Expert: Sally Wendkos Olds - 3/1/2008

Question
I have a 5 month old who I breastfeed.  He seems to be gaining weight okay (7lbs7oz @ birth; 11lbs14oz @ 2months; 14lbs3oz @4 months).  Yesterday, I fed him about 1 tsp of rice cereal thinned out with breastmilk (mostly liquidy).  He seems to like and want to eat it.  However, I have read that when you introduce solids early your milk supply decreases.  I am a bit worried that I have just enough milk for him--he sleeps early at 5pm, I pump at 9pm, he wakes up for feeding around 3am.  Should I wait until 6 months for solids?

Answer
Dear Mai,

First, congratulations for giving your son the best start in life by breastfeeding him!

The American Academy of Pediatrics does recommend exclusive breastfeeding until 6 months, but many pediatricians feel that it's okay to introduce solid foods at about 4 months. So you're well within that window. If your son seems content with breast milk alone, you might wait another month to give him solids. But if you want to start now, that would be okay too. Do what feels most comfortable for you.

I am attaching an excerpt from my book (see below) with suggestions for introducing solid foods.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks, M.D.
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Offering Solid Foods
• Nurse your baby first before you offer her food by spoon. She’ll be more open to trying a new experience if she isn’t wildly hungry.
• Pick a time when there are few distractions, and both you and your baby are relaxed.
• Sit her on your lap, where she will feel secure.
• Introduce a single-ingredient food first. If your baby develops a rash or any other symptom, you’ll be able to identify a possible cause.
• The first serving should be between one-half and one teaspoon of food.
• Use a spoon—the kind with a small bowl and a long handle works best. Do not feed solids from a bottle, since that can release too much food at once, causing a baby to choke.
• Start spoon-feeding by putting a little food into the bowl of the spoon, turning the spoon upside down, and scraping the food onto the top of the baby’s tongue. He will easily propel the food to the back of his mouth where he will swallow it. He’ll probably like it and will want more.
• Introduce new foods one at a time, over a fairly long period of time: There’s no need to rush in with a cornucopia of new foods.
• One good first food is iron-fortified rice cereal mixed with expressed breast milk, water, or formula; after your baby is a year old you can use homogenized milk. Rice is a good starter, since babies are least likely to be allergic to it.
• A good progression after iron-fortified rice cereal includes other cereals, fruits, vegetables, and meats. Among babies’ most enjoyed flavors are those of applesauce, bananas, pears, peas, carrots, and squash.
• Do not feed your baby directly from a jar of baby food. Take out the amount you plan to feed, and refrigerate the rest. If the baby doesn’t eat all of the food you removed, throw away whatever is left. The saliva that goes back into the food can foster the growth of bacteria.
• Do not heat food in a microwave; it may heat unevenly and make food too hot.
• Consider these first few feedings of solid foods “practice feeds,” just like those first few nursings so many months ago. Your baby now has to learn how to master a completely new set of muscle movements to take the food from a spoon and to swallow it. At first she’ll get more food on her face, her bib, and you than she will in her mouth. You’ll be surprised, though, at how quickly she’ll catch on, and how soon she’ll be ready to start eating foods she can pick up with her fingers.
• Ask your pediatrician which finger foods are safe for your baby. Some, like raw carrot or even zwieback, can cause choking if they’re given to a baby who cannot properly chew and swallow small enough amounts.
• Avoid, as much as possible, foods that contain added sugar, salt, and starch. You can make your own baby foods (which can be as easy as using a fork to mash a ripe banana or cooked peas). Or you can buy organic baby foods. Jarred foods may be more convenient when you are traveling, or when your table food is not appropriate for your baby.
• In any case, read the labels and graduate your child to table food as soon as she is ready. Commercial “stage 3,” “junior,” or “toddler” foods are unnecessary and costly.