Please note: introducing solid foods is a big step for you and your baby. We recommend that any actions you take in this activity be done with support and counsel of your healthcare advisor.

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Q: I am a vegetarian, is it okay to have my baby be a vegetarian also?
Q: My one year old used to love vegetables and ate them with enthusiasm - but recently she's refusing to eat any. I'm not sure what I should do, I'm worried that she isn't getting enough nutrients?
Q: I am breast-feeding my four month old exclusively, and still taking my pre-natal vitamins - does my baby need a vitamin?
Q: My 11 month old loves to feed herself and really prefers table foods to "baby" foods. I am always worried that she's going to choke, are there any foods which I should avoid?
Q: Is it true that breast-feeding can help prevent obesity?
Q: In order to avoid obesity, should I give my baby skim milk at twelve months?

Q: I am a vegetarian, is it okay to have my baby be a vegetarian also?

A: The health benefits of a vegetarian diet have been well documented in adults - and for the most part, it is possible to meet all of children's nutritional needs with a vegetarian diet, as long as it is carefully monitored and supplemented. Of course, there are various degrees of vegetarianism and the more strictly vegetarian one eats, the more at risk one becomes for vitamin deficiencies (especially vitamin B12, vitamin D, iron, and possibly at risk for growth failures). It is very important to discuss your decision to adhere to a vegetarian diet with your primary care provider (PCP) so s/he can help to determine if supplementation is needed and if your child's energy needs are being met. Of particular importance is the need for vitamin B12 supplementation in breast-fed infants whose mothers are vegans (very strict vegetarians who do not eat any foods from animal sources).
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A: You are not alone - this is a common occurrence and a great concern for parents. First of all, let me say that you should not get discouraged, be patient and never give up. Keep offering her a variety of healthy foods - including vegetables. Just try small amounts - and respect her "choices." If she isn't even taking small bites, try sneaking them into foods. For instance, puree vegetables and add them to pasta sauces, or mix with fruits and put in yogurt, shred carrots and zucchini and put them in muffins - I've even seen recipes for adding chopped spinach to brownies! Maybe you don't have to go that far but be creative. Your child is getting smarter and smarter every month and it is going to be harder to sneak those vegetables by her, but they are an integral part of a healthy, well balanced diet. Toddlers often refuse what used to be their favorite foods, but it is usually just a temporary situation, that's why it is important to continue offering vegetables. And in the mean time serve more fruits (hopefully she hasn't given those a break) - essentially, they have many of the same vitamins and nutrients. It is also a good idea to give a multi-vitamin; think of it as a safety net in case she hasn't eaten well and met all her nutritional requirements. Additionally, it is important for your daughter to see you eat and enjoy vegetables regularly - children learn from modeling.
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A: Breast milk is the perfect food for your baby, however there are certain situations where vitamin supplementation is necessary for a healthy baby. Breast milk has low amounts of vitamin D (whether or not you are taking vitamin supplements), but fortunately, our bodies can synthesize it from sun exposure. However babies who have darker skin, or live in colder climates further from the Equator (where skin is covered when outdoors) may not get enough sun exposure and are at risk for vitamin D deficiency (rickets). Rickets is a serious, yet preventable condition, and therefore vitamin D supplementation is usually recommended for breast-fed infants. Also - if you choose to breast-feed exclusively for longer than four months, it may be prudent to give an iron supplement because although the iron in breast milk is better absorbed than other sources, this is the age when iron stores are depleted in the body. Extra iron requirements can usually be met by fortified infant cereals, but if you have not given any cereal by 5 or 6 months, check with your PCP about starting supplements to avoid anemia. And as I mentioned before, if you are a vegan, you need to supplement the baby's diet with a multivitamin. Always discuss these issues with your PCP, s/he will recommend an appropriate vitamin supplement if and when it is necessary.
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A: Most people avoid giving infants and toddlers the obvious hazards such as hard candy, nuts, and chewing gum, for example. But two foods which cause many choking deaths in children are grapes and hot dogs. They are slippery and firm - perfect for getting lodged in a small airway. These foods are still given to infants and toddlers, even though they are so dangerous, and there is no real nutritional need for them (yes grapes are healthy, but there are safer fruit choices). Only give these to children under three if they are peeled and cut into very small pieces. Remember - all foods can be potential choking hazards. To decrease the chance of choking, serve small and soft pieces of food, ALWAYS have your child strapped in an appropriate feeding seat - or if old enough, sitting down (not walking around) for meals and all snacks. Never let toddlers eat in areas where they cannot be directly observed - as with all accidents, choking can occur very quickly.
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A: Yes - breast-feeding plays a major role in preventing pediatric obesity - a growing problem in the US which puts young people at risk for diabetes, hypertension, and heart disease. These used to be thought of as conditions which only affected adults. In order to prevent these conditions, it is important to establish healthy eating habits from the beginning. And breast-feeding is the best way to accomplish this. For one thing - mothers learn from the get-go to pay closer attention to babies' satiety cues because there are no external ways to see when babies are full and have had enough. Breast-feeding also introduces babies to the tastes of foods that their mothers are eating - giving them earlier exposures to healthy foods which will make it easier for them to accept later. It is never too early to implement healthy habits. In addition to breast-feeding, I think the most important things you can do to help your infant are to help her pay attention to her own food cues and avoid forcing foods, offer a variety of nutrient-rich foods, avoid partially hydrogenated oils and processed foods and avoid giving large amounts of juice. Good eating habits established in infancy will continue into childhood and have a direct impact on health.
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A: Under normal circumstances, babies should receive whole milk until two years of age. It is not necessary to restrict dietary fat intake in healthy babies and toddlers - as long as they are getting a balanced diet. In fact, fat is crucial for neural development in this age, and whole milk is a good source of essential fatty acids.
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