9 mo. old anemic breastfed. What foods?

[Agnus]

My thirty something daughter has a 9 month old. This is her first child. She intends to breast feed until he weans himself. I visited a week ago (I only get to see him about ever 3 months) I suspected that he might be borderline anemic.

I did not express my suspicions to her. Now I have an email from here saying that he is "just slightly anemic" She added a disclaimer though that the "nurse said the test might show that because she was not able to get enought blood on that draw." I can handle explaining that part to her. The test only takes a drop from the tube the amount for a glucose monitor and they are looking at the quality not quantity, the color or the hemoglobin.

I have enough lab background to let her know this.

However, it is his diet that I am concerned about. His primary source of nutrition is still breast milk. I told her, much to her surprise that back when she was a baby Laleche promoted starting the baby on meat around 6 months. She said that meat is not recomended today until much later. (was it a year she said?)

She does not feed consistently nor regular meals. Some days all he has is a few cheerios. The only foods she gives him are. carrots, brochli, peaches, white grape juice (rarely), squash, I think he may have had green beans, has not had peas yet. rice cereal, barley cereal.

She told me her peditrician said she can introduce new foods more frequently than ever 4 days (actually she said that he told her that you do not have to waite four days after introducing a new food. I did not ask for an explaination on what she meant by "waiting")

She said that she is waiting anyway because Daddy has so many food allergies and she does not want to introduce an allergy. OK I can accept her concern.

She is totally opposed to supplementing with formula. Or giving suplemental vitimines.

She admits to her emoational reluctance to let him get nourishment from anything other than her milk. Daddy was initially the one to start feeding him as she just could not beare to.

Since the newest thing according to her is not to feed meat yet how can I help her find ways to get some iron into this little guy. As I said there are days he only gets cheerios or bits and I do mean bits of bread. Yes as grandma I know bread is a choaking hazard.

Remember I am grandma and so I am limited because I can easily seem interfering and critical.

What is the rational for not giving meat yet? What can I suggest she give to increase his iron that will go along with current guidelines (what ever they are) ?

She is intelligent. a bit militant about her baby's breast nutrition. And I think she pretty much calls the shots with the doctor. Though she does like her doctor as he is supportive and lets her lead from what I am told.

[Gompers, BSN, RN]

She won't even consider supplemental vitamins and iron? What about increasing the iron in her own diet?

[TexasPediRN]

hmm..

from moms point of view that dad has so many food allergies, i can understand why she is hesitant about waiting on foods. however, he is 9 months, and growing like a weed i'm sure, and really should be on solid foods by now. certain foods that are allergy prone should be avoided- no eggs, peanuts, etc.

[color=#1177bb]how many times a day should my baby be eating solid foods?

at first he'll eat semi-liquid cereal mix just once a day. by around 8 months he should be eating solid foods three times a day. a typical day's diet at this point might consist of:

* breast milk or iron-fortified formula

* iron-fortified cereal

* small amounts of non-citrus juice

* yellow and green vegetables

* fruit

* small amounts of proteins such as poultry, cottage cheese, tofu, and meat

try having your daughter go to this website where i got the above information:

http://www.babycenter.com/refcap/baby/babyfeeding/113.html#6

i don't yet have children of my own, but i do work closely with kids and their parents. i think that you can casually mention to mom that you are concerned about his anemia, and that she should look at this website (or print the info out for her). tell her that you have found some ways that she should try to keep him healthy and growing and counteract that anemia at the same time. breast milk is best, and that can be stressed, to a point. when a child is past 6 months they need to be started on those solid foods and getting rice cereal which is fortified with iron.

i think that as long as you dont attack your daughter, you have a right to show concern for your grandson. i read this is her first child,and that she wants to breastfeed until he weans himself- she needs to be the one to wean him.

i hope all goes well, but i do think you should talk with her about your concerns. the baby needs iron, its a vital nutrient, and if she refuses to do suppliments, maybe trying new foods that are rich in iron would be an idea she is willing to do.

good luck :) and just let her know how much you care about your grandson and want to help nuture his mind and body!

[Agnus]

She won't even consider supplemental vitamins and iron? What about increasing the iron in her own diet?

