They say that eating solids will help your baby sleep through the night

The original reader-posted questions was: 

They say you can start feeding your infant solids at 4 months of age, and it should help them sleep more through the night. I heard this is an oldwives’ tale and not true at all. Why can you start feeding your infant solids at four months, and does it really help them sleep through the night?  

Man did this open the proverbial can of worms!  Talk about conflicting/lack of research.  I found several different studies that covered these questions. The studies were from various countries (Finland, Germany, Australia, The United States) and involved thousands of infants. Bottom line, every one of them stated that there isn’t enough information to give clear guidelines on when to start solids. All that time and money spent, and still the experts can’t agree and/or prove when the best time to start solids is.  I guess it just goes to show that we are all unique individuals with unique needs…from birth.

Much of what I read surprised me. Generally speaking “They say you should delay solids until at least 6 months old” and the most recent studies say just the opposite! Two studies that I reviewed in particular demonstrated an INCREASE in food allergies when solids are delayed past 6 months.  Meaning, if you don’t give your baby solids before they are 6 months, you might be putting them at a higher risk for food allergies.  

As far as the sleeping part of the question, the reader is on the right track.  Feeding your infant solids in the hopes that they will sleep through the night is, in fact, an old wives’ tale. However, there was a study done in 1989 that officially disproved this misconception. The following are translations of two different studies. One pertaining to solid foods and sleep and the other to the introduction of solids and the relationship to allergies. 
 
  
Infant Sleep and Bedtime Cereal
Michael L. Macknin, MD; Sharon VanderBrug medendorp, MPH; Mary C. Maier, MD

Pediatrics & Adolescent Medicine (Originally published in American Journal of Diseases of Children, 1989)

http://archpedi.ama-assn.org/cgi/content/abstract/143/9/1066?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Macknin+ML%2C+Medendorp+SV%2C+Maier+MC.+Infant+sleep+and+bedtime+cereal.+Am+J+Dis+Child.+1989+Sep%3B143%289%29%3A1066-8.&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

Who?

The authors are from the Departments of Pediatric and Adolescent Medicine and Biostatistics and Epidemiology at the Cleveland Clinic Foundation (Ohio).

What?

To find out if feeding infants rice cereal before bedtime helps them to sleep through the night

Why?

Many people are under the assumption that starting an infant on solids will help them to sleep through the night sooner.  This study aims to provide scientific data to support or disprove that theory.

How?

106 infants were randomly assigned to begin bedtime cereal feedings of 1 tbsp per ounce of milk at either 5 weeks old or at 4 months old.  Each infant’s caretaker recorded the infants sleep from age 4 to 21 weeks for one 24 hour period per week. Sleeping at least 8 consecutive hours was considered “sleeping through the night”. These results were also reviewed for 6 consecutive hours of sleep.

Results:

There was no significant trend or consistent finding in either group to have better sleepers than the other. Feeding infants rice cereal before bedtime does not appear to make much difference in their sleeping through the night.

  
 
Age at the Introduction of Solid Foods During theFirst Year and Allergic Sensitization at Age 5 Years 
Mikael Knip and Suvi M. Virtanen, Carina Kronberg-Kippilä, Raili Salmelin, Riitta Veijola, Jorma Ilonen, Olli Simell, Bright I. Nwaru, Maijaliisa Erkkola, Suvi Ahonen, Minna Kaila, Anna-Maija Haapala 
Pediatrics

http://pediatrics.aappublications.org/cgi/content/full/125/1/50?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=age+at+the+introduction+of+solid+foods+during+the+first&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Who?

The Authors listed above conducted this study from several different Universities and Hospitals across Finland. They included data analyzed from 994 children that were included in a previous birth cohort study in Finland.

What?

The medical professionals wanted to find out if there was a relationship between when solid foods were started in the first year of life and allergies developed in those children at 5 years old.

Why?

Current guidelines recommend exclusive breastfeeding for the first 6 months of life and not to introduce solids until after that time period in order to prevent allergies. These guidelines lack clear evidence supporting those recommendations. Very few studies have investigated this topic and of those that have the results are inconsistent. This study tries to assess the association between when solids were started in the first year and food and inhaled allergies that developed by the time those children turn 5 years old.

How?

The Finnish investigators used the information provided by a study done in 1996-1997 which examined the effects of maternal diet during pregnancy and lactation in line with the child’s diet during infancy and childhood on the development of type 1 diabetes, allergies and asthma. This study originally included 1067 children, but information on the age at the time that they first ate solids was only available on 994 children.  From those 994 children, data was analyzed for when solids were introduced and what foods they were.  Foods included: potatoes, fruits and berries, carrots, cabbages, oats, wheat, rye, meat, fish and eggs.

At 5 years of age, blood samples were drawn to test for allergies by measuring the ammount of specific IgE concentrations in the samples.

The researchers then applied statistical analysis to the data to determine the relationship between when the children first ate the solid foods listed above and if they had evidence of food allergies or inhaled allergies that pertained to those foods in their blood samples.

Results:

Food allergies of any kind were present in 17% of the 994 children and 23% were sensitive to inhaled allergens. Cow’s milk allergy was present in 12%, egg allergy in 9%, wheat allergy in 5% and fish allergy in 1%.

The median introduction of cow’s milk to these children (usually in formula) was 2 months old. The median age of the introduction of solids was 3.5 months old. Potatoes were most often the first food introduced, followed, in order, by fruits and berries, carrots, cabbages, cereals, meat, fish and eggs.

