Do Babies Who Eat Solids Before 6 Months Sleep "Better"?

Better for whom?

The media had fun this week with a study that told us:

"The early introduction of solids resulted in small but significant improvements in infant sleep characteristics."

Not "changes" to infant sleep, but "improvements".  A "making better" of. 

Or in this case, a change reported as an improvement because of author bias that longer = better.

Human infants rouse and signal frequently when close to their caregivers.  As I cover in my book, there's a whole host of reasons they do this,  yet things can interfere with or even stop this normal communication entirely.  As an example (and as this study confirms) the further away from their parents babies are, the less they signal.  This is precisely why "baby tamers" are always keen to get baby in their own room despite safety guidelines. 

These behaviours are assumed to be desirable by the study authors, because it results in a longer sleep stretch for caregivers and result in them feeling their baby is more "normal".

Attempting to manipulate and shift infant sleep patterns to be more like those of an adult and thus more convenient for parents isn't new, in fact it sells very well. 

Whether it's comfort blankets (although nowadays we prefer to call them "transitional objects") to "condition" a baby to accept cloth over a caregiver, or cry it out so the baby realises signalling is futile - it's considered entirely normal in Western society.  As such we like to pretend there are no consequences or cost to the infant of doing so.

In biological terms if we explore animals generally, the more mammals "signal" - the healthier they and their relationship with their caregivers is considered to be.  As with anything, when we intervene to shift away from the biological norm- we have the potential for both risks and benefits.

If we examine the risk and rates of SIDS, studies show us that not hitting deep sleep levels and retaining the the ability to rouse and signal is the best protection infants under 6 months have.   We know for example some studies find non-breastfed infants are less rousable, whilst others also link not breastfeeding an increased risk of SIDS, when compared to those who are mix-fed or exclusively breastfed. 

What impact does introducing solids and reducing arousal ability further, have on SIDS?  

It would seem prudent to ask given the authors note:

"Following the early introduction of solids, infants in the EIG slept significantly longer and woke significantly less frequently than infants in the SIG."

Although this effect was only visible in babies around 5/6 months (despite some having food from 3), what impact does introducing solids before readiness have on rates of infection, longer term microbiome and overall health? 

They didn't explore that either.

The "significant" change referenced is an average of 15 minutes total sleep in these older babies - which let's be honest, in knackered parent land is but a snifter. 

As was highlighted on Twitter, it would take longer than this to give the food and deal with the solid poop that comes with it.  Yet authors noted 10% fewer arousals, which is huge in terms of a shift from the biological norm.

What also isn't clear from reading the media coverage is the data is from "parental questionnaires". 

Here tired new parent who barely has time to shower and eat some days, pick the baby sick from your hair and accurately recall your baby's sleep for the last week please.  Make sure you're entirely honest about how much breast and formula you're giving too (rather than putting what you think we want to hear or what you'd rather be doing); after all your answers are going to influence the nation!

Seriously?  Researchers have already established that this isn't a reliable method of data collection.

Although the study authors don't acknowledge this, they do comment:

"The commonly held belief that introducing solids early will help infants sleep better could have produced a reporting bias. Mothers, anticipating improved infant sleep, could have reported better outcomes."

Ya think?

Given we have numerous studies highlighting babies can and do reach for food and start eating when ready and that there are risks before this time, why are researchers even going there with sleep?

A quick glance and no conflict of interest is disclosed.  So I dug a little deeper:

First - you'll recognise the names from the EAT study:

Professor Gideon Lack states on his bio that he receives "Personal remuneration: Lectures (SHS Nutricia, Nestle, SHS International)"

Dr Michael Perkin says he receives "Personal remuneration: Lecture (SHS Nutricia)"

Next I checked out the author associations:

"The Population Health Research Institute, St George's, University of London, London, England."

I dug out their financial statement which outlines that they've received grants from a number of people including the "Wellcome Trust".  A quick click later and we can see the Wellcome Trust's financial statement shows they own profitable shares in Nestle...

A cynic might propose parents may not be the only ones with a bias, but when has that ever stood in the way of a good headline?

Infants, Vitamin D & The Truth About Diet

ALL infants need vitamin D supplement in the UK, anyone in the Northern hemisphere is deficient! As rickets reappear, so do generalised guidelines - and parents are often told that diet can't provide much vitamin D, instead it's all about sunshine and supplements.

Official Guidance

The NHS say:

"Vitamin D only occurs naturally in a few foods, such as oily fish and eggs. It is also added to some foods, such as fat spreads and breakfast cereals. The best source of vitamin D is summer sunlight on our skin. 

It's important that young children still receive vitamin drops, even if they get out in the sun.  All babies and young children aged six months to five years should take a daily supplement containing vitamin D, in the form of vitamin drops. This helps them to meet the requirement set for this age group of 7-8.5 micrograms (mcg) of vitamin D per day.  Babies who are fed infant formula don't need vitamin drops if they are having 500ml (about a pint) of formula or more a day. This is because formula is already fortified with the vitamins they need.  If you are breastfeeding your baby and didn't take vitamin D supplements during your pregnancy, your health visitor may advise you to give your baby vitamin drops containing vitamin D from the age of one month."

So I thought it might be interesting to explore just how much D lurks in food and what contribution this could realistically make to intake.

First we need to talk briefly about the different types of vitamin D.  There are 6, but D2 and D3 are the types sold as supplements.  D3 is generally considered superior to D2 but again it gets more complicated because not all studies nor experts agree.

It's also not easy to tease things apart, as many studies use synthetic supplements, whilst in nature other compounds that work in synergy (if you want to get techy read more here) are also found. 

Some studies that make the case against D2, highlight more is needed to generate the same circulating levels and it has a much shorter life after a single ingestion when studied over the next 28 days, however when it comes to infants they concede:

"Despite early evidence of differences in potency between the 2 vitamin D forms on a per weight basis, it must be highlighted that the widely practiced addition of vitamin D2 to milk in the United States and Europe in the 1930s served to successfully eradicate rickets as a significant health problem.  Additionally, fortification of milk with either vitamin D2 or vitamin D3 to this day has proven effective in the elimination of infantile rickets in North America. 

To prevent infantile rickets, a minimal intake of 2.5 μg (100 IU) vitamin D/d in infants with little sun exposure was shown to be efficacious (10). Thus, despite potential differences in the dose equivalence of vitamin D2 and D3, it is likely that vitamin D2 is currently provided at a high enough dose per kg infant body weight to maintain adequate bone mineral metabolism." here

In short, in "real life" either appears to protect against rickets, in a lab D3 sometimes looks better on paper - particularly when discussing supplements..

Eggs:

They're often quotes as offering a little, but not much D.  But what if that depends on the egg?

An independent study showed that UK eggs today have 70% more vitamin D3 than in the 1980's.  Birds also need sunlight or food sources of D and the reduction in caged hens and increase in free range and organic who see daylight,  plus improvements to their diet mean things have changed.

