Let’s get real. These are real questions from a real mom of a real baby that is a patient of mine. The mom asked a collection of common questions I address at the 6 month well visit, I decided to just post the questions along with my responses here. I will probably do this again for a prenatal visit, a few infant age visits, a 2 year old visit, and school age and teen visits.
Q: When should I start juice?
A: Never! For the sake of fostering healthy habits and protecting children’s teeth, just stick with water. At 6 months a baby can start drinking water and practice drinking it from a sippy cup. I used Nuby cups (with handles, without handles) for my first child, starting with the spout version and then around 9 months we switched to straw cups. My second child had a cleft palate so our sippy cup options were more limited. After trying several brands, we used the Born Free cups (pink, gray, and green options). More recently, my kids used the Contigo brand (lots of colors, options to purchase set of 2 or 3), but they were hard to clean. When on of the spouts got moldy, customer service was excellent and sent us 2 new bottles. Currently we are using the Thermos Funtainer (so many themes from princesses to superheroes to star wars) with removable parts to wash, and also inexpensive replacement parts. Few parts and easy to clean are absolute musts because mold creeps up very quickly, and also filling them with just water is much easier to clean than juice.
Q: What else can we give the baby aside from cereal, fruits, and veggies?
A: So much!!!! Between 6 to 9 months, you can offer clumpier foods on a spoon, and eventually transition to letting the baby try to pick up finger food and self feed. As long as development is on par and the baby is interested, you can probably pretty much offer anything that is a safe size and mashable soft. A safe size would be small, around the size of the child’s thumb, and not a circle shape – which can occlude the airway. This is why even for kids up to 5 years old (or even 10 years old according to what certain pediatric emergency medicine doctors do for their own kids… ahem…), grapes and hotdogs should be cut in half lengthwise. For 6-7 month old babies who are learning eat round fruits, I recommend cutting blueberries in half (or maybe even in quarters at first) and cutting grapes into 1/4 to 1/8 pieces depending on size and removing the grape peel. I often diced and steamed zucchini, squash, and carrots for baby and toddler meals. Steaming frozen broccoli florets and peas (and flattening them with a fork after they are cooked) is a fast option. You can also soft scrambled eggs (I mix them with milk to make it more mushy) or tofu, or mix in salmon or fish flakes in the rice cereal (obviously removing any bones. I make meat puree by first making a broth without adding salt and put the broth, broth veggies and meat into a blender puree. The baby can also try peanut butter (look for options without added salt or sugar) at 7-8 months of age. I recommend adding it to oatmeal and bananas to make it less sticky and more smooth. Basically, the baby at this point can try anything soft and safe size except for honey. Offering a rainbow as in a variety of colors of foods is a great way to ensure your child is getting a well balanced diet. Below are some snacks the baby can try as well. There are also products such as teething biscuits (Rice Mum Mums), puffs (check out bulk prices for Happy Baby and Gerber), and yogurt melts (save by buying bulk Happy Baby and Gerber) that dissolve soon after contact with drool, but I usually caution letting the baby try small pieces first, and then offering the whole piece once they are more familiar with the process of chewing/mashing-food-with-gums. Of course all this is general advice, so definitely consult with your child’s pediatrician first and especially for babies with severe eczema or a family history of food allergies.
Q: What can we do to help the baby with teething?
A: Teething medications are not recommended by pediatricians. They may contain ingredients with dangerous side effects like problems breathing. Others are not effective at all. Teething or amber necklaces pose a choking hazard. I often tell parents, if it ain’t broke, don’t fix it. If the baby is just drooling, but otherwise smiling, laughing, and interested in toys, and eating well, then no intervention is needed except to put a bib on the baby and repeat 100x a day. If the baby seems to be uncomfortable, you can try cold teethers (put a few in the refrigerator so you can rotate them), or a frozen (and briefly thawed) moist washcloth. Distract the baby with singing, toys, reading, music, or making silly faces in the mirror. If the baby is having a hard time settling, then you can try pain medications such as ibuprofen or acetaminophen (call office for dosage if you are unsure). Never aspirin. Call the pediatrician if the baby has a fever (research shows that temperatures >100F are not caused by teething) or if you are using pain medications for more than 2-3 days. The doctor may want to examine the child in the office to rule out ear infections or other problems.