Starting Solids FAQs

• I was told from his doctor that apples and bananas could be constipating. Is this true? NEW!
  
• My son is almost 6 months old and he doesn't like and of the cereals. Is he getting enough iron from his formula to compensate for no cereal or is this a problem?
• If I start her [my young infant] on cereal and fruits at 4 months, will she loose the full benefits of breast feeding?
• I have read that yogurt is a good introduction to dairy for infants, but I have noticed sugar as an ingredient. Should I be concerned about this?
• I have a 3 month old son that I am debating on whether to start solids at 4 months. He is breastfed, but I worry about his nutrition from me as I have an almost 2 year old that keeps me going all day, and there are several days that I do not eat very well.
• She has started to eat solid foods. Do I have to, or need to give my daughter red meat?
• What are the pros and cons of starting baby on cereal at four months?
• Our 6 month old does not like cereals at all. Is it okay to skip the cereal and give her the vegetables to start with instead?
• Why wait until four months to start solid foods?

My baby is six months old and just beginning to eat solids. I was told from his doctor that apples and bananas could be constipating. I thought bananas were high in fiber and potassium. So, is this true? Or is it just that it could cause constipation in large quantities?

Bananas and apples are great first foods for your six month old. They are not constipating in amounts your baby will be eating. In fact they really aren't very constipating in any quantity. Bananas are lower in insoluble (roughage) fiber and water than most fruits so are often recommended after a bout of diarrhea because they are bland easy to digest. Also, they contain a soluble fiber known as pectin, which acts like a sponge in the digestive track, absorbing excess water. However, while they may help in the recovery of diarrhea, they will not cause constipation. Apples on the other hand are recommended to help fight constipation. Applesauce will have less of an effect than whole apples in that regard. Bananas are a good source of potassium which is often lost during bouts of diarrhea. Therefore, you often seen bananas recommend after a case of the ‘runs’ but it's not so much to "constipate" as to replace this important electrolyte. What is most important to prevent constipation in little ones is to make sure they get plenty of fluid.
 

My son is almost 6 months old and has been eating solids since about 4-1/2 months old. I started with all of the cereals but he didn't like any of them so now we feed him fruits and veggies but without any cereal. Is he getting enough iron from his formula to compensate for no cereal or is this a problem?

It depends upon the amount of formula that he is getting. Read the label of the formula, determine the amount of iron in one serving, and calculate how many servings he is getting and then you will know. If he is coming up short, then speak to your pediatrician about getting some iron supplement drops. Have you tried mixing the cereal into the fruits that he is eating? It may be a way of getting some iron rich cereal into his diet. Earth's Best offers several varieties of iron-fortified cereals. Have you tried the multi-grain flavor as a new taste option for your son http://www.earthsbest.com/products/cereal.php ? Continue to offer the cereal on a regular basis. He may begin to like it, but you need to keep giving him the opportunity to come to like it. Older babies and toddlers often take 10 to 15 exposures to a new food to even agree to taste it. It may take even more than that to come to like it. Once your son is weaned from his formula, he will absolutely need supplemental iron, and infant cereal is a great way for him to get it, even well into his toddler years. Or, you can soon switch him to Earth's Best Sesame Street Instant Oatmeal that is also iron fortified http://www.earthsbest.com/products/cereal.php
 

I have a 15 weeks old infant. She is exclusively breastfed. If I start her on cereal and fruits at 4 months, will she loose the full benefits of breast feeding?

The benefits of breastfeeding will continue so long as you continue to nurse and so long as the breast milk composes the bulk of her diet. The initial introduction of solids is more for your baby to practice, then for nutritional benefit. At four months the solids she consumes should be only iron-fortified cereal, prepared with breast milk. Hold off on the fruit until five months or older, when her tummy is bigger and she can manage less concentrated nutrition. But for now, breast milk is the best nutritionally. At four months a little iron-fortified cereal is fine in order to stimulate the development of her swallowing technique and to supplement her diet with iron.
 