How much?
Well one medium sized egg can now contain as much as two-thirds (66%) of the RDA for an adult according to EU labelling regs.

At the time several, including the director of the "British egg information service" (made me chuckle) called for this significant egg finding to drive industry use (Pinchen H., Roe M., Finglas P. M., Buttriss J., Grey J., Cryer A.2012)

So, the EU lists adult RDA of 5µg and the NHS states that 1-5 year olds have a requirement of 7-8.5µg.  If one egg provides 66% of adult RDA, each egg provides roughly 3.3µg.  I wouldn't call nearly 50% an insignificant contribution would you?  

Fish:

Fish can be a good source of D3.  This study though found farmed salmon contained 75% less than vitamin D than wild did.  As farmed fish is now the supermarket standard, you can see why some conclude it's not always easy to obtain D from food.

Furthermore cooking method impacts; baking salmon retains almost all the vitamin D, whilst frying in vegetable oil reduced the content by half.

What this paper also highlighted was that type of fish, diet, environment all impacted on vitamin D levels. You can see a list of the vitamin D value of fish here - although researchers concluded that the lists were out of date and new tests were needed.

Mushrooms:

Mushrooms are a huge vitamin D secret mainly because they can be hacked (by exposing them to bright sunlight), to have a higher D level either during after picking, Maitake for example, when grown in the sun can boast as much as 28.1µg per 100g, with 1 cup serving providing 20µg of D.

This has been dismissed by some as it's D2, however along with what we learnt about about D2, a 2011 study specifically explored mushrooms.

They found "the bioavailability of vitamin D2 from vitamin D2-enhanced button mushrooms via UV-B irradiation was effective in improving vitamin D status and not different to a vitamin D(2) supplement"

And a 2013 study again exploring vitamin D and mushroom consumption/bioavailability noted several things. 

First that the D2 in mushrooms was as bioavailable as that in a supplement. Furthermore the D2 in mushrooms was as effective at raising and maintaining blood levels of D as a supplement of either D2 or D3.

Second that D4 had been found in mushrooms as early as 1937. Therefore they decided to test a range including oyster, portabella & shiitake and found all contained varying levels. Another study continued their research exploring the D4 and again found this linked to light exposure.

Further examination revealed some also provided D3 whilst "Shiitake mushrooms not only produce vitamin D2 but also produce vitamin D3 and vitamin D4"

Leading them to conclude:

"The observation that some mushrooms when exposed to UVB radiation also produce vitamin D3 and vitamin D4 can also provide the consumer with at least two additional vitamin Ds"

Hack my shrooms

Some mushrooms like button, grow in the dark and so naturally have lower levels of vitamin D. However this study found a short short exposure to sunlight increased the vitamin D levels from 5µg to 374µg per 100 grams.

And the more exposure, the more vitamin D.  Putting Shiitake mushrooms with 40 IU of vitamin D into the sunlight for eight hours with the gills upward (ie sun-drying) resulted in 46,000 IU of vitamin D2. Another six hours (14 hours in total) of sunlight exposure boosted levels to an astonishing 267,000 IU of vitamin D per 100 grams."

In addition, researchers found that one year later, the sun-dried mushrooms retained a large amount of vitamin D; therefore sun-dried mushrooms could be stored and used in winter months.

Some feel more data is needed about mushrooms however because of one particular study in which researchers gave "sun-treated" or untreated mushrooms to a group of adults.  They found vitamin D2 supplementation via mushrooms didn't help overall, as the participant's vitamin D3 levels reduced to compensate - thus giving no-overall effect.  The massive flaw in this study as I see it is that these were healthy adults who started with totally normal serum levels, and maintained totally normal levels.  Yet it appears well accepted when giving a D supplement that the blood level does not keep increasing even with ongoing supplementation. It rises into the ideal range and then it stabilises. Vitamin D is consumed by the body, it is utilised and then inactivated (Dr David Grimes, Consultant physician and gastroenterologist)

Meat

You can see a table here of the different values recorded in meats in different studies.  As you can see beef offal packs a huge punch.

Our shift in what meats we choose to eat has also likely reduced our vitamin D intake:

This review finds numerous studies linking fat and vitamin D and says it was:

"significantly associated with the fat content of whole cuts, and in the cuts 8 to 10 times more vitamin D-3 and 2 to 3 times more 25(OH)-D-3 was found in lard and intramuscular fat than in the lean parts."

Fatty whole joints slow cooked used to be pretty standard as they were cheap (now often called "traditional cuts").  Many locally recall their parents home rendering lard and "dripping" which was even eaten on bread for lunch.

Then came the fat phobic/convenience era and lean steaks with the fat removed that could be cooked in minutes increased in popularity.  Use a Griddle so you make sure you strain as much of the evil arterty clogger away.   Liver was left behind, the overcooked dried offerings presented as school dinners etched on our brains, mingled with a fear of overdosing on vitamin A.  Lard and tallow were replaced with vegetable and sunflower oils and without realising we also waved goodbye to fat soluble vitamin D.

The problem with the convenience era, is that animals don't grow 33 leg chops and chickens don't have 20 breasts.  We therefore need many more animals to meet demand than when "nose to tail eating", that is consuming as much of the animal as possible rather than selecting choice cuts.

The trouble is if nobody wants a huge chunk of the animal, the parts we do want become more in demand - this drives down price and producers need to find cheaper and more economical ways of raising animals. 

Hello factory farming; feeding animals low grade foods, keeping them in low grade conditions provides cheap meat and fish. But at what cost?

Turns out raising animals in substandard conditions leads to substandard meat.  What the animal is fed impacts on what nutrients it provides, to quite a large degree.  It also turns out that animals, like humans need sunlight themselves to produce adequate quantities of vitamin D, or they need their feed supplementing too.

13 Baby Led Weaning Myths

"Baby-led weaning (often also referred to as BLW) is a method of adding complementary foods to a baby's diet of formula or breastmilk. 

Baby-led weaning allows babies to control their solid food consumption by "self-feeding" from the very beginning of their experiences with food. The term weaning should not be taken to imply giving up formula or breastmilk, but simply the introduction of foods other than formula or breastmilk." (wikipedia)

I love BLW for lots of reasons;   it allows baby to regulate their own intake, offers oodles of sensory opportunities and the chewing and processing promotes good oral development.

Seven years ago when I used it to introduce solids to my baby, my health visitors had never heard of it (although one did come round to learn more) and as he was born at 34 weeks gestation a few people thought I was rather mad, he would surely choke or starve! Yet it worked brilliantly.

As more people recognise the benefits of letting babies feed themselves, I've noticed when working with parents (in person and online) the same myths and questions arise.  So I thought I would share my thoughts here to save repeating :-)

1. Baby must be able to sit unaided to start solids.

A mum the other day online asked whether that meant when baby was placed in the seated position, or when they could actually get themselves there from laying down?

Some babies are 8/9 months before they can sit unsupported, why can they not eat before then even if showing other signs of readiness?  Once babies can sit unsupported you wouldn't feed them without support until truly stable, as they will still randomly tip over after a bit which is hardly safe when consuming food.

