Before You Counsel on Introducing Complementary Foods, Including Potentially High Allergen Foods

In this episode, we will discuss when and how to advise parents on introducing complementary foods (aka “solids”), including foods that are potentially allergenic. This is a topic that will invariably come up for you during your rotation. We’ll discuss the timing and sequence of introducing solids, and then talk about the rationale behind early introduction of potentially allergenic foods.  Definition of “complementary” foods” - a catch all category for “all solid and liquid foods other than breast milk or infant formula”.  Also referred to as “solid foods” Definition of potentially allergenic foods -  eggs, peanut butters, nut butters, fish, shellfish, etc.  When to Introduce solid foods We will start recommending the introduction of solid foods in the form of puree, around the time an infant turns 4-6 months old –  Baby should be able to demonstrate adequate head control in the office with us An infant’s renal and gastrointestinal systems can only start to metabolize complementary foods around the age of 4 months.  An infant will usually develop motor and dental development skills to sufficiently chew and swallow foods around 6 months.  Introducing complementary foods too early can be associated with harmful health side effects, e.g., obesity  Importance of introducing complementary foods Breastmilk and infant formula do not contain all the nutrients a growing infant will need to continue growing and developing appropriately.  LEAP study – babies less likely to develop peanut allergy if peanut products were introduced at 4-11 months This study had HUGE implications regarding the introduction of potentially high allergen foods into infant’s diets to reduce the risk of developing a food allergy to them. The introduction of complementary foods First offer  a variety of single-ingredient foods (such as pureed vegetables, fruits, grains and meats),  in any order that parents desire Iron-fortified cereal is often a good choice as iron stores from mother become depleted by about 4-6 months of age.  Recommend only providing 1-2 new foods per day in case the child has an adverse reaction  The main calorie source for these infants should still be formula or human milkor Important foods to avoid include: honey (due to the risk of botu...

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