I have read that yogurt is a good introduction to dairy for infants, but I have noticed sugar as an ingredient. Should I be concerned about this? What are some other dairy alternatives for the beginning solid eater (8 months)?

Yogurt is a wonderful way to introduce an older baby to dairy. Just be sure that you only offer plain, un-sweetened, whole milk yogurt. You may have to go to a natural food store to find it, but they are available. Plain, unflavored yogurt may not appeal to your baby due to its slightly acidic nature. But, that is easily remedied by adding mashed ripe banana or other favorite fruits into it. Hopefully, this way of eating yogurt (plain or with added fruit) will be what your child comes to prefer. Many of the yogurts on the market are really desserts in disguise, they are so loaded with unnecessary sugar and calories. Once your baby gets to be two or three, you can switch to the low-fat plain yogurt, but for now the fat and calories in yogurt made from whole milk is important.
 

I have a 3 month old son that I am debating on whether to start solids at 4 months. He is breastfed, but I worry about his nutrition from me. I have an almost 2 year old that keeps me going all day, and there are several days that I do not eat very well, sometimes not even 2 meals a day. Should I worry about the nutrition he is receiving from me, therefore begin him on food at 4 months (and only organic). He is not on a vitamin supplement.

Take the cue from your son. If he's growing fine, if he seems satisfied from the nursing, then waiting to introduce solids until he is a little older would be appropriate. In fact, as busy as you are, nursing would be more efficient for you and just as nutritious for your son while still ensuring time together. The nutrient content of breast milk is not totally dependent on your diet. In fact breast milk will draw from your body stores to make sure it's nutritious. For example, if your diet is low in calcium, rather than producing breast milk also low in calcium, your body will draw on bone stores of calcium to supply the breast milk. Perhaps the most important thing for you to do at this point is to concentrate more on your own diet and fluid intake rather than baby food. The amount of liquid you take in is as critical as the foods you eat. So, at least get plenty to drink. Perhaps a good idea would be to drink one of those vitamin and mineral enhanced meal supplements during the day. While it's not ideal, it's much better than skipping meals or fluids.
 

I have a 6-month-old daughter. She has started to eat solid foods. I do not eat red meat. Do I have to give my daughter red meat?

While red meat is a great source of iron and protein, it is by no means the only source. Millions of healthy babies are raised as vegetarians, never eating meat of any kind. If you choose not to include red meat in your baby’s diet, you will have to be sure you give her other excellent sources of iron and protein. There are many foods that can accomplish that. For a baby, the best way to ensure they are getting the iron they need is to serve them iron fortified infant cereal twice a day. When they get older, other iron-fortified cereals can be used. Also, a vitamin and mineral child’s supplement that contains iron would be a good idea. Protein is found in an abundance of foods including eggs (no egg white until the age of one to prevent allergies), dairy products, legumes, nuts and seeds, seafood and poultry.
 

My doctor suggested that I start my four-month-old
on cereal, but I have read and heard from others that the new thoughts on this are to wait until 6 months. What are the pros and cons of starting her versus waiting?

Some of the benefits of waiting include the chance for your daughter's immune system to develop a little more so that allergic reactions are less likely, particularly to common allergens, the chance for her digestive system to develop so that she can more easily digest solid foods, the insurance that solids are not taking the place of the more nutrient dense formula or breast milk, and the chance for her to better develop her ability to communicate with you to let you know when she's full.

Some of the benefits of starting solids at 4 months, include the addition of iron into baby's diet (iron fortified baby cereal is the recommended first food) at a time when birth stores of iron are gone, but need is critical and high, the chance for your baby to practice using her maturing ability to chew and swallow (i.e. capitalizing on a 'readiness' period), and, helping to meet growing appetite needs that may not be satisfied with breast milk or formula.

For the most part, you need to make the decision with your doctor based not on what the book says, but on what you read from your baby. If your baby is not able to sit up, unsupported in a chair, if she can't move her head away or have some other means of telling you she's full, if she is small and her tummy can only hold small amounts of food at a time, it's best to keep her on a more nutrient dense formula or breast milk. But, if your four month old is precocious, is sitting up, has a hearty appetite and seems to be showing some interest in solids, then you should take advantage of her readiness.