So what's the relevance?

The key is that baby is upright and has a clear passage from mouth to stomach....

This baby is reclined, eating solids in this position is not recommended.

Both these babies are supported, yet have good head control, are not slumped to one side and food can move easily from mouth, to throat to stomach.  They may or may not be able to sit unsupported but as we can see that's really irrelevant, they are maintaining a safe eating position.

In fact lets compare it to a baby in a high chair:

Again we have no idea whether this baby can sit unsupported or not, because she's supported by the seat behind and the tray in front.  It really doesn't matter as she has a clear passage from mouth to gut.  She would be sat in this chair exactly the same way whether she could sit by herself or not.

Gill Rapley says:

"Sit the baby up to the table with everyone else. He can be either in a high chair or on an adult's lap – supported, if necessary, so that he can use his hands and arms freely. Make sure he is sitting upright to handle food, not lying back or slumped."

I confess it's a long time since I read Gill's book, but I don't recall anything about baby sitting unaided there either.  Anyway as I say, personally I don't see a rationale for it.

2. Vegetables & fruit are the best first solids.

I think it takes a lot for people to make the mental shift from the old fashioned weaning schedule, when solids were introduced before gut closure.  Babies of three and four months (particularly before 17 weeks) are at increased risk of allergies from exposure to solids - therefore vegetables were considered "safer", particularly those considered easier to tolerate, and with low allergenic potential such as carrots, pears and butternut squash!

Pre six months nutritional needs are met by breastmilk, and so babies don't need vitamins and minerals from foods.  From around the middle of the first year, requirements for additional protein, iron, zinc, B Vitamins and vitamin D increase  - but the best sources of these aren't fruit and vegetables!  We know some infants are more at risk of low mineral stores than others, for example those born early, at low birthweight or to mums of poorly controlled diabetes.

We also know babies have small tummies, so they need nutrient dense foods - ie foods which provide good amounts of vitamins, minerals and calories even when consumed in small amounts.  Breastmilk has around 70 Kcal per 100g, in comparison carrots for example have 27 Kcal, less if there if they're not drained well.  

Judy Hopkinson, Ph.D., Associate Professor of Pediatrics at Baylor College of Medicine says:

"It is important to remember, that when solid foods are introduced, the amount of breast milk a baby consumes decreases."

If a baby has an underlying feeding problem or isn't taking enough milk, baby may then I believe take food in addition to solids (which is why Dr Newman recommends earlier solids rather than formula if extra nutrition is required from around 17+ weeks), for typical babies though a reduction in milk feeds occurs.

This means that although vegetables are healthy, the vast majority don't offer anything that breastmilk doesn't ie milk is also abundant in these same nutrients too - but they do have less calories and less easy to assimilate iron and zinc.  Vegetables gradually become more significant the more baby transitions to solids, and important when baby is no longer drinking breastmilk or formula.

Therefore whilst parents think they're giving gentle, harmless foods by not offering their 8 month old anything more than plums and pears, to ensure optimum growth and protect against deficiencies, food should contain nutrients babies begins to need first.  

In Canada meat and eggs are now recommended as ideal first foods, the La Leche League have suggested this for years - in fact there are not many cultures who wean on to refined grains, vegetables and fruit.  This makes sense as baby has all the enzymes to easily digest meat  at 6 months, and it's also high in protein, iron, B vitamins and zinc - the foods we know infants need first.  Egg yolks are extremely easy to digest and if organic are also an excellent source of vitamin D.  Obviously vegans and vegetarians can meet requirements via their normal sources of these nutrients, although as less bioavailable clever food pairing is also required (which I'm assuming those choosing either diet are already familiar with).

3. Closely followed by grains: bread, pasta, cereal.

Let's start with bread as a product.

Made at home contains: Wheat Flour, Yeast, Water, and Salt (with a very small amount of sugar if any).

Wharburtons meduim sliced contains: Wheat Flour,Water ,Yeast, Salt,Vegetable Oil, Soya Flour, Emulsifiers E481, E472e, Preservative Calcium Propionate, Flour Treatment Agents Ascorbic Acid (Vitamin C), E920 (Vegetarian)

The sodium amount in one slice of bread is 0.4g yet according to the NHS:

"The maximum recommended amount of salt for babies and children is:up to 12 months – less than 1g salt a day (less than 0.4g sodium)"

Which means one slice equals more than baby's total daily maximum allowance - yet breastmilk and infant formula also contain sodium..

Wheat gets even more complicated as: 

"Today's wheat is a far cry from what it was 50 years ago.  Back in the 1950s, scientists began cross-breeding wheat to make it hardier, shorter, and better-growing.

Today's hybridized wheat contains novel proteins that aren't typically found in either the parent or the plant — some of which are difficult for us to properly digest. Consequently, some scientists now suspect that the gluten and other compounds found in today's modern wheat is what's responsible for the rising prevalence of celiac disease, "gluten sensitivity," and other problems."

Read more here, here, here and here.

Lastly grains also contain phytic acid, a substance present in grains in relatively large amounts. Phytic acid is often referred to as an “anti-nutrient,” as it blocks absorption of minerals, like iron, magnesium, zinc, and calcium, in the body; the very things baby needs to absorb.  Other cultures who eat grains early, typically either prechew, sprout or ferment.  You can read more here and here.

As part of a balanced diet for an adult, quality grains may not be a huge issue for some; but when we're looking at nutritionally significant foods for babies who don't consume much, it seems to me there are far more valuable solids to explore, particularly in the first year or two.

The bigger picture is also that we are eating more wheat than ever before, hidden in products you wouldn't necessarily expect to find it. Hit the supermarket and check out how many ice creams, salad dressings and processed meats contain wheat.  Then consider some get cereal for breakfast, bread for lunch and pasta for dinner!

4. And only one type.

Just carrots, peaches or whatever else parents have selected. To me baby led weaning isn't just in the sense they feed themselves, but also that they lead what they choose to eat from a balanced meal.

Gill discusses in her book how some theorise the baby will choose foods with the nutrients he might need, guided by taste (2, 3) - but how if you only have a single food offered?

For those with severe food allergies in the family or where reactions may be serious, it of course makes sense to present things as individual foods before mixing in say a curry or casserole where it may be more difficult for baby to avoid potential allergens.

Similarly higher risk foods such as egg, dairy, peanuts etc should be given at different times so it's easy to identify if there is a problem, which item caused it.

For the most part however there is no evidence supporting the concept of introducing one food every few days and watching for a reaction, particularly once the gut is closed; people can develop a food intolerance at a later date too.

5.  Babies need bland.

Baby rice being the king of!  Breastfed babies are exposed to tastes and flavours via breastmilk and so often parents report their baby is far more interested in tasty meals.  Herbs, spices, garlic and pepper are all suitable.

