Eating solids

[AussieMumofOne]

Hi all! Some thoughts and questions on solid foods!

There are such strict recommendations on when to introduce what foods here in Australia but most of these guidelines seem to be based on outdated research. We had to see a paediatric allergist about BC's eczema and we discussed this topic.

I believe that holding off on the introduction of some solids until the baby is older (ie; peanuts, eggs, strawberries, gluten...) is more likely to cause the allergy, rather than prevent it, and the allergist agreed and said that the emerging research is supportive of this. If anyone here in Australia heard a recent story on the news about the early introduction of eggs to prevent an allergy, the specialist that we saw was a part of this research and is a highly respected allergist, therefore we trust his advice.

My main question was, if BC does have an allergy, is the reaction that he would experience now, any different to that than he would experience if we did introduce the food at the current recommended age, ie; 12 months for example, and he said 'no, the reaction would be the same'. So he suggests introducing VERY small quantities of these foods earlier than currently recommended, only a tiny tiny amount and then gradually introducing the quantity of that food and keeping a close eye on the baby.

So, my point is, when did you introduce certain foods into your childs diet? BC is nearly 5 and 1/2 months now and he is eating a huge variety of fruits and vegetables. I am thinking of introducing pureed meat to his vegetables at 6 months, did anyone else do this? What about the introudction of allergenic foods like strawberries and eggs?

Thanks in advance!

[annisis]

To be honest, I heard what experts were saying about when to introduce foods and kept that in the back of my mind. But I gave what I wanted to Josiah when I intuitively felt it was appropriate. I just watched him closely for reactions. And I felt comfortable with that. Now, research is coming out that many things I gave him are better to be introduced early. So, that makes me feel even better about my intuition!

Josiah also had a mild case of eczema, something I believe he inherited from me and chronic ear infections that he inherited from his father. Interestingly, I found through personal research that cow's milk is considered mucous producing and can cause ear infections. So for the past year, Josiah has been on goat's milk. Not an ear infection since! We are now back to cow's milk after a few test trials. This one is looking to be successful!

I tried to give him small samples of everything I ate, in the hopes that he would develop his palate. Well, no dice there, but no allergies either at this point. If you equip yourself with the information of what is and isn't an allergen and the possible reactions, then you should feel confident introducing your child to new foods.

Hope this helps!

[AussieMumofOne]

Thanks so much annisis! Is Josiah a good eater now?

There is lots of contradicting opinions and evidence on the link between milk allergies and ear infections and milk consumption and mucous production. Most of the research says that milk doesn't increase milk consumption but lots of anecdotal evidence suggests a strong relationship. Many a parent comes into my clinic telling me that their child's middle ear infectons have improved since they started withholding dairy. It would be nice if there was some research to support this though! There is some research that says that this can be the case if you have a dairy intollerance. This is because of the traditional allergic reaction that will occur when you come into contact with the allergen (in this case, milk), swelling! As the Eustachian tube swells, it blocks the middle ear space from equalising with the atmospheric pressure and as the cells in the middle ear use up the available air, a negative, sucking pressure is created (Eustachian Tube Dysfunction). If the pressure is signigicant enought, it will then suck the fluid from the cells in the middle ear space and this will fill the middle ear (otitis media). If the Eustachian tube is still blocked, the fluid has no where to go and can become a breading ground for bacteria and viral infections, thus causing acute otitis media, or an ear infection.

Back to the topic at hand though! When did you introduce pureed meats into his diet?

[annisis]

I introduced meats at the same time as everything else. In fact Josiah started on solids a month earlier that most babies. Very slowly, of course. He was a great eater until a few months ago. I had him eating spinach salads that I had chopped into tiny pieces. Right now, he is at a stage where he wants to assert his independence so he will say no to things just to say no. It will pass, I'm sure! All in good time!

Thank you for telling me about the milk. I had suspected as much. Infections, to me, always seemed to be a sign of an allergy-- like the body is just rejecting something, it swells, and then closes in whatever it was rejecting and bacteria, etc. that cause the infection. But I am no expert in that area. I tried the goat's milk out of desperation. His father had tubes until he was 12! And he had to have one ear drum rebuilt! And he just had a CT Scan that will tell us whether or not he will need ear surgery again soon. I want my son to avoid this if at all possible. When I took him off cow's milk, I also did everything that I could to build his immune system, just in case.

