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Starting solids too early: a communication problem?

Posted by Dr. Claire McCarthy  March 26, 2013 10:32 AM

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Why is it that 40 percent of mothers in a study gave solid foods to their baby before doctors say they should?

That's a lot of moms. More than a third. Headed toward half. These are not just a few moms mixing some rice cereal into formula to prevent spitting up. This is a lot of moms doing what medical professionals are really clear is a bad idea.

mom and baby.jpg
You know what I think? I think we medical professionals need to own this one. We aren't doing a very good job of communicating--or listening.

You know what the top three reasons moms gave for starting early were?
  1. "My baby was old enough." (88.9 percent)
  2. "My baby seemed hungry" (71.4 percent)
  3. "My baby wanted to eat the food I ate, or in other ways showed an interest in solid food" (66.8 percent)
These are reasons you would give if either you didn't clearly hear the doctor say no solids before 4 months--or if you did hear, but didn't agree.

It doesn't help, of course, that doctors are a bit wishy-washy and unclear when it comes to when exactly parents should start solids. The American Academy of Pediatrics says 6 months--but also say that it could be a little earlier. And there have been a couple of studies recently that suggest that starting solids before six months could actually be good for future health. 

But nobody is saying that before 4 months is okay, and that's when these moms were starting solids (the mean age was 12 weeks). Before four months, babies may not be developmentally ready to eat solids. Too many calories too early, also, raises the risk of of obesity--and studies are showing that being overweight in infancy raises the risk of future obesity. Plus, getting solids early can interfere with breastfeeding--and breastfeeding is really good for babies.

We doctors clearly need to start talking about solids early. Lots of us (including me) sometimes don't mention anything until the 4 month visit--which is obviously too late. 

But even more, I think we need to realize that we have a habit of throwing a lot of information at people. And we also have a habit of using doctor-speak, and not exactly making it easy for people to admit when they don't understand or remember everything we say. That's not good. We need to fix that. And we need to give more written materials, and tell families about good websites where they can get information in between visits.

We also need to do a better job of asking people about their own beliefs and needs--and really listening to their answers. Whether it's because they think a baby will sleep better--or because Grandma tells them it's time, parents have reasons for ignoring us. When we don't ask about those reasons or circumstances, we miss the opportunity to talk with families about other options--and help them in other ways.

And parents...please, talk to us doctors. Let us know what you are thinking and doing. Tell us if you don't agree with our advice. Give us a chance. We're on your kid's team too--let's do a better job of working together.

I joined Bridget Blythe on NECN to talk about this:

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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