Sometimes the problem in the 2nd 6 months of life is too much solid food too
early, offered as a replacement for milk.  Milk remains the mainstay of the
infant diet for 12 months because it is more calorie dense than most of the
solids typically fed to babies (e.g. strained fruits, veges, thin rice
cereals.)  These foods are high fiber and bulk, do add some vitamins,
minerals etc. but if the baby fills up on these, they may replace some of
the fat-rich millk calories.  Using expressed hind milk to thicken or mix
cereals or fruits adds value.  Accessible sources of complimentary protein
might be a smarter choice for the infant diet. Complementary foods are a
study in themselves.  WHO and LINKAGES both have good papers available on
introduction of complementary foods and I've found them useful in terms of
counseling moms on starting solids appropriately and in ways that don't
compromise good growth.

Additionally, the pattern of the breastfed baby is to be fat early, lean
later.  Many of these babies are robust growers early on and then catch down
to their appropriate genetic curve as they mature.  Looking at the stature
of the parents is appropriate.  I talked to a woman on the ph. yest. who was
worried (when doctor wasn't) about her baby daughter in the 5th percentile
at 1 year of age.  I asked the mother how tall she was, and she responded
that she was just under 5 feet tall.  Dad is 5ft 8in. so these are not big
people.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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