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Sunday, March 9, 2014
Newborn and Infant Care
My daughter is seven months old and has a healthy appetite. I`m confused though because so many people tell me different things about feeding my child. She has been through and likes all the Gerber first foods and is now on Gerber 2nd foods. However, her pediatrician said to start her on little bits of steamed veggies, crackers and soft fruit. They said not to start her on meats or pastas yet. They also said the quanity of formula she drinks should be reducing. At the same time, I have friends who said their children were completely off baby food by nine months. What is OK to feed a baby this age? Not OK? What should be added over the next few months and when? What should be avoided? Also, her pediatrician said the amount of formula she drinks should decrease as she starts to eat more food. She doesn`t seem to take as many bottles on the weekend but still takes the same amount at daycare. Should I have them give her water or juice instead? Will the formula hurt her? On the weekends she takes about 3-4 bottles. At daycare she is taking 4-5 plus about 1 1/2 at home. I`m not sure why she takes so many more at daycare. I know she`s fed food there too. She is average in weight and a little above average in height. In fact, at her six month visit the doctor said she was getting trimmer. Please advise on proper nutrition and when she should be off baby food and formula? Also, she is on Enfamil but I wuld like to switch her to Carnation follow-up. the ped office says not enough tests have been done on Carnation yet the ads say it is easier on the baby. What`s the real scoop?
Your question and the different advice you have received illustrate the many different approaches to infant nutrition. I could go to ten different textbooks, nutrition guidelines, health care professionals, or other mothers---and come up with ten different recommendations about feeding your daughter. Although it is a basic physiologic need, there is no absolute "best" plan. I will give you some general infant nutrition guidelines, followed by my recommendation for you. Some general guidelines are: Human milk or a commercial infant formula (that is as close to human milk as possible) should form the primary diet for the infant until about 12 months of age. Solid foods are typically introduced when the infant shows signs that he/she is ready for solid foods, usually around 4 to 7 months. Most experts would recommend starting with iron-fortified cereals first, then adding strained vegetables, meats, and then fruit. After the infant is able to handle the strained foods, the consistency of the foods can be increased. Sometime around 9 months of age, the infant begins to take less mother`s milk or formula and is more interested in solid foods. This actually makes it easier to wean babies from breast or bottle, so that by around 12 months of age, they are able to drink from a cup. The type of solid foods that the infant can handle is somewhat dependent upon her dentition. She needs enough teeth to chew before she can handle some foods. You may want to provide both baby foods and regular foods for some meals. Now my recommendation to you is to remember that *you* are the expert when it comes to feeding your daughter. From what you have described, she seems to be thriving, so you must be making appropriate choices for her. I encourage you to listen to the advice of your pediatrician and follow your own instincts in feeding your baby. Don`t worry about what other people say or what their babies were eating. Mothers have been feeding babies since the beginning of time---this is an area in my opinion, mothers know best. Your daughter`s consumption of formula will go down as she eats more solid foods and her hunger is sated. I would imagine that the fact that she takes more formula in the daycare than at home is related to many factors. When you are feeding her solid foods, you have more time and experience feeding her than the best daycare worker--she just may eat more solid foods when you feed her, and need less formula to be full. Daycare workers may rely on more formula feeding than solid foods, because it is more convenient for them. Also she may be sucking the bottle as a comfort measure or just because---it`s there. Again, I wouldn`t worry about this--she will naturally decrease her consumption as she needs to. Now the one question that is remaining is the question of switching from an infant formula (Enfamil) to the new Carnation formula. I agree with your pediatrician that there is no evidence to "prove" that it offers an advantage to the infant. However, there is also no evidence that it would be detrimental to the infant. I believe that the Carnation product is less expensive than infant formula, so that may be a consideration. However, as you increase solid foods, her formula intake will decrease so you will need less formula. Since she seems to be thriving on Enfamil, and will be gradually decreasing the amount of formula she takes, I think I would opt to not switch the formula at this time. However, I do believe that she would probably do well on that product too. You may not be aware, but before there were commercial baby formulas, a whole generation of Americans were fed evaporated milk (such as Carnation) mixed with water and a little Karo syrup. So, Mom, my advice to you is to listen to the experts, then use your own judgement about feeding your daughter. You are the expert--we are just advisors. Best of luck.
Judy Wright Lott, RNC, NNP, DSN
Associate Professor of Nursing
College of Nursing
University of Cincinnati