Colicky Baby: Can a Low FODMAP Diet Help Colic? with Kate Scarlata, MPH, RDN

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<v SPEAKER_1>Okay, this email a mom just sent me.

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<v SPEAKER_1>My baby Amelia is seven and a half months and self-feeding since her disgust at me trying to spoon feed her purees on day one.

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<v SPEAKER_1>I've listened to 200 of your podcast episodes in the last four weeks.

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<v SPEAKER_1>200 episodes for real?

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<v SPEAKER_1>I love this, but I also totally acknowledge that you may not have time to listen to hundreds of hours of audio or hunt and peck all over the internet to piece together how to start Solid Foods.

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<v SPEAKER_1>If you're not sure where to start, I have a free online video workshop called Baby-Led Weaning For Beginners.

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<v SPEAKER_1>It's very succinct.

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<v SPEAKER_1>I just re-recorded it.

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<v SPEAKER_1>It's packed with tons of videos about safely prepping food for your baby and what to do if they have an allergic reaction and how to lower your anxiety about choking risk.

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<v SPEAKER_1>Plus, everybody on this free training also gets a copy of my 100 First Foods list.

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<v SPEAKER_1>So you'll never run out of ideas about what to feed your baby next.

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<v SPEAKER_1>So you're welcome to listen to 200 plus episodes of this show.

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<v SPEAKER_1>But if you've got 75 minutes, you can clear on your calendar.

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<v SPEAKER_1>The Baby-Led Weaning For Beginners video workshop is probably a better use of your time.

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<v SPEAKER_1>You can get signed up for the workshop by heading to the website, babyledweening.co.

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<v SPEAKER_1>Again, that's babyledweening.co for the free Baby-Led Weaning For Beginners video workshop, where you also can grab a copy of my original 101st foods list.

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<v SPEAKER_1>Your baby choking on food is a very rare, but real risk.

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<v SPEAKER_1>And CPR can save your baby's life.

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<v SPEAKER_1>I think it's very important that every parent and caregiver take an infant refresher CPR course before their baby starts solid foods.

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<v SPEAKER_1>I know in our house, everyone involved in helping with our kids and who helps to feed babies needs to know CPR.

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<v SPEAKER_1>And there's a fabulous online CPR course that I take every quarter and that I recommend to parents and caregivers.

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<v SPEAKER_1>And right now, you can get this same online CPR course for free when you sign up for my choking prevention and response course.

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<v SPEAKER_1>So I developed the choking prevention and response course.

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<v SPEAKER_1>I co-teach it with Brandon Dorkson.

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<v SPEAKER_1>He's a certified CPR instructor from Thrive Training Institute.

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<v SPEAKER_1>We also co-teach with the speech language pathologist who specializes in pediatric swallowing.

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<v SPEAKER_1>So this course is for parents who are particularly anxious about their baby choking on food.

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<v SPEAKER_1>If that is you, I created the choking prevention and response course for you.

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<v SPEAKER_1>And inside of it, I'll show you how to stop unsafe seating situations.

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<v SPEAKER_1>We have a posture checklist proven to protect your child's airway.

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<v SPEAKER_1>I'll show you how to modify choking risk foods.

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<v SPEAKER_1>It's so important to facilitate safe swallowing for infants.

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<v SPEAKER_1>And then we'll troubleshoot feeding difficulties that can impact safe swallowing at meal times.

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<v SPEAKER_1>Things like pocketing and over stuffing and excessive gagging, we cover all of that.

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<v SPEAKER_1>And you get free lifetime access to the online CPR course when you register for the choking prevention and response course.

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<v SPEAKER_1>So in order to sign up for this special, you go to the website bit.ly slash CPR choking.

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<v SPEAKER_1>So I'll spell that out.

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<v SPEAKER_1>It's B-I-T dot L-Y slash C-P-R choking in order to get free online CPR when you register for the choking prevention and response course.

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<v SPEAKER_1>And the pressure is out there, parents.

