August 17, 2009,
E.D. asks from Loveland, CO on August 13, 2009
Schedule for Introducing Solids
My 4 month old is growing like a weed, in the 60th to 88th percentile on everything but weight. His doctor recommended that he start solids. He did cereal great for two weeks and now the dr wants me to start incorporating vegetables and fruit into his diet in addition to getting him to take in a lot of formula/breastmilk. How do you get all this food in your child each day? I need some ideas on what type of feeding schedule other moms use.
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So What Happened?™
Thanks for the advice. To answer some of the questions that were posted, my son has been on Breast Milk and Formula since he was 3 weeks old. He nursed exclusively until then but was not getting enough so we had to supplement, only after trying many different things to increase my supply. He has had major problems with constipation since he was born and giving him a bit of juice each day does the trick. He has been showing signs of wanting to eat for over a month before we even dared starting him on cereal. He has done great with cereal, so good that we can take the juice out and he is still regular. I know others don't agree with my dr but I trust him and respect him as he is raising his kids along side mine and he wouldn't reccomend anything he wouldn't do for his own kids. Thanks again for all the comments.
C.E. answers from Provo on August 14, 2009
just choose two times close-ish to meal times for the rest of the family, one for cereal and one for veggies/fruits (start with the green veggies). if it's too stressful to do it close to meal times, don't worry. i just like to start early teaching the kids that we all eat together at the table at certain times. by 9 months all my kids wanted to participate in family meals, no matter what feeding schedule i'd been doing with them. if you or your husband have food allergies, avoid giving those to your baby for a while. ask your parents if you had any reactions to foods when you were little if you can't remember. i remember getting rashes on my face after eating apples until i was at least 3. sure enough, my son got the same rashes when i fed him applesauce.
J.P. answers from Denver on August 14, 2009
For a different viewpoint I thought I would offer the following: My midwife who is also a naturopath says that children are ready for solids when they get teeth. Of course they will be interested in food before then because they see you eating it, but their bodies are not ready to digest it until they have teeth. It is the body's way of telling you it is ready for solids. The saliva changes at that time to better digest non-liquid food. So if your little one has teeth already go for it.....however, if not I wholeheartedly disagree with your doctor. A child can get all the nutrition they need from breast milk for the first year....any solids before then are simply practice. Do not stress yourself out over feeding schedules...he's so young. If you do decide to continue with solids then one word of advice....make sure he always gets breast milk/formula BEFORE he eats solids. He will not get enough nutrition from solids at this stage in the game so you do not want him to fill up on the solids....his liquid nutrition is more important at this point.
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J.D. answers from Denver on August 14, 2009
I wanted to give you a couple of great resources that discuss starting solids and what foods to start with, etc:
According to La Leche League:
You will know that he is really ready to start solids when:
* he is about six months old
* he can sit up without any support
* he continues to be hungry despite more frequent nursing which is unrelated to illness or teething
* he has lost the tongue-thrusting reflex and does not push solids out of his mouth
* he can pick up things with his finger and thumb (pincer grasp)
Babies who are ready for solids can usually feed themselves. Mothers often report that they knew their babies were ready when they picked up food from a plate, chewed it, swallowed it, and wanted more.
I look to Dr. Sears for a lot of baby health & nutrition. Here's some starting solids resources from him:
http://www.askdrsears.com/html/3/t032000.asp (make sure to click on the link at the bottom-which foods do I begin with?)
If you have questions that several pointed out about feeding before 6 months, Sears addresses that too: http://www.askdrsears.com/faq/fit12.asp
My daughter didn't start until much later, but each child is different. I'm a fan of waiting, but you have to go with your instincts. I hope the resources help! Good luck!
J.M. answers from Denver on August 14, 2009
I agree with most, 4 months seems really early to be introducing so many foods and you may want to consider a new doctor and a different approach.
I do have a comment on weight concerns in infants as I dealt with these with my son. Babies come in all shapes and sizes short and round, long and lean, and everything in between...all can be normal. Concerns begin when more than two lines on the growth chart are crossed e.g. 50th to 25th to 10th especially when the baby does not seem satisfied or is overly fussy. Everything I have learned about growth is that every baby is different and normal has a wide range. Take a holistic approach in your evaluation of his weight "problem" and consider getting a different professional opinion.
