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Subject:
From:
Jennifer O'Quinn <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 19 Nov 2008 20:14:43 -0500
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I have to concur with Jamelle...I think many medical schools and nursing schools are still 
teaching the myth that "delaying" the introduction of solid foods results in oral aversion. 

That myth had its roots in case reports of infants who were not fed by mouth at all for an 
extended period of time (e.g. tube feeding) and thus had nothing by mouth whatever (not 
just solid foods but no breast or bottlefeeding either).

Some doctor, somewhere, at sometime extrapolated that if babies were not fed solids 
early they would become orally averse. Studies were never done to back up that wild 
assertion, but like a lot of "medicine" it is a "tradition" that still lingers even in the era of 
evidence-based medicine.

At least one study has been done which refutes the myth... the gist of the conclusion of 
the study was that since breastfed babies use their entire mouths and jaws to breastfeed 
they don't become orally averse to solid foods, and they are better prepared for chewing 
than bottlefed babies.

My recollection of the research I've come across that looks at the outcomes of delaying 
solids through the second year of life mention anemia, inadequate protein intake, and 
rickets without mentioning oral aversion.

Of course I haven't run across every piece of research so maybe it does happen at the 
extremes.

One thing to keep in mind is that the primary cause of infant malnutrition the world over 
is the too early, and too copious introduction of solid food which displaces breastmilk 
from the diet. Solid food no matter how nutritious by adult standards is not good nutrition 
for a baby because it is not nutrient dense enough.

During the first year of life no breastmilk should be displaced from the infants diet at all.
The idea behind introducing complementary foods after 6 months is to add it on top of the   
mothers milk supply at full lactation in case there is any short fall between what a 
mother is producing and what the infant needs. That is why mothers should "nurse first 
for the first year" to try to guard against displacing any breastmilk from the diet.

If a baby consumes a lot of solid foods before a year of age it means his mother's milk 
supply is low, and measures should be taken to correct the undersupply. If the 
undersupply cannot be corrected it would be better for the baby to be fed ABM rather 
than have a diet predominantly of solid food.

For some mothers/infant dyads there is no shortfall between what the infant needs and 
what the mother can produce throughout the first year and her baby will appear to be 
"orally averse" to solid foods. It is not that the mother waited too long to introduce solid 
food and the baby can't eat, it's that he doesn't need the solid food and prefers the taste 
of his mother's breastmilk to solid food.

After a baby triples his birth weight most mothers will find that their milk supply has 
been outpaced by the baby's growing protein requirements and the baby will suddenly 
become interested in eating solid foods whereas before he could take them or leave 
them.

Hope that helps,
Jennifer O'Quinn IBCLC

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