Feeding New Babies New Foods

This week's guest columnist is Dr. Nichole Miller, a family practice resident at the University Health Center here in Lafayette.  Dr. Miller has a four-month old baby, and know of what she speaks: Brandon's mom was excited, her baby is 6 months-old, sits up without much assistance, and is now interested in food.  Great!  What a big step in little guy's development.  But now: "Which foods should I start with?  Is he really ready to eat foods?  What if he has food allergies?  Sheesh, why is it so complicated?" Every parent's journey includes the exciting time of feeding foods for the first time.  This new adventure comes with those questions.  According to the American Academy of Pediatrics (AAP), babies are ready for solids when they can hold their heads up, sit with minimal support, and open their mouths to food.  Easy enough, right?  But again, what foods to start?  Start with simple puree foods, like baby cereals.  Vegetables should come before fruits.  No highly allergic foods, like foods containing peanuts or egg. Give one new food at a time and wait three days before introducing another new food.  This helps identify any food allergies your child may have- if baby starts with a bad rash, vomiting, or diarrhea after eating that new food, stop serving it.  If you give new foods too close together, you can't know which one caused the rash. Let's fast-forward: Brandon is now one year and his mom is at the next hurdle, the picky eater stage.  Every parent worries about picky eaters.  The AAP reminds parents that toddlers sometimes just aren't hungry.  Brandon may eat all his breakfast and not touch lunch or dinner.  Instead of fighting about food, offer a variety of foods and let your toddler choose.  Whatever he doesn't eat, offer it at the next meal.  Remember the four main food groups: meat, dairy, fruits and vegetables, and breads and cereals.  Offer items from each group.  Avoid highly processed foods, which means foods which are highly packaged and have ingredients you can't pronounce. That covers the "do's" of feeding toddlers food, let's talk about the "don'ts."  Say Brandon still won't eat any foods, only drinks milk.  Milk is good for a kid, right?  So mom feeds him all the milk he wants- four 8-ounce bottles per day.  Since he won't eat meals, she lets him snack all day.  This is common with new parents and toddlers, and reveals three don'ts.  First, no bottles after one year- kids should drink from sippy cups.  Second, toddlers shouldn't drink more than three 4-ounce cups of milk per day- more than that kills their appetite for foods, and filling up on milk robs a kid of important food nutrients.  Finally, snacking also kills appetites for meals, and snack-grazing behavior contributes to obesity. However, Brandons' parents read our blog and he is eating a variety of foods and is doing great.  Now Brandon's dad offers him grapes.  He eats one and begins to choke.  Mom panics, pounds him on the back, and he coughs up a barely-chewed grape.  Many small firm foods are choking hazards for toddlers because they don't know how to grind their food while chewing.  The AAP recommends the following foods be avoided: un-cut hot dogs, hard candies, nuts, peanut butter chunks, popcorn, seeds, whole grapes, and the like.  Parents should take a CPR class to learn choking management like the Heimlich maneuver. Another food concern is eating things that aren't food.  Say Brandon is now 7 years-old and in T-ball.  He just finished a game and is enjoying some sunflower seeds like real baseball players.  However, unlike the guys on TV, he is swallowing the shells with the seeds instead of spitting them out.  The next day, Brandon has terrible pain when pooping.  The pain gets so bad he's brought to the Emergency Department.  On x-ray, we see the shells stacking up and forming an impaction in Brandon's rectum.  Also, the shells' sharp edges hurt like broken glass.  Brandon has to go the Operating Room to get the horrible impaction out. Parents, never let your kids eat sunflower seed shells- just the seeds please!  Leave the shell eating-and-spitting to the pros, who get paid to do that on TV.