Wednesday, November 3, 2010

First Foods for Baby: Alternatives to Rice Cereal

Is This Your Only Option?

Why is rice cereal the most common first food? It is a combination of tradition, cultural norms, pediatrician recommendations and the influence of the corporations that produce baby food.

While most parents stick with tradition and start with rice cereal, many parents are starting to question this and are beginning to wonder if it really is the best first food for baby. We want to do what is best for our kids, often going with what is comfortable and familiar.

According to the AAP, the order that foods are introduced is not generally of concern after 4-6 months of age as long as breast milk is the primary source of nutrients. This is assuming that parents are waiting until about 6 months, which is not the case in many households. The typical order of foods introduction in the United States is iron-fortified infant cereal, then fruits and vegetables, and lastly meats.

The WHO recommends exclusive breastfeeding for the first 6 months of life. After that solids can be introduced, with meat, poultry, fish or eggs eaten daily or as often as possible and continued breastfeeding for at least 1 year.

What are the reasons given by pediatricians and advertisers to start with rice cereal? Most of the reasons only apply when solids are introduced younger than 6 months of age. The recommendations for WHEN to start solids have changed, but unfortunately food choices have not. Some of the reasons include: the benefit of a bland flavor and smooth texture; helping baby to sleep through the night; the non-allergenic property of rice and the iron fortification.

It turns out that 6 month old babies enjoy different flavors and textures, can sleep through the nice with or without rice cereal, can have allergic reactions to any food including rice cereal and may not absorb the iron added to rice cereal. In fact, there might be a biological reason to hold off on grains. Some experts point out that the enzymes needed to digest grains are not at their full level until after 6 months.

When we add nutrients to foods that aren't naturally there, we usually later realize that something was missing, it was the wrong amount or we learn something new about our needs. It makes more sense to use foods that contain natural sources of the foods that babies need rather than a manufactured product. Meats contain very available sources of iron and zinc when compared with fortified foods. Egg yolks are loaded with nutrients including choline for brain development, and the list goes on.

If you are confused about what to feed your baby, you are not alone. There is not a lot of information available on this topic. Here are my recommendations based on a combination of my experience as a dietitian and a mom and the available literature.

I suggest starting with a variety of fruits, vegetables and meats. A variety of textures and flavors will ideally help your child enjoy more foods be a less picky eaters in the long run. Feel free to add herbs and spices to make the food more exciting. As your child begins to depend more on complementary foods and less on breast milk, the variety will help to ensure that all his needs are being met.

Here are some wonderful first food ideas: bananas, avocado, sweet potato, squash, chicken, egg yolks, yogurt, meat (excluded processed meats), fish (other than shellfish), carrots, broccoli, beans or liver.

I hope this has helped to clear up some of the confusion and provided some new ideas and alternatives to rice cereal. Not all foods are appropriate for all babies. If you have a family history of food allergies or if your baby has other related medical history please discuss food introductions with your pediatrician.

Tuesday, November 2, 2010

an introduction to baby led weaning

In my training as a dietitian I did not learn anything about baby led weaning. I had not heard of it until a friend told me that was how she was introducing her son to solid food. I immediately looked for more information and found very little. I bought the one book (that I know of) on the subject, read it and decided to try it along with some pureed food.

What is Baby Led Weaning?

It is a way of introducing a baby to solid foods without using purees. Baby is offered several foods at every meal and is not fed with a spoon. The baby chooses his own foods and learns how to feed himself. It encourages the use of foods that the family is eating, with only a few rules and foods that should be avoided in the beginning. The key is that it is started at 6 months and not before.

What Foods are Used with this Method?And What Should be Avoided?

The foods are cooked to a point of being soft, but not mushy. They should be easy to manage. Fruits and vegetables are best eaten when cut into stick shapes. Meats are offered on the bone, cut into strips or in large chunks. Mashed potatoes, cooked squash, or grains can be offered, but limited the amount of whole grains to avoid filling up too much. In the early days of feeding it is important that she get most of her nutrition from breast milk or formula. It is recommended to hold off on feeding milk (as a drink), nuts, tuna fish, honey, wheat, salt, sugar and processed foods. As long as the family meal doesnt include any of these things, baby can eat casseroles or other mixed dishes right along with the family.

What about allergies and introducing foods one at a time?

According to this method, as long as there is no family history of allergies it is considered safe to offer eggs, fats and dairy products (other than milk to drink) right away. The suggestion to introduce foods one at a time and only feed rice cereal for the first few weeks is based on the assumption that some parents will start solids at 4-5 months or earlier. At 6 months the digestive system can handle a wider variety of food than most people assume.

What is the parent/caregivers role during eating?

Ideally the whole family is together during mealtimes. The parent chooses what to offer her child and is there for support, but does not need to encourage the child to eat or help choose foods from the plate. It is important to offer a wide variety of foods, to ensure that she is getting enough of the nutrients she needs. The baby is in charge of deciding how much to eat at each meal. She has the ability to eat until she is satisfied and will know when to stop on her own.

Are there any potential risks with this feeding method?

It is essential to start this method at 6 months and not before. The digestive system and coordination for self feeding is not developed until about 6 months. If she is allowed to choose her own foods and feed herself, choking should not be an issue.

I will continue to add information on this subject from both my own experience and my research of journals and books.

For now here are some links:

Baby Led Weaning - "The Bible" that help start this approach(1)

La Leche League Discussion of BLW

IVillage - Mom or Baby Led Weaning?

Association of Breastfeeding Mothers (U.K.)

Today Finley had steel cut oatmeal with yogurt for breakfast. I spoon fed her a small amount and then allowed her to eat some with her hands. What a mess! I was not prepared for the mess this would make. It was fun to watch her play with the food and taste it when she wanted to. I can see how it is more natural to have her in control of when and what she eats. For lunch I will give her some squash and some leftover chicken.