Starting Solids… When is the right time?

 By Andrina Wilson, Sleep Coach & Midwife

Health professionals and breastfeeding experts agree that breastmilk or formula is all your baby needs until six months of age. It is important that your baby is both developmentally and physiologically ready to eat solid foods. This is generally between the ages of 6-8 months.

Parents often decide to introduce solids earlier than recommended for a multitude of reasons. Often they are guided by what other parents are doing, their WellChild service has recommended it, they think it will help their baby sleep longer or, the most common reason I hear – “my baby stares at me when I’m eating”. Babies are inquisitive creatures, they learn by watching the world. Following your mouthful or grabbing food from your plate does not mean that their tiny, immature gut is ready for solids.

Below is a list of just a few of the organisations that recommend that all babies are exclusively breastfed (no cereals, juice or other foods) for the first six months of life:

  • World Health Organisation
  • UNICEF
  • Ministry of Health NZ
  • American Academy of Pediatrics
  • American Academy of Family Physicians and Research
  • Australian National Health and Medical Council

 

Immunity and Allergies

Babies are born with what is often referred to as an ‘open gut’. This means that the spaces between the cells of the small intestines are large enough for macromolecules including whole proteins and pathogens (disease causing cell) to pass directly into the blood stream. This is beneficial for breastfed babies as it allows antibodies to pass through and gives the baby passive immunity via the mother. However, if a baby is given solids before the gut closes, around six months of age, it can predispose the baby to allergies and allow large, disease causing pathogens to pass through.

Exclusive breastfeeding for at least the first three to four months of life reduces the risk of allergic disease, coeliac disease, Type 1 Diabetes, respiratory tract infections, ear infections and Sudden Unexpected Death in Infancy (SUDI). The risk further decreases for babies exclusively breastfed for the first six months of life. Furthermore, introducing solids prior to six months of age is also associated with an increase in body fat in adolescents and adults.

Do I need to worry about my baby’s iron levels?

Healthy babies born at term (>37 weeks gestation) have enough iron stores to last at least six months. Breastmilk is rich in iron and is easily absorbed by babies gut. Approximately 50-70% of iron that is available in breastmilk will be absorbed (3-12% in formula), compared with only 4-10% of iron fortified cereals.

Babies born prematurely (<37 weeks gestation) may be at risk for iron deficiency anaemia, as a significant amount of babies iron stores are laid down in the last trimester of pregnancy. It is important that you discuss this with your pediatrician at birth. In New Zealand it is common for an iron fortifier to be added to expressed breastmilk and given to babies born prematurely. Prematurity is not an indication that your baby will need to start solids before six months.

 

Will solids help my baby sleep through the night?

This may not be what you want to hear, but giving your baby solids will not help them to sleep longer.

A 2010 study showed that babies who were given solids prior to four months of age slept, on average, half an hour less each day than babies who were not given solids. Babies wake in the night for many reasons, hunger often being way down the list. Around five months of age, babies sleep patterns change significantly. All babies will wake 4-6 times in the night and without knowing how to self-settle, they will need your assistance to get back to sleep. Click for more info.

 

But my baby keeps grabbing my lunch!

Babies explore the world by touch and taste. They will put almost anything they can get their tiny hands on to their mouth, but this doesn’t mean they necessarily want to eat it! Showing interest and/or grabbing the food on your plate doesn’t mean your baby is hungry or needs additional foods. It’s simply their way of exploring their environment and being a part of the fun!

Babies LOVE to be involved in meal times – have them sit with you at the table with some clean, baby friendly utensils like plastic spoons, bowls etc. and let them learn by watching. They may imitate your chewing actions which is fantastic for when they do start eating solid foods. You could also give baby a cup of expressed breast milk or “momsicle” (frozen expressed breastmilk) for something new to try.

 

At the end of the day, you as a parent know what is best for your baby. However, it is important to consider the reasons for starting solids – is your baby truly ready to start solids (both developmentally and physiologically) or are they just interested in what’s on your plate because it is colourful and smells different? Could they be waking in the night because they’re trying to master a new skill like sitting unaided or crawling, rather than being hungry? It is also important to consider the future implications on your baby’s health – the evidence that starting solids prior to six months increases the risk of allergies and infection is black and white.

It’s so cliché, but your children grow up so quickly. Blink and you’ll miss it! Sometimes we need to slow down and enjoy the present. When they start critiquing your culinary skills, you’ll look back fondly on the day when they nuzzled into your chest, staring into your eyes and that beautiful milk-drunk haze spreads across their face… savour that image, just a little bit longer.

 

References:

Cameron, S., Taylor, R., & Heath, A. (2013). Parent-led or baby-led? Associations between complementary feeding practices and health-related behaviours in a survey of New Zealand families. BMJ open, 3(12), e003946.

Kramer, M., Guo, T., Platt, R., Sevkovskaya, Z., Dzikovich, I., Collet, J., Shapiro, S., Chalmers, B., Hodnett, E., Vanilovich, I., Mezen, I., Ducruet, T., Shishko, G., & Bogdanovich, N.(2003). Infant growth and health outcomes associated with 3 compared with 6 months of exclusive breastfeeding. American Journal of Clinical Nutrition, 78(2):291-5.

Ministry of Health, NZ. (2015). Feeding your baby. Retrieved from http://www.health.govt.nz/your-health/pregnancy-and-kids/first-year/6-12-months/feeding-your-baby

Nevarez, M., Rifas-Shiman, S., Kleinman, K., Gillman, M., & Taveras, E. (2010). Associations of early life risk factors with infant sleep duration. Academic Pediatrics, 10(3):187-93. doi:10.1016/j.acap.2010.01.007

World Health Organisation. (2011). Exclusive breastfeeding for six months best for babies everywhere. Retrieved from http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/

World Health Organisation. (2001). The optimal duration of exclusive breastfeeding: A systematic review. Retrieved from http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_01.08/en/

 

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