What to Expect the First Year (70 page)

Chances are you've heard a conflicting message or two … or five … about when to start spooning up solids, all of them spooning up confusion: Start at 4 months! Definitely not before 6 months! You didn't start yet? No wonder your baby's not sleeping through the night!

Want the real dish on what's the right time for solids? First, listen to the experts. The AAP recommends holding off on feeding solids until your baby is 6 months old (and if you feel the need to start earlier to definitely wait until your little one is at least 4 months old).

Next, tune in to your baby. While most babies are ready for solids somewhere within those widely accepted guidelines (4 to 6 months), your little one's individual development definitely tops the list when deciding whether or not it's time to graduate to a more varied diet.

Though you might be eager to hop on the feeding bandwagon sooner rather than later (It's fun! It's cute! He'll sleep better! She'll cry less!), there are plenty of reasons why starting a baby on solids too soon isn't smart. First, a very early introduction to solids can occasionally trigger allergies. Second, a young baby's digestive system—from a tongue that pushes out any foreign substance placed on it, to intestines still lacking many digestive enzymes—is unready
developmentally for solids. Third, solids aren't necessary early on—babies can fill all their nutritional needs for the first 6 months of life from breast milk or formula alone. Bringing on the solids too soon can also undermine future eating habits (baby may reject those spoonfuls initially simply because he or she isn't ready, then may reject them later because of previous parental pushing). And fourth, especially in formula-fed babies, early introduction of solids can lead to obesity later on in childhood and beyond.

On the other hand, waiting too long—say, until 8 or 9 months—can also lead to potential pitfalls. An older baby may resist being taught the new (and challenging) tricks of chewing and swallowing solids, preferring to cling to the tried-and-true (and easy) methods of tummy filling: breastfeeding or bottle-feeding. And, like habits, tastes may be tougher to change at this point. Unlike the more pliable younger baby, an older baby may not be as open to opening wide for solids when milky liquids have long monopolized the menu.

To decide if your baby is ready for the big step into the world of solid foods at 4 months, not till 6 months, or somewhere in between, look for the following clues—and then consult the doctor:

• Your baby can hold his or her head up well when propped to sit. Even strained baby foods should not be offered until then. Chunkier foods should wait until a baby can sit well alone, usually not until 7 months.

• The tongue thrust reflex has disappeared. This is a reflex that causes young infants to push stuff out of their mouths (an inborn mechanism that helps protect them from choking early on). Try this test: Place a tiny bit of baby-appropriate food thinned with breast milk or formula in your baby's mouth from the tip of a baby spoon or your finger. If the food comes right back out again with that tiny tongue, and continues to after several tries, the thrust is still present and baby isn't ready for spoon-feeding.

• Your eager beaver reaches for and otherwise shows an interest in table foods. The baby who grabs the fork out of your hand or snares the bread from your plate, who watches intently and excitedly with every bite you take, may be telling you he or she's hungry for more grown-up fare.

• Baby is able to make back-and-forth and up-and-down movements with the tongue. How can you tell? Just watch carefully.

• Your little one is able to open wide, so that food can be taken from a spoon.

For more on starting solids when the time comes,
click here
.

“How can I tell if my baby's teething? She's drooling and biting on her hands a lot, but I don't see anything on her gums.”

You may not be able to predict exactly when the teething fairy will fly in for a first visit (or future ones), but a number of signs can signal that she's on her way. Just which signs (and how uncomfortable they are) vary wildly from little teether to little teether. For one baby, teething means lots of discomfort and big-time tears, while another baby might breeze to a mouth full of teeth without a complaint. Still, you can expect to see at least some, and maybe many, of the following symptoms (some of which can precede the actual appearance of a tooth by as much as 2 or 3 months):

Drooling.
Does drool rule at your house? Since teething stimulates drooling, the faucet can start flowing early (usually anywhere from about 10 weeks to 3 or 4 months)—and often. Some babies drool buckets throughout their teething tenure.

Chin or face rash.
The constant drip of saliva on those sweet cheeks and chin, around baby's mouth and neck, even on the chest area, can trigger chapping, chafing, dryness, redness, and rashes. Try to keep the areas as dry as possible by patting away the drool gently (and changing wet t-shirts quickly), create a moisture barrier with Vaseline or Aquaphor, and moisturize with a gentle skin cream as needed. Have some nipple cream on hand (like Lansinoh)? It's great for protecting tender baby skin, too.

Coughing.
All that drool can make babies gag and cough (you'd choke, too, with a mouthful of spit). And as long as your little gagger isn't showing any other signs of cold, flu, or allergies, it's nothing to stress about.

Biting.
Those pearly whites poking through those tender gums may
be teeny tiny, but the pain and discomfort they cause can be plenty big. Counterpressure, aka biting, can bring the sweet relief your little teether is seeking. Teething babies will gum down hard on whatever they can find, from their own fists and fingers, to teething rings and rattles, to your nipples, shoulder, fingers … even your cheeks.

Pain.
The inflammation of tender gum tissue can cause what seems like terrible pain to some babies, while others barely seem to notice. First teeth usually hurt the most (as do the molars, because they're just plain bigger), although most babies eventually get used to what teething feels like and aren't quite so bothered later on.

Irritability.
Get ready for the crankies. Your baby's mouth will ache as that little tooth presses on the gums and pokes up to the surface, and not surprisingly, it'll probably make her feel fussy. Some babies are cranky for just a few hours, but others can stay crabby on and off for days or even weeks.

Feeding fussiness.
Uncomfortable, cranky babies may seek comfort in a breast or bottle only to find that the suction of suckling makes tender gums feel worse. For that reason, teething babies may be fussy feeders—and frustrated ones. Babies on solids may also be off their feed. If your baby refuses several feedings in a row, check with the pediatrician.

