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INFANT NUTRITION
By Kimberlee Blyden-Taylor
Doctor of Naturopathic Medicine
Organic is always the best choice.
What to feed first?
This decision can be a source of considerable anxiety for many new parents. Everybody seems to have different advice and every book has a different answer. I developed the food introduction schedules below based on medical nutrition textbooks, the latest research articles, naturopathic writings, the many healthy babies in my own clinical practice, and my own 2 babies. What I think makes these tables practical is that they are based not just on which foods have what vitamins but also on what an actual baby will actually eat!
Is Baby Ready?
The World Health Organization recommends waiting until six months of age, at the earliest, to introduce solid foods. Babies’ intestines do not produce adequate enzymes earlier than this. The intestinal enzymes change with the eruption of the first teeth and now baby is ready to digest solid food. Early introduction of solids increases the rate of food allergies, colds, earaches and diarrhea in the first several years. Baby will tell you she’s ready for solids when she starts cutting her first few teeth, grabbing for your food, and generally increasing her demand for breastmilk (or formula). A baby who is slow cutting teeth may not want much solid food until those first few teeth come through. If mom is eating healthfully, and baby is breastfeeding adequately, there is no worry if baby does not start solids "on time". Bring baby in for check-ups at 6, 9, and 12 months to ensure baby is developing properly.
First Foods: Grains or Veg? Or Fruit??
What should be first? I like brown rice cereal first, mixed with breastmilk (or formula – be sure to see the "Naturopathic" Formula recipe at the end of this article). Brown rice is highly digestible (more so than the cellulose of veg/fruit), nourishing to Spleen Qi (digestive energy), and has very little texture and taste. Babies are usually more fussy about texture in new foods, than taste. Baby’s very first feeding should be at a time when she is well-rested, in a good mood, and hungry, but not ravenous. Mix a teaspoon of brown rice cereal into breastmilk and let baby experiment. Let her touch it, play with it, smell it, and generally have fun. Avoid mealtimes being a battle of wills between feeder and eater – very little will get eaten and nothing will be properly digested. The goal from 6-9 months of age is to introduce baby to the concepts of mealtimes and eating, NOT to actually get large amounts of food into baby. This approach takes the pressure off of both you and baby and generally more food actually does get eaten!
Ideally new foods should be added one at a time, with 2-3 days between each new food. Watch for any adverse reactions such as diaper rash, rash around mouth (or anywhere else on body), runny nose, watery eyes, irritability, lethargy, or "hyperactive" behaviour. If there has been a possible reaction, test the food again one week later to confirm. If baby reacts a second time, eliminate the food for 6 weeks before trying again. Second, try mixing in a little apple or pearsauce into the brown rice cereal and breastmilk. Babies generally like the taste of fruits and the sweetness is significantly reduced by mixing them into cereal. Many people worry that a baby who is introduced to fruits first won’t eat vegetables. I generally see the opposite in my clinic. Babies who enjoy foods and mealtimes are generally willing to try all sorts of foods. After a few fruits, try mashed avocado mixed into the rice cereal. Avocado is light tasting and high in essential fatty acids.
Some babies won’t seem interested in these first purees, prefering to smell, touch and gingerly taste things off of your plate. If this is the case, go with baby’s flow! Make sure she is picking up foods she can mash with her tongue against the roof of her mouth (e.g. a very ripe avocado chunk), and that the foods are unseasoned (no butter, salt, spices, sugar, etc.) Once baby starts making faces, turning her head or pushing foods away, respond promptly to her cues and end the meal. This way she knows she has control in the feeding process. A baby who is allowed to follow her own hunger/eating cues will eat only when hungry and will stop when she is full. These children have been shown to have significantly lower rates of obesity and eating disorders then children who are made to eat after they have indicated they are finished.
It’s true that babies thrive on routine. Everything in their world is new; routine gives baby some known solid ground from which to try new things. Get into a routine around mealtime. Start with one solid feeding a day. Breakfast is often a good choice because baby is well-rested. Be sure not to breastfeed too much in the morning or else baby won’t be hungry enough for solids. Once baby is eating a fair amount at breakfast, add a second feeding to the day. I usually choose dinner, as baby can be part of the family routine and is generally rested enough from her afternoon nap.
There is considerable debate over supplementation of iron, zinc and vitamin D in breastfed babies. Most infants are iron-replete at six months, but past six months their supply declines. Even though human milk is a rather poor source of iron, its absorption rate is much higher (50%) than that of iron-fortified formula (4%) or cow’s milk (10%). Likewise, zinc has a higher absorptive rate in human milk than cow’s milk, but is very dependant on mom’s intake. I recommend that every nursing mom take a high quality multivitamin and extra zinc (25-50mg/day). Mom and baby should be outside at least 15-30 minutes every day in order to make adequate levels of Vitamin D.
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