When to Start Solids?

When to start solids has been a cause of much confusion among moms. Doctors vary in their opinion with some recommending that babies start at 4 months, while others believe that delaying solids to 6 months is better. However, there are some old school doctors who recommend adding cereal to night time bottles to help babies sleep longer! Naima had her first taste of solids at 6.5 months on Father's Day in 2008.

Meanwhile, my niece Anya is turning six months on Thursday and her doctor already gave the go signal for her to start solids. My sister commented that during meal times Anya always stares at them and at the food. They are still deciding whether to start her as soon as she hits 6 months or at 7 months (which is actually 6 months adjusted).

Anyway, during one of the LATCH workshops, the resource doctor presented a study from the American Academy of Pediatricians which again referred to 4 months as the minimum age for starting solidds:

1. "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."

If you need a clearer copy of the guidelines/statement, the same is reproduced in this webpage. This policy statement actually referred to a study 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." Because of recommendation number 6 (as quoted above), a lot of doctors believe that there is not much difference if a baby starts solids at 4 or 6 months, as long as baby is at least 4 months.

I still strongly believe that baby needs to be at least 6 months to start solids and I was very happy to read about this news two weeks ago, that based on a Dutch study, "babies are less likely to develop a respiratory or gastrointestinal infection if they are exclusively breastfed for at least 6 months."

According to the researchers: "We observed protective effects of breastfeeding on infectious diseases mainly in the first 6 months of life. Exclusive breastfeeding until age 6 months tended to be more protective, than exclusive breastfeeding until age 4 months." I need to show my sister this study and hopefully, they decide to delay starting Anya on solids.

*Update: I had a conversation with Dr. Z last Saturday. Doctors generally recommend 4-6 months because that this time, babies are developmentally ready for solids. However, the WHO recommends 6 months because this recommendation is targeted to 3rd world countries where access to clean facilities, ingredients, water for preparing solid foods are not generally available. Thus, if you check the American Academy of Pediatricians' recommendations, they state 4-6 months. Interestingly though, the US is a 1st world country - and we are not. This is why I still do not understand why our doctors here recommend starting at 4 months despite the WHO recommendation.