When do I have to start introducing food to my child? At what age should I do it? What do I include first in your diet? What about the allergens? Surely if you are a father or mother you have asked yourself questions of this type more than once.
From CuídatePlus we summarize the answers in one: the order does not matter, only the age at which they are introduced.
This is reflected in the document Recommendations of the Spanish Association of Pediatrics on Complementary Feeding, recently published and coordinated , of the Breastfeeding Committee and Nutrition Committee of the Spanish Association of Pediatrics.
Supplementary Feeding In Babies
As indicated by CuídatePlus José Manuel Moreno, coordinator of the Nutrition Committee of the Spanish Association of Pediatrics, “this document is a sign that we have stopped being as strict as before in relation to complementary feeding. There is no longer a certain order to follow when introducing food, but it must be adapted to the child, family tradition or food availability. ”
As the coordinator of the document points out, “the guidelines vary greatly between regions and cultures and that is why rigid instructions should not be given to parents since there are no better foods than others to start with”, although what experts do recommend is Start with the richest in zinc and iron. What is important, whatever the food, is “include them one by one and at intervals of a few days, to observe intolerance and acceptance, and not add salt, sugar, or sweeteners, so that the baby gets used to the natural flavors of
For example, if the father decides to introduce the egg into his son’s diet, “he must do it several times a week. Although it is not necessary to do it every day, yes, at least three a week, ”Moreno exemplifies. In this way, in addition to observing possible intolerances, “the child will consolidate the new flavor”. Keep in mind that “the child does not recognize the flavors so you have to give them time to become familiar with them.” This process should be followed with all foods.
At present, this would be ideal, however, there are parents who prefer to have established guidelines that serve as a guide to avoid mistakes. For them, the document of the AEP includes an orientation calendar of food incorporation.
At what age should we start?
The AEP document makes it clear that the order does not matter, but what about the age at which they are introduced? At this point, Moreno is blunt: “A very early introduction of complementary feeding can lead to short and long-term risks for the child.” The guide explains that “if there is no availability of breast milk before 4 months, only starting formula (type 1) should be used as a substitute”.
It is important to know, in addition, that “although benefits of the introduction of feeding in breastfed children at 4 or 5 months in children have not been demonstrated, there has been an increase in infections, both in developing countries and in countries developed. ” Therefore, the current recommendation is “wait at 6 months to start with complementary feeding in children with breast milk,” advises Moreno. In those artificially breastfed, “the recommendation is less unanimous, although in any case it should never be started before the fourth month.”
Why at that age?
Waiting at 6 months of life is key because “it is when the children’s organism has the necessary maturation at the neurological, renal, gastrointestinal and immune levels,” says Gómez Fernández-Vegue. It is also important that the child has an interest in food, that it does not have the extrusion reflex, that is, the expulsion of non-liquid foods with the tongue, that it is able to take food by hand and take it to the mouth and keep the sitting position with support.
Regarding the risks of introducing food before 4 months, the document states:
- Possibility of choking.
- Increased acute gastroenteritis and upper respiratory tract infections.
- Interference with the bioavailability of iron and zinc in breast milk.
- Replacement of milk intakes with other less nutritious foods.
- Increased risk of obesity
- Increased risk of atopic eczema
- Increased risk of type 1 diabetes
- Higher rate of early weaning, with added risks that this carries.
But, just as there is a period to start there is also a limit that should not be exceeded. According to Moreno, “we must not wait to do so beyond 7 months.”
In fact, the late introduction of complementary feeding entails, among other problems, “nutritional deficiencies, especially iron and zinc, increased risk of food allergies and intolerances, worse acceptance of new textures and flavors or greater possibility of altering the oral motor skills, ”according to pediatricians.
What do we do with allergens?
Another question that parents ask themselves is when they should introduce the foods that produce the most allergies. In this sense, the document of the AEP indicates that “at present, there is no evidence that delaying the introduction of potentially allergic foods beyond 6 months prevents the development of allergy to these, regardless of the risk of atopy they present” . On the contrary, “there are studies that suggest that the early introduction of some of these foods in small quantities may decrease the subsequent appearance of allergy.”
In the case of gluten, the thing is different, since today it is not known what is the best way to introduce it in order to reduce the incidence of celiac disease. “Until a few years ago it was thought that the best way to do it with breast milk, between 4 and 6 months, but currently there is no evidence that this is so,” they clarify from the AEP. Therefore, the recommendation they make is “to include gluten in the diet between 4 and 11 months of age, ideally around the sixth month and in small amounts at the beginning.”
“Cereals can be introduced into powders dissolved in milk, added to purees, in the form of boiled and sauteed rice, bread, pasta, corn cakes, quinoa or oatmeal, depending on the age and maturation of the infant and family customs,” Pediatricians report.
Here it is important to make an important note and it is that, according to the guide, “it is a mistake to replace a breastfeeding with formula milk with the sole purpose of giving cereals since it can condition an unnecessary early weaning and they are not consumption foods mandatory in the diversification process, especially if the diet is balanced and rich in iron through the consumption of other foods such as meats. ”