Most mothers may be starting their infants on solid foods months sooner than specialists recommend, mistakenly believing their children are old enough to graduate from breast milk or formula – but many say they’re simply following doctors’ orders, according to a study published today.

Parents should wait until their little ones are at least 6 months old before offering them solid foods, say many child-nutrition experts, including the American Academy of Pediatrics.

But researchers at the Centers for Disease Control and Prevention – who surveyed 1,334 new moms – discovered that almost 93 percent of those women had introduced solid foods to their infants before 6 months, that 40 percent did it before the 4-month mark, and that 9 percent had offered solids to their babies before they were even four weeks old, according to the study, published today in Pediatrics.

“Fifty percent said that their health care provider told them it was time to introduce solid food,” said Kelley Scanlon, a co-author of the study and lead epidemiologist in the nutrition branch in the division of nutrition, physical activity and obesity at the CDC.

“That, for us, indicates that health care providers need to provide clearer guidance and really support women in carrying out the recommendation,” Scanlon said.

Physicians' groups settled on the 6-month cut-off after earlier research determined that children who get solid food at too early might be at a greater risk for developing chronic diseases, such as diabetes, obesity, eczema and celiac disease, Scanlon said.

The mothers who volunteered for the CDC study filled out food diaries and questionnaires designed to ferret out their opinions on why and when solid foods should be offered.

Among the moms offering solid foods to infants younger than 4 months, the most commonly cited reasons for doing so included: “My baby was old enough;” “My baby seemed hungry;” “I wanted to feed my baby something in addition to breast milk or formula,” “My baby wanted the food I ate;” “A doctor or other health care professional said my baby should begin eating solid food;” and “It would help my baby sleep longer at night,” researchers reported.

What’s more, moms who fed their babies formula were far more likely to start solids too early versus those who exclusively breast-fed (53 percent versus 24 percent), the study showed.

One food expert unaffiliated with the CDC study suggested that some health-care providers may simply be unfamiliar with current baby-feeding recommendations.

“I think this is worrisome,” said Ann Condon-Meyers, a pediatric dietician at the University of Pittsburgh Medical Center and Children's Hospital of Pittsburgh. “I think it may show that word isn’t getting out that … it is 6 months before solid foods should be offered.”

Still, the study’s findings didn’t surprise Condon-Meyers, who added: “I work in pediatrics and we see a lot of early introduction of solid foods when we do patient histories.”

In addition to possibly boosting, a child’s risk for contracting certain chronic diseases, introducing solid foods too early often means babies don’t drink an adequate amount of breast milk or formula, and that can translate into poorer nutrition, Condon-Meyers said.

Breast milk and formula have all the nutrients and vitamins a baby needs and in the right proportions, Condon-Meyers said.

“If you start giving solid food too early then you are diluting the nutritional intake,” she said. “You’re getting more calories, but less of the nutrients a baby needs to grow.”

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Iron supplements may help boost brain development and ward off behavioral problems in babies who are born a bit on the small side, a new study from Sweden suggests.

Low birth-weight babies are more likely to end up iron deficient, researchers said. They need more of the nutrient for catch-up growth and haven't stored as much as other babies if they're also born premature.

For that reason, very early-term and very small babies are often put on iron - but less research has looked at babies born just shy of normal weight, to see if they are also at risk.

"I think this further solidifies the evidence that it's a very good idea to give these (marginally low birth-weight) children iron supplements," said Dr. Magnus Domellof, from Umea University, who worked on the study.

The research was led by his colleague, Dr. Staffan Berglund. Their team followed 285 infants born between 4 pounds, 7 ounces and 5 pounds, 8 ounces.

When the babies were six weeks old, the researchers randomly assigned them to get iron drops - either one or two milligrams per kilogram of body weight - or iron-free placebo drops each day until they were six months old.

Then at age three and a half, Domellof's team brought the kids back for IQ tests and surveyed parents about their behavioral issues. The researchers compared kids in the iron- and placebo-drop study groups with another 95 children who were born at normal weight.

There were no IQ differences based on whether the smaller-than-average babies had been put on an iron regimen. All three low birth-weight groups had average scores between 104 and 105. ("Cognitive impairment" in this study was considered an IQ under 85.)

