Feeding

Spitting up

• It is very common for babies to spit up after feeds. This is usually normal and not harmful to the baby as long as it does not seem to bother them, is not projectile, and they are gaining weight well.
• A few things to try at home for frequent spitting up:
  • Pacing feeds- if baby is trying to drink their bottle very fast, try to slow them down by taking breaks or using a slower flow nipple
  • Burp them frequently to prevent air from getting trapped
  • Keep baby upright or in an inclined position for 15-30 mins after each feed
  • Avoid bouncing baby around or excessive movement after feeds
  • Try smaller more frequent feeds to decrease the volume baby is taking at once.
• Please reach out if you are concerned about the amount or frequency your baby is spitting up.

Starting Solids

• Solids can be introduced anywhere from 4-6 months of age. It is best to assess for signs of readiness at any age.
• Signs of readiness:

  • Sitting: Baby is able to sit with minimal support

  • Head Control: Baby is able to hold head upright and steady while seated for duration of meal (about 15 minutes)

  • Reach & Grab: Baby is able to pick up objects while seated and easily bring them to the mouth

  • Interest: Baby intently watches you eat, mouths for food, or leans forward for it

• When starting solids initially, it is more for experimentation with new textures and flavors, rather than for nutrition. Breastmilk/formula should still be your baby’s main source of nutrition.
• We usually recommend introducing one thing at a time so that it is easier to monitor for any reaction. If baby does well with a food, then it is okay to combine that food with introducing other new foods later on.
• It is very common for babies to gag when learning to eat solid foods and even with trying new foods. It is important to know the difference between gagging and true choking. This website Gagging vs. Choking When Baby Starts Solids – Solid Starts has a great explanation about the difference and even has videos you can watch.
• Solid Starts App or website- great way to look up specific foods quickly. Will show you at what age the food is recommended to be introduced, how to prepare the food based on age, and if it is considered high risk for allergy for free. They have other great free resources as well. Can pay for other features such as food tracking.
  • Website: First Foods for Babies Starting Solids – Solid Starts
  • App: Can be downloaded for both IOS and Android devices.

Introducing Common Allergy Foods

• One of the biggest allergens we get questions about is peanut butter.
• There is very good research that the earlier peanut butter is introduced, the less likely children are to develop a peanut allergy. Thus, we recommend for most children, that you start introducing peanut butter between 4-6 months of age. For some high-risk children, we may recommend doing it earlier or seeing an allergy doctor before adding it to the diet.
• Peanut butter is a little too thick to give straight out of the jar. You can thin it out with some water or breast milk to a better consistency.
• Try to give peanut butter 2-3 times a week.
• The other common foods that cause food allergies that you should introduce early include: tree nuts (ie almonds, cashews, walnuts, etc), fish, shell fish, soy, dairy, eggs, and wheat. For the dairy, babies cannot drink cow’s milk, but you can give dairy products, such as cheese or yogurt.
• If your child were to develop allergy symptoms with any of these foods, you should notify us immediately. Food allergy symptoms generally present within minutes of the food being ingested and are listed below.

Symptoms of mild allergic reactions:

• Mild symptoms of an allergic reaction can include ONE of the following (more than one would constitute a more severe reaction):

Transitioning to Whole Milk

• Cow’s milk is not recommended for any baby under 12 months of age. Breastmilk or formula should still be used until the first birthday.
• When introducing cow’s milk, we recommend using whole milk until your child is two years old. WHOLE milk for 2 WHOLE years! This is due to the high fat content that helps with brain development. After 2 years old, we can further discuss a lower fat milk.
• When introducing cow’s milk, it is ok to try to switch from formula or breastmilk all at once. It may be beneficial to offer a small amount of milk at first to see how baby responds. If they do not like the taste or do not take to it well at first, it is okay to mix small amounts of milk into formula/breastmilk and then gradually increase the amount of cow’s milk you are adding until they are fully transitioned.
• This can also be a good time to introduce a sippy cup and to transition away from using a bottle.