Introducing Solids

Every parent has a number of magical parenting moments pre-programmed in his or her brain even before the baby is born.

Watching your child’s first step….

Having your first phone conversation….

Letting go of the two-wheel bicycle for the first time as your child   rides away…

All are common, wonderful parenting expectations. The first feeding is one of those seminal events most of us are counting on.

Is the timing of that first feed important?

Most paediatricians think the answer is YES! Many babies have the oromotor (chewing and swallowing) skills to handle solid foods at three to four months of age, but development has little to do with the timing of solid food introduction.

What we know is that the introduction of simple solids at about six months of age reduces your baby’s risk of developing food allergies later on in childhood. Too early raises the risk, too late and your child’s risk is raised as well.

Is My Baby Ready to Eat Solids?

How can you tell if your baby is ready for solids? Here are a few hints:

• Is your baby’s tongue-thrust reflex gone or diminished? This reflex, which prevents infants from choking on foreign objects, also causes them to push food out of their mouths.
• Can your baby support his or her own head? To eat solid food, an infant needs good head and neck control and should be able to sit up.
• Is your baby interested in food? A 6-month-old baby who stares and grabs at your food at dinnertime is clearly ready for some variety in the food department.
• If your doctor gives the go-ahead but your baby seems frustrated or uninterested as you’re introducing solid foods, try waiting a few days or even weeks before trying again. Since solids are only a supplement at this point, breast milk and formula will still fill your baby’s basic nutritional needs.
• Is your baby making chewing motions?
• Does your baby show significant weight gain? (birth weight has doubled)
• Can your baby close his/her mouth around a spoon?
• Can he/she move food from front to back of mouth?
• Does your baby seem hungry after 8 to 10 feedings of breast milk or 1185ml of formula in a day?
• Is your baby teething?

Introducing Solids to your baby

When your baby is ready and the doctor has given you the ‘OK’ to try solid foods, pick a time of day when your baby is not tired or cranky. You want your baby to be a little hungry, but not starving; you might want to let your baby breastfeed a while, or provide part of the usual bottle.

Have your baby sit supported in your lap or in an upright infant seat. Infants, who sit well (usually around 6 months), can be placed in a high chair with a safety strap.

Most babies’ first food is a little iron-fortified infant rice cereal mixed with breast milk or formula. The first feeding may be nothing more than a little cereal mixed in a whole lot of liquid. Place the spoon near your baby’s lips, and let the baby smell and taste. Don’t be surprised if this first spoonful is rejected. Wait a minute and try again. Most food offered to your baby at this age will end up on the baby’s chin, bib, or high-chair tray. Again, this is just an introduction.

Note: Do not add cereal to your baby’s bottle unless your doctor instructs you to do so, as this can cause babies to become overweight and doesn’t help the baby learn how to eat solid foods.

Once your little one gets the hang of eating cereal off a spoon, it may be time to introduce a fruit or vegetable. When introducing new foods, go slow. Introduce one food at a time and wait several days before trying something else new. This will allow you to identify foods that your baby may be allergic to.

Your baby may take a little while to “learn” how to eat solids. During these months you’ll still be providing the usual feedings of breast milk or formula so don’t be concerned if your baby refuses certain foods at first or doesn’t seem interested. It may just take some time.

Tips for preparing baby’s food

With the hectic pace of family life, most parents opt for commercially prepared baby foods at first. They come in small, convenient containers, and manufacturers must meet strict safety and nutrition guidelines. Avoid brands with added fillers and sugars.

Preparing your own baby food

If you do plan to prepare your own baby foods at home, pureeing them with a food processor or blender, here are some things to keep in mind:

• Protect your baby and the rest of your family from food borne illness by following the rules for food safety (including frequent hand washing).
• Try to preserve the nutrients in your baby’s food by using cooking methods that retain the most vitamins and minerals. Try steaming or baking fruits and vegetables instead of boiling, which washes away the nutrients.
• Freeze portions that you aren’t going to use right away rather than canning them.
• Avoid home-prepared beets, collard greens, spinach, and turnips. They can contain high levels of nitrates, which can cause anaemia in infants. Serve jarred varieties of those vegetables.
• Whether you buy the baby food or make it yourself, remember that texture and consistency are important. At first, babies should have finely pureed single foods. (Just applesauce, for example, not apples and pears mixed together.) After you’ve successfully tried individual foods, it’s OK to offer a pureed mix of two foods. When your child is about 9 months old, coarser, chunkier textures are going to be tolerated as he or she begins transitioning to a diet that includes more table foods.

