Baby Feeding & Nutrition

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• QHow should I feed my 1-year-old?

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  A RealAge answered

  Your child should be weaned off of pureed food at around 1 year; she can eat everything you eat if it is in chewable pieces (except potential allergens if there's a family history). Make sure foods are in pieces smaller than one half inch so they will not be choking hazards, and watch your child when he eats.

  Serve whole milk from 12 months up until age 2. Babies need the fat for brain development. After that, your doc may suggest that you switch to 2 percent milk. There's absolutely no need to give your child soda or even fruit juice, with the exception of prune juice for constipation and calcium-fortified orange juice if she doesn't drink milk. (But dilute these with equal parts water so that your child doesn't get used to overly sweet tastes.)

• QShould I give my child fruit juice?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  It’s actually best if you don’t. Your infant or toddler does not need juice. Although 100% fruit juice may contain some useful vitamins, juice often ends up being extra sugar and calories that your child doesn’t need. Plus, juice doesn’t have the valuable fiber found in fruit. One of the best things you can do for your child’s future nutritional health is to get your infant used to drinking water. How many adults do you know who don’t like plain water? It’s often because they didn’t get used to the taste when they were young.
  Even watered-down juice on a regular basis can get your child in the habit of wanting sweet-tasting beverages. It’s best to stick with water and milk whenever possible. If you do choose to give your child juice, keep it under 4 to 6 ounces a day. Treat sweet-tasting drinks like you would a dessert—on special occasions, let your toddler choose juice or another sweet treat such as cake. You might be surprised at his choice.
  An exception to this recommendation is if your baby is constipated. In such cases, your pediatrician may recommend small amounts of prune, apple, or pear juice along with a high-fiber diet to help with this problem.

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• QWhat are some signs that my baby is allergic to infant formula?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  Signs of a true milk protein allergy are usually not subtle. You may see hives (blotchy red skin rash), eczema, facial swelling, vomiting, or trouble breathing. Another type of formula allergy may produce bloody diarrhea and poor weight gain. There are some babies, however, who may have more mild symptoms such as spitting up, fussiness, and changes in stool pattern. Always talk to your pediatrician if you are concerned that your baby may have a milk or other food allergy.
  
  If your baby experiences any trouble breathing, facial swelling, vomiting, or hives, call your pediatrician immediately. The doctor may recommend that your baby be given a soy-based or hypoallergenic formula.
• QWhat are the preparations of infant formula?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  The following preparations of infant formula are available:
  
  • Ready to feed: As the name states, your baby can drink the formula as is. Although convenient for travel if you can’t or don’t want to carry water for mixing, the bottles are heavy to carry around and often more expensive.
  
  • Liquid concentrate: Easy to mix—you simply add equal parts of the liquid formula and water, shake, and feed. Again, it is heavier to haul around in your baby bag and a slightly more expensive option than powder.
  
  • Powder: This preparation is the most commonly used and least expensive option. Also, powder is fairly light to carry. The mixing ratio is 2 ounces of water for 1 scoop of powder formula. Simply shake or stir and then serve.
• QWhat are the nutritional additives found in infant formula?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  The following additives are in infant formula:
  
  • Iron: Iron is vital for blood and brain development. Contrary to popular belief, iron in formula does not cause constipation. More importantly, low-iron formulas do not contain enough iron for a baby’s growing needs.
  
  • DHA and ARA: These are 2 fatty acids (lipids) that naturally occur in breast milk and are thought to be important in brain and eye development. DHA and ARA have now been added to many formulas.
  
  • Probiotics: Similar to those found in yogurt with live bacteria cultures, probiotics have recently been added to some infant formula. Although the use of probiotics is advertised as leading to a healthier immune system and decreased infant illness, more studies need to be done on the risks and benefits.
  
  • Organic: New on the market are organic formulas. They are certified to be pesticide, antibiotic and growth hormone free. Only time and research will tell if there is any medical benefit, but if buying organic is important
  to you, it is fine. Just make sure you buy a reputable brand to ensure that it contains everything your baby needs to grow and develop.
• QWhat foods should I avoid giving my baby?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  Avoid giving your baby the following:

  • Honey: Never give a baby younger than 1 year honey because of the risk of infant botulism, a deadly disease. Babies, unlike older children and adults, don’t have the ability to fight the botulinum toxin contained in honey.

