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Start solids at ‘around six months’: new infant feeding guidelines

Infants should be exclusively breastfed until six months of age and solids should be introduced at “around six months”, according to official new infant feeding guidelines released today.

The guidelines, released by the National Health and Medical Research Council, are based on the latest scientific findings and are an update on 2003 guidelines.

The decision to keep the recommended age at which solids are introduced to around six months is significant because the food industry had lobbied to have the recommended age reduced to four months, one expert has said.

A press release accompanying the release of the guidelines said there were several differences between the old and new guidelines.

The press release said that, “Specifically, the evidence has strengthened for:

  • The benefits of breastfeeding.
  • The association between breastfeeding and a reduced risk of becoming obese in childhood, adolescence and early adulthood.
  • The association between breastfeeding support and increased duration of exclusive and any breastfeeding.
  • The importance of introducing solid foods at around 6 months of age to meet nutritional requirements and decrease risk of allergy development.
  • The order of introducing solids; as long as iron-rich foods are included in first foods, foods can be introduced in any order and at a rate that suits the infant.
  • The implementation of the Baby Friendly Hospital Initiative improves breastfeeding outcomes.”

Professor Amanda Lee, Chair of the Dietary Guidelines Working Committee, said the scientific evidence clearly showed that “around six months of age is the optimum time to introduce solids for children.”

“There have been some reports in the media about allergies and the suggestion that infants should be introduced to solids at an earlier age to stop allergies. We found no evidence of that,” she said.

However, the new guidelines said that delaying the introduction of solids beyond six months may increase the risk of allergies.

“We don’t want mothers to be introducing solids after seven months,” Professor Lee said.

Dr Karleen Gribble, Adjunct Research Fellow at the School of Nursing at the University of Western Sydney said it was “a really big deal” that the new guidelines retained six months as the recommended age that babies start solid foods.

“There was extensive lobbying to get that changed [to four months] from industry,” said Dr Gribble, who was not involved in writing the new guidelines.

“We’ve yet to have the labelling changed on baby foods in Australia, so if you go into the shops you’ll see baby foods labelled as suitable from four months.”

Introducing solids too early put the baby at risk of infection, said Dr Gribble.

“And also their guts aren’t really mature enough to digest the food properly anyway. When the recommendation was four months, a lot of parents were introducing them at two to three months because ‘their babies were very advanced’,” she said.

Dr Yvette Miller, Senior Lecturer in Public Health at the Queensland University of Technology, said she was pleased to see the guidelines made it clear that infants do not need other fluids in the first six months of life.

“This is something about which there is still a lot of conflicting advice and confusion among women. Some of our recent work has found that infants who are given other fluids early (like being given water in the first month of life) have double the risk of too-early introduction of solids,” said Dr Miller, who was not involved in writing the guidelines.

Dr Miller said it was good to see the guidelines advising that continuing breastfeeding beyond the six-to-12-month period is beneficial for mother and baby and recommending unrestricted breastfeeding (instead of scheduled feeds) as a practice that may overcome many common breastfeeding problems.

Breastfeeding

Where possible, babies should be breastfed exclusively for the first six months of life and breastfeeding should continue for “as long as the child and mother desire”, the document said.

To help facilitate that, health workers should encourage community-based services supporting breastfeeding families and “support in the community and workplace for flexible work schedules, suitable environments for breastfeeding, expressing breast milk, storage of expressed breast milk and child care,” the document said.

Paid parental leave schemes and lactation break entitlements should also be promoted, the guidelines said.

Research showed that breastfeeding reduced the risk or severity of obesity, SIDS, asthma, urinary tract infections and a range of other problems, the guidelines said.

While most women do not have medical problems that prevent them from breastfeeding, the guidelines recognised it will not be possible for everyone and provided advice on how health workers and parents can ensure formula is used correctly.

Crying

It is normal for six-week-old infants to cry for around three hours a day, the guidelines said.

