Saturday, June 28, 2008

Supplementing Options - What to feed baby?

When you first start to supplement, you may wonder what options you have for baby. Many moms are very opposed to using formula and investigate such things as rice, soy, or goat milk. Some moms wonder if they can use juice, solids, or cow's milk. In general, all these things do depend on your baby's age.

Here are my ideas based on what I've read and also done that worked.

For babies younger than 6 months old or for those who really aren't eating any solids of any significance at all, your options are pumped breastmilk or formula. The American Academy of Pediatrics (AAP) recommends the following options in terms of nutrition for very young babies from their first choice to the last:
1. Breastmilk via nursing
2. Mom's pumped breastmilk via bottle or other device
3. Pumped Breastmilk from a donor
4. Formula

The AAP also recommends that babies get breastmilk exclusively for the first 6 months - meaning no water, gripe water, formula, etc. For babies who must have a supplement, formula is the next logical choice, unless mom is able to pump or get donated pumped milk. Of course, some moms chose to use formula for various reasons and that is ok on here with us, but please do note the guidelines and that BM is considered best. So, if baby must be supplemented before 6 months old, use formula or BM before offering solids, as that is more in line with what is best for baby. That means, no rice milk, soy milk, cow's milk, water, gripe water, etc, etc...and no solids.

For older babies that need to be supplemented, mom may be able to get away with increasing solids or offering some limited other types of liquids - provided that baby is able to "make up" any deficits when with mom - so perhaps getting in an extra nursing session at night. Just make sure that you don't displace good fat/calories with a lesser source or that you don't skimp on it during the day at daycare without offering baby a chance to "catch up" later. Most babies who are nursing well remove milk much more efficiently than the pump - so even if mom has trouble pumping, most babies who are nursing effectively and efficiently will do just fine to make up the difference later that day when they are with mom. Just make sure you are offering frequently and not limiting time or access.

If baby is older than 6 months, but younger than 12 months and you need to boost nutrition or perhaps are struggling because you can't pump enough for all of baby's bottles for say, daycare, then you might be able to use some other foods. For instance, avocado is very high in fat and calories. Beans are high in protein and a good source of fiber. My daughter LOVED black beans! So, look to make sure that the solids they are eating are the "best choice", meaning if your child isn't gaining well and must be supplemented or you can't pump enough for those bottles, then skip the "puffs" and chose a more nutritious option. Noodles with a bit of olive oil is a good choice. Always BF or bottle first, as BM or formula should be baby's primary source of nutrition - then follow up with a nice meal.

If baby needs some liquids (maybe on a hot day!), 4 oz of juice a day is all that is recommended - so you can mix that with water to make it go a bit further (and baby won't get too used to the super sweets!) or you can offer baby some ice water or water in a sippy. Juice should never be given in a bottle. But for a baby 6-12 months, you want to make sure that they get enough calories and if you are short on milk the best way to do that is from good solids or to use formula. So, skip the "puffs" and the regular cow's amounts of juice can be used (watch that 4 oz guideline!), or formula. Water can be given as a liquid to wash down food if baby is eating well and mom doesn't want to give formula and then offer to nurse or give pumped milk again, as appropriate.

Babies over 12 months of age have lots of options, including cow's milk, soy milk, etc. Again, the 4 oz juice rule is still in effect! So, chose good nutritious options and supplement as needed with regular WHOLE milk (baby's need the fat until they are 2 years old for optimal brain development!).

So, I hope this helped you think through some more options for supplementing based on age. Let me know what you think or if any of this helped you!

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