I’ve started feeding solids to my second baby. And I have to admit — it’s very different this time around (oh…and that’s a picture of my little guy).

I remember being so scared – and overwhelmed – the first time. Should I make my own baby food or use jarred food? It seemed like such an ordeal to make my own baby food. But soon I realized it was just easier to use regular food.

This time I’m already trying to find ways to have my boy eat what we are eating. And in doing so I’m reminded that the best first foods are actually the easiest to prepare.

1. Iron-fortified cereal: I’ve noticed that some moms are skipping cereal and going straight to fruits and vegetables. The problem with this is that babies need iron due to their rapid growth. At about 6 months of age, iron stores deplete and babies need iron from complementary foods. A key reason iron-deficiency has declined in recent years is due to iron-fortified products like cereal.

There are plenty of whole-grain infant cereals available like Earth’s Best. These cereals are can be combined with other foods including vitamin C-rich fruits and veggies (see below) which help increase the absorption of iron.

2. Cantaloupe: I’ve noticed that cereal is often blamed for baby constipation. I personally think stopped-up babies just aren’t getting enough fresh fruits. At 6 months babies can eat mild, skinless raw fruits like cantaloupe, pears and mango. Cantaloupe is rich in vitamins A and C. If it’s ripe enough it can be mashed with a fork or thrown in the blender to smooth it out.

3. Avocado: All you have to do is mash avocado, add some breast milk or formula and you’re ready to go. For a thicker consistency mix it with oat or rice cereal. Avocados are a source of vitamin E, contain fiber and are rich in monounsaturated fats.

4. Sweet potato: I recently bought a bag of a bunch of small sweet potatoes. All I do is punch both sides multiple times with a fork and put it in the microwave for 2 minutes each side. Then I cut it in half and spoon out the insides and mix it with breast milk or formula until reaching the desired consistency. Sweet potatoes are rich in both vitamins A and C.

5. Winter squash: I love making this at dinner time so it’s easy to save a little for my boy. Like sweet potatoes, winter squash is an excellent source of vitamins A and C

6. Banana: Bananas are the easiest and most convenient fruit to prepare. Simply mash up to desired consistency and add breast milk or formula. Add it to cereal or serve it by itself. Bananas contain fiber, potassium and even some vitamin C.

Now that my boy has tried these easy first foods, it’s time to step it up and start cooking and pureeing some veggies. I also plan on including pureed meat as it’s a highly absorb-able source or iron and zinc. I’ll be sure to update you on the next phase of feeding my baby. I have to say, so far he is an eating machine.

I’ve received many relevant nutrition questions from moms since starting Raise Healthy Eaters. So I thought I’d share these questions in the form of regular “Ask the Dietitian” blog posts. If you have a burning nutrition question go ahead and ask away. I will try my best get back to you within 2-3 days – and I just might post about it.

Q: Can parents actually CREATE an allergy by giving baby 2 new foods at a time, or not waiting long enough between introducing two new foods?

A: Giving two foods at once won’t create a food allergy; it will only make it difficult to tell which food made your baby allergic if he or she does have a reaction (vomiting, diarrhea, breathing problems or a rash). The standard wait time after introducing a new food is 2-3 days. Experts don’t know exactly what causes food allergies except that they tend to run in families.

There’s a lack of evidence that any type of feeding regimen makes food allergies more or less likely to happen. According to the newest report from the AAP, there’s little evidence that waiting to introduce highly allergenic foods like egg whites, milk, wheat, soy, peanuts, tree nuts, fish and shellfish and citrus is helpful. In fact, some new studies suggest that introducing these foods earlier may be beneficial but the research is still preliminary.

In my infant feeding guide, I do suggest waiting to introduce highly allergenic foods and spreading them out over time. This way if your child experiences a reaction he or she will be a little older and better able to communicate with you. If you have a family history of food allergies, it’s a good idea to find a pediatrician who has experience in this area.

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References/Resources:
AAP Policy Statement: Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children (Jan 2008).

This information on this site is for educational purposes only and does not take the place of medical advice. Please verify with your healthcare provider.

I was searching for a “vitamin D only” supplement for my newborn and all I could find was Trivosol which contains vitamins A, C and D. I don’t see the need to add vitamins A and C…. I only wanted to add D. I went to a few stores and found nothing. I find this hard to believe now that the American Academy of Pediatrics recommends 400 IU vitamin D for breastfed infants starting the first few days of life.

Where are the marketers when you need them?

So I went someplace I knew had answers: Google. I was happy to find Carlson Vitamin D Baby Drops 400iu 11 ml drops. There was only one store in San Diego that sold them and my gracious mother-in-law picked it up for me. I could have ordered it online but time was of the essence.

These drops are very easy to use. You just put a drop on your nipple or bottle and baby sucks it down. You can also use these drops on your older kids by putting a drop in their milk or other beverages. Each little bottle should last a year – there are 365 drops. Pretty cool.

