Infants are being given sugar, salt and even the odd crisp before they reach the ideal weaning age of six months, according to the largest study into infant nutrition. Anne Dempsey reports
The largest study undertaken here on infant nutrition gives some disquieting insights into how parents feed their children in the first six months of life. Data indicates that some eight-week-old infants are fed solid food, some mothers add extra salt, sugar, gravies and butter to baby meals, and some babies are snacking on crisps, biscuits and chocolate as early as six months.
Funded by the DIT and conducted by research dietician Roslyn Tarrant for her Phd in Infant Nutrition, Current Weaning Practices in Ireland follows 560 mothers and their babies at the Coombe Women's Hospital from pregnancy to six months after birth.
There is now evidence of the link between poor diet in early infancy and a later risk of chronic diseases such as cardiovascular disease and diabetes.
The study will be completed in January 2007, but already its preliminary conclusions provide food for thought for parents and professionals alike. For example, while the WHO recommends that children should not be weaned to solids until six months (26 weeks), the average weaning age in the study was 15 weeks.
It's a difficult area, concedes Tarrant. "Research indicates that introduction to solids before 15 weeks placed infants at higher risk of infections, food intolerance and allergy, as well as overweight and obesity risk in childhood/adulthood. Too early solids also place extra demands on the immature renal system. On the other hand, from a mother's viewpoint, waiting until six months can be unrealistic. For example, at four to five months, holding off giving solids to a hungry baby boy 9lbs at birth is difficult. I think we have to inform parents of the recommendations and encourage them to stick with them, while understanding that in the real world this can be tough.
"Each baby is different and grows at a different rate. However, research shows that mothers who receive good quality advice and information are more likely to introduce solids later. Support is available from your GP, public health nurse, breastfeeding clinics at the local health centre, La Leche League, and Cuidiú, the Irish Childbirth Trust. Six months is the ideal time to introduce solids, but mothers who hold off until four months will benefit their baby."
Some 82 per cent of the study participants are Irish, with 18 per cent non-nationals. Some 51 per cent of mothers breastfed, but this fell to 38 per cent on leaving hospital and 25 per cent six weeks later. "A 1993 study showed a 36 per cent breastfeeding rate after birth, so things are improving, but the fall-off rate indicates that women may need more support," says Tarrant. A minority of mothers added solids - rusk or baby rice - to the baby's bottle which is discouraged. "The bottle is not an appropriate mode of delivery for solid food. It makes babies lazy, and not distinguishing between drinks offered in bottle or cup and food offered by spoon."
Eight per cent of babies were weaned to solid food at six-10 weeks, 70 per cent at 11-16 weeks, with 12 per cent weaning after four months. Predominant reasons for early weaning were the baby seemed hungry or dissatisfied. "Health professionals believe that a baby should be waking regularly and fed frequently. It can be the perception of mothers that babies should be sleeping through the night, but professionals will say that feeding every two to four hours is normal in small babies. Again, this can be difficult for parents," says Tarrant.
Some mothers were weaning babies on to sugar-added cereals, fruits and yoghurts. Ideal weaning foods should be sugar-free, such as pure baby rice, baby cereal or natural yoghurt with fruit purée. Gradually and progressively broaden the range of foods, says Tarrant, recommending a mix of home- prepared and baby foods to include meat, fish and fresh vegetables. "If they refuse something, continue to offer at regular intervals. Repeated exposure does work, so persevere. Giving babies a narrow range of foods could turn them into faddy eaters, the earlier the variety and range the better. Many mothers, for example, did not offer red meat to the baby, but this is a valuable source of iron which is needed at six months to supplement the baby's by then depleted iron stores. Generally choose savoury options over sweet. Weaning time is a critical window of opportunity.
"Babies should not need snacks, and fatty snacks can lay down surplus fat cells. Certainly, do not offer salty snacks or add salt to baby meals. Salt places too much stress on infant kidneys, and has been linked to infant death in the UK. Long term it can affect blood pressure in later life. Overall, encouraging healthy food preferences, positive food behaviour and patterns in infancy lays down good foundations for life."