The theme of this year’s World Breastfeeding Week is breastfeeding and the family table. One of the biggest ways this affects parents is when to start solids. The American Academy of Pediatrics used to give the green light to starting rice cereal at 4 months, but they have changed their tune and now recommend a full six months of exclusive breastfeeding before starting any solids.
This changed recommendation is due to solid research. In one study comparing two control groups of mothers starting solids at 4 vs. 6 months, the benefits were varied and obvious. The mothers who started solids at six months lost more of their pregnancy weight and their babies crawled and walked earlier. Summary studies show that introducing solids before six months has been linked to decreased immunity to diseases, a whole host of gastrointestinal problems, more allergies and orthodontic problems and the longer an infant is exclusively breastfed, the more benefits on future intelligence.
An old wives tale says that feeding cereal before bed or putting cereal in the bedtime bottle helps babies to sleep better. Several studies have completely debunked that myth. I think most of the time parents try this, it’s about when babies start sleeping longer, regardless, which makes it easy to link the two unrelated factors. When a baby is ready for solids, the clues will be there: the tongue thrust reflex will end and the baby will start trying to grab food off your plate with a pincer grasp and more than just sucking and exploring with their mouths, the babe will start trying to chew with its gums. Breastmilk provides the fullest, best nutrition for infants until that point and beyond.
this is when Fiona started on solids. Of her own (tricky) volition.
Kristen, I spent lots of time and money trying to induce lactation with Jake (adopted child #1) with zero success, and didn’t even bother with Daniel (adopted child #2). Any suggestions for finding breast milk for #3, when that time comes? I’m totally with you on the breast milk is best policy, but there are obvious limitations…. It’s too bad we won’t be in Asheville (the all-natural capital of the USA) for #3…
Amber,
Milk Banks require prescriptions for breastmilk (which you probably won’t get unless you adopt a high needs baby) and it’s UNBELIEVABLY expensive. Most insurance plans don’t cover it either. I don’t know all that you tried to induce lactation, but if an IBCLC (International Board Certified Lactation Consultant) who had managed to help other moms induce lactation was working with you and your doctor, I think it might not be worth trying again. If you research and find things you weren’t doing that might have helped, maybe give it another go. I know it’s a very difficult and demanding process. To be honest, the best chance you have at getting breastmilk without inducing lactation is renting a hospital grade pump for a sympathetic nursing mom in your church and getting a few bottles a day that way. If someone in your same situation rented the pump for me, I’d gladly do it while I surfed the computer, read or watched TV. But formula isn’t awful, it’s a much better substitute than plain old cows milk for sure, and there are surely babies who need it (like your sweet boys!)
Oh, and hello Amber, by the way. I have been wondering how you all are doing when I look at you on my fridge :o)
Thanks for debunking the myth regarding cereal. I have often thought that I would try cereal early if I needed a sleep aide. Nice to know (before I try)that it doesn’t make a difference.
Jay started solids at 5 months, but I think he really was ready. The cues you listed are good. You have to leave some room for variability in individual babies. That said, I think it would have been better for my milk supply if he hadn’t started that early, but we were following our pediatrician’s advice, and it took me a while to find out that I wasn’t making enough milk, so that getting back on the wagon was pretty hard at that point. Maybe I’ll make myself pump next time…
Lenise, there is definitely room for variability, but for the vast majority of babies, waiting is definitely more beneficial, even waiting beyond 6 months. And they (AAP, WHO, USDHHS, UNICEF, ADA…) have all in the last decade changed the recommendation for exclusive breastfeeding from 4-6 months to just plain 6 months. Babies who are exclusively or partially formula fed are more likely to be ready earlier (gastrointestinally) but there are usually more compelling reasons to wait (overall health, family history of allergies, cost/time/fuss of solids, etc.)
Kate ate pureed veggies 1 or 2 times a week starting at six months because she really really enjoyed it. I wasn’t crazy about giving them to her. When she got the pincer grasp down, she started eating puffed rice a few times a week, too. She started to really eat solids daily at about 9 months. Unless a mom has supply issues, the calories and nutritional balance of breastmilk is superior to any solids. I guess I would tend to downplay variability because more parents tend to rush solids unnecessarily than anything else. There’s also a great deal of debate about whether breastfed babies should have iron or vitamin fortified cereals, so that’s something to consider as well. Avacado or banana are good alternative first foods for those who are concerned about that.
there’s such a thing as “World Breastfeeding Week”?
unbelievable
who knows, maybe I’ll have the opportunity to give it another go next time… and I’ll keep an eye out for moms with milk to go round next too! Thankfully, both the boys did very well with formula, so I won’t feel quite as guilty if nothing works out.
I’ll be sending and update email out in a couple of weeks- we miss you guys!
