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Expert Q&A:
My child is 3 months old -- when should I introduce solids?

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Answered by Suzanne Dixon MD, MPH

"I love this job!" says Suzanne Dixon. "I believe I can bring the best of information to families by the thousands every day. I'm not shy about tapping my colleagues and friends all around the country so that we can get the latest, best, and most sensible advice on every issue."

Suzanne Dixon, MD, MPH, was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her paediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former USSR.

Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in paediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education andis just coming out in its third edition. She has served as an associate editor for Infant Mental Health and currently reviews for several major paediatric journals.

Dr Dixon is a fellow of the American Academy of Paediatrics and served in national positions in that organization. She is a member of the Society for Paediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Society for Developmental and Behavioral Paediatrics.

Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental paediatrics in Montana and works with local advocacy groups on education and women's health. Dr Dixon has been married for 25 years and has three sons. She and her husband travel frequently and enjoy being amateur anthropologists.

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Question


I have a 3-month-old foster child who's thriving on fresh goat's milk. When should I start feeding her solids and juice?

Answer


The latest recommendation is to introduce solid foods at 6 months. Juice isn't necessary but up to 4 ounces can be given by cup after 6 months. Citrus juices are best left until after 1 year of age. However, I am very concerned about your child's current diet. Goat's milk, like cow's milk, is very high in minerals and protein. It's designed to promote the rapid growth of baby goats, so I'm sure your child is gaining weight. The salt and mineral balance in this milk, however, may be causing a strain on your child's gut and kidneys. The protein component may be setting her up for later allergies. These are the same reasons that we advise parents to avoid cow's milk for the first year of life, to allow for the baby's digestive and immune systems to mature. Goat's milk is deficient in folic acid, iron and vitamins A, C and D. Although the last four can be provided as a supplement, folic acid cannot. The body doesn't store it well and uses it to produce rapidly dividing cells such as those that make blood cells. Folic acid deficiency can lead to anaemia and other difficulties. Commercial formulas are designed to closely imitate the composition of human milk. They are the next best thing to human milk for human infants. I strongly advise you to switch to one of these until she is a year old. In addition, unpasteurised milk can carry a real risk of infection, from gastroenteritis to tuberculosis. These infections are very serious in young infants. Commercial formulas are manufactured to the highest standards and, if prepared according to package directions, do not add risk of infection. Infants should avoid fresh milk products other than human breast milk. If commercial formula seems too expensive and you are on Income Support, contact your child health clinic to see if you are eligible for tokens for free milk (or baby milk if your baby is under a year old).
 
 
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