Cultural norms vary widely so if we look at Indian cuisine and first foods, one example is a "cereal" made from rice (not processed, stripped of any goodness and then refined with synthetic vitamins baby kind!), toor dal (split peas), cumin seeds (bitter, spicy), ajwain seed (strong, spicy thyme like flavor), asafetida (tastes a bit like strong onions with a touch of earthy truffles) and dried ginger - bit of a far cry from a rusk!  Google the nutritional qualities of each ingredient and you will also see it's a good source in magnesium, zinc and iron with a low GI and is considered easy to digest.

6. Baby has to be exactly 182.6 days old (6 months).

Why? Does the magic gut fairy wave a wand on the eve of night 181 thus rendering the baby ready for solids? No.

It's a guideline not a rule.  I hear people say I'm going to start BLW at 6 or 7 months and wonder, if it's baby led, how do you know when you will start unless actually you're picking the date and it's not baby led at all?

I don't want to cover again the ins and outs as I covered everything here  but from a biological perspective it makes no sense babies would be able to pick up food, get it to their mouth, chew and swallow before they're ready to eat, because how would cave woman have known about the 6 month rule?  How would our ancestors have known to withhold food even after the baby was helping themselves?

Furthermore if you're going to buy into the concept of self feeding and that being able to do this indicates solid readiness, then surely it also follows that if babies aren't ready, you can present them with all the solid food in the world yet they won't be capable of eating it?

Indeed Gill Rapley conducted some small scale research and found:

“The babies who participated in the research were allowed to begin at four months. But they were not able to feed themselves before six months. Some of the younger babies picked food up and took it to their mouths; some even chewed it, but none swallowed it. Their own development decided for them when the time was right."

Just like I think baby led is more than self feeding and should encompass self selection of foods, I also think that should extend to when they do so.

7.  Tongue tie doesn't impact on starting solids.

This really confuses me.  The tongue is pretty key to eating (ask anyone who has ever suffered Bell's Palsy ), it needs to move the food laterally to the gums/teeth for mashing, it needs to retrieve bits that get stuck in the cheeks or roof of mouth, it needs to undulate to move the food to the back of the mouth for swallowing - how can that always happen if the tongue is anchored to the floor of the mouth in a way that significantly hinders these actions?

I'm not suggesting for a second all babies slow with solids have tongue tie, nor am I saying a restricted frenum always causes eating problems; but it's equally wrong to say that it never can, as this mum's diary clearly highlights.  If baby is still struggling with excessive gagging, pouching food (getting it stuck in cheeks or roof of mouth) or doesn't really seem to have progressed two or three months into the eating journey and parents have concerns, it's worth ruling out.

8.  Babies need water with their meal as soon as they start solids.

The general consensus seems to be formula fed babies should be offered water when solids are introduced; breastmilk however is around 88% water and so if you are feeding on cue there is no rush to introduce extra fluids with meals.  Playing with cups and water outside of mealtimes (some find in the bath allows for spillage!) can give baby time to enjoy that experience in itself.

9.  Puree on spoons is still BLW - if not you're a purist.

Of course some foods are easier to spoon - yoghurt or soup for example; and preloading spoons for odd foods is I think pretty instinctive.  However recently I've heard of people blending or mashing all meals, before loading up spoons and calling it BLW.  Yet I'm not convinced appetite regulation is that easy when things aren't solid.

Take a punnet of strawberries, you're average 6-9 month old might eat anywhere from a bite to a few. Puree the punnet however and you get a surprisingly small amount of mush.  Think how much fruit you need to make a smoothie, it's much easier to consume larger amounts of blended food than you would consume  in their solid state.

Having to pick up and bring food to the mouth and then process, rather than just swallowing, slows down the eating process allowing the baby more time to recognise they are full.  Babies pushing a preloaded spoon a few inches to their mouth eat much faster than those feeding themselves.

It also removes a lot of the sensory experience - visual identification and textures of foods, learning how to pick up a particular item and manipulate using fine motor skills, not squishing too hard or letting it fall.  I think Gill in one of her presentations has said previously, how can a child build a relationship with foods if green mush is sometimes apple, sometimes avocado, sometimes cabbage?

10.  Everything has to be in its whole untouched state, no mashing or it's not BLW.

I know this seems rather a contradiction to the above statement but some things are shades of grey, not black and white.  Whilst there is the extreme of pureeing everything to a soup and calling it self feeding, there is also the other end of the spectrum - some foods  that are nutritionally valuable are much more difficult for babies to process.  Previously premastication would be used in hunter gatherer societies, plus perhaps bashing something with a rock or squishing it between fingers eg nuts or meat (no mincers then!).

Surely instinct also plays a part?  

If baby enjoyed a meal, yet at a later date the same items are presented cooked/chopped differently, say in a casserole with a slippery sauce baby may struggle to pick it up as well as before - how can they be less ready for the food than they were before?

Helping baby by say roughly squishing to make more "graspable", is hardly comparable to spooning down jars at 4 months.

To some degree processing is often done - we don't present baby with a whole chicken and say he's can only eat it if he can carve himself a leg.  Nor offer eggs but declare baby only ready if he can get through the shell.  When offering a piece of chicken the parent is already subconsciously deciding the size and shape of what baby receives; whether that is one piece baby can hold, shredded which baby can practice picking up skills, made into minced balls or a mixture depending upon what the parent feels baby handles best, is to me personal preference rather than "weaning rules".

11.  Food is just for fun until they're one!

Agh this is up there with my pet hate sayings along with "happy mum = happy baby"!

A blogger who makes some great points (although also some I don't agree with!) sums it up well:

"I think the phrase “Food before one is just for fun” needs to go die a merciful death, to be honest. In all likelihood, the phrase itself was invented by some well-meaning person who wanted to encourage a more relaxed approach to solids among anxious mothers who were engaging in weird little mompetitions with other mothers about who could cram the most “jars” inside their child--and in the process, harmfully crowding breastmilk/formula out of the baby's diet.

But it’s looking increasingly as though this phrase has begun to be interpreted as meaning that solid foods play no nutritional role at all before one year of age—and that therefore, it’s completely fine and not an issue if months and months go by while your older baby eats basically no foods at all and does not receive any micronutrient supplementation either. And the evidence suggests strongly that this is just not true."

WHO say:

"At 9-11 months of age, for example, the proportion of the Recommended Nutrient Intake that needs to be supplied by complementary foods is 97% for iron, 86% for zinc, 81% for phosphorus, 76% for magnesium, 73% for sodium and 72% for calcium (Dewey, 2001)."

Nobody is suggesting babies need vast quantities of foods, to be on 3 meals per day ASAP, if baby is enjoying picking from a balanced diet, normal amounts can vary hugely.  Milk should absolutely be babies main form of nutrition, fueling bone and brain growth and only starting to tip in the favour of solids towards the end of the first year.

What's more nobody is suggesting food isn't fun!  Of course it is, it's an amazing learning experience.  But it isn't just for fun.

I think it's this belief that in part leads to some parents choosing less nutrient rich foods believing they're not actually needed at this age.