Either way, make sure your daughter has a reliable source of iron in her diet, either from formula, cereal or drops. Iron deficiency at her age can have long lasting consequences. And, while you may hear that breast milk is a good source of iron, there simply isn't enough in breast milk to satisfy the need.
 

We just started our 6 month old on solids a few weeks ago. I had tried the baby cereals and she does not like them at all. I have tried them with both breastmilk and water and she still will not eat it. Is it okay just to skip the cereal and just give her the vegetables to start with instead?

I strongly encourage you to continue to try the cereal. Given enough chances, she may begin to enjoy it. You may want to try adding a little applesauce or pureed bananas to the cereal to make it a little more appealing.

The reason I say this is for several reasons. The first and most important is, the iron in the cereal is a critical nutrient for you child to be getting now. Birth stores of iron have been depleted, yet her growing body and brain are demanding iron in rather large quantities in proportion to her size. Breastmilk is an inadequate source of iron at this point. So, getting your baby well established on an iron-fortified cereal for the next year to year and a half is a good idea. Of course, should you find she simply will not ever take up the cereal habit, you could supplement with iron drops or an iron fortified formula.

Another reason I suggest the cereal, mixed with breast milk, is that it is a better balance of nutrients that your baby needs. Cereal mixed with breast milk provides a nice mix of protein, fat and carbohydrates and supplies a good amount of calories. Vegetables, on the other hand, are low in calories and could fill her up without providing the calories she still needs. Vegetables in small amounts are good now, to help her develop a taste for them, and to provide some vitamin C and A. However, they are not a good substitute for cereal mixed with breast milk. As an alternative to the cereal, you may mix the vegetables with some egg yolk in order to increase the caloric density and nutrient content, but still, the iron would be missing so some iron drops would still be necessary.
 

Why is it that everyone tells you not to start foods before four months of age? My grandmother fed me when I was two weeks old.

Breast milk was designed by nature to meet the needs of a baby for at least the first six months of life. The American Academy of Pediatrics stated, "Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first six months after birth. Infants weaned before 12 months of age should not receive cow's milk feedings, but should receive iron-fortified infant formula. Gradual introduction of iron-enriched solid foods in the second half of the first year should complement the breast milk diet. It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired ... In the first six months, water, juice, and other foods are generally unnecessary for breastfed infants."

The nutritional and medical sciences have come a long way since the days of our grandparents. Feeding solids in the first few weeks of life began in the 19th century, not as a response to meeting the appetite demands of babies, but because the industrial revolution was starting and nursing mothers needed to get back to the factories, leaving their babies for someone else to feed. That practice lasted well into the 20th century and only now is beginning to change as we learn more about what is best for baby.

What we have learned is that babies swallowing ability is not matured enough to swallow solids. Also, their digestive systems are not capable of handling the solute load that many of the solid foods put on it. In other words, babies are born with some growing up to do before being able to best swallow and digest solids.

Developmentally, by four months, most infants will be able to sit with support and will have good control of their neck and head. This allows the baby to indicate a desire for food by opening his mouth and leaning forward and to indicate disinterest or fullness by leaning back and turning away. In other words, the baby can better control his intake according to his hunger and satiety. Until baby can express these reactions, feeding solids may end up being a forced feeding situation. There are some babies who can do this at three months of age. So, really, it is a general suggestion which must be adapted to individual needs. A premature baby may have to wait to 6 or more months before he can be an active participant in solid feeding. You will need to go with what your baby is telling you. Cultural differences will continue to exist, as will generational ones. I, like you, was brought up in an age when solids where introduced early on. It is not so much an issue of what babies can survive on, or even turn out fine on, it is a matter of trying to find out what is optimal for your baby. No doubt, he will grow up successfully either way, but if we can optimize his ability to regulate his intake according to his body signals we should try to do so. I know that here in the U.S., we have an epidemic of obesity, that may be partly caused by people eating when they are not hungry, or feeling like they have to 'clean their plate' even when their stomach says full.