Nourishing a Growing Baby by Jen Albritton, CN

Jen Albritton spoke to our Continuing Education for Moms Seminar October 25, 2007  Jen, author of the Growing Wise Kids series,  helps establish a Foundation for Family Health incorporating traditional foods in the diet and dispelling nutritional myths, based on the writings of Weston A. Price (Nutrition and Physical Degeneration) and Sally Fallon (Nourishing Traditions).

Food is what nourishes the body and makes us healthy and strong – especially when one’s weight hovers around 20 lbs! Infant nutrition is critical for proper development, maximizing learning capacities, and disease prevention. At no other time in life is nutrition so important. But what is best? The research clearly points in the direction of Weston A. Price Foundation principles.

Breast or Bottle
Numerous studies support the benefits of breastfeeding. For example, breastfed babies tend to be more robust, intelligent, and free of allergies and other complaints like intestinal difficulties. Other studies have shown breastfed infants have a reduced rates of respiratory illnesses and ear infections., Some researchers believe breast-fed infants have greater academic potential than formula-fed infants, which is thought to be due to the fatty acid DHA found in mother’s milk and not in many U.S. formulas.

However, other studies show the opposite. In 2001, a study found breastfed children had more asthma than bottle-fed. A Swedish study found that breastfed infants were just as likely to develop childhood ear infections and childhood cancer as formula-fed babies.
 
So, what is the best for baby? It comes down to nutrition! Hands down, healthy breast milk is perfectly designed for a baby’s physical and mental development, but this is only true when a mother supplies her body with the right nutrients.

A typical modern diet is filled with products based on sugar, white flour, additives, and commercial fats and oils, which do not nourish or build. The proper nutrients are necessary to create breast milk that will provide all a growing baby needs. These include quality fats and proteins from foods such as grass-fed meats, butter, olive oil, cod liver oil and egg yolks as well as complex carbohydrate-rich foods like vegetables, whole grains, and legumes – think whole food, natural, and seasonal.

Bottom line, in a perfect world, with perfect nutrition, every woman would breastfeed. Unfortunately, we don’t live in a perfect world. What about low milk supply, an unwell mother, or adoption? Luckily it is possible to make a wholesome food baby formula (see Nourishing Traditions by Sally Fallon).

After (or With) the Breast or Bottle
Ideally, breastfeeding should be maintained for a year, with a goal of six months for working mothers. The first years of life require a full spectrum of nutrients, including fats, cholesterol, carbohydrates, vitamins, and minerals. Once breast milk is no longer the sole source of these nutrients, where should one go?

There are three concepts to keep in mind. First, make your little one a “whole foods baby”! Avoid processed and refined foods as much as possible, including many brands of baby food; they are usually devoid of nutrients and have added “undesirables.” It is always best to make your own baby food from organic, whole foods. (You can freeze it in one-serving sizes for later use). Better-quality, additive-free, prepared brands of baby food, like Earths Best, do exist, but it is still better to make your own baby food to be assured of the quality – plus making baby food puts mom on the right track for home food preparation for the years to come.

Second, go slowly and be observant; every baby will have an individual response to different foods. Introduce new foods one at a time and continue to feed that same food for at least four days to rule out the possibility of a negative reaction. Signs of intolerance include redness around the mouth; abdominal bloating, gas and distention; irritability, fussiness, over-activity and awaking throughout the night; constipation and diarrhea; frequent regurgitation of foods; nasal and/or chest congestion; red, chapped or inflamed eczema-like skin rash.

Finally, consider the tiny, still-developing digestive system of your infant. Babies have limited enzyme production, which is necessary for the digestion of foods. In fact, it takes up to 28 months, just around the time when molar teeth are fully developed, for the big-gun carbohydrate enzymes (namely amylase) to fully kick into gear. Foods like cereals, grains, and breads are very challenging for little ones to digest. Thus, these foods should be some of the last ones to be introduced. (One carbohydrate enzyme a baby’s small intestine does produce is lactase, for the digestion of lactose in milk.