“Despite the fact that disease is diagnosed in less than 5% of such infants, they are at risk of medicalisation of their behaviour, and of diagnosis of a range of disorders, including colic (unsettled infant), ‘silent reflux’ and lactose intolerance. They are also at risk of early cessation of breastfeeding,” the document said.

When do babies start teething?

When do babies start teething?

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When do babies start teething?

Most babies sprout their first tooth when they're between 4 and 7 months old.

An early developer may get his first tooth as early as 3 months, while it may take a late bloomer until he's a year old or more. (In very rare cases, a baby's first tooth is already visible at birth.) Whenever your baby's first toothmakes its appearance, celebrate the milestone by taking pictures and noting the date in your child's baby book.

Teeth actually start developing while your baby is in the womb and tooth buds form in the gums. Teeth break through over a period of months, and they often appear in this order: the bottom two middle teeth first, then the top two middle ones, then those along the sides and back.

Teeth can erupt one at a time, or several can come through at once. They may not all come in straight, but don't worry – they usually straighten out over time.

The last teeth to appear (the second molars, found in the very back of the mouth on the top and bottom) usually come in around your baby's second birthday or in the months after. By age 3, your child should have a full set of 20 baby teeth, and they shouldn't start to fall out until his permanent teeth are ready to start coming in (around age 6).

There's a wide range of normal for when teeth come in, but they do usually appear in a predictable order. Get the scoop on teething and tooth loss. See all baby videos

What are the signs a baby is teething?

Some babies get through teething with no signs at all, but many parents report that their babies do experience discomfort. The most likely signs of teething include:

  • Irritability or fussiness
  • Drooling (which can cause a facial rash)
  • Swollen, sensitive gums
  • Gnawing or chewing behavior
  • Refusing to eat
  • Trouble sleeping

Is it true that teething can cause a fever, diarrhea, or a runny nose?

Some parents say their baby also gets a fever, diarrhea, or a runny nose just before a new tooth arrives, but there's no scientific proof that teething causes these symptoms. The American Academy of Pediatrics says that although a baby's body temperature may rise slightly when teething, a true fever (rectal temperature of 100.4 degrees F or higher) and diarrhea aren't normal symptoms. If your child has a fever along with other symptoms such as lack of appetite, vomiting, lethargy, or diarrhea, call her doctor to rule out anything more serious.

How can I help my teething baby feel better?

  • Give your child something to chew on, like a firm rubber teething ring or a cold washcloth that you've chilled in the refrigerator (not freezer).
  • Rub a clean finger gently but firmly over your baby's sore gums to ease the pain temporarily.
  • If your baby is old enough for solids, he may get some relief from eating cold foods, such as applesauce or yogurt.
  • If your baby is old enough to eat finger foods, it may help him to gnaw on a hard, unsweetened teething biscuit, such as zwieback. Just keep an eye on him and be mindful of choking.

Is it safe to give my baby pain medication?

If gnawing, rubbing, or other common methods to ease teething pain don't work, some doctors recommend giving a baby infants' acetaminophen or ibuprofen (for babies 6 months and older). Ask your baby's doctor for the correct dosage before giving any pain reliever to a child younger than 2.

Are any pain relievers unsafe to give my baby for teething pain?

  • Aspirin: Don't give your baby aspirin (or even rub it on her gums) to ease teething pain because it can lead to Reye's syndrome, a rare but potentially life-threatening condition.
  • Homeopathic teething tablets and gels: The U.S. Food and Drug Administration (FDA) advises parents not to use these products because of reported seizures, breathing problems, and other side effects in children. Researchers at the FDA are investigating these claims, and some manufacturers have stopped distributing them in the United States, but they're still available in some stores and online.
  • Benzocaine: Don't use topical gels or medications containing benzocaine. The FDA warns that the use of teething products can lead to methemoglobinemia, a rare and serious (sometimes fatal) condition in which the amount of oxygen in the blood drops dangerously low.

 

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