If you are using commercially prepared baby food in jars, spoon some of the food into a bowl to feed your baby. Do not feed your baby directly from the jar, because bacteria from the baby’s mouth can contaminate the remaining food. It’s also smart to throw away opened jars of baby food within a day or two.

Infants usually like fruits and sweeter vegetables, such as carrots and sweet potatoes, but don’t neglect other vegetables. Your goal over the next few months is to introduce a wide variety of foods. If your baby doesn’t seem to like a particular food, reintroduce it at later meals. It can take quite a few tries before kids warm up to certain foods.

Foods to Avoid

Some foods are generally withheld until later. Do not give eggs, cow’s milk, citrus fruits and juices, and honey until after a baby’s first birthday.

• Eggs (especially the whites) may cause an allergic reaction, especially if given too early.
• Citrus is highly acidic and can cause painful diaper rashes for a baby.
• Honey may contain certain spores that, while harmless to adults, can cause botulism* in babies. Regular cow’s milk does not have the nutrition that infants need.
• Fish and seafood, peanuts and peanut butter, and tree nuts are also considered allergenic for infants, and shouldn’t be given until after the child is 2 or 3 years old, depending on whether the child is at higher risk for developing food allergies. A child is at higher risk for food allergies if one or more close family members have allergies or allergy-related conditions; like food allergies, eczema, or asthma.
• Since babies don’t eat much in the way of solids, milk and soy allergy is often the big problem in young infants.

Some possible signs of food allergy or allergic reactions include:

• rash
• bloating or an increase in intestinal gas
• diarrhoea
• fussiness after eating

For more severe allergic reactions, like hives or breathing difficulty, get medical attention right away. If your child has any type of reaction to a food, don’t offer that food until you talk with your doctor.

Signs and symptoms of anaphylaxis (a severe, potentially fatal allergic reaction) can occur anywhere from within minutes of exposure to a food to two hours after exposure.

Helpful Hints

1. Breast milk is the best choice for the first year of life. Amounts consumed will vary for every child.
2. Iron fortified commercial formula is the best alternative to breast milk.
3. Introduce solids with iron fortified infant rice cereal. Try 1 teaspoon at first and gradually increase to 2 or 3 tablespoons at a meal. Many babies are not ready for solids until 6 months.
4. Combinations of foods should be avoided until your baby has eaten each food individually.
5. Water can be offered in small amounts.

* Botulism = “a rare but serious paralytic illness caused by botulin toxin. The toxin is produced by the bacteria Clostridium botulinum. C. botulinum is an anaerobic, Gram positive, spore-forming rod. Botulin toxin is one of the most powerful known toxins: about one microgram is lethal to humans. It acts by blocking nerve function and leads to respiratory and musculoskeletal paralysis.

Infant botulism affects about 100 infants per year in the United States, with the majority in the state of California. Infants less than 12 months of age are susceptible, with almost 90% of cases occurring between the ages of 3 weeks and 6 months of age at presentation. The mode of action of this form is through colonization by germinating spores in the gut of an infant. The first symptom is usually constipation, followed by generalized weakness, loss of head control and difficulty feeding. Like the other forms of botulism, the symptoms are caused by the absorption of botulinum toxin, and typically progress to a symmetric descending flaccid paralysis. Death is often the eventual outcome unless the infant receives artificial ventilation.

Honey, corn syrup and other sweeteners are potentially dangerous for infants. This is partly because the digestive juices of an infant are less acidic than older children and adults, and may be less likely to destroy ingested spores.”

Wikipedia