A relationship between food allergens and these foods were found when:

Potatoes were introduced in children over 4 months old

Oats were introduced in children over 5.5 months

Rye was introduced in children over 7 months

Meat was introduced in children over 5.5 months

Fish was introduced in children over 8.2 months

Eggs were introduced in children over 10.5 months

Inhaled allergies were also associated with the late introduction of these foods.

This study provides evidence for increased risk of allergic sensitization with delayed introduction of solid foods.

The guidelines that suggest that infants be exclusively breastfed for the first 6 months are based mainly on the idea that the gut mucosal barrier of the infant is immature (meaning the digestive system isn’t developed enough to sufficiently digest solid foods). Newer studies are showing that delaying the start of solids in infants may actually be increasing the chance for allergies.

This is one of several studies that I reviewed that conclude that late introduction of solid foods is associated with increased chance of sensitivity to food and inhaled allergens.

 

 

My thoughts:

So, to answer the reader posted question: You can start feeding your baby solids whenever they show an interest and ability to eat them.  If your infant sits on their own on your lap or in a high chair, shows interest in your food (stares, smacks their lips, reaches for your food) and can seemingly take food from a spoon then they are ready to try.  And no, feeding them solids does not mean that they will sleep through the night. Here is our story:

Okay, so first I read a ton of information supporting exclusive breastfeeding until at least 6 months of age. The American Academy of Pediatrics includes this in their recommendations as well as The World Health Organization (two organizations that hold a lot of clout in our society).

Our pediatrician suggested to us that we give Little Man rice cereal, fruits and veggies at his 4 month check up.  He was actually one week shy of 4 months old but already weighed over 15 pounds. He was exclusively breastfed up to that point and still waking at least 2 times per night to eat (for a total of 8-9 feedings every 24 hours).  The doctor associated the night wakings with him not getting enough calories and suggested solids.  I waited until he was actually 4 months old before I served him his first tablespoon of runny rice cereal.  I really didn’t want to start him on solids until he was 6 months old, more because I didn’t want to rush him out of his little baby stage than anything else. So I reluctantly gave him his rice cereal every night. He developed a rash on his torso and face, but he had been pretty rashy since he was born, so this wasn’t really anything super new.  He didn’t really show any signs of discomfort, so I applied cortisone (dr. recommended) very sparingly every other night if he needed it and kept on with the cereal.  He also started to have some pretty obvious digestive discomfort and was having daily issues with going potty. His BM’s were also really runny and icky and I called the doctor a few times to make sure all of this was normal. I was assured that it was just going to take some time to make the transition to solids and his naive digestive system would soon become used to it.

He was a natural with eating off of the spoon and kept most of the sloppy cereal in his mouth.  I couldn’t shovel it in fast enough to keep him happy so it went something like *shovel, swallow, whine, shovel, swallow, whine* until all of the cereal was gone.  Then there was a pretty fussy baby until I got him into his room to breastfeed him until he was full.  After several days of successful cereal consumption, I mashed up a small piece of banana to mix with his cereal.  Down the hatch without a problem (the rash was still there, but seemed to be mild). A couple weeks later, I offered him pureed peaches for the first time. He ate a tablespoon or so with his nightly cereal and then proceeded to throw them all up a few minutes later.  No more peaches. A few days later, we tried pureed pears.  He ate them without a problem but the next day, the rash was more uniform, red and spread out over his chest and stomach.  No more pears.

Now seems like a good time to add that he was still waking up twice per night to eat…even with the solids. Hmmm.

Anywho…I started to do some research on the introduction of solid foods and based on what I found from the above sited sources, I took Little Man off of the solids.  He was about 5 months old and I felt awful that I had been shoveling all of this food down his throat when the “experts” say that he didn’t need any solids for another 2 months or more.

Then I started to do research for this question emailed to me about starting solids and sleeping through the night. Ok, so now I’m reading scientific data that states that waiting to give your baby solids until they are 6 months old could increase their risk of food allergies.  What the…?!?

No wonder nobody really knows when to start their baby on solids! Even the experts can’t agree on what is best.  I read somewhere along the way that people didn’t even entertain the idea of giving a baby solids before their first birthday until the 1920’s. I guess that is when research decided they should stick their noses in to help everyone be better parents.  I’m sure in countries and societies that don’t have access to TV, journal publications and the media in general have a perfect understanding of how to parent…as I’m sure we would too if we didn’t have so much interference with our primal instincts.  It’s funny how an abundance of information on something can actually mess with our ability to do the simplest task…like knowing when and what to feed our children.

In my opinion, do what you think is best. There are pictures of me eating rice cereal at 1 month old (presumably mixed with cow’s milk *gasp*) and that is probably what “they” recommended back then. It is worth noting that I don’t have any of the food allergies mentioned above…just a fluke allergy to pineapple…I’m not sure where that comes from.

A little less trying to please the research gods and a little more trying to please our little ones would probably go a long way.  Although the fear of “messing up” is a weight heavily perched upon our shoulders by our ever judging society.  *sigh*

One Response to “They say that eating solids will help your baby sleep through the night”

  1. […] And if you haven’t read the gory details of this Finnish Study, you can find it here: http://www.mamafication.com/2010/04/26/they-say-that-eating-solids-will-help-your-baby-sleep-through… […]

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