and average values. I surely do not recommend counting calories for your infant, but if you are wondering in general if your baby is getting enough, it might benefit you to run through their list of foods for the day and see if they are roughly measuring up (formula is 20 Cal/oz. Breastmilk is estimated to be the same, but of course there can be variations). I personally have never added up J's daily intake. I just have to take one look at those chunky thighs--that's all I need to know.
- Why do I have to wait until twelve months to start giving my baby cow's milk? There are two main reasons. The first is that there is a high incidence of cow's milk allergy or intolerance. But, your kid will likely be ingesting cow's milk in other forms before he's a year old (formula, cheese, yogurt, etc), so that's not reason enough. The second reason is that cow's milk does not contain an appropriate concentration of nutrients that a baby younger than one year requires, so we don't want that to become the baby's main source of milk. It will not kill your kid if he takes some sips of cow's milk when he is eleven months old. We just don't want cow's milk to become a substitute for the all important breastmilk or formula until he is fully ready, which we generally think is around a year old.
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I read a couple other questions about food allergies, which I would like to cover later since it is such a big topic... Thanks so much for all your feedback. See ya next week!
Lea, you are so good. Really good job :)
ReplyDeleteGreat post again! :)
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