ASK THE DOCTOR: Infant-care advice comes from all sides
By DR. JIM MITTERANDO
The Patriot Ledger

Q I have a one-month-old baby boy and I am so confused with all the different information I am getting. The baby books say one thing, my doctor says another and my mother says something else. For example, my mother is insistent that I give the baby some cereal in his bottle at night to help him sleep longer; my doctor says don't. What should I do?

A As a new parent who wants to do the right thing for your child, it can be confusing and overwhelming. There is a lot to learn and it is very common to receive conflicting advice from various books, from health-care providers and from your parents. The important thing to realize is that there is no one ''right'' way of raising a child. Parents want to do what is best; but often what is ''best'' may depend upon your values and your child's disposition. Be wary of anyone who tells you that you ''must'' do something a certain way.

The most common conflict is between grandparents' advice and current recommendations from doctors and parenting books. Parenting continues to change and what was thought ''best'' when they raised you may now be thought to be unnecessary or rarely harmful. But don't sweat it. Despite your parents doing it differently, you made it this far and turned out OK. Your children, when grown, will undoubtedly go through the same conflicts when they become parents.

Cereal added to a baby's bottle does not help the baby sleep longer and should be avoided those first few months. Rice cereal is sometimes added to thicken the formula when infants have significant reflux (very spitty babies).

Grandparents are also quite anxious to start solid foods in infants. Solids do not need to be introduced before 4 to 6 months of age. There is no rush - breast milk and formula provide all the necessary nutrients until six months. Grandparents will report how you started eating solids at one month of age but infants are not developmentally ready to eat solid foods until four to six months.

Certain cereals, such as wheat, can cause food allergies if introduced too early. Rice, oatmeal and barley cereals can be introduced after four to six months of age. Wheat and breakfast cereals such as Cheerios should not be introduced until eight months to avoid food allergies.

Family members often advise boiling water and sterilizing bottles when preparing formula. This is no longer recommended. You do not need to boil the water when preparing formula. Bacteria counts in tap water are low and safe to drink. You can simply take water from the tap and mix it with powdered formula in the bottle. If you are making a large amount of formula for the day, the powder dissolves easier if you warm the water. When traveling, it is easier to put water in the bottle and add the powder when you need it rather than preparing formula and carrying it in a cooler.

Also, you do not need to sterilize the bottles and nipples in boiling water. Bottles and nipples simply need to be cleaned and not boiled or sterilized.

An important point, though, is to keep the kitchen counter clean and avoid contact with anything (i.e. sponges) that has touched raw meat or poultry since the bacteria in meat can be dangerous to infants. You should wash sponges or dish towels every day or two since they often harbor bacteria.

It is OK to take your newborn out in public places including the mall. Take victory laps with your infant around the neighborhood showing off your new arrival. Newborns do well going home to a house full of older kids who expose them to a lot more germs than any public area.
I often point out that we survived a million years living in caves and we made it this far so don't worry too much about the little things. If you have any other uncertainties or conflicts of advice, call your health care provider.

Dr. Jim Mitterando is a family doctor at Health Care South/Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible.

Copyright 2002 The Patriot Ledger
Transmitted Tuesday, June 18, 2002