Introduction of Solids

You won’t want to begin trying solid foods until your baby is somewhere between 5-8 months of age.  Some research suggests that it is better to wait until 6 months of age to introduce solids as the undeveloped digestive system can be sensitive and food allergies can develop.  Since breast milk is such a great food I decided to wait until Zara was at least 6 months to begin any food introduction.

You should always nurse your infant first before offering a solid food. Offer whole foods in as close to the natural state as possible (mashed and cooked fruits and vegetables, cooked cereal grains, etc.). At about 9 months you may let your baby attempt to feed herself as part of her exploration.  Each item needs to be individually introduced for 3 days at a time to make sure delayed food sensitivities don’t crop up within the 72-hour window.  If your baby shows any of the following symptoms eliminate it for a while before you try it again. Don't offer any combinations until all the foods have been introduced individually.

Diarrhea

Constipation

Unusual fussiness

Lethargy

Stuffy/runny nose

Coughing/wheezing                                

Ear infections

Change in personality                               

Rash around mouth or anus (or other skin reactions)

It is very import how and in what order you introduce your food groups.  I prefer the following order and within each group I’m including the foods and the order I used for Zara.

1.     Vegetables:           

a.     Yellow/Orange vegetables first: squash, yams, sweet potatoes, carrots (corn is a common allergen so wait until 1 year)

                                               i.     For Zara: kopacha squash, butternut squash, sweet potato, yam, carrots

b.     Green Vegetables:  green Beans, broccoli, spinach, peas

                                               i.     For Zara:  green beans, peas, broccoli, spinach

c.      Various colored: cauliflower, purple yams, bok choy

                                               i.     For Zara: cauliflower, purple yams

2.     Fruits:  Limit these and think of them like a desert always giving veggies first: applesauce, pear, banana, papaya, mango, prunes, peaches

a.     For Zara: applesauce, pear, mango, prune, peach, papaya

b.     Hold off on all citrus, pineapple and kiwi until 1 year as these are hard on the tummy due to acidic content

3.     Proteins:  Lentils   Zara:  Lentils Hold off on the rest of the bigger beans and meats until baby is 1 year or more.

The easiest way to make baby food is to steam the fruit or veggie in distilled or filtered water and then blend using the distilled water that captured some of the nutrients while steaming. I recommend freezing in cubes for easy reheating.  Use the silicon ice cube trays as the food is easier to pop out and put in a bag.  See the photo of me doing this with squash.  That way once all the food is introduced you can easily mix and match.

                  

Baby Shoes, Oh My!!

When you have a baby girl cute little shoes are favorite gift. Then you find out that it is impossible to keep them on.  So in my quest to keep my daughter’s feet warm, I have discovered that there are two awesome solutions to the shoe problem. 

The first solution is the sock that looks like a shoe.  We were given these as a gift and I love them! Notice the green sneaker-looking socks on Zara’s feet!

The second solution is Robeez a wonderful shoe that is easy to pull on with elastic.

I’ve also noticed that my daughter takes a somewhat different approach to trying on shoes than I do.

The Poo

As a doctor you spend an incredible amount of time caring for and asking questions about people’s poo. Then when you become a parent you also start to care a whole lot about your little one’s poo. Has she had one, and what color or consistency was it?  When a baby first start solids, like rice cereal, the most common problem is constipation.  The poor little one will exhibit some of the following signs:

·      Grunting when having a movement

·      Getting red in the face

·      Getting red-faced, straining and crying (this lets you know it really hurts)

·      Not having a movement daily or at the very most every other day

·      Having hard, nugget-like poo

·      Fussy and passing stinky gas but no movement

As parents we feel so awful for our little ones and want to make them feel better and I am no exception.  About one week into starting rice cereal poor Zara got constipated.  As a doctor I know the soothing techniques for this and also the things to give baby, but it still tugged at my heart strings to see her uncomfortable.

Here are my suggested options with a few commonly used techniques also thrown in:  (not all things work for all babies so you may have to try a few)

·      Give a warm bath or lay a wet washcloth heated in the microwave on the tummy (always check temperature!)

·      Massage warm mineral oil warm on the tummy counter clockwise

·      Gently insert a lubricated Q-Tip into the anus and move in a clockwise circle for 5 seconds (you will usually see a bowel movement within the next hour or so)

·      Get baby a chiropractic adjustment along with massaging the low back (often mis-alignment or tight muscles will restrict movements)

·      Put pear juice in the rice cereal

·      Use probiotics for baby and mom

·      Put molasses in the baby’s bottle with milk  (corn syrup is sometimes suggested but not very healthy)

·      Finally ----try an enema.  This is a last resort and make sure you are home if you do this

We have used the first six options for poor Zara and she is doing great.  Check out the baby probiotic the pear juice I use.  Probiotics for mom need to be more specific depending on mom’s bowel movement habits so please check with your doctor on what you should take.

Rice Cereal Time!

Starting Solids and Signs of Readiness

Most pediatricians will tell parents to start their babies on solids somewhere between 4-6 months.  As a doctor, I encourage patients to lean more towards 6 months to start any solid other than rice cereal.

You can start rice cereal if:

1.   Baby is able to sit up with support to reduce the chance of choking

2.   Baby is hungry after 32 oz. of formula or 6 full breast feedings

3.   Baby has been sleeping through the night for at least 2 weeks and then suddenly starts waking from hunger or starts waking early from naps and is hungry.

4.  Baby show interest in your food

5.  Baby has doubled his/her birth weight or weighs around 15 lbs.

I had to start Zara on rice cereal at 4.5 months even though I was hoping to wait until 6 months because she had all the signs.  Since it wasn’t my goal to start other foods for another month and a half, I decided to use a technique involving spiking the bottle because I wanted to wait on spoon and eating skills.  For about a month and a half I gave her 5 oz. of breast milk mixed with 1 tablespoon of rice cereal in the bottle right before bed.  You may have to do this two times a day if your baby needs the extra nutrition and calories.  Try this for the first time at lunch so you can see if your baby has any skin or digestive reaction. If baby reacts you can try oat or barley but you may want to wait until baby is closer to a year old. If your baby has already cut a tooth and you give solids right before bed, remember to take a wet washcloth and wipe the tooth to prevent decay and gum disease.  Zara still hasn’t cut any teeth so it’s not an issue yet but it will be eventually.