As a GP working in family medicine and Allergy, I recognise it’s hard to keep on top of ever-changing research and guidelines on what to feed children. If only the headlines could keep still for long enough we may be able to digest the facts to disseminate the right information to parents!
Guidelines surrounding infant feeding rely heavily on available scientific evidence at-the-time, especially surrounding allergy prevention and new research means our guidelines are constantly changing making it hard to keep up.
Over the past four decades, we transitioned from the early introduction of solids (before four months of age), to telling parents about reducing exposure of potentially allergenic foods like peanuts, cow’s milk and eggs to delaying the introduction of allergenic foods to even denying mothers their morning peanut butter on toast!
However, we are now adopting the view that early exposure may be protective or at least have a neutral effect, even in at-risk infants! At-risk meaning those with a family history of allergy should not avoid allergenic foods! In a study published in the New England Journal of Medicine, atopic infants at risk for peanut allergy were randomised to either consume or avoid peanuts until five years of age. Amazingly, the prevalence of peanut allergy was significantly greater in the avoidance group, indicating that preventing exposure to potentially allergenic foods is unwarranted, even in at-risk infants.
So where does that leave us to advise parents…
Here are seven infant nutrition tips that also summarise the current infant feeding facts that even your local doctor is learning right now!
- Maternal exclusion of potentially allergenic foods is unwarranted during pregnancy or lactation. So, yes you can have the peanut butter!!!
- If possible, children should be exclusively breastfed for six months, with the introduction of solids at four to six months (with continued breastfeeding).
- Introducing solids should be based on the child’s developmental progress, including feeding behaviour (such as transition from sucking to biting), appetite, growth, and their expressions of interest in food. I suggest this is something to discuss at your 4 and 6 month vaccination apppointments with your GP or early childhood nurse.
- The evidence does not support the delayed introduction of potentially allergenic foods, even in at-risk children. Parents can introduce one new food at a time to make it easier to monitor if there is a reaction. I always say, a new food every 48 hours when your first starting solids.
- Repetition is the key. Children can be offered a food item up to 10 or more times before they will even put it to their lips! Do not stress if they hate the brocolli! So parents should keep persevering, let them explore the food and get familiar with it.
- It is important to provide children with a wide variety of foods for texture and taste exposure. So parents should not assume their child won’t like a particular food (in fact, they might be surprised with what their child will eat!). Play with colours and shapes and presentation of food.
- Infant taste-buds are sensitive. What may be bland to an adult, is not to an infant. So parents should be discouraged from adding too much salt or sweeteners to their child’s food.
Dr Suzan Bekir is a general practitioner with a special interest in family medicine and allergy and works at Australian allergy centre and collective.care allergy.
Concerned about food allergy? Want to speak to Doctors who understand allergy and perform food and air allergy skin prick testing on site, then please call Australian Allergy Centre and collective.care Allergy clinics on 1300 344 325. Bulk billing available.
Bella vista, Wollongong, Edgecliff.
Adapted from M. Jensen.7 nutrition tips to share with new parents, Medical observer. 31 January 2017