When to start solid foods?

[Spring Lily]

Hi, I hope this is the right place to post this.

I have 5 1/2 month old twins who were born at 34 weeks. They're both doing well healthwise and are hitting their milestones for adjusted age, sometimes even close to their actual age. My DD is still very small, in the 2nd percentile for height and weight. We're BFing exclusively.

The thing is we're starting to hear people (family and a peds nurse we see for RSV shots) telling me that I should start them on solids. I've been planning to wait until they hit 6 months, adjusted, so that's still a couple months away! The babies are very interested in food, try to grab my plate and make chewing motions with their mouths, but neither can sit up on their own yet. I don't see how a little baby food is really going to help my DD gain weight, either. She shouldn't fill up on solids; if she needs protein and calories then she should be getting breastmilk instead! I don't think of solids as being for nutrition purposes when a baby is under a year, anyway.

So I'm just wondering, when did you start your babies on solids? Did you go by adjusted age or actual age?

[PE&M]

My dd is a 27 weeker. She just turned 9 mons / 6 mons adjusted. She weighs a whopping 10 lbs. Her ped & I both feel it's best to wait a while longer & get as much bm in her as possible.

Then again, she's not interested in food yet.

If YOU want to wait, then I think you should.

[~bookcase~]

i've the similar issues. my twins are 5 months, born at 32 weeks, daughter on 4th percentile. i intended to wean at 6 months adjusted at earliest. i read a leaflet just recently that stated weaning should happen between the 5th and 7th month after birth (not adjusted) to avoid food aversions/ sensory issues.....but i'm not 100% convinced and wonder if this more relevant for micro preemies where i understand these are more common issues. that said, my daughter definitely has come through more sensorily damaged than my son, so i'm keeping it in mind iyswim.

otherwise i'll be following their cues as any other baby:
sitting up
teeth
swiping for food from my plate

etcetcetc

[irangel]

honestly i'd ignore them and start when you feel they're ready. there's no harm in waiting until their 6mos adjusted age, especially if they're not showing an clear signs of being ready now. And baby food as less calories per ounce than both breastmilk or formula so it definitely will not help with weight gain but can hurt if it starts to replace the breastmilk/formula intake.

I started both my 29wkr and my 25wkr on solids at 6mos adjusted.

[irangel]

Originally Posted by shukr

i read a leaflet just recently that stated weaning should happen between the 5th and 7th month after birth (not adjusted) to avoid food aversions/ sensory issues.....

This is a somewhat highly debated topic even among GIs it seems. Obviously on the one hand some doctors feel it's better developmentally to start based on actual age but the other side is that the gut is still developing when a preemie is born and development outside of the womb, as we know, is not equal to development inside the womb and therefore it's best to wait until adjusted age to introduce solids. I tend to believe in delaying for preemies, especially micros who are likely to have weight gain problems and more GI issues. I wonder how the difference between UK and USA plays into the suggestion of when to start solids with preemies.

[elephantine]

I started tiny amounts of solids around the time my 29 weeker twins were getting teeth. I was never able to make enough breastmilk to exclusively feed them so I figured their guts had already been dealing with formula so long, little amounts of yogurt and organic fruit/veggie puree wouldn't hurt. They were about 5 months adjusted age when they had their first taste... but didn't start eating more regularly till they were about 10 months adjusted.

[jlovesl]

Every baby is different and if you have faith in your ped. do what he/she suggests you do. My 31 weeker started solids at 4 months corrected age. Not for weight gain but to help with his reflux. And to, your baby will let you know when milk is not enough to satisfy them. But you should ask your doctor and never listen to family(did they have a prem?) We also found some nurses who fancied themselves as doctors giving us ill advise. Telling us he should be doing this and that already. Well we talked to our ped.(who we LOVE) and he actually told us to report that nurse because they are not to give their opinion of care when they don't know the circumstances. She was a vaccination nurse.

[GOPLawyer]

I don't see how a little baby food is really going to help my DD gain weight, either. She shouldn't fill up on solids; if she needs protein and calories then she should be getting breastmilk instead! I don't think of solids as being for nutrition purposes when a baby is under a year, anyway.

I could not agree more! I seriously don't get peoples' obsession w/ starting solids. Like you said...BM is what's important now. Solids are just for practice at this point.

if you have faith in your ped. do what he/she suggests you do.

JMO but I would NEVER blindly follow anyone's suggestions. Do the research and decide for yourself.

[Spring Lily]

Thanks, everyone! This has been very helpful. If anything it just reassures me that I'm not crazy to be waiting. My gut just tells me they're not ready yet, especially since they can't sit up on their own. My smaller one is, the ped & I believe, "younger" than the other one in many ways--and measured a month behind at birth. So in some ways her system is less developed, more like a 30 weeker.

I don't think I'll wait for teeth, because my older child didn't get any until 8 months! She did well on pureed veggies, so I was fine with that. I don't think the teeth do a lot to help them chew, anyway, but I know everyone has their own viewpoints & feeding methods.

Our 6 month visit is in a couple weeks, so I plan to talk to the ped about it. She knows I'm cautious about everything (vaxes, solids, etc) so I know she won't pressure me.

[foreverinbluejeans]

Brain growth is the most important thing for a baby in the first year. If babies have anemia they don't have enough red blood cells to carry oxygen to their brains. It's important to make sure preemies don't get anemic.

Human milk iron is well absorbed but it might not be enough for a preemie. That's why statements about breastmilk include words like "for the healthy, full term baby." Preemies should have their blood checked. This may just involve a heel prick and a 5 minute test. If the baby is anemic the baby may really need iron and may need it in the nasty vitamin form.

If you don't give it to your baby your baby may end up in the hospital. If doctors don't think you are giving it to your baby when you have been told to you may end up having child protective services investigating you. My son had an undiagnosed genic disorder and the hospital thought I was "starving" him. I was lucky that another hospital figured out what was wrong before he was taken away.

When preemies start solids iron rich foods are important.

[sbrinton]

If there is some concern about anemia, I would suggest trying floradix or floravit. We used this with our youngest who was anemic in the first months after his birth (at 31 weeks). We found that it brought his iron levels up quickly enough to keep our ped happy.

We're planning on waiting to do solid food until our baby is 6 months adjusted too, although I suspect it may be difficult because he's already salivating when we eat something that smells good.

(warning: toddler melting down...)

[henriksmom]

My son's neonatologist also told us to wait until 6 months corrected. Our son was born at 29w 6d. After his first month he was gaining 1 kg a month and now has slowed down a lot. I know that his growth could not go on forever but he eats at the low end, or less, of his requirement. I know how much he eats since I pump and measure. He is getting more active and is burning off his calories. I will keep my eyes open for his signs or readyness but he is still under 5 months corrected.

[Spring Lily]

Update:

I went to the ped and told her that I was planning to wait until 6 months corrected, and she said, "That's a good idea." She agrees that they're not really ready yet, although my DS could start sooner if I really wanted him to. I don't want to push it because it's only another 6 weeks, and I'm not in any hurry. It did feel good to get that validation from the ped, though. (We have a great, respectful ped.)