Pediatrician Dr. Joelene Huber answers parents’ common baby questions in the areas of feeding, sleeping and playing.
FEEDING
Q: When should I start my baby on solids? How do I know she’s ready?
A: Babies are typically ready to start solids around six months of age. Some babies may be ready to start solids a few weeks earlier than six months and you can follow the baby’s feeding-readiness cues. Some signs of readiness to eat include:
- She has good head control and is able to sit up in a highchair (this is preferable over holding her in your lap for a feeding).
- She starts to get hungry between feeds or doesn’t seem to be getting enough from breast milk/formula and still seems hungry.
- She watches you eat and seems interested in your food.
- She opens her mouth when she sees food coming.
- She can hold food in her mouth without pushing it out with her tongue.
- She can turn her head or lean back to indicate she doesn’t want the food, is full, or not hungry. It’s important to follow and listen to a baby’s fullness cues and allow her to indicate when she’s full. Babies who are allowed to express when they are full may be less likely to overeat later in life.
Q: What are the best foods to start first?
A: The first solid (puréed) food you feed your baby should be rich in iron, such as a store-bought iron-enriched cereal, meat, or meat alternatives like cooked egg yolk, tofu or well-cooked puréed legumes, like chickpeas. Most healthy term infants are born with sufficient stores of iron, but at around six months those stores become depleted and breast milk alone can no longer meet baby’s nutritional requirements, especially for iron. New foods should be offered one at a time every two to three days so that in the event of a reaction, it’s easier to determine which food may have caused it.
SLEEPING
Q: I don’t think my baby likes sleeping on her back. How important is this?
A: Placing babies on their backs to sleep—not only at nighttime, but also for naps and in the stroller—reduces the risk of Sudden Infant Death Syndrome (SIDS) by 50%. SIDS is the unexpected, unexplained death of an apparently healthy infant under one year of age. Occasionally placing babies on their tummies to sleep could place them at an even higher risk of SIDS. Don’t assume all babysitters know to place your baby on her back to sleep—make sure to communicate your safe sleep practices to all caregivers. Visit the Health Canada website for a Safe Sleep for Baby brochure.
Q: Besides back sleeping, what else can I do to help lower the risk of SIDS?
A: There are many benefits to breast feeding, but one you may not know is that any amount of breast feeding is considered one of the protective factors against SIDS. Exclusively breast feeding in the first six months can reduce the risk of SIDS by up to 50%.
Another way to cut the risk of SIDS is by de-cluttering the crib. Remove pillows, quilts, stuffed animals, bumper pads, ties, sheep skins, toys, monitor cords and any other objects from the crib. Babies should sleep in a current Health Canada regulated crib/cradle/bassinet on a firm, flat mattress, with a fitted sheet. If using a baby sleeping bags (i.e., a Sleep Sack) as an alternative to a blanket make sure it fits the baby properly with no risk of the baby sliding down inside of it.
Avoiding smoking during pregnancy and creating a smoke-free environment (i.e., in the house and car) after the baby is born is also a very important way to reduce the risk of SIDS. Reducing exposure to second-hand smoke helps reduce the risk of SIDS.
Q: What’s the current thinking on room sharing vs bed sharing?
A: Many parents don’t know that room sharing (not bed sharing) is recommended for the first six months and could reduce the risk of SIDS by 50%. Room sharing means having the baby in a current Health Canada regulated crib/bassinet/cradle in the same room as their parent/caregiver, within arms reach, for the first six months. This should be distinguished from bed sharing (baby sharing the same surface as their parent, such as a bed, couch or arm chair) which can increase the risk of SIDS and accidental death. Adult beds and adult bedding are not designed according to baby safety standards for sleep and babies could get trapped, roll off, or get smothered. Don’t ever settle for any substitutes for a regulated crib/cradle or bassinet, such as baby swings, car seats, or bed sharing.
PLAYING
Q: My baby hates tummy time—why is it so important?
A: Tummy time is crucial because it helps baby build head and neck control, and upper body and abdominal strength, which are important for gross motor development. Babies skulls are soft and if they primarily spend time their backs, the back of their head can become flattened—supervised play time on their tummies helps prevent this and helps them develop important skills, such as head control, rolling, and sitting.
Q: What can I do to help my baby enjoy tummy time?
A: Many parents don’t know that tummy time can begin regularly in the newborn period by placing the baby on her tummy while awake after each diaper change for a few seconds (always supervised). To help your baby enjoy tummy time more, get down on the floor face to face with her or lay down on your back on the floor and place your baby on your chest (chest to chest). It will help to have you close to interact with as she works on those important gross motor developmental skills. As your baby gets older and has better head control and upper body strength, supervised tummy time play can include reaching for and interacting with bright toys and looking at interesting things (i.e., a non-breakable mirror) and you can work up to 10 to 15 minutes of supervised tummy time play intervals throughout the day (i.e., three or more times a day).
Great parent web resources on feeding, sleeping, and playing: