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Should you Delay Introducing Grains to your Baby?

I keep on hearing around the internet that babies should not be fed grains before age 1. Maybe age 2.  The reason given is that until that age, babies don’t make enough amylase, an enzyme that digests complex carbohydrates. Sounds scientific. But what about the complex carbs in fruits and veggies. I’ve never heard to delay vegetables…this theory sounds like a bit fishy. A shoot-off from the anti-grain-diet popularity in the adult world. Which is a bit sad, really. Transferring the newest fad diet onto our babies?! But maybe there is proof of this. Although I haven’t seen one reference on the opinion blogs I read on this topic, so I am skeptical. But if there is, I certainly want to know, as a mom of young kids and dietitian specializing in babies! So here’s what I found out.

Amylase is present in saliva as well as produced by the pancreas. To look first at salivary amylase, it’s important to know that very little digestion occurs in the mouth to begin with. It’s almost all in the small intestine. And normally salivary amylase is inactivated when it reaches the stomach, due to ph. However, salivary amylase is responsible for the beginning of carbohydrate breakdown, and is found at very low levels in newborns. But is it low until a year or two of age? No. Between 3-6 months salivary amylase increases in abundance (1). Another study found it to be 2/3 of adult levels by 3 months of age (2). So although I hear this as an excuse that babies can’t digest complex carbs, research and physiology easily prove otherwise.

Now to move on to the small intestine, where most digestion occurs. Maybe this is the source of this problem? Here the pancreas excretes pancreatic amylase to help break down long carbohydrate chains into simple sugars for digestion. I found out that pancreatic amylase levels are only 3% adult levels in newborns, and begin to increase at seven to eight months. Pancreatic amylase levels don’t reach full adult values until 5-8 years (3, 4).

So with limited pancreatic amylase, does this mean the baby can’t digest carbs? What would this lead to? Basically the complex carbs would make it undigested to the large intestine and be fermented by bacteria, causing gas (5). Then be absorbed by the colon. Not deadly, but certainly uncomfortable! Here are a few reasons why most babies CAN digest complex carbohydrates, despite lower levels of pancreatic amylase

1) There are other enzymes in the small intestine that break down the carbs, so they can be used for energy instead of just producing gas.  Phew! Isomaltase and glucoamylase are at mature levels in the term fetus (6). Glucoamylase splits the multiple glucose molecules from a complex carbs so they can be absorbed, and is particularly important in infants who have low levels of pancreatic amylase.

2) Interestingly, it seems that once complex carb-containing food is introduced to your baby, his/her body responds by secreting more amylase (7). The same thing occurs with protein introduction and trypsin, the enzyme that digests protein (7). So the body adapts somewhat to what it is fed.

3) Breast milk contains amylase of the salivary type too (8). Normally salivary amylase is inactivated once it reaches the stomach, due to more acidic pH levels. However the amylase in breast milk is not inactivated in the stomach and it continues to work in the small intestine on digesting the breast milk (9). This amylase activity also transfers to solid foods for the breastfed baby, making it easier for them to digest carbs (8, 9). Again – the wonders of breast milk!

Even without a lot of pancreatic amylase, starches can be broken down and used by babies under 1 year of age. Despite the supposed dangers – allergies, learning disabilities etc. etc. that are claimed to be linked to grain intake in young children. Even review studies show few established negative consequences of high intakes of carbohydrate for young children (age 0-4 years). Basically, just cavities (of course influenced by oral hygiene), with no evidence for detrimental effects on nutrient dilution, obesity, diabetes or cognition (10).

I feel comfortable introducing grains before a year of age. But when is the best time? Recommended guidelines are to start solids around 6 months of age, concentrating on iron fortified foods. While I am promoting grain intake as ok for 6-month-old babies, fortified infant cereal is still not the best source of iron. Meat and alternatives are. So after introducing some meat and alternatives (and a fruit/veggie if you like), a gluten-containing grain should be introduced fairly soon. Wheat pasta, cooked barley or rye bread for example, it certainly doesn’t have to be commercial infant cereal. Why do I suggest introducing gluten-containing grains early? You thought gluten was the devil?? Because research shows that gluten introduction should occur no later than 7 months of age, and late introduction (as well as early introduction, before 4 months) has been shown to increase the risk of celiac disease (11). This fits along the newer school of thought in allergy prevention: delayed exposure may actually be detrimental. So turns out you are safe to follow your health authority's guidelines for starting solids in your baby, and don't worry about the unfounded fear-mongering out there!

Want to know more about starting solids? If you're interested in using Babyled Weaning to start solids watch my free webinar: "How to get started with Babyled Weaning"

1)    Morzel M et al. (2011). Saliva electrophoretic protein profiles in infants:

changes with age and impact of teeth eruption and diet transition. Arch Oral Biol. 56(7):634-42.

2) Sevenhuysen GPHolodinsky CDawes C. (1984). Development of salivary alpha-amylase in infants from birth to 5 months. Am J Clin Nutr. (4):584-8.

3) Gillard BKSimbala JAGoodglick L. (1983). Reference intervals for amylase isoenzymes in serum and plasma of infants and children. Clin Chem. 29(6):1119-23.

4) O'Donnell MDMiller NJ. (1980). Plasma pancreatic and salivary-type amylase and immunoreactive trypsin concentrations: variations with age and reference ranges for children. Clin Chim Acta. 104(3):265-73.

5) Mobassaleh MMontgomery RKBiller JAGrand RJ. (1985). Development of carbohydrate absorption in the fetus and neonate. Pediatrics.  75(1 Pt 2):160-6.

6) Lee PCWerlin STrost BStruve M. (2004). Glucoamylase activity in infants and children: normal values and relationship to symptoms and histological findings. J Pediatr Gastroenterol Nutr. 39(2):161-5.

7) Zoppi G, Andreotti G, Pajno-Ferrara F, Njai DM, Gaburro D. (1972). Exocrine Pancreas Function in Premature and Full Term Neonates. Pediatric Research (1972) 6, 880–886.

8) Lindberg TSkude G. (1982). Amylase in human milk. Pediatrics. 70(2):235-8.

9) Heitlinger LALee PCDillon WPLebenthal E. (1983). Mammary amylase: a possible alternate pathway of carbohydrate digestion in infancy. Pediatr Res.17(1):15-8.

10) Stephen, A et al. (2012). The role and requirements of digestible dietary carbohydrates in infants and toddlers. Eur J Clin Nutr. 66(7):765-79.

11) Chmielewska ASzajewska HShamir R. (2013). Celiac disease--prevention strategies through early infant nutrition.World Rev Nutr Diet.108:91-7.

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