Can sitting or standing hurt a young baby’s bones?

The Pediatric Insider

© 2016 Roy Benaroch, MD

Desiree wanted to know: “Is it true that putting an infant (2-4 month old, before they can sit unassisted) in a sitting position can damage their spine? I’ve read posts by people about this but don’t know how much truth there is. Assuming child can hold head up enough to be able to ‘sit’ on someone’s lap or on a sitting device for relatively short periods of time? Is there a limit to how long this should be or that it becomes dangerous?”

Little babies love to master new things. And they have fun doing it, too—their eyes sparkle when they learn to stand in your lap, or when they sit up with a little help to see the whole world. When they’re lying down on the floor or their bed they can only see the ceiling. Where’s the fun in that?

Their little minds and bodies are made to grow and develop and try new things. Spending time on their tummies helps babies develop muscles in the front of their chests, and helps practice the coordination to lift their heads and look around. Time sitting up exercises different muscles, too. And bones themselves grow and develop based on the stresses and loads that they feel—so, yes, standing up is a good thing to help babies grow stronger and more confident of their skills.

A few caveats – keep a little common sense in mind. Those gizmos that help babies sit up are fine, but not if you put them on top of a table or counter. They can still topple out of them, so never use them on a raised surface. Also, a baby has to be able to hold his or her head up unsupported to stay in an upright position.

Is there a limit to how long babies should try these new positions? Sure – let the babies tell you. If it starts to hurt, they’ll get upset, and that’s when you’ll pick them up or move them or try a new activity. If bones are being “damaged” by the stress of a new activity, they’ll hurt, and you’ll know it. That’s why people feel pain when they should stop doing something. Babies are very good at telling you when something hurts.

They’re also very good at telling you when they’re happy. So help your baby learn new things and try new ways of standing, sitting, and getting around. Have fun!

When to start solid foods, and what to start with

The Pediatric Insider

© 2013 Roy Benaroch, MD

I like writing about food and feeding issues, especially for babies and toddlers—mostly because there is so much misinformation out there, information that’s complex and confusing and difficult for anyone to keep straight. Start avocados at 33 weeks, start egg whites at 42 weeks, move from stage 1 to stage 2 jars after baby gets 1 ½ teeth. Rules, rules, rules.

All that stuff is a crock. Feeding babies is much simpler.

When to start solids: somewhere between 4 -6 months of age is an ideal window. Babies are happy to meet new things and have new experiences then, and they’re really interested in what you’re eating. So give them a taste.

There’s plenty of medical evidence that 4-6 months is an ideal time. You’ll minimize your child’s risk of celiac and type 1 diabetes, and provide essential iron and vitamin D that’s inadequately supplied by nursing alone. Starting earlier than this window seems to increase the future risk of obesity; starting later can lead to problems with oral motor functioning, and can increase the risk of food allergies.

What foods to start with: anything you like. The old advice, to start with (and stick with) rice cereal never made any sense. There’s nothing magic about rice cereal.

The only requirement for first foods is that it can be mushed up. Junior isn’t going to chew anything just yet, so whatever you’re feeding him needs to be, essentially (but not literally) pre-chewed. You can start with a banana or avocado, and mash it up with a fork; you can start with some well-cooked noodles, and mush them up; you can start with some soup vegetables, or a bit of egg, or ground meat, or just about anything else. Don’t be afraid of flavor, and don’t limit yourself to what the baby food companies put in jars.

The only foods to watch out for are choking hazards, foods that are too stiff or unmushable for babies to handle. Think steak, pecans, raw vegetables, or Al Gore.

There’s also a special admonishment against honey for babies less than 12 months of age, because it can transmit botulism in babies. That’s a really short list of things that babies shouldn’t be fed.

If you like, you can start with a single food and build up from there, starting a new food every few days. That’s been advised for years, to help parents tell which foods might have caused which reaction. But most babies will not have food allergies; and most food reactions in babies are mild. If there is a strong family history of genuine food allergies (say, in both parents or in siblings), you can take feeding slowly, one food at a time—but it is probably a mistake to delay solids altogether. Remember: introducing foods later may increase the risk of allergy.

That’s it—it’s almost too simple. Start at 4-6 months. Start with, pretty much, whatever you’re eating, just mushed up. Let your baby enjoy many different flavors, and share the meals (and the mess!) together. Yum!