There is an old Chinese saying, “sickness enters via the mouth”. When it comes to good oral health and general health, what we eat and drink play a definite and significant role. For example, what we eat and drink contributes to what micro-organisms (e.g. bacteria) establish. Our own unique mix of micro-organisms (microbiome) are determined during the early years of life!
The mix of micro-organisms in our mouths determines how susceptible we are to oral diseases such as tooth decay, gum disease.
Baby grows at the fastest rate in the first twelve months of life and achieves many amazing developmental milestones during the first three years. It’s easy to understand why nutrition is especially important during these early years.
Embarking on the solids eating stage, is one of those memorable milestones. Healthy dietary habits are shaped from this starting point, so introducing good eating habits from the beginning is not just a good idea, but an essential one.(1)
When it comes to starting solids, Stanford Children’s Health recommends not to introduce solids before 4mths of age because generally speaking, most babies are not physically developed enough yet to swallow solids properly. In addition, early introduction of solids has been associated with increased risk of overfeeding and weight gain. The National Health and Medical Research Council of Australia recommends introducing solids from 6mths of age. At around 6mths of age, baby led weaning can be tried.
The NHMRC also recommends:
- Introduce iron-rich solids e.g. iron-fortified rice cereal and fish, at 6mths to prevent micro-deficiencies.
- Include a variety of textures from puree to lumpy to near normal progressively from 7-9mths (the age when most infants are chewing). Textures and chewing assist with normal oral motor and jaw development.
- Finger foods can be added by 8mths of age and when baby is sitting well without support.
- Delayed introduction of a variety of textures may contribute to later feeding difficulties.
- Protect baby against choking risks by avoiding hard foods such as whole nuts.
- Avoid sharing of utensils, food or drink to reduce /delay the colonization of decay-causing bacteria from carer to infant.
- Always supervise while infants are eating and drinking
The introduction of foods containing high concentration of nitrates such as spinach, beets, carrots, green beans, squash, is best delayed until after 6mths of age. Excess nitrates and nitrites are associated with increased risk of methaemoglobinaemia, a condition where oxygen delivery in the blood is affected, and young infants are more susceptible.(2,3)
Introducing honey into baby’s diet too early can pose a risk for infant botulism, a condition that is very rare but leads to detrimental diffuse muscle weakness and paralysis. UK and US infant feeding authorities recommend that honey should be avoided until after 12mths of age.(4,5) The use of honey on dummies/pacifiers is also best avoided, both to prevent the risk of infant botulism and also, tooth decay in baby’s teeth.(6)
Baby’s acquisition of a particular taste, preference for a particular food and general eating style are influenced by patterns and choices of food intake and eating styles within their family.(1) Positive parental and sibling models from young are critical.(7)
Early exposure to a food or taste is likely to lead to an enhanced preference for that particular food or taste. Delay introduction of added sugars, salts and other flavourings is therefore recommended. In addition, excessive sugars can promote childhood obesity and excessive salt can adversely affect baby’s kidney functions.
Pave the way for a healthy mix of micro-organisms by healthy feeding and eating from the beginning and hopefully, we will have established dietary habits that will benefit our children for a lifetime.
REFERENCES
- Birch LL, Davison KK. Family environmental factors influencing the developing behavioural controls of food intake and childhood overweight. Pediatr Clin North Am 2001; 48(4): 893-907.
- Sanchez-Echaniz J, Benito-Fernandez J, Mintegui-Raso S. Methemoglobinemia and consumption of vegetables in infants. Pediatrics 2001; 107(5): 1024-1028.
- Chan TY. Vegetable-borne nitrate and nitrite and the risk of methaemoglobinaemia. Toxicol Lett 2011; Jan 15; 200(1-2):107-108. doi: 10.1016/toxlet.2010.11.002.
- Koepke R, Sobel J, Arnon SS. Global occurrence of infant botulism, 1976-2006. Pediatrics 2008; 122(1): e73-82. doi: 10.1542/peds.2007-1827.
- Grant KA, McLauchlin J, Amar C. Infant botulism: advice on avoiding feeding honey to babies and other possible risk factors. Community Pract 2013; 86(7):44-46.
- Benjamins LJ, Gourishankar A, Yataco-Marquez V, Cardona EH, de Ybarrondo L. Honey pacifier use among an indigent pediatric population. Pediatrics 2013; 131(6):e1838-1841. doi: 10.1542/peds.2012-3835.
- Scaglioni S, Salvioni M, Galimberti C. Influence of parental attitudes in the development of children eating behaviour. Br J Nutr 2008; 99(Suppl.1): S22-25. doi:10.1017/S0007114508892471.