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Guidelines for
Introducing Solids
by Dr.
Rosemarie Thomas, Paediatrician
The World Health Organization and the American
Academy of Pediatrics, both recommend as the gold standard,
exclusive breast‑feeding to age 6 months. If not breast, an infant
formula that contains iron [not low iron] should be used. Baby's
stomach doesn't have the enzymes to digest anything but lactose [the
sugar in milk]. The iron in breast milk, or iron fortified formulas
is needed for brain growth. Extra water is not needed.
Solids may be introduced between 4 to 6
months.
At this time, baby is developmentally ready, by
losing the tongue‑pushing reflex [4 months], and by sitting up
unsupported [six months].
- Start Solids: Cereal in a bowl with breast
milk or formula. In T&T, we love to add cereal to the bottle, and
make milk tea. This habit should be discouraged, as it prevents the
baby from learning to advance to an adult type diet and one may
overfeed, and encourage obesity. Start with rice, as this causes
fewer allergies.
- Fruit: Fresh such as
banana/mango/watermelon or applesauce etc. Fresh fruit is always
better, but jar foods may be used also. We are blessed with an
abundance of fresh fruit in our twin islands!
- Juice: Fresh squeezed to cup or bottle
e.g. watermelon, carrot, grape or apple. Some experts advise
starting citrus a little later, because of higher incidence of
allergies.
- Extra water may be given
- Introduce one new food at a time, every 2
to 3 days, in case of allergic reactions.
6 ‑ 9 Months
- Finger foods‑bread/crackers
- Porridge e.g. cream of wheat, oats
- Calaloo/mashed potato/eddoes/dasheen/yam
- Split pea‑dhal consistency
- High chair useful, as baby is now sitting
up, baby should have 3 meals a day.
No extra salt or sugar needed
7 – 9 Months
Aim is to be eating out of the family pot by
age 9 months. Offer strips of chicken or beef or fish or more
legumes [if vegetarian]. At this age, your baby should be having
three meals a day. The volume of milk consumed will decrease: you
may start offering the cup for drinks, including milk. Baby’s rate
of growth will be slower.
I year
Milk is no longer the main food source. Your
baby should be off the bottle [latest 15mths] and consuming other
solid foods. By this age not more than 2 cups of milk per day [as
cereal or drink] is the recommended intake. You may change to cow's
milk. Before l year of age, cow's milk has insufficient iron, and
causes hidden bleeding from baby's gut. Offer milk in cup or with
a straw.
If your baby is still consuming large volumes
of milk at this age, there is a risk of problems of anaemia, poor
growth and dental caries [bottles in the mouth, especially at night
promote caries]. Late weaning is difficult to interrupt, since
habits are difficult to change. It is therefore best to discontinue
the bottle by one year to fifteen months and introduce a varied
solid diet.
Dr.
Rosemarie Thomas, Paediatrician, Lajoya Pediatrice Centre.
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