12.  Babies have the same tastes we do.

How can I sweeten yoghurt or porridge is a question I frequently hear.  Adding pureed fruit seems to be a common suggestion, but I always have to wonder why?  Whilst many adults are used to eating foods packed full of hidden sugars and so to them things taste bland or sour without,  why encourage sweetening for baby?

It's also normal for them to pull a funny face or shudder if something is bitter, tart or sour - but this doesn't necessarily mean they don't like it or it isn't worth offering again.  It can take ten tastes of something for baby to get used to it. Bitter foods are considered important to our health, despite the fact many now eat very little - these taste buds are typically underdeveloped, whilst sweet are over enhanced.

Recommendations are to eat more vegetables than fruit, and where possible choose traditional varieties; some new types of fruit are being bred for their intense sweet taste to suit ever sweetening palates.  For example grapes should be prominently sweet with a hint of sourness and a deep flavour, yet many now are designed to taste like balls of sugar with thin skins and extra water (juiciness sells) to compete with the every growing confectionery industry.

13.  BLW are slow to start solids compared to puree led and may go hungry.

Many say BLW babies consume less foods than those puree fed, but we could also flip that to say puree weaned babies eat more than those BLW.  Some worry BLW infants will go hungry as they can't consume enough.

A small study published last year found:

"BMI scores differed significantly between groups lower BMI were associated with baby-led weaning in the whole sample. The mean BMI percentile rank for the baby-led group was close to the expected average."

"In contrast, the mean percentile rank for the spoon-fed group was above the average level, indicating that more children in this group were likely to be classed as overweight."

"BMI z-scores were also found to differ significantly between the weaning groups. We found there to be an increased incidence of obese children in the spoon-fed group (n=8) as compared to the baby-led group (n=1)" (6)

and

In contrast, more children in the baby-led group were classified as significantly underweight (n=3)

The baby-led group was close to the expected average, furthermore 9 children were obese, 8 spoon fed and 1 baby led.  3 children were underweight, all baby led.    Therefore the risk of overweight when spoon feeding was statistically much greater than the risk of being underweight was if baby led.  They concluded:

"Our results suggest that baby-led weaning promotes healthy food preferences in early childhood that could protect against obesity. This finding is of note given the serious problems with childhood obesity facing many modern societies."

References

1. The Role of Zinc in the Growth and Development of Children Nutrition 2002;18:510–519

2. Davis, Clara M. Results of the self-selection of diets by young children. Can Med Assoc J1939 41: 257-6

3. Strauss, Stephen. Clara M. Davis and the wisdom of letting children choose their own diets.Can Med Assoc J 2006 175: 1199

4. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.

5. Hambidge KM, Krebs NF. Zinc deficiency: a special challenge. J Nutr 2007;137:1101-5.

6.  1.I. Blossfeld, A. Collins, M. Kiely, C. Delahunty, Texture preferences of 12-month-old infants and the role of early experiences, Food Quality and Preference, Volume 18, Issue 2, March 2007, Pages 396-404, ISSN 0950-3293, 10.1016/j.foodqual.2006.03.022.

Daily Telegraph - Stop You're Killing Us!

And not so much softly as with a brutal thwack.  My eyes are bleeding this week after seeing not one, but two lots of dire material hitting the Daily Telegraph. It's beyond painful reading, so much so I briefly pondered whether perhaps flu had rendered any of their journalists who are able to string a half decent story together incapable; or if perhaps some morale boosting team bonding jaunt had left the offices empty?  I hear you can get good deals on a twin room at this time of year...

But Anna White's offerings are cringe worthy, even for the Telegraph.  Think car crash.

Her first offering entitled "The witches of breast milk need to back off" (seriously, hello Mr Editor!)

Let's forget content for a moment and pretend the piece isn't an excuse for someone to unload their personal baggage in print, the article is messier than leaving your 2 year old unsupervised with a tub of Sudocrem!  Perhaps Anna needs to debrief her own experiences before she can rationally and coherently attempt eloquence when covering infant feeding?

To be honest, I'd rather forget the content for more than a moment; permanent deletion "Men in Black" style would be better.  I found it uncomfortable reading, as Anna's emotionally charged attack picked out midwives, health visitors and nurses as "witches".  One Facebook reader suggested the piece needed an Armadillo style re-write, but to be honest I just didn't have the heart.

When I read the piece, I see a mother who tried to breastfeed and like so many was failed.  Who writes about a Health Visitor waving a magic wand and lifting the guilt fog, whilst not recognising the guilt dripping from her own words.  Who clings to the "potential fairy tale" that Joan Wolf might just be right, and that formula is absolutely nearly as good as breastmilk.  Surely anyone who loves their baby and didn't succeed would feel the same?

Only someone emotive about infant feeding writes an article as provocative as this, resorting to playground name calling and not so thinly veiled insults.  Those who work with mothers who haven't breastfed for as long as they planned,or who have been that mother, know that feelings often remain long after the relief of being told it's fine to formula feed has passed.

Her next article however "Is baby-led-weaning a load of mush?", takes terrible journalism to a whole new level.  One can't actually use this piece to weigh up the pros and cons of introducing solids this way, because Anna clearly has done absolutely no research into either the concept or how it's done.

Anna says:

"Picture this family scene...mid-afternoon Mum tweets tonight's set menu, offering her kids a choice of main course and pudding. A reply pops up on Facebook "Cottage pie please Mum but make that with lamb not beef, drop the carrots, and I'll have the gravy on the side." As ridiculous as that sounds is it but 10 years down the line from a six-month-old selecting tea from a platter of finely chopped foods. From the child's earliest culinary memory he is dictating the dish du jour."

"Baby-led-weaning means letting your little one choose food themselves - a term coined by former health visitor and mid-wife Gill Rapley." 

That's right Anna, every meal time mothers everywhere gather their child up, take them to the fridge and let the babies self select.  The youngest know to point and grunt at desired items, whilst the older ones competently sign the exact ingredients required for a three course meal.  Honest.

"From his throne-like high chair oh bibbed-one chooses his food, reaches for it and feeds himself."

His throne like high chair?  (has Anna been snooping on the Beckhams I wonder?).  The irony in implying there is something "precious" about a child reaching for, and feeding himself (as apposed to his mother mushing it to save him chewing, then popping it in his mouth to save him feeding himself too) clearly lost on this writer.

Apparently mums are divided on the issue, which is interesting as whilst I read lots from people who have done one thing or another; it's hardly the stuff of explosive discussions.  As Gill Rapley herself points out, long before she coined the phrase "Baby Led Weaning", mothers had for centuries been introducing solids this way.

A rather flaky "against" argument develops:

"On one side of the table: what if your child, who has no concept of solids or how they taste, doesn't like any of the components of your evening meal? Forget the hassle of purée, you now have the faff of preparing dinner for two and a finger food buffet for one - a toddler tasting menu."

