Do You Have Questions about Feeding Baby Safely?
By Alan Greene, MD, FAAP
Most parents are concerned about what is and isn’t safe to feed their baby. I like to keep it as simple as possible because there are so many benefits from feeding baby a wide variety of foods – both nutritionally and for helping baby develop as an adventurous eater. However, there are some safety guidelines that I recommend adhering to for babies:
• Do not warm bottles of mom’s milk or formula in the microwave. It’s tempting because it’s fast and easy, but hot spots can form that may burn the inside of baby’s mouth. Gentle warming by placing the closed bottle in a container of hot water is fairly simple. There are also bottle warmers designed especially for heating milk to the correct temperature that take the guesswork out of the process. Milk directly from mom is even simpler.
• Do not add rice cereal to baby’s bottle. There is an old wives’ tale that rice cereal in the bottle can increase the amount of time baby sleeps and is therefore a good thing. In reality the rice cereal switches off baby’s inborn satiety mechanism, which can lead to a life-long habit of overeating and eventual obesity. Obesity in American children is one of my biggest health concerns. (I suggest avoiding white rice cereal altogether and limiting rice in general to no more than once a day because of current arsenic concerns).
After starting solids and before one year of age:
• Do not feed honey, to prevent botulism in the baby.
• Do not feed raw milk or soft cheese, yogurt, or pudding made from unpasteurized milk to prevent baby from getting bacterial infections.
• Do not feed raw or undercooked fish, meat, or eggs. Poultry, meat and eggs commonly contain bacteria that could harm babies. Thankfully, these are killed by adequate cooking. (Skip homemade ice cream or cookie dough made with raw eggs!) Raw fish might contain parasites, and is not worth the risk for babies.
• There is no need to delay starting any particular solid food in order to avoid food allergies. Delaying or avoiding any food – even egg, fish, or peanut – beyond 6 months has never been shown to decrease allergies in healthy kids.
• Avoid starting the most allergenic foods (cow’s milk, egg, peanut, tree nuts fish, shellfish, soy and wheat) when a child is taking antibiotics, or when the gut is otherwise inflamed, as from illness. This isn’t a hard and fast rule, but there is some early indication that food allergies might be more likely when started during these times.
• Avoid whole peanuts or other shapes and textures that could cause choking for babies.
My take on the best timing to start solid foods at all is different than what I've seen elsewhere:
Breast-fed babies are already getting perfect, complex real food that provides a myriad of subtly different flavor combinations -- helping to teach the baby to enjoy variety and to enjoy the foods that mom eats. I suggest exclusive breastfeeding until babies vigorously demand solids, usually about 6 months (watching the baby for cues, not the calendar). Continuing breastfeeding in addition to solids remains valuable long after the first birthday.
Formula-fed babies, though, are getting a simple, processed food that addresses only the main nutrient needs we understand so far. I'm grateful we have them for when needed, but the babies are exposed to only one flavor profile, again and again for months on end. I suggest starting real food earlier for these babies, when they demonstrate strong interest in what mom is eating -- sometime after 4 months.
Trying new foods and flavors can be a lot of fun to experience with baby, however always keep in mind key safety guidelines to ensure a pleasant and healthy feeding experience.