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BOTTLE FEEDING

Look how happy Lucy is! Held in place at a steady thirty-degree angle, she sucks happily from her space-age “Riteflo” antireflux feeding device. This modern system is designed to provide a continuous flow and to detect any air bubble before it can reach the nipple. The nipple, by the way, is an exact molded replica of yours, with the same recoil coefficient as genuine skin. Each time the level of the fluid reaches a burping gradation, the Riteflo beeps to remind you to perform the ritual procedure. But that’s not all! The system is loaded with Riteflo brand formula’s latest blend, fortified for brain development and reinforced with mommy’s personal amino-acid profile . . . enhanced, of course, to be better than mommy! You can already tell Lucy is getting smart by the sparkle in her eye.

Even without fancy equipment or formula, bottle feeding is simple and straightforward. Here’s a how-to guide.

How?
Lucy may be a genius, but it doesn’t take a genius to suck on a bottle. As soon as she’s awake and shows an interest in sucking, put the nipple in her mouth. She will automatically move her jaw and suck out some of the milk. It’s as simple as that.

How Much?
At first, Lucy will drink very little, maybe a couple of ounces per feeding. When she’s hungry, the signs aren’t subtle: She’ll root or cry. When sated, she’ll push the nipple away, slow her sucking, or fall asleep. As she gets older, she’ll steadily increase the amount she ingests, from about twenty-four ounces at one month of age up to about thirty-two ounces at six months. These are rough numbers; the best way to know if Lucy is still hungry is to offer her a little more than usual on occasion and let her decide if she wants it.

Around eight months, when she’s eating a significant amount of solid food, Lucy will reduce her milk intake herself by simply not finishing her bottle the way she used to. Or she’ll just take fewer bottles. However, there are considerable variations at this stage. Some babies drink barely ten ounces of formula and already eat a tremendous amount of solid food, whereas others are still swilling their five bottles daily and hardly touching the stuff that requires chewing. Both are fine.

How Often?
Bottle feeding, like nursing, should occur on demand. Initially, Lucy will wake up at different intervals, seemingly hungry, and you should encourage her to regulate her own feeding. If you try to impose a more rigid schedule, you’ll find it rough going. She will end up imposing hers on you anyway, which will be on average every three hours until she is eating a significant amount of solid food at roughly six months [See: Schedule].

Around three to four months, the only noticeable change is that Lucy takes much less time to eat. She can gulp down her bottles in record time while looking around for distractions.

Real questions from real parents
How much is too much?
Be aware that overfeeding is relatively easy with a bottle, because the supply is unlimited and Lucy may take it just for soothing purposes. In any event, if you do happen to overfeed her, you’re likely to get the extra milk back in the form of spit-up.

How long can I leave a bottle out if it has been used?
Until the next feeding, which means as long as six hours.

Should I sterilize the bottle?
Washing of the nursing equipment is more than enough. Babies are able to fight germs and aren’t meant to ingest only sterile nutrients.

What kind of nipple is best?
Lucy can suck on any kind. Don’t pay attention to the brand or the shape; it’s all marketing. The hole of the nipple should be big enough that she can feed with ease but small enough that it doesn’t flood her mouth with milk. Don’t bother with the antigas bottles that provide a specific inclination or an extra plastic bag to squeeze the air out; they’re just more marketing rip-offs.

What about burping?
Babies swallow more air while bottle feeding, which causes more spit-up. This is easily remedied: Just keep Lucy upright for a while after feeding and massage her back. This will move the air up and the food down, even if she doesn’t muster a full burp.

If my baby wakes up ten minutes after feeding, does it mean she’s still hungry?
Not necessarily. She might simply crave comfort. The best way to know is to give her a little more food. If she takes it willingly, then she’s hungry; otherwise, she’s not. As with most feeding matters, common sense is the final authority.

When can I put cereals in her bottle? Never. There’s no obvious benefit. It won’t help her sleep at night, and the additional calories are unnecessary. Worse, it can bind the stools.


CHOOSE A TOPIC

FEEDING

You were very excited to start feeding Lucy solid foods. Excited but scared, because so many allergies run in the family. You’ve already introduced the three grains in what you believe to be the proper order (barley, rice, and oats). You waited anxiously for a reaction, inspected the diapers carefully, and watched her skin for any suspicious rash. When nothing turned up, you boldly introduced fruits and vegetables, according to color and consistency. You cautiously stayed away from the forbidden ones: carrots for nitrates, oranges for their laxative properties, and strawberries because of allergies. After a while, your excitement about solids was lost amid all these rules and regulations, and you went to the baby jars, which seemed like less of a hassle.

