Wed, 16 Jul 2003

Baby food, serious issue for parents

Dear Dr. Donya,

I am the mother of a five-month-old baby boy, my second child. When he was four months old, I started to introduce solid food, apple sauce and bananas. I tried each type for a week, but unfortunately he did not seem ready, as he refusing the food by screaming and closing his mouth tight. I stopped for a week and then tried again, but he still refused to eat solid food.

My questions are: At the latest, at what age must he start taking solid food? Six months? What is the best feeding schedule for a beginner? Is vomiting common in babies younger than six months? At what point should we consider seeing a specialist, in terms of how frequently vomiting occurs in a day?

Separately, he also has a sweat, cold hands and feet. I would highly appreciate your advice on this also.

Thank you.

-- Patricia

Dear Patricia,

Solid food can be introduced from an age of four months up to six months. Below are the physical characteristics of a baby ready to eat solid foods: * Able to sit up and control head movements. * Able to control upper body movements and pull food toward them when it is wanted, or push it away when they are full. * Doesn't keep pushing food out with their tongue.

When you start, use a very small spoon for feeding solid foods, and introduce only one food at a time. Wait a week before introducing another food and always watch to see if the baby has any reaction such as vomiting, diarrhea, wheezing or a skin rash.

If you feed only one new food at a time and there is no reaction, you can continue feeding that food without being concerned about possible allergies.

If your baby doesn't want to eat a new food, don't force feed. Offer it again the next day. If the food is still refused, wait two or three weeks before offering it again.

Dry-packed iron-fortified baby cereals mixed with breast milk, milk formula or water are usually the first solid foods to give to infants, as they meet the baby's iron requirements.

To mix your baby's first cereal helping, use one teaspoon dry cereal with two tablespoons of breast milk, milk formula or water. The mixture should be very thin.

As your baby is able to accept more food, mix equal parts liquid to dry cereal. Do not use raw or pasteurized cow's milk to mix cereal. Cow's milk is difficult for a baby's system to digest until after one year of age.

At first, give only a small amount of cereal -- about one teaspoon twice a day. Gradually increase it to two to three tablespoons twice a day. Remember, your baby's appetite for food will be small at first. Learn your baby's body language indicating that he is full, such as starting to play, blowing bubbles, pushing the spoon away or turning the head. Respect your baby's signaling that he is full.

You can introduce strained vegetables and fruits after the baby is comfortable with eating cereal. Vegetables are usually introduced first, because starting with the sweet taste of fruits may make some vegetables less appealing.

Introduce one vegetable or fruit at a time. Begin by adding mild-flavored vegetables such as carrots, sweet potatoes and green beans to your baby's diet, and then add peaches, apple sauce and pears. After your baby has accepted several kinds of vegetables, offer two different varieties each day for added nutrition.

Offer strained, lean meats after your baby fully accepts vegetables and fruits. As with cereals, vegetables and fruits, offer a single kind of meat at a time. Processed meat dinners are not recommended, because they have less protein than single ingredient foods such as strained meats or vegetables. Introduce cooked egg yolks after meats have been accepted. Egg whites may cause a reaction and should not be introduced until after your baby's first birthday.

In regards vomiting, it depends on the cause. Is the cause a dislike for a particular food, overeating or an illness? You have to be clearer about the circumstances of his vomiting. He may have an allergy to bananas if he keeps vomiting after eating it.

If young children start to vomit and it has never happened before, it can be serious. Here are symptoms to watch for before taking your child to a doctor: Cannot take in any liquids, no urination in the past six hours, urine is orange in color, continuous vomiting, change in consciousness and drowsiness.

-- Dr. Donya