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Baby's First Year

Good Nutrition Crucial During Rapid Growth


In the first 12 months of life, a baby's weight triples and his or her brain size doubles. "There is no other time in your life that the brain doubles in 12 months," says Dr. Lillian Beard, a Washington, D.C., pediatrician.

No wonder parents are concerned about "what goes in the mouth, what goes out and sleep," she says. Now a "grand-pediatrician" seeing children of former patients, Beard also keeps busy as an associate clinical professor of pediatrics at George Washington University School of Medicine and Health Sciences, as an assistant professor at Howard University College of Medicine and as an occasional spokeswoman for the American Academy of Pediatrics.

Here, she offers a quick guide to baby's nutrition.

The First Months: For the first four to six months, babies should be fed solely breast milk or iron-fortified formula.

"There is no controversy about breast milk" being the healthiest food for a baby's first year, Beard says. For mothers who are unable or choose not to breast-feed, Beard recommends only iron-fortified formulas.

Introducing Cereal: Each child develops at his or her own pace, Beard says. Look for these signs that the baby is ready for cereal: Baby nearly sits up without support. Baby mimics chewing and gets excited when others are eating. Baby eats more than 32 ounces of breast milk or formula a day.

Cereal should be fed with a spoon, and baby should be able to swallow it. Putting cereal in a bottle poses a great risk of choking and prevents the child from developing important motor skills.

Other Food: Introduce one food at a time, feeding baby this food for three to four days and watching for any reaction, such as a rash, diarrhea or simple irritability. Babies' dietary tracts are not fully developed, and they may not be ready for certain foods. Start with simple rice cereal and slowly introduce pureed noncitrus fruits such as bananas, apples or pears, then complex cereals, yellow and orange vegetables, green vegetables and finally poultry and meats. By the eighth to 10th month, baby should be ready to attempt table food.

Baby Food: Beard urges parents to make baby food if they have time. Steam or boil a fruit or vegetable, then mash it with a fork or puree it in a blender, using the cooking water to get a smooth consistency. Processed baby foods, she says, are just as good. Manufacturers have, for the most part, stopped adding sugar and salts and are required to meet an FDA standard.

Fats: "At least 50% of a baby's calories need to be fat calories," Beard says. Fat is crucial to the development of the brain, spine and central nervous system.

Juice: It's OK to introduce juices at the same time as cereal, Beard says, but dilute the juice heavily with water. Start out with apple or white grape juice. Beard recommends using only juices prepared specifically for babies.

Iron: "Sadly, about 25% of infants are iron-deficient, and that is totally avoidable," Beard says. A recent Case Western Reserve Medical study in Cleveland found that children who had iron deficiencies that were later corrected still performed lower on intelligence tests than children who never had deficiencies, Beard says. Breast-fed babies need added iron after the fourth month, but Beard says they can get that in iron-fortified cereals.

Vitamins: Breast-feeding mothers should continue taking prenatal vitamins because they benefit both mother and child, Beard says. Pediatricians will sometimes prescribe vitamin drops for infants.

Forbidden Foods: Infants should not be fed nuts or peanut butter, both because of the great choking hazard and because some children have violent allergies to these foods. Citrus fruits, chocolate, strawberries and honey should not be fed to babies until they are a year old.

"Honey may be deadly," Beard says, because it contains spores that may cause botulism. Hot dogs and popcorn can also cause choking.

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