Some child-rearing books would have you believe that introducing your baby to solid foods is a risky scientific experiment. These books are full of frivolous warnings that could drive any parent crazy.

The reality is much different. When Lucy is ready (usually around six months), introducing solid food is very natural and straightforward. Unfortunately, too many parents approach this new phase with apprehension. This is the effect of clever marketing and lobbying by baby-food companies that try to sell processed foods by arguing for their superiority. But most of the myths are simply untrue. For example, you may hear that you should, after introducing a nutrient, wait three days before introducing another, in order to detect any reactions. This is unnecessary. Real food allergies are extremely rare, and their effects are very obvious. The allergic reaction would be immediate and fairly mild the first few times. If Lucy is predisposed to allergies, delaying or avoiding the introduction of certain foods won’t prevent an eventual reaction, so it’s better that you know early on. Sensitivity to foods is another phenomenon that shows up as a mild rash on the face or trunk within a few days or results in looser stools [See: Food Reactions]. It could be hard to pinpoint the offending substance if you’re mixing foods, but it doesn’t really matter, since these reactions are mild, short-lived, and may not even recur with the same exact food.

Before Six Months
Technically, Lucy doesn’t need anything other than breast milk or formula until this age. Even after six months, calories from solid foods play a modest role, taking on additional importance only when she reaches eight to ten months of age.

In order to start eating solid foods, Lucy needs to be able to do three things. First, she has to sit up (until they become teenagers, it is hard for children to eat slumped over). Second, she must coordinate all the muscles involved in swallowing. It doesn’t sound like much, but bringing the food from the front of the mouth to the back and then down the throat takes some real coordination. Last, but not least, she needs to be interested in eating.

The average baby fulfills these conditions around six months of age, although some do so earlier. Not long ago, parents used to spend hours under their doctors’ directives trying to feed three-month-old babies spoonfuls of bland cereal. Now most doctors agree that an infant can thrive perfectly well with breast milk and/or formula for a good six months. This does not mean, of course, that you can’t try a few little tastes of food here and there. Doing so makes for a fun-filled family moment. If you don’t mind the mess, once in a while you can mash up a bit of what you’re eating and put it on your finger, then let Lucy eat it off. You’ll get a broad grin and probably some excited arm flailing. And who knows? She may actually eat some of it.

Real questions from real parents
Why does my baby stare at me when I eat?
Your baby is always looking at you, no matter what you do.

Someone told me that my baby should start eating solids when she reaches twelve pounds. Is that true?
Some babies weigh twelve pounds at three months, others at one year. Weight has nothing to do with when you introduce solid foods. Eating is a developmental stage.

My baby is so big. Doesn’t she need solid foods?
Big babies don’t need to eat any sooner than small ones. And to tell you the truth, chubby babies tend to be a little less coordinated and sit up later, so they may not be able to eat solids until they reach their own comfort zone in terms of coordination.

Should I put cereals in the bottle?
You can, but there’s no reason for the extra calories, and the starch content may provoke constipation [See: Cereals].

Would solid foods help my baby to sleep at night?
Sleeping at night has less to do with hunger and more to do with Lucy’s capacity to soothe herself when she wakes up [See: Sleeping].

From Six to Eight Months
Around this age, Lucy is ready. She is able to sit upright better and has refined her swallowing technique. When the time comes to feed her solids, introduce them liberally. Purée any mild-tasting fruits and vegetables and offer them to her. Lucy will act surprised at first, but she’ll grow accustomed to the new foods and let you know what she likes. Foods popular among babies include sweet potatoes, carrots, bananas, apples, squash, peas, green beans, and mangoes. Harder fruits and vegetables should be strained, while softer ones can be puréed without cooking. Prepare meals without spices at first, but don’t be shy about adding them a few weeks after this initial introduction.

How, When, What

How Much?
Lucy will take whatever she needs, from nothing to a whole bowl. It’s also very easy to tell when to stop: Lucy pushes the spoon away or spits out the food. Conversely, as long as she keeps eating, there is no reason to stop feeding; let her tell you.

When?
Whenever it’s convenient for both of you, but try to pick a time when Lucy is neither too hungry (she won’t have the patience) nor too full (she won’t have the interest).

How Often?
Start with once daily but increase to two or even three times a day, depending on Lucy’s interest. The goal is three meals a day.


What?

