Monday, January 4, 2010

Nutricious or not?

As is common practice in the USA so is here on our little island of Aruba. We tend to go along with the "trend", and drift towards what is going on there. Now even though we are considered part of the Dutch Kingdom that is.

This is true even when it is when to start solids and which solids to introduce. We (mothers in general) are advised, by our local Yellow Cross and Pediatricians, to start our baby's at around 6 months of age (as is every where else by WHO (World Health Organization)) with solids. Now this does not automatically mean that when baby is 6 months that he is ready for solids. This is a guideline. Even though I do hear the stories of "I started my 2 month old on rice cereal" or "I put just a scoop of cereal in the bottle so that baby would sleep the whole night". I find these negligent comments so horrific! I usually would listen attentively and then excuse myself with all my restraint just not to make a comment to the poor mother that I would eventually feel sorry for. I am defensive when it comes to baby and the correct nutrition. My mom-in-law can stand testimony to that! But okay back to the topic at hand.

I was reading an article from Pediatric News and it made some sense. Even though I must say that I don't fully agree with all that is stated below. A babies main source of nutrition is breast milk and/or formula during his first year of life.

Rice Cereal Can Wait, Let Them Eat Meat First: AAP committee has changes in mind

There is no good reason not to introduce meats, vegetables, and fruits as the first complementary foods, according to Dr. Frank R. Greer, a member of the American Academy of Pediatrics's Committee on Nutrition.

Introducing these foods early and often promotes healthy eating habits and preferences for these naturally nutrient-rich foods, said Dr. Greer, who is a professor of pediatrics at the University of Wisconsin in Madison.

Rice cereal has traditionally been the first complementary food given to American infants, but “Complementary foods introduced to infants should be based on their nutrient requirements and the nutrient density of foods, not on traditional practices that have no scientific basis,” Dr. Greer said in an interview.

In fact, the AAP's Committee on Nutrition is working on a statement that will include these new ideas, Dr. Greer said in an interview. Currently, there are no official AAP recommendations for introduction of complementary foods. “There are suggestions of what complementary foods to introduce in various AAP-sponsored publications, which are based on the traditional introduction of solid foods starting with infant iron-fortified cereals and progressing through vegetables and then fruits.”

Complementary foods are any nutrient-containing solid or liquid foods other than breast milk or formula given to infants, excluding vitamin and mineral supplements. By 6 months of age, human milk becomes insufficient to meet the requirements of an infant for energy, protein, iron, zinc, and some fat-soluble vitamins (J. Pediatr. Gastroenterol. Nutr. 2008;46:99–110).

Rice cereal has been the first complementary food given to infants in the United States for many reasons, including cultural tradition. By the 1960s, most U.S. infants (70%–80%) were fed cereal by 1 month of age. By 1980, rice cereal predominated, as it was considered to be well tolerated and “hypoallergenic”—given growing concerns about food allergies, he said. (See box.)

However, newer thinking is that the emphasis for complementary foods should be on naturally nutrient-rich foods. This includes protein and fiber, along with vitamins A, C, D, and E and the B vitamins. In addition, saturated and trans fats should be limited, as should sugar, said Dr. Greer.

In light of this thinking, rice cereal is a less than perfect choice for the first complementary food given to infants, he said. Rice cereal is low in protein and high in carbohydrates. It is often mixed with varying amounts of breast milk or formula. Although most brands of formula now have added iron, zinc, and vitamins, iron is poorly absorbed—only about 7.8% of intake is incorporated into red blood cells.

In contrast, meat is a rich source of iron, zinc, and arachidonic acid. Consumption of meat, fish, or poultry provides iron in the form of heme and promotes absorption of nonheme iron, noted Dr. Greer. Red meat and dark poultry meat have the greatest concentration of heme iron. Heme iron is absorbed intact into intestinal mucosal cells and is not affected by inhibitors of nonheme iron from the intestinal tract. Iron salts present in infant cereal are generally insoluble and poorly absorbed.