Foods introduced too early can cause in digestive troubles and increase the likelihood of allergies (particularly to those foods introduced). The baby’s immature digestive system allows large particles of food to be absorbed. If these particles reach the bloodstream, the immune system mounts a response and is likely to cause an allergic reaction. Six months is the typical age when solids should be introduced,,, however, there are some exceptions. 

Babies do produce functional enzymes (pepsin and proteolytic enzymes) and digestive juices (hydrochloric acid in the stomach) at this younger stage work on proteins and fats. This makes perfect sense since the milk from a healthy mother has 50-60 percent of its energy as fat, which is critical for growth, energy, and development. In addition, the cholesterol in human milk supplies an infant with close to six times the amount most adults consume from food.

In some cultures, a new mother is encouraged to eat six to ten eggs a day and almost ten ounces of chicken and pork for at least a month after birth. This fat-rich diet ensures her breast milk will contain adequate healthy fats.

Thus, a baby's earliest solid foods should be animal foods since their digestive system, although immature, is better equipped to supply enzymes for digestion of fats and proteins rather than carbohydrates.  This explains why current research is pointing to meat as being a nourishing early weaning food.

Is Cereal the Best First Food?
Remember, the amount of breast milk and/or formula decreases when solid foods are introduced. This decrease may open the door for insufficiencies in a number of nutrients critical for baby’s normal growth and development. The nutrients that are often in short-supply when weaning begins include protein, zinc, iron, and B-vitamins. One food group that has these nutrients in ample balance is meat.

Unfortunately, cereal is the most often recommended early weaning food. A recent Swedish study suggests that when infants are given substantial amounts of cereal, it may lead to low concentrations of zinc and reduced calcium absorption.

In the US, Dr. Nancy Krebs headed up a large infant growth study that found breastfed infants who received pureed or strained meat as a primary weaning food beginning at four to five months grew at a slightly faster rate. Kreb’s study suggests that inadequate protein or zinc from common first foods may limit the growth of some breastfed infants during the weaning period. More importantly, both protein and zinc levels were consistently higher in the diets of the infants who received meat. Thus, the custom of providing large amounts of cereals and excluding meats before seven months of age may short-change the nutritional requirements of the infant. 

Meat is also an excellent source of iron. Heme iron (the form of iron found in meat) is better absorbed than iron from plant sources (non-heme). Additionally, the protein in meat helps the baby more easily absorb iron from other foods. Two recent studies, have examined iron status in breastfed infants who received meat earlier in the weaning period. While researchers found no measurable change in breastfed babies' iron stores when they receive an increased amount of meat, the levels of hemoglobin (iron containing cells) circulating in the bloodstream did increase. Meat also contains a greater amount of zinc, which means more is absorbed. These studies confirm the practice of traditional peoples, who gave meat – usually liver – as the first weaning food. Furthermore, the incidence of allergic reactions to meat is minimal and lower still when pureed varieties are used.

Don’t fear fats!
Pediatric clinicians have known for some time that children fed low-fat and low-cholesterol diets fail to grow properly. After all, a majority of mother’s milk is fat, much of it saturated. Children need high levels of fat throughout growth and development. Milk and animal fats give energy and also help children build muscle and bone.

 In addition, the animal fats provide vitamins A and D necessary for protein and mineral assimilation, normal growth and hormone production.
Choose a variety of foods so your child gets a range of fats, but emphasize stable saturated fats, found in butter, meat, and coconut oil and monounsaturated fats, found in avocados and olive oil.

Foods to Introduce
Egg yolks, rich in choline, cholesterol, and other brain-nourishing substances can be added to your baby’s diet as early as four months, as last as baby takes it easily. (If baby reacts poorly to egg yolk at that age, discontinue and try again one month later.) Cholesterol is vital for the insulation of the nerves in the brain and the entire central nervous system. It helps with fat digestion by increasing the formation of bile acids and is necessary for the production of many hormones. Since the brain is so dependent on cholesterol, it is especially vital during this time when brain growth is in hyper-speed.