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<v SPEAKER_1>Parents hear it all the time.

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<v SPEAKER_1>I should start solid foods early because I have a big baby.

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<v SPEAKER_1>My mother-in-law was telling me, that's a big baby and he needs to start eating food.

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<v SPEAKER_1>Or I have a small baby and my doctor said my baby should start solid foods early in order to have some catch up weight.

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<v SPEAKER_1>And what about iron needs?

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<v SPEAKER_1>And maybe it will help them sleep through the night.

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<v SPEAKER_1>And there's no shortage of reasons why parents feel this pressure.

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<v SPEAKER_1>Sometimes it's internal, but oftentimes it's external.

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<v SPEAKER_1>And it's always about starting solid foods before the baby is really ready.

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<v SPEAKER_1>Hey there, I'm Katie Ferraro, Registered Dietitian, College Nutrition Professor and mom of seven, specializing in Baby-Led Weaning.

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<v SPEAKER_1>Here on the Baby-Led Weaning With Katie Ferraro podcast, I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning.

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<v SPEAKER_1>When it comes to starting solid foods, I feel like there are two types of parents or caregivers out there.

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<v SPEAKER_1>Those who are absolutely dreading the experience, like, oh no, I just got our baby's milk and their nap schedules figured out.

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<v SPEAKER_1>Now we have to do this solid food thing.

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<v SPEAKER_1>And then on the other side are the ones who are just so excited.

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<v SPEAKER_1>They honestly cannot wait to make the transition to solid foods.

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<v SPEAKER_1>Personally, I was always a bit in the former camp, the dreading the experience, even though I'm a dietician and I teach infant feeding.

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<v SPEAKER_1>Every time I had a baby turning six months of age, I was like, oh my gosh, this is a ton of work to help another person learn how to eat.

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<v SPEAKER_1>This episode though, is for the parents and the caregivers who really just cannot wait.

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<v SPEAKER_1>The ones who say, oh my gosh, yes, I'm so excited.

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<v SPEAKER_1>I know all about the signs of readiness to eat, but my baby really wants to start early, okay?

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<v SPEAKER_1>Or we have parents who are like getting a lot of external pressure.

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<v SPEAKER_1>Sometimes it's a doctor who will say careless things in passing like, oh, start solid foods at four or five months of age.

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<v SPEAKER_1>Or we have grandparents who say, that's a big baby, he's hungry, he needs to eat food now.

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<v SPEAKER_1>Or maybe you worry that your baby is small.

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<v SPEAKER_1>And so there's lots of different reasons why you might consider starting solid foods prior to six months of age.

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<v SPEAKER_1>And in this episode, I want to address the reasons why we might sometimes consider starting solid foods early.

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<v SPEAKER_1>And I wanna look at the data that either supports or refutes these different ideas and then point out one particular situation, the one situation where it might actually be okay for your baby to start something other than infant milk prior to six months of age.

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<v SPEAKER_1>If you're not already following this podcast, please take a second and hit subscribe or follow so that both of the new infant feeding episodes that I release every week show up in your podcast feed.

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<v SPEAKER_1>I do a mini solo Baby-Led Weaning training episode every Monday.

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<v SPEAKER_1>And then there's a longer interview style episode with another feeding expert that always comes out on Thursday.

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<v SPEAKER_1>And I like to start each of these mini training episodes with a Baby-Led Weaning tip of the day.

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<v SPEAKER_1>And today's tip is, if your baby is not yet six months, or baby just turned six months, and you're feeling pressure to start solid foods to fill a gap, okay, maybe you're worried your breast milk isn't enough, or your baby needs more than just formula, or, oh my gosh, they need to start getting iron from foods, or maybe they were born prematurely and you need to put on some catch-up weight, please know that your baby cannot yet use food to help them meet their nutrition needs because your baby does not yet know how to eat food.

