Nestle Answers: Introducing solids - maybe, kind of, sort of at 6 months

This is one of a series of posts that features Nestle’s answers to my questions that came out of the Nestle Family event. To access the other questions and answers, go to follow-up questions for Nestle and click on the questions you are interested in. Answers will be posted as they are received and analyzed.

Question

You indicate that “Nestle complementary foods are not marketed or presented as breast-milk substitutes” and that you support the May 2001 WHA Resolution that changed the recommended duration of exclusive breastfeeding from 4-6 months to 6 months. Given your support in this regard does this mean that you do not market any food/drink products at all for the use by infants under 6 months of age in any country and that none of your labels for cereal or baby food indicates that it can be used starting at 4 months?

Nestle's Answer

Nestlé fully supports the May 2001 WHA Resolution 54.2 which changed the recommended duration of exclusive breastfeeding from 4 – 6 month to 6 months, thereafter introducing complementary foods while recommending continued breast feeding for as long as possible. Thus we implement this resolution in the same way as we implement the WHO Code and we have completed label changes on complementary foods to follow the 6-months recommendation. In addition, in developing countries Nestlé applies the WHO Code not only to starter formula (0-6 months of age) but also to follow-on formula (6-12 months). It is the only major manufacturer to do so.

My Response

I asked about labels. I didn't ask about websites. While I don't have time tonight to run out to all of our local stores to check the labels on the products, a few clicks of the mouse demonstrated that if Nestle does "fully supports the May 2001 WHA Resolution 54.2 which changed the recommended duration of exclusive breastfeeding from 4 – 6 month to 6 months", it obviously forgot to tell its Web staff.  I went to three Nestle baby websites and found suspicious content and recommendations on all three.

Gerber USA

I figured I would start my journey in the United States. I went to Gerber's (owned by Nestle) website to get information on its baby food products and on introducing solids. While all of the labels in the product pictures are too small to be able to see what is marked on them, there was some interesting information on introducing solids.

In response to the question "When should I start my baby on solid foods", Nestle doesn't say to wait until at least six months. Instead, it says "around the middle of your baby's first year". Around the middle could mean a bit before six months or a bit after six months. Depending on how the individual person interprets "around" that could mean between 4 months and 8 months.

Nestle mentions the baby should reach the Supported Sitter developmental stage. There is no information provided on when that might be. Also other leading sources on when you should introduce solids indicate that the baby should be able to sit well without support (i.e. sits independently) .

Instead of clearly and unequivocally saying that the baby must be at least 6 months old and have met certain developmental milestones, Nestle has chosen to just eliminate the information on the age at which solids should be introduced.

Nestle Canada

This one was even more overt. Nestle Canada has age-based pages that indicate what the baby should be doing and eating at different stages. On the page for 4 to 5 months old, Nestle is heavily pushing solids using both visuals (the baby being spoon fed and the box of cereal) and text (the links on introducing cereal and introducing solids).

When you actually click on the links on introducing cereal and introducing solids, some of those pages tell you that you should wait until six months. But if that is the case, what on earth is this information doing on the 4 to 5 months page to begin with? And shouldn't they move them from the 4 to 5 month section (where it is linked from and as appears in the breadcrumb) to the 6 to 7 month section?

Also, on its product page for baby cereals Nestle Canada conveniently doesn't mention an age to start its Stage 1 cereals, but its Stage 2 cereals are listed as being for 6 months and up. Wouldn't Stage 1 logically come before Stage 2 and therefore be before six months?

Nestle Germany

There are 47 products listed in the Stage 1 (Stufe 1) category that is listed as 4 months and up. Those products, a few of which can be seen in the screen capture from the 4 months and up product page, include

• vegetables


• fruit


• meals of mixed vegetables and meats (including spaghetti bolognese)


• cereals


• juices and teas

These products include ingredients like berries, honey and tomatoes that are not supposed to be introduced until much later due to being allergens, botulism risk, etc. The labels on the products listed on the website clearly have the same 4 months and up label that is listed on the website itself.

The AAP recommendation

On page 54 of IBFAN's monitoring report, or the second page of the section on Nestle's Code violations, IBFAN provides the following interesting information [emphasis mine]:

In April 2003 the company [Nestle] announced that it had "completed label changes on complementary foods to follow the six-month recommendation". During their general monitoring, IBFAN observers have checked the age recommendations of all companies and provide evidence that the change promised by Nestlé finally occurred in many countries but not in all. See Section 2 for continuing violations.

It is hoped that Nestlé will abandon its double standard and apply the change in all countries, reflecting the universality of the Code and subsequent Resolutions. Other companies would have to follow suit if Nestlé continues a decisive leadership role.

However, at the end of 2003, Nestlé gave a large grant to the American Academy of Pediatrics (AAP) to pay for the cost of sending the AAP 2004 Pediatric Nutrition Handbook for free to over 50,000 doctors. The Handbook reverses AAP's 2000 endorsement of "six months exclusive breastfeeding" by going back to the old “4 to 6 months.” The Handbook mentions “4 to 6 months” several times but has only one footnote to say that the AAP Section on Breastfeeding favours the 6-month recommendation. Double standards once again?

