Q&A with Dr. Jay

Question: My one month old is not sleeping through the night, and I have been told that if I give her some rice cereal in her bottle, that she would sleep longer. Should I do this?

Dr. Jay: You should not give your one month old rice cereal. This is one of the most asked questions about babies and feedings. It is advised that you should not start any solid foods until a minimum of 4 months of age. If you can, waiting until 5-6 months of age would be even better. This is because their digestive system just cannot process solid foods until this time. There have been studies that link early food introduction with food allergies. Another reason not to do this is because solid food should be started when they are able to take it from a spoon and not drink it from the bottle. If you have heard this advice and the person claims that their baby started sleeping through the night, it is because the cereal acted as a bulking agent in the baby’s stomach, and made the baby feel full. This is not a healthy alternative. Your baby was designed to drink mother’s breast milk or formula, so give them what they need.

Question: What is your recommendation about cough and cold medicine for children?

Dr. Jay: Just a few weeks ago, the Food and Drug Administration (FDA) advised that over the counter cough and cold medicines should not be given to children under 4 years of age. The American Academy of Pediatrics (AAP) suggests waiting even longer until 6 years of age. These recommendations are a big change for many pediatricians who have been advising parents for many years that it was acceptable to give these medicines as early as 6 months of age. One of the biggest problems is that there are no standard dosing guidelines or a standard age when they can be started. Most of the medicines will say to ask your doctor for dosing and this of course will vary from doctor to doctor. I used to advise that cough and cold medicines could be started at 6 months of age but I gave specific dosing amounts. I always advised first to try nasal saline in the nose followed by bulb suctioning. A humidifier may also be useful in breaking up the mucous.

Now, I am following the FDA recommendation of waiting until 4 years of age and doing the non-medicinal attempts previously mentioned (nasal saline, bulb suctioning, and a humidifier). Unfortunately, parents can still buy these medicines and many will continue to use them. I do feel there are benefits of giving cough and cold medicine but we have to wait until we can agree with an acceptable dosing schedule, dosing amount and at what age we can start.

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