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<v SPEAKER_1>And as we'll cover in this episode, whenever you hear a recommendation like, oh, that baby needs to start solid foods early because they have reflux, or you should start foods early because your baby needs to gain weight, that is an asinine recommendation.

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<v SPEAKER_1>Again, because your baby does not yet know how to use food to meet their nutrition needs.

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<v SPEAKER_1>Okay, if your baby truly does have unique or added nutrition needs, maybe because of prematurity or underlying medical conditions, then your pediatrician should be recommending a pediatric dietician to work with you who's going to help you fortify your baby's infant milk supply.

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<v SPEAKER_1>So breast milk or formula.

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<v SPEAKER_1>Okay, they're not going to tell you to force feed food that your baby doesn't know how to eat yet.

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<v SPEAKER_1>Okay, and I want you to hang tight because in this episode, we're going to go through some of the research and the rationale to dispel these myths because maybe you're hearing some of that like, oh, I need to start early stuff.

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<v SPEAKER_1>And I want to, again, cover that one situation where it might be warranted to start solid foods early.

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<v SPEAKER_1>So I want to tell you a quick story about a new mom who is also a friend of mine.

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<v SPEAKER_1>So she's a dietician, but back in the day, she was actually my undergraduate nutrition intern.

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<v SPEAKER_1>So a long, long time ago, I was a consultant dietician at the San Diego Meals on Wheels.

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<v SPEAKER_1>I did a lot of adult nutrition prior to specializing in infants.

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<v SPEAKER_1>And this was my dietetic, she was my student intern.

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<v SPEAKER_1>Then she was my dietetic intern when she got into like studying to be a dietician.

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<v SPEAKER_1>Now she's a mom.

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<v SPEAKER_1>Like it's been just so cool watching her go through this whole just transformation into an adult basically, and now a mom.

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<v SPEAKER_1>And so we met for breakfast recently.

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<v SPEAKER_1>It was when her baby was five months old and she had a lot of questions about baby-led weaning and starting solid foods early.

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<v SPEAKER_1>And I love this mom because she is totally not on social media.

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<v SPEAKER_1>She's like, it gives me so much anxiety.

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<v SPEAKER_1>It's just not for me.

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<v SPEAKER_1>So I liked it because she didn't come into the conversation with a bunch of like weird external random input from social media stuff that she was seeing online.

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<v SPEAKER_1>She just knew what she knew from studying to be a dietician and then what her own family and her own lived experience as a mom were like all bringing to the table.

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<v SPEAKER_1>So what she was feeling at five months of age with her daughter, she said, my daughter is so interested in food, Katie.

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<v SPEAKER_1>She is dying to eat with the family.

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<v SPEAKER_1>Like they would be at the meals and the baby was reaching for food.

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<v SPEAKER_1>And so the mom asked me, does that mean that my baby should start solid foods now at five months of age?

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<v SPEAKER_1>Like I think she's ready.

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<v SPEAKER_1>She's so ready is actually what the mom told me.

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<v SPEAKER_1>But when I asked her, is your baby able to sit up on her own yet?

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<v SPEAKER_1>Mom said, no, not yet.

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<v SPEAKER_1>She's getting stronger, but she really doesn't have good head and neck control yet.

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<v SPEAKER_1>She can't sit on her own.

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<v SPEAKER_1>And that kind of brings me to the first section of this episode, which is, why does waiting till the six month mark really matter?

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<v SPEAKER_1>Okay, and if we look at this idea of waiting until babies are six months of age, it's important because two different reasons.

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<v SPEAKER_1>Your baby doesn't need anything except infant milk.

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<v SPEAKER_1>And again, for the sake of this conversation, that means breast milk or formula.

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<v SPEAKER_1>So your baby doesn't have any needs outside of infant milk up until six months of age, right?

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<v SPEAKER_1>The American Academy of Pediatrics, the World Health Organization, all major health bodies at this point, for the most part, recommend exclusive breastfeeding for the first six months of life.

