On Friday, a British research team led by a pediatrician from the University College London called into question a common recommendation that babies in developed countries be exclusively breastfed until 6 months old. (The same researchers believe that exclusive breastfeeding for six months remains best in developing countries where there is a higher risk of infection.) The new review, published in the British Medical Journal, suggests that feeding only breast milk for as long as 6 months may lead to iron deficiency or trigger allergies.
Just what we need. More confusion over infant feeding recommendations!
Let’s break this down, shall we? The most important thing to clear up is that this study does not raise questions over the benefits of breast milk. It is still widely considered the best option. If you can and want to provide it, you should. Rather, the study raises questions about when we should begin supplementing the diets of exclusively breastfed babies with solid foods.
The World Health Organization (WHO) has long recommending exclusive breastfeeding for 6 months, but their guidelines were created to account for health considerations in both developed and developing nations. In developed countries, beginning solid foods closer to 4 months may ensure adequate iron intake and more successfully prime the palate to accept new flavors, especially the bitter flavor of vegetables. The authors of the study said, “Bitter tastes, in particular, may be important in the later acceptance of green leafy vegetables, which may potentially affect later food preferences with influence on health outcomes such as obesity.”
As for allergies, the study authors noted research from Sweden that found a correlation between a delayed introduction of gluten until 6 months with an increase in celiac disease. Apparently, they found that the incidence “fell to previous levels after the recommendation reverted to four months.”
So what does this all mean?
The most sane thing that I’ve come across in all of the hubbub over this study is advice from Dr. Greene, Professor of Pediatrics at Stanford University. He basically says that when it comes to feeding baby, you should use common sense and trust your instincts, and this study suggests no different.
It’s not new information that iron deficiency can be an issue for exclusively breast fed babies (I’m sure many of you have been advised to supplement with iron drops). And the allergy issue is far from clear cut. Dr. Greene says, “We knew giving your child solid foods before four months puts them at risk for food allergies, but now starting them later could leave them vulnerable too.” So, it may be that starting solids at 4- or 5-months-old is right for your child. It depends on their particular nutritional needs.
Dr. Greene points out, “Babies will let you know what they need. If they’re making a fuss over the food you’re eating, they’re letting you know it’s time to sample some solid foods. Another sign is if your baby isn’t producing three to five wet diapers a day. That could mean he’s lacking nourishment and ready for a more rounded diet.”
Dr. David Katz of Yale University’s Prevention Center said that, even with this new study, it is still inconclusive whether 4 or 6 months is a better time to start your child on solids. If your child is healthy, you follow your child’s growth pattern with your doctor and listen to their cues, chances are everything will be fine. After all, we humans have been around for a looonnnnngggg time and feeding our little ones since before any guidelines. Mother’s milk might be the gold standard, but mother’s instinct is best.
The bottom line: If your child can sit up on her own and is showing a strong interest in solid food at 4- or 5-months, start slow and give it a go. And if she is exclusively breastfed, include foods rich in iron like dark leafy greens or even prunes.
How’s that for a guideline?
Here are some great ideas for easy baby food recipes to help get baby—and you!—started on solids, whenever the time is right.