Nutrition: Baby and Beyond (cont.)

Member: Why is it unacceptable to feed my 6-month-old milk, but my pediatrician recommended that I give her yogurt?

Dr. Paula: Ordinary milk is processed in a way that is difficult for the infant gut to utilize and the result can be nutritional deficiency and iron deficiency anemia when ordinary milk is used in the place of breast milk or formula before age 1. Another problem with ordinary milk is that the lactose is difficult to digest and yogurt is a lactose-free way to introduce a semi-solid to your infant's growing menu. Be sure you use active live-culture yogurt, preferably whole milk yogurt, for your infant to ensure adequate fat intake and to address the lactose issue. Only live culture guarantees that lactose will not be a problem.

For more fun information about this subject, you might want to check out Chapter 11 of my Good Nutrition Guide for Babies, Toddlers, and Preschoolers. It's called "The Good and Bad 'Moos' About Milk."

Member: My 1-year-old weaned herself off formula but won't really drink milk. Sometimes she drinks it; mostly she just lets it dribble back out of her mouth. She's eating table food and drinking juice and water. Should I be concerned about her not wanting milk?

Dr. Paula: First, dump the juice. Even if it's calcium-fortified, it is nutritionally imbalanced and does more harm than good. Your 1-year-old doesn't need as much milk as you probably think. Remember that a slice of cheese is equivalent to 2-4 ounces of milk depending on the quality of the cheese, so home-made pizza and cereal with milk and a little yogurt more than covers most infant's calcium and vitamin D needs. For a true milk rejecter, you may need a vitamin D supplement to be sure your child gets enough. Your doctor can prescribe that. A 1-year-old needs only 16 ounces equivalent of milk a day.

Some infants reject milk because they experience discomfort when drinking it from lactose intolerance, although this is not as common as people think. You might try lactose-free milk but you will have to search for whole milk versions and they are difficult to find. True milk allergy is very rare and very obvious in that your infant would not just reject milk but would also have physical signs you could not miss. Most infants reject milk because they are in need of other types of textures and foods and it is the parent who is usually most anxious as a result of not knowing how different the needs of a toddler are from the huge milk needs of early infancy. Count the ounces in these other dairy products before deciding to continue urging milk on your infant. And never offer chocolate milk as an incentive.

Member: My baby has breast milk intolerance when I eat milk products. There is a family history of food allergies. Our doctor has told me not to eat any milk, wheat, or soy products. Why is she having a reaction and is it the breast milk?

Dr. Paula: Your doctor has put you on the right track as far as protecting your infant from future allergies. The protein of cow's milk passes easily into breast milk much the way that medications do. So, you are feeding your baby cow's milk through your breasts to a degree when you ingest cow's milk products yourself. This is not uncommon. Even moms without strong allergic histories should be cautious with their cow's milk intake during the nursing period and remember you don't need to drink milk to make milk. Cows eat grass!

Dr. Paula: I drove my poor mom crazy as a kid, not eating anything she fed me. Can anything be done to avoid getting a taste of my own medicine as a parent? Or are picky eaters born that way?

Dr. Paula: Picky eaters are made, not born, and usually they are made by example. I suggest that you broaden your own food choices if you are still picky as a way of modeling good eating habits for your child. Don't expect quick results, but in the long run, the more variety both in color and category of foods that you present to your infant, the more likely you will avoid the picky eater syndrome. Vegetables and fruits are usually eagerly eaten when they are presented as finger foods and in interesting shapes.

Don't overreact to your growing infant's choosiness, which is not the same as picky eating. Your infant's interest in round shapes should only lead you to provide round food at the right age (meaning early toddlerhood). This is not an introduction to picky eating. Parents are very often hyper-eager to introduce new and interesting foods to their child's menu but choosing carefully extends to safety issues as well as nutritional ones. Your infant's gag reflex goes a long way to guiding you so that if your baby returns foods that you think are soft enough, that is probably a signal that the foods were not soft enough for safety. A good early finger food is a soft-baked french fry along with soaked Cheerios, but never leave your child unwatched while eating and aim for appropriate shapes that fit not only in your child's hand comfortably but also cannot block your child's airway. Anything larger than a nickel needs to be cut smaller. Number one foods to be avoided are: carrot sticks, all nuts, hot dogs, and popcorn. I'm also a fruit fan but avoid berries unless you squash them first and your baby is over a year of age. They make unfortunately perfect plugs.

Moderator: Grapes too!

Member: What is your opinion of the impact of Bovine Growth Hormone (bGH)? Do you give your daughter milk from cows that could have been injected with this hormone?

Dr. Paula: Mounting evidence is pointing to the risks involved in additives for any kind for children's foods including hormones in milk. However, as the story is not yet complete, most milk products, with the exclusion of formula, do contain hormone additives. To the extent that you can avoid any food additives without compromising your child's total nutrition, you should aim for purity of food.