10 FAQs regarding infant feeding

Today’s technology, computers and the World Wide Web have transformed our world into a global village. Gone are the days of pulling out a dusty encyclopaedia when you needed some information. Today we are spoilt and by the click of the button, we have access to pages and pages of up to date information.

The question is, however, how can we tell which information is credible and scientifically based and which isn’t? How can we tell which information is recent and which is outdated?

In order to help along the way, here are some frequently asked questions relating to infant feeding which I hope will help all parents along the way.

1. At what age should solids be introduced?

The debate on when is the best time to introduce solids is age old. It is generally recommended to introduce solids between the ages of four to six months depending on the readiness of your baby. It is important to not introduce solids too early (i.e. before 17 weeks of age) or too late (i.e. after six months of age).

The World Health Organisation recommends introducing solids at six months of age. It is best to use this timeline as a guide and to focus more on your baby’s cues that they are ready for solids during this time. All babies develop differently and some are ready to go with food at four months, while others are quite content with their milk until five or six months.

Here are some all-important signs that your baby is getting ready for solids:

• Baby’s ability to hold up their head.
• Their ability to sit well with support.
• Seems dissatisfied after milk feeds.
• Showing an increased interest in your food at family mealtimes.
• Absence of the tongue thrust reflex i.e. pushing everything that is put in his mouth back out.

2. Can babies eat honey?

Honey is deliciously sweet and although it makes a great addition to a cup of Rooibos tea, it is not recommended for babies under the age of one year. We always recommend not introducing sweet or sugary foods to your baby or toddler.

In addition to this, however, honey contains spores of Clostridium Botulinum, which can cause botulism poisoning and due to this The American Academy of Paediatrics (AAP) advised honey to not be introduced before 12 months of an age.

Botulism spores cannot be destroyed during household cooking methods and temperatures and therefore baked goods containing honey should also be avoided.

3. Can my baby drink fruit juice?

The best fluids to give to your baby is either breast milk or formula milk, as they both contain important nutrients such as carbohydrate, proteins, fats, vitamins and minerals to support growth and development.

Fruit juices are not a suitable drink for babies as they are high in sugar. Fruit juices are marketed as a fruit replacement and often labelled as a good source of vitamin C. Don’t be deceived by this clever labelling. Fruit juices are not a substitute for fruit, but a high sugary drink which results in a quick release of too much sugar into the bloodstream.

They also offer little nutritional value and are not a suitable replacement for actual fruit. Babies exposed to fruit juice from a young age usually become accustomed to the sweet taste, making the transition to only water quite difficult.

Babies (when age appropriate) and toddlers that are introduced to water only and exposed to the family drinking water, learn to develop this behaviour and will usually continue to drink water as they grow older. Therefore, it is recommended to save some pennies and scrap fruit juice from the house.

4. Can I add salt or spices to baby food?

It is always recommended that baby food taste delicious and to offer varying flavour combinations. Adding spices such as curry powder or pepper are, however, discouraged – although many cultures introduce spicy foods to babies during the weaning process.

Baby tummies are very sensitive and the spices can aggravate their tummies and gut. Salt should always be avoided. Salt has become a household staple and it is often an automatic reaction before you eat to add salt (often before even tasting the meal).

Parents often ask if salt can be added to baby food to make it taste better? Due to the sodium content, however, it should be avoided in babies. Baby food should still be full of flavour and you can focus on using natural herbs such as basil, sage, thyme, rosemary to flavour foods, as well as gentle spices such as cinnamon or nutmeg.

5. Will adding baby cereal to my baby’s bedtime bottle make them sleep through?

Any parent of a baby will understand how truly gruelling sleep deprivation can feel. This is particularly true for parents of babies who prefer to rather play during the night then sleep, or those babies who are cat nappers and wake soon after going to sleep and mum just finished making a delicious cup of tea.

The pure exhaustion can make any parent desperate to find a miracle cure to make their little angels sleep through the night. The time old tradition or myth: “Add some baby cereal to the bottle – your baby will have a blissful full night’s sleep” sounds like a simple solution and is very tempting for any sleep-deprived parent.

It is important to remember, however, that a baby’s sleep pattern is not only regulated by nutrition. Yes, a baby may show signs of hunger during the night and then nutrition does play a role, which may occur when a baby is transitioning from milk intake to needing solids.

“All babies develop differently and some are ready to go with food at four months, while others are quite content with their milk until five or six months.”

There are also other factors that influence a baby’s sleep pattern and babies who are well fed, dry and comfortable temperature-wise may still wake in the night. Adding baby cereal to the bottle firstly provides empty calories that offer no nutritional value, which can result in overfeeding and, if introduced to a younger baby, can contribute to discomfort and wind.

A study conducted by Macknin, who looked at infant sleep and baby cereal provided the following results:

“We studied whether feeding infants rice cereal before bedtime promotes their sleeping through the night. One hundred [and] six infants were randomly assigned to begin bedtime cereal feeding (1 tablespoon per ounce in a bottle) at 5 weeks or at 4 months of age. Caretakers recorded the infants’ sleep from age 4 to 21 weeks for one 24-hour period per week.