  • Choking hazards: Whole nuts, grapes, popcorn, hot dogs, and raw carrots are serious choking hazards, so keep these and other small or hard foods away from infants and toddlers.

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• QWhen can I start giving my baby water?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  

  There is no need to give any water, sugar water, electrolyte solutions (such as Pedialyte, Enfalyte, or LiquiLyte), or juice to newborns unless directed by your pediatrician. Breast milk or formula is all your baby needs.
  
  Once your infant starts solids, around 4 to 6 months of age, you can start introducing water at mealtimes. Getting your infant used to the taste of water (instead of sweet beverages) will create a healthy habit for life.
  
  Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions About Babies and Toddlers
• QWhat foods should I first feed my baby?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  As far as which cereal to try first, it depends on what's coming out the other end. If Junior is a loose pooper (sounds like a Seinfeld character, eh?), start with oatmeal or rice baby cereals, which are more constipating. If she's plugged up, then start with barley baby cereal, which makes stools looser. Whichever you choose, try it at least four days in a row, unless she gets a rash on her bottom, vomits profusely each time you try it, or has another dramatic reaction. If she does, she may have a food allergy, and you should stop giving her that food immediately.
  
  After those first four days, you can add another food. Keep following this pattern, trying each new food for four days before adding another one. Your early options include:
  

  • Another kind of cereal.
  • Puréed vegetables such as green beans, carrots, peas, squash, and sweet potatoes. Make sure to alternate green and orange ones; too many orange foods can make your kid look orange -- that's called carotenemia.
  • Baby fruits, like applesauce, bananas, pears, apricots, and peaches. Don't mix these with the cereal, because once she has cereal with fruit, she won't want to eat it plain ever again!

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• QHow can I help my baby avoid weight problems later in life?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  Here are four ways to improve your baby's odds of not having weight problems. They begin with a healthy pregnancy, of course. Some of this new research may surprise you, and scientists don't totally understand all of it yet, but not doing these is strongly associated with childhood obesity by age 7.
  

  1. If you smoke, stop today. It's important for weight problems as well as for many other medical reasons. Don't go near anyone who smokes either. Secondhand smoke is just as bad.
  2. Limit how much "baby weight" you gain. The healthier your weight during pregnancy, the better for both of you. Extra fat cells in your body teach the fetus that extra fat cells are essential for survival. Also, the more you weigh now, the less you should gain during pregnancy. If you're overweight, gain 15 to 25 pounds tops; if you're obese, 11 to 20 pounds. During the first trimester, a typical mom-to-be needs only 100 extra calories a day (a glass of skim milk); during the second trimester, 250 calories (10 walnut halves and an apple); during the third, 300 calories (three pieces of fruit).
  3. Breastfeed for 12 months. It's what the American Academy of Pediatrics recommends for multiple health reasons. Not only will it help your baby avoid obesity later, it will also help you lose weight after pregnancy.
  4. After your baby is born, be sure she sleeps at least 12 hours a day. Not getting this much sleep early in life is strongly associated with childhood obesity later.

  
  
• QWhen can I give my baby solid food?

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  A Dr. Tanya R. Altmann, MD , Pediatrics, answered

  The American Academy of Pediatrics and most pediatricians recommend starting solids around 6 months of age, depending on when your infant is ready.
  
  So how do you know when your infant is ready? All babies grow and develop at slightly different rates, and although some cultures start solids in the first few months with no apparent harmful effects, this isn't generally recommended because your infant really isn't developmentally ready for solid food yet.
  
  First, she has to have good head control, which most infants demonstrate around 6-months of age. In addition, she needs to be able to move the food with her tongue from the front to the back of her mouth, also something that occurs around 6 months. If you put a small amount of rice cereal on her tongue and she pushes it out of her mouth (tongue thrust reflex), she may not be developmentally ready for solid food. But if she is drinking more than 36 ounces a day, it’s probably time for a bit of solid nutrition. Another sign you will begin to notice around this age is that she may pull away from the breast and bottle, looking around for other interesting things to do (or eventually eat). She may also watch you intently as you eat.
  
  As long as your baby is at least 4 months old and meeting most of these criteria, go ahead and talk to your pediatrician about trying solids. If she spits the food out, simply wait a few days and try again.

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