Choline is another critical nutrient for brain development. The traditional practice of feeding egg yolks early is confirmed by current research. A study published in the June 2002 issue of the American Journal of Clinical Nutrition compared the nutritional effects of feeding weaning infants 6-12 months of age regular egg yolks, enriched egg yolks, and an otherwise normal diet. The researchers found that both breastfed and formula-fed infants who consumed the egg yolks had improved iron levels when compared with the infants who did not. In addition, those infants who got the egg yolks enriched with extra fatty acids had 30 percent to 40 percent greater DHA levels than those fed regular egg yolks. No significant effect on blood cholesterol levels was seen.

Thus, the best choice for baby is yolks from pasture-fed hens raised on flax meal, fish meal, or insects they will contain higher levels of DHA. Why just the yolk? The white is the portion that most often causes allergic reactions, so wait to give egg whites until after your child turns one.

Don’t neglect to put a pinch of salt on the egg yolk. While many books warn against giving salt to babies, salt is actually critical for digestion as well as for brain development Use unrefined salt to supply a variety of trace minerals.

Around four months is a good time to start offering cod liver oil, which is an excellent source of omega-3 fatty acids DHA and EPA (also important for brain development) as well as vitamins A and D. Start with a 1/4 teaspoon of high-vitamin cod liver oil or ? teaspoon regular dose cod liver oil, double that amount at 8 months.

 Use an eye dropper at first; later baby can take cod liver oil mixed with a little water or fresh orange juice.

If baby is very mature and seems hungry, he may be given mashed banana during this period. Ripe banana is a great food for babies because it contains amylase enzymes to digest carbohydrates.

At Six Months
Pureed meats can be given at six months (or even earlier if baby is very mature). Meats will help ensure adequate intake of iron, zinc, and protein with the decrease in breast milk and formula.

A variety of fruits can be introduced at this time. Avocado, melon, mangoes, and papaya can be mashed and given raw. High-pectin fruits such as peaches, apricots, apples, pears, cherries, and berries should be cooked to break down the pectin, which can be very irritating to the digestive tract.

As time goes by, move up in complexity with food and texture. At about six to eight months, vegetables can be introduced, one at a time so that any adverse reaction may be observed. Carrots, sweet potatoes, and beets are excellent first choices. All vegetables should be cooked (steamed preferably), mashed and mixed with a liberal amount of fat, such as butter or coconut oil, to provide nutrients to aid in digestion.

Early introduction to different tastes is always a good plan to prevent finickiness. Feed your little one a touch of buttermilk, yogurt, or kefir from time to time to familiarize them with the sour taste. Lacto-fermented roots, like sweet potato or taro, are another excellent food for babies to add at this time.

At Eight Months
Baby can now consumed a variety of foods including creamed vegetable soups, homemade stews, and dairy foods such as cottage cheese, mild harder raw cheese, cream, and custards. Hold off on grains until one year, with the possible exception of soaked and thoroughly cooked brown rice, which can be served earlier to babies who are very mature.

One Year
Grains, nuts, and seeds should be the last food given to babies. This food category has the most potential for causing digestive disturbances or allergies. Babies do not produce the needed enzymes to handle cereals, especially gluten-containing grains like wheat, before the age of one year. Even then, it is a common traditional practice to soak grains in water and a little yogurt or buttermilk for up to 24 hours. This process jump-starts the enzymatic activity in the food and begins breaking down some of the harder to digest components.

The easiest grains to digest are those without gluten, like brown rice. When grains are introduced, they should be soaked for at least 24 hours and cooked with plenty of water for a long time. This will make a slightly sour, very thin porridge that can be mixed with other foods.
After one year, babies can be given nut butters made with crispy nuts (recipe in Nourishing Traditions), cooked leafy green vegetables, raw salad vegetables, citrus fruits, and whole egg.

Just Say No
One important warning: do not give your child juice, which contains too much simple sugar and may ruin a child’s appetite for the more nourishing food choices. Soy foods, margarine, and shortening, and commercial dairy products (especially ultra-pasteurized) should also be avoided, as well as any products that are reduced-fat or low-fat.

By the way, baby fat is a good thing; babies need those extra folds for all the miraculous development their bodies are experiencing. Chubby babies grow up into slim, muscular adults.

