http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_00.1/en/index.html – see page 10 + 11

Breastmilk does not provide complete nutrition for the second six months of life. I am all for full term breastfeeding (I am still feeding my 18 month old), but I think it is fair to point out that the energy gap between what a baby needs and what breastmilk can provide gets wider from about 6 months.

There are other important nutrients which are also needed – iron stores from birth run out at around six months, so it’s important for babies to get some iron from other foods.

While I think that many doctors are ill informed and try to bully us into pushing solids before the baby is really ready, it’s important for parents to be informed of the facts, so they can make an informed decision.

Baby who resisted rice cereal (Photo by LizaWasHere)

As I replied in the comments section:

“In general I agree that it’s a good idea to start solids around 6 months of age and I certainly believe every mother should do her own research and consult a doctor for medical advice.

When a baby resists solid food and/or has a family history of allergies or shows signs of severe and numerous food allergies, some mothers choose to rely on breast milk for the baby’s sole (if not “complete”) source of nutrition. Kellymom.com says: “Some babies are exclusively breastfed for a year (and occasionally up to two years) with no problems at all. In addition, some doctors recommend that babies with a high risk for allergies be exclusively breastfed for a year.”

Kellymom also notes: “The current research indicates that a baby’s iron stores should last between six and twelve months, depending upon the baby.” Your comment implies that there is no iron in breast milk, although perhaps that is not what you intended. The good news on iron is that “up to 50% of the iron in human milk can be absorbed by the infant, as compared to 10% in cow’s milk, and 4% in iron-fortified formulas.” (LLL fact list). Some (many?) babies might need an additional source of iron (from solid food or vitamin supplements) at some point after 6 months, but not all babies will.

The points I hope to make are that parents need not worry quite as much as some seem to about getting solids into a baby, that breast milk continues to provide the bulk of nutrition, that it’s not always a good idea to push solid food when the baby resists or has allergies, and that there is anecdotal evidence (and perhaps more) that some babies thrive on breast milk alone for up to one year and even beyond.”

Your Thoughts?

Did anyone reading this delay (or stop feeding) solid foods after six months of age? What was your experience and reasoning?

Post from: Breastfeeding 1-2-3

Helping my baby feed herself some yogurt

Five More Tips for Helping Your Baby with Solid Food Feedings

11. Don’t starve the baby of breast milk in the hope of encouraging solid food intake. I hope that sentence speaks for itself, but in case not, let me explain what I mean. Don’t give in to the unhelpful suggestion or thought that you are feeding the baby too much breast milk and that is the reason the baby shows little interest in solids. People who think that are misguided on a few levels: (1) it’s nearly impossible to feed a baby too much breast milk (you cannot force a baby to nurse when the baby is not interested, and babies self-regulate at the breast whereas milk from a bottle flows freely and it is harder for a bottle-fed baby to control the amount consumed), (2) depriving the baby of milk does not encourage solids but does encourage a cranky, potentially malnourished baby, and (3) there is no rush to get the baby to eat much solid food because breast milk provides the bulk of nutrition through the first year (and in fact some babies thrive on breast milk alone — see the comments section for more discussion on that assertion).

A baby who is resisting solid foods simply might not be ready for any number of reasons. Maybe the gag reflex has not completely gone away. Perhaps your baby is teething or ill and needs some time off from or a delay in starting solids. It’s even possible that your baby knows what is best. I have heard anecdotes about babies who resisted solid food or certain foods in particular and those babies turned out to have one or more food allergies. If you suspect a food allergy, read “A” Is for Allergy Prevention and Reduction.

12. Offer a choice. As I’ve said before, I believe most food issues are about control. If you limit food choices and try to force your baby to eat a particular food, that can backfire to the point that your child severely limits the foods he or she will eat. Give your baby the control by offering a choice at any given meal. “Squash or applesauce?” “Pears or kiwi or both?” Even a six-month-old can indicate a preference for food through facial expressions, sounds, or grabbing for a particular food. The idea is not to prepare two separate meals or to waste food, but to show the baby what’s on offer and to provide the food the baby will actually eat!

Of course, the choice is not “veggies or fast food chicken nuggets.” All of the options you offer should be nutritious. This will become more and more important as the baby becomes older. At my house, a child can choose whether to eat any or all of the fruit, vegetable, grain, and/or meat offered at that particular meal. If the child chooses not to eat any of the items on offer (this has happened two or three times with my four-year-old), then she gets to wait until I finish my meal before I will prepare one other healthful option (usually something unexciting like whole grain cereal and milk). I look at my child’s nutrition over the course of a week and do not worry about any isolated meal.