I'll let you draw your own conclusions.

Supportive on the surface only?

Perhaps Nestle has now updated all of its product labels in store to say six months plus (but I can't be sure of that and highly doubt it). But even if they have, these other actions regarding Web content, handbooks, and other materials suggest that Nestle is using other ways of continuing to perpetuate the myth that solids should be introduced before six months of age. In fact, like the boycott that so few Americans are aware of, you will probably find that few Americans (Germans, Canadians, etc.) are aware of the updated recommendation and Nestle would like to keep it that way.

Comments

[Follow-up questions for Nestle]

[...] 11. You indicate that “Nestle complementary foods are not marketed or presented as breast-milk substitutes” and that you support the May 2001 WHA Resolution that changed the recommended duration of exclusive breastfeeding from 4-6 months to 6 months. Given your support in this regard does this mean that you do not market any food/drink products at all for the use by infants under 6 months of age in any country and that none of your labels for cereal or baby food indicates that it can be used starting at 4 months? ANSWER HERE [...]

[Missy @ Marketing Mama]

Wow. This is crazy.

Six months is six months is six months.

I really, really, really hope that someone, ANYONE at Nestle, with an ethical bone in their body, is taking notes at all of your responses and making CHANGES if there are discrepencies that shouldn't be there.

But I think that's too polyannish of me to wish for that.

[Esther]

This is a question I've recently looked into because my son just turned five months old this week, and we decided to begin introducing solids because of his keen interest in food & the fact that he has hit the various developmental milestones mentioned above.

On almost every baby site discussing the issue of introducing solids that I've read (and I've been reading them a lot lately), it has a 4-6 or 4-5 month section outlining the kinds of starter foods such as rice cereal that one could use. They virtually all have disclaimers saying that there are recommendations to wait until 6 months, and yet, many parents (myself included) opt to introduce a little earlier. I spoke to our granola-loving doctor and she told me, "I'd say it's best if you wait til 6 months, but it's okay if you start slowly introducing solids over the next few weeks". So in a 24hr period, he is now getting one feeding of solids and I nurse him the other 6 or so times.

Again, I'll just say that almost everywhere I read about this issue (whether it's owned by Nestle or not) mentions a 4-6 month period, with some kind of disclaimer attached.

[slee]

Wow. Just wow. I am introducing a spoon to my 5 month old, sometimes even a wet spoon, so he can get used to the idea of a spoon and what is done with it. He enjoys playing at eating, but still is mr. Tonguethrustboy, so I know he isn't ready, despite all the solids promoters out there. Amazingly, mr. Notreadypants is 5 months old. Hmmmmm, almost sounds like these 6 months suggesting types know what they're talking about. *eyeroll*

[phdinparenting]

@Esther: It sounds like you have made up your mind, but if you are still reading on the issue, you might want to take a look at this:

http://www.kellymom.com/nutrition/solids/solids-when.html

It is true that a lot of places still say 4 to 6 months or 4 to 5 months, but that is because they haven't updated to the most recent recommendations from the leading health authorities in the world.

[MZ]

I waited until 6 months to introduce solids to my son. He knew right away what the spoon was for...tried to grab it out of my hand and shove it into his mouth, hahahaha. I am fairly certain that the rice cereal box (Gerber) said 4-6 months on it. I don't have the box anymore though.

[Mike Brady]

I believe the reason that Nestlé was so resistant to changing the age of use marketing for its complementary foods was that if you are introducing foods at 4 months, these are going to be soft foods and some parents would prefer to buy these ready prepared. If you wait until the baby is ready for complementary foods then it can eat solid foods, and it is far easier to use food prepared for the whole family (taking care over salt). So those 2 months were important for Nestlé to hook parents into buying processed baby foods, which is why it took 9 years of campaigning to force it to change its policy.

Personally, I like the concept of baby-led weaning and you might like to search for information from the many support groups for this approach.

[Michelle @ doudoubebe.com]

I think the truly most telling phrase in Nestle Family's response is "we implement this resolution in the same way as we implement the WHO Code" - ah, so not at all except where legislation with enforcement provisions requires it.

[Charlotte Young]

I fully support the Nestle boycott, and have read a LOT of eye opening articles. However this statement:

QUOTE Nestle doesn’t say to wait until at least six months. Instead, it says “around the middle of your baby’s first year“.

Is a La Leche League guideline - they have long said around the middle of the first year. I think this allows for the difference between infants as in my personal experience some are ready at 5 months, some 8 or 9! (just like some sit and crawl pre 6 mths and some don't sit unaided till 7/8 mths!) As an advocate of baby led introduction of solids, I don't personally agree with 6 months AND various milestones such as sitting unaided - as despite extensive reading I have been unable to find sufficient evidence to support this. What the evidence (used to determine a 6mth guideline) does indicate, is that external and internal systems develop in tandem; if an infant can pick up the food, chew and swallow - they are ready for solids. This will be somewhere around the middle of the first year.

