If pediatricians want to improve children's health, they should start by changing how they advise parents to introduce solid to their infants. It's outmoded, overly cautious and at odds with current research on how good eating habits develop.
Because pediatricians are worried about food allergies, the American Academy of Pediatrics (AAP) tells parents to introduce one new food at a time and to wait a few days before introducing another new food. This, of course, teaches repetition, not variety.
Let's be clear, the AAP policy is well-intentioned, but it doesn't help prevent allergies, it just makes it easier for parents to identify food allergies. The policy does, however, make it difficult for parents to teach their children good eating habits.
In France, where the child allergy rate is similar to ours (around 5 percent) there are no such go-slow recommendations. One study found French parents made an average of 18 changes in the foods they offered from day-to-day. What's the result? French children develop a more diverse palate. More importantly, they develop the habit of eating a variety of different foods.
Of course, food allergies can be serious, so I don't want to minimize how important it is for doctors and parents to be on the lookout for them. But here are three things to keep in mind:
1. The kinds of foods parents generally introduce first -- rice cereal, fruits and vegetables -- are the least likely to be allergenic.
2. The American Academy of Allergy, Asthma and Immunology now recommends that parents introduce potentially allergenic foods to their children when they are between four and six months old. Waiting any longer may actually increase the risk of food allergies.
3. Allergic reactions to food are rarely fatal.
Food allergies get a lot of media attention because they're very scary. But a new study published in Clinical & Experimental Allergy shows that the incidence of children dying from a food allergy is more than 10 times lower than their chances of dying from an accident. To give that some perspective, according to the CDC, homicide is the third leading cause of death for children under 5; food allergies don't even make it onto the list for the 10 Leading Causes of Death.
Food allergies can always be identified retrospectively. Eating habits, however, are incredibly difficult to change. In an excellent editorial in The New York Times last week, "Bad Eating Habits Start in the Womb," Kristin Wartman reviews some evidence for the importance of introducing variety at an early age. She writes: "[T]aste preferences that develop at crucial periods in infancy have lasting effects for life. In fact, changing food preferences beyond toddlerhood appears to be extremely difficult."
It's easy to imagine a policy that wouldn't pit allergy identification against eating habits: Introduce as much variety as possible during weaning. If your family has a history of food allergies talk to your pediatrician about when and how to introduce foods like shellfish and peanuts.
~Changing the conversation from nutrition to habits.~
© 2013 Dina Rose, PhD, is the author of the blog It's Not About Nutrition. Dina's book, It's Not About the Broccoli: Three Habits to Teach Your Kids for a Lifetime of Healthy Eating is scheduled for release January, 2014.
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