Should babies go on diets?

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To many people, a chubby baby is a healthy baby. But a new
study may be calling that age-old belief into question. A group of
researchers at Harvard Medical School looked at nearly 45,000 infants
and children over a 28-year period, and found that babies who grew very
quickly in the first two years of life were more likely to be obese
later on. The study, which was published in Archives of Pediatric & Adolescent Medicine,
found that babies who jumped two or more height-and-weight percentile
milestones by the age of two were twice as likely to be obese by age
five as their slowergrowing counterparts. Interestingly, the study also
found that the highest obesity rates in later childhood occurred in
babies who jumped two milestones in the first six months of life. 
While
some doctors have lauded the study for calling attention to the
much-publicized “childhood obesity epidemic” happening across North
America, others say the study itself is cause for concern – could it
prompt nervous parents to put their babies on a diet? 
“There’s
no doubt about it, the trend toward heavier kids in our society is not
acceptable,” says Dr. Janine Flanagan, a developmental pediatrician at
St. Joseph’s Health Centre in Toronto. “And yes, identifying the problem
early is a good thing. But where I got my back up with this study is
that they were even looking at the first six months. During that time we
actually expect rapid growth – it’s quite normal, and it’s good. And no
one would ever, ever put a baby under one year old on a ‘diet.’”
Dr.
Flanagan says where she starts to be concerned about obesity is between
the ages of one and two, and she says rapid weight gain during that
period can almost always be attributed to consuming excessive amounts of
liquid from the bottle. “These babies are drinking bottles and bottles
of milk or formula. The weight gain is not from the solid food they’re
eating. Almost all the time, it’s the bottle that is making them fat.
Ideally, you want to get them off the bottle by the time they’re a year
old, and focus more on solids, with liquids to wash their food down at
mealtimes.” Heavier babies in that age range are often not getting
enough exercise, either. “They’re always being carried around or pushed
in a stroller, and they need to walk and crawl more.” 
While
an increased awareness about childhood obesity is a good thing, Dr.
Flanagan says this study could cause potential harm. “The unintended
consequence is you have parents who stop providing adequate nutrition to
their children. There’s a fine line between alerting parents and
alarming them so they restrict food in a young baby.”

When should I introduce solid foods?

The
Canadian Pediatric Society (CPS) and the World Health Organization –
recommend exclusive breastfeeding for the first six months of a baby’s
life. 
However, the American Academy of
Pediatrics (AAP) has recently changed its recommendation to “about four
to six months” to allow for the introduction of solid foods, and the CPS
is working to follow suit, says Dr. Janine Flanagan. “We’re going back
to recommending introducing solids at four months, which is what used to
be the recommendation. The main reason for this is that by delaying
solids until six months, there is an increased risk of allergies in
children.” 
Between four and six months is the
baby’s “oral tolerance window,” says Dr. Flanagan, in which the body
learns to accept most foods and not reject them as foreign. “If a child
is not exposed to certain allergens before six months, they are more
likely to become allergic to them. We’re breeding this population of
highly allergic kids because we’re missing this window.” The concept
that introducing solids early causes obesity? “That’s absolutely
untrue,” says Dr. Flanagan. “Starting solids earlier has absolutely no
link to obesity.”
Originally published in ParentsCanada, May/June 2012