Given some of the "starting solids" pages I have seen on other AM sites, I think this is actually quite unoffensive....

[@japraker]

Did someone say it's the 30th anniversary of the WHO Code decision next week? Wouldn't look good to have lots of boycotting going on... but if they keep it relatively discreet, only appearing in specific blogs (off Twitter, off Facebook, out of the mainstream press) they might succeed in appearing "compliant".

Note that their nestle.com homepage has just changed to include a 10-year endorsement of health education in Brazil (which enables them to introduce "educational material" into schools) and the cocoa initiatives they use.

There is a multitude of sites (great for clarity of information), one of which is www.babymilk.nestle.com (from which it is currently impossible to access the page "Nestle and infant formula")

"Trust" is an essential element of internet communication. Anyone else noticed the disclaimer on the www.nestlebaby.com site ? :
"By clicking on the "I understand" link below, you confirm your understanding that Nestlé is supplying this information about formulas for informational or educational purposes."

I'm seriously impressed by your answers, phdinparenting Annie !

[toyfoto]

I agree completely with what 'Mike Brady' said. Nestle knows its window for sales of prepared baby food, especially the starter products, is smaller when it's introduced at the recommended time.

My daughter nursed exclusively for six months and then we just pureed produce and meats in a food processor. By the time she was a year she was refusing pureed food and wanting to feed herself from the table. My son nursed almost exclusively for a year. He just wasn't interested in food. He bypassed pureed all together when he started eating solids.

[OHmommy]

I remember reading many parenting websites when my first born was an infant. I read them and prepared a list of questions for my pediatrician. Nestle or any website should not take the place of a doctor.

They have to be vague on an American website because in America it's much easier to take things to court. Lawsuits are everywhere.

Germany and most of Europe can not be compared to the US. Mothers in those countries do start introducing solids much earlier than here. I was born in Poland and took my children there last summer. I had a 1yr old and needed to purchase some jarred food at points. Many of the labels read 4 months. In ethnic grocery stores in Chicago, baby cereal (not Nestle) is labeled as 4 months. There are soups on the market in Europe with ingredients mst Americans would not serve a one year old that are marketed toward 6 months old. It's just different and you can not compare the marketing of baby food to that of the US. In my opinion, as a person who has traveled extensively to Europe.

[Naomi]

We did entirely baby led solids with our second child and did not buy a single pre-prepared 'baby' meal. Let me tell you that was the way to go, after 6mo, and without adding to the coffers of a inconsistent and bumbling company like Nestle. I know it is exciting and feels special to rush solids, especially with your first child, but after you get over the novelty of it- it is not a big deal to wait until later......see the Kellymom link she posted already.

[Rebecca]

While I agree that Nestle, and all baby food companies, should label their products in accordance with the ages recommended by leading health authorities, I feel that age recommendations in general are arbitrary. Babies are so individual - some are ready for solids before 6 months, some not until much later (mine wasn't ready until around 7 months). I don't believe that something "magical" happens at 6 months that suddenly makes a baby ready for food and assuming so can be dangerous. So, my tendancy is to look to the baby for signs of readiness (as with baby led solids/weaning), while keeping the recommendations of the health authorities in mind, as the reasons for exclusive breastfeeding for 6 months and delaying solids are compelling. Also, there can be reasons for starting solids early (though usually as a last resort), but I won't get into that, as this is already off topic.

Anyway, it's incredibly frustrating that Nestle continues to offer vague answers to your questions - apparently "fully support" does not mean fully implement in the world of Nestle double-speak. I think thet're being deliberately ambiguous. Why is it so difficult for them to update their marketing information and stop misleading consumers? I'm probably being incredibly naive here, but are their unethical marketing practices really that profitable?

[Rebecca]

PS - your responses are awesome! Are you sending them to Nestle?

[phdinparenting]

@Charlotte Young:

I agree that there are worse sites out there. My point was that they claim to fully support the recommendation of exclusive breastfeeding until at least 6 months, but they don't really do so.

With regards to LLL, its http://www.llli.org/FAQ/solids.html" rel="nofollow">recommendation on when to start solids is:

You will know that he is really ready to start solids when:

* he is about six months old
* he can sit up without any support
* he continues to be hungry despite more frequent nursing which is unrelated to illness or teething
* he has lost the tongue-thrusting reflex and does not push solids out of his mouth
* he can pick up things with his finger and thumb (pincer grasp)

I would prefer that the say "at least six months old" instead of "about six months old". At least their other information is good in terms of sitting unsupported and so on.

Interestingly though, LLL also differs with Nestle in another area. It says that if a working mom is having trouble pumping enough at work, that early introduction of solids (e.g. mashed banana) is preferable to giving formula. See: http://www.llli.org/llleaderweb/LV/LVDec99Jan00p130.html" rel="nofollow">Introducing Complementary Foods.

