The important question really isn't whether or not an exclusive diet of
breast milk is nutritionally adequate for an 18 month old.  That is easily
monitored by looking at how the child is growing in terms of weight, height,
and head circumference, hemoglobin levels, the child's health (is he sick a
lot?) his activity levels (is he a busy beaver like a typical healthy 18
month old, or is he apathetic and lethargic?) and temperament (is he sunny
and happy, or is he morose and sad and cranky?), and his
motor/speech/cognitive development.  If all those things are on track within
normal limits, then he *is* getting what he needs.  Give him vitamin drops
if you are concerned about some specific vitamin.

The important question is WHY is an 18 month old not eating any solids?  A
normal 18 month old human child will be interested in solids, interested in
eating and the social interaction that accompanies eating, putting
everything in his mouth, not just food, etc.  When children of this age
don't eat, that suggests something is wrong.  If his parents are withholding
food, that's a major problem.  If they are offering food but he refuses,
why?  Does he have a cognitive delay?  Does he have pain when he chews?
Does he gag and choke when he tries to eat?  He may have some sort of oral
aversion or defect of the esophagus, or tactile sensitivity or sensory
integration problem.  He may be highly allergic to many foods and doing
everything he can to keep them out of his body til it matures a bit more.

The point it, you need to find out WHY he isn't eating, and then work to
solve the cause of the problem, which might involve any number of different
things -- you don't just say "Yes, breast milk is enough nutritionally" even
though it probably is.

Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
Specialist in child feeding and child growth

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