Josiah,
Yes, there is. Considering that worldwide less than half of mothers breastfeed, we need it. In the United States, only a small minority of moms make it to 6 months of breastfeeding. If even half of the mothers on WIC and Food Stamps breastfed, we’d save hundreds of millions of dollars a year in formula alone, not considering the medicaid savings for less illness and allergies, etc.
Amber,
I’m looking forward to an update! I think more moms would be interested in helping than you might think, especially since they would get the use of the hospital grade pump to store a little for themselves, too.
Good point!
I will say I’m a firm believer in cues, because every baby’s needs are different, though I do read up to have a general idea what to expect.
Since you’ll always be incredibly more well-read than I on the topic, Kristen, do you take requests for WBW topics? :-) The big mystery to me is scheduling feeding. I know some people stand by their schedule. All I have read about it is my LLL literature, which disagrees with it, but, as all such polemic lit tends to be, I think the discussion could be slightly more nuanced than LLL portrays. From a common sense point of view, feeding when he’s hungry seems to work, because I can’t predict when he’s going to hit a growth spurt or something. On the other hand, I can see a lot of benefits to a schedule (perhaps even just a loose one), gives structure to the day, etc. What have you come across in your reading?
It doesn’t look like Kristen has responded yet (she’s tremendously busy today, whereas I’m sitting around at work!).
Schedule feeding is recommended by Ezzo, and Kristen has written *A LOT* on Ezzo. As has Alexandra (see links).
Separated from Ezzo, who has *MAJOR* issues, I’d recommend that you avoid imposing a schedule on a child, but wait for a schedule to come about. We decided with Kate that we were going to demand feed, but Kate worked herself into a routine that was very clear to us. It made it really easy to see when something was going different with her, and kept her well feed and nourished (which is a common risk with schedule feeding).
I’m sure Kristen will chime in here with some better composed thoughts.
Jeannette, a post at your request will appear later this week :o) I was wondering what else I was going to write for WBW, and I think you persuaded me that I have enough topics to go through Friday :o)
I haven’t written that much about Ezzo. Maybe two blog posts. One was really long, though :o) Alexandra (tulipgirl.com) is the Ezzo-info queen since she used to use and teach it.
Breast is Best. God made it that way, Hallelujah! My son Josiah is 2.5 yrs now but for the first 9 months of his life he was in the 5% for weight and the 80% for length, my little stringbean. My Peds never brought up the idea of using formula, and they never questioned my breastfeeding. They did ask how breastfeeding was going, that’s all. We started food at almost 5 months, and it was a good thing. He plumped up and got to the 45% by his first b-day. It wasn’t that I had trouble breastfeeding, it’s just his appetite was not voracious. He would not have been any better with formula.I am very thankful I had peds that were understanding and nurses that were gentle everytime he weighed in. His appetite for solids was awesome! He’d eat anything! And today he is as tall as a 4 yr old and is a healthy weight. I’m glad I didn’t give up just because of weight. I cried alot, but he was a happy rosey cheeked boy! That’s that! His sister has NONE of the same problems, she’s my chubby girl!
Weighing in to skew the results. Of my 4 babies, all 4 were exclusively breastfed until about 7.5 months. All 4 were late walkers (14m, 17m, 20m!!, 12m – she’s our “advanced” one *grin*) and only 2 of them crawled, the other 2 scooted.
Not to say I was disappointed by any stretch, just to say that delaying solids doesn’t necessarily mean your baby will crawl/walk according to the textbooks…
Katie you’ve REALLY gotta start saying “Josiah not Roe” or “JosiahK” instead of “JosiahQ” or something to distinguish, ’cause I go flying through reading these comments and everytime I’m like “what…who, huh?” and then I check the name.
but yes, WBW. I’m buying the bumpersticker. Just the other day I called my mom and told her (and her boobs) thanks for contributing to my sucess. Seriously.
Thankfully she’s got a good sense of humor.
My Harry is eating more solids than I would like him to be eating right now, but in the big picture it’s not really that much and it is all OK. He started grabbing for cups and food right about 6 months and I tried a bit of cereal with him and he was not thrilled, but then the rice crispies were the winner – man he acted like it was the best thing in the world. One morning I put him down on the kitchen floor to play while I poured milk for the other children and he crawled over to the pantry door and started banging it. I opened the door and pulled out my tupperware cereal keeper with his rice crispies and he squealed so loud. I laughed and laughed. Every morning he eats some crippies while the others eat their breakfast and I’ve added a few small bites of bananas or pears to the plate this past week. Now that he has those two bottom teefers (this past Monday) he loves to put cheerios between them and bite them.
Today he awoke to the most swollen gums (top) I have ever seen in any of my babies. Poor thing all he wants to do is nurse, nurse, nurse. He reaches for food, tries it, then throws it or a fit – it just hurts too bad right now. None of my other ever went through this and I just ache for him. but the nursing calms him and fills him up and gives him all he needs – he is just now 8 months old.