I don’t understand why more people aren’t jumping on the vitamin D bandwagon. My son’s pediatrician said nothing about vitamin D at our 2-week visit. Maybe it’s because we live in Southern California where the sun shines daily? But like the AAP states in their policy report, it’s impossible to determine if any child or adult is getting enough D from the sun.

A recent study showed that one-third of new moms and over half of their infants were deficient in vitamin D at birth. Researchers from the University of Southampton found that women with low levels of vitamin D during pregnancy had children with lower bone density at 9 years of age. And research reveals that up to half of adolescents have insufficient blood levels of vitamin D.

Last year I wrote an article with vitamin D expert Dr. Michael Hollick – Is Your Family at Risk for Vitamin D Deficiency? Speaking with him opened my eyes to the long-term consequences of falling short on the sunshine vitamin – and they go far beyond bone health. If you have some time, check it out.

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References:

Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, Arden NK, Godfrey KM, Cooper C; Princess Anne Hospital Study Group. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: longitudinal study. Lancet: 2006; 367(9504):36-43.

Marcason W. Vitamin D: are children and adolescents at risk for deficiency? Journal of the American Dietetic Association. 2009;109:952.

It’s been 22 days since my second child was born. My nipples throb and I’m loopy from little sleep and bad TV – what better time to have a frank discussion about breastfeeding?

I wish someone would have told me what nursing was really like before I had my first child. Yes, I took the breastfeeding class but it did little to prepare me. My child had a weak suck, didn’t gain enough weight and ended up receiving most of my breast milk through a bottle. I was the poster child for an anxious new mother (my in-laws have told me multiple times how much better I am doing the second time around!).

Equipped with realistic information, I believe the act of getting breast milk to babies can be more successful – and rewarding – for many women. Here’s what I think moms-to-be need to know…

1. The first 6 weeks are grueling: When I was having difficulties breastfeeding my daughter, a friend told me that even when everything goes right, nursing is still hard. Now that I have a successful feeder the second time around I know what she means.

The tough first 6 weeks are the result of recovery from birth mixed with severe lack of sleep and hormonal changes. In order to establish a successful breastfeeding relationship, it’s up to mom to feed baby around the clock (every 1-3 hours). And the first couple nights home from the hospital babies tend to be awake most of the night and asleep all day. Being solely responsible for feeding a baby can weigh on a new, exhausted mother.

Instead of being taking off guard with this reality, a mom-to-be can prepare by letting her loved ones know that breastfeeding will be her main concern the first few weeks. Family and friends can help by bringing meals, watching the baby while she sleeps or babysitting older children. She can work to get everything done before birth so she can put all her energy into feeding, knowing that at about 6 weeks baby will sleep longer and feedings will become more predictable.

2. It hurts! Every nursing book says that breastfeeding shouldn’t hurt if you are doing it right. But most of the moms I know including me, say that sore nipples are a pain those first few weeks. This adds to the challenge of initiating a breastfeeding relationship because newborns like to nurse constantly.

Being proactive about nipple pain management can help a new, nursing mom. Make sure you have some nipple cream like Medela’s lanolin that you can put on your nipples after feeding. Let your nipples air dry when you can. The pain is often due to a bad latch so make sure you see a lactation consultant in the hospital, have one visit you at home or go to support groups for additional help.

3. Pick out a lactation consultant ahead of time: The night I brought my first child home from the hospital my breasts were engorged and she couldn’t latch on. I was up at 3am searching frantically for a lactation consultant hoping to find one available 24 hours a day.

When things go wrong at home you don’t have the luxury of time – you need someone to come right away. Before the baby comes get a list of lactation consultants from friends and pick one just in case you need her. You can even call her ahead of time to check availability. Hopefully you won’t need one but it’s good to have a name and number in your back pocket.

4. Have a pump just in case: Some moms-to-be figure they don’t need a pump right away because they won’t use it until later. Every new mom needs a pump! If your baby has difficulty breastfeeding or won’t latch you’ll need to pump to keep your milk supply up. And if the doctor recommends you supplement with formula you might as well supplement with your own breast milk.

Remember, milk production works on supply and demand and if you give formula your supply decreases. If this happens in the first few weeks, you may not be able to get your supply back up later. Additionally, pumping allows your husband or partner to take over one late night feeding to give you a much-needed break.

5. You’ll be convinced you don’t have enough milk: Newborns nurse frequently. I used to take this as a sign that I didn’t have enough milk. The books I read said newborns feed every 3 hours. Apparently my second child didn’t read these books because he likes to feed constantly – and I’m trusting he knows what he’s doing. Babies also go through growth spurts at 3 weeks and 6 weeks when all they want to do is nurse. Knowing this is normal can ease your mind and build confidence that you do indeed have enough milk.

As long as your baby is gaining weight and having enough pee and poo diapers, they are fine. Save the routine-building for after 6 weeks and just feed your baby when they seem hungry.

