Thursday, May 2, 2013

New Research: Why Parents Give Solid Foods Early

The American Academy of Pediatrics (AAP), American College of Obstetrics and Gynecology (ACOG) and American Academy of Family Physicians (AAFP) all recommend parents wait to start solid foods until about 6 -months of age. Why? Babies are not developmentally ready for solid foods until around this time and babies started on solid foods early are also at higher risk of certain chronic diseases such as diabetes and obesity . Yet, many parents start solid foods earlier than is recommended.

A group of researchers from the Centers for Disease Control (CDC) in Atlanta, Georgia decided to look at the age at which parents start solid foods and whether or not this varies by feeding method (breastfeeding,  formula feeding, or a combination of breast milk and formula feeding,). They also assessed the reasons why parents start solid foods in the first place.
The Study
1334 mothers were asked to complete food-frequency questions as part of a larger infant-feeding study. Reasons for starting solid foods before 4 months of age were assessed as well.

What they found was that fewer mothers who were exclusively breastfeeding started solid foods early compared to mothers who were formula-feeding and mixed feeding (24.3% exclusive BF, 52.7% formula fed, 50.2% mixed fed). About one quarter of mothers breastfeeding exclusively started solids before 4 months of age whereas about half of babies fed formula or both formula and breast milk were started on solids early.
Many of the reasons parents started solid foods early were related to the baby’s behavior. The most common reasons for starting solid foods early were: “My baby was old enough”; “my baby seemed hungry”; “I wanted to feed my baby something in addition to breast milk or formula”; “my baby wanted the food I ate”; “a doctor or other health care professional said my baby should begin eating solid food” and it would help my baby sleep longer at night.” Let’s take a look at each of these reasons:

“My baby seemed hungry”
A baby showing hunger cues should be fed and babies only need breast milk or formula for the first 6-months of life. Sometimes it might seem that babies are more hungry than usual. There are several reasons why this might happen. Babies go through growth spurts when they will eat more than usual. This is normal! It does not mean your baby needs to start other foods besides breast milk or formula. Every baby is different, but growth spurts are normal around about 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months of age. Watch for hunger cues to be sure your baby is hungry. Babies may also “act hungry” about 10-15 minutes after a feeding. This fussiness is generally caused by either gas or a bowel movement that is making the baby uncomfortable. Sometimes your baby will wake up after you lay him down to sleep after a feeding. This does not mean that your baby is still hungry! For more information about why this and other behaviors occur, click here.

“I wanted to feed my baby something in addition to breast milk or formula”

While it is very exciting to reach the milestone of starting your baby on solid foods, breast milk or formula is enough nutrition for your baby to grow and develop normally for the first 6-months of life. Exclusive breastfeeding until 6-months is also recommended by the AAP. When your baby is old enough you will get to introduce many new foods and share lots of feeding experiences!
“My baby wanted the food I ate”

While we don’t know exactly why the mothers in this study thought their babies wanted the food the mothers ate, we do know that it is developmentally normal that around 4 months of age babies develop the ability to point at things they want to learn about. Sometimes parents misinterpret this pointing as the baby “wanting” the food that the parent is eating. Your baby is just trying to explore his new world! Offering other things to reach for such as a toy or book can fulfill your baby’s need to explore.
“A doctor or other health care professional said my baby should begin eating solid food”

The AAP, ACOG and AAFP all recommend waiting to start solid foods until about 6-months of age. However, it can be confusing when doctors recommend something different than what you would expect. When other recommendations are made that you are not familiar or comfortable with, discuss the reasons for the recommendation and any concerns you have with the health care provider.

“It would help my baby sleep longer at night”
Starting solid foods does not help babies sleep longer. One study (Macknin 1989) showed that adding cereal to a baby’s diet before bedtime did not make the baby sleep any longer.

Understanding hunger cues and other normal baby behaviors may be helpful in delaying solid food introduction! Knowing why babies behave the way they do may help parents address the common concerns listed above without having to start solid foods early. When did you start solid foods with your baby? How did you make the decision to start at that age?

Clayton HB, Li R, Perrine CG, Scanlon KS. Prevalence and reasons for introducing infants early to solid foods: variations by milk feeding type. Pediatrics. 2013;131(4):e1108-14.

Macknin ML, Medendorp SV, Maier MC. Infant sleep and bedtime cereal. Am J Dis Child. 1989 Sep;143(9):1066-8.

1 comment:

  1. In my country (Greece) doctors recommend starting solids at 4.5 months old, especially if the baby is formula fed. For breastfeeding babies the usual instructions are starting at 5.5 months of age.
    I exclusively breastfed my baby and started giving solid foods to her when she was 5 months old. She seemed ready to eat solids and moreover I wanted to be able to leave for a few hours and she didn't take a bottle no matter how much I tried.