I wanted a thread for all us solids delaying mamas to offer each other support and discuss our choice to delay solids until AT LEAST 6 months minimum, or to ask questions about why to delay. I know how hard it can be to take so much pressure from others to feed our kids solids early, especially with so many pediatricians still operating outside the AAP recommendations and offering solids as an option at as little as 4 months.
Here is some basic info on why solids should be delayed, for any mama's who are considering it:
Health experts and breastfeeding experts agree that it's best to wait until your baby is around six months old before offering solid foods. There has been a large amount of research on this in the recent past, and most health organizations have updated their recommendations to agree with current research.Unfortunately, many health care providers are not up to date in what they're telling parents, and many, many books are not up to date.
The following organizations recommend that all babies be exclusively breastfed (no cereal, juice or any other foods) or formula fed if need be for the first 6 months of life (not
the first 4-6 months):
- World Health Organization (WHO)
- US Department of Health & Human Services
- American Academy Of Pediatrics (some sources say 4-6 now, but they maintain that infants should be EXCLUSIVELY breastfed until 6 months)
- American Academy of Family Physicians
- American Dietetic Association
- Australian National Health and Medical Research Council
- Royal Australian College of General Practitioners
- Health Canada
Most babies will become developmentally and physiologically ready to eat solids by 6-9 months of age. For some babies, delaying solids longer than six months can be a good thing; for example, some doctors may recommend delaying solids for 12 months if there is a family history of allergies.
*REASONS FOR DELAYING SOLIDS*
Although some of the reasons listed here assume that your baby is breastfed or fed breastmilk only,experts recommend that solids be delayed for formula fed babies also.
- Delaying solids gives baby greater protection from illness.
Although babies continue to receive many immunities from breastmilk for as long as they nurse, thegreatestimmunity occurs while a baby isexclusively breastfed. Breastmilk contains 50+ known immune factors, and probably many more that are still unknown. One study has shown that babies who were exclusively breastfed for 4+ months had 40% fewer ear infections than breastfed babies whose diets were supplemented with other foods. The probability of respiratory illness occurring at any time during childhood is significantly reduced if the child is fed exclusively breast milk for at least 15 weeks and no solid foods are introduced during this time. (Wilson, 199 Many other studies have also linked the degree of exclusivity of breastfeeding to enhanced health benefits
- Delaying solids gives baby's digestive system time to mature.
If solids are started before a baby's system is ready to handle them, they are poorly digested and may cause unpleasant reactions (digestive upset, gas, constipation, etc.). Protein digestion is incomplete in infancy. Gastric acid and pepsin are secreted at birth and increase toward adult values over the following 3 to 4 months. The pancreatic enzyme amylase does not reach adequate levels for digestion of starches until around 6 months, and carbohydrate enzymes such as maltase, isomaltase, and sucrase do not reach adult levels until around 7 months. Young infants also have low levels of lipase and bile salts, so fat digestion does not reach adult levels until 6-9 months.
- Delaying solids decreases the risk of food allergies.
It is well documented that prolonged exclusive breastfeeding results in a lower incidence of food allergies. From birth until somewhere between four and six months of age, babies possess what is often referred to as an"open gut."This means that the spaces between the cells of the small intestines will readily allow intact macromolecules, including whole proteins and pathogens, to pass directly into the bloodstream.This is great for your breastfed baby as it allows beneficial antibodies in breastmilk to pass more directly into baby's bloodstream, but it also means that large proteins fromotherfoods (which may predispose baby to allergies) and disease-causing pathogens can pass right through, too. During baby's first 4-6 months, while the gut is still "open," antibodies (sIgA) from breastmilk coat baby's digestive tract and providepassiveimmunity, reducing the likelihood of illness and allergic reactions before gut closure occurs. Baby starts producing these antibodies on his own at around 6 months, and gut closure should have occurred by this time also.
- Delaying solids helps to protect baby from iron-deficiency anemia.
