The risks of feeding babies before the 6th month

“Man, a 2m baby (2 months) died because the mother gave bean broth with angu and the intestine necrotized (not even surgery helped), the “pediatrician” told the mother to remove the breast and give nest + mucilon to 1m baby ( 1 month) to gain weight, you have no idea what a children’s hospital is like because of several cases.”

The above statement, posted on Twitter a few weeks ago, went viral, setting off a wave of comments — and doubts — about introducing babies to food.

BBC News Brazil spoke with experts to clarify some of the main questions mothers have – how long should breastfeeding be done? When should the first food other than milk be given and how? Is supplementation with formula necessary? Bottle should be used or not?

Scratchs

According to pediatrician Rosângela Gomes dos Santos, president of the Department of Breastfeeding of the Society of Pediatrics of São Paulo (SPSP), “breastfeeding must be exclusive until the sixth month and must continue until two years or more”.

This is what the World Health Organization (WHO) recommends, explains the expert. The guidance is followed by the Ministry of Health and is included in the folder manual for mothers.

In Brazil, however, less than half (45.7%) of babies under six months of age are fed exclusively on breast milk, according to a survey funded by the agency itself (National Study of Infant Food and Nutrition, 2020).

“Breastfeeding should be exclusive until the sixth month and, from that period onwards, you can introduce food”, says Santos to BBC News Brazil, stressing that “water or tea” should not be given to the newborn.

According to the pediatrician, the introduction of food before the sixth month, other than breast milk or formula prescribed by the pediatrician (for mothers who cannot breastfeed during this period), can cause health problems for the baby.

“The newborn’s intestine is not developed enough. In extreme situations, he can have an intestinal infection and this can generate generalized complications, leading to death”, he says.

But, normally, what happens, says pediatric intensive care physician Cinara Carneiro, is that the introduction of food before the recommended time generates a picture of malnutrition in the baby.

“The child can be chubby, fluffy, but she is malnourished. Because, in fact, she does not have the proper proportion of the nutrients offered. She can have anemia or overload of renal function, leading to an injury”, he explains.

“What we have to be aware of is that, when food is offered at an inappropriate time in the child’s development, he will have nutritional deficiency. This, consequently, leads to a delay in his development”, he adds.

Santos, from SPSP, adds that the use of milk formulas by mothers who cannot breastfeed should be thrifty — and they should be done following medical recommendations.

“The mother, even the one who has difficulty in breastfeeding, should try to do it as long as possible. And, as for milk formulas, they have to be made following the correct dosages”, emphasizes the specialist.

Carneiro makes a reservation, however, about neonates (up to 28 days old).

“As there is a greater risk of them, especially premature babies, developing a condition called necrotizing enterocolitis (injury to the inner surface of the intestine), breast milk is prioritized and formula is avoided. Hence the importance of milk donation banks”, explains.

According to the Ministry of Health, “breastfeeding reduces mortality by up to five years by 13%, prevents diarrhea and respiratory infections, reduces the risk of allergies, diabetes, high cholesterol and hypertension, leads to better nutrition and reduces the chance of obesity. In addition, the act contributes to the development of the child’s oral cavity and promotes the affective bond between mother and baby”.

‘Food introduction’

From the sixth to the ninth month, “the child must know all the foods”, says Santos.

“It’s a way for the body not to create resistance against any food, to avoid the development of allergies”, adds the pediatrician.

“From six months onwards, the introduction of other foods is already recommended because the breast itself will not nourish the child in view of her development and everything she needs”, adds Carneiro.

But how should food be introduced?

“The food must be kneaded or in pieces (the so-called BLW method, from the English “Baby-led weaning”, or “baby-led weaning”), it cannot be blended in a blender or passed through a sieve”, says Santos.

“A protein, a vegetable, a grain. It has to be a healthy food, it shouldn’t contain salt for up to a year. You should also avoid sweets for up to two years.”

“The mother can begin to see if the baby has the ability to eat pieces. Give his mother something for him to put in his mouth. It is a learning process. But it is necessary to teach her”, he adds.

The goal, according to the pediatrician, is to encourage the newborn to chew.

“The problem is that, many times, the mother introduces the bottle very early and the child loses the habit of chewing. when sucking the bottle. Therefore, we end up seeing a lot of children over six months who have a lot of difficulty chewing, but this stimulation is important”.

Santos recalls that the child must experience “everything”.

“Food can be in very small pieces as long as the child is under supervision. That is, she takes it with her hand and takes it to her mouth. Sometimes, the mother gives these thicker formulas and the child just swallows, without chewing”

Therefore, beating the food in a blender or passing it through a sieve ends up delaying the development of the muscles of the face, according to the pediatrician.

“The ideal is to move from the breast to the cup. No bottle. We advise mothers not to use bottle and pacifier”.

Regarding posture, adds Santos, the child must be seated.

“From six months onwards, she is already able to sit. With the exception of premature babies who have developmental delays.

misinformation

Andreza Prado, lactation consultant and perinatal educator, points out that many mothers — as well as their support network, grandmothers, for example — still believe that breast milk does not nutritionally meet the baby’s needs.

“This is a myth. The failure of breastfeeding is not linked to the quality of the milk. We urgently need to make mothers aware that breast milk, in its nutritional composition, is sufficient for the newborn”, says she, who is a mother of two children, Caio and Elis.

“Unfortunately, many mothers still believe that if the baby does not gain weight, it is because their milk is weak”, he laments.

“The baby should not be offered any liquid other than breast milk and, in cases where this is not possible, the milk formula prescribed by the pediatrician”, he reinforces.

On her Instagram account (@manasdopeitoamamentacao), Prado guides mothers on breastfeeding – this is, according to the expert, vital to debunking common myths and avoiding misinformation.

Therefore, she advocates that mothers seek guidance from specialized professionals since pregnancy.

Among the most common mistakes, he cites, are the lack of information about the so-called “effective feeding” (when the child takes the entire areola — or most of it — and not just the nipple), the use of artificial nipples and the imposition of of breastfeeding schedules.

“The correct attachment of the baby is very important. How is he sucking milk? Is he sucking and feeding? Many mothers believe that pain during breastfeeding is normal. But this pain ends up annihilating breastfeeding and is one of the main reasons for early weaning It shouldn’t be like that and it shouldn’t be like that”, she says, noting that mothers must “know how to position the baby at the breast”.

“The use of artificial nipples, such as a pacifier and bottle, interferes with suction. You should avoid them as much as possible”, he recalls.

“Finally, breastfeeding has to be on demand, that is, whenever the baby wants, whether night or day. And as much as you want, until you feel satisfied. The mother should not impose breastfeeding schedules”, he concludes.