Diarrhea.
Doctors usually won't go on record saying so (since actual diarrhea isn't something to write off in a wee one), but to hear most parents tell it, loose poop happens when babies are teething, probably from all that swallowed drool. It may or may not happen with your teething baby, but make sure to report any diarrhea (liquidy, runny stools—not seedy mustardy ones) to your baby's doctor if it lasts more than two bowel movements.

Elevated temperature.
Another symptom that doctors are reluctant to link to teething is a slight increase in temperature—especially since the first teeth often pop in around the same time babies start to lose some of the immunity protection they acquired through mom, making them more susceptible to infections and bugs. But like inflammation anywhere else in the body, inflamed gums can sometimes produce low-grade fever (less than 101°F, measured rectally). Treat it like any other low-grade fever—with a call to the doctor if it lasts for 3 days, sooner if it is accompanied by other worrisome symptoms. And definitely don't dismiss a higher fever as teething related.

Wakefulness.
The teething fairy doesn't work only the day shift—she can work plenty of miserable mischief at midnight, too. In fact, like many pains, teething pain may be more bothersome to your baby in the evening hours—possibly disrupting nighttime slumber (even if she previously slept through). The wake-ups may be just momentary, so before offering comfort, see if she can settle herself back to sleep. If she's still restless, soothe her with patting or lullabies, but avoid a return to nighttime feedings if she's already given them up (these habits can continue long after teething pain has left the building).

Gum hematoma.
Teething can trigger bleeding under the gums, which looks like a bluish lump. It's nothing to worry about and can heal faster (and feel better) with the help of a cold compress (a frozen washcloth can work wonders, but don't put ice directly on the gum).

Ear pulling and cheek rubbing.
Teething babies may tug furiously at their ear or rub their cheek or chin. The reason? Gums, ears, and cheeks share nerve pathways, and so an ache in the gums (especially from erupting molars) can travel elsewhere. But since ear infections can also trigger ear yanking and cheek rubbing, do check with the pediatrician if you suspect your baby may be bothered by more than just teething (for example, if it's accompanied by a fever, not just a slight elevation in temperature).

“My baby seems to be in so much pain from teething. What can I do to help him?”

If you could, you'd take your baby's pain on for him. Since you can't, try these time-tested teething remedies to take at least some of the pain away:

• Something to chew on. Babies will chomp down on just about anything they can get their gums on when they're teething. That's because the gumming action provides soothing counterpressure. But not all little ones are fans of teething rings, or devotees of the same type of ring. Some like their teething toys soft and pliable, some like them harder. Some prefer plastic (some soft, some hard), others wood, others cloth. A textured, bumpy surface can offer more relief than a smooth one, a shape that fits neatly into that little mouth may score more points than one that is big and bulky, and squeaky sounds can offer a dose of distraction—but again, let your baby vote on the winner.

• Something to rub against. Some of the best teething tools are the ones attached to your baby's hands—those yummy fingers, of course. But your bigger, stronger fingers can actually be even more effective pain relievers. Wash one thoroughly (and trim any sharp nails), and use it to firmly massage your baby's sore spots. Just don't be surprised if your baby barracuda bites down.

• Something cold. Chilling your baby's gums numbs them—while easing inflammation and swelling. Keep a stash of teething rings in the freezer, try a frozen wet washcloth (you can store a supply of these in the freezer, too, each in a single layer separated by wax paper). If your baby has started solids, you can serve a feeder filled with frozen banana, applesauce, or peaches, or chilled avocado—and if he is over 6 months, you can also offer a bottle or sippy of ice cold water. Still on breast milk or formula only? Those can be frozen and provided in a feeder for his gumming pleasure as well.

• Something to ease pain. Still searching for teething relief? You can occasionally break out the baby acetaminophen (once your little one is over 6 months, you can opt for baby ibuprofen). The FDA warns against using benzocaine-based teething gels to numb pain, so don't turn to these or to homeopathic teething tablets or gels without the doctor's advice. A safer natural way to soothe? Soak a washcloth in chamomile tea (which calms inflammation), wring it out, freeze, then let baby suck on it. He's not a fan of cold? Just skip the freezer part and hand over a wrung-out wet washcloth at room temperature. Or try rubbing some room-temperature chamomile tea directly on those achy gums.

Tooth Eruption Chart

“For the last 3 weeks my baby has had a little cough. He doesn't seem sick, and he doesn't cough in his sleep—he almost seems to be coughing on purpose. Is this possible?”

Even as early as the fifth month, many babies have begun to realize that nothing beats an admiring audience. So when a baby discovers that a little cough—either triggered by teething or discovered when he was experimenting with sounds—gets a lot of attention, he may continue coughing just for its effect. As long as he's otherwise healthy and seems in control of the cough rather than vice versa, ignore it. Though your little performer may never lose his flair for the dramatic, he will probably give up this attention-getter as he (or his audience) becomes bored with it.

“My baby has been pulling at her ear a lot. She doesn't seem to be in any pain, but I'm worried that she might have an ear infection.”

Babies have a lot of territory to discover—some of it on their own bodies. The fingers and hands, the toes and feet, that diaper area, and another curious appendage, the ear, will all be targets of exploration at one time or another. Unless your baby's pulling and tugging at her ear is also accompanied by crying or obvious discomfort, fever, fussiness, food refusal, and/or other signs of illness (
click here
if it is), it's very likely that it's a sign of curiosity, not a symptom of ear infection. Some babies may also fuss with their ears when teething (a result of the pain that's referred from sore gums to the ear) or when they're tired. Redness on the outside of the ear isn't a sign of infection, just a result of all that rubbing. If you suspect your baby's sick—or if ear pulling continues unexplained—check with the doctor.