[carpe vestri vita]

We waited until 6 months to introduce solids as per the current recommendations. We skipped purees. We gave him what we were eating from the beginning. Zed loves meat. We made no concessions for supposedly allergenic foods. He's had eggs, strawberries, peanut butter, citrus, wheat, etc. He has not had shellfish or chocolate. We don't eat the first. And the latter is because DH eats milk chocolate, and Zed is dairy intolerant.

[AussieMumofOne]

Excellent advice, thanks ladies! I am going to introduce yoghurt to BC in the next few days and meat in the next few weeks. BC is currently such a great eater that I'm sure all will go well! Thanks for your advice. 

[Skylark]

Our girl had her first solids at 10 months, before that exclusively BF. There is a number of readiness signs to follow, check some of the previous threads we talked about it. But Breastfeeding and delaying introducing solids till later actually can prevent development of allergies


Here is some info I shared before:

"Here is the link to the article about introducing solids:

http://www.askdrsears.com/html/3/T032000.asp

It explains about the time schedule for it, ideas, ways to do it. It also explains the reasons why it is not so good to introduce solids too early due to possible allergies.
There are also some ideas about what to introduce first, and how to know when you baby is ready. Some recipes, explanations why some foods are better then others.

Avocados are one of the best foods to start with...

They are low in sodium and cholesterol-free, contain quite a bit of vitamin A (which is good immune booster), vitamin B-6, folic acid, niacin, phosphorus, magnesium, and iron. Ounce-for-ounce avocados contain more potassium than 45 other fruits, juices, or vegetables, including bananas, peaches, carrots, and green beans, and they are one of the only fruits that contain monounsaturated fats, which are essential for baby's development.

Avocados also are higher in calories than any other fruit or vegetable. This is a plus for babies, since feeding infants calls for foods that contain a lot of nutrition per unit of weight and volume.  For variety, avocados can be mixed with apple or pear sauce, cooked squash, or sweet potatoes.

Some other good first foods are :

applesauce, bananas, carrots ( steamed, mashed), pears, squash ( steamed, mashed), sweet potatoes "

[AussieMumofOne]

That is certainly what is currently suggested but the emerging research is suggesting that delaying the introduction of solids is actually linked with a higher risk of allergies, there are many many peer reviewed, published journal papers reporting this. Of course there is lot of contradicting opinions here so I am certainly not questioning what was right for your bub! BC has been on solids since he was four months under the guidance of a paediatrician and paediatric allergy specialist. He is doing really well! I think it's wonderful that you are able to breastfeed your baby and you should be so proud! I only wish that I was able to breastfeed but a medical condition prevented me from experiencing this joy. Breastmilk does definitely boost the immune system but we won't let it get us down because we weren't able to do this. Thanks for sharing!

[AussieMumofOne]

For anyone interested, some current research suggesting that early introduction of solids (between four and six months) is more likely to prevent allergies, than cause them:

(I haven't included all the details about the methods and other scientific protocols but you can click the links if you want more information!)

The introduction of solids in relation to asthma and eczema - http://adc.bmj.com/content/89/4/303.abstract

Background: Despite scarce scientific evidence, current feeding guidelines recommend delayed introduction of solids for the prevention of asthma and allergy.
Conclusions: Results do not support the recommendations given by present feeding guidelines stating that a delayed introduction of solids is protective against the development of asthma and allergy.


Timing of Solid Food Introduction in Relation to Eczema, Asthma, Allergic Rhinitis, and Food and Inhalant Sensitization at the Age of 6 Years: Results From the Prospective Birth Cohort Study - http://pediatrics.aappublications.org/cgi/reprint/121/1/e44

OBJECTIVE. Current prophylactic feeding guidelines recommend a delayed introduction of solids for the prevention of atopic diseases. This study investigates whether a delayed introduction of solids (past 4 or 6 months) is protective against the development of eczema, asthma, allergic rhinitis, and food or inhalant sensitization at the age of 6 years.
CONCLUSIONS. This study found no evidence supporting a delayed introduction of solids beyond 4 or 6 months for the prevention of asthma, allergic rhinitis, and food or inhalant sensitization at the age of
6 years. For eczema, the results were conflicting, and a protective effect of a delayed introduction of solids cannot be excluded. Positive associations between late introduction of solids and food sensitization have to be interpreted with caution. A true protective effect of a delayed introduction of solids on food sensitization seems unlikely.


