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?

References

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.

Getting the Help You Need Part 3. Dealing with Help that You are Better Off Without

In the first part of this short series on getting help in the early postpartum period, we talked about how to ask for and organize help in those early weeks after your baby is born. In the second part, we shared some ideas about what to do when friends and family who have offered to “help” are making more work for you. In this last post in the series, we’re going to share some ideas about what to do when the help you are offered is incompatible with your ideas of parenting. An example might be a well-meaning grandmother who wants to give your baby “a little brandy” to help you get some sleep. I’m sure you all have been offered advice that you would never take. New parents tend to be barraged by advice. We shared some of examples of the worse advice we’ve received in a previous post.

Remember, we are focusing on situations and people in your life who are trying to help you, even if the advice they are offering is just...bad. For example, in the last post, we made up a story about a sister who has called bubbling with excitement about a book called “Baby Care in Less than 10 Minutes Per Day” based on the premise that babies can raise themselves (without help from adults). Far-fetched I know, but we used this example because, with all the baby-care books on store shelves, we assumed some of you may have been experienced a situation something like this.

When you find yourself needing to disagree with people who think they are helping you, keep the following in mind:

• Pick your battles. If the person is a stranger, only visiting for a short time, or has little contact with you or your baby, you can get away with a non-committal “we’ll keep that in mind” and move on. If the “helper” is staying while, will be visiting frequently, or is someone who is close to you, you will find yourself needing to have “a talk.”
• You have the right to your position; you are the parent. The responsibility of caring for your baby, however daunting, is ultimately yours.
• Don’t avoid or skate around the important issues. Be honest and clear.
• Don’t let the person confuse the disagreement over their advice with your relationship. Whether or not you choose to read your sister’s book does not affect how much you love her.
• Providing a reason for your position can be helpful but you do not need to criticize or persuade the person to agree with your view. You need only to make it clear that you respectfully disagree.

So what would this conversation be like? Maybe something like this: “Hi Sis, thanks so much for coming over, we could really use some help with the house this week. I know you’re excited about that new book but Fred and I spent a lot of time while I was pregnant learning about how to take care of the baby. We know the way we’re doing things takes time (a lot more than 10 minutes a day) but we’re okay with that. I appreciate your offer but I don’t want to read the book. We like to spend time with the baby and we’re lucky to we have you to help with all the rest.”

Be prepared for a little awkwardness or frustration from the person who has offered help and give them time to move on. Things will soon return to normal. We realize that some of you are dealing with more serious situations and complicated relationships. If that’s the case, we again encourage you to reach out for professional help if you find yourself overwhelmed.

We hope that this short series has given you some practical tips to get the help you need. Remember, getting help is important, for you and your growing family.

Next time: Secrets of Baby Behavior is 18 Months Old!

A good resource for tough talks: Stone D, Patton B, Heen S. Difficult Conversations: How to Discuss What Matters Most. Penguin Books, New York 1999 (there is a more recent 10th anniversary edition).

Let’s Talk about Tantrums Part I: The Basics

If you haven’t yet had the unforgettable experience of having your own child throw a tantrum in a public place, you’ve probably seen your share of tantrums in stores, restaurants, or at the movies. Nearly 90% of both boys and girls between 18 and 36 months of age have tantrums. Even though it seems like they last forever, most tantrums last between 5 and 10 minutes (75% of tantrums last 5 minutes or less). Children may develop their own tantrum “style” but tantrums typically include one more of the following behaviors: screaming, crying, stamping, throwing, running, pushing, or flailing arms and legs. Sometimes children having tantrums will bang their heads, punch, or kick anyone within reach. While we realize there is plenty of advice for parents to help them understand and deal with their children’s tantrums, we’ll offer our own take on this common experience.

Why Tantrums Happen

Why does a sweet happy singing child suddenly melt down into fits of rage? Why do anger, frustration, sadness, and fear become so out of control in older infants? In the past, parents believed that older infants and toddlers chose to kick and scream to get their way. Babies certainly learn quickly that specific cues or behaviors are likely to get desired responses but these discoveries come out of babies’ experimentation to find “cause and effect,” not out of attempts at manipulation.