“Sleeping through the night was defined as sleeping at least 8 consecutive hours, with the majority of time being between the hours of midnight and 6 AM. The results were also reviewed changing the requirement from 8 hours to 6 hours. There was no statistically significant trend or a consistent tendency of one group to have a higher proportion of sleepers than the other.

“Therefore, feeding infants rice cereal in the bottle before bedtime does not appear to make much difference in their sleeping through the night. It is therefore recommended to not use this method to try induce a full night’s sleep and to rather explore other avenues to help your little one to sleep more rested at night.”

Image: LStockStudio/Shutterstock

6. What time of the day is the best to start introducing solids?

The best time of the day to start offering solids to your baby is when your baby is most alert and awake and in a good happy space. You want to try avoid introducing solids when your baby is too tired or too hungry or too full from a milk feed.

During the beginning stages, you do not need to worry too much about introducing at breakfast or at lunch time, for example. Choose a time of day that is best on that particular day. The best time would be in-between sleep time and in-between milk feeds, so that you can ensure your baby isn’t too tired, too hungry or too full.

This applies to mom and dad, too. In the beginning stages, you do not need to worry too much about routine and if you having a busy day, skip that day and introduce again the following day. You will find that a routine will develop naturally where you offer one meal a day, to two meals a day, to three meals a day, as food will be introduced in accordance with current routine, milk feeds and sleep time.

7. Must I introduce one food at a time or can I offer a combination?

The commonly recommended first foods are vegetables and fruits, which are low allergenic foods. They, therefore, have a low risk of inducing an allergic reaction. Due to this, some guidelines recommend starting with a vegetable mix such as green veggie mix or orange veggie mix.

Although most babies will tolerate the veggie mixes, the disadvantage of this is that if your baby does have a reaction, although unlikely, you will be unable to identify which food was the trigger food. Due to this, some guidelines recommend starting with single vegetable or fruit and increasing from there.

Often parents feel conflicted in which way to go. The best recommendation is to choose what you feel more comfortable with. When I started introducing solids to my baby, I started with one vegetable or fruit at a time, and once I had introduced three or four, I combined the vegetables and fruits into mixes. This worked well and also offered a new taste dimension from existing flavours.

Proteins are potentially allergic foods and can induce an allergic reaction, so a new protein food should be introduced one at a time every two to three days. Aim to introduce earlier on in the day (i.e. at breakfast or lunch) so that you can monitor your baby for a reaction.

Once established on the protein, you can move it to dinner and introduce a new protein at breakfast or lunch. You do not need to be nervous about introducing foods such as dairy, nut butters, eggs or fish.

Previous recommendations advised for potentially allergic foods to be withheld from the diet until later on to “protect” the body from an allergy. Newer research contraindicates these previous recommendations and shows that withdrawing these foods could be more detrimental.

If you have a strong family history of allergies and if your baby has an existing allergy, please chat further with your dietician.

Image: Gayvoronskaya_Yana/Shutterstock

8. Where is the best place to feed my baby?

Traditionally, it was always recommended that babies be fed in a feeding chair on the counter or table or in a high chair. We want to promote sensory stimulation and social aspect at meal times, so meals, therefore, do not need to limited to the feeding chair.

You can feed your baby on your lap or on dad’s lap. Meals do not need to be limited to the kitchen or dining room. When age appropriate, sit on the floor with a blanket or even outside under the trees on a warm day. Aim for family meal times together.

It is important to ensure that your baby is always well supported and sitting upright when being fed.

9. Should I encourage messy play?

It is important to always encourage your little ones to interact with food and experience messy play and to explore food. Always offer some food for them to touch, taste and hold when age appropriate.

Do not worry about mess; the more they touch, smear and play with the food, the better! It will probably end up everywhere – in their hair, up their sleeves or even behind their ears – and your baby will love it. Offer different textures such as avocado or banana and steamed broccoli or cauliflower.

If your baby is spoon-fed, this can be offered in combination with a meal to ensure your baby still gets a good nutritional intake.

10. What milk can my baby progress onto after one year of age?

By one year of age, infants can be progressed onto full cream cow’s milk provided their diet is varied and contains foods from all food groups (and your baby does not have an allergy to cow’s milk).

At this age, toddlers are eating a full diet and due to dairy (such a yoghurt and cheese) being included in the diet, there is no longer a nutritional demand for milk feeds although by this age. Most toddlers will still have a morning feed and bedtime feed. Toddlers who are picky eaters, and those who eat a limited range of foods and or exclude food groups, may require a growing up milk, as these are fortified with vitamins and minerals, and provide protein, iron and calcium, which can narrow the gap in the nutritional intake.

If you are unsure whether or not your toddler requires a growing up milk, be sure to chat further with your dietician or paediatrician.

Wishing you all the best for your journey with your little ones. Remember to create a positive environment around meal times; offer variety and keep it fun!

The original version of this article can be found the website of our partner, Nutripaeds.

Also read:

Introducing solids: what’s the difference between spoon feeding and baby-led weaning?
How to stop breastfeeding