
IF there is one topic that is sure to fire up debate it’s when to start your baby on solids. But one thing is becoming increasingly clear — starting solids between four and six months reduces a baby’s risk of developing food allergies.
“It would appear the early introduction of different foods allows a baby to develop tolerance,” says Professor Karen Simmer, professor of newborn medicine at the University of WA.
But studies suggest that delaying solids until six or seven months increases a baby’s risk of having food allergies, adds Professor Simmer, who is also director of neonatal intensive care at the King Edward and Princess Mary Hospitals in Perth.
“International and national allergy bodies agree there is mounting evidence that if you delay the introduction of solids until six or seven months the incidence of food allergies rises dramatically,” she says.
Despite the evidence in favour of introducing solids between four and six months, it’s common to hear cases where mums have been told very firmly by health professionals to wait until their baby is six months to give them solids.
So why is there so much conflicting advice?
As Professor Simmer explains, the confusion is caused by the fact the World Health Organisation (WHO) recommends solids not be introduced until a baby is six months old.
Not wanting to go against the WHO, the National Health and Medical Research Council, the body that sets the gold-standard medical guidelines in Australia, also recommends solids be introduced at six months.
However, the WHO guidelines were designed to protect babies in developing countries from gastro infections given the water used to prepare solids is more likely to be contaminated, Professor Simmer points out. But in developed countries like Australia introducing solids earlier doesn’t carry these same risks.
“The WHO recommendations were probably made largely thinking about developing countries where food hygiene is not as strong,” Professor Simmer says.
“There was one study in Belarus that showed there was slightly more risk of infection if solids where introduced before six months but I don’t think that applies in Australia.”
But what about the foods that commonly cause allergies — peanuts, shellfish, eggs and tomatoes? Is it really safe to offer these foods to young babies?
According to Professor Simmer there is no reason to delay offering these foods to a baby in their second six months.
“I don’t think delaying egg would make much difference to a baby’s risk of an allergy.”
Even peanuts are no longer contraindicated in children who do not have an increased risk of allergy, such as a sibling or family member with a known allergy.
“You could give a little smooth peanut butter paste on bread in your baby’s second six months,” she says.
But Professor Simmer adds you wouldn’t give a baby a whole piece of bread and smooth peanut butter or a whole egg for their first taste. As with all foods just give very small tastes and gradually build up the amount offered, she advises.
Another cause for confusion around starting babies on solids foods is the WHO recommends exclusive breastfeeding for the first six months of a baby’s life.
Some people believe this means babies shouldn’t be given solids until they are six months. But it actually means babies should ideally receive breast milk alone and not breast milk and formula, Professor Simmer says.
In fact, introducing solids can help keep breast-feeding going when mums go back to work. If carers are able to offer hungry young babies a small snack they won’t need to offer a bottle of formula to tide them over until mum arrives.
“As a working mum I breast fed my children for a long time. I did not want to use formula but a little bit of custard or jelly was something the carer could offer,” Professor Simmer says.
“It was much better than formula as it didn’t interfere with breast feeding.”
While paediatricians prefer mums to exclusively breastfeed their babies until at least six months, Professor Simmer believes they should supported if this is not possible.
“ I am a great believer in breast-feeding but I also know from my own practice it doesn’t always work for mums.”
By Heather Saxena. Not to be reproduced without the written permission of the author.
www.babiesandkids.com.au
BOX: Important Messages
Start your baby on solids between four and six months to reduce the risk of food allergies.
Start solids when you feel your baby is ready but do not delay beyond six months.
There is no need to delaying foods known to cause allergies (eggs, peanuts etc) but offer only a very small taste at first. And wait until your baby is over six months.
Additional Reading
Australasian Society of Clinical Immunology and Allergy guidelines on infant feeding