Older babies’ brains are ready to experience feelings such as anger, disappointment, and frustration but they aren’t able to control those emotions. Think of it like leaving a pot of water on a hot stove and finding that you can’t turn off the burner or move the pot once the water has started bubbling. The water continues to boil, becoming more and more intense until the water evaporates away. Compare this image with that of the toddler shouting with frustration at his mother in a store, getting louder and louder until he bursts into tears and falls exhausted into his mother’s arms.

Jen B got first hand experience with a tantrum just a few days ago returning home with her family from a trip to Grandma’s house. Her daughter, Olivia, happy to take trips throughout the weekend, suddenly became aware that they were headed home. “Where’s the beach?” She asked a little distressed, and then asked if they were going back to Grandma’s house. Of course, she was reassured that they would see her grandparents soon but Olivia was already angry and losing control. The screaming and crying began and lasted all the way home.

Facts about Tantrums

In a 2003 study, researchers studied 335 children to get a better understanding of tantrums in children up to 5 years of age. Some of their findings include:
During tantrums, screaming and crying tend to go on continuously; aggressive behaviors tend to be intermittent
Shorter tantrums (less than 3 minutes) usually include only crying and one other behavior like stamping or dropping to the floor, longer tantrums (3 minutes or more) are more likely to include more behaviors and aggressive actions
Children who are distressed (sad or fearful) will have longer tantrums than those who are angry

We know that tantrums can be exhausting and embarrassing for parents and children. In part 2 of this series, we’ll share some tips to help you cope with tantrums.

Next time: Let’s Talk about Tantrums Part II. Common Triggers

Sources:

Osterman K, Björkqvist K. A cross-sectional study of onset, cessation, frequency, and duration of children's temper tantrums in a nonclinical sample. Psychol Rep. 2010; 106:448-54.

Potegal M, Kosorok MR, Davidson RJ. Temper Tantrums in Young Children 2: Tantrum Duration and Temporal Organization. Dev Behav Pediatr 2003; 24: 148-154.

Potegal M, Davidson RJ. Temper Tantrums in Young Children 1: Behavioral Composition. Dev Behav Pediatr 2003; 24: 140-147.

The worst advice we've ever received...

Last week we posted the best advice we ever received. While each of us has benefited from other parents' pearls of wisdom, there have been other times when we have been given some very bad or strange advice. In this post, we describe the worst advice we have ever received.

Give your baby beef jerky when she’s teething – Jen B

One day, my family was out shopping and our daughter started getting fussy. The checkout clerk asked me if my baby was ok and I told him that she was getting a tooth. His face lit up. “I have the best advice for teething,” he said. He went on to explain that when his kids were young, he would give them beef jerky to chew on when their mouths were sore. “It’s tough, so they can’t bite off any chunks and it tastes so good. The best part is that you’ll know she needs another piece when she throws it down because she’s gotten all of the flavor out.” I wanted to burst out laughing, but I just said "thank you" and rushed out of the store. As desperate as I was for a way to help fight the pain and end the fussiness, loading our baby up with salt and “beefy flavor” wasn’t going to be something I would ever try! For information about teething, see our posts on The Truth about Teething (Part 1 and Part 2).

Leave your baby to cry herself to sleep – Kerri

The worst parenting advice I received was from a friend of mine who told me always to let my baby, Elisabeth, cry herself to sleep in her crib. I remember sitting outside her bedroom door crying myself. It broke my heart to listen to her cry. I was told that she would eventually tire herself out and go to sleep without me having to rock or pat her. I tried this a couple of times and after about 20 minutes of her screaming, and her eventually making herself vomit from crying so hard, I decided that this method was not the right choice for our family. Every family may be different, but I learned very quickly that the best way for my family to get my baby to sleep was to rock her then put her down in her crib once she was asleep.

A dozen bad ideas to deal with persistent crying – Jane

As mentioned in an earlier post, when my daughter was a newborn, she was a "persistent crier" who would cry inconsolably for several hours per day. Of course, it was stressful to care for her and my husband and I were desperate for some useful advice. Well, we certainly got some advice, nearly everywhere we went, but very little was useful. It seemed that everyone was certain that they had "the cure" for my two-week-old daughter's fussiness. Some of the "cures" included giving her things to drink (teas, soda, brandy), feeding solid foods (cereal diluted and put into a bottle, syrup, oatmeal, or other baby foods), doing things to soothe her (vacuuming next to her, driving her around the neighborhood), using "special holds," leaving her for hours in a baby swing, and just telling her to be quiet. In those days, I didn't know anything about cues, persistent crying, or how different babies deal with stimulation. If I only knew then....