Good point. But how much is actually excreated in breast milk? I thoght that was the issue that it is not (or very little ) excreted in breast milk

[Agnus]

I do think you should talk with her about your concerns. The baby needs iron, its a vital nutrient, and if she refuses to do suppliments, maybe trying new foods that are rich in iron would be an idea she is willing to do.

Good luck :) And just let her know how much you care about your grandson and want to help nuture his mind and body!

Thanks.

I have the diplomacy thing down.

"Typical diet" aside, what specifically are those foods and do they fit into current guidelines.

What is the rational for no meat?

I know this sounds like a dumb question. Yes, I took nutrition way back when but it has been 35 years since I needed to be concerned with infant nutrition.

[zambezi, BSN, RN]

A lot of moms are concerned about the levels of hormones in the meats today. I have no idea if there are other reasons...

I also know alot of moms raising their kids vegetarian and know that it is possible to provide enough iron to a growing kiddo without meat, you just have to get creative...you can look into some non meat high iron choices and suggest them to her (sorry, I don't know what those might be though) and mabye they will be more appealing to her than starting with meat. Just a thought.

[Agnus]

Hum. did not think about the hormones in meat. Could be the issue. Yes, I agree a lot of veg. babies out there doing fine.

I guess I will have to do more home work and do some digging on infant nutrition and general nutrition to find the right things to suggest.

I know green leafys and beans have iron. But it is often bound up in green leafys. Well I guess I will have to some searching to find more.

[babynurselsa, RN]

My ped suprised me with the last one saying to hold on meat until 9 months. This was my 4th kiddo and I am pretty sure it was 6 months or so with the other 3.

The baby cereals are iron fortified. I always mixed mine with breast milk instead of formula or juice. Maybe she will find that a little more acceptable to her. Spinach and the other green leafy type things. Gerber has the whole Organic line now.

The baby's iron store are depleted at around 4 months and that is usually when they begin to need iron supplementation.

My now 11 1/2 month old was eating finger foods by 9 months. He was refusing anything spoon fed. So take comfort in the fact soon he will just start grabbing what he wants and expand his own diet. :)

[Agnus]

So take comfort in the fact soon he will just start grabbing what he wants and expand his own diet. :)

Oh I am about the most laid back first time grandma you have ever seen. I am not worried. Kids left alone with a variety of nutritious foods will get what they need.

Well this guy is 9 months. He is doing a good job with the spoon. Like everything he is offered. My daughter is a super cook and the only comercial baby food that she uses is cereal. It is not that she is entirely opposed to comercial baby food. Real food is cheap and easy. In other cultures babies eat the foods served to the family. Only in this culture do we introduce baby food wich is totally different and bland to what the family eats. Then turn around and try to get the kid to like the foods of the rest of the family later. and we wonder why they get to be picky.

He loves mommy's cooking and get fresh fruit not cooked.

[jeepgirl, LPN, NP]

It would at least help if the baby was on the supplemental vitamins. From the way you talk, she would be TOTALLY freaked if baby ended up severly anemic and needed transfusion. I've only taken care of kids that were a bit older (I can't think of one younger than 16 months... and that one was a weird case anyway) with it, and I know it has to be EXTREMELY bad to indicate transfusion... but I think you know what I mean. We always go to worst case senario. The vitamins will help, and if her PCP recommends them I would encourage her (as grandma) to use them as well.

[OB_or_NICU_hopeful]

I read this is her first child,and that she wants to breastfeed until he weans himself- she needs to be the one to wean him.

Child-led weaning isn't a bad thing.

[Spidey's mom, ADN, BSN, RN]

Child-led weaning isn't a bad thing.

Yep. :)

My youngest is 4 and I can't remember the sequence of foods or timing -

We did rice cereal but no baby food in jars. I smashed up what we were eating mostly. Lots of fresh veggies, bananas. I also took vitamins myself - the prenatal ones.

Most babies get mildy anemic - I wouldn't worry. She is seeing a doctor and no doctor I know is "led" around by a patient. If the baby is meeting growth expectations, the baby is probably fine.

steph