PRESCRIPTIONS
Careful feeding required in baby's first year

By Amy Tousman

During those nine months of pregnancy, your baby ate whatever you did. Now that you've brought your bundle of joy home, what's he or she going to eat?

The first year is a time of rapid growth, a time when your baby's weight typically triples. At no other time do growth and development proceed at such a fast pace.

Healthy babies should be fed only breast milk or iron-fortified infant formula during the first four to six months of life outside the womb. Ideally, baby's first food should be breast milk. Even if you plan to use formula, it will be worthwhile to breast feed even for a few days. During the first two to three days after birth, the breasts produce a disease-fighting substance called colostrum, which protects against infections and colds. The longer you breast feed, the more protection your baby will have.

Rather than putting infants on a rigid feeding schedule, they should be fed on demand — that is, when they are hungry. This will help them avoid obesity later. In the first few months, babies are hungry every two to four hours.

Sometime between four and six months, it is good to add solid foods. Any earlier and you increase the chances of food allergies, digestion problems and choking. A baby should be ready for solid foods when he or she can:

• Sit up and keep the head up.
• Turn the head away to indicate fullness.
• Move the tongue from the front toward the back of the mouth to swallow foods.
• If formula-fed, drink eight ounces of formula at a meal and appear hungry again in less than four hours.

One new food should be introduced at a time. Feed the same food for several days before introducing a new food. This helps detect food allergies.

Rice cereal mixed with breast milk, formula or water should be offered first. Infants can easily digest it, and it rarely causes allergies. After rice cereal, other hot cereals can be added. Some babies are allergic to wheat cereals, so they should be last. All cereals should be iron-fortified because a baby's supply of stored iron gets low at about 4 months of age.

Between 5 and 7 months, strained or mashed vegetables, fruits and poi may be given. Between 6 and 8 months, 100-percent juices can be added. They should be diluted with water and offered in a cup. Canned drinks with low true-juice content and sugary syrups are not recommended.

During this time, meats and egg yolks can be served. Plain, strained meats are best. Egg whites can cause allergies, so only the yolk is recommended. Plain toast and teething biscuits also can be given.

Between 8 and 12 months, babies may be introduced to finely chopped or soft table foods. By this age, babies have a few teeth and can bite into and chew soft foods. Foods such as tofu, plain yogurt and cottage cheese can be added. Babies can practice feeding themselves finger foods such as unsweetened dry cereal, toast, crackers, soft cooked vegetable strips, peeled soft fruit pieces and cheese cubes.

When your baby turns 1, you may try adding whole milk and whole egg. Avoid serving skim or low-fat milk before age 2. Babies need the fat and cholesterol in whole milk for brain growth and development. All liquids should be served from a cup by this age.

By 1, babies usually can eat the same types of foods as the rest of the family. However, many foods still need to be cut in small pieces.

Foods such as hot-dog pieces, grapes, nuts, popcorn, peanut butter, raw vegetables and meat chunks can cause choking. These foods should be avoided until a child is 2 years old.

By the time you throw the first birthday lu'au, they should be able to drink from a cup and eat with a spoon. They will have come a long way in 12 months!

Amy Tousman is a registered dietitian at Straub Clinic & Hospital Inc. and a member of the Hawai'i Dietetic Association.

Hawai'i experts in traditional medicine, naturopathic medicine and diet take turns writing the Prescriptions column. Write: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; consult your doctor.