A little rum can go a long way – Jen G

The worst (well-meaning) advice I received was from a family member who told me to give my baby a spoonful of rum before bedtime to help her sleep. She said: “That will knock her out!” Luckily, I was too horrified to follow that advice in any way, shape or form. At the time I remember not having the words to respond to this elder family member. Now, looking back, I realize that many people will very lovingly give you outdated (or just completely inappropriate) advice about how to raise your child. A friend of mine once said “take what works for you and leave the rest.” So, that’s what I do. Most people are just trying to help you out because they know (usually from experience) that parenting is a tough job. To them I say “thank you for sharing!” and either incorporate their advice, if I think it is a good idea, or politely disregard their comments.

Next time: An update on one of our personal stories

The best advice we ever received...

When I found out I was pregnant with my daughter, I couldn’t wait to tell everyone I knew. While I expected my friends and family members to be excited too, I didn’t expect to be immediately showered with parenting advice. The farther along I got, the more advice I got, even from people I didn’t know. I assumed that this outpouring of advice was because I was having my first child, but now that I am pregnant with my second child, it is clear that people just love to give advice. Sometimes the advice is helpful and other times it’s not. In this post, each of us at the Human Lactation Center have provided the best advice we ever received.

Go with the flow – Jen B

The best advice I ever got was to “go with the flow.” As I’ve mentioned in previous posts, I like to make plans. I would be perfectly happy if I could plan out every detail of my daily life months in advance. Unfortunately, when dealing with babies, things don’t always go according to plan. For example, I wanted to make all of my daughter’s baby food from scratch, but after just a few weeks I realized that, with all of the other things going on in my life, it was just easier to buy the jarred food. I still made some of her food, when I had time, but I didn’t panic when my plans changed. I’m not saying that new parents shouldn’t ever make plans, but it is important to be flexible, to “go with the flow.”

Sleep while your baby sleeps - Jen G

When I first heard these words of advice from a sweet little old lady in the produce department of my supermarket I said “OK” with a big question mark in my furrowed brow. As friends and family members shared the same advice, I wondered why everyone was so concerned about my sleep. As my sleep deprivation continued, I realized that maybe I should listen and not try to do a dozen different chores or catch up on phone conversations while my daughter was napping. I felt like nap times were the only time during the day when I could get things done or do what I wanted to do. When my daughter was young, I would inevitably be woken up multiple times during the night and wake up just a tad less than refreshed the next morning. But if I took a nap with her, not only was it easier to get her to take a nap, but I actually got some rest as well! Then I was ready to conquer the afternoon. Our nap time together became a beloved ritual that my daughter, now a very energetic 3-year-old, and I still indulge in...once in awhile.

Accept help - Jane

Actually, the total gist of the advice was “accept all help that is offered and when you are ready, offer help to others.” As I explained in an earlier post, I did not have my own mother around to help me when I had my children. My independence and my ability to accomplish things on my own were very important to me and I believed that my husband and I did not need any outside help in caring for our children. Fortunately, I realized quickly that I was just being naive. Taking care of a newborn is more than a 200% time job. When you add household chores, paying bills, work tasks, and other outside responsibilities to child care duties, it is no wonder that new parents feel crushed by it all. I learned to accept the help that was offered to me and to “pay it forward” to other new parents whenever I got the opportunity. Believe me, it is worth it for yourself, your partner, and your baby. Accept help.

Accept advice but make informed decisions - Kerri

As a new parent, getting advice is almost unavoidable. Even when you don’t ask for it, people seem to need to tell you what they did and why you should do it too. I recommend accepting advice you are given, then picking and choosing which advice to follow. As you’ll see next week, people can give some pretty strange advice to new parents. If someone gives you advice that seems a little strange, do some research and see if it is something you want to try. I think it is most important to make an informed decision and to never do anything you aren’t comfortable with. There are wonderful resources for new parents (this blog included, although I may be a little biased) and you can always discuss any questions you have with your pediatrician.

Now that we’ve shared the best advice we’ve ever gotten, we’d love to hear from you, so send us a comment. We will even feature the best of the best in an upcoming post.

Next Time: The worst advice we ever received