However, significantly more babies given placebo drops had behavioral problems, as reported by their parents. The issues included problems managing emotional reactions, anxiety and depression, as well as sleep and attention problems.

Almost 13 percent of the placebo-group babies scored above the cutoff for clinical behavior problems, versus about 3 percent of kids who had taken iron drops and kids from the normal-weight comparison group.

That suggests iron deficiency in infancy may be a direct cause of behavioral problems later in childhood, the researchers wrote Monday in the journal Pediatrics.

They are continuing to monitor the same group of kids as they get older, to see if new cognitive or behavioral problems develop or old ones get better as the children head into grade school.

Domellof said he and his colleagues didn't see any extra stomach problems in kids or delayed growth linked to the use of iron drops. Some research has suggested giving excessive iron to young kids who aren't deficient may stunt their development.

But, "I would not be afraid of recommending this to all children (born) below 2,500 grams (5 pounds, 8 ounces) at this dose," Domellof told Reuters Health.

"Here's where an ounce of prevention is worth a pound of cure," said Dr. Michael Georgieff, a child development researcher at the University of Minnesota in Minneapolis who had reviewed the study as part of Berglund's dissertation committee.

He said it's important for all parents to know their baby's iron requirements when they leave the hospital.

"The issue with these marginally low birth-weight infants is, people really haven't paid a lot of attention to them, but the evidence is accumulating that they are at risk for behavioral problems and less than ideal cognitive function," said Dr. Betsy Lozoff, who studies the effects of iron deficiency in infants at the University of Michigan in Ann Arbor.

For most babies in the United States, extra iron is recommended starting at four to six months, either through supplements if the mother is breastfeeding or through formula. Very small or premature babies typically have their iron monitored from birth.

But Lozoff, who wasn't involved in the new research, said that in many places, there are no recommendations for how to treat babies who are just below a normal birth weight.

"This would suggest that it should just be a routine supplementation, and it can be at a low level of iron," she said.

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Myhealthnewsdaily.com

The number of babies born exposed to addictive drugs while in the womb is increasing, a new study suggests.

Between 2000 and 2009, the incidence of neonatal abstinence syndrome — a disorder that occurs in babies exposed to illegal or prescription drugs during pregnancy — increased nearly threefold in the United States, the study found.

The rate of mothers using opiates such as heroin, morphine, codeine and Oxycontin at the time of delivery increased fivefold over that same period.

Neonatal abstinence syndrome most commonly occurs in newborns exposed to opiates while in the womb. The condition can bring increased irritability, tremors, seizures and respiratory distress.

During the study period, the average cost of treating babies with neonatal abstinence syndrome (NAS) increased 35 percent, and the length of time these babies stayed at the hospital remained about the same (16 days, on average).

"The increasing incidence of NAS and its related health care expenditures call for increased public health measures to reduce" exposure to opiates before birth, the researchers write, in a paper published online today (April 30) in the Journal of the American Medical Association.

In addition, standardizing the care these babies receive, and developing new treatments for the condition may better treat babies with NAS symptoms and reduce the length of their hospital stays, the researchers said.

Researchers from the University of Michigan Health System analyzed information from two national databases — one for children and one for adults — each containing information from about 7 million people released from the hospital.

Between 2000 and 2009, the rate of newborns diagnosed yearly with NAS increased from 1.20 per 1,000 births to 3.39 per 1,000 births. Also over this period, the number of mothers using or dependent on opiates increased from 1.19 per 1,000 births to 5.63 per 1,000 hospital births per year.

Average hospital charges for newborns diagnosed with NAS increased from $39,400 to $53,400, the researchers said.

In 2009, about 13,500 infants were diagnosed with NAS, an estimate that equates to about one infant born per hour with the condition.

Treating mothers who use opiates with a drug called buprenorphine may have advantages over the traditional treatment, which involves use of methadone, the researchers noted, pointing to a 2010 study that showed that newborns whose mothers were treated with buprenorphine required 89 percent less morphine, and spent 43 percent less time in the hospital.

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