Common sense prevails when looking at foods that best nourish infants. A breastfeeding mother naturally produces the needed nutrition when she consumes the necessary nutrients. The composition of healthy breast milk gives us a blueprint for an infants needs from there on out. Finally, be an example. Although you won’t be able to control what goes into your child’s mouth forever, you can set the example by your own excellent food choices and vibrant health.

Editor's Note:  The above information originally appeared in the Weston A. Price Journal and is reprinted by permission from the author.  This information is not intended to replace the advise of your doctor.  When making feeding decisions for your baby, be sure to consult with a physician.

Follow- up Comments:  After reading this article, Angela Plunkett, certified Nutrition Consultant felt compelled to reply witih a slightly different point of view regarding Breast Feeding.  I personally agree with Angela, that breast feeding should be encouraged well past age two in a baby where possible.  I personally breast fed all my children past the age of two including when I was a full-time working mom. Here is Angela's reply:

Dear Marilyn -
 
I am an RN, an International Board Certified Lactation Consultant, La leche league Leader, Mom, ....etc.
 
I believe that a lot of Jen's data isn't current. She refers to research studies that show that formula fed babies are healthier. Often these studies aren't set up in a way that their outcomes can be generalized to the entire population, like the researchers would like you to believe. The studies are often funded by formula or pharmaceutical companies too.  Therefore, they have no place in an article that should be encouraging breastfeeding.
 
The article suggests that babies should be breastfed for only one year and that babies who's moms work only get to breastfeed for 6 months. That's not very encouraging for breastfeeding and isn't data supported by the American Academy of Pediatrics or the World Health Organization. AAP says babies should be breastfed for at least 1 yr and for as long there after as mom and baby desires. The WHO suggests a minimum of 2 yrs. Many working mom find they can pump at work and provide all the breastmilk their baby needs for as long as they are willing to pump. I would say babies in daycare need to nurse even longer to get all the immune factors they can from Mom since they are subjected to an increase amount of germs away from mom
 
The article states that breastfeeding is only best for the baby if Mom has the right nutrients. This is a very discouraging statement to moms who may consider their diet not good enough to be able to breastfeed their new baby. Plus it's not entirely true. Consider moms in 3rd world nations. They have a far from nutritiously sound diet, yet their breastfed babies are much healthier than the formula fed babies, even when ready made formula is used. A lot of nutrients that are low in our diet, can be made extra by and are pulled from our body for the breastmilk. One such mineral is Calcium. If our diet is low in Calcium, Calcium will be pulled from our bones in order to make our breastmilk perfect for our baby. After weaning, that Calcium will be replaced in our bones at a higher rate than it was pulled, so our bones are actually stronger after lactation.
 
The article next suggests that if a mom has a low milk supply or is unwell, one should just start feeding the baby wholesome, nutritious food. I think perhaps we should consider helping the mom increase her milk supply because her milk is more nutritious than any whole foods we could feed the baby.
 
I do like the articles ideas on introducing solid foods slowly and making ones own baby food. I would like to see the research data supporting the need for cod liver oil for DHA that the baby should start taking at 4months. Breastmilk is full of DHA, that is why formula companies are trying to incorporate it into their formulas. But the research shows that after 18 months old, there is no difference between the babies who had DHA formula and those who had regular formula, but there is a big difference between them and the breastfed babies. The idea being that it needs to be naturally occuring DHA. If one is wanting to increase DHA in a breastfed baby's diet, it would be better to fortify the Mom's diet with DHA.
 
I don't mean to say the article is completely antiquated, but with my lactation background, all the old news on breastfeeding presented in this article hit a nerve with me. If we want to concentrate on feeding babies nurioushingly, we need to be providing the most current breastfeeding information available. Good breastfeeding research data can be found in professional journals such the Journal of Human Lactation, but for an article written for the lay population, I would suggest researching information on the www.LaLecheLeague.org website.
 
This got longer than I meant for it to. Thank you for considering my thoughts.
Angela Plunkett RN, IBCLC, LLLL
 
Ed Note:  Angela, thanks for giving us an encouraging look at breast feeding and its importance.

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