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<v SPEAKER_1>And that is because breast milk or formula is sufficient to meet your baby's needs for the first six months of life.

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<v SPEAKER_1>So from a nutrition standpoint, you don't need anything.

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<v SPEAKER_1>From a developmental standpoint, babies can't sit relatively on their own, usually until after the six-month mark, okay?

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<v SPEAKER_1>Your baby's probably not gonna be sitting on their own right at six months.

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<v SPEAKER_1>It's usually gonna be six months plus one week, or six months plus two weeks, or six months plus three weeks.

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<v SPEAKER_1>And sitting relatively independently is a physiological way.

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<v SPEAKER_1>That's the body showing us, listen, this baby has the trunk strength and the head and the neck control to support a safe swallow.

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<v SPEAKER_1>So waiting until that six month mark is important.

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<v SPEAKER_1>Again, because nutritionally, your baby doesn't need anything, and developmentally, they're not sitting yet, so they're not safe to be swallowing anything except infant milk.

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<v SPEAKER_1>Now you'll hear other objections, and I wanna address those, okay?

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<v SPEAKER_1>Let's talk first about iron.

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<v SPEAKER_1>Sometimes parents will say, well, my baby needs iron, because I heard at six months of age, the iron that they got from me, mom, at the tail end of pregnancy, it's gone.

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<v SPEAKER_1>That's certainly not the case, okay?

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<v SPEAKER_1>You did give your baby a big boost, a bolus of iron at the tail end of pregnancy.

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<v SPEAKER_1>So if you went full term, 40 weeks, your baby 38 weeks, whatever, your baby got most of their iron from you.

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<v SPEAKER_1>And that iron that they got lasts, that maternal iron stores lasts for about the first six months of life.

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<v SPEAKER_1>But it's not that like they totally disappear at the six month mark, okay?

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<v SPEAKER_1>Around six months of age is when babies start to lose that maternal store of iron, and they need to start getting iron from external sources.

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<v SPEAKER_1>But you need to remember that infant milk will continue to be an important part of nutrition even after your baby turns six months of age.

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<v SPEAKER_1>So yes, the iron might be dipping, but you don't need to go get 100% of your baby's iron from food right at six months of age, okay?

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<v SPEAKER_1>You will start introducing iron-containing foods.

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<v SPEAKER_1>I mean, a lot of iron-rich foods on our 100 First Foods list, and these are the foods that you can offer your baby before they turn one.

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<v SPEAKER_1>But your baby needs a lot of time to practice learning how to eat those foods, and you don't need to stress that they're not getting enough iron, because remember, they're getting iron from either the breast milk or their formula.

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<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

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<v SPEAKER_1>Now, another objection here is, well, what if I have a big baby?

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<v SPEAKER_1>My baby's so big, that baby's hungry, that baby needs to eat.

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<v SPEAKER_1>How many parents I see who say, oh my gosh, my mom is pressuring me, my mother-in-law saying that the baby's big and the baby needs to eat.

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<v SPEAKER_1>Whether you have a big baby or whether you have a small baby, infant milk is sufficient to meet your baby's needs for the first six months of life.

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<v SPEAKER_1>I don't want you to question, oh my gosh, is my breast milk enough?

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<v SPEAKER_1>Yes, your breast milk is enough.

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<v SPEAKER_1>Yes, the formula that you're offering is enough up until six months of age, and then after six months of age, after that, when they're sitting on their own, then we start introducing those complementary foods.

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<v SPEAKER_1>But the complementary foods is that they're complementing the infant milk.

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<v SPEAKER_1>So just don't forget about the infant milk continuing to provide nutrition even after the six-month mark.

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<v SPEAKER_1>Sometimes parents will worry, oh my gosh, my baby is small.

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<v SPEAKER_1>And I mentioned it earlier, but if you do have a baby who has been diagnosed with growth faltering or what sometimes is still called failure to thrive, you've got to be working with a pediatric dietician.

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<v SPEAKER_1>They're going to help you fortify the infant milk supply.