13. Ease up if it is not going well. Hindsight will often reveal why a baby was refusing a particular food or solids in general. Let your baby rely on the nutrition from breast milk as you slow down the process. Your baby will sense if you become tense or anxious about food. Don’t let your anxiety become contagious! The goal is for your baby to enjoy solid food, not any particular amount of food or any one certain food. Success breeds success, and a baby who has a good experience at meal time will look forward to the next meal. A child who refuses vegetables at one meal just might eat them at the next, and in the end the child quite possibly will eat better if you do not engage in a battle of wills over a certain food. It all comes back to the issue of control.

14. Invite over a peer. If your older baby still does not show much interest in solids or does not eat many different types of food, it can be very helpful to invite over a little friend you know is a good eater! Go on a picnic or have a play date. Talk to the other parent in advance about serving a food the other child will readily eat. When your child sees the other child eating that food, your child might very well want some too!

15. Read up on the subject. If you missed parts one and two of this series, see 5 Tips for Helping Your Baby Enjoy Solid Food and More Tips for Your Baby and Solid Food. If your baby is just starting solid food, check out Starting Your Baby on Solid Foods: When, What and How. For more detailed reading, you might enjoy the following books:

Super Baby Food by Ruth Yaron
Child of Mine: Feeding with Love and Good Sense by Ellyn Satter
My Child Won’t Eat!: How to Prevent and Solve the Problem by Carlos González

What are your thoughts? Do you agree or disagree with my tips? Have you read any of the books I mentioned? Do you have any other books you recommend?

Post from: Breastfeeding 1-2-3

I thought I would update how Nicole is doing at six months of age.

Solid Foods

Nicole continues to enjoy trying new solid foods. As you can see, mashed ripe avocado is one of her favorites! Just as with breastfeeding, I believe in baby-led solid food feeding. She feeds herself with her fingers or with a spoon that I have pre-loaded for her with food. She controls how much she gets, and I make sure to take her out of the high chair before she ever gets upset. I want that feeding chair to be a happy place! It must be working because she certainly is an enthusiastic eater so far!

Measurements

At six and a half months I took her in for her six-month well baby visit with the pediatrician. I would have taken her in earlier, but we both had rotavirus and I completely forgot about the appointment! So, at 6.5 months she weighed 17 pounds, 11.5 ounces, and was 27 inches in length. That puts her in the 75th and 90th percentiles on the CDC growth charts. I have yet to translate it to the WHO charts because that requires me to convert from pounds to kilograms and inches to centimeters, and that’s just too much math at the moment, even with on-line conversion calculators. I just look at Nicole and know that she’s doing fine — that’s all I need to know!

Sleep

When Nicole was getting her two bottom teeth in she woke up more often at night, every hour or two. Now that they are in and she’s not yet working on her top teeth, she is thankfully back to sleeping in four hour stretches or more.

She’s started crawling, and that could have contributed to the extra night-waking too. She wants to practice her abilities to roll around, push up on all fours, and crawl right off the mattress (which is on the floor for that very reason).

Reflux

For the record, and for all those mothers out there wondering when the spit-up will stop, please oh please make it stop, at six months Nicole only spits up occasionally rather than after every feeding. There was significant improvement some time after she turned five months old, both in the frequency and volume of spit up. She never had a problem to the point that I was concerned, especially in light of the fact that she was certainly growing well, not projectile vomiting, and not showing any worrying signs of food allergies. Still, I am not sorry to see the spit-up lessen!

And you?

Anyone else out there just starting to introduce solid foods? How is it going?

Post from: Breastfeeding 1-2-3

Nicole turned five months old this week (remember what she looked like at two months old? I could go on and on about “where has the time gone” and “blink of an eye” etc.)! Breastfeeding continues to go extremely well. I’d tell you how often she feeds except I have no idea! I nurse her whenever and wherever she needs it, and she might go anywhere from five minutes to three hours between nursing sessions. I know for certain she gets up an average of twice per night, unless she’s sick with a cold and then it might be three to four times.

We are still exclusively breastfeeding if you don’t count the one time I let her suck on an apple core and her dad let her suck on a pineapple slice! (Not something I recommend by the way, as the American Academy of Pediatrics advises waiting six months to introduce solid foods). As you can see she can sit up now (one of the signs of readiness for solid foods) and she’s definitely showing interest (hence the few licks of apple and pineapple!) but I will wait at least another month before officially starting solids. She remains in the 80 to 85th percentile for weight and length on the WHO growth charts. No one has suggested she start solids but I always keep in mind what my friend said upon being told that her exclusively-breastfed four-month-old needed to start solids due to his weight: “Well, how do you think he got this big in the first place?”

Post from: Breastfeeding 1-2-3