Each parent obviously has to make their own decision based on their own circumstances. I think if the mom is producing enough milk (as most do), there is no need to even consider introducing solids before 6 months. After the 6 month mark, the parents can check for readiness. That said, if Nestle says it full supports the recommendation of exclusive breastfeeding for 6 months, I think it should update its website and its product labels.

[@Artemnesia]

Oh I get it. This statement:

"Thus we implement this resolution in the same way as we implement the WHO Code and we have completed label changes on complementary foods to follow the 6-months recommendation."

means that they might start following the Code in a particular country when they are forced to by law. And possibly they have changed a few labels for the countries that have legislated the Code and placed penalties for violation. So basically the answer is that they are going to continue violating the Code in every way they can, and in every place they can, for as long as they can.

Unfortunately many pediatricians, even, don't have the updated information. I had a pointed conversation with mine when he brought up solids at our 4 month well-baby visit. You'd think they would practice evidence-based medicine especially when it comes to babies, but sadly that's not always the case.

What's the problem with solids before 6 months? First and foremost they're unnecessary. There's no benefit. There is, on the other hand, the potential to do harm. Under 6 months of age most babies still have an open gut, meaning macromolecules (like proteins) can get into their bloodstream and provoke a reaction. This is one of the main reasons that formula is undesireable. A single exposure to anything other than breastmilk when a baby's intestines are open bumps them into a higher risk category for not-to-be-messed-with things like type-1 diabetes.

Obviously they are loathe to lose two months of potential profit. After all the products are used for a short period of time. Anything that can be done to lengthen that is good for the company. But, it's not good for babies. I really wish they cared about that. Baby-led solids are a great approach but there are uses for purees too. Not all children are ready to handle the types of food and textures available from family dinners. The "old school" way before food processors was premastication. There's nothing inherently wrong with giving purees to an older baby. But there is something very wrong with exaggerating the amounts the baby will eat, and the timing of starting the complementary foods, and what this Q & A has taught me is that Nestle knows that but doesn't really care.

[phdinparenting]

@Mike Brady:

I agree completely.

We did mostly baby-led weaning with my daughter and hardly bought any prepared baby foods for her at all. My son, however, has always had texture issues and needed "baby food", either store-bought or home-made.

[phdinparenting]

@Rebecca: No, nothing magical happens at 6 months, which is why you have to watch for readiness signs after the 6 month mark has passed. But there are risks with introducing solids before six months.

[Ruby in Montreal]

Just popping in to say that I've selected your blog as one of a group I've recently discovered, which deserve special mention.

You can pick up your One Lovely Blog Award by going to this post http://www.schoolsout.blogalogues.com/announcements-events/lovely-blog-award" rel="nofollow">http://www.schoolsout.blogalogues.com/announcements-events/lovely-blog-award.

Congratulations!
Ruby

[Candace]

While I understand, intellectually, how this sabotages breastfeeding and contributes to an anti-breastfeeding culture, I find it as hard to work-up outrage about this issue.

However, it is a source of personal frustration for me. I cannot count the number of women who have told me their doctors recommended starting solids at 4 months' or even younger because the baby is so big or it will help the baby sleep. As a mama whose babies were quite large at that age, I can tell you it is rubbish.

And I disagree with @OHMommy that they are vague in the US for legal reasons. If it was about legal action, they could still write "at least 6 mos and able to..." and be just as covered.

But still...compared with slave labor and pushing formula in the third world...I'm just more inclined in the west to be vaguely annoyed at packaging but then say let the consumer do his or her research.

[@Artemnesia]

Fair enough, I'll agree that changing the baby puree/cereal labeling may not be the most pressing issue at hand. And actually I think I used to have sort of the same opinion about the 4 versus 6 month standard.

But, the thing is, it actually does matter to the health of babies-- more than would first appear. The mentality sometimes seems to be that they should be started as soon as possible. That's why you get mothers of 5 month olds saying, "My child seems ready in every way so why should I wait?" Well, lots of reasons. I kind of went into the whole open-gut issue in my other post but that's not the only reason. Early introduction of solids is associated with early weaning. Sometimes mothers start so soon with solids, and proceed so quickly, that they accidentally wean their babies before their time. Going fast with solids actually has serious consequences nutritionally-speaking since breastmilk contains more fat, calories, and nutrients than virtually any solid food. You can actually stunt a baby's growth by feeding them too many solids. I also tend to think of studies like this one, that found early solids (before 6 months) more than quadruples the risk of pneumonia, and doubles the risk of ear infection.

Full breastfeeding duration and associated decrease in respiratory tract infection in US children.
http://www.ncbi.nlm.nih.gov/pubmed/16452362

There are other studies like that one for some other illnesses, etc. The greatest immune protection a baby gets is when exclusively breastfed. Food with iron interfere with an element in breastmilk called lactoferrin, which kills bacteria and viruses, and once solids or formula are added the baby's gut flora changes for the worse.

It's all well and good to leave it up to people to do their own research, but the reality is that not everyone will. If people see the age "4 months" on a whole bunch of infant food why wouldn't they assume this is the appropriate time to start? It is necessary to protect babies worldwide by setting standards on the marketing of complementary foods.