I think I actually snorted my coffee at this paragraph.  If the child has no concept or solids or how they taste, how can they at that point dislike anything?  They can't until it's offered.  Then they may (believe it or not)  dislike whatever puree is offered, just as they may dislike your meal.  Does Anna keep a selection of "absolutely zero effort" purees on hand?

Because here's the thing Anna, pureed baby food doesn't magically appear when you turn the blender on.  Nope, you have to spend time lovingly creating a meal, squishing it up and then dividing into weeny portions to freeze.  If he doesn't like it?  You have the hassle of making more.  If he throws it across the kitchen several nights in a row, let's see how quick you're claiming self feeding infants are "dictating the dish du jour".

Again the irony seems to woosh right over Anna's head.

When babies are starting solids at their own pace, the answer to what if they don't like dinner is: "So what?". Nutritionally babies don't need to eat every time food is on offer, milk is their main form of nutrition in the first year.  Solid foods are initially for taste and texture.  If they don't like dinner, perhaps they will like breakfast, or lunch; or perhaps they will (if not truly ready) wipe it about the table, gnaw the edge before abandoning it down the side of their seat.  If it's something you were making anyway it's no big deal.

Anna ploughs on regardless.

"There is something rather medieval (and messy) about a feeding style where the little critic lobs rejected courses over his shoulder. This early selection process gives children the freedom to turn their noses up at food making it difficult to later on enforce such rules as no greens, no pudding. Staple values end up in the bin once you hand over control on a plate."

Firstly, are we seriously suggesting puree weaned babies don't turn their noses up at foods?  Don't clamp their mouth shut and twist their little heads fiercely side to side?  Don't manage to grab the dish and tip it on their heads?  I have photo evidence proving otherwise!

Food is a fantastic sensory experience for babies, think of all the smells, tastes, textures.  How much pressure before something squishes or slides out of your hand?  As Gill herself says, parents spend a fortune on sensory toys - whilst the best toy of all is right their under their noses.

To have a parent controlling the food, the spoon and what's on it deprives them of this experience.  It also makes it easy to overeat which can lead to constipation.

"But for mums who are more budget eatery than fine dining there is limited time and money to provide a tapas style supper, much of which may end up on the wall."

A tapas style supper?  Did Anna actually even Google Baby Led Weaning before attempting this article?  I don't understand how serving up an extra portion of your meal is "tapas style", well unless of course you're having tapas anyway!  How does a meal cost any more served whole rather than blending?

"Diet-related anxiety on the part of the parent, albeit their own intake or that of the child, can allow the toddler to use food as emotional blackmail."

I absolutely agree anxiety around eating should be avoided.  Mothers who used baby-led weaning were found to be less anxious about feeding and less controlling than “spoon-feeding” mothers.(1)

As for emotional blackmail, I think the thing is that a healthy appetite isn't the only thing that can be shaped by a parent's attitude.  Perhaps reconsidering strategies like "no greens, no puddings", might help.

Anna concludes:

"My four-month-old twin girl is already a particular feeder - the type of teat, temperature and position can determine how much milk she deems to drink, and as a premature baby it's a volume game. Allowing her breaks, remaining calm and playing while feeding, works for us."

Which despite all Anna's comments above sounds like responsive parenting.  To the trained ear I suspect whatever makes her daughter fussy with the bottle, is likely the root cause of their breastfeeding problems too.

"So when it comes to serving up the solids to twins with potentially differing tastes I intend to practice the technique, you'll get what you're given, in the hope it limits mealtime chaos."

Excellent, Baby Led Weaning all the way then Anna?

1.  Brown A, Lee M. An exploration of experiences of mothers following a baby-led weaning style: developmental readiness for complementary foods. Matern Child Nutr. Nov 28 2011.

Does spoon feeding predispose babies to obesity?

Was the question in the news this week.  Well actually the Beeb covered it as:

"Spoon feeding 'makes babies fatter"

Nice.

The discussion that has followed has been interesting, such a provocative title is intended to have mummies grabbing their iPhones to read more - and indeed many responses were to chip in anecdotal data (ie I did X and my child is Y) 

The news coverage follows a study published this month in BMJ Open entitled "Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample".  The aim:

The impact of different weaning methods on food preferences and body mass index (BMI) in early childhood is not known. Here, we examine if weaning method—baby-led weaning versus traditional spoon feeding—influences food preferences and health-related outcomes.

So what's the upshot?

The reality is that the anecdotal comments on Facebook were ultimately nearly half the size of the study.  It contained a mere 155 children,  92 given finger foods and 63 spoon fed.  The age range was 20–78 months.  The study examined weight and taste preferences.

It's therefore definitely important to recognise the limitations of this study (and the authors do).  No adjustment was made for early feeding method ie we know breastfed infants are exposed to different flavours via breastmilk, and therefore may well be part of forming "tastes".  We need to look at what the first foods were in both groups because sweet foods such as baby rice have also been show longer term to impact on obesity levels.  Ideally we also need a study of a much larger group and also over a much longer period of time ie what happens at puberty and beyond.   Being slim and able to regulate ones appetite from a selection of healthy choices at 4, doesn't mean this will be the case at 20, 30 or 40.

However - I still think it's worth studying the evidence a bit further; to work out exactly what it does and doesn't say, because as usual this seems to have caused a little confusion.

One blog on Babycentre read:

"When researchers compared kids based on BMI, they found that kids who’d experienced old-fashioned spoon feeding were more likely to have become obese. In addition, those kids tended to rate sweets as their favourite foods.

By contrast, the kids who’d experienced baby-led feeding showed a preference for carbohydrates, not sweets. And these kids were more likely to end up underweight."

Note -  it was parents who rated the children's taste preferences, not the kids.  This means there is the potential for a variance in expectations and perceptions, plus the diet offered.

The blog goes on to say:

"So in this small survey, baby-led weaning was linked with skinnier kids."

What the study actually says is:

"BMI scores differed significantly between groups lower BMI were associated with baby-led weaning in the whole sample. The mean BMI percentile rank for the baby-led group was close to the expected average."

"In contrast, the mean percentile rank for the spoon-fed group was above the average level, indicating that more children in this group were likely to be classed as overweight."

"BMI z-scores were also found to differ significantly between the weaning groups. We found there to be an increased incidence of obese children in the spoon-fed group (n=8) as compared to the baby-led group (n=1)"

and

In contrast, more children in the baby-led group were classified as significantly underweight (n=3)

So you could phrase it that the "baby led weaned is linked with skinnier kids", but only if you are holding spoon fed, potentially heavier babies as the basis for comparison.  Truth is the baby-led group was close to the expected average ie they were just normal weight.

Furthermore 9 children were obese, 8 spoon fed and 1 baby led.  3 children were underweight, all baby led.    Therefore the risk of overweight when spoon feeding was statistically much greater than the risk of being underweight was if baby led.

What the study also doesn't tell us is what the child's position was prior to solids, which is surely significant?  Were some infants already considered above expected weight and this has continued with solids, or has there been an increase since introduction?  Were those underweight already so before solids? If something is underlying such as a hidden tongue tie, not only may that influence weight pre solids, but may also impact on method of introduction; if baby is orally sensitive they may have refused a spoon and thus be baby led weaned as a result rather than a choice.

