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Most Infant Feeding Assumptions Called Myths, Not Science

Posted on: Monday, 10 October 2005, 18:00 CDT

By J.M. HIRSCH

Ditch the rice cereal and mashed peas, and make way for enchiladas, curry and even - gasp! - hot peppers. It's time to discard everything you think you know about feeding babies. It turns out most advice parents get about weaning infants onto solid foods - even from pediatricians - is more myth than science.

Rice cereal may not be the best first food. Peanut butter doesn't have to wait until after the first birthday. Offering fruits before vegetables won't breed a sweet tooth. And strong spices? Bring 'em on.

"There's a bunch of mythology out there about this," said Dr. David Bergman, a Stanford University pediatrics professor. "There's not much evidence to support any particular way of doing things."

Word of that has been slow to reach parents and the stacks of baby books they rely on to navigate this often intimidating period of their children's lives. But that may be changing.

As research suggests a child's first experiences with food shape later eating habits, doctors say battling obesity and improving the American diet may mean debunking the myths and broadening babies' palates.

It's easier - and harder - than it sounds. Easier because experts say 6-month-olds can eat many of the same things their parents do. Harder because it's tough to find detailed guidance for nervous parents.

"Parents have lost touch with the notion that these charts are guides, not rules," said Rachel Brandeis, a spokeswoman for the American Dietetic Association.

"Babies start with a very clean palate and it's your job to mold it

It's easy to mistake that for a regimented process.

Most parents are told to start rice cereal at 6 months, then progress to simple vegetables, mild fruits and finally pasta and meat. Ethnic foods and spices are mostly ignored by the guidelines - cinnamon and avocados are about as exotic as it gets - and parents are warned off potential allergens such as nuts and seafood for at least a year.

Yet experts say children over 6 months can handle most anything, with a few caveats: Be cautious if you have a family history of allergies; introduce one food at a time and watch for any problems; and make sure the food isn't a choking hazard.

Parents elsewhere in the world certainly take a more freewheeling approach, often starting babies on heartier, more flavorful fare - from meats in African countries to fish and radishes in Japan and artichokes and tomatoes in France.

The difference is cultural, not scientific, said Dr. Jatinder Bhatia of the American Academy of Pediatrics' nutrition committee who says the American approach suffers from a Western bias that fails to reflect the nation's ethnic diversity.

Bhatia said he hopes his group soon will address not only that, but also ways to better educate parents about which rules must be followed and which ones are only suggestions.

Rayya Azarbeygui, a 35-year-old Lebanese immigrant living in New York, isn't waiting. After her son was born last year, she decided he should eat the same foods she does - heavily seasoned Middle Eastern dishes like hummus and baba ghanoush.

"My pediatrician thinks I'm completely crazy," said Azarbeygui, whose son is now 13 months old. "But you know, he sees my child thriving and so says, 'You know what, children in India eat like that. Why not yours?"'

How to introduce healthy children to solid food has rarely been studied. Even the federal government has given it little attention; dietary guidelines apply only to children 2 and older.

In a review of the research, Nancy Butte, a pediatrics professor at Baylor College of Medicine, found that many strongly held assumptions - such as the need to offer foods in a particular order or to delay allergenic foods - have little scientific basis.

Take rice cereal, for example. Under conventional American wisdom, it's the best first food. But Butte said iron-rich meat - often one of the last foods American parents introduce - would be a better choice.

Dr. David Ludwig of Children's Hospital Boston, a specialist in pediatric nutrition, said some studies suggest rice and other highly processed grain cereals actually could be among the worst foods for infants.

"These foods are in a certain sense no different from adding sugar to formula. They digest very rapidly in the body into sugar, raising blood sugar and insulin levels" and could contribute to later health problems, including obesity, he said.

The lack of variety in the American approach also could be a problem. Exposing infants to more foods may help them adapt to different foods later, which Ludwig said may be key to getting older children to eat healthier.

Food allergy fears get some of the blame for the bland approach. For decades doctors have said the best way to prevent allergies is to limit infants to bland foods, avoiding seasonings, citrus, nuts and certain seafood.

Source: Advocate; Baton Rouge, La.

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