I hope this helps clarify! :)

[Candace]

I do understand all this.

This mentality also extends to car seats, where it is even more of an important safety issue (in my opinion) and where manufacturers are whole-heartedly complying with expert recommendations. People are asking "How soon can I...?" Instead of "For how long can I continue...[this safer option]."

You are right that many people don't do their own research but again, I tend to be libertarian about things. I willing to make exceptions for things like slavery.

My point is simply that, yeah, the message should be six months...but I just find it hard to get as worked up over it.

[Rebecca]

The Newman Breastfeeding Clinic and Institute also indicates that low milk supply might be a reason to start solids early, but only as a last resort and as a way to avoid or reduce formula intake. They also suggest a couple of other instances in which solids might be started earlier (though I'm sure in these instances one should seek input from the baby's doctor). However, they are also flexible on the timing, saying "around 6 months". Info can be found here: http://www.nbci.ca/index.php?option=com_content&view=article&id=49:starting-solid-foods&catid=5:information&Itemid=17 and http://www.nbci.ca/index.php?option=com_content&view=article&id=28:other-foods-a-breastfeeding&catid=5:information&Itemid=17
Be warned - these recommendations differ significantly from the more standard recommendations regarding starting solids, though they do make sense to me.

[Charlotte Young]

QUOTE - phdinparenting October 10, 2009 at 10:20 am
@Rebecca: No, nothing magical happens at 6 months, which is why you have to watch for readiness signs after the 6 month mark has passed. But there are risks with introducing solids before six months. END QUOTE

But if you pick apart the research - whilst I can totally see why 6mths was picked as a guideline, the evidence after 5mths is very patchy. This in my personal opinion is perhaps due to some being ready and some not (ie caregivers took say early waking as a sign, rather than the whole picture)

QUOTE What’s the problem with solids before 6 months? First and foremost they’re unnecessary. There’s no benefit. There is, on the other hand, the potential to do harm. Under 6 months of age most babies still have an open gut, meaning macromolecules (like proteins) can get into their bloodstream and provoke a reaction. END QUOTE

But here is where I get confused, because several studies used in the 6mth guideline review, also showed external and internal systems very likely develop in tandem. Therefore once a baby can get food to mouth, chew, move to back of mouth and swallow (which is not a particularly easy thing to do and impossible with a strong tongue thrust) the gut is ready to accept solids (and thus closed)

When introducing food via mush (or jars!) an infant goes from not eating to eating in minutes. Waiting until 6mths ensures the infant is ready - because there is no physical requirement to be so to accept mush (beyond loss of strong tongue thrust) it is solely reliant on parental judgment. Some on the ball parents, might get this right. Some not as educated in infant development might get it wrong. Saying 6 mths is a way of trying to ensure readiness - and if not the baby being 2/3 mths older is more able to express this (they can push food away as an active recipient compared to the 12 weeker reclined in a bouncer) So I totally agree with the 6 mth guideline. But I think the key is readiness, not a magical date.

However - babies introduced to solids via baby led weaning, have a very different developmental pattern in terms of going from not eating to eating. This happens not in a moment, but over a period of days - even weeks. If you introduce a child to solids from the time they can actively sit well supported at the table and pick things up (around 4/5 mths depending upon the infant) - firstly they squish, drop, pick up, lick, bash it off the table etc and really explore food on a sensorial level. They progress to sucking and gnawing bits off - which again are often spat out at first (and then often sloshed around the table when squishy!) Nappies don't change from breastfed to solid type overnight either, gradually a transition happens. Somewhere (often around) around 6mths, food starts to go down and without regualation or risk of over eating solids - they naturally increase solids intake at their own pace.

I think switching off instincts for a guideline is almost as bad as blindly following a website.

As to whether there is no benefit - I also only from personal experience feel that depends. My second child was born at 34 weeks, excl bf from birth and wasn't given any sort of supplements from the hospital (our unit doesn't at this stage) Just over 5 mths he could not sit unaided (nowhere close) but had a straight back when supported (which when it comes to sitting is what I feel is the important thing to ensure straight passage) he would become frantic if anywhere near you when eating meat. He would literally shove his face in the plate and lunge madly at the fork. If you took it away he would sob hysterically and no amount of playing with a spoon and bowl would cut it! He wasn't interested in anything but meat and suckned and gnawed on it no end. At 3yrs 2mths he's still nursing, so no early weaning here - but I think that again is linked with mush led weaning, not baby led.

I would personally like to see more research into those infants who had solids pre 6mths - but on a baby led weaning basis where they had selected and helped themselves rather than spoon fed when the parents decided.

[Charlotte Young]

Also meant to add - it also makes no sense to me on a biological developmental level that an infant would posess the skills to pick food up and swallow it, should their internal system not be ready to digest it. It's illogical.

