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March Survey

From Breast is Best to Chicken Soup

It all starts with those first five words, "Are you going to breastfeed?" and from then on, you realize you have truly stepped into the world of babies, food and bowel movements. There is no turning back. From this moment on you will have to make decisions that technically seem to simple yet with a closer look actually demand a level of contemplation beyond reason.

Pediatricians and family physicians seem to be following some higher authority when it comes to babies and food. They often discuss this issue with us as if there were right and wrong answers and if we don't follow the plan we worry that we might actually harm our precious bundle. "If I give my baby pears before introducing carrots, is that ok?"

We at the Bilingual/Bicultural Family Network were curious to learn about the experiences families around the world were having with babies and feeding and what they were being recommended by their medical establishment. About a year ago we did an informal survey on the Bilingual Families discussion list and received numerous responses (see chart below for synopsis of parents from each country). Here is what you told us:

Variations abound
As expected, most countries have their own set of "rules" when it comes to babies and food. While it was recommended to many of you not to feed babies meat or fish until they were close to a year old, other countries the recommendation was to introduce meat and fish much earlier. Italy was exceptional in that a baby's' first meal was a special broth made with a number of ingredients. Most countries, however, suggested starting babies on some kind of porridge or gluten-free cereal at first and then to slowly add fruit and veggies.

Allergies are a global concern
Many countries suggested starting foods one at a time for a few days to ascertain whether the baby would have an allergic reaction or not. Most countries also recommended that cows milk be introduced no earlier than 12 months, in part due to the chances for an allergic reaction. With lactose intolerance affecting more and more of our populations, it is no surprise that this suggestion has gained support. Some were told not to introduce foods with gluten until their baby was older, another indication that concerns abound about certain grains and allergic reactions.

Breast is Best could use a little help
In every country the recommendation to new moms was to breast feed. However, only some birthing facilities actually provided the support new moms needed and would have expected. If a mother had trouble with breastfeeding, many places were more than willing to simply supplement with formula and leave it up to the mother to decide whether she wanted to keep trying to breastfeed or not. In some medical establishments, although breastfeeding was officially recommended, babies were nevertheless given formula without first asking the mothers. In the areas where there was a lot of breastfeeding support, mothers tended to appreciate the help and were encouraged to continue breastfeeding for at long as possible.

Consensus on when to start solids
Across the board, 4-6 months was the general recommendation for when to start solids. Some were encouraged to introduce solids so that the mother could slowly wean from breastfeeding. In some cases this was due to the need to go back to work and the lack of breast pumps and support at work for lactating mothers. Others were encouraged to introduce solids since it was thought that the breastmilk wouldn't provide enough nutrition otherwise. However, as one mother pointed out, the fact that the medical establishment wasn't very insistent either way meant that she could make decisions based on what she felt was right.

Generational misconceptions and pressure
Many mothers felt that their mothers or mother-in-laws were nervous about them breastfeeding longer than 4-6 months. This older generation felt that this wasn't a good idea for a number of reasons. Some believed the milk would be too thin for the baby. Others thought that it was just plain strange to breastfeed for so long. One mother in Italy said that the older generation even had the impression that if the baby continued to breastfeed for a long time he wouldn't want to drink regular milk later. Clearly the previous generation was as steeped in their understanding of the rules of their day as we are in ours today.

The most enlightening realization from this survey is that although many different recommendations abound throughout the world on how to feed our babies, there still isn't one answer for everyone. Within fairly broad limits, it would be difficult to do anything wrong when making choices for how and what to feed your baby. With only the knowledge of our local community and the recommendations of our medical establishment it is hard to imagine anything other than how we are doing things. The "rules" we follow and the choices we make feel universal. Yet, when compared against the rest of the world, it is easy to realize that there is no "one size fits all" when it comes to raising our children.

A Special Thank You to everyone from the Bilingual Famliies dicussion list who responded to my request for information! You are a wondeful group of amazing parents!

Name of Country

Encouragement to Breastfeed?

Recommended Age for Starting Solids

Recommendations for Introducing Solids

Additional Info

Finland

Yes, for at least 9 months

4-6 months

Oatmeal/gruel - veggies – fruit – meat at around 6-8 months – milk around 12 months

Special attention is paid to ‘evening snack' so babies won't be hungry in the night. Fiber and fish important parts of diet

United States

Yes, for at least 6 months, year is best and longer if possible. Some were encouraged to breastfeed others weren't encouraged either way

4-6 months or when parents feel children are ready

Simple grains – veggies – fruits – meat around 9 months – milk, egg whites, strawberries, fish, honey around 12 months – longer for peanuts

Often big discrepancies between what is recommended and what parents actually do.

Jarred food available but not taste the best. Fairly easy to make own food with food processor

Taiwan

Yes

Start with a rice, gruel/porridge cooked in pork broth then over time start adding more foods to it. No raw apples under 8 months of age.

Chinese feel that bananas are bad for bones so not given to children.

Germany

Yes, for at least 4 months, 6 months or longer is even better

4-6 months

Pureed carrots – potatoes – fruits - meat after 6 months – milk, eggs, fish after 12 months

Recommended meals: breastmilk for breakfast, veggies/potatoes/meat for lunchtime, fruit and grains in the afternoon, a porridge made with milk for evening snack just before bed. Encouragement to replace milk with water and tea during meals, except during breakfast.

New Zealand

Yes, for at least the first year and longer if possible. Although encouraged, older generation think it is odd to breastfeed for so long.

