The Grandparent Way
We all have parents or grandparents who say, “I gave you a pork chop when you were four months old and you turned out just fine.” For years doctors rejected the early introduction of certain foods and advocated a more conservative, stepwise approach. The idea behind this was to offer more allergenic foods (like fish, eggs, and peanut butter) later in life in order to avoid allergic reactions. Well it turns out that the “grandparent way” of introducing foods is the right way- not offering a pork chop at four months of age due to the choking risk, but a more liberal approach toward the introduction of new foods.
Recent studies show that the introduction of solid foods after 6 months of age, even foods considered highly allergic, have no bearing on future allergies. In fact, one of the reasons we are seeing more children with food allergies may be due to the fact that we did not sensitize them to a variety of foods early on. Doctors tell patients to introduce dogs and dirty surfaces to infants to decrease their risk of allergy and illness later in life, but thus far this philosophy hasn’t extended to peanut butter and allergenic foods. However, studies over the past several years have challenged this recommendation. One study, comparing the rate of peanut allergies among children in the United Kingdom and Israel, showed that children in Israel had almost tenfold fewer peanut allergies despite the fact that they were introduced to peanuts earlier and ate them more frequently and in larger quantities. A similar study in the United Kingdom concluded that children who were introduced to peanuts earlier in life (around 13 months of age) had a lower incidence of peanut allergy than those who waited until three years of age.
So, it appears we had it backwards. Unfortunately, parents still hear the same strict guidelines on how to introduce solid foods.
- You must introduce rice cereal first
- You must introduce one food at a time and wait three days between foods to monitor for an allergic reaction
- You must give egg yolks before egg whites
- You should not introduce peanut butter until the age of three
- You cannot give your child any dairy foods until one year of age
- You cannot offer your child fish or meat until they are at least 8-10 months old
Try not to follow the “old rules” and instead follow what I like to call “the grandparent way”. Introducing a variety of foods early on sensitizes your child and may actually decrease their risk of allergies to these foods later on as well as create a better and more adventurous eater (if you don’t give a food until your child is three they probably won’t like that food as much as one they have been trying all along.) This includes foods considered highly allergic such as fish, eggs, and peanut products. So, for the sake of an example (though probably not very appetizing)if you want to put in a blender whole eggs, fish, meat, cheese, yogurt, citrus, and peanut butter and give it to your child, be my guest. You can even try different consistencies of food. Many babies do best with a pureed consistency but it is OK to try foods that your baby can hold and feed themselves, a process called baby led weaning. Of course, you want to be careful of the consistency to avoid choking, for example a piece of banana or cooked carrot are good options. And try to relinquish a little control and allow your child to explore and make a mess- something me and my wife had trouble doing.
Daddy vs. Doctor—Pickles and Potato Chips
We started our daughter on solid food when she was six months old. Aubrey showed all the signs of being ready to go for the solid stuff. She was sitting without support, grabbing at our plates when we ate, and she always seemed to want to put everything in her mouth. Still, she wasn’t at all interested for the first couple of weeks when we tried introducing solids. She would just turn her head and make a face. (Mission not accomplished.) Then there was the matter of the mess. My wife and I are both Type A personalities (one of us more than the other, but I won’t say who), so she would feed Aubrey holding a spoon in one hand and a washcloth in the other, more focused on keeping things neat than enticing Aubrey to eat. When we started Aubrey on finger foods, I called my wife “The Electron Microscope” because the pieces she offered were so small you could barely see them. It definitely took some time for us to let go and allow our daughter to do what babies do so well: make a mess.
When we started to introduce finger foods at eight months, we were confronted with the same initial response: Aubrey wasn’t interested. We would place a couple of Cheerios on her tray and she’d play with them until they were either scattered across the kitchen floor or stuck to her sweaty palms. She would grab at my food when I was eating, but when I tried to stick a piece in her mouth that was not pureed, she’d turn her head and make a face like I was torturing her. My wife and I would joke that our daughter was happy to put anything in her mouth except food. Then one day my wife was holding Aubrey and eating a sandwich. Aubrey reached over to her mom’s plate, grabbed a pickle in one hand and a potato chip in the other, and went for it. She licked the pickle and then the potato chip, looked at my wife, and gave that expression that children give when they think they’re getting away with something illegal. Then it was back to the pickle and the potato chip. She went back and forth sucking on the two foods voraciously, as if we hadn’t fed her in days. (Mission accomplished, but so much for the low-salt rule.)
After that, Aubrey was off to the races, picking up whatever food we put in front of her and refusing anything we tried to put in her mouth. Like most developmental milestones, it was nice to witness her progress, but I reminisce about the days when we had more control. For more information on the introduction of solid foods and much, much more see my book Eat Sleep Poop - A Common Sense Guide to your Baby's First Year
DR SCOTT COHEN IS A PEDIATRICIAN IN BEVERLY HILLS, CALIFORNIA, AUTHOR OF, "EAT, SLEEP, POOP" AND A MEMBER OF THE KIDS DOC FOUNDING TEAM