Friday, June 17, 2011

Pass the pumpkin


When is the best time to start your baby on solid foods?
There is always much discussion among mothers about when to introduce solids. 
The World Health Organisation recommends starting when your baby is around six months, and this is also what most Australian health professionals and the Australian Breastfeeding Association recommend.
The recommendations are certainly important, because a young baby’s digestive system cannot cope well with the fats and proteins that are in other food and drinks.
An infant’s kidneys can’t handle the large amounts of sodium found in processed foods designed for children and babies don’t need the extra kilojoules that solid foods may give them.
Research has also shown that a baby will not necessarily sleep any longer when solids are introduced to their diet (both my daughters are proof of that!).
Also, babies have a natural tongue-thrust reflex that makes their tongue push out food when it is put into their mouth, and they begin to lose this at around six months making it easier for them to swallow food.
At six months of age, babies do start to need extra nutrients, and there is also less risk of food intolerance.
Plus, they are ready to experience new tastes and textures, and will start developing teeth and stronger jaws at this age.
However, a review of breastfeeding research published in the British Medical Journal earlier this year said there was emerging evidence that breast milk alone did not provide enough nutrition for infants.

The authors, from several leading child health institutes in Britain, said although breast milk offered babies many health benefits, including protection against infection, studies in the past decade showed babies denied solid foods before six months could be at higher risk of wheat allergy, coeliac disease (permanent intestinal intolerance to dietary gluten) and iron deficiency anaemia - a condition that can cause irreversible neurodevelopmental damage.
The deputy chairman of the NHMRC dietary guidelines working committee, Professor Colin Binns, who is reviewing the evidence for new breastfeeding guidelines to be released this year, said the British review offered no compelling evidence to change the advice that exclusive breast milk was best for infants.
Professor Binns, from Curtin University's School of Public Health, said research showed the introduction of nutritious solid foods between five and seven months was ideal and that doing so earlier could cause a baby to become overweight, increasing the chance of obesity later in life.
He said introducing foods too early could expose a baby to bacteria that caused diarrhoea and cause a mother's breast milk to dry up if feeding became more sporadic as a result.
“Breast milk is by far the most nutritious food a baby can be given,” Professor Binns said.
The senior lecturer in midwifery and breastfeeding at RMIT, Jennifer James, said advice should be changed only on the basis of large, rigorous studies.
I firmly believe that the best time to start your baby on solids is when they show signs of being ready for solids - and that’s usually around six months of age.
Some babies may become interested in the food you’re eating, grabbing at food and putting it in their mouth, or opening their mouth when you put a spoon near them.
Some babies seem to be hungry a lot more, and weight gain is not continuing at a desired rate.
Babies who are ready to start solids should also have good head and neck control and be able to sit upright.
In any case, watch, listen and take your cues from your child.
One other issue that worries many mothers is whether to give breast milk (or formula) first, or give solid food first at mealtime.
I don’t think there is any right or wrong answer here. 
If breastfeeding and introducing solids is going well, it probably doesn’t matter. There is also no reason that a baby needs both breast and solids every time they eat.
But remember that starting solids doesn’t mean replacing breastfeeding. It is still recommended to keep breastfeeding along with eating solids for at least one year.
The best place to start is with infant rice cereal. Start with a teaspoon, just once a day, then increase the amount each day until they are eating a maximum of two tablespoons. Try mixing it with breastmilk.
You can then try solids twice a day and thickened slightly as they eat more.
Common foods to try include pureed potato, pumpkin, carrot, banana, cooked and pureed pear, apple, meats, rusks, and toast fingers.
Then when you child is around eight months of age move on to fish, rice, pasta, bread, cheese, yogurt and other fruits, ensuring that the food is soft, at room temperature and doesn’t pose a choking hazard (such as grapes).
Avoid salt and sugar for as long as you can.
When you introduce different foods, try each one for about four days to get your child used to the taste and texture, and so you can watch for signs of intolerance or allergies.
If your family has a history of allergies it is best to seek professional advice about the best way and the types of foods to introduce.
If your baby doesn’t like something, try it again some other time.

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