Starting your baby on solids? Here are three new things I tell parents to do

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All pediatricians have certain “speeches” they can do in their sleep — like the safe sleep speech, the potty-training speech, the healthy diet speech, or the speeches for managing fever, common colds, or vomiting and diarrhea. But research over the past few years has changed one of those speeches: the speech about starting solid foods.

I still say the same things about waiting until at least age 4 months to start (closer to 6 months is likely better, especially if baby is getting breast milk), and about not starting two new foods at a time (so as to know the culprit should baby get constipated or a rash). But now, there are three big changes to what I will say:

1. Don’t give rice cereal. Rice cereal used to be my go-to starting food. It’s mild and babies usually like it, and you can add breast milk or formula until you get to a consistency that works well for babies new to the concept of food on a spoon. But then the Consumer Products Safety Commission came out with a report raising concern about the amount of arsenic that may be in rice and rice products (the rice plant is very good at pulling arsenic out of the soil, where it is often found because of arsenic-containing pesticide use). Arsenic can cause all sorts of problems, including an increased risk of cancer. The report said that babies who get two servings of rice cereal a day could double their cancer risk over a lifetime. Given that there are other kinds of cereal (like oatmeal), there is simply no reason to take that risk.
2. Do give peanut products. This is a real turn-around. For years, we told parents not to give peanut butter or any peanut products until children were two or three years old, for fear of causing an allergic reaction. It turns out that we had it entirely backwards; a recent study showed that giving peanut products early can actually prevent peanut allergy. Of course, parents should talk to their baby’s doctor before giving peanut products if there is a family history of peanut allergy or if their baby might be at higher risk of food allergies for another reason (like having bad eczema or other allergic symptoms). You should also never give whole peanuts or chunky peanut butter. But some smooth peanut butter on a cracker, or foods that contain peanut, should be one of baby’s early foods.
3. Make fish part of your child’s diet. And your whole family’s diet, too. I never used to talk about fish as a first food, but now I do. It’s full of important nutrients — and a study from Sweden showed that children who ate fish during infancy cut their risk of allergies by 25%. The researchers followed the babies in the study until they were 12 years old, and that reduction in risk was still there — with just two fish meals a month! We do worry about the level of mercury in fish, but two servings a week is fine, especially if you stick to fish that tends to be lower in mercury, such as tilapia, catfish, or cod.

Those are the three things I make sure all families do now. There is one other thing I tell families to at least consider:

• Skip the spoon and let baby feed himself. In baby-led weaning, parents and caregivers wait until the baby can hold food and feed himself (of course, it’s really important not to give anything the baby could choke on, and to closely supervise all meals and snacks). Doing things this way has three advantages: It puts off feeding until the baby is really ready (as opposed to when the parents are ready). It puts the baby in charge of how much he eats (a study from New Zealand found that this kind of feeding decreased the risk of obesity). It also brings baby to the table and encourages family meals, and family meals are good for the health, development, and behavior of children as they grow.

Every baby and every family is different, and there are lots of circumstances that might change your pediatrician’s advice for your child. Be sure to talk to your doctor to get the best advice for you.