The Babycentre blog then goes on to say:

"But notice what the study didn’t show. It didn’t show that the graduates of baby-led feeding were more likely to eat vegetables (they weren’t). Nor did it show that baby-led feeding made kids more interested in nutritious, balanced diets. Or that spoon feeding increased a child’s chances of becoming a picky eater.

When it came to these variables, the two groups had similar outcomes.

And maybe we shouldn’t be surprised. It’s not clear to me that letting babies feed themselves is going to turn them into exemplary eaters. What makes children accept healthful foods is repeated exposure, social cues, and pleasant experiences. There are many good reasons to offer your baby safe finger foods. Self-feeding is stimulating for the baby and fun to watch. But we shouldn’t assume baby-led feeding is the key to good eating habits. Or that the spoon is the road to ruin."

But in fact the study actually states:

"Interestingly, the baby-led group showed increased preference for all food categories except sweets compared to the spoon-fed group (although this was only significant for carbohydrates)".

The researchers of the study also seemed to draw quite different overall conclusions:

"Our findings show that baby-led weaning has a positive impact on the liking for carbohydrates—foods that form the building blocks of healthy nutrition (ie, those found at the bottom of the food pyramid). This is a significant finding since, to date, the factors thought to be most influential on early food preferences are sweetness and familiarity (exposure). Consistent with previous research, the spoon-fed group preferred sweet foods most, whereas the baby-led group most preferred carbohydrates (even though significantly higher exposure to carbohydrates was reported in the spoon-fed group)." 

and

"Our results suggest that baby-led weaning promotes healthy food preferences in early childhood that could protect against obesity. This finding is of note given the serious problems with childhood obesity facing many modern societies."

Whilst as discussed the study is limited - I definitely think it's an interesting foundation.  To me there are many logical reasons for letting a child self feed, potentially improved appetite regulation longterm is one, and it also makes sense to me that it is much easier to overeat if someone is spoon feeding you.

People suggest as long as you are responsive and stop when their cues show - you prevent overeating, but I'm not sure it's as clear cut as that.  Firstly if you take anything and purée it, you can eat more of it - if you don't believe me make a smoothie and see how many pieces of fruit you use.  I've heard it said you can consume three times the amount of food in a blended state, and whilst overall I haven't check how solid the evidence base is for this - a 2006 study I found is interesting:

"70 twelve-month-old infants were exposed to cooked carrots prepared in two different textures; pureed and chopped. Infants’ mean intakes in grams for the pureed and the chopped carrots were 70.9 ± 49.1 g and 24.6 ± 28 g respectively. Infants consumed significantly more puréed carrots (t(69) = 8.50, p < 0.001)" (1)

The ability to consume more calories for the "full feeling" is the reason on diets such as Slimming World, you can have unlimited whole fruit but v limited amounts of smoothies.  Similarly if you're ill often they are recommended as an easier way to increase intake of nutrients and calories.

Many mums also note constipation in purée weaned babies (indicating the solid/fluid balance has shifted too far), whilst this is virtually unheard of in self feeding infants.

Next there is speed.  The Babycentre blogger above said:

"How did hunter-gatherers make baby food mash? No special technology needed. The mother took a bite of the unprocessed food, chewed it into a pulp, and then spit it into the baby’s mouth."

So for each mouthful the mum has to chew and process the food before passing to baby - which provides a natural gap after each mouthful, much like if baby were eating it themselves.  Plenty of time to recognise they're full.  Compare this to a mum feeding her baby puree from a bowl, and the speed with which the spoon is reloaded and returned.

Also, sure cavemum prechewed foods such as meat and roots - but is there anything to suggest she did this for ALL foods?  Logically to me you would do this for something hard to break down, but why if something was already soft?   Even after mastication, meat is not that completely smooth texture of a purée?

We know when babies are getting ready to eat they begin a chewing action, they often do it when you're eating - why if they're only meant to eat foods which requires swallowing with no chewing at all?  Perhaps a study on jaw development between spoon fed and purée weaned infants may also be interesting (particularly if earlier feeding methods were also included in the study)?

Something that seems to have been overlooked by most discussing this (and indeed the study) is age of introduction.  I think this is a key point of baby led weaning ie when baby starts reaching for foods they get them, rather than the parents deciding if baby is showing signs of readiness.  There is evidence cavewomen wore their babies in slings, and so when do you think they would have weaned?  When baby started chewing actions and trying to grab solids - or when their baby woke more frequently at night?  Bearing in mind of course night time would be when a baby then did most of their feeding, and of course they would be sleeping together - baby wouldn't be in a different cave.....

Furthermore what effect does today's puree practice have on foods?

Chewing by the mother would begin the digestive process - see here.  But blending according to this referenced article has a different impact:

"The more processed a food is, the quicker it can raise your blood sugar levels. Fruit purées are more processed compared to whole fruits, but not as much compared to fruit juices. In other words, fruit purees can raise your blood sugar levels faster compared to fresh fruits, but not as fast as fruit juices. Unfortunately, fruits lose a lot of their fiber and nutrients when processed into a puree. Opt for whole fruits as much as possible, because their higher fiber content will help prevent a large increase in blood sugar levels. If you prepare your own fruit purees, keep the peel on, after washing it thoroughly, to increase the fiber content of the purees.

Some mums are told to blend and then put through a sieve or moulee, removing fibre and resulting in a product more comparable to juice.  There also seems to be some discussion over whether "resistant starches" are broken down in a food processor, thus making them available and increasing calorie content by more than 5%.- however I haven't had time to go into a long evidence based hunt for this, so you would need to if you want to know more!

The researchers also highlight that how the food is presented also impact on preference stating:

Foods in their whole food format, such as toast, rather than a pureed form may highlight awareness of perceptual features (such as texture) that is masked when food is pureed.

The study that examined chopped and blended carrots above found:

"A great variability in the consumption of chopped carrots was found within the infants. Analysis showed that familiarity with different textures, especially chopped foods, is the strongest predictor of intake and liking of chopped carrots."

and

"The present research is a first step to explain the variation in infants’ consumption and liking of different textures. It highlights the importance of not only varying the child’s experiences with different flavours but also with different textures to foster the infants’ transition to an adult diet."

What do I think?
I think there has to be some instinct mixed in with the research.  I did purée feeding with my first and baby led with my second, and I would never return to mush again!

However, I did also follow my instincts - yes raw carrot and lettuce are a lovely sensory experience for a younger baby new to eating, but I wouldn't only provide these as a meal; I would add something softer and more nutrient dense such as say fish cakes and steamed broccoli.  Roasted veg were a favourite and if the carrots were still a bit hard, sometimes I would give them a slight squish as I put them down to make them a little easier for him - particularly if he was "shouting" he was hungry.  Similarly I would make things such as porridge thicker, so they were easier for him to self feed

There are no prizes for ignoring your instincts and presenting baby with a selection of foods because they are what you think you should be giving in order to do  "pure" baby led weaning.

