This is part 2 of a 3 (or 4 or 17...) part series on starting solid foods. Be sure to read Part 1: When To Feed Baby Solids.
Baby's Iron Needs
One of the primary concerns of infant nutrition is iron. After about 6 months, the iron that baby stored during the last months of pregnancy start to become depleted, which puts baby at risk for anemia. Babies born prematurely, those with small gestational size and those whose mothers have difficult to manage diabetes are at even higher risk of iron-deficiency anemia.
Due to high rates of anemia in 1960's and 70's, most infant formula today is iron fortified, with US formulas typically having 10-12 mg/L and European formulas typically having 4-7 mg/L. Much less iron is found in breastmilk, but what is contained is more "bioavailable" (more readily absorbed) than iron found in fortified formula or foods.
While breastmilk is touted as nature's perfect baby food, it doesn't supply sufficient iron for many babies in the second half of their first year.
The Case Against Rice Cereal
Rice cereal and other fortified single-grain infant cereals have long been the standard recommended first food for babies in the US. Goodness knows, my father-in-law starts asking me if I've started my babies on "pablum" when they reach 2 weeks old!.
Rice cereal and other highly processed fortified cereals are commonly recommended first foods due to their high iron content, low-allergen potential, and palatability (babies tolerate it well).
Recently there have been growing concerns about the metabolic effects of getting our kids hooked on such a high carbohydrate (sugar), refined food from the start. Dr. Greene, is a pediatrician and crusader against rice cereal primarily because of his concern about its relationship to the obesity and diabetes epidemics. Read more about Dr. Greene's White Out Campaign and his stance on infant cereals.
If you've ever heard that babies can't digest starches, here's a fabulous post from Science of Mom that dives into the deep end of the nerdy mommy pool (and I love it!). But if you've got a little one about to wake from a nap or a dinner to prep, I'll summarize for you - babies can digest starches.
Meat As A First Food
In a study that compared babies who ate pureed meat as a first food to those who ate iron-fortified infant cereal, the meat-fed babies had an increased rate of head growth but there weren't significant differences in blood chemistry including iron levels. There were also no differences in tolerance or acceptance of the foods or in motor or mental performance of the babies in the two groups.
The Canadian Government recommends meat and other iron-rich foods as baby's first foods and base this recommendation on a joint commission to examine evidence-based feeding practices which included the Canadian Pediatric Society, Dieticians of Canada, and the Breastfeeding Committee for Canada.
Fruits Or Vegetables As Baby's First Foods
If you start babies on fruits they will prefer sweets and not eat veggies, right? Wrong. Multiple studies from the field of nutrition and the field of medicine indicate that the most important variable to determine acceptance of vegetables is repeated exposure (i.e. keep trying the food over and over with your baby even if they make a silly face).
It made a lot of sense to me as a mom when a scientist explained that breastmilk and formula are naturally sweet so sweet tastes are already introduced long before solids are initiated. Here's an interesting video from The Curious Parent that features a food researcher and biologist discussing taste preferences in infants and young children.
Allergenic Foods And Your Baby
The recommendations have changed! Parents were previously told not to give babies dairy, eggs, peanuts and other allergenic foods in the first year.
But the American Academy of Asthma, Allergy and Immunology now states that there is no evidence that delaying the introduction decreases the risk of food allergies. In fact, there is growing evidence that early introduction of allergenic foods has a protective effect against food allergies and that delaying the introduction of them could increase the risk of food allergies (beyond 10 months for eggs was the only specific age I could find).
The American Academy of Pediatrics is now following the AAAAI guidelines and does not recommend withholding allergenic foods (that's a lot of A's).
It is widely recommended to introduce one new food every 3-4 days and monitor for any signs of allergy or reaction (hives, skin redenning, stuffy nose, teary eyes, stomach upset, bowel changes, irritability). A simple, downloadable Food Log is available in the CanDo Kiddo Etsy shop.
Baby's First Foods Around The World
I was curious to look at the question of what to feed my baby from a cultural perspective and was surprised to find that around the world, most parents are giving pretty similar first foods. Rice porridge, beans and lentils, meat and fish, fruits and vegetables were common choices in most areas of the world. Here's a cool infographic from Plum Organics that shows specific first foods by country.
Iron is one of the most important nutrients to prioritize as your baby starts solid foods.
Offering your baby naturally iron-rich foods as early foods might pose less risk of future obesity or diabetes than highly processed fortified baby cereals.
Your baby is hard-wired to prefer sweeter flavors and the very first tastes of solid foods might be better received if they are sweet or neutral/bland flavors.
Since it's now viewed as safe to introduce allergenic foods early, our options for naturally iron-rich and nutritious foods for our babies has expanded! Yippee!
What We Did.
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I mixed NurturMe's Quinoa Baby Cereal into pureed foods to thicken them and add nutrients. I also added unsalted bone stock (not the same as broth) to many of my baby's homemade vegetable purees because of the nutritional content. I personally couldn't stomach the idea of pureeing my own meat so I bought a few weeks' worth of organic baby food with meat in them.
Because we progressed my baby very quickly through purees to soft solids (here's how), by 8-9 months he was eating mostly soft table foods cut up for him - red beans and brown rice, ground beef with white beans, oatmeal and yogurt, and just about every fruit and vegetable we've got in the kitchen.