A recent report by the Centers for Disease Control and Prevention (CDC) revealed that many parents are feeding their infants solid food far earlier than recommended by pediatric specialists. This is alarming news as feeding an infant food other than breast milk or formula well before he is ready can adversely affect the baby from a nutritional and immunologic standpoint.
For many years the American Academy of Pediatrics (AAP) advised parents to introduce solid food only after their babies had reached 4 months of age. Last year, however, with new information about infant nutrition in hand, the AAP changed its recommendation to 6 months of age.
There are a number of reasons for this recommendation, and the primary one is the nutritional support of a baby’s immune system. Breast milk is widely considered the ideal form of nutrition for babies. Research studies have shown that breastfed infants have far fewer ear infections, respiratory problems and gastro-intestinal issues. A six-month delay in the introduction of solid food helps ensure that babies receive the nutrition they need through breastfeeding. If breast milk is not a feeding option then formula feeding for the first six months is the next best course.
Another reason is the baby’s comfort. The digestive system of infants (the CDC report revealed that nine percent of those surveyed fed their infant solid food as early as 4 weeks old) is just too immature to properly handle solid foods and trying to do so would cause the baby to become gassy, fussy and uncomfortable. Many parents in the survey indicated they fed their baby solid foods early thinking it would help the child sleep through the night.
However, the discomfort associated with trying to digest these foods actually would have the reverse effect on a baby. On a related note, there is no medical evidence that supports the notion that feeding babies solid foods earlier will help them gain weight.
In addition to the calendar timing, a baby will provide signs that he is ready for some solid foods. For example, a baby will watch others more carefully and with greater interest as they bring a fork or spoon to their mouths. An infant may also show a change in his or her feeding pattern, asking to be fed more often.
Solid Foods: A Timeline
Grains are the best first food and rice cereal should be introduced at the start as it is the least allergenic of the grains. Oats and barley can be introduced later in the process.
After cereals, parents should introduce fruit and vegetable purees. Which fruits and vegetables are introduced first is really a matter of preference for the baby but in general, an infant might enjoy vegetables such as sweet potatoes and carrots more than green beans and peas. Also, applesauce and bananas may be more palatable than peaches and pears. Complex protein purees, such as meats, should not be introduced until a baby is 9 months old.
Remember, introducing solid foods does not mean breast milk or formula is no longer needed. Both are still an important part of your infant’s daily nutrition requirements. Parents should consult their baby’s pediatrician on the right mix.
It is also important for parents to introduce each new food one at a time, and then wait three days between each new food to see if the food agrees with the baby. Excessive gas, vomiting or diarrhea are signs that the new food is not being tolerated well.
Allergic reactions are a whole other story and can range from stomach pains, hives and rash to more severe symptoms. Be sure to consult with your pediatrician if you notice an adverse reaction to a certain food. Moreover, be mindful of allergies in the family. If a parent, sibling or a close relative has a specific food allergy, then caution should be taken when introducing that food.
Some other solid food guidelines:
Milk products are best introduced after 9 months of age. Whole milk products are recommended, as a baby’s body and brain need the fat for proper development. Also, never serve raw milk to a baby. All milk products should be pasteurized.
Since egg white is highly allergenic it is best to wait until a baby is 1 year old before introducing eggs. Honey should also never be given to babies under 1 year old.
Shellfish should not be given to infants under any circumstances.
Food is nutritious and fun and introducing it properly can make feeding time a positive experience for both baby and parents. Since every child is different, please consult with and follow the feeding guidelines outlined by your child’s pediatrician. And remember, go slow – there is no rush when it comes to introducing solid foods.
Vicki Iannotti, M.D. is Associate Chief of General Pediatrics at Maria Fareri Children’s Hospital at Westchester Medical Center, the children’s hospital for Westchester County and the Hudson Valley. For more information about the hospital or to schedule an appointment with a Children’s Hospital doctor, please visit www.westchestermedicalcenter.com/mfch or call 877-WMC-DOCS (877-962-3627).
