Spooning those first few bites of pureed food into an infant’s mouth is an exciting rite of passage for new parents and an important milestone for their children. However, new research shows more than half of American babies are eating solid food too soon.
The study examines data about the food intake of 1,482 children across the U.S. More than half were introduced to solid food at younger than six months — the age recommended by the American Academy of Pediatrics (AAP) — and 16 percent were younger than four months. Why are so many parents ignoring the guidelines, and why is this a problem?
It’s Worth the Wait
For decades, the AAP recommended against babies eating solid food before four months old. This guideline changed in 2012, based on growing evidence of the health benefits of breast milk. Since then, scientists have discovered even more reasons for pediatricians to believe six months is the ideal age to introduce solid food.
“Breast milk and/or formula fully meets infants’ nutritional needs for the first six months,” explained Dr. Dawn Peters, a pediatrician at Alewife Brook Community Pediatrics, affiliated with Winchester Hospital. “Breast milk and formula are complete foods. It has all the protein, fat, carbohydrates and nutrients they need. With breast milk, babies are also getting antibodies from the mother which can help protect them from infections. Babies are only going to be hungry enough to take in so many calories a day. If they fill up on solid foods, they won’t drink as much, so they won’t get enough of those nutritionally complete calories.”
After six months, infants need more calories and nutrition than they get from breast milk or formula, said Dr. Peters. That’s when it’s time to start introducing solid food.
Why the Rush?
There are many reasons parents give solid foods before six months — including the advice of family and friends, their own excitement, the baby’s interest in food and financial constraints.
“Often, there is a lot of external pressure from family,” Dr. Peters explained. “Just like women who breastfeed get pressured to give formula, family members might insist the baby is hungry, but if you’re giving formula or breast milk, you know you’re giving your baby complete food. If you introduce solids earlier, you may be missing things.”
Even so, Dr. Peters says there are circumstances where pediatricians might approve of early introduction out of necessity, for example, if the baby is having trouble gaining weight or experiencing constipation.
Every kid is different. Parents know that, and so do pediatricians. Dr. Peters suggests that parents talk to their doctors about when it’s time to introduce solid foods. This includes any reasons they might have for starting early, especially financial reasons.
“Some women aren’t able to breastfeed, and formula is expensive,” she pointed out, “but the Women, Infants, & Children (WIC) Nutrition Program will often cover most of those costs. Pediatricians need to know if parents are struggling to provide formula, because we can help them find assistance. It’s part of what we’re here for – to help make sure you have what your baby needs.”
What Not to Feed Your Baby
The guidelines for introducing new foods have gotten much less complicated. Not so long ago, pediatricians recommended holding off on nuts, eggs and other known allergens until a child has reached a certain age. Now, almost everything is fair game at six months, except for honey and cow’s milk, which shouldn’t be given until 12 months. Cheese, yogurt, butter and other dairy products are usually fine.
“The recommendations have changed several times over the past 15 years, because so much research has shown that early introduction of known allergens might actually help to prevent those allergies from developing, especially with peanuts,” said Dr. Peters. “For children who have bad eczema, a strong family history of food allergies or who have already had an allergic reaction to a food, we often suggest consulting with an allergist before moving ahead. Otherwise, as long as the food is not a choking risk, it’s OK to give.”
Even after babies begin eating solid food, they still need breast milk or formula for at least the first year. This is typically enough to keep them hydrated.
“It’s OK to give a little water after six months, but before that, the kidneys might be a little immature to handle water,” Peters noted. “As for juice, unless you’re treating constipation or they’re sick and you need to keep them hydrated, there’s really no evidence to support drinking juice at any age. It’s better to have the whole fruit, whether it’s cooked or raw.”
When in doubt about what to give an infant and when, Dr. Peters suggests the best course of action is to talk to the child’s pediatrician.
“The most rapid period of growth your child will ever experience is over the first year of life, so you want to ensure they’re getting everything they need. That’s what your pediatrician wants, too, and we’re here to help in whatever way we can.”