the truth about feeding and nourishing your child
My oldest child's first solid food was not an organic apple slice, a calcium-rich cheese stick, or free-range chicken. It was a half-sour pickle. Perhaps after all that milk, she was looking for something with a little zing. One friend had a baby who loved licking slices of lemon and lime. Another had a toddler who preferred "spicy" water (sparkling mineral water or seltzer) over flat, and salad greens dressed with garlicky olive oil. All these children, like millions of others, then proceeded to go through the "picky eater" phase, but managed to survive, thrive, and eventually expand their culinary horizons beyond fish sticks.
Your decision on what and how to feed your child starts before birth, when you are still pregnant and your child is being nourished in the womb. Once your baby comes into the world, you'll choose breast- or bottle-feeding. You'll make decisions on types of milk and formula, baby foods, solid foods, snacks, beverages, and much more. You'll also get lots and lots of advice, funny looks, and criticism if you do things a certain way. But if you can separate out the fiction from the facts, on topics ranging from breast-feeding to food allergies, you'll be able to feed your child with confidence, even if he insists on dropping his spoon from his high chair just to watch you pick it up. Here, then, are some of the most popular misconceptions-and facts to set you straight-about feeding your baby and young child.
Breast-feeding and Bottle-feeding
facts and fiction (and lots of opinions)
myth
Babies who breast-feed very often probably aren't getting enough milk.
reality
The frequency of feedings is not an indicator of whether or not your baby is getting enough breast milk.
the facts
If you are feeding on demand, which many pediatricians and breast-feeding advocates recommend, then you might feel that your baby is constantly at the breast and you may worry that he's not getting enough milk. But assuming you have developed a steady supply of milk, that you aren't limiting feeding times, and that your baby is latching on to the breast correctly, it's likely that he's simply having a classic growth spurt. The more you feed him, the more milk you will naturally produce for his growing appetite!
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myth
If you are breast-feeding, you must always offer both breasts at each feeding for equal amounts of time.
reality
It's more important to let your baby finish with one breast first, even if that means she doesn't take the second breast at the same feeding.
the facts
Each time you breast-feed, you produce different types of milk. Foremilk is the initial breast milk that a baby drinks when she nurses at the beginning of a feeding. It resembles skim milk-high in volume but low in fat and calories. As the feeding progresses, the fat content of your breast milk increases and it begins to more closely resemble whole milk. Finally, toward the end of the feeding, your baby drinks hind milk, which is highest in calories and fat, and low in volume.
This means that if you switch your baby to the second breast too soon, she may fill up on the lower-calorie foremilk from both breasts rather than obtaining the normal balance of foremilk and hind milk. This may make it harder for her to get the calories she needs to gain weight.
Some mothers offer both breasts at each feeding; others offer one breast per feeding, then switch to the other breast for the next feeding, alternating throughout the day. If you alternate breasts at each feeding, allow your baby enough time to get both foremilk and hind milk.
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myth
No spicy foods or alcohol if you are breast-feeding!
reality
You can have a beer with your enchiladas.
the facts
If you're consuming a healthful, balanced diet, you needn't be obsessive about restricting certain foods and beverages from your diet. Even if you make poor food choices, your baby will still extract the nutrition he requires from your breast milk; but chances are you'll feel a lot better if you eat a good diet. So, is it true that if you eat garlic or onions or cabbage, and drink liquor, your baby will have an upset tummy or suffer from the effects of your alcohol consumption?
Some studies have shown that babies get gassy after their mothers eat foods from the cabbage family (like Brussels sprouts, kale, or cauliflower), or that they balk at "garlicky" tasting milk. But unless your infant is truly sensitive and colicky, he can handle a varied diet. It takes about five hours for the foods you eat to pass into your milk supply, so if you're concerned about the "tummy connection," pay attention to what you eat and when you eat it.
As for alcohol, you avoided it during your pregnancy, but now that you're breast-feeding, can you resume drinking an occasional serving of beer, wine, or other liquor? Many doctors agree that no harm will come from occasional or light (not heavy) alcohol consumption-a few drinks over the course of a week, for instance. Very little alcohol makes it into the breast milk supply, especially if you consume food with the alcohol. If you're at all concerned, then breast-feed (or express milk) before having a drink. By the time your baby is ready for his next feeding, you will have metabolized the alcohol (in a 120-pound woman consuming an average drink, this takes about two and a half hours).