Relation between early introduction of solid food to infants and their weight and illnesses during the first two years of life - http://www.bmj.com/content/306/6892/1572.abstract

OBJECTIVE--To assess the relations between early introduction of solid food and infant weight, gastrointestinal illness, and allergic illnesses during the first two years of life.
CONCLUSION--Early introduction of solid food to infants is less harmful than was previously reported. Longer follow up is needed, but, meanwhile, a more relaxed approach to early feeding with solids should be considered.


Can early introduction of egg prevent egg allergy in infants? A population-based study - http://www.jacionline.org/article/S0091-6749(10)01173-5/abstract

Background - Infant feeding guidelines have long recommended delaying introduction of solids and allergenic foods to prevent allergy in high-risk infants, despite a paucity of evidence.
Conclusions - Introduction of cooked egg at 4 to 6 months of age might protect against egg allergy. Changes in infant feeding guidelines could have a significant effect on childhood egg allergy and possibly food allergy more generally.

[carpe vestri vita]

Today (or yesterday depending on your time zone ) there were announcements on several news sites regarding a new paper on the introduction of solids. I found the news to be a bit inaccurate about it, to say the least. I'm not particularly eloquent, but I found a blog post that seemed to sum it all up pretty well. http://www.analyticalarmadillo.co.uk/2011/01/starting-solids-facts-behind-todays.html

[Skylark]

Very good precise UNICEF's UK response to media reports questioning the recommendation to introduce solid food to babies at 6 months



An article published in the British Medical Journal (BMJ) is being reported in the media as questioning whether exclusive breastfeeding for 6 months is appropriate for UK babies.1 This article is not based on new evidence but rather a re-analysis of older evidence, much of which is the same as that used as the basis for weaning recommendations from the World Health Organization (WHO) and the UK’s Departments of Health (DH).

There is a wealth of robust evidence that breastfeeding saves lives and protects both the short and long term health of mothers and babies in industrialised countries.
Breastfeeding reduces the risk of infections, as well as the risk of diabetes and obesity in children and breast cancer in mothers. It is also associated with improved parenting capability among low-income women, and with reduced incidence of neglect and postnatal depression, thereby improving the life chances of children.

WHO recommended the introduction of solid food at around 6 months alongside continued breastfeeding in 2001. This was based on evidence that the early introduction of solid food to babies increased the risk of infection and disease. In 2003, DH also began to recommend introducing solids at ‘around 6 months’, changing from its previous position of ‘at 4-6 months’. The authors of the BMJ article question this recommendation for UK babies. The basis of their arguments is that delaying introducing solid food may increase the risk of iron deficiency anaemia (IDA), coeliac disease and food allergies, and that introducing new tastes may increase acceptance of green leafy vegetables and so encourage healthy eating later in life.

Iron deficiency anaemia

IDA is strongly influenced by iron stores at birth (which is related to the mother’s iron status and length of gestation) and early cord cutting (which is still common and canreduce iron stores by up to 33%). IDA is also associated with poverty and deprivation. Ensuring that the mother is not anaemic and that cord cutting is delayed will in turn ensure that the baby’s own body stores and breastmilk will provide sufficient iron for over 6 months.
The majority of the food commonly introduced to babies in the early months such as cereal, fruit and vegetables are low in iron and will therefore not help prevent IDA. However, if they are introduced before a baby needs them, they will displace breastmilk from the baby’s diet and may thereby reduce the amount of iron consumed.