D.D. answers from Denver on August 14, 2009
I'm not sure I agree with your doctor that you need to add fruits and vegetables yet. The others are right that they need only milk or formula until six months or so. One question, did your little one express any interest in solids before you gave rice to him? The pediatrician we had in California before coming to Colorado told us to give our boy solids when he "asked" for them. The reason that you don't feed solids too early is that there are litterally microscopic holes in the intestines of infants, through which food molecules can pass, and this is thought to set up the process for food allergies. Their gut isn't "closed" until at least six months. That said, I'd stick to the breast as much as you can, formula, and rice for now. Breast milk is amazing... it changes in composition as your little one's nutritional needs change. But, if you do want to go ahead with solids I suggest going in this order: Orange first, then green. You are just in time to start with the orange: winter squashes like acorn, butternut, etc, and sweet potatoes. A couple of teaspoons is all he needs. I suggest making your own by baking the squash or potatoes, puree in a food processor, and add breast milk (if you're pumping) or a bit of formula to make the consistency smoother and softer. Another thing you can start before greens is mashed bananas or avocados. Both of these are great, high in minerals and GOOD fat that will help put weight on your little guy. Bananas might cause some constipation, but not if you're giving only a little and still plenty of time at the breast. After a a couple of MONTHS of orange, start on the green. This is because the orange stuff is easier on his gut than the green. When you start green, steam peas, green beans, summer squashes, etc. until very soft. Puree and add milk/formula to a good consistency. I bought a bunch of little tiny Rubbermade containers and put the purees in those. They were just enough for one serving, and I could do the cooking once per week. This was really helpful because I worked at the time. If you cook the food and put it in little containers, then you can put them in the fridge for a week. Since you do it in small portions from individual cups the food is not exposed to anything until you are ready to feed your son.
My son had a rough start as he didn't nurse well due to minor deformities in his mouth. He was supplemented with formula after EVERY nursing session. He wasn't declared a "well baby" until he was about ten weeks old. Our pediatrician in California was very supportive of my desire to nurse, and even though my little guy was skinny for a LONG time, he didn't push solids. Now, my little joy is healthy as can be at two and a half. The Cali doc was a little bit older, about 50 or so, but not so old that he was in the school of thought of starting solids early. I think the advice he gave to us was wonderful, and our boy has grown big and strong and VERY healthy!
One more thing, it is a myth if you start with fruits that you'll never get your baby to eat vegetables. Our California doc explained that fruit has such a high sugar content that is is difficult for babies to digest. Like most kids, my son ate vegetables for quite a while, and then decided he doesn't like them now. I keep offering, and eventually he'll take them up again.
As for schedule.... we gave our guy solids only AFTER nursing, just twice per day to start.
L.K. answers from Fort Collins on August 14, 2009
I would recommend you perhaps look into another family doctor or pediatrician.
With my first (I was 19 when I had him) and he was in the 90th percentile for height but not weight. My then doctor had me start him on cereal and that led to nothing but tummy problems. He is fine now and was so after his first year. But he was very fussy and I truly believe it was because of starting solids too early. With my second who I just had (we have a different doctor) he is again in the 90th percentile for height but low on weight. That is just the nature of our babies. We are waiting till 6 months to start food and it has been A LOT easier. Ultimately you are the one that knows your baby the best, but I just wanted to let you know what happened with our first since it made life a little bit more difficult that first year.
S.P. answers from Provo on August 14, 2009
It is advised to wait till at least 6 months to introduce fruits or veggies. If your son is growing so well on breastmilk alone, why is your Dr. telling you to feed him anything else. Baby food is mostly for them to learn new textures. Breastmilk or formula should be the main source of nutrition for the first year. I have a little guy right now that hit 20lbs at 3.5 months and that is all from milk. Your body will and is keeping up with his nutritional needs.
D.R. answers from Denver on August 17, 2009
4 months old is a perfect time to start, esp. with the consent of your Dr. This is where you eventually want to be by around 10-12 months (sample schedule):
6:00 am: 6 oz bottle
9:30 am: 2 Tbsp cereal, 2 Tbsp fruit, 6 oz
1:00 pm: 2 Tbsp veggies, 2 Tbsp fruit, 6 oz
4:00 pm: 6 oz
6:30 pm: 2 Tbsp veggies, 2 Tbsp cereal
Add each food item one at a time (4-day rule) and take your baby's cues. Start with cereal at dinnertime for a while, then add cereal at breakfast for a while. Then add veggies at dinnertime, followed by fruit at breakfast. This could take a couple of months. Yes, he will start to eat the bottle AND the food (amazing, isn't it?). Then eventually add the lunchtime food. Your Dr. should also have some kind of recommendations as far as food goes, too, but what I have written is fairly standard (although at some point you can incorporate a little protein, some bread, and maybe some juice if you like). You want to stay around 24-28 oz of formula/day, so adjust the food intake accordingly.