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The New Rules of Introducing Solids to Your Baby

Jeanine Henderson

When my son Jules was 5 1/2 months old, I visited a lactation consultant for help with a stressful milk-supply situation. “I'm pumping three times a day at work, and before bed, and I'm still not sure he's getting enough milk,” I told her. “How can I increase my supply?” Eager for a solution, I continued my barrage of questions. When I paused for a breath, she asked: “Have you tried introducing solids yet?” “Oh no, not yet,” I told her. “The American Academy of Pediatrics (AAP) recommends breast milk exclusively for the first 6 months, so I was waiting until then.” Exactly then. Obviously, I follow rules religiously. She commented that, at the time, the AAP recommended starting solids between 4 and 6 months. She helped me identify the signs that Jules might be ready for “real” food. Could he hold his head up and sit while supported? Yep. Did he seem to be interested in our food? Considering he'd swatted at the seaweed salad dangling from my chopsticks the night before, I'd say so. My pediatrician thought starting solids was a great plan. That night, we offered Jules pears, and he ate like a pro. I kept nursing and pumping, and combined with solids, the milk I was making was enough — just as nature planned. Disagreement within the AAP's committee on nutrition and breastfeeding fueled the dueling rules — introduce foods between 4 and 6 months and breastfeed exclusively for six. Since then, the AAP has settled on a unified message: Introduce solids between 4 and 6 months while continuing to nurse, avoiding formula if possible. Could it be that there were other infant-feeding revisions I'd overlooked? As it turns out, there are a number of baby food rules many moms take as gospel that now border on myths. Reconsider these, and you may just sidestep a slew of obstacles.

6 Rules Worth Rethinking 

1. For healthier purées, make your own. While making your own might save you money, homemade baby food is generally not any healthier than the store-bought purées, says Melinda Johnson R.D., a lecturer in child and family nutrition at Arizona State University. “Both canned and jarred baby foods are very nutritious,” says Johnson. “[Purées] contain just the food plus some water to get the right thickness without unhealthy add-ins like sugars or salt.” Of course, always scan the label for any additions, just in case. “Even sugar in the form of fruit juice concentrate is not a good choice for babies,” says Johnson. (It's full of “empty” calories, just like any other added sugar.) And, yes, making your own purées definitely expands your options — but the variety of baby food flavors on the market is changing to encourage the development of a more sophisticated palate. “As a parent who once thought only homemade baby foods were healthy, I discovered such a great array of premade, organic fruit and vegetable combos that now I give my son both,” says Marie Roker-Jones, mom to Logan, 9 months. “I make purées to save money and use the premade ones for convenience.” “While it might save you money, homemade baby food isn't any healthier than store-bought purées.”

2. Introduce vegetables before fruits or baby might refuse them. We're all born with an innate preference for sweet foods — beginning with breast milk — but “it's a myth that if you start with fruits, they're not going to like vegetables,” says pediatrician Jillian Parekh M.D., assistant clinical professor at Albert Einstein College of Medicine in the Bronx, New York. In some cases, offering a fruit and a sweet vegetable like carrots or sweet potatoes before a vegetable like green beans might work best. Keyla Kirton of West Babylon, New York, thinks giving her son mashed bananas as a first food — as is custom in her native Panamanian culture — is a prime reason now 2-year-old Matthew “eats almost anything.” With his older sister, “I ignored my family's traditions and gave her veggies first and waited until she was almost 8 months,” Kirton says. “Now, at 7, she's a very picky eater.” Branch out beyond carrots and peas. Your child is most open to trying new tastes between 6 months and a year, so bombard her with flavors then. Research suggests it could take 15 times before baby will accept a new food, so the first few bites may be a bust. If you know she already likes something, mix it in.