Coeliac disease

Coeliac disease is associated with the early introduction of gluten (from cereals). There have been a number of observational studies which have suggested that the exact timing of the introduction of gluten into the diet may influence the development of this disease. The Government’s Scientific Advisory Committee on Nutrition and Committee on Toxicity of Chemicals in Foods, Consumer Products and the Environment have been asked to analyse the evidence on this issue and its draft statement can be found at: www.sacn.gov.uk/meetings/sub_groups/maternal_child_nutrition/19012011.html

This statement concludes:

Currently available evidence on the timing of introduction of gluten into the infant diet and subsequent risk of coeliac disease and T1DM is insufficient to support recommendations about the appropriate timing of introduction of gluten into the infant diet for either the general population or high-risk sub-populations. However, there is evidence suggesting that not being breastfed at the time when gluten is introduced into the diet is associated with an increased risk of subsequently developing coeliac disease.

Food allergies

The incidence of genuine food allergy (as opposed to food intolerance) is rare. 10 There is speculation and some observational data that when there is a family history of true allergy then early introduction of certain foods may be beneficial. Random control trials are now being undertaken to test this theory. Should this prove to be the case (which is by no means certain) then high risk families would need to be advised on a case-by-case basis. This would not affect public policy as applied to the majority of children not affected by allergies.

Introducing bitter tastes

The BMJ paper claims that introducing bitter tastes early will increase the acceptance of green leafy vegetables and so prevent obesity later in life. This is purely speculative.

Breastmilk changes flavour depending on the mother’s diet and so exposes the baby to various tastes from birth onwards. Food preference is also dependant on a number of factors including what is given, how it is given and parental attitude. Current DH recommendations take account of these factors and encourage parents to introduce a range of healthy foods in an appropriate manner.

Recommendations

The UNICEF UK Baby Friendly Initiative supports continued research into improving infant health. However, any new research should then be considered as part of the whole body of evidence and any recommendations made should be based on the full evidence rather than on single papers. It is unfortunate that the BMJ press office and the UK media have focused on a single piece of comment which has resulted in sensational headlines and risks misleading parents and damaging infant health. When considering this analysis it should be noted that three of the four authors have declared an association with the baby feeding industry.

The DH recommendation is that solid food be introduced at around six months, regardless of whether the baby is breastfed or formula-fed. It is acknowledged that babies’ individual development varies widely and that some babies may be ready for solid food before and after this time. Since the introduction of this recommendation the number of babies experiencing the potentially harmful introduction to solid food before 4 months has reduced.

Health professionals should continue to support mothers with accurate information based on DH and WHO guidance, helping them to recognise the signs of when their baby may be ready to try new foods, while continuing to breastfeed.


http://www.babyfriendly.org.uk/pdfs/unicef_uk_response_to_BMJ_article_140111.pdf

[TracyR4]

Interesting. I know here in the US the thought is the later the better. But to be honest if they are allergic to something they just are.
I have four girls and introduced foods to them at different ages and to be honest it really didn't matter.

When I had my oldest the recommendation was 4 months old ( this was 13yrs ago by the way) and as I had other children the recommendations became later and  later. It really didn't matter. Out of my 4 children only one has food allergies and that would be my last child whom didn't take in solid foods until about almost a year old. I breast fed her for an entire year. It really didn't prevent allergies at all. But then she also has medical problems that could be compounding the problem of allergies too.

Sometimes I wonder if they just make this stuff up seeing if any of it could possibly turn out right. I don't know. 

[Ezhik]

I was told by my health visitor that I could introduce egg straight away as long as I made sure it was cooked through. I never realised it was an allergen until discussing Nicholas' lunch with other mums and one asked why I was giving egg as it wasn't supposed to be given until later... 

I did keep track of what I was introducing and when, watching out for reactiong, especially as he was so tiny and had really bad reflux. I think you have to go with your instincts a bit - if there are lots of allergies in your family, be wary and watchful when you introduce those things (whenever that is). There are no food allergies in our family and to be honest, I have always fed him anything he'll eat (which is anything, really!) and just kept an eye out for reactions.

I am more of the opinion that delaying introductions to various things (be it peanuts or dust) is only likely to cause more of a reaction later, if there will be a reaction at all. But I'm no doctor 

[NewMom27]

Thanks a ton for the valuable information and giving insight about the subject.

Really appreciate.

Thanks

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