Tagged with 'intro-to-solids'

Did you know baby foods were created because doctors used to recommend feeding babies WAY earlier than we do now? Even 3-6 weeks of age in some cases! The texture had to be pureed if you’re feeding them that young.

A registered dietitian's thoughts on introducing grains to an infant.

At least 40% of moms are feeding their infants solid foods far too early, and that may lead to problems for their children later in life, according a new study published in the medical journal Pediatrics.

Researchers wanted to know how many babies were being fed solid foods (including cereal and baby food) sooner than recommended, whether breastfeeding or formula feeding made a difference, and why solids were being introduced early.

Current Recommendations for Infant Feeding and Introducing Solid Food

When the study began in 2005, the American Academy of Pediatrics (AAP), which also publishes the journal Pediatrics, recommended introducing solid foods when babies were between 4 and 6 months old.

In 2012, the AAP changed their recommendations, stating babies shouldn't eat solid food until they are about 6 months old. Moms are recommended to exclusively breastfeed their babies until they are about 6 months old, so babies can reap all the benefits of mother's milk including extra immune protection and possible protection for future chronic illnesses like obesity and type II diabetes.

Study and Findings

As part of the two-year study, 1,334 mothers filed out monthly questionnaires about what their babies ate during the last week. Scientists then analyzed the data reported by the mothers to determine at which age babies were being fed solid food.

They found 539 moms, or 40% of moms, gave their babies solid food early. Previous studies had put that estimate at 19% and 29%. Researchers believe based on this study, they may actually be underestimating how many moms introduce solids early because the study was more likely to have older, more educated and higher income moms participating. According to the study, mothers of lower socioeconomic status are at a higher risk of early solid food introduction.

Among the 539 moms who did introduce solids early, nearly 1 in 10 gave their babies solids before they were 4 weeks old.

Researchers found formula-fed infants were about twice as likely to be introduced to solids early, compared to only breastfed babies.

Moms were also given 12 reasons to choose from to explain why they introduced solid food early. Among the top answers:
– 90% of moms said they thought their baby was old enough to start eating solids.
– 71% said their baby seemed hungry a lot of the time.
– 55% believed their doctor or another health care professional said their baby should start eating solids.

Risks With Early Introduction

Giving your baby solid food too soon has been linked to a higher risk of obesity and diabetes, according to the study. Other research has also shown starting infants on solids before 4 months can lead to allergies and eczema.

There's a lack of awareness of what the recommendations are, and babies are not developmentally ready for solid food before they are 4 months old.

Some of these moms are getting information about when to feed their babies solids from generations (ex. grandparents, nurses, and friends) who may have started their babies on solids at an earlier age.

Developmental Signs of Readiness for Solid Food

Every baby develops at a slightly different pace, but there are some signs to look for to help parents figure out if their child is ready for solids:
– Is the baby sitting up? Can he hold her head up?

– Does your baby open his mouth when food comes his way?

– Is he big enough? (Babies typically double their birth weight by 4 months)

– Can he take food off the spoon and actually swallow it?

– Can he keep the food in his mouth without his tongue thrusting the food out?

Take-home Message

Parents need clear and accurate guidance on when to introduce solid food to their babies, and pediatricians and health care professionals need to support them by explaining to the parents that crying doesn't always mean the baby is hungry - he could also be wet, sick or just needs soothing.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

Reference:

1. Clayton HB et al. Prevalence and Reasons for Introducing Infants Early to Solid Foods: Variations by Milk Feeding Type. Pediatrics Vol. 131 No. 4 April 1, 2013:e1108-e1114.

As a mom of a baby boy who recently started complementary foods, aka: “solids,” these new findings are really exciting! Released in January 2013, the recommendations were written after finding that delayed introduction of solid foods, including the top allergenic foods, as previously recommended (in 2000), did not lead to fewer food allergies among children at risk for developing allergies based on family history. In fact, over the past decade, the incidence and prevalence of food allergy and allergic diseases in general have increased substantially, leading to the re-evaluation of the 2000 recommendations.

Food allergies affect mostly young children, and about 90% of these allergies are caused by 8 foods: cow's milk, eggs, soy, peanuts, tree nuts, wheat, fish, and shellfish. With the exception of peanut allergy, the majority of children outgrow their food allergies.

The Nuts & Bolts of Introducing Complementary Foods (aka: “Solids”) per the 2013 Recommendations

• The AAP prefers moms exclusively breastfeeding until baby is 6 months old. There are also a couple developmental milestones your baby should achieve before introducing any complementary foods. Baby should be able to sit upright with support and have sufficient head and neck control.

• In an unselected population of children, feeding solids before 4 months old is associated with a higher incidence of atopic dermatitis, which was also detected 10 years later.

• No current evidence suggests delaying the introduction of solid foods beyond 6 months of age will prevent allergic disease.

• In fact, interestingly enough, delaying the introduction of solid foods, especially the highly allergenic foods, may increase the risk of food allergy or eczema.

General Advice for Introducing New Foods to All Children

• Most pediatric guidelines suggest first introducing single-ingredient foods between 4 and 6 months of age, at a rate not faster than one new food every 3 to 5 days.

• Complementary foods in the United States are typically rice or oat cereal, yellow/orange vegetable (ie: sweet potatoe, squash, and carrots), fruits (ie: apples, pears, bananas), green vegetables, and then age-appropriate vegetables with meats.

• It is common for acidic fruits (ie: berries, tomatoes, citrus fruits, and vegetables) to cause, on contact with the skin, a localized skin reaction or rash. However, these do not usually result in a systemic reaction so delayed introduction of such foods is not recommended.

• The committee doesn't recommend introducing one of the highly allergenic foods as one of the first complementary foods. Once a few typical complementary foods mentioned above are tolerated, highly allergenic foods may be introduced.

• Offering whole cow's milk as the infant's main drink should be avoided until 1 year old for reasons unrelated to allergic disease, but rather increased renal solute load, and low iron content.

• It is ok to introduce other cow's milk-based products, such as cheese and yogurt before age 1 year.

• Whole peanuts and tree nuts, but not peanut/tree nut butters, carry aspiration risk and should be avoided until your baby's primary care physician feels they are safe.

How to Introduce Highly Allergenic Foods

• Give the initial taste of one of these foods at home, rather than at day care or at a restaurant.

• For some foods, such as peanuts, most reactions occur in response to what is believed to be the initial ingestion.

• If there is no apparent reaction, the food can be introduced in gradually increasing amounts.

• Introduction of other new foods should proceed at a rate of one new food every 3 to 5 days if no reactions occur.

New Recommendations for Eating Allergic Foods During Pregnancy

While pregnant, I heard varying information about whether or not to eat allergenic foods. The thought was, if I ate a lot of peanut butter, my baby would have an increased risk of having a peanut allergy. With the new recommendations, we know this is not true. Avoidance diets during pregnancy and lactation are not recommended at this time, but more research is necessary for peanuts.

Note: These recommendations come from a collaboration between the American Academy of Pediatrics (AAP), the joint guidelines of the European Society for Pediatric Allergology and Clinical Immunology, and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

For more information, please visit: Fleischer, DM et al. Primary Prevention of Allergenic Disease Through Nutritional Interventions. J of Allergy and Clinical Immunology: In Practice. Vol. 1, Issue 1: 29-36, Jan. 2013.