The introduction of iron supplements and iron-fortified foods, particularly during the first six months, reduces the efficiency of baby's iron absorption. Healthy, full-term infants who are breastfed exclusively for periods of 6-9 months have been shown to maintain normal hemoglobin values and normal iron stores. In one study (Pisacane, 1995), the researchers concluded that babies who were exclusively breastfed for 7 months (and were not give iron supplements or iron-fortified cereals) had significantly higher hemoglobin levels at one year than breastfed babies who received solid foods earlier than seven months. The researchers foundnocases of anemia within the first year in babies breastfed exclusively for seven months and concluded that breastfeeding exclusively for seven months reduces the risk of anemia.
- Delaying solids helps to protect baby from future obesity.
The early introduction of solids is associated with increased body fat and weight in childhood. (Wilson 1998, vonKries 1999, Kalies 2005)
- Delaying solids helps mom to maintain her milk supply.
Studies have shown that for a young baby solidsreplacemilk in a baby's diet - they do not add to baby's total intake. The more solids that baby eats, the less milk he takes from mom, and less milk taken from mom means less milk production. Babies who eat lots of solids or who start solids early tend to wean prematurely.
- Delaying solids helps to space babies.
Breastfeeding is most effective in preventing pregnancy when your baby is exclusively breastfed and all of his nutritional and sucking needs are satisfied at the breast.
- Delaying solids makes starting solids easier.
Babies who start solids later can feed themselves and are not as likely to have allergic reactions to foods.
Signs that indicate baby is developmentally ready for solids (baby should have most if not all):
*Baby can sit up well without
*Baby has lost the tongue-thrust reflex and does not automatically push solids out of his mouth with his tongue.
*Baby is ready and willing to chew.
*Baby is developing a pincer grasp, where he picks up food or other objects between thumb and forefinger. Using the fingers and scraping the food into the palm of the hand (palmar grasp) does not substitute for pincer grasp development.
*Baby is eager to participate in mealtime and may try to grab food and put it in his mouth.
What if my 4-5 month old seems developmentally ready for solids?
Four- to five-month-old babies are sometimes very eager to participate at mealtime, but it doesn't necessarily mean that they are ready to eat solids - more often it's just the normal developmental urge to do what everyone else is doing. Research studies tell us that there are many health advantages to delaying solids for about 6 months for all babies, not just the babies who are not yet interested in mealtime.
There are a number of things you can do to let baby participate in mealtimes without starting solids:
*Let baby sit with the family at mealtime - in a lap, booster seat or high chair.
*Give baby a cup of water or expressed milk. Your baby can entertain himself at mealtime while learning to use a cup. 1-3 ounces of water in the cup should be plenty (often for the entire day). Many moms choose to use only water or a small amount of breastmilk to avoid wasting the "liquid gold" while baby learns to use the cup.
*Offer baby sips of water from your cup or straw. Even if baby hasn't figured out how to use a straw yet, you can put your straw in water, block the top end of the straw with your finger to trap a little water in the straw, then let baby drink the water from the lower end of the straw (unblock the top end once it's in baby's mouth).
*Offer baby spoons, cups, bowls and other baby-safe eating utensils to play with during mealtime.
*Give baby an ice cube (if it's a baby-safe size & shape) or ice chips to play with.
*Offer baby a momsicle (popsicle made from breastmilk) or slushy frozen breastmilk to eat with a spoon.
Myths about solids readiness
There are many myths and outdated information regarding how to tell if baby is ready for solids.
MYTH: Baby's weight has reached a "magic" number
Just because your baby achieves "x" number of pounds, or has doubled birth weight, (or however much your baby weighs) does not mean that she is automatically ready for solids - particularly if she is under 6 months.
The American Academy of Pediatrics/World Health Organization recommendations for starting solids at 6 months or later has no exceptions for babies who weigh more. The research that I've seen on the health benefits of starting solids at 6 months and later holds for all babies, no matter what their weight.
It's the maturity of the digestive tract and baby's developmental readiness that makes the difference, not baby's weight.
It's rather interesting to note that moms are told to start solids for both big and small babies. It's not even uncommon to hear opposite arguments for both sides from the same person!
MYTH: "Your baby is big so you need to start solids."
Moms might be told to start solids for differing reasons when they have a large baby.
Some are told that since baby is big, they won't be able to produce enough milk to satisfy baby. This is quite untrue - almost all mothers have the ability to produce enough milk to exclusively breastfeed twins and even triplets. If you allow your baby to nurse on cue, your body will make enough milk for your baby.
