The Practicing Parent: Baby food & diabetes

215,000 kids and adults are living with Type 1 Diabetes, a serious illness requiring a lifetime of injections. New research reveals what you feed your baby could play a significant role in the chances of your little one developing the disease.

The research from the University of Colorado Denver warns there's a small window of time to introduce solid food, from four to six months of age.

According to Colorado School of Public Health Dr. Jill Norris, if mothers introduce solid food before the fourth month, there's a two-fold risk of diabetes. And she says, "if the first time you introduce them is after six months, you have three-fold increased risk of type 1 diabetes."

The research was done in children with an increased genetic risk for Type 1, but researchers believe the findings may apply to all babies.


BACKGROUND: Juvenile, or type 1 diabetes, is an insulin-dependent disease that primarily affects children and is carried throughout adulthood. This chronic condition occurs when the pancