Melanie Cole, MS (Host): There's no handbook for your
child's health, but we do have a podcast featuring world-class clinical and
research physicians covering everything from your child's allergies to zinc
levels. Welcome to Kids Health Cast by Weill Cornell Medicine. I'm Melanie
Cole. And joining me today is Dr. Elizabeth Odom. She's an Assistant Attending
Pediatrician at New York Presbyterian Hospital, Weill Cornell Medical Center.
She's an instructor in Pediatrics at Weill Cornell Medical College, Cornell
University, and she's a certified lactation counselor. And she's here today to
tell us about the introduction of solid foods with our babies, and such an
exciting time.

Melanie Cole, MS: Dr. Odom, thank you so much for being
with us. I'd like you to jump right in with when can we start with those
complementary foods, whether we're formula-feeding or breastfeeding. You know,
we all kind of look forward to that time when we can start doing the little
spoons and feeding like we see on the media and on TV. When do we get to start
that?

Dr Elizabeth Odom: Well, I always feel the same way. I'm
always so excited when we get to start talking about this with patients,
because it's such a fun experience. So generally, we recommend starting foods
between four and six months of age. And the biggest thing we're looking for is
making sure that babies have developed really good head control and they're
able to hold up their heads for long periods of time.

Melanie Cole, MS: Okay. Well, that's a great tip. So,
they have to be able to sit up and hold up their heads. Or do they not have to
be able to sit up, just hold their head?

Dr Elizabeth Odom: They need to be sitting upright with
support. So, that means that if we give them a little bit of help, having them
in a height chair, holding our hands at their waist, they're able to hold their
torso in their head up. But if we were to let go of our hands and they did a
little bit of that wobble and toppled over, that would be okay.

Melanie Cole, MS: Okay. Well that's really good to know.
And you and I were talking off the air having a fun conversation about when I
was feeding my kids and the foods that I started with. You're a pediatrician
and you're an expert, what foods are best to start with? Speak about those
first foods and what you tell parents when they say, "Well, what do I do?
You know, how do I start?"

Dr Elizabeth Odom: So, the very first food that we
recommend babies start with is baby cereal. And I personally prefer an oatmeal
cereal over other kinds. So, wheat cereals and mixed grain cereals are higher
risk due to a risk of an allergic reaction. And I recommend avoiding rice-based
cereals because there's some concerns about arsenic exposure.

So typically, I say we start with an oatmeal cereal first. And
the reason I recommend that is because we all have iron stores in our bodies
and babies' iron stores tend to start dropping between four and six months of
age, and baby cereals are fortified with iron. So, this way we know that
they're getting a little bit of iron into their diet. But after we do a few days
of these oatmeal cereals, that's when I say we're going to progress on to all
of the fun other foods. And I like to start with pureed vegetables and fruits.
You can do whichever one you've been dying to try first. Oftentimes people are
really excited about sweet potatoes or avocados. Some people want to do peas or
carrots, and any of these are completely fine. It's whatever you're most
excited to start with.

Melanie Cole, MS: And we were talking about making our
own versus the jars. And of course, similar to breastfeeding versus formula,
the cost is an issue. When you buy those little tiny jars, you know, they can
get pretty expensive. And making your own though can be a little bit time
tasking. So when you're talking to parents, what are you seeing that parents
are trying to do on their own versus going out and getting food?

Dr Elizabeth Odom: It's quite variable. So, some parents
are so excited to make their own food and some really wanna use the jarred baby
food, because the idea of making their own food is too stressful. And whichever
one you want to do is absolutely fine. If you are thinking about making your
own homemade baby food, there are tons of gadgets out there that you can buy.
But at the end of the day, all you really need is either a blender, a food
processor or even a hand mixer, because you're basically going to steam these
baby foods and then turn it into some sort of puree. So, it's not actually
quite as stressful as people imagine. I think sometimes all of the gadgets we
see on the market make people feel a little bit intimidated, but it's less
scary than it seems.

Melanie Cole, MS: Well, I concur with that. And a nice
blender, one of those nutribullets, anything like that. And then, you just
strain it out if it's stringy, little sweet potatoes or things. But avocado is
a fantastic food to mix with a little breast milk or formula, make it a real
good consistency, feed it to baby. Such a sweet time.

When can a baby start drinking other types of milk, Dr. Odom,
besides breast milk? And if so, are we looking at oat milk? Are we looking at
almond milk, whole milk? Are there other milks we should try at some point?

