Babies and Food: The American Academy of Pediatrics Changes Its Mind

AAP LogoThere have been a handful of comments throughout this blog and on various message boards asking about babies in relation to food.

“Is it okay to give them eggs?”

“When can we give them meat?”

“What should we start with?”

“Are you sure you should be feeding them ______ (insert food here)?”

As parents, we always want to be sure we are doing what is absolutely best for our children but sometimes what is best is often clouded by what is traditional.  Traditional recommendations for babies involve rice cereal, pureed foods, stage 1, stage 2, part a, part b foods.  No seasonings.  Bland foods.

“Safe” foods.

In 2008, the American Academy of Pediatrics’ Committee on Nutrition, chaired by Dr. Frank Greer, MD, published an article entitled, Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas.

You can read the article in its entirety here: http://pediatrics.aappublications.org/cgi/content/full/121/1/183

To sum, they were investigating allergy triggers in infants, the role of dietary restrictions and if they were even necessary and how breastfeeding/formula feeding fit into the whole circus.

Dr. Greer, in an interview just four months later, summed up their findings quite nicely when he said:

For instance, if you’re going to have a peanut allergy, it has nothing to do with when you were introduced to peanuts. If a mother eats peanuts during pregnancy or lactation or if she feeds her 6-month-old peanut butter, it has no effect on whether you get peanut allergy. If you’re going to get it, you’re going to get it. There’s even evidence from one study that if you don’t introduce egg into the infant’s diet until after 6 months, the baby is more likely to develop an egg allergy.

He also went on to say:

Now we can tell mothers: If you have exclusively breastfed for 4 months and your child is not at risk for allergy, you can introduce any food at 6 or 8 months or whatever.

The very next year, in 2009, the same committee published Rice Cereal Can Wait, Let Them Eat Meat First: AAP committee has changes in mind, which recommends foods rich in iron and nutrient dense foods like meat as first foods.

So.

This was all published in public journals three years ago.  Why are pediatricians and health professionals still recommending the same rice cereal and other bland, step by step feeding routines?

That’s a good question. I can tell you that of all the statements the Committee on Nutrition has published in the past 8 years, none have gotten as much interest from the press and from allergy groups as this one. We’ve also sent out announcements in the American Academy of Pediatrics newsletter. The message is getting out there. I’m not sure the pediatricians are picking up on it.  - Dr. Greer from the 2008 interview

Rice cereal has been the first complementary food given to infants in the United States for many reasons, including cultural tradition. – 2009

The vast majority of what is recommended and practiced is due to tradition.  The fact is, however, times have changed.  More research is out there and it is up to us, as parents, to know this and to make sure our health care professionals know it as well.

To sum up.

If your child has been breastfed or formula-fed exclusively for at least 4 months, at the age of 6 months, you may feed them anything you want to provided there is no family history of allergy.

So much easier to remember than what stage or what list of what foods you can give when, right?

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