Yahoo Lifestyle Starting solids - sooner or later
Back in the 1960s, new mums were sometimes encouraged to offer their babies ‘a scrap of Marmite with cooled boiled water’ at just two weeks of age. At six weeks, a hearty broth of mutton, chicken or fish was on the menu, and by 12 weeks it was practically open season, with everything from tinned vegetables and egg yolk to jellies, custards and cereals on offer for bubs.
My, how things have changed! Today the official World Health Organization guidelines suggest sticking exclusively to nourishing breastmilk until your baby is at least six months of age, after which time certain foods such as iron-fortified rice cereals, full-fat yoghurts and pureed vegetables can slowly be introduced. Other, potentially allergenic foods including eggs, wheat and fish are typically not recommended to be started until later, often at 12 months or beyond, depending on who you consult. This is sage advice, says Dr Ronald McCoy, spokesperson for the Royal Australian College of General Practitioners.
“There are a lot of myths around this, and lack of education, so it’s taken a long time to get a globally consistent approach to infant nutrition,” he explains. “We now understand the supreme importance of breastfeeding and there’s overwhelming evidence of its many benefits up to the age of six months.”
A bunch of preliminary studies, however, are beginning to throw a spanner in the works when it comes to the widely held belief that delaying the introduction of certain foods can stop allergy and asthma from being ‘triggered’.The research suggests that introducing food early – from the age of four months, not six – may actually lower your child’s risk of developing allergies, eczema, asthma and food intolerances. One study published earlier this year in the Journal of Allergy and Clinical Immunology found early introduction of solid foods to be associated with a reduced risk of peanut (and perhaps egg) sensitivity by the age of three.
In a similar vein, study results released late last year by The University of Melbourne and Murdoch Childrens Research Institute revealed babies given egg after 12 months of age were up to five times more likely to develop egg allergy than bubs introduced to egg at four to six months of age.
Given the rise in allergy-related conditions over the past decade – in line with the rise in the age
of solids – research such as this is grabbing a lot of attention. Australia now has one of the highest rates of allergy and asthma in the world, with hospital admissions for severe allergic reactions to food in young children increasing fivefold in the space of 10 years.
It’s not just in Australia, either. Research shows peanut allergies, for example, have doubled in recent years in other areas of the western world. Some health experts are now calling for a return to pre-2001 guidelines, when starting solids at four months was the norm. But is this the right way to go?
Too early to tell
Many breastfeeding advocates, including Kate Mortensen, manager of the Lactation Resource Centre of the Australian Breastfeeding Association, question the validity of the allergy research. “None of the research was conducted on exclusively breastfed babies,” Kate points out. She also cites her own evidence to show that breastfeeding exclusively for the first six months has numerous other health benefits for growing babies, reducing their risk of infections and illness, including gastro and respiratory infections, and obesity. Studies also show it may reduce the risk of SIDS.
The research is certainly not conclusive, agrees Professor Dianne Campbell, a paediatric specialist from The Children’s Hospital at Westmead. “Even though a lot of the studies suggest that there might be a protective effect of introducing some solids between four and six months, we only know that by association,” she says. “Until we do more randomised controlled studies, we won’t know for sure.”
What we do know, she says, is that the old theory that delaying certain foods, such as eggs, beyond the start of other solids to prevent allergies no longer holds true: “There currently is very little evidence that delaying solids well into infancy is going to be protective.”
For this reason, Australia’s peak allergy body, the Australasian Society of Clinical Immunology and Allergy (ASCIA) has now softened its guidelines and recommends introducing complementary solid foods from “around” four to six months. ASCIA says there is simply not enough evidence to prove that delaying potentially allergenic foods such as eggs, nuts, wheat, cows’ milk and fish will stop your child from getting a food allergy or eczema. This also applies to infants with older siblings who have food allergies.
Is bub ready?
Confused about what to do about solids? “I would say to parents that when their child is developmentally ready – and it varies from child to child – if they seem interested in solids, you can introduce them in a staged way from four months,” says Professor Campbell, who reminds that “there’s no specific reason to avoid things that we might have previously avoided, such as egg, wheat or fish.”
Common readiness signs include your littlie watching keenly as you eat or even trying to grab food from your plate, and the ability to sit unsupported and hold her head upright and steady.
When you do introduce solids, the key, say Professor Campbell and ASCIA, is to continue breastfeeding at the same time. This is, of course, important for meeting your bub’s nutritional requirements, but it may also help prevent the development of allergies to those foods. (Though again, we don’t know for sure.)
What is clear is that our foremothers may have been misguided; children are not developmentally ready for solids before four months of age, says Dr McCoy. “Babies have a reflex where their tongue pushes out anything placed in their mouth. It protects against choking and it means they won’t eat solids before four months.”
If you are worried about allergies and food intolerances, speak to an expert, Dr McCoy advises. “What I say to anxious parents is that the general recommendation is to try and do exclusive breastfeeding for six months,” he says. “Then introduce foods one at a time, and if there are significant problems, see your doctor, a paediatrician or a reputable children’s hospital.”
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