Forty percent of mothers surveyed reported giving their baby solid food before the baby was four months old. (Andy Peters/Flickr)

A new survey from the Centers for Disease Control finds that mothers (the CDC surveyed only mothers) are giving their babies solid food too early, despite guidelines from the American Academy of Pediatrics.

In the survey, or more than 1,334 women, just over 40 percent of mothers gave their babies solid food before they were four months old.

For years, the AAP had recommended that babies be at least four months old before being given solid food. But last year, it recommended that babies be breastfed — exclusively — for six months, before “complementary” foods are given. Now we see that many mothers are not even waiting the full four months.

From USA Today:

Understanding parents’ motivations is important, because a number of health problems are associated with the early introduction of solid foods, says study co-author Kelley Scanlon, an epidemiologist with the Centers for Disease Control and Prevention. These findings “don’t offer a full understanding why, but they give us some insight,” she says.

The moms cited reasons such as, “My baby was old enough,” and, “It would help my baby sleep longer at night.”

According to the American Academy of Pediatrics, the head and neck control and overall coordination that infants need to safely eat solids does not develop until around 4 months. In addition, the early introduction of solids may increase the risk of some chronic diseases, such as diabetes, obesity, eczema and celiac disease, the study notes.

Giving solids too soon also ends exclusive breast-feeding, which the AAP recommends for about the first 6 months because of numerous health benefits for infants, including reduced risk of respiratory and ear infections, diarrhea, diabetes, obesity and sudden infant death syndrome.

A bit of cereal added to a bottle of formula is sometimes recommended by physicians for babies with reflux, says Lana Gagin, a pediatrician at the Helen DeVos Children’s Hospital in Grand Rapids, Mich. She was not involved in the study. From a medical standpoint, however, “There is no good, solid evidence that it helps a baby sleep,” she says. …

“We didn’t expect to see so many (give solids) before 4 months,” says Scanlon. She says the finding in this study that 40.4% do so is higher than previous findings that range from 19% to 29%. Unlike most past studies, which surveyed mothers two or three years after they first introduced solids, the new study asked moms to recall what was fed during the previous seven days.

 

(fikirbaz: Flickr)

Patti McCowan was fairly new to her job as director of perinatal and pediatric services at Tulare Regional Medical Center when statistics came out showing the hospital had the worst rate in the county for exclusive breastfeeding.

That was four years ago and only 15 percent of new mothers were exclusively breastfeeding — meaning they weren’t giving their infants any supplemental formula — while in the hospital. But 80 percent of women coming in to give birth said their goal was to breastfeed exclusively, McGowan says.

“We were not doing something right,” said McCowan. “We were letting 65 percent [of babies] have a bottle. We realized something had to be done.”

Jump ahead to 2012, and Tulare Regional Medical Center has one of the highest rates for exclusive breastfeeding in the Central Valley– nearly 62 percent, according to the California Department of Public Health — and the highest in Tulare County.

The county’s other two hospitals had much lower exclusive breastfeeding rates; one was 27.9%, the other was 38.5%.

Changing Policies and Procedures

Much of Tulare Regional Medical Center’s increased rate is due to an overhaul in policies and procedures, said McCowan.

The hospital started by sending its obstetrics and gynecology team to a breastfeeding seminar called Birth and Beyond California. Once the medical staff all had the same training, they could offer uniform advice to mothers.

Previously, said McCowan, a nurse or a doctor might speak from personal experience instead of objectively offering information on breastfeeding. “Now we all get the same education and we all educate in the same way,” she said.

A quality assurance team also looked at hospital policies to see which ones needed to be changed or updated to better promote breastfeeding.

For instance, nurses no longer give out pacifiers or offer a bottle to a baby just because the mother wants to rest or take a nap. “That’s not the right reason to give a bottle,” said McCowan. Pacifiers aren’t handed out because “you don’t want new babies sucking on something artificial. Any baby awake enough to be sucking needs to be nursing.”

One thing hospital staff members have learned, said McCowan, is “if you give mothers the right information, they will make the right choice.”

Another policy change was the establishment of skin-to-skin bonding during what is called the “golden hour.”

“The first hour after a baby is born, we let the family in to say hello, then have them leave and put the baby on the mother skin-to-skin so they have that attachment and bonding that’s so important,” said McCowan. She said most infants, if allowed, will breastfeed on their own in an hour or two.

The Affordable Care Act also supports breastfeeding mothers. As of Aug. 1, new or renewing health insurance plans now must cover certain preventive services, including breastfeeding counseling, for women at no out-of-pocket cost.

The Tulare program already has two full-time lactation nurses on staff, a strong ratio for a smaller regional hospital delivering approximately 100 infants a month.

Partnerships

The hospital also partnered with First 5 Tulare County, a group focused on children’s health, to increase its breastfeeding rates. The Tulare County Women, Infants and Children (WIC) program worked with Tulare Regional to help women continue to breastfeed after leaving the hospital.

“Tulare Regional Medical Center has made amazing progress,” said Linda Sward, a breastfeeding/nutrition education coordinator with Tulare WIC who also is the Tulare County Breastfeeding Coalition chairperson.

Sward said the medical center’s program is effective because of the major policy shifts that took place to promote breastfeeding as well as the number of people, including the two lactation consultants, trained to assist in breastfeeding. “They really help the mothers. There are people with real skills there six days a week,” she said. “It really, really has come a long way.”

In January 2011, the California Women, Infants and Children Association recognized Tulare Regional Medical Center as a leader in promoting and improving breastfeeding rates in the state of California.