3. Wait until baby's at least a year old before giving him eggs, fish or peanut butter.  Your mother's advice is probably outdated (she put you to bed on your belly in a drop-side crib with fluffy blankets for goodness sake!), but even parents your age might have outdated info. When I started feeding Jules solids, it was recommended to wait beyond baby's first birthday to introduce three highly allergenic foods: eggs, fish and peanut butter. In 2010, the AAP amended its stance. “Unless you have a high family history [of food allergy], you don't need to wait anymore,” says Jatinder Bhatia M.D., chair of the committee on nutrition for the AAP. “You can offer eggs and shrimp.” Nuts are OK too. Nithya Das of Brooklyn, New York, a first generation Indian-American, introduced her daughter, now 2, to cashews, almonds and peanuts (puréed!) at about 10 months. “It was a priority to introduce Indian flavors at an early age, including nuts,” says Das, who runs the website halfpintgourmet.com, a healthy recipe resource for parents. “We don't have any nut allergies in our family, so I was comfortable giving her these. I'm always vigilant about keeping an eye out for an allergic reaction.” Offering new foods one at a time, three days apart, will help you easily track an allergic reaction or sensitivity back to the offending food.

4. The first solid food you introduce should be rice cereal.  Rice cereal is a commonly recommended food because it's unlikely to cause an allergic reaction, and it's fortified with iron, which is especially important for babies who are exclusively breastfed and don't get extra iron from formula, says Jennifer Shu M.D., spokeswoman for the AAP. But, really, you can start with whatever you'd like. “I skipped right past the cereal to mashed banana and puréed sweet potatoes, which worked well for us,” says Cristen Pantano, mother of two in Pittstown, New Jersey. Or consider starting with puréed meat: Red meat is naturally rich in iron, which is why pediatricians are increasingly recommending it as a first food, says Dr. Shu. Early eating experiences are about helping your child figure out how to use her tongue, not to mention utensils, so whatever you choose for those first spoonfuls, take a low-key approach to offering it. “This is all a new adventure for your baby, so enjoy the experience,” says Tina Ruggiero R.D., co-author of The Best Homemade Baby Food on the Planet.

5. Between ages 1 and 2, all toddlers need whole milk. Yes, babies' developing brains need fat, but clinical trials have repeatedly shown that “reduced-fat milk [2 percent] will support their development just as well [as whole milk],” says Bhatia. Taking these studies — and the skyrocketing rate of childhood obesity — into consideration, the AAP issued a policy paper in 2008 stating “for children between 12 months and 2 years of age for whom overweight or obesity is a concern or who have a family history of obesity the use of reduced-fat milk would be appropriate.” There's a movement among some pediatricians (including Bhatia and others within the AAP) to broaden this reduced-fat milk recommendation to be the general rule for toddlers 12 to 24 months. “You're trying to create lifelong habits,” says Bhatia. “And [if you started on whole milk] it can be difficult to suddenly start drinking reduced-fat milk.” (If you've ever tried to switch from cream to skim milk in your coffee, you get it.) Sumara Case, a mom of two in Buffalo, New York, is on board with the above recommendations. “I wasn't worried about my daughter getting enough fat since she was eating healthy fats from other foods,” says Case. Not sure whether 2-percent or whole milk is best for your toddler? Talk to your pediatrician.

6. Baby sets the schedule. During your baby's first few months, it's true that you should feed him when he wants to eat, which helps baby learn to recognize hunger and fullness. But as your child nears his first birthday, transition to a more structured meal and snack schedule, says Johnson. “We have a generation of kids who are still feeding on demand, which is leading to grazing during the day and then picky eating at the table because they never get truly hungry before mealtime.” Offer a meal or snack every two to three hours — have him sit down at the table to eat — and avoid snacks and sippy cups (except for water) in between. “That way your little one can build up a bit of an appetite, which makes the food you're serving for dinner more appealing,” says Johnson. My husband, Jon Olin, says not filling a cup of milk for our 19-month-old son every time he asked for it took a little getting used to. “You want to make sure he's getting everything he needs and, because you've been trained to respond so much during the first year, you assume that they're telling you what they need, when they need it,” says Olin. “But then he wasn't eating very well at meals. We cut out the on-demand milk, offered water instead, and his appetite at the table improved.”

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