There is no evidence that having an occasional alcoholic drink during breast-feeding harms babies permanently; so no need to "pump and dump" your milk if you've had a single drink. However, you may prefer that your baby not be exposed to milk that may contain any alcohol if you suspect he has a reaction to even the smallest amount. In one study, babies who nursed after their mothers ingested a small serving of alcohol sucked more frequently during the first minute of feeding, but then took in less milk in later feedings. Researchers could discern a different odor in the milk of alcohol-consuming mothers, so perhaps the babies drank less because they didn't like the smell of the milk. However, the babies also took shorter but more frequent naps, which suggests that perhaps they consumed less milk because they were sleepy.
What about caffeine? Unless you can clearly connect its consumption to ill effects in your baby (irritability or wakefulness, for instance), you needn't avoid it completely. However, babies are unable to eliminate caffeine from their systems effectively, so it may build up and cause problems for days or even weeks after you've ingested it. Pay attention to your consumption of caffeinated beverages (not just coffee and colas, but energy drinks, certain caffeine-containing cold remedies, and substances like chocolate-though white chocolate has no caffeine) and moderate your consumption accordingly.
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myth
You must drink milk to make milk.
reality
While getting enough fluid is important, milk consumption is not essential.
the facts
While it would be nice to think that consuming large amounts of milk (especially in the form of a favorite ice cream or shake) automatically ensures a steady supply of breast milk, it's not true. Since you're losing fluids when you breast-feed, it makes sense to supplement them regularly, but water will do the job, too. If you are concerned about your calcium consumption, then by all means drink milk (fat-free or reduced fat are the healthiest choices, and try other forms of dairy or other calcium-rich foods), but there are no set recommendations for nursing mothers on milk consumption. (The recommended daily calcium intake for a nursing mother over eighteen years of age is 1,000 mg, the same as for any other adult.) No mammals have to drink milk to make milk; humans are no exception.
You may have heard that you should drink eight glasses of water a day when you're breast-feeding. There is no research to suggest that that's a magic number (and in fact, the wisdom of drinking at least eight glasses of a water a day has been questioned in recent years by researchers); there is also no evidence that upping fluid intake increases breast milk output. The best advice is to pay attention to your body and drink when you're thirsty.
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myth
If you develop an illness or infection or are taking medication, stop nursing.
reality
In most such cases, there is no reason to discontinue breast-feeding.
the facts
If you develop a common infection-whether it's a breast infection (mastitis) or an illness like strep throat or a bad cold-there is no need to stop breast-feeding. In fact, with regard to breast infections, they clear up faster if you continue to feed with the affected breast. Your baby probably already has the same germs that caused you to get sick, and you're actually boosting his immunity naturally by feeding him breast milk. If he does catch your cold, remember that you are providing him with important antibodies that will help him fight the virus. Even if you have symptoms such as fever or coughing, keep breast-feeding and don't worry about passing the infection on to your baby; chances are he already has some form of it, since by the time you develop these symptoms you've been contagious for a day or longer. (Note: If you are infected with the AIDS-causing HIV virus, you can pass the virus on to your child and therefore should not breast-feed.)
If you take medication, as with any other substance you ingest, a small amount may pass into your milk supply, but in a minute quantity that is unlikely to affect your baby. You can safely take most over-the-counter medications, such as cold and cough remedies, pain relievers (ibuprofen, acetaminophen), and stomach medications, as well as most prescription medications. (With regard to over-the-counter pain relief, since aspirin is linked to the rare but dangerous Reye's syndrome, the AAP recommends that it be used with caution.) In addition to asking your own doctor and pharmacist (remind them that you are nursing), check with your pediatrician if you have concerns about a particular medication that you've been prescribed. Even most antidepressants are usually considered safe for nursing mothers, since most health professionals believe that the benefits of taking the medication outweigh any risks to the child. Breast-feeding experts add that the negative consequences of interrupting regular breast-feeding are greater than the risk of exposing a baby to a minute amount of a drug. (For the latest information on breast-feeding and contraindications, you can go to http://www.cdc.gov/breast feeding/disease/contraindicators.htm.)