4-6 months, or later if desired

Rice cereal – apples and pears – pumpkin, sweet potatoes/yams, potatoes, carrots – veggies like peas, corn, etc and finely minced meat from 6 months on – fish at 9 months – milk at around 12 months – nuts not before 3 years

A district nurse visits you and your baby at home until your child is 5 years old and in school. Weight and measurements are taken and parents are advised on feeding and other issues. Lactations consultants are available as well as nurses who can help with other issues.

Belgium

Yes, for at least 3 months, but no specific encouragement or pressure.

4-6 months or when bottle or breastfeeding doesn't seem to be enough (when bottles go to more and 5 per day)

Start with fruits and then add veggies

Spain

Yes, for as long as you can, yet most stop at around 6 months

4-6 months

Apples, bananas, oranges and pears at 4 months – veggies and chicken at 6 months – fish and foods with gluten (like bread) at 8 months

Moms often stop breastfeeding at around 5-6 months because they return to work. There is an emphasis on no gluten before 8 months

United Kingdom

Yes, but no specific encouragement or pressure

4 months for formula fed, 6 months for breastfed babies

Introduce cereals, fruits, veggies, etc. first and most everything at 6 months except for things like nuts, chocolate, milk.

Different advice when to start solids, not a lot of knowledge of the recommendations by postnatal care providers but nice that they were fairly relaxed about individual choices overall.

Sweden

Yes

4-6 months

Oatmeal/gruel - veggies – fruit – meat at around 6-8 months – milk around 12 months

Special attention is paid to ‘evening snack' so babies won't be hungry in the night. Fiber and fish important parts of diet

Italy

Yes but parents are often quick to supplement with formula and doctors are fine with it.

4-6 months

Babies first solid meal: A vegetable broth is made by cooking potatoes, carrots and celery. To this broth you add rice cereal, a jar of pureed meat or parmesan cheese and a small amount of vegetables plus, of course, a trickle of olive oil (considered vital to the meal). After the baby eats this, they are fed a grated apple or pear. Over time, more and more veggies and starches are added to this broth meal.

Many old-school doctors say to stop breastfeeding at 6 months or maximum 12 months for fear that babies won't want to drink regular milk or because they believe breast milk is no longer nutritious after a year.

 

Meal right before bedtime is discouraged.

France

Yes, they are happy if you are going to breastfeed but there is no real encouragement either way. Doctors happy if you breastfeed for a month and delighted if for 3 months.

4-6 months

One mother recommended to start with the following puree: one lettuce leaf, one carrot, 1 leek, 1 zucchini, one spoon of olive oil and apple-pear compote. Green veggie and meat, white fish 3 times a week and chocolate 2 times a week starting at 6 months. Introduce ½ an egg yolk once a week at 9 months and after 10 months everything is fine.

It was assumed that nothing would be given to the baby unless the pediatrician recommended it ahead of time.

Korea

Yes (baby was in NICU and hospital staff provided breastfeeding support, had special pumping room and wrote letter to insurance that pump was medical necessity)

4-6 months

Babies are given a barley tea for upset stomach. New and nursing mothers are given a “seaweed soup” since it is supposedly healthy and a good source of iron.

Turkey

Yes but you must mention that you want to breastfeed exclusively otherwise they will feed baby formula as well

4-6 months. Encouraged to breastfeed for at least 6 months, at least a year is best

Start with rice, apple, pear purees then gradually add vegetables, meat, fish. Careful attention paid to indications of food allergies.

Pediatrician insisted on pure natural food to be given to baby.

Japan

Yes, woman very much encouraged. Emphasis on breast massaging to help with milk production.

4-6 months

From 2-3 months babies are given non-caffeine teas, light fruit juice/baby sport drinks and light soup. From 4 months a watery double-boiled rice pap. Later small pieces of finely chopped vegetables added, later noodles, fish. Grated fruit.

Many hospitals supplement with formula the first day so that the mother can rest. Babies often weighed before and after breastfeeding and will be given formula if baby didn't get enough milk. Impression from older generations that milk gets too thin when baby is around 8 months or so.

Russia

Yes, encouraged but the establishment is still adjusting to this

Not earlier than 6 months and only if baby is showing strong interest.

Cereal followed by vegetables. Later fruit and juice followed by meat, egg yolk, yogurt and milk at 12 months.

The old trend was to introduce fruit juices early on. More and more women are trying to breastfeed longer but the older generation still encourages stopping breastfeeding sooner.

Norway

Yes, establishment assumes you will breastfeed. Encouraged to breastfeed for at least 6 months and longer if possible.

At 4 weeks, start giving baby 5ml of cod liver oil (for vitamin D due to less sun). Start regular solids at 4-6 weeks.

Start with various pureed vegetables, potatoes, porridge of various types. Breastmilk usually given as a “dessert” so that baby will try new foods before getting breastmilk.

The WHO recommends 3 years of breastfeeding which made news in Norway since Gro Harlem Bruntland, a former Norwegian Prime Minister, was in charge when the decision was made.

Slovenia

Yes, the establishment assumes you will breastfeed and that if you don't want to, that you will at least give it a try.

4-6 months

Fruits given first followed by other foods.

Fully paid maternity leave for 12 months plus a strong social encouragement helps mothers decide to breastfeed for longer than they probably would otherwise.

Portugual

Yes, encouraged to breastfeed but no specific support is given. Most don't breastfeed more than 4 months.

4 months

4 months: formula, porridge (gluten free), fruit puree and 3 yellow vegetable soup with no salt and little olive oil. 6 months: introduce meat and egg yolk, gluten cereals, rice, pasta. 9 months: fish, egg whites, oranges. 12 months: can start eating same food as adults. Chocolate and ice cream at 2 years old.

Not common to see women breastfeeding in public since most only breastfeed up to 4 months (there is 4 months paid maternity leave).

 

 

 

 

 

 

 

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