BTW, our pediatrician was thrilled when I told her that I always nurse him first before I give him the solids of a meal. She said a lot of moms have to be told over and over to give solids after nursing, not nursing after solids. Too much solids too soon and they get plugged up – the breastmilk keeps things moving. hahaha.
I’m one of those moms who are smack in the middle of the schedulers and demand feeders. I think there are brilliances in both. All three of my kids worked themselves into a schedule, as you mentioned happened with your Kate. And when I say schedule, I use that term very loosly because I myself never look at a clock. I don’t even wear a watch.
So – yeah, they nursed every few hours when they wake up hungry. But I’m (being mother of three that I am) not above nursing a baby to sleep. (Just sleep, sweet baby, name your price). I’ve never read anything Ezzo except Babywise – so I don’t know anything about the toddler/later stuff that apparently is more problematic to some (?)… Anyway, the things I took from that are to work on nursing a whole meal vs. a “snack.” It can be problematic adding new milk into a tummy when it’s half-full of partly digested milk idea. So I feed them till they’re full. And then give them a whole meal when they are hungry. Whenver that is – but it’s usually 3 and a half hours. And the other thing is I typically put my babies to nap or bed awake. The don’t usually cry and if they do, it’s for like maybe 20 seconds. I liked the idea of my kids not having a sleep crutch and I think I have the happiest sleepers on the planet. But, like I said now, I’m not above nursing my 3rd baby to sleep sometimes because WE ALL NEED THE PEACE!
Oh, and sorry this is long but one last thing. I didn’t really give solids to my second until she was about 8 mo. She just could NOT figure out the spoon thing. But she was content so – it all comes out in the wash.
The whole meal vs. snack thing is Ezzo, not science. I’m not saying that some babies can’t thrive being fed that way, but since each mother’s milk production and the stomach capacities of babies vary widely, it won’t work for everyone. I wrote some about Ezzo here: http://www.thisclassicallife.com/tclarchives/2005_03_01_index.php#111211617393242231
There is a lot out there on milk production, try googling “breastfeeding milk production” but basically, the more you nurse, the more milk you will make, and the fattier it will be.
It doesn’t really matter who has used those words – I mean it’s not like Ezzo himself invented the words ‘snack’ and ‘meal.’ They are fair terms in a discussion on feeding a baby because everyone knows exactly what I’m referring to. But that’s neither here nor there.
But stomach capacities – could that not be a Catch-22? As in, obviously babies whose mothers feed them small amounts are logically going to be hungry again sooner. And likewise maintain a smaller stomach. I’m just thinking out loud…
And, from experience, adults are that way, too. I know plenty of people that have many small meals throughout the whole day. And lots of others have their 3 square meals a day. Debate about which is better goes back and forth for adults as well. I persobally think it comes down to different strokes for different folks. And when I eat more for a few days (like around Christmas), my stomach stretches and I need more food to feel full. But also eating a bigger meal I stay fuller longer. Common sense tells me it’d be that way for babies, too.
Could you also maybe address demanding/(“cue” (wink! :) feeding and sleeping? Not all, but a few of the demand babies THAT I KNOW are typically poor sleepers. I’m only referring to ones I know personally – not hypothetical stats here. You can direct me to a link if you know of one, doesn’t matter.
I have heard from every ped and expert that I’ve ever trusted that more meals are better for babies because it keeps their blood sugar up amd helps them to grow (fattier milk content.) Because breast capacities are so different, one mom can make 3x more milk than another, and both can sucessfully breastfeed, so obviously some moms are going to be able to feed less and get the same amount of milk in, but I really hesitate to hold that up because some just won’t be able to make enough milk that way and, if you are having trouble making enough milk, you need to nurse nurse nurse. If a baby has reflux, the standard recommendation is half the amount, twice as much. The only time babies need less is if their mom has OAL (overactive letdown) and then they don’t really need to nurse less, their mom needs to block feed.
Like I’ve said every time I’ve talked about it, I know that some babies can thrive in non-demand feeding breastfeeding relationships. It’s just something that has contributed to milk supplies diminishing, failure to thrive, etc. for many moms and that concerns me. I’ve read a lot on this issue (and yes, I have read Babywise) and I feel that there is a reason every major medical organization nationally and internationally recommends demand feeding.
As far as sleep goes, I think there are lots of other factors that play into this (sleep training, co-sleeping, etc.) but I did write about that once here: http://www.thisclassicallife.com/weblog/index.php/archives/41
For the record, both of mine have always been decent sleepers. Lexi is better than Kate was, for sure, and she wasn’t that bad.
I’m glad you are here, Moriah, and I have real life friends who schedule feed and we are still friends. I’m probably more antagonistic about it on the blog than anywhere else. But you know, this IS my soapbox ;)
I read the sleep post link you wrote and I agree wholeheartedly, bytheway.
I’m too tired to talk/think more about this now so, g’night!