Another issue is when to begin introducing complementary foods, said Dr. Greer. This varies by nationality. In Germany for example, complementary foods are introduced to 16% of infants by 3 months. A third (34%) of infants in Italy and half (51%) of infants in the United Kingdom are introduced to complementary foods by 4 months. In the United States, 18% of infants are introduced to complementary foods—cereal—by 3 months, 40% by 4 months, 71% by 5 months, and 81% by 6 months.

Those complementary food choices for infants aren't always the most nutritious either. By 6 months, roughly a third of U.S. infants have been introduced to fruit (71%) and vegetables (73%), but only 21% have been introduced to meat. In a 2008 study in Pediatrics, researchers reported that 15% of infants have less than one serving of fruit or vegetable per day by 8 months of age (Pediatrics 2008;122[suppl. 2]:S91–7). In contrast, half of 10-month-old infants had eaten at a fast food restaurant, 22% had eaten carryout food, and 28% had eaten restaurant or carryout food at least twice in the previous week.

Early experiences promote healthy eating patterns, said Dr. Greer. It's known that food flavors are transmitted to breast milk; infants whose mothers eat fruits and vegetables during lactation will have greater consumption of fruits and vegetables during childhood (Public Health Nutr. 2004;7:295–302). It's also been shown that infants are more accepting of food after repeated exposure (Am. J. Clin. Nutr. 2001;73:1080–5).

Dr. Greer reported that he has no relevant financial conflicts of interest.

Don't Avoid or Delay Introducing Allergenic Foods

Delaying or avoiding the introduction of allergenic foods during a critical window in the first year of life doesn't appear to prevent the development of food allergies and may even put children at increased risk, according to Dr. Greer.

There is a lack of evidence to support food allergen avoidance in infants, he said. Any benefits appear to be largely in the first 3–4 months of life, when exclusive breastfeeding is of the greatest benefit for prevention of atopic disease.

Oral tolerance is an antigen-driven process and depends on regular exposure to food antigens during a critical early window. Allergen avoidance may be unsuccessful or detrimental in allergy prevention in infants, he said. There is some evidence that continued breastfeeding during new food introduction is beneficial in preventing atopic disease.

In 2008, the AAP recommended that complementary foods should not be introduced before 4–6 months and noted that there is no indication that delayed introduction of certain foods, including allergenic foods such as wheat, fish, egg, and peanut-containing products, protects against atopic disease(Pediatrics 2008;121:183–91).

Likewise, the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recommended in 2008 that complementary foods should be introduced between 17 and 26 weeks.

The group also recommended against the avoidance or late introduction of allergenic foods such as wheat, fish, egg, and peanut (J. Pediatr. Gastroenterol. Nutr. 2008;46:99–110).

Most allergic reactions to foods (90%) are due to eight food types: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. However, studies generally have not supported a protective effect for a maternal exclusionary diet during pregnancy; a diet excluding cow's milk, eggs, peanuts, and fish has not been found to protect against the development of atopic disease in infants.

Dietary food allergens, including peanuts, cow's milk protein, and egg, can be detected in breast milk. In the majority of studies, especially those with follow-up beyond 4 years of age, there is no convincing evidence that restricting the maternal diet results in long-term prevention of atopic disease in infants.


Now I myself started my daughter and son on rice cereal but soon moved on to veggies, fruits and meats. My daughter started to eat at 7 months and my son at 6. My nephew started to eat at 10 months and he eats everything! I found that after the first week I had no use in feeding them cereal. They could get better nutrition from other better foods. They ate what we ate and that was how simple it was. I would sometimes prepare a huge pot of fully packed food and store in small containers and freeze it. I would then have a back up for those lazy days or for when they would stay with my parents or my husbands parents. Planning ahead was not an inconvenience. It was a strategy on our behave to ensure that our children get the best that their growing bodies need. Breast milk, fresh veggies and fruit, fresh meat and fish and organic home made baby food were all provided by us to them.

Healthy eating habits are taught and learned from the parents example. And baby will let you know when he is ready to try some solid food, don't force the spoon into his mouth to entice him to start when he knows that his tiny body is not ready. Save your baby a lot of discomfort and yourself some stress and listen to his cues.

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