b2b777
LIF Adult
Member since 9/09 4474 total posts
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Re: Starting cereal.. Advice/question
My doc's recommendations are actually online! I found this and thought it might be helpful:
Starting Solid Foods
This is intended as a guideline to help you start solid foods for your infant. This is an exciting and fun time. Make sure to have your cameras ready!!!
When? We recommend starting solid foods at about 5-6 months of age. Some babies may need to start sooner-we will guide you in those specific and rare cases. Children should be fed in a high chair or in an inclined infant seat.
The Rules:
? Introduce one new food at a time, adding a new food every 4 days, or about 2 new foods per week.
? Always give solid foods first at the meal, and then finish up with the breast milk/formula. What will happen over time is the babies will adjust their own calorie intake by taking less liquid as they take in more solid foods. This may take several weeks/months.
? Always start the new food in the first half of the day-either for breakfast or lunch-that way if there is an allergic reaction, you will see it.
? Always let the baby stop you-you feed the baby as much as they want. They will usually turn away from the spoon or refuse to open their mouths when they are finished.
5 Months: We start with cereals. These are baby cereals that you can buy at the baby sections of most supermarkets, or at baby stores like Babies R Us and Buy Buy Baby. There is not a particular brand of cereal that we recommend. We recommend starting with oatmeal (plain cereal-not mixed with fruit). We don’t recommend giving rice cereal due to the concerns with arsenic contamination and rice products. You start off with one meal/day, and if the baby takes it well, you can go up to 2 meals/day. This time is really meant to “teach” the baby to eat off of a spoon-some babies take to it very easily from the start, and some need some time to get used to it. NEVER PUT CEREAL IN THE BOTTLES-IT IS ONLY MEANT TO BE FED WITH A SPOON. Start off with a small amount of cereal in a bowl and add either breast milk or pre-mixed formula until it becomes a consistency easy to feed with a spoon. Start off with a looser consistency at first, and then make it thicker as time goes on and the baby gets more used to it. There is no need to measure anything.
6 months: Start fruits and vegetables and go up to 3 meals/day. You should continue to give cereal at least 1-2 times/day due to the fact that it has iron fortification. The key to good nutrition is variety-so mix up the meals day to day and meal to meal. For example, you may give cereal and a fruit for breakfast, a vegetable and fruit for lunch, and cereal and a vegetable for dinner. Be creative and have fun. There are no set rules other than the 4 listed above. You can start the fruits/vegetables in any order that you want to. You can start jars of brand name baby foods or you can make your own. Making your own is much simpler and much more economical than you think. All you need is a pot, a steamer, and a blender or food processor.
Use a serving spoon to place a small amount of the food in your baby’s bowl, and use a baby spoon to feed your baby. You can refrigerate any food remaining in the jar for up to 2 days. You can freeze appropriate serving sizes of your homemade foods in ice cube trays and then just defrost them as needed.
The stools may change a lot once solids are started. The stools may become hard, and the child may strain more to poop. If this happens, start pureed prunes or prune juice. If you use prune juice, mix it with equal parts of water. Then give 1-2 ounces 1-2 times/day as needed. If the prunes are not working, you are not giving enough.
7 months-12 months:
Start table foods. You can offer yogurt and cheese (all dairy should be whole fat until 2 years of age). You can now offer meats, beans, pasta, bread, pretty much whatever you are eating short of a few exceptions (see below). This is also the time you can offer “puffs” and cheerios. Everything you offer should be soft and about the size of a pea (that is smaller than the size of the airway so the child may gag but shouldn’t choke). Just like everything else, this requires practice. Gradually you should transition from baby foods to table foods as the basis of the meals. We recommend home cooked meals rather than jarred/prepackaged food, and we suggest moving from baby food right to table foods instead of using stage 3 foods. Whole milk is started at 12 months of age, in a cup. Also, as the baby starts taking more and more food over these months, you will see that the amount of breast milk/formula that they take will also start to decrease. The big picture goal is that at a year of age babies should be having about 12-14 ounces of whole milk/day, and they should be having 3 meals with 2 snacks. Stay away from nuts, popcorn, raisins and small, hard foods as they may cause a choking risk.
Food Allergies: If a child is allergic to a food, they usually develop large, red, itchy welts called hives, and they may vomit. You should always have Benadryl around just in case (The dosing is on the “Medication Dosing” handout). Due to risk of allergies you should:
? Make sure you follow the one new food every 4 day rule while trying peanuts, other types of nuts, fish, shellfish and eggs. All of these foods can be tried after 9 months of age. If there is a family history of nut allergy, then the child should be tested by an allergist before giving them any nuts.
? No honey until one year of age.
Several parents get very nervous advancing to table foods and finger foods in this age group. You shouldn’t be. Enjoy this time. Even if the child doesn’t have teeth yet, they can start eating finger foods. Believe me, they will gum the food and do just fine! Literally give the child the food off of your plate. Don’t make them separate meals. They want flavorful foods, and you should season their food the same way you do your own. (yes, even spicy foods). The children who only eat macaroni and cheese and hotdogs were only offered those foods. You also want to encourage fattening foods. In this age, children become much more mobile and they are constantly burning a lot of calories. Make sure to add extra fats to their foods-like olive oil into their pasta, meats, vegetables, etc. 1 tsp of olive oil is 120 calories, so it is a healthy way to introduce a good amount of polyunsaturated fats and calories.
The child should also be encouraged to feed themselves. Place the finger foods onto their tray, and let them place it into their own mouths. Yes, kids will make a mess and throw food onto the floor, but that is part of the learning process. No one said having kids wouldn’t be a messy job!
