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Many U.S. infants are fed solid food too early, CDC study finds

baby food
CC/Flickr/lovelihood
In the study, 55 percent of the mothers who introduced solids early did so on the instruction of their physician or other health-care provider.

Many American parents are starting their infants on solid foods before their bodies are able to handle such foods, according to a new study from the U.S. Center for Disease Control and Prevention (CDC).

The study, which was published online Monday in the journal Pediatrics, found that 40.4 percent of mothers introduced solid foods before their infants were four months old — significantly more than the 29 percent cited in previous research.

And 9.1 percent of the mothers in the new study introduced solids before the infants were four weeks old.

The early introduction of food is a concern because of its association with an increased risk of chronic diseases, including diabetes, obesity, eczema and celiac disease. When a baby is put on solid foods, he or she is also less likely to receive breast milk, which is associated with many health benefits, including a lower risk of respiratory and ear infections and diarrhea.

The American Academy of Pediatrics (AAAP), which publishes Pediatrics, revised its infant feeding guidelines in 2012 to recommend that infants not be introduced to solid foods before the age of six months, two months later than their previous guidelines. The American College of Obstetrics and Gynecology and the American Academy of Family Physicians have similar guidelines.

Less likely among breastfed babies

The findings are based on a sampling of 1,334 mothers who answered a series of survey questionnaires during the first year of their child’s life. The surveys were taken between the years 2005 and 2007 — before the AAP revised its guidelines.

If the AAP’s new recommendation had been in place, note the CDC researchers, 92.9 percent of the mothers surveyed for the new study would have been classified as “early introducers.”

One of the purposes of the CDC study was to determine if breastfed babies were being introduced to solid foods on a different time frame than formula-fed babies. The researchers found that mothers who were breastfeeding their babies exclusively (without supplemental formula) were less than half as likely to introduce solids before four months than non-breastfeeding mothers (24.3 percent compared to 52.7 percent, respectively).

Misconceptions about infants’ needs

The most-cited reasons given by the mothers in the study for the early introduction of solid foods were the following:

  • “My baby was old enough to begin eating solid food.”
  • “My baby seemed hungry a lot of the time.”
  • “My baby wanted the food I ate or in other ways showed an interest in solid food.”
  • “I wanted to feed my baby something in addition to breast milk or formula.”
  • “A doctor or other health care professional said my baby should begin eating solid food.”
  • “It would help my baby sleep longer at night.”

Breastfeeding mothers also said they worried that they were not producing enough milk.

As the CDC researchers explain, these reasons reflect many misconceptions about infants, especially about why they cry and their feeding and sleeping schedules. Infants often require breast milk or formula every two to four hours, for example, and there is no good evidence that solid foods will help them sleep longer. Nor is an infant demanding food each time he or she cries.

“Recognizing signs of hunger may be difficult for mothers, particularly during the first few months of infancy when a mother is adapting to a new infant and learning to understand the infant’s cues regarding specific needs,” write the study’s authors.

Encouraged by their doctors

Lack of knowledge about the needs and behaviors of infants may explain why parents think it’s a good idea to introduce solids early to their child, but it doesn’t explain why doctors and nurses are encouraging them to do so, particularly when it goes against the recommendations of their own professional organizations.

In the study, 55 percent of the mothers who introduced solids early did so on the instruction of their physician or other health-care provider.

Some of the providers, say the CDC researchers, may be relying “on their own infant feeding experiences rather than evidence-based guidelines when counseling women.” Many doctors have reported in other studies that they feel they’re inadequately trained on the subject of infant feeding.

Caveats

Like all studies, this one had several limitations. Most notably, its participants were mostly white and moderately middle class. Yet, as the CDC researchers point out, that may mean that the early introduction of solid foods to infants may be more prevalent in the United States than this current study found. For other research has suggested that low-income moms are even more likely than their wealthier peers to give their infants solid food at an earlier-than-recommended age.

For inexplicable reasons (this is government-funded research), the study is behind a paywall at Pediatrics. Thus, only the abstract is available to be read for free.

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Comments (2)

Gold Standard

Mothers milk is far and away the superior baby food. It is the only food designed by nature solely for humans.

People will talk about "supplementing" mothers milk with adulterated cows milk (formula). When we use the term supplement, it is synonymous with "in addition to", but in fact we should use the term "substitute'' when solid foods or formula is given in place of mothers milk. And it is a sub-standard substitute at that. It's like the difference between Tang and fresh squeezed O.J.

When it comes to introducing babies to solid foods, better late than early is the best plan.

Crazy new ideas?

Despite some outside pressure to begin earlier, I didn't begin introducing my daughter to solids until she was almost 7 months old. I was nursing, which I did for 14 months, and producing plenty of milk (with enough left over to freeze that I never had to supplement with formula). She also didn't seem hungry all the time, so I didn't see any reason to start sooner. Fortunately for me, our pediatrician was probably about 60 and didn't believe in some of these new, crazy ideas like starting 3 month olds on solids, or waking a healthy baby in the middle of the night to eat. So when people questioned why I was waiting to start solids, at least I had his opinion to back me up!

When I did start solids, I began with rice cereal, then whole grain cereal. She was probably 8 or 9 months by the time we started bananas and applesauce. I do plenty of things wrong as a parent, but I think I definitely did some things right when it comes to food because she is now almost 4 and for the most part a very healthy eater-she usually prefers a cup of fresh blueberries over a cookie.