It seems like the advice and recommendations for introducing solid foods that are top allergens is constantly changing. Changes to recommendations can be a nightmare for new, and experienced, parents who are bombarded with [conflicting, old wives tales etc] advice on how to best feed their little ones. There has been one confusing item in particular that a few parents are emailing about; starting baby on solid foods early, prior to 4 months of age. This really needs to be cleared up and clarified so I thought I would post for all to read.
In particular, the new studies have lead some to believe that the current winds of change mean that babies can be started early on solid foods. In other words, some parents are believing/wondering if it’s now ok to start solids earlier than 4 months of age.
The only change regarding timing of introducing solid foods is the change in when to introduce foods that may cause allergies. It is important to note that the AAP continues to recommend exclusive breastfeeding for 6 months, while the AAP Commmittee on Nutrition states that solids are fine to introduce anytime between 4 and 6 months of age. One AAP report specifically notes that
“Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.” Click to view report
There are 8 foods that make up 90% of all allergenic foods. These 8 foods are
- Tree nut (walnut, cashew, etc.)
Since early 2008, several studies have been done that point to the conclusion that delaying these allergenic foods may not prevent “atopic disease” e.g asthma and eczema. For families with a history of food allergies and intolerance, the recommendation continues to be one of caution and delay.
German Study “This study found no evidence supporting a delayed introduction of solids beyond 4 or 6 months for the prevention of asthma, allergic rhinitis, and food or inhalant sensitization at the age of 6 years.”
Dairy Introduction past 9 months ” More delay in introduction of cow milk products was associated with a higher risk for eczema.”
ESPGHAN study “Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies, either in infants considered at increased risk for the development of allergy or in those not considered to be at increased risk.
Finnish Study – Late Introduction of Solids “Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens. Eggs, oats, and wheat were most strongly related to food sensitization, whereas potatoes and fish were most strongly related to inhalant sensitization.