COMMENTARY

When to Start Solids: Best Practices in Infant Nutrition

Christopher J. Chiu, MD; Justin L. Berk, MD, MPH, MBA

Disclosures

March 05, 2021

This transcript has been edited for clarity.

Christopher J. Chiu, MD: Welcome back. We are The Cribsiders, the pediatric medicine podcast that interviews leading experts in the field to bring you clinical pearls and practice-changing knowledge, and answer lingering questions about core topics in pediatric medicine.

Justin L. Berk, MD, MPH, MBA: We are summarizing our podcast episode on infant nutrition. We interviewed Dr Joan Meek, who's a pediatrician, dietitian, and certified lactation consultant. She has been chair of the American Academy of Pediatrics breastfeeding section. Dr Meek gave us a lot of great pearls about feeding infants.

Chiu: My favorite pearl was about the benefits of breastfeeding. We know that breastfeeding benefits both the mom and the baby. For the mom, breastfeeding reduces the risk for diabetes, hypertension, and breast and ovarian cancer. For infants, breastfeeding is linked to a decreased risk for severe diarrhea, otitis media, obesity, and lower respiratory tract infections.

Berk: One thing I have always struggled with is when to start iron and vitamin D supplementation in breastfed infants. We talked about how breastfed, healthy term babies should receive iron supplementation at around 4 months, because there is a little less iron in breast milk. Fortified formula milk does have iron.

However, vitamin D supplementation should start immediately for any breastfed infant. Any infant consuming less than 34 oz of fortified formula daily should just go ahead and start vitamin D after birth or at the time of discharge to help prevent rickets and other vitamin D deficiencies.

Chiu: Age is not the only factor to consider in determining when an infant is ready for solid food. You can start feeding solids when the baby can sit upright. They have good head control and they can push back food.

Berk: Mentioning that major milestone for when it's safe to start solid foods was a good pearl. You can hear the full podcast and see images of typical clinical findings here: #14: Infant Nutrition: Digestible Pearls with Dr. Joan Meek, MD

Chris Chiu, MD, is assistant professor at The Ohio State University, where he is also the physician lead at OSU's Outpatient Care East Clinic and serves as the assistant clinical director for the internal medicine residency. He is an Air Force veteran and a self-proclaimed gadget geek. Follow him on Twitter

Justin Berk, MD, MPH, MBA, is assistant professor of medicine and pediatrics at the Warren Alpert School of Medicine at Brown University. He is a clinical educator active in ambulatory and inpatient care and pediatrics. He enjoys coffee, thinking about hiking, and being a generalist. Follow him on Twitter

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