Whichever fruits and vegetables she seems to fancy. Follow her cues, not some rigid list from a book. Feel free to mix and match in the same meal (or even the same dish). You can add a little cereal to thicken the purées that are too liquid, but there’s no need for cereals alone; they are bland and bulky, and their iron benefits are overstated. Instead, use baby staples such as sweet potatoes, apples, and bananas, which all contain plenty of starch on their own [See: Cereals].

In What Order?
Start with fruits and vegetables. The idea that you should introduce vegetables before fruits to avoid creating a sweet tooth is just an unfounded myth. A carrot has virtually the same amount of sugar as an apple. As Lucy’s interest grows, you can mash up protein sources such as soft cheeses, yogurt, fish, or meat. Even at six or eight months, her little stomach can handle all of these. Again, waiting three days in between nutrients is overcautious. Food reactions are rare, so it’s better to be a little more adventurous and deal with a mild reaction than it is to avoid a new food entirely for fear of an unlikely reaction.

How Soft?
At first, make the food pasty. As her ability to chew increases, you can introduce chunkier consistencies.

What Kind?
Homemade food is always fresher, tastier, and cheaper than jar foods. If you’re concerned about organic ingredients, shop at a health food store.

Real questions from real parents

Is there anything we should avoid?
Not really. Uncooked honey is not recommended in the first year because of the remote risk of botulism, but Lucy doesn’t need it anyway. Processed sugars are not ideal either, although a lick of ice cream isn’t the end of the world, and it will probably get you a standing ovation.

What if my baby doesn’t have teeth yet?
Not only are teeth optional for Lucy at this point, but even if she had them, she wouldn’t use them. The ones she has in front are meant to break hard foods which you’re not giving her at this age.


What about choking?

Choking is not a hazard with mashed or puréed foods. If the food goes down the wrong pipe, Lucy will bring it right up by coughing, and she’ll be a little more careful the next time [See: Choking].

How much is too much?
Trust Lucy to regulate her own appetite.

What should I do with regard to breast milk or formula?
Let Lucy adjust her own intake. The more solid food she eats, the less liquid nutrition she will require.

What about the nitrates in carrots and spinach?
A small amount of nitrates could be found in these vegetables if they were grown in a region with nitrate-rich soil. Nitrates can cause an extremely rare anemia in babies younger than three months, but at six months, when Lucy is first trying solid foods, the risk is negligible.

How about citrus?
Whatever mild citrus you can mash is fine: kiwi, for example. Lemons and oranges are impractical for this purpose, although some babies enjoy the acidity. Let Lucy decide. Initially, the acidity of some fruits may give her a brief case of the runs, but that will resolve itself rapidly.

What about berries?
Same as citrus: After their initial frowns, babies love berries. On occasion, berries may induce mild sensitivity reactions, including a slight rash on the face and body that lasts a day or two. If this happens, keep the offending fruit away for a month or so and then reintroduce it. The reaction may not recur. True allergies to berries are very rare.


Should I hold off on dairy foods?

Don’t feed Lucy cow’s milk in a bottle yet, but feel free to include cheese and yogurt in her diet. Dairy allergies are overstated and rare [See: Milk, Cow’s], and lactose intolerance does not develop until late in childhood in predisposed children.

Introducing solids is straightforward and simple. Dismiss all the unnecessary warnings that you come across, ignore baseless anxieties, and join Lucy in this fabulous process of discovery.

From Eight to Ten Months
Now the fun really starts, as you introduce Lucy to new foods regularly. Three times a day, take whatever you are eating, put it in the food processor (or mash it up well with a fork), and feed it to her. I mean it: Short of hot pepper, feed her some of everything, no matter how spicy or bitter, no matter how “adult” you think it is. For the longest time, the accepted wisdom was that infants needed bland and tasteless diets. This just isn’t true.

In all her senses, Lucy has flashy tastes: She prefers a red toy to a beige one, she’d rather listen to head-banging music than “The Four Seasons,” she’d sooner touch something furry than a smooth surface, and at mealtime, she’d rather eat something spicy than bland mash from a jar. Spices are not only perfectly safe for infants but recommended. Garlic, salt, pepper, and other spices are encouraged (you’re gonna see some funny surprised faces at first), but after that she’ll be all over her funky new tastes. Some babies like lemons. Others go for liver. This age represents a precious window of opportunity to develop a palate for exotic flavors. Don’t underestimate or shortchange her with bland food.

Real questions from real parents
What if my baby is not interested in solids?
Some don’t develop their interest until later on, and that’s fine. The liquid diet has plenty of calories. Keep offering Lucy solid foods casually. Everyone ends up eating eventually.

What about finger foods?
By now Lucy can hold food by herself, and you should encourage her to do so, as long as it is something that won’t break into hazardous chunks. Soft fruits are fine, as are biscuits or bread. But don’t overdo the starch, as it will interfere with her appetite for healthier foods. These finger foods also tend to act as pacifiers, so try not to let Lucy have food unless she’s hungry [See: Finger Foods].


What about salt?

Babies can handle salt as well as adults can, if not better, since their kidneys are brand-new.


What about milk?

You can give Lucy yogurt and soft cheeses, but cow, sheep, or goat’s milk in a bottle is still off-limits until ten months [See: Milk, Cow’s].

What about eggs?
Some people tell you to feed babies the whites; others, to feed them the yolks. They’re both right; babies can eat both the white and the yolk. If a mild sensitivity reaction occurs, stay away from eggs altogether for a couple of weeks, then reintroduce them [See: Eggs].

What about juice and water?
Juice is hardly ever necessary. You can start giving a little water at mealtime or between meals in a bottle, or in a cup with your assistance.

I want to give my child a balanced diet, but I’m a vegetarian. Is meat necessary for babies?
Lucy should eat whatever you eat. If you don’t eat meat she can follow the same diet, as long as she gets plenty of other sources of protein [See: Vegetarian Diet].

Do I have to process the food completely?
It depends on your child. Some babies can eat chunky foods early on, while others still have trouble chewing at ten months. Increase the consistency steadily, and pay attention to Lucy’s response.

In Summary
In general, there’s little that can go wrong with food introduction. You will notice that Lucy enjoys things you never thought she would, and mealtime will become a kind of adventure for the whole family.

From Ten Months to a Year
If you’ve followed the program described above, Lucy is probably eating almost everything by now. She’s also attempting to feed herself, which you should encourage despite the mess. If she’s on formula, you can stop it at this point and give her cow’s milk (or any other milk) instead. There is no need to wait until one year—the “officially” recommended age—to graduate to milk, since you’ve probably given her dairy in the form of yogurt with no problem. If she’s going to have trouble handling cow’s milk, two months won’t make a difference by this point. The amount of milk she needs will vary from almost none to four or five bottles a day, depending on her solid-food intake.
If Lucy is still not very interested in food, it could be that she simply isn’t ready yet. Like every milestone, eating varies from one baby to another. But it could also be that your cooking is too bland or that you’re relying too heavily on tasteless jar food. I have seen countless babies turn their heads away for this very reason. Feed her some of your food; it’s tastier, fresher, and cheaper. Finally, if Lucy refuses to eat, it could be that you aren’t giving her a chance to work up an appetite; don’t be too quick to offer breast milk or formula.

After a Year
By this time, Jimmy should be eating everything you give him and doing it by himself. Encourage this autonomy; it’s the best way to learn how to control his intake, and feeding him could come across as pressure. You will almost certainly notice variations: At some meals he’ll clean his plate, and at others he’ll leave almost everything. Respect his shifts in appetite.

Jimmy’s schedule should coincide with yours: three meals a day and two snacks in between. The composition of the meals should also be the same as yours: more or less: a good, common-sensical diet. Don’t count calories, ounces, or recommended daily allowances of vitamins.

As for milk, the amount will vary. Contrary to what experts thought years ago, there is no minimum intake for milk after one year, and some children just don’t drink any. Milk is a good source of calcium, but so are yogurt, eggs, cheese, broccoli, and fish. Is there such a thing as too much milk? If you sense it’s interfering with Jimmy’s appetite for other foods, limit his access to two to three bottles daily, max [See: Milk, Cow’s].

By now Jimmy can eat everything. He can even have shellfish, seafood, or raw fish, although most children don’t really go for the oyster platter. Indeed, if he has a rare shellfish allergy, it’s better that you find out early on. Limit processed sugars or juices that contain too much sugar, at least at home, where you have more control. Sugar reduces the appetite and fosters both bad eating habits and cavities. Slow sugars such as pasta should not be given in excess either, as kids rapidly develop a predilection to starch that can be hard to break.

At this point, you are probably very pleased with Jimmy’s voracious appetite. Enjoy it while it lasts, because this will change in the next few months, when he discovers that he can get more desirable food by throwing what he finds undesirable on the floor [See: Picky Eating].









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