6. The payoff is huge: Okay, enough of the downsides to breastfeeding. Once you get past 6 weeks you begin to see the benefits. Pain subsides and feedings become predictable. You start to enjoy the time alone with your baby. When baby wakes in the middle of the night there’s no need to warm up milk you just feed them and put them back to sleep. Babies become more efficient and breastfeed quicker. Knowing how hard it once was makes your success even sweeter. When it’s time to wean it’s usually hardest on mom.

7. There’s a third feeding option: When my first child refused to breastfeed at 7 weeks I was devastated. But I remembered that my sister-in-law pumped milk for her daughter for 6 months. So I decided to pump as long as I could. Not only did I make enough milk for my daughter but I produced about 5 extra ounces a day that I stashed in the freezer. Yes, pumping was a pain but I was still able to get breast milk to my daughter and it got easier as time went by. I kept offering her the breast and at 4 months she started to breastfeed. We made it 11 months with a combination of breastfeeding and pumping. I was very grateful for that pump!

Don’t get me wrong. I have nothing against formula. I know that breastfeeding does not always work for every mom. But exclusive pumping is another option for moms to consider. Most healthcare providers don’t know about full-time pumping and may discourage you from it. Just know that many moms make it work – for more information see this book/website on exclusive pumping, check out www.gotbreastpump.com and visit the online support forum (pumping moms) at Baby Center.

My hope is that breastfeeding goes smoothly for new moms everywhere. But by being prepared for the potential pitfalls, moms are more likely to be successful in this venture.

For more on infant nutrition see our Infant Feeding Guide

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When everyone is offering up advice—mothers-in-law, strangers, friends — starting your baby on solids can be a stressful experience.

When my daughter was almost 6 months old, I looked around for credible information on starting solids. Dissatisfied with what I found, I decided to research the subject myself. I slowly began to separate fact from fiction. Here’s what I discovered.

Myth #1. “Breast milk provides all the nutrition your baby needs for the first year.” I heard this repeatedly from moms and people everywhere. The theory goes like this: the first year of feeding solids is really only practice – babies get all the nutrition they need from liquids.

Yet at 6 months baby’s iron stores run out and breast milk is low in iron. Zinc is another mineral that is needed from complementary foods around 6 months. According to a 2007 review study in the American Journal of Clinical Nutrition, by 9-11 months babies need to get more than 90 percent of their iron and zinc sources from complementary foods in order to meet their needs!

While more common in developing countries, iron deficiency can cause growth problems and poor intellectual development. Zinc deficiency can cause reduced growth and possible growth stunting. A study looking at 9-month-old breastfed babies in the US revealed that 30 percent had lower than recommended levels of both iron and zinc.

Myth #2. “Meats should be introduced after 9 months.” I’ve heard this from both health professionals and moms. But everything I read, including statements from the American Academy of Pediatrics, says meats actually make an ideal first food at 6 months. Why? They are rich in iron and zinc, the same to micronutrients babies older than 6 months need from complementary foods.

The truth is we’ve evolved from meat-eating humans and babies’ growing bodies need key nutrients from such foods. It is believed that hunters and gatherers used to pre-chew meat and give it to their babies. That doesn’t mean a meat-free diet is bad for your child, just talk to your pediatrician to see if supplementation is necessary.

Myth #3. “You should introduce vegetables before fruits so your baby doesn’t prefer sweet foods.” I’ve found nothing to back up this statement. Actually, there is little evidence that any specific sequence of introducing food is necessary at all. Instead, feeding solids should be based on baby’s nutritional needs along with a dose of common sense. Most babies accept a variety of foods early on so parents should take advantage of this by repeatedly trying new items.

Myth #4. “If you wait a long time to introduce highly allergic foods, you’ll decrease your baby’s risk of developing a food allergy.” Up until recently many health professionals (including me) believed this to be true. Yet a recent report from the AAP shows there is little evidence that waiting to introduce certain foods does any good in the food allergy department. According to the AAP report:

–There is little evidence that a baby starting solids at a later time (beyond 4-6 months) helps to prevent food allergies – and that includes highly allergenic foods. If your baby is at increased risk for food allergies, work with your pediatrician on food introduction.
–Infants with a strong family history for food allergies can decrease the risk of developing atopic dermatitis (eczema) and cow milk allergy by breastfeeding for at least 4 months.
–Exclusive breastfeeding for at least 3 months protects against wheezing in early life.

Myth #5: “Babies need baby food.” Remember, babies got along for centuries without jarred baby food. That’s not saying that these items aren’t convenient, they just aren’t a necessity. Using the food you buy for the rest of the family and altering the texture to match baby’s development is easier and cheaper. And by 10 months a majority of babies prefer finger foods to pureed items. In the scheme of things, the baby food/pureed stage is really short.

For references and more information on feeding your baby solids see our Infant Feeding Guide.

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