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As recommendations change for introducing infants to solid foods, even some veteran parents may benefit from some new approaches.

Pediatrician Joe Maurer of The Children’s Clinic of the Children’s Hospital of Greenville Health System said current guidelines have changed.

First, Maurer said a child should sit up and show interest in food around 4 – 6  months of age.

“It’s not natural to feed a child when he or she can only lie on his her or her back,” Maurer said.

Breast milk or formula should remain the primary source of nutrition, he said, given before or after a solid feeding, gradually reducing the intake of liquid nutrition at the baby’s own pace.

“Parents don’t need to actively wean them,” Maurer said.

Try one new food — such as pureed fruit or vegetables — at a time, waiting three to four days to observe reaction, Maurer said.

Previously, parents had been advised to delay peanut butter until babies became toddlers. Now, Maurer said the new recommendation is exposure at 6 months of age. Families with a severe history of allergies should seek additional medical guidance, as special monitoring may be needed. In the absence of family history of allergy, however, Maurer recommends a “small spoonful once a week” to get babies used to the allergic component.

A new theory circulating on alternative wellness sites that claims babies do not have the enzymes to break down rice is controversial, Maurer said. Instead, he suggests parents watch for fussiness or digestive problems and “use common sense” to decide whether rice cereal is an acceptable choice for their babies.

Maurer is a fan of the trend of baby-led weaning, where parents skip jarred food.

“It helps children develop cognition and motor skills,” Maurer said. “It offers many advantages, including a better transition to independence when babies move to adult food.”

Some early research suggests baby-led weaning may also reduce risk of obesity, he said.

Maurer said products marketed as infant “puffs” may have healthy-sounding names but actually offer low levels of nutrition.

Although babies picking up these small cereals develop coordination, parents should avoid additives and preservatives, he said.

Organic or homemade baby foods, however, are not necessary if parents watch nutrient levels carefully, Maurer said.

“If paying more for organic food causes home stress and does not make economic sense, there are plenty of foods that are healthy (without any added junk),” he said.

When’s the best time to add whole milk?

At age 1, toddlers can transition to milk, Maurer said.

Whole milk is typical until age 2, he said, unless a family has obesity concerns, in which case a doctor may suggest 2 percent low-fat milk.

After age 2, skim milk or 2 percent  milk is acceptable, but families should consider calorie content, he said.

If a child has a milk protein allergy, Maurer recommends enriched soy milk, which contains calcium, vitamin D and protein.

“If (soy milk) is not tolerated, a family may move to almond or other dairy-free products,” he said, “but should pay close attention to the nutritional labels and make sure a child is getting the vitamins and minerals necessary.”

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