[@Artemnesia]

The pincer grasp appears at around 9 months of age. Or some say a range of between 7 and 11 months. If you're waiting for the baby to get the food to their mouth and swallow it on purpose then that's virtually never going to be happening at 4 or even 5 months, probably not even at 6 in most cases. And by that time the gut is no longer totally open. So, that would seem to argue that waiting for the pincer grasp/hand to mouth ability is the most natural course and probably correct.

However, if you look to more "natural" cultures, or history, infant feeding often involves chewing up family foods and giving that to the baby as a first solid (it's called premastication.) There's been some interesting published work lately about that actually. Waiting for the baby to feed herself may not actually be the most natural course...but I won't go to far into that since it's pretty OT! :)

[Charlotte Young]

Infants don't need a pincer grasp to pick up food. They do for smaller things like peas and sweetcorn (which would also tie in with by the time they can manage things like that, they have also refined the chew/swallow action) They only need a palmer grasp for bigger things - which appears much earlier following the reflex. I think it's a combination of not only hand to mouth - but also mouth to gut (the first can happen without the latter). The Baby Led Weaning DVD and book by Gill Rapley shows it in action :)

I saw some research a while back re premastication - which mainly involved meat, with the theory it would likely have been a combination of foods the infant picked up themselves when sat on someones knee/on a hip etc and chewed meats. Haven't spotted anything recently, might have to have a dig about.

[Charlotte Young]

or even "palmar grasp" just realised my typo and don't think I can edit!

[Christina]

As a Registered Dietitian, I really appreciate your asking this question and sharing the information. I talk to parents every day about feeding their babies, and I am appalled at how many tell me, "but my doctor said to start solids at 4 months!". I hear it every day. I am not legally allowed to contradict their doctor (it's sometimes a fine line between providing nutritional counseling and "dispensing medical advice") but I can tell them what the research says about the risks. Even my son's (former!) pediatrician was pressing me to start giving him rice cereal, starting about a week before he turned 4 months. Thanks for challenging Nestle on this and so many other important issues and sharing this information with us.

[mimi]

Introducing solids.

My girl was born just shy of 9 pounds, and poked her head out the top of the growth charts from then forward. She was exclusively breastfed until a couple of weeks past 6 months. She was, from the minute she was born, humongous and hungry. But the boobs kept her healthy, happy, and growing.

She was, I have to tell you, colicky and a terrible sleeper. Many, many, many people tried to get me to 'fill her up' with solids from about three months on. My friend who had a similar rotten infant (I say with love) gave in and introduced solids.

I must report: both kids are still rotten sleepers, three years later. "Filling kids up" with cereal at 3mos is a tactic of desperation by the sleep-deprived. If kids seem to sleep better once solids are introduced, I figure it's mostly because they generally get less colicky after 3-4 months anyways, and steadily become better / more regular sleepers over that first year.

I know this doesn't address the substance of the Nestlé problem here, but I wanted to take up that really prevalent reason people introduce solids when they know it's not recommended.

[Andrea]

Interesting. I haven't looked in a bit (my youngest is almost 2) but last I checked, the WHO and CPS sites said 6 months for sure, no disclaimer.

[phdinparenting]

@OHmommy: Unfortunately, things sometimes take time to trickle down to doctors. I tend to follow websites of organizations that are taking the lead in researching these issues when making decisions for my family. I have a friend who is a family doctor and she says that if the WHO changes a policy, that may get adopted the next year by the Canadian Pediatric Society, and then be part of the updated guidance sent to doctors the following year. When my son was an infant, the recommendation globally had already changed to 6 months, but that hadn't trickled down to my doctor. By the time my daughter (2.5 years younger) was an infant, my doctor did have the correct information.

[Andrea]

When my first was born, even the CPS was saying 4-6 months, as was our ped, and while we knew the WHO was recommending 6 months, we split the difference and started DS at 5 months old, he loved it and never looked back. A month later, the CPS formally announced it was now recommending waiting until 6 months. Go figure.

With our second, we knew more and fully intended to wait the full 6 months (despite comments, again, about how could bm be enough for such a big boy -- nevermind how wonderfully he'd been developing on bm alone until that point!) At 4 months he started showing many of the same signs as his brother had, reaching for food, interested in what we were eating, pretending to "chew". I wondered how I would hold off for 2 more months. But I did, and gave him banana "around" 6 months (maybe 2 days ahead). And know what? He really couldn't care less, and ate very little for 2 months, and in the end ate almost no cereal and very little pureed food. Imagine the frustration I would have caused us both if I'd gone only by "signs" of readiness at 4 months old? Not to mention any potential issues early introduction could have caused. I know from experience new parents get excited about this stuff, but really, there is no rush, and besides the (possible) iron issue, there is nothing in any processed baby cereal that is better than what baby is getting in bm already. And in the case of many cereals, there are a whole lot of things baby doesn't need.

Fortunately, early introduction in the case of my first did not interfere with bf (and as others have mentioned, in neither case did solids "help" my boys sleep either! ;))

I agree this issue is small in comparison to the others, but Nestle's double talk still says a lot about the company as a whole.