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<v SPEAKER_1>Telling you to start solid foods early or start foods to help your baby with catch-up weight is, as I mentioned, ridiculous.

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<v SPEAKER_1>There's a very important episode I want you to listen to.

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<v SPEAKER_1>If you are being pressured to start solid foods early for catch-up weight, it's episode 110, and I interviewed Rosan Meyer.

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<v SPEAKER_1>She's a PhD dietician.

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<v SPEAKER_1>She's a global leader in growth chart interpretations.

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<v SPEAKER_1>And we did a whole episode on catch-up weight.

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<v SPEAKER_1>Why starting solid foods early will not help your baby gain weight.

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<v SPEAKER_1>We also sometimes hear parents who are pressured to start solid foods because of sleep.

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<v SPEAKER_1>So they'll say, oh my gosh, well, I heard if I start solid foods, it will help my baby sleep through the night.

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<v SPEAKER_1>And I've interviewed a lot of different sleep experts here on the show.

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<v SPEAKER_1>General consensus is your baby's ability or their inability to sleep has absolutely no bearing on whether or not they should start solid foods.

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<v SPEAKER_1>So if you need more recommendations about how to set your baby's sleep schedule, if you're still working on that around the time that you're starting solid foods, go back and listen to episode 146.

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<v SPEAKER_1>It was with Aubrie DeBear about setting your baby's sleep schedule when starting solid foods.

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<v SPEAKER_1>So when might it be okay to start solid foods early?

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<v SPEAKER_1>There is a little bit of data that for babies with severe reflux, early introduction of solid foods may help reduce reflux symptoms in some but not all babies.

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<v SPEAKER_1>The problem is though, if your baby's not showing you the other signs of readiness to eat, then you could be inadvertently increasing the risk of choking and food allergy if you're introducing the solid foods too early.

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<v SPEAKER_1>So as far as reflux goes, I've got an episode that I did with the pediatric gastroenterologist named Peter Lu, and we talked about starting solid foods early.

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<v SPEAKER_1>I'm going to link to that right below where you're listening to this as well for the reflux parents.

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<v SPEAKER_1>But for the most part, I want you to know that your baby's reflux, most of it resolves before one year of age, okay?

00:13:59.052 --> 00:14:00.972

<v SPEAKER_1>And it becomes less common as your baby gets older.

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<v SPEAKER_1>And in most cases, the worst, worst, worst reflux peaks at three to four months of age.

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<v SPEAKER_1>So you're probably going to be on the recovering side of it as you go to start solid foods.

00:14:10.952 --> 00:14:19.412

<v SPEAKER_1>Now, there is one instance when starting solid foods prior to six months of age, the research supports that it may be beneficial, but it's not super black and white.

00:14:19.452 --> 00:14:23.612

<v SPEAKER_1>And that's when it comes to peanut allergy and babies who are at high risk for peanut allergy.

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<v SPEAKER_1>So the general recommendation is if your baby's at high risk for peanut allergy, and I'll explain what that is in a second, then your baby might benefit from introduction of peanut protein between four and six months of age to help lower the risk of peanut allergy.

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<v SPEAKER_1>But here's the thing, what puts your baby at high risk for peanut allergy?

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<v SPEAKER_1>The only babies who are at high risk for peanut allergy are babies who have an egg allergy and or have severe eczema.

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<v SPEAKER_1>And I'm not talking the run-of-the-mill eczema like all your babies have, severe eczema plus or an egg allergy, those two things.

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<v SPEAKER_1>If you have one or the other or both, your baby is in the high risk category for peanut allergy.

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<v SPEAKER_1>And the guidelines say introduction between four to six months.

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<v SPEAKER_1>Here's the kicker though, there's no data to suggest that starting that peanut protein at four months is any more protective against peanut allergy than if you were to wait until six months of age.

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<v SPEAKER_1>So what would I do if I had a baby that had an egg allergy and or severe eczema?

