Breast milk or formula? Which solids and when? Whether you're pregnant or a new parent, this guide answers your questions about what to feed your baby from birth to age 1.
It's as simple as this: the best way to feed your baby is to breastfeed. The benefits are numerous, chief among them being that breastfed babies are healthier—as infants and in later life—than their formula-fed counterparts. But babies aren't the only ones who benefit from breastfeeding: Moms enjoy perks, too, post-delivery and even years later.
One of the most remarkable features of breast milk is that it not only provides perfect nutrition, but it does so dynamically: Its composition evolves in concert with your baby's needs. According to Ruth A. Lawrence, M.D., a professor of pediatrics, obstetrics and gynecology at the University of Rochester in New York and author of Breastfeeding: A Guide for the Medical Profession (Mosby-Yearbook, 1998), for the first few days after childbirth, your body produces colostrum, the earliest form of breast milk. Not only is it brimming with antibodies to protect against infection, but it is also high in protein and low in sugar and fat, which makes it easier for your newborn to digest. Following colostrum, your body begins to produce mature milk, which is higher in protein, fat and sugar to fuel your baby's growth and development.
Then there are the short- and long-term health benefits. Mother's milk protects babies against lower respiratory infections, diarrhea and ear infections. And again, that protection is dynamic: "Mothers produce immunological components in breast milk that are specific to their environments," says nutrition researcher Jane Heinig, Ph.D., a certified lactation consultant and editor in chief of the Journal of Human Lactation. In other words, if everyone in your family is fighting a bug, your breast milk will help your baby's immune system go to battle. "Studies also show that breastfed kids are less likely to have chronic diseases, allergies and Hodgkin's disease," Heinig adds. "And they show a small but consistent advantage in cognitive and academic tests."
One advantage for moms is that after delivery, breastfeeding helps the uterus contract, reducing the risk for hemorrhage. There are other pluses as well: "Women who nurse for more than three months are more likely to return to their prepregnancy weight by the end of the first year," says Heinig. "And mothers who breastfeed even longer have a lower risk for premenopausal breast cancer and ovarian cancer."
Finally, breastfeeding gets the "No Housekeeping" seal of approval. Breastfeed your baby and you may never know the joys of mixing and storing formula or sterilizing bottles and equipment. You will never know the heartbreak of the bottle that's 1 ounce short of getting your baby to sleep.
Never again will perfect nutrition be this brainless. Don't miss the boat.
Benefits aside, some women simply cannot breastfeed. Others choose not to or perhaps breastfeed for only a short time. For them, formula is the answer.
Formula Options While choosing the right breast milk is as easy as lifting your shirt, choosing the right formula is more complex; there are different types, such as cow's, soy and hypoallergenic, and different formulations: powdered, concentrated and ready-to-feed. When it comes to which type to use, iron-fortified cow's milk is a common first choice (but check with your pediatrician before deciding on any formula).
"Doctors choose it because it most closely resembles breast milk," says Joanne Saab, a registered dietitian at the Hospital for Sick Children in Toronto. Some parents fear giving their babies milk-based formula because of the risk of an allergic reaction, but only 3 to 4 percent of infants have a true milk allergy, according to Saab. "Unless you have a family history of milk allergy, cow's milk-based formula is a safe place to start," she says. If you do have a family history, be sure to let your pediatrician know so she can recommend the best formula for your baby.
Surprisingly, soy formula may not be a good alternative for babies with milk allergy. Why? "Many babies who are allergic to milk are also intolerant of soy protein," Saab says. However, soy-based formula is a fine choice for parents who object to using animal products or for the rare infant with galactosemia, an inability to digest the milk sugar galactose.
In hypoallergenic formulas, milk proteins have been broken down to make them more digestible. If your baby shows signs of milk allergy (diarrhea with blood or mucus, irritability during bowel movements, vomiting, a rash, wheezing or congestion), ask your pediatrician about these specialty formulas.
Store-brand formulas are a cost-effective alternative to name brands, although some may not contain the newest beneficial ingredients. Once you find a brand you like, stick to it: Frequent switching can be tough on your baby's system.
As for the formulation, powdered, concentrated and ready-to-feed formulas are nutritionally interchangeable. Parents of frequent and exclusive bottle-feeders can save money by mixing their own powdered formula. If your baby takes an occasional bottle, ready-to-feed formula, though more expensive, is not a bad deal: Unopened cans keep longer than open cans of powder. If you opt for concentrated formula, follow the directions exactly when preparing. Over-diluted, under-diluted or undiluted concentrate (or powder, for that matter) can lead to malnutrition or kidney damage and never should be fed to a baby unless recommended by the child's doctor or dietitian.
Finally, remember that formula is only as safe as its handling. Pediatric gastroenterologist Bryan Vartabedian, M.D., suggests the following:
* Heat your baby's bottle in a pan of warm water; microwaving creates dangerous hot spots. * Don't freeze formula; doing so robs it of nutritional value. * Use refrigerated formula within 48 hours; use formula at room temperature within two to four hours. * Throw away all formula your baby doesn't finish. Bacteria from saliva spoils the milk.
The scoop on solids
Parents look forward to spoon feeding with astronomic levels of anticipation. There's no shortage of unsolicited—usually contradictory—advice out there, and very little in the way of hard-and-fast rules. So how do you begin?
1. Tune in to your baby's needs The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for the first six months, but many experts believe that a baby's system is ready for solids at the age of about 4 months. "Before that, there's an increased risk of allergy and eczema," says Vartabedian. "But around 4 to 6 months, babies are developmentally ready to eat." In other words, the extrusor reflex, which causes babies to push food out of their mouths with their tongues, begins to fade. At this age, babies are also able to sit with support and turn their heads away when they're not interested.
If your 4- or 5-month-old shows a keen interest in food or seems hungry even after a feeding, ask your pediatrician about starting solids. Waiting until 6 months is fine, but don't go much longer than that: Babies who don't develop a taste for solids by 7 or 8 months sometimes have a hard time acquiring one later, according to Vartabedian.
2. Pick a plan and go with it Introduce one food at a time, with three to five days between introductions so you can rule out allergies. Don't get hung up on finding the perfect sequence; you aren't cracking the genetic code. Rice cereal mixed with breast milk or formula is a good first choice, but you also can start with a cooked or mashed fruit or vegetable. Contrary to popular advice, introducing fruits first will not bias your baby against vegetables.
3. Be patient You will spend eons coaxing food into your baby's mouth only to have it spit back out. (Yesterday's peas become today's Exorcist moment.) Feeding a baby is a dirty—sometimes heartbreaking—job. Just remember that for the first five or six months of eating solids, your baby is still getting most of the nutrition he needs from breast milk or formula.
4. Don't fret In a matter of months, no one will remember whether your baby ate sweet potatoes or pears first, or whether grandma recklessly mashed bananas into his rice cereal. Plus, excessive hand-wringing at the highchair can lead to long-term feeding problems (not the least of which may be parents' indigestion).
5. Keep it interesting As your baby hones his eating skills, keep him challenged with new tastes and textures. Follow these guidelines on when to introduce certain foods: * Meat after the age of 7 months * Mashed table foods (sweet potatoes, well-cooked carrots and soft fruits are good choices) at 8 months * Soft, diced finger foods at 9 months * Cheese after 9 months * Whole milk and honey at 12 months * Whole eggs at 2 years (as long as there is no family history of egg allergy) By his first birthday, your tiny, milk-drunk newborn will be transformed into a competent eater, ruler of the highchair and ready for cake. Which is, of course, a whole new challenge.