[Kayris]

I get the reason behind this post, but I wanted to say this: I don't know a single mother who would walk into a store, see a baby item labeled "4 to 6 months" and make the decision to start solids based solely on that. All the moms I know have more sense than that.

With my first, I intended to wait until 6 months, because there are a few food allergies in the family. But by 4 months, he could sit unassisted, could palm smallish objects, and was very interested when we ate. When he snatched a breadstick off my plate at a restaurant and tried to stuff it in his mouth, our pediatrician suggested we try cereal and we went for it. He had no tongue thrust at that point either. We did rice cereal until the box was gone, switched to oatmeal, and did that until 5 months, at which point we introduced a couple of benign fruits, in addition to breastfeeding.

With my second, I also intended to wait until 6 months, especially since she was meeting her motor milestones much later than her brother. But at 5 1/2 months, she suddenly went from sleeping 8-10 hours at night to waking up 5 times a night and I was exhausted, crabby, unable to function. So we started cereal and lo and behold, she went back to sleeping through the night.

What I'm saying is that every baby is different, and that we made the decision to start solids before 6 months based on our individual babies AND advice from our pediatrician, not from some random website or notes on a box of infant food. I've got a pretty good brain in my head, and I can make the distinction between what my babies were telling me they needed and what advertising trying to sell a product is saying.

[Barbara]

Ha, Michelle, this is exactly what I thought when I read their reply!

[MZ]

Interesting! I thought I had read on LLL's website that they as an organization oppose introducing solids until 12 months. I fully intended to do baby-led weaning but there was no way I was going to wait that long to introduce solids so I decided not to go to their meetings for fear I'd be ostracized.

My son's pediatrician, who is very pro-BFing, had told us not to give solids more than 1-2x a day for the first few months (after 6 months) because breast milk or formula should remain the staple of the diet.

[MZ]

Our pediatrician was the only one of any of my friends' who knew and recommended the WHO guideline. My other friends were instructed to start solids at 4 months and one of their pediatricians said that by 4 months the baby has received all the nutrients he's going to from breastmilk so she might as well go ahead and wean her son, so she did!

[Haley-O (Cheaty)]

Every major brand out there should be scrutinized like this. Marketing these days is so corrupt it's scary. This is such a great demonstration of critical thinking all round. Companies like this are certainly insidious. Thanks for continuing to bring awareness.

[phdinparenting]

One of my twitter followers (@AndreiaRFPS) just sent me this link to the Portuguese site that says you can start fruits and veggies at 4 months too:

http://www.nestlebaby.com/pt/baby_nutrition/home_nutrition_step1.htm

[Aurelia]

I'm just going to say that for those of you who had kids waking up and colicky and therefore thought it was a great idea to start solids, goddamn I wish more doctors would just give out infant dose Zantac (ranitidine) at birth to any kid who even looks like they have colic.....

All my kids had reflux, (it is the actual medical cause of colic) and for the first two we went through hell and everyone on earth tried to get me to give them formula, even though there was zero evidence that bottles of formula help colic. Then it was give them solids early, blah blah, and I succumbed with our first at four months, and it didn't do shit. Made him worse some days. For my second he had terrible reflux/colic but I said to hell with the extra work of spooning all that slop in his mouth and just gave him the boob for well over 7 months and then solid food. In thirteen years of parenting I've never seen one kid who had less colic or slept better because they ate solid food earlier. Not one.

And now there are idiots who say that if a kid has reflux they should go off of breastfeeding and take extra thick formula and cereal. Even though it never works either, and damages the breastfeeding relationship permanently! (This is why Jack Newman is not enthused about the reflux diagnosis, although I've tried arguing that meds plus breastfeeding works fine, so why not?)

This time, with my third I was prepared. He breastfed no problem, but was in a lot of pain. So we gave him Zantac, and the colic was gone and life was heaven and everyone shut up with their crappy advice about feeding him solids early. He didn't get solids until much later, no cereal, actually started him on ground up veggies and ground beef tenderloin and a few other verboten foods. No allergies, no problems, no issues. Huge, healthy, happy. Breastfed plus medication was a miracle.

I wish to god someone like the college of physicians and surgeons would send out orders to doctors telling them the proper guidelines for infant feeding, but also for diagnosis and treatment of colic and reflux. I'm so tired of hearing about incorrect medical crap coming from Doctors! Especially when there are so many mothers so completely desperate for sleep and help.

[Charlotte Young]

QUOTE 15 MZ October 10, 2009 at 10:40 pm Interesting! I thought I had read on LLL’s website that they as an organization oppose introducing solids until 12 months. END QUOTE

La Leche League Concepts
La Leche League philosophy is based on 10 concepts:

For the healthy, full-term baby breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth

[Charlotte Young]

In the UK, even the Department of Health Guidelines are contradictory:

These are three paragraphs which sit back to back in the publication:

QUOTE
Until six months, your baby needs only breastmilk or infant formula milk. Around six months your baby needs more than milk alone and is able to eat solid foods in addition to breast or formula milk.