Other moms are told that baby is eating too much, so mom should reduce baby's intake by limiting nursing and/or starting solids. There is absolutely NO evidence that a large breastfed baby will become a large child or adult, and limiting nursing can be quite dangerous for a baby.
MYTH: "Your baby is small so you need to start solids."
Another reason often given for starting solids is because baby is small . I really don't see the sense in this. Ounce for ounce, breastmilk has more calories than most baby-safe solid foods and significantly more nutrients than any type of solid food that you can feed your baby. In addition, starting solids will quite possibly reduce the amount of milk that your baby is getting overall, rather than increase overall intake. One of the first recommendations for a baby who genuinely has slow weight gain is to decrease or eliminate solid foods and nurse more often.
MYTH: Baby needs to start solids because there is not enough iron in breastmilk.
An additional reason given for starting solids is the "lack of iron in breastmilk." Breastmilk does have lower iron levels than formula, but the iron in breastmilk is more readily absorbed by the baby's gut than the iron in formula. Also, formula-fed babies tend to lose iron through fissures that develop in their intestines as a result of damage from cow's milk. Breastfed babies do not lose this iron. Sometime after the first 6 months (much later for a lot of babies), most babies will require an additional source of iron other than mother's milk. This can most often be obtained through small amounts of solid food. Read more on iron and the breastfed baby here: Is Iron Supplementation Necessary?.
MYTH: Baby needs solids so he will sleep longer at night.
The popular belief that feeding solids at night will help baby sleep through the night has no basis in fact. See Will giving formula or solids at night help baby to sleep better?
MYTH: If you don't start solids by "x" months, then baby will have problems with solid foods
This is another myth that is not supported by research for normally developing, healthy babies.
There is certainly a "window of opportunity" for starting solids, but this varies widely from baby to baby. At some point (usually around 6-8 months) baby will become developmentally ready to eat solid foods (able to sit up, chew, pick up food, etc.). At around the same age, the gastrointestinal tract is physiologically mature enough to handle a diversity of foods. At this point, most healthy babies will be ready and willing to eat (even if it's only occasionally and in tiny amounts).
Occasionally, parents will be told that baby must start solids by 6 months (or 8 months, or 10 months) or baby will have problems learning to accept and eat foods that require chewing. This "limited window of opportunity" idea is widely believed, but unproven.
I've not been able to find any research data to support the idea that there is a limited window of opportunity for introducing solids in normally developing, healthy children. There does appear to be some limited evidence that babies who have been tube-fed long-term or have serious developmental delays may have problems learning to eat if they don't get a chance to practice eating solids between 6 & 10 months. A small study involving case studies of several mentally retarded children was done back in 1964 (Illingworth RS, Lister J. The critical or sensitive period, with special reference to certain feeding problems in infants and children. J Pediatr 1964;65(6) part 1:839-48.). This study suggested that there may be a "critical and/or sensitive" period for introducing chewable textures to these children, and if solids are not introduced during this time, an important developmental milestone may be missed (possibly leading to rejection of solids later on). This study is the only one I've found referenced with regard to the "limited window of opportunity" claims regarding the normal development of children.
I asked a speech & language pathologist I know about her experiences with this. She has worked with many young children who have feeding problems, including developmental delays and problems with chewing and oral texture aversion. She said that she could not think of any reason that delaying solids would cause feeding problems, and said that the the problems in the children she had worked with had generally started at birth or relatively soon after. None of these children had a feeding problem caused by a delayed start to solid foods.
Why Early Introduction of Solid Foods has Changed
It seems that therecommendations for introducing babies to solid foods are continually changing. These changes and updates often cause quite a bit of confusion and frustration among parents who are looking to start their babies off with healthy eating.
Many parents look to their own parents and/or grandparents for advice and for these experiences to guide them. Often it is heard that "My Grandma fed my Mom rice cereal when she was just 2 weeks old and my Mom is alive and healthy" or "My Mom fed me cereal at 8 weeks old and I am fine".
These sentiments, when considering the above, bring on the question of "Why should I wait to introduce my baby to solid foods?".
