DEAR DOCTOR K: When should I start giving my baby solid foods? Will starting solids too early increase her risk of food allergies?
DEAR READER: Breast milk or iron-fortified infant formula provides all the nutrients your baby needs for the first 6 months. Most pediatricians I know do not recommend starting solid foods before 4 months. The introduction of solid foods before 4 to 6 months may not provide the proper balance of nutrients — and it may increase the risk of your infant's developing food allergies.
Before you begin, discuss the introduction of solid foods with your pediatrician. Most recommend one of the iron-fortified infant cereals, such as rice, oatmeal or barley, for the first food. These types of cereals are least likely to cause allergies. Mix the cereal with breast milk or formula.
Watch for signs and symptoms of allergy, such as rash, wheezing, stomachache, diarrhea, gas, fussiness or vomiting. True food allergies are rare, but if you notice any of these things and suspect an allergy, stop giving the food in question and call your pediatrician.
Keep these things in mind:
— Add only one new food at a time. Wait from five to seven days between new foods so that you have time to watch for a possible allergy. (Choose a longer interval if you have a strong family history of allergies.)
— Commercially prepared baby foods are nutritious and safe for babies.
— You also can make your own baby food. Except for bananas, all fruits and vegetables should be cooked first and then pureed. Do not add salt, sugar or other seasonings. Refrigerate or freeze homemade baby food right after cooking.
— Do not feed your baby directly from a jar unless you plan to use the entire jar at one meal. That's because the spoon will contain bacteria from the baby's mouth, and if you leave some of the food in the jar for a future meal, the food may be ruined by the bacteria. So if you aren't going to use the whole jar for one feeding, then use a clean spoon to place the food you are going to feed the baby into a clean bowl.
— Refrigerate opened jars of baby food.
— Wait until your infant is at least 1 year old to give foods that commonly cause allergies: egg whites, peanut butter, other nut butters, oranges, grapefruit, other citrus fruits, shrimp, lobster, other shellfish.
— Do not give honey to your infant before 1 year; honey can cause life-threatening food poisoning.
— Finally, don't give your child solid foods that could get stuck in the child's windpipe and cause choking until the child is at least 3 years old. I'm referring to foods such as raw carrots, grapes, popcorn, raisins, nuts, jelly beans, pieces of hot dog, hard candies.
This may all seem like obvious advice, but you'd be surprised how often parents make these mistakes. Usually no harm is done, but the child has been put at unnecessary risk.
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)