Wednesday, November 3, 2010

First Foods for Baby: Alternatives to Rice Cereal

Is This Your Only Option?

Why is rice cereal the most common first food? It is a combination of tradition, cultural norms, pediatrician recommendations and the influence of the corporations that produce baby food.

While most parents stick with tradition and start with rice cereal, many parents are starting to question this and are beginning to wonder if it really is the best first food for baby. We want to do what is best for our kids, often going with what is comfortable and familiar.

According to the AAP, the order that foods are introduced is not generally of concern after 4-6 months of age as long as breast milk is the primary source of nutrients. This is assuming that parents are waiting until about 6 months, which is not the case in many households. The typical order of foods introduction in the United States is iron-fortified infant cereal, then fruits and vegetables, and lastly meats.

The WHO recommends exclusive breastfeeding for the first 6 months of life. After that solids can be introduced, with meat, poultry, fish or eggs eaten daily or as often as possible and continued breastfeeding for at least 1 year.

What are the reasons given by pediatricians and advertisers to start with rice cereal? Most of the reasons only apply when solids are introduced younger than 6 months of age. The recommendations for WHEN to start solids have changed, but unfortunately food choices have not. Some of the reasons include: the benefit of a bland flavor and smooth texture; helping baby to sleep through the night; the non-allergenic property of rice and the iron fortification.

It turns out that 6 month old babies enjoy different flavors and textures, can sleep through the nice with or without rice cereal, can have allergic reactions to any food including rice cereal and may not absorb the iron added to rice cereal. In fact, there might be a biological reason to hold off on grains. Some experts point out that the enzymes needed to digest grains are not at their full level until after 6 months.

When we add nutrients to foods that aren't naturally there, we usually later realize that something was missing, it was the wrong amount or we learn something new about our needs. It makes more sense to use foods that contain natural sources of the foods that babies need rather than a manufactured product. Meats contain very available sources of iron and zinc when compared with fortified foods. Egg yolks are loaded with nutrients including choline for brain development, and the list goes on.

If you are confused about what to feed your baby, you are not alone. There is not a lot of information available on this topic. Here are my recommendations based on a combination of my experience as a dietitian and a mom and the available literature.

I suggest starting with a variety of fruits, vegetables and meats. A variety of textures and flavors will ideally help your child enjoy more foods be a less picky eaters in the long run. Feel free to add herbs and spices to make the food more exciting. As your child begins to depend more on complementary foods and less on breast milk, the variety will help to ensure that all his needs are being met.

Here are some wonderful first food ideas: bananas, avocado, sweet potato, squash, chicken, egg yolks, yogurt, meat (excluded processed meats), fish (other than shellfish), carrots, broccoli, beans or liver.

I hope this has helped to clear up some of the confusion and provided some new ideas and alternatives to rice cereal. Not all foods are appropriate for all babies. If you have a family history of food allergies or if your baby has other related medical history please discuss food introductions with your pediatrician.

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