Health experts agree that around six months is the best age for introducing solids. Before this, your baby’s digestive system is still developing and weaning too soon may increase the risk of infections and allergies. Weaning is also easier at six months. If your baby seems hungrier at any time before six months, they may be having a growth spurt, and extra breast or formula milk will be enough to meet their needs.

If you decide to wean at any time before six months, there are some foods that should be avoided as they may cause allergies or make your baby ill. These include wheat-based foods and other foods containing gluten (e.g. bread, rusks, some breakfast cereals), eggs, fi sh, shellfi sh, nuts, seeds
and soft and unpasteurised cheeses. Ask your health visitor for advice, especially if your baby was premature.

Solid foods should never be introduced before four months.
END QUOTE

Hardly a surprise then that some parents are left a bit confused!

[ladykay]

Basically, ITA with the concerns raised here, but just want to share a couple of anecdotes: My kids are in their twenties now, so I did this back in the stone age of the 1980s. With my first child we waited until 6 months and started with banana. He wasn't that interested all that interested in solids until around 8 months or so though. With my second, she started to try to pry food out of my mouth when she was 5 months old. That seemed like a pretty strong sign of readiness; so I tried holding a cracker out to her, she grabbed it, put it right in her mouth and ate it. We decided she was ready. BTW, they both nursed until they were about 4 1/2 years old.

[Channa]

I see your point about them not doing what they say they do. But I still find it unlikely that a mother whose pediatrician says no solids until 6 months is going to walk into the supermarket, see a package labelled 4-5 months, and decide to trust the package labelling over her pediatrician. Possible but unlikely.
I think the much bigger problem here is that most pediatricians I know of are still recommending starting solids too early. You should hear some of the idiotic reasons my friends' pediatricians have given for disregarding all the guidelines:
"Well, the AAP says 6 months, but YOUR baby isn't sleeping through the night, so clearly YOUR milk is insufficient without supplementing with solids."
"Well, the AAP says 6 months, which means they NEED to be eating FULL MEALS of solids by 6 months, so you'd better start getting them used to solids by 4-5 months."
Seriously. They are engaging in way more creative interpretations than Nestle is. Ah, if only we could boycott pediatricians.

[Charlotte Young]

Which came first the chicken or the egg? I suspect AF companies also influence paediatricians; via publications, adverts, packaging etc

[phdinparenting]

@Charlotte Young: Exactly. That is what I was getting at with this:

However, at the end of 2003, Nestlé gave a large grant to the American Academy of Pediatrics (AAP) to pay for the cost of sending the AAP 2004 Pediatric Nutrition Handbook for free to over 50,000 doctors. The Handbook reverses AAP’s 2000 endorsement of “six months exclusive breastfeeding” by going back to the old “4 to 6 months.”

In addition to publications, advertising, packaging (that you mentioned), add sponsored conferences, meetings, lunches, samples, etc...

[Rosemary]

Very much in agreement with Charlotte Young - we did partially baby-led feeding with my first child, and complete with my second. My first did not want food until 7 months - we followed his cues after seeing how much he resisted being introduced to solids right on the dot of 6 months. My second wanted it just before 5 months - we followed hers. (Coincidence or not, they both started solids right when they got their first teeth.) But we did not give her food she could not feed herself. That rules out anything Nestle could have offered her at almost 5 months, and I would not advocate in general for babies to be fed mush, but if you must, then yes, please do start at or after 6 months. At 5 months, my DD was gnawing and sucking on things but very very little was getting swallowed. Right at 6 months, she figured out how to work the process of chew & swallow, but still took in very little. By 9 or 10 months she was picking up the pace on solids to the point of doing about 2 meals a day. By 12 months she was spoonfeeding herself and the rest is history. Nursing didn't seem to decrease in relation to solids intake until after 12 months, and even then it was a slow shift.

LLL does say the middle of the first year, but this is not meant to be an opening for 4-6 month old "starter" cereals - it's in the context of a recommendation for whole foods in as close to their natural state as possible. The timing is meant inseparably to go with the kinds of foods LLL recommends, but leaves room for parents to make the decisions that work best for their particular child and their particular family, to trust your baby's cues and trust that if you are offering something healthful and natural, your child will be interested in it when the time is healthful and natural for them to have it.

Given that most people assume you have to feed your baby purees & cereals first, I don't generally advocate for starting before 6 months, but in the context of promoting baby-led solids, I will mention watching the baby, not the clock. Wish Nestle weren't selling baby food at all, but given that they do, I do think it's irresponsible to market it for under 6-month olds, for all the various reasons already given here!

[Azucar]

Baby led weaning is the best thing ever. Any by "best thing ever" I mean the way that babies were supposed to be fed until baby food companies brainwashed us.

[mother in israel]

I don't think that the case for waiting 6 full months is as strong as it was a few years ago. Studies on celiac have shown benefits to introducing tastes of gluten earlier, and other studies indicate that 4 months of exclusive breastfeeding may be enough to provide maximum allergy protection. Israel changed its recommendations, which may or may not have been influenced by formula companies, but I have heard that this is a matter of debate in the WHO as well.