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Infant Food Recommendations May Be On The Way

by Sue Hubbard, M.D.

A new year has begun and with that there often come changes, one of which may be in how infants are introduced to solid foods. The American Academy of Pediatrics (AAP) has recommended that infants be fed breast milk or formula exclusively before beginning solid foods between four and six months of age it is typically recommended that infants begin spoon feedings with an iron fortified cereal, such as rice cereal. After a baby has “learned” how to eat cereal from a spoon, other foods are started typically beginning with vegetables, followed by fruits and then meats.

For many years I was taught that women who exclusively breast fed their infants for the first six months of life might be able to prevent allergic disease in their children. This was especially recommended for mothers who had a strong family history of allergies. Many pregnant and nursing mothers also restricted their dietary intake of peanuts, shellfish and other foods in hope that this too might help reduce allergies in their offspring. For many years it was recommended that children also be restricted from eating peanuts in hopes of preventing peanut allergies that were suddenly on the rise.

What we did find is that we reduced the incidence of choking episodes from peanut aspiration, but peanut allergies continued to rise and I have no idea what children were eating for lunch seeing that my own children were raised on peanut butter and jelly sandwiches (cut in triangles I might add). Those recommendations changed several years ago, although many mothers still balk when I recommend peanut butter for their toddlers.

Now, a study out of Finland, published in the December issue of Pediatrics Online, showed that the late introduction of solid foods is associated with an increased risk for allergic sensitization to foods and inhalant allergies in children at five years of age.

Scientific evidence for delaying food introduction now seems to be pointing in the opposite direction. This study actually showed that by delaying the introduction of eggs, milk and cereal children were at increased risk for developing atopic dermatitis (eczema). The late introduction of fish and potatoes (go figure that one) led to more inhalant allergies. This was determined by drawing IgE levels in children at 5 years of age.

So, there will be a lot of new studies being done to try and reproduce the Finnish data. New recommendations about infant feeding are already forthcoming from the AAP and should be published in February.

In the meantime, I would not worry about introducing foods to your baby after five to six months of age as long as they are pureed and easy to swallow. You can still wait several days between starting new foods, but no need to be as limiting. There are many foods that we eat including numerous fruits and vegetables that may be pureed in a Cuisinart or blender or even mashed with a fork that are not offered in typical baby food jars. Why not feed your baby black eyed peas (remember we all need good luck), or avocado or mashed potatoes when you are fixing these foods for yourself. The broader the palate as an infant may encourage less picky eating later on.

Stay tuned for more on this subject.

That’s your daily dose, we’ll chat again tomorrow.

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