Liz recently sent us this question:
My 5-month-old son recently started solids. He's in the 95th percentile for his height and weight. He's a voracious eater, and let's just face it, he's a bit of a hoss. I'm really confused about how much I should be feeding him and when. He started cereal at just 2 1/2 months old under the advisement of his pediatrician because he was consuming insane amounts of formula. The doctor told me at his 4 month check-up to start solids, warning me that his formula intake would drop. The doctor didn't tell me how much formula he should be getting.
I am a young, single mom struggling to raise my son under my parents' roof while trying to finish school and working a semi-full-time job. My mother (so full of advice that it brims over constantly), having successfully raised two "big" baby boys of her own, insists that I am not feeding the little piggy enough, while my dad insists that he is not hurting for any nutrition, according to his size.
I have read up on the subject, and all the books say solid food is just an added bonus to formula (where most of the nutrition is) until 6 months or so. He is now eating cereal in the morning, a jar of veggies at lunch and a jar and a half at supper. His formula intake varies, but is usually around 30 ounces per day, and he'll eat whatever and whenever you offer him food.
Am I feeding him too much? Too little?
Liz, this is a timely question because a study was recently published regarding weight gain in infants, including infants under 6 months old. The researchers found that in the last 22 years, the number of fat babies (95th percentile after adjusting for height) has increased by 73%. This is not good news since other research in the last five years has shown that rapid weight gain prior to the sixth month of life is associated with obesity in later life.
Let me be clear -- I'm NOT telling you about this research so that you can wonder whether your son is going to be obese later in life. Remember, some kids are simply bigger, some are smaller. A lot depends on genetics. I'm telling you this because what this research suggests is that our society's perception of a "fat baby" as "healthy baby" may need to change. Thus, your mother's notion that "bigger is better," may not be so!
Now, because Mary and I are not qualified to provide nutritional advice, we consulted a pediatric nutritionist on your behalf. Here's what she told us:
"With the amount of solids he's taking, she may want to cut back on formula to about 24 ounces. Just put a little less in each of his bottles. I don't know if she's giving him any juice, but I'm really opposed to juice for infants. It's mostly sugar water and can really add up the calories. She also may want to give him 2 ounces of water a day. I really like it that she's giving him veggies twice a day.
With respect to cereal, I would start with about 1 tablespoon of rice cereal mixed with an ounce or 2 of formula. He should be encouraged to actually suck the cereal off the spoon rather than have mom use the upper lip to scrape it off. The cereal mix should be pretty soupy. Once he gets the hang of eating the cereal, I would increase it to 2-3 tablespoon once or twice a day. I usually ask that babies not have anything but formula or breast milk added to the cereal (no fruit, juice, sugar, or other sweetener). If he tolerates rice cereal, he can move onto oatmeal, barley, and, finally, mixed cereal."
Additionally, the research cited above and our pediatric nutritionist stress watching the baby's behavioral cues. If he is turning his head away, begins spewing the food out of his mouth, or he starts crying as the spoon nears his mouth, he's done! And, given he'll eat anything when offered, he shouldn't eat outside his regularly scheduled feedings. He should also not be "forced" to finish his meals. He'll let you know when he's hungry (his crankiness or crying may be a clue!) and when he's done. He knows better than anyone!