Six months ago one of my clients was told that her baby at 1 1/2 years was
anemic (9.7) and was given a prescription for ferrous sulfate. When given
to baby, she immediately had gas pains and generally felt bad, in addition
to not wanting to take it.

Mom called me and we talked about alternatives, namely FOOD.  She had asked
the doctor about foods, but she insisted on the supplement, and urged mom
to cut back on breastfeeding.  The baby wasn't too eager to eat much solid
foods. I first suggested that mom give her zinc supplements to increase her
appetite. And I gave her a list of iron-rich foods.

She gave the zinc, and within a week the baby was much more eager to eat.
Mom began to offer the iron-rich foods, not having any high caloric, low
nutritional foods in the house. ( Well... maybe hidden somewhere.)

Ped had insisted on a re-check in 2 weeks.  Mom chose to not go in at that
time.  She took the baby in this week at 2 years and the hemoglobin count
was 12.9. The doctor was most pleased and mom enlightened her in the way to
resolve a low heme count with food. It sounded like a very thorough
nutrition lesson.

Baby's appetite is very good now.  Here is what she has been eating:

Steamed spinach with oranges every day

Egg yolk 5 times a week (on other days, lean beef)

Raw carrot 2 meals a day

Green beans every other day

One slice of "Hunger Filler" bread, a local high-quality, whole-grain,
multigrain bread with great ingredients

Yogurt with wheat germ

Bananas and apples.

What is interesting is that when I was working with this breastfeeding
couple 2 years ago, mom's diet was atrocious--lots of carbohydrates, only
about 2 vegetables, white bread, very little protein of any kind.  She had
always had trouble liking many foods. Now the whole family is eating better.

What a shame it would have been if she had just given the elemental iron
supplement, cut back on breastfeeding, and not made any changes in the
baby's or the family's diet.  Short cuts are often just "short."

I think that health care providers often think (perhaps rightly so) that
suggesting dietary changes won't have an effect.  But I have seen many
families' diets improve dramatically with the responsibility of feeding the
children. ( I am a case in point.) Nutrition information should be taught
to the parent as diligently as immunization information. I think that
particularly breastfeeding mothers will want to look for the most
nutritious foods for their babies.

Rice cereal, "baby food" and baby vitamins are another short cut that short
changes the growing child.

People also believe that children don't like vegetables.  That is not true
if the child has a good appetite and the food is offered as a part of the
family diet and the child is allowed to feed herself "real" food.  And if
the vitamins and minerals that the vegetables offer aren't substituted for
with children's vitamin/mineral supplements.

There is the cute cartoon in which Mom says, "Of course you like
vegetables.  You are vegetarian!"

We need a lot more training in nutrition as it pertains to food. It's not
hard to learn what nutrients are offered by what foods.  When this mom
called I looked in a couple of books and gave her a long list of iron-rich
foods.  She then picked and chose what she thought she would like to feed
her baby. The baby had some opinions, of course.  She didn't care for the
dried apricots and peaches. Mom couldn't think of what to do with black
strap molasses, as she is not much of a baker.

I am quite proud of where this mom has come, and she is proud too.

Patricia Gima, IBCLC
Milwaukee

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