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myth
If your baby has diarrhea or is vomiting, stop breast-feeding.
reality
You can safely nurse your sick baby.
the facts
If your baby develops a stomach bug and begins throwing up or having bouts of diarrhea, it turns out the best fluid she can ingest is breast milk. If you have an older baby who is already taking solid foods, you may try stopping the solid foods (check with your pediatrician first) to help with the tummy problems, but don't withhold breast milk. With its invaluable nutritional components-its necessary fats, carbohydrates, and proteins as well as its hydrating properties-it's a superior choice over the "rehydrating" drinks you'll find in the baby-care aisle of your local drug store. Even if she can't seem to keep anything in her stomach, she's still benefiting from breast-feeding, and the milk itself, which is extremely digestible, isn't what's making her throw up. Vomiting is a natural reflex that can be triggered when the gastrointestinal tract is irritated. Breast-feeding can help to calm your upset baby and bring her discomfort to an end.
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myth
Some babies are allergic to their mother's milk.
reality
No baby is allergic to its mother's milk.
the facts
Some food allergies are very real, but this one is completely false. It is biologically impossible for your baby to be allergic to your breast milk. Some babies may develop allergies to foods their mothers ingest during breast-feeding, including a reaction to the cow's milk proteins found in dairy products. Bloody stools in young infants can be caused by an allergic reaction to cow's milk protein; if this is the case, the condition usually clears up when the nursing mother lowers her consumption of dairy (she may be advised to give up cow's milk altogether). However, it's unusual for a baby to develop allergies or other severe reactions to foods a nursing mother consumes. (See pages 10-12, "No spicy foods or alcohol if you are breast-feeding!")
If someone (other than a doctor) tries to tell you your baby is lactose intolerant, it's most likely not true. Lactose intolerance is highly unusual in early childhood; it is caused by the body's inability to produce enough lactase, the enzyme that breaks down lactose (milk sugar). Most babies have a generous supply of this enzyme from birth and its production does not generally decline until later in life.
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myth
Breast-fed infants need water, too.
reality
Breast milk is the only fluid your infant needs.
the facts
Not that long ago, doctors advocated small amounts of water (or formula or sugar water) for a newborn in his first hours of life before breast milk, since there was a concern that the baby would somehow be unable to swallow the colostrums-rich milk. However, we now know that babies are perfectly capable of drinking breast milk as a first fluid, and that because of its easy digestibility and nutritional makeup, it's the best drink you can offer your newborn.
Even in hot weather, or when your baby has a fever, breast milk is still preferable to water. It has all the fluid your baby needs (it is 88 percent water), with vital nutritional benefits that water (or juice or "rehydrating" solutions) cannot offer. Unless your baby develops a medical condition that warrants supplementing with water or other fluids, stick to breast milk as the drink of choice. There is no need to offer water until your baby starts on solid foods (usually at four to six months, the suggested range for most babies by the AAP), when his need for additional fluids will increase. (Note: If your infant is bottle-fed, check with your pediatrician on guidelines for offering water.)
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myth
You can't get pregnant while you're breast-feeding.
reality
Breast-feeding is not a reliable form of birth control.
the facts
Breast-feeding does provide a temporary, natural type of birth control because the resulting hormonal changes brought on by lactation prevent normal ovulation, provided you are fully breast-feeding (absolutely no supplementary liquids or solids plus regular, frequent feedings). If you can't ovulate, you can't get pregnant. However, even though this effect can last for several months, eventually-especially if you are not exclusively breast-feeding, and once feedings become less frequent-your hormonal balance will change and regular ovulation will return. Once your cycle is normalized, you can get pregnant again, even if you are still breast-feeding.
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myth
Bottle-fed babies don't bond as well to their mothers as breast-fed infants do.
reality
Babies, no matter how they are fed, and parents have a unique bond.
the facts
If you can't or choose not to breast-feed, you will probably get an earful about how you're missing out on a once-in-a-lifetime opportunity to "bond" with your newborn.
(Continues...)
Excerpted from Baby Facts by William Sears Andrew Adesman Copyright © 2009 by William Sears. Excerpted by permission.
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