Introducing infants to solid foods

The goals of infant nutrition are to promote optimum health, growth, and development.  We can also prevent iron deficiency anemia, reduce the risk of developing food allergies and prevent obesity.

Breast milk provides an ideal and complete food for full term infants until 5 or 6 months of age when you add Vitamin D. Infant formulas are designed to have the same nutritional benefits of breast milk.

Iron

Iron in mother's breast milk is better absorbed than the iron in formula, but formula iron is still adequate. In spite of this, many babies develop iron deficiency anemia by one year of age. Why? Solid foods may be started too late and/or the introductory foods are not rich in iron. Neither breast milk or formula can meet the iron needs of growing full-term babies after 6 months of age. That's why iron-fortified cereals are typically started between 4 and 6 months of age. 

Allergies

Delaying certain foods (eggs, nuts, etc) until the baby's first birthday has not worked to reduce food allergies. New evidence shows just the opposite. Early introduction, after 4 months but before 6 months of age, may reduce the chances of developing allergic reactions to these foods.

Introducing new foods

One new food item every few days is the rule of thumb. Foods that have successfully been introduced can continue in a baby's diet. Make a list of meats, fruits, cereals, nut butters, dairy items, seafood and shellfish and put it on your refrigerator. After using each new food for 3-5 days, check it off, because it's not new anymore. It can now be part of your baby's varied dietary choices.

Start with at least two meals a day and advance to three meals within a few months. Baby food purees can be store-bought or homemade. 

Whole milk and dairy

Even though starting whole milk is still recommended at a year, introducing dairy can begin earlier. Soft cheese or yogurts blended into baby's pureed dishes is fine. Small amounts of dairy on a regular basis helps prime baby's immune system to tolerate dairy products and reduce chances of milk allergy. 

Nuts

Nut butters and peanut puffs are recommended, but NOT whole nuts! Whole nuts can choke children under 5 years of age. Any pureed nut or nut butter (pecan, peanut, walnut, chestnut, cashew) can be blended into baby's foods just like soft cheese and yogurts.

Seafood

The same approach goes for shellfish and seafood. Pureed and boneless, fed separately or blended into already accepted pureed foods at lunch or dinner.

Bread

Introduce zweiback teething bread between 6 and 7 months. They soften easily and quickly in a baby's saliva. Most baked breads are easily gummed by most infants.

Self feeding

Do not start pieces of soft foods until your baby is picking up objects with two fingers in a pincer grip, just like you pick up a penny off of a table. Try a Cheerio to see if your baby has the skill. And when your baby has that skill, it's time to make sure coins and small round objects aren't laying around. Babies tend to put them into their mouths which can be dangerous.

Variety is the spice of life with infant nutrition – one new food every few days. An early introduction to a variety of all types of food may be the best way to avoid food allergies. Enjoy the privilege and responsibility of parent choice in the foods you offer, giving your baby optimum nutrition for health, growth, and development. 

Dr Marc Tannenbaum, a concierge pediatrician in Atlanta, offers his recommendations. With pediatricians trying to maximize the use of breast milk and at the same time, trying to prevent allergies and obesity, Dr.Tannenbaum's approach is one that is being used by more and more providers. 

Tannenbaum's web site www.priority-pediatrics.com                            

Dr. Stan