If a mum feels more confident initially giving something a rough mash with a fork before letting baby self feed, which builds confidence and develops into more sliced/whole foods as baby develops - this is surely better than mum think she doesn't want to do whole foods and so needs to purée and spoon herself?

Something else I haven't seen discussed much from the study is choking.

"93.5% of the baby-led group reported that their child had never experienced a choking incident (a serious concern for parents and practitioners"

It's a real shame they didn't also collect this figure for the purée weaned - as my first had a choking incident when she began more solid foods at around 8 months.

I think the researchers sum up well:

"A large controlled prospective study is now required, which examines weaning practices in tandem with the other key factors, including BMI, milk feeding practices (breast vs bottle/formula fed), socioeconomic status, locus of control and picky eating. In particular, a study is needed that includes a greater proportion of children who have been formula/bottle fed in order to compare the relative impacts of weaning method and milk feeding practices on food preferences and health outcomes in early childhood"

1.I. Blossfeld, A. Collins, M. Kiely, C. Delahunty, Texture preferences of 12-month-old infants and the role of early experiences, Food Quality and Preference, Volume 18, Issue 2, March 2007, Pages 396-404, ISSN 0950-3293, 10.1016/j.foodqual.2006.03.022.

Nine Good Reasons NOT To Use Baby Rice

1.  It's bland and tasteless, yet sweet - which may influence later food choices:  Try it - whilst the texture may be a new experience for baby, there's certainly no flavour enjoyment.  People mix things with it like apple or pear - why?  Why not just give the fruit?

Dr Greene in his paper "Why White Rice Cereal for Babies Must Go" states:

"Some taste preferences are hardwired. And different babies experience taste differently, in part because of hereditable differences in taste bud density.  But careful studies of human twins and of young animals suggest early exposures and social interactions outweigh genetics when it comes to food preferences.(11)"

"Indeed, up to 85 percent of the variability in eating patterns is due to environmental, not genetic factors.(12,13,14,15,16) 

We know in animals that the first bite of solid food can be particularly influential.(14) For human babies the moment of the first bite is laden with positive associations. The child has often been staring at the parents’ food choices, eager to learn what eating is all about. The child is the center of attention at an emotionally charged moment, often with a camera capturing the event.  The processed white rice flour is often mixed with breast milk or formula, giving it an even stronger positive association. 

Conversion of the white rice flour to glucose begins while the cereal is still in the baby’s mouth, lighting up the hard-wired preference for sweets (and the cereal is nearly 100% glucose by the time it is absorbed in the intestines). Given this “perfect storm” of extrinsic and intrinsic factors, both initially and throughout the formative months, it is easy to see how a preference for processed refined grain products could become firmly established, and later in life, challenging to change."

2.  It's outdated: back when guidelines suggested 3-4 month weaning (ie before the gut was closed) introducing what is considered to be a low allergen food that is easy to digest (due to the processing) was considered safest, otherwise food proteins can potentially provoke an allergic reaction.  If weaning commences when baby is ready ie they are reaching for food and putting it in their mouth, or at around 6 months as guidelines now suggest; the gut is closed and thus this is not an issue.  Furthermore, in small babies mixing with foods was to try and coax the baby to accept a flavour they may typically reject - a baby ready for solids is ready to enjoy full flavours too.  Those breastfed have already experienced a range of tastes via breastmilk, so why would they need a tasteless food?

3.  It's highly refined: and not in the elegant and cultured in appearance sense - but over processed like white bread which is stripped of nutrients by the processing   It is often then fortified with synthetic vitamins - some just with Thiamin (B1) whilst others are "enriched with 13 vitamins and minerals, like iron and zinc".  However these are less bioavailable to baby than those naturally occurring in foods.

4.  It can cause deficiencies:  consider that when a baby starts solids, the food is shown to displace total milk intake over a 24 hour period.  In a breastfed baby this means they are swapping calorific nutrient rich foods for a poor substitute.  Studies have also shown infants who received iron fortified foods (as some baby rice is) before 7 months, had significantly lower haemoglobin levels at one year than those who had not.  Excess iron also potentially causes harm to the body.

5.  It's high in sugar: Dr. Alan Greene, a paediatrician at Stanford University who started the campaign "white out" says:

"I have been studying nutrition very carefully for more than a decade now and one of the things that I have become convinced of is that white rice cereal can predispose to childhood obesity," said Greene. "In fact I think it is the tap root of the child obesity epidemic." 

Besides its touted digestion benefits, Greene said white rice cereal is also high in calories and made of processed white flour.

"The problem is that it is basically like feeding kids a spoonful of sugar," said Greene.

"The difference between white rice and brown rice is huge," said Greene. "White rice is basically 94 percent starch."

6.  It could be linked to diabetes: A 2010 study published in Arch Intern Med found Those who ate white rice 5 or more times a week had a 17% increased risk of type 2 diabetes compared with those who ate it less than once a month. Those who chose brown rice or another whole grain instead of white rice had up to a 36% reduced risk.

Another study entitled "Carbohydrate Nutrition, Insulin Resistance, and the Prevalence of the Metabolic Syndrome in the Framingham Offspring Cohort", found:

"Whole-grain intake, largely attributed to the cereal fiber, is inversely associated with HOMA-IR and a lower prevalence of the metabolic syndrome. Dietary glycemic index is positively associated with HOMA-IR and prevalence of the metabolic syndrome."

7.  It can contain Arsenic (yes really): From the NHS

"Rice fields are regularly flooded and arsenic is naturally present in the soil. Subsequently the substance is present at a relatively high level in rice. High levels of arsenic are reportedly linked to an increased risk of certain cancers. Researchers in this study tested levels in 17 samples of three unnamed brands of baby rice in British supermarkets and found that 35% of them contained high levels. The Food Standards Agency is reported as saying that there is no danger to infants, but that food regulations should be updated. There are currently EU and US legislations governing inorganic arsenic content allowable in water, but not in foods."

Brown rice is likely to contain more than white, so is not really a viable alternative.  There are currently no EU-wide regulations for arsenic levels in food after the European Food Safety Authority ruled that previous safety limits were inadequate.

8.  It can contain other toxic metals:  A study featured in the journal of Food Chemistry, found feeding infants twice a day on the shop-bought baby foods such as rice porridge can increase their exposure to arsenic by up to fifty times when compared to breast feeding alone.

Exposure to other toxic metals such as cadmium, which is known to cause neurological and kidney damage, increased by up to 150 times in some of the foods tested by Swedish scientists, while lead increased by up to eight times.

Researchers said:

"Alarmingly, these complementary foods may also introduce high amounts of toxic elements such as arsenic, cadmium, lead and uranium, mainly from their raw materials."

Read more 

9.  It's pointless:  Ultimately the question has to be - why use it?  Rather than why not.  There is no research or logic suggesting a baby needs baby rice, and given potential risks what are the benefits?