As Oliver approaches four months old, our thoughts are starting to turn toward the introduction of solid foods. To be clear, all major health organizations (including the World Health Organization, UNICEF, Health Canada and the American Academy of Pediatrics) advise exclusive breastfeeding for the first six months of babies’ lives; but regardless, there is no shortage of companies marketing baby foods to parents of babies as young as four months old.
Even one generation ago, parents were still being instructed to begin feeding solids at around four months of age with the introduction of single-grain (e.g. rice) cereals. It was thought that the addition of cereal to a babies’ diets would increase satiety and therefore help babies sleep through the night. We now know that this is not true. We also know that adding rice cereal to a baby’s bottle is useless at best, and a potential choking/aspiration hazard at worst. Parents could subsequently introduce single pureed fruits and starchy vegetables at six months of age, followed by mixed pureed vegetables/fruits and pureed meats at around nine months of age.
Now, parents are advised to wait to introduce solids until babies are capable of sitting unsupported (approximately six months), but can begin feeding pureed fruits, vegetables and meats in any order. Commonly allergenic foods such as egg whites, tree nuts and cow’s milk, however, are not recommended to be introduced until babies reach a minimum of one year old.
I thought that these new guidelines would make rice cereal a thing of the past, but apparently this is not the case. Highly-processed rice cereal is still the most commonly suggested first food for babies. Why on earth, I wondered, anyone would recommend that babies be fed something so completely devoid of nutrition? It turns out that there are two reasons: 1) because it is bland; and 2) because it is fortified with iron.
Conventional wisdom still holds that babies’ first foods should be as bland and inoffensive as possible in order to minimize the potential for allergic reactions. Babies who begin solid foods before their digestive systems have sufficiently matured are more likely to develop food allergies; however, this is a result of premature introduction of solids, and not a result of the order in which the foods are introduced.
The argument for introducing iron-fortified cereal stems from the fact that babies are born with only enough iron stores to carry them through approximately the first six months of life, and that breast milk is very low in iron when compared with infant formula. Thus, it is often thought that babies require supplementation from about six months onward. This argument, unfortunately, ignores the fact that the naturally-occurring iron in breast milk and other foods is vastly more bioavailable (easily absorbed) than that which is used for fortification of infant formulas and cereals. It also ignores the fact that iron deficiency anemia is almost completely unheard of in exclusively breastfed infants. In fact, a 1995 study concluded that babies who were exclusively breastfed for seven months had a lower risk of anemia than those who weren’t.
As parents, it is natural to want to see a baby reach his or her developmental milestones as early as possible, with the introduction of solid foods being no exception. The availability of processed baby cereal and produce purees has enabled us to foist this important milestone upon our children sooner than nature would otherwise allow.
But the fact is, a four-month-old baby cannot safely eat real solid foods, which is precisely why we can only feed them bland mush. Most babies younger than six months lack the gross motor control to sit upright without support. They lack the fine motor control to release food from their hands, and to masticate food and move it to the back of the mouth for swallowing. They also lack the necessary enzymes for chemical digestion of most foods other than mother’s milk. Giving them easily-digestible processed foods does nothing to hasten their development, since babies actually treat these so-called “solid” foods as thick liquids and simply suck and swallow them as they would breast milk.
So as much as we are eager to introduce Oliver to all of the exciting new smells and tastes of solid food, we will patiently wait until he shows true signs of developmental readiness.