Learn about optimal nutrition and delaying solid foods, the "open" gut, why 6 months of age is a good age to start solids and why 12 months of age is the time to introduce anything, and learn about the various reasons why solids were introduced early in the past.
If solids were introduced early in the past and babies grew up "fine", why should I wait now?
As with any evolution, the evolution of medicine and the science of dietary nutrition and infant nutrition has taken quite some time. In the past, there was not a wealth of research to suggest that an infant's gastrointestinal system was unable to properly utilize, absorb and process solid foods.Early introduction of solid foods that were not full of proper vitamins, minerals and other nutrients, robbed babies of crucial nutrients needed to sustain their rapidly developing systems.
While it maybe true that your Grandmother or your Mother grew up "fine", it may also be possible that their nutritional status' were less than optimal. Vitamin and mineral deficiencies were common in infants years ago as were illness and higher infant mortality rates. As science progressed, infant mortality rates began to drop as infants began receiving the proper, optimal nutrition for their growing bodies.
For example,The Journal of the Royal Society for the Promotion of Health
notes the following:
Introducing solid food "early" in the past
"The health benefits of breastfeeding for babies and mothers have long been recognized and it is now globally recommended that it be continued exclusively for six months. Although there are few controlled trials to support this recommendation, the most important advantage is less morbidity [death] from gastrointestinal infection in developing countries. There is also evidence that respiratory tract infections and atopic dermatitis is reduced, and the maternal risk of breast cancer decreases, particularly with a longer duration of breastfeeding and a high parity. "
To point out a rather extreme analogy, let us recall that we were once told that smoking was not bad for one's health. Indeed, smoking was touted as being a cure for some ills. Another example, it was once thought that hugging your baby would create a spoiled, ill-tempered child; and that hugging your baby should be limited.
As science progresses and studies are completed, the evidence has shown that smoking is indeed dangerous for our health and that hugging babies helps raise more emotionally secure adults.Evidence has now shown that the early introduction of solid foods is not a good idea, even if your Grandmother or your Mother did it.
Many years ago, indeed within the last century, infants began to be introduced to solid foods very early on in their new lives. These solid foods were typically a mixture of some sort of flour with a milk base. The reasons for this were many and varied. Prior to the invention of infant formula, babies were breast fed up to the first year of life and oftentimes longer.Breast milk is the most perfect food for babies after all. Current studies and research have proven that breastfeeding as long as possible and introducing solid foods at 6 months of age or later is best.
Many underdeveloped societies continue to delay solids for as long as possible; it is inconvenient, if not almost impossible, for those who must toil or gather food all day to stop to prepare food for their infants. Breastfeeding for as long as possible is not only most healthy, it is most convenient and is the ultimate "fast food". In the "old days", when it came time to progress in giving an infant solid foods, many babies were eating straight from the table. Babies were often eating "adult food" at an age when they were able to "chew". Today, this is called baby led-weaning. These early "table foods" often consisted of breads, eggs, and bits and pieces of "pre-chewed" foods that the mother would offer. Gerber and other commercial baby food companies did not exist until 1927 and later.
Introducing babies to solid foods in the past included practices and recipes that would shock us today
For example, we found this from the year 1852; read an excerpt from a cookbook which includes a chapter on cooking food and feeding babies and children:
From Cookery for Children, Sara Josepha Hale, 1852:
"Food for a young infant-- Take of fresh cow's milk one table-spoons full, and mix with 2 table-spoonsfull of hot water; sweeten with loaf-sugar as much as may be agreeable. This quantity if sufficient for once feeding a new-born infant; and the same quantity may be given every 2 or 3 hours -- not oftener -- till the mother's breast affords the natural nourishment."
"Thickened milk for young infants when 6 months old- Take 1 pint of milk, 1 pint of water; boil it and add 1 tablespoon of flour. Dissolve the flour first in half a teacup of water; it must be strained in gradually and boiled hard for 20 minutes. As the child grows older, one-third water. If properly made, it is the most nutritious, at the same time the most delicate food that can be given to young infants."
Ms. Hale's book also recommends stale bread as a staple in the diet as well as liberal amounts of sugar in fruits and vegetables. I wonder what Ms. Hale would think of her feeding advice and recipes in this day and age considering the studies and research in nutrition. It's a good thing that as the years passed and science evolved, the medical community began changing its stance on infant nutrition and introducing solid foods to infants.