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<v SPEAKER_1>Personally, I would wait until six months of age and make that peanut protein probably the first food that I introduce once they are showing me the other reliable signs of readiness to eat.

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<v SPEAKER_1>Now, if your baby is not in the high-risk category for peanut allergy, which most of you listening will fall there, then you introduce peanut protein around the six-month mark.

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<v SPEAKER_1>So again, I want you to be aware of peanut protein and the importance of it, as well as the introduction of the other allergenic foods.

00:15:37.152 --> 00:15:43.052

<v SPEAKER_1>But is it cut and dry that doing it at four or five months is going to lower your baby's risk significantly more than if you waited until six months?

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<v SPEAKER_1>Not necessarily.

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<v SPEAKER_1>So, kind of a gray area there.

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<v SPEAKER_1>And unfortunately, a lot of pediatricians misinterpret the guidelines about peanut recommendations.

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<v SPEAKER_1>And they're telling parents things like start peanut at four months of age, not taking into consideration that the babies they're talking to are really not at high risk for peanut allergy.

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<v SPEAKER_1>So for most babies, rule of thumb, wait until six months of age to introduce that peanut protein.

00:16:03.152 --> 00:16:08.812

<v SPEAKER_1>So if you're feeling pressure to start solid foods before six months of age, in the vast majority of cases, there's only a downside to it, right?

00:16:08.832 --> 00:16:10.732

<v SPEAKER_1>There's no upside to starting solid foods early.

00:16:10.752 --> 00:16:12.032

<v SPEAKER_1>It only increases the risk of choking.

00:16:12.052 --> 00:16:14.012

<v SPEAKER_1>It can actually increase the risk of food allergy.

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<v SPEAKER_1>Waiting until six months of age and when your baby's showing you those reliable signs of readiness to eat is one of the surefire ways to ensure that you guys have a fun and safe introduction into solid foods.

00:16:23.832 --> 00:16:28.072

<v SPEAKER_1>And if you want to learn more about starting solid foods safely, I teach a free online workshop.

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<v SPEAKER_1>It's called Baby-Led Weaning For Beginners.

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<v SPEAKER_1>I'll show you how to make the first two weeks of foods.

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<v SPEAKER_1>We'll talk about the introduction of allergenic foods.

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<v SPEAKER_1>Plus, everybody on that workshop gets a copy of my original 100 First Foods list.

00:16:38.992 --> 00:16:44.392

<v SPEAKER_1>You can sign up for the workshop at babyledweaning.co/workshop, or I'll link it below where you're listening to this.

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<v SPEAKER_1>I also have a full program that shows you how to make all of the foods on my 100 First Foods list.

00:16:49.352 --> 00:16:58.192

<v SPEAKER_1>If you're ready to dive in with this whole approach to Baby-Led Weaning and you want a totally done-for-you, expert-led program, Baby-Led Weaning With Katie Ferraro might be for you.

00:16:58.292 --> 00:17:01.232

<v SPEAKER_1>And that's also linked up at babyledweaning.co.

00:17:01.512 --> 00:17:02.592

<v SPEAKER_1>Thank you so much for listening.

00:17:02.652 --> 00:17:08.032

<v SPEAKER_1>I'll link everything I talked about today on the show notes at blwpodcast.com forward slash nine.

00:17:08.332 --> 00:17:11.272

<v SPEAKER_1>And I want to say a special thank you to our partners at Airwave Media.

00:17:11.552 --> 00:17:16.452

<v SPEAKER_1>If you like podcasts that feature food and science and using your brain, check out some of the podcasts from Airwave.

00:17:16.472 --> 00:17:17.592

<v SPEAKER_1>And thank you so much for listening.

00:17:17.652 --> 00:17:18.432

<v SPEAKER_1>I'll see you next time.

00:17:27.137 --> 00:17:36.457

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00:17:36.677 --> 00:17:44.797

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00:17:50.177 --> 00:17:53.417

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