Starting Solids - Why I Don't Recommend Baby Rice
The phase of starting babies on solid food is currently one of hot debate with conflicting information. This is representative of the current climate of change in nutrition globally. The aim of this blog post is to shed some light on this, look at our current guidelines compared to other research and also show why I am strong opposed to starting babies off on baby rice or any other variation of infant cereal.
Up until around six months of age, babies obtain all the nutrients they require from breast milk or formula. Just as a side note here for those that do not know my previous challenges with breastfeeding you can read this here. Breast milk has relatively low amounts of iron – when you look at the typical composition it is virtually none. However, babies are born with enough iron stores to last through to six months of age. Formula typically has a little bit more iron than breast milk to allow for a decreased absorption rate (25% less), however it is low overall, again for the reason that babies have sufficient iron stores at birth.
Our current World Health Organisation (WHO) guidelines recommend exclusive breastfeeding/formula feeding until around the six month mark. This is something I strongly advocate for. Here is where the confusion can often start as in New Zealand, some health care providers recommend from 4-6 months. In my expert experience in working with mums the percentage of babies physically ready to start solids at four months of age is very small. And no, starting solids is not something that may help babies start to sleep through the night – if anything it can actually make sleep go backwards as their digestive system is learning to adapt to this, more so if they are not ready and/or are given baby rice which will add to digestive discomfort.
The low drop off in iron stores at six months has previously been the driving reason for the recommendations to start babies off on an iron fortified baby rice cereal. While, yes this is a concern for infants, through providing nutrient dense baby food (from real food) this can be overcome without having to use a heavily processed product which babies gastrointestinal tracts are not ready for and does not support ongoing exposure of nutrient dense food sources.
It takes two years for a babies GI tract (gastrointestinal tract) to be fully mature. Over this period babies and children will be physically adjusting to different foods. Specifically, in order for the body to digest grains it uses an enzyme called amylase (this is responsible for splitting the starches present in grains). At around six months of age babies start to produce small amounts of salivary amalyse but pancreatic amylase which is required to fully break down grains, is not produced in a full volume until about the age of 10-12 months when the molar teeth are fully developed (Edwards & Parrett, 2002, British Journal of Nutrition).
Grains which are not well digested can impact on a babies GI tract. In particular the lining of the intestine can be affected, upsetting the delicate balance of bacteria which can decrease immunity and also decrease the body’s ability to absorb key nutrients. This can also result in digestive cramping, bloating, discomfit and overall irritability. There is some research to suggest that the introduction of grains may play a role in the development of certain food allergies and intolerances as well.
There will be variation between infants in their ability to digest grains especially as the small amount of salivary amylase will partially break down the glucose molecule bonds - this makes it tricky as parents to determine just how much your baby is being affected by early introduction of grains.
In addition to the digestive discomfort, grains of any kind, especially those highly processed, require the production of insulin in order for the carbohydrate to be taken up by the cells. Excessive amounts of insulin production long term can affect metabolism, blood sugar regulation, increase the risk of type two diabetes and weight management difficulties. New research has been emerging over the last few years on this response in adults, including from my colleges and PhD supervisor Grant Scholfield.
While further research is required to understand the long-term implications of the impact of excessive insulin production in infants, the basis of a optimal diet is formed from good vegetable, protein and fat intake - starting babies off on this is paramount.
Lack of Nutrients
Unlike vegetables and meat, baby cereals lack in overall nutrients. They provide high energy but not the vitamins and minerals that babies require. In particular vitamin A, folate, zinc, calcium are not provided in baby cereals. For example 1 tablespoon of carrots give enough Vitamin A for the whole day for a baby 6-10 months old (WHO).
Regardless of if you do start with baby rice, it is crucial to introduce nutrient dense food sources (vegetables, meat/meat alternative sources and fat). Given babies often do not consume huge amounts of food over the first few months, starting off with these foods will ensure that they are getting the key nutrients they require. If your baby is only going to have one meal or even two meals a day we want to make sure these contain as much key nutrients as possible (this is what is defined as nutrient dense) for which baby rice is not.
Habit and Preparation
Habits and practicing the preparation of meals are key to children eating well long term. Vegetables in particular is something that many parents struggle getting into little ones. Starting children off on vegetables can play a key role in saving these battles, it is a lot harder adjusting to their taste when babies have had other foods, especially those that are processed. In addition the preparation involved is important for parents to get used to – and trying to use as much of the family meals as possible and adapt them to babies makes life significantly easier! This is one of the key reasons I created my Baby and Toddler Cookbook
So what do you start babies off on?
Interestingly enough the WHO and UNICEF both recommend “introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond”. In the WHO Complementary Feeding Guide the recommendations are to start babies off on foods which are:
*Rich in nutrients and energy
*Clean and safe
*Easy to prepare from family meals
What is key here is that, there is no mention of baby rice at all – the only suggestion is to start with a stable food in your particular country of origin. I would recommend starting with a vegetable such as pumpkin or butternut pumpkin - both have a lot of natural flavour and are easy on the GI tract.
Once babies have adjusted to this, quickly (within 1-4 weeks into the starting solids journey depending on development) adding a form of meat or meat stock into the puree to ensure babies are getting a high source of iron, fat and vitamin B12.
A note on bought baby food – I do recommend making your food at home, I know it takes time but a lot of bought baby food just does not compare nutritionally. Always check the back of the label, many contain sugar and/or rice even if it says ‘lamb and peas’ on the front. I have really helpful hints on how to make baby food easy in my blog here and equipment that will honestly save you time!
Starting solids is a journey and right now it can be tricky to know if what you are doing is 'right' especially with conflicting information out there and a food industry which is heavily influenced by global brands. My book The Nourished Baby provides a comprehensive step-by-step guide to starting solids, including a full week-by-week guide of what foods to introduce and when. I now also have this introduction plan as a magnetic fridge guide too.
In addition, myself and my team of senior nutrition consultants do a special starting solids consultation over skype any where in the world can help with your food journey or if you baby is struggling to eat. As I mentioned at the start of this blog, I know there is a lot of conflicting and often outdated information on starting solids and we are here to help.
x Dr Julie Bhosale