The "Open Gut" and Introducing Solid Foods Early
"In our colonial and pioneer days, most people raised their own food, but as our nation has become industrialized and urbanized, we find that now only 7 per cent of our population produces the food for our entire nation, and our consumers generally buy their food in stores. Even as late as the beginning of the twentieth century, infant feeding practices could be considered unscientific and primitive. Only in recent years have knowledge of metabolism and the rapid increase in nutritional science permitted progress in infant feeding. " Feeding families and children - 1176 to 1976 A bicentennial study
It is said that infants have an "open gut" or a "virgin gut". This state of the gut (intestines) extends from birth to between 4 and 6 months of age. "After birth the gut mucosa is challenged by a myriad of antigens, from viruses to commensal microbiota and dietary antigens. Although controlled in the mature gut, these antigens may induce inflammation in the developing gastrointestinal tract." Pediatrics, Journal of the American Academy of Pediatrics
Studies have shown that an immature gut may allow whole proteins, microbes, pathogens and possibly bits of foods to pass into the bloodstream. It is quite possible that this is a causative factor in developing food allergies and "colic".
Optimal Nutrition and Introducing Solid Foods Early
It is a known fact that breast milk, and even formula, contains the proper combination of essential nutrients to sustain a baby's healthy growth and development well into the 9 month age range or longer. While your grandmother may have been fed rice and milk gruel at 2 weeks of age, science now tells us that solid foods should not replace breast milk or formula too early. Introducing solid foods early will deprive a baby of these crucial nutrients and also replace the amounts of breast milk or formula a baby needs.
"Exclusive breastfeeding for the first 6 mo of life followed by optimal complementary feeding are critical public health measures for reducing and preventing morbidity and mortality in young children." American Journal of Clinical Nutrition - Feb. 2007
With the advance of science, we also now know that basing an infant's diet on cow's milk is not healthy. Cow's milk has been shown to hinder iron absorption and does not contain all the important nutrients a baby needs to grow healthy. For this reason, science tells us it is best to introduce cow's milk at 12 months of age. We also now know that an infant needs "good" fats and carbohydrates in the diet; a diet of stale bread or plain flour soaked in warmed cow's milk does little to boost the nutritional status of an infant.
Self-Regulation of Food Intake and Introducing Solid Foods Early
Many pediatric authorities suggest that the early introduction of solid foods may lead to obesity later in life due to the lack of self-regulation. Your baby needs to be able to learn for him or herself when he or she is full. In the past, this type of information, based on scientific research, was unavailable to parents.
Babies who are fed solid foods earlier than 6 months of age may lack the ability to regulate how much solid food they are eating. As you are feeding your baby, you control the amounts that your baby is eating. Until a baby is able to clearly indicate that he or she is full (either by turning away from the spoon, batting the spoon away or clamping the mouth closed for example), the risk of overfeeding solids is high. Again, parents need to pay close attention to their babies cues particularly if they are introducing solids early.
6 Months of Age and 12 Months of Age - how are these ages "magical" in that solid foods are now ok?
Many parents often wonder why it is that once baby turns 6 months of age, suddenly baby is ready for solids. There are many reasons that 6 months of age is the "magical" age for introducing solids, here are a few
Baby's intestines should be fully "closed"
Babies are less likely to aspirate foods
Baby is better able to recognize that she is full and regulate how much she needs to eat
Baby is able to indicate she is full by turning away from food
Baby should be have fully developed head control and be able to sit up with minimal assistance
Baby has had breast milk or formula during the crucial first 6 months of life; giving him the healthiest start with optimal nutrients
There are many reasons that 12 months of age is the "magical" age for introducing "forbidden" solids; here are a few:
Baby's system is less likely to think that foreign proteins, like the egg protein, need to be considered invaders and fought off. Creating an allergy is considerably reduced in older infants
Baby has been sensitized to a variety of foods and allergies are less likely to be induced
Baby's development is such that some forbidden foods, cow's milk for example, will not adversely affect health
Baby's gastrointestinal system is better able to process pathogens, such as botulism spores in honey.