>>Is there any recent information printed related to the advisability of
delaying solids until after 6 months?  4-6 months? Pediatricians here are
very skeptical of delaying solids and vitamins past 4 months.<<

Without even looking at the literature, I feel like this issue *should* be
easy to address. First of all, the AAP recommends starting solids somewhere
at the 4-6 mo. mark. Who decided to make it 4, rather than 6? Why? I haven't
heard any good answers to date; let *them* defend that one! When I had my
babies and went in for my 4, 5, and 6 mos checks, I always had the doctor
assess the baby's health first. It was, of course, always a clean bill of
health. Then, when they suggested solids before I was ready, I would just
say, "you said he looks healthy, right? That you don't have any health
concerns," and they'll say, "yes...." , at which point I would say, "well,
breastfeeding seems to be going just fine and baby hasn't acted interested in
solids yet. I'd like to just keep breastfeeding for awhile." My ped backed
off at that point.  If iron is brought up--- and this is usually the issue--
than ask for a hematocrit first!  But if baby looks and acts healthy, should
we be suspicious of anemia?

The real issue is this: where did all the concern for early solids come from?
 Most of our current pediatric advice is taken from our experience with
formula-fed babies, at least here in the U.S.  Formula-fed babies do indeed
run a risk of inadequate iron around 6 mos! What we need to do is point out
that breastfed infants are in a different category and shouldn't be treated
in the same manner.  And then, go back to the original question: what is the
baby's current health status? If it is healthy, why mess with it?

And then there is the issue of "signs of readiness".  As far as I can tell,
pediatrics totally ignores these cues in favor of the calendar.  The most
important one, in my mind, is the tongue thrusting reflex that pushes out
foreign objects. If baby is pushing stuff out, he probably isn't ready to eat
solids yet; why are we violating his instinct, his red flags?

This may not be "scientific", but it is common sense, and this is what I
teach my parents.

RE: vitamins, which I haven't yet addressed: I find that pediatricians seem
to be backing down more easily on this one than in the past. To the best of
my knowledge, ABM's contain the "RDA" for babies in vitamins, and so it is
supposedly only an issue for breastfed babies. But you know what? Unlike
solids & iron, I'm not even sure what vitamins they supposedly aren't getting
enough of!  And the fluoride issue is taking another swing back towards the
middle again, against supplements.  I'd like to see the literature that
*proves* that babies need vitamin supplements, ever, when healthy and
breastfed!  And I'm not talking about the comparison about what' s in
breastmilk vs what's in ABM....... I want to see the proof of vitamin
deficiencies in breastfed babies. Seems like there are few situations for
concern.

-Lisa Marasco, BA, IBCLC
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