Cups: At 6 months of age start introducing a straw cup to the baby with water in it. It may take several weeks for the baby to get the hang of drinking out of the straw cup, but it will happen if you keep offering it consistently. A good cup to start with is: PLAYTEX® THE FIRST LIL' GRIPPER™ STRAW TRAINER CUP. It is a great starting cup because it has a wide straw which is not too long and the body of the cup is soft so you can squeeze it gently and teach the child to drink out of it (almost like a box drink). We do not recommend traditional sippy cups since they are really modified bottles. With a sippy cup, you still have to tip the cup up to suck the fluid out. Long term sippy cup use has shown to cause increased risk of cavities and speech impediments since it can change the shape of the mouth/teeth. Straw cups are the best negotiation since they are the closest you can get to an adult like drinking cup, that doesn’t allow the baby to spill everything around the house. Also, they are very versatile. If you forget the cup at home, you can put a straw in any cup and the baby is able to drink from it. When you go to buy these cups, ignore whatever the age requirement is on them-most say 18 months -3 years old. That is silly since most babies are able to start drinking from a straw cup at about 6 months of age. Your goal is to get them proficient at drinking out of the straw cup by 12 months of age. That is the time you should transition away from bottles all together and start putting whole milk in a cup. The longer you keep the bottles past a year, the harder they are going to be to get rid of, and the more money you are likely to give pediatric dentists!!! Babies should never sleep with the bottle in their mouth.
Water:
Babies do not need any water until 6 months of age. At 6 months, you should introduce water in a straw cup. The water can be whatever water you drink at home. (Filtered, bottled, etc.) You do not need to buy special water for the baby. Let the baby have as much or as little as they want. There is no amount they “should be” having.
Juice:
We NEVER recommend juice except therapeutically to treat constipation. Even though the commercials on TV may tell you otherwise, juice has very little nutrition and is very high in sugar and calories. If you choose to ignore this advice, at least make sure that you are diluting the juice significantly-about 90 % water and 10% juice. Children should never have soda or other sugary drinks such as fruit punch, Kool-aid, lemonade and iced tea. This is true forever. In a perfect nutritional world, where kids don’t go to birthday parties, children only need to drink water and milk to be healthy.
Dairy:
After 1 year of age, children only need 2-3 servings of calcium/day. That may be a yogurt, slice of cheese or glass of milk. Children should have a maximum of 2 cups (12-14 ounces of milk/day). From 1-2 years of age, children should only have whole fat dairy products. After 2 years of age, all dairy should be reduced to low fat- 1% or skim depending on family preference. Most kids get too much dairy. Don’t get into the habit of giving your child more milk if they don’t eat well. We want kids to eat their calories, not drink them.
Organic Foods/Milk?
It is really a personal preference.
Vitamins:
The new recommendations are that all children get 400 IU of Vitamin D starting from the newborn period. All breastfed babies and formula fed babies who are taking in less than 32 ounces per day (which is most formula fed babies) need this supplementation. Either Tri-Vi-Sol or D-Vi-Sol which is made by the Enfamil Company, or Carlson’s Vitamin D drops are good sources of this additional Vitamin D. In Nassau County, and some areas of Suffolk County, there is no Fluoride in the water. In Queens, and the rest of New York City, there is Fluoride in the water. If you live in an area where there is no Fluoride in the water, then a multivitamin with Fluoride is recommended for children starting at 6 months of age. We will provide you with a prescription for this vitamin if needed. Otherwise, as the child grows, any over the counter multivitamin is ok to start if you chose to-just be sure to stay away from “gummy vitamins” since they increase the risk for cavities.
Behavioral Component of Eating:
Be flexible and relaxed. As babies get older, they usually want to handle some of their own food. This is the way babies learn to feed themselves. Let babies eat the foods of your culture. Try to have “family meal time” in which the entire family eats together. Follow the child’s lead-don’t try to force them to eat. Believe us, kids do not go on hunger strikes-they will eat when they are hungry. Don’t get stressed over feedings. If you look at what a child eats over a week, you will see that it is actually pretty well balanced. Don’t look at it day by day. Don’t look at one meal, look at the big picture. We want to create healthy attitudes towards foods and eating. There is a great book put out by the AAP that really offers parents practical, reality-based strategies for getting kids to eat right.
Common “Toddler Feeding” pitfalls:
? Don’t let your child play and eat at the same time. Try to have them secured in a chair during meals. We want our kids to recognize “meal times”. You don’t want to be chasing after your toddler to put a bite of food in his/her mouth. This behavior of eating while playing may also increase the child’s risks of choking.
? Don’t make your child multiple food choices at every meal-in other words, don’t be your toddlers “Short order cook”. Make one thing, and if they don’t want to eat it, let them go hungry. They will make up for it at the next meal.
? Don’t give milk or other caloric liquids if the child refuses to eat. Try to give milk after the child eats to encourage them to eat foods.
? Don’t let your child have dessert or snacks if they don’t eat at a meal.
? Even if you are eating yourself up inside over what or how much your child is willing to eat, never let them see it!!! Toddlers are very manipulative and they want your attention. If you give them any attention for not eating, they will purposely not eat to get your attention.
? Feeding a Toddler is really a power struggle. Let them think they are in control, and they will eat better.
? Remember, very few toddlers eat a variety of vegetables. Hide them where you can (pureed soups always seem to be a good vehicle for this) and don’t worry. It will improve as the child gets older.
? Don’t buy “Junk food” and “Fast Foods” for your kids. They will get used to whatever you get them used to. Again, they will be exposed to this stuff at birthday parties and at other people’s homes. Let it be “special occasion” types of food and keep it out of your home.
Bon Apetit…..
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