On the Feeding of Supplemental Foods to Infants

Recommendations and practices of feeding solid foods to infants are widely divergent in the United States and in other countries. Although few differences in health are noted from such divergent practices, the consequences may be subtle or may require long-term, careful observations. The previous Committee on Nutrition statement1 on this subject reviewed the history of the use of solid foods and showed that solid or supplemental foods were seldom offered to infants before 1 year of age until about 1920. Breast milk, for the most part, or modified cow's milk formulas supplied all or most of the nutritional needs of infants during the first year. The first supplements to the diet were cod liver oil to prevent rickets and orange juice to prevent scurvy. Over the next 50 years recommendations were made that some cereals and strained vegetables and fruits be introduced at about 6 months of age to: (a) supply iron, vitamins, and possibly other factors; and (b) help prepare the infant for a more diversified diet. A much wider variety of infant foods became available, and these were introduced into the infant's diet earlier and earlier. Some of the reasons for earlier introduction of solid foods were the desire of mothers to see their infants gain weight rapidly, the ready availability of convenient forms of solid foods, and the mistaken assumption that added solid foods help the infant to sleep through the night. INFANT FEEDING PERIODS Infant feeding should be considered in three overlapping stages: the nursing period, during which breast milk or an appropriate formula is the source of nutrients; a transitional period, during which specially prepared foods are introduced in addition to breast milk or a formula; and a modified adult period, during which the majority of the nutrients come from the foods available on the family table.