Dr Elizabeth Odom: Typically, a baby needs to be
drinking only formula or breast milk for the whole first year of life. And
after they turn one year is when we can start introducing other types of milk.
And we recommend they drink whole cows milk. There are a lot of discussions out
there about the different types of plant-based milk. But almond milk, oat milk,
these things are very low in protein and they aren't really a balanced milk for
babies. If you really don't want to do cow's milk, I tend to prefer a soy milk
because it has a good amount of protein and fat. Pea milk, which is made with
pea protein, is also a decent option. But I definitely recommend that you talk
to your doctor about this if you're thinking about trying other types of milk.

Melanie Cole, MS: Well, that was great information. Now,
as we're looking at these new foods, you mentioned starting with an oatmeal
type food and then trying our vegetables and fruits. How long do we wait before
we introduce new foods to a child? And what are we looking for as far as red
flags for allergies or intolerance?

Dr Elizabeth Odom: So, we recommend that babies wait
three to four days after trying a new food before we introduce anything else
new. And we're watching really closely for an allergic reaction. The biggest
signs of an allergic reaction that we're looking out for is rashes, hives,
vomiting, swelling of the lips or tongue or difficulty breathing. These are all
signs that your baby could be having some sort of reaction to the food that
they're eating. And if you see any of these reactions, I recommend that you
talk to your doctor before you try giving that food again. Sometimes babies can
get a rash and it's completely unrelated to the food that they just ate. But
we'd much rather be cautious so that we know what's going on and we're taking
good care of your baby.

Melanie Cole, MS: Dr. Odom, I think one important aspect
of when we start to feed our baby other things is that some parents look
towards fruit juice. Now, we're talking solid foods and the little bird mouth
opening, it's so sweet. But then, there's also fruit juice. And the AAP joined
leading health organizations recently, I don't know, this last couple years, to
approve new guidelines for healthy drinks. Should a child have fruit juice or
smoothies with vegetables and fruit? Speak about those things and if they're
acceptable for babies and into toddlers.

Dr Elizabeth Odom: Babies should not have any fruit
juice unless it's specified by their pediatrician for a medical reason. After
the age of one, the AAP says they can start having a maximum of four ounces of
fruit juice a day. But I would say that's the maximum. I would recommend
keeping fruit juice completely out of the diet if we can. If your child is
going to have a little bit of fruit juice, it should be a hundred percent
juice. You can dilute it with water and it should be out of a cup rather than
any sort of bottle. But there really is no reason that a child or a baby needs
any fruit juice. It's just extra sugar. And the fruit juice companies have done
a great job of advertising themselves. But I'd say avoid it if we can. They
really just need milk and water.

Melanie Cole, MS: I agree with you. I absolutely agree
with you. Occasionally orange juice because it's so unique and good, the
occasional apple juice because kids really like it. But really, you're right.
They really don't need anything but milk and water. And they have so much
sugar, those fruit juices. So, what great information. You are just a wealth of
information. Dr. Odom, I'd like you to wrap it up. Best advice about first
foods for baby and really when that most important time is and any questions we
should be asking our pediatrician, because we love our pediatricians.

Dr Elizabeth Odom: So, definitely talk to your
pediatrician before you're going to start serving solid foods. Remember it's
between four and six months, your baby should have really good head control and
should be able to sit with support. And then, embrace it. In the beginning,
babies aren't getting a lot of calories from their food. They're still getting
all of their calories really from milk. But it's a really fun experience.
Developmentally, it helps them to develop and control their tongue movements.
It helps with fine and gross motor skills. And it's just a wonderful experience
to really see your baby's reaction to foods. If your baby seems like they're
not interested in a certain food, remember that it can take over a dozen times
of trying a new food for their palate to adjust and get used to it. So, keep
offering different foods to really expand your baby's palate because one day
the switch can flip and they might love that food that they've been
uninterested in for the past month.

Melanie Cole, MS: I agree with you completely, and as we
switch it up and get more creative, you are really helping that palette to
develop and then your child will eat anything. I'm telling you, it works that
way. I don't know. But thank you so much, Dr. Odom. What great information
you've given us today.

And Weill Cornell Medicine continues to see our patients in
person as well as through video visits, and you can be confident of the safety
of your appointments at Weill Cornell Medicine. That concludes today's episode
of Kids Health Cast. We'd like to invite our audience to download, subscribe,
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don't forget to check out our Back to Health series. There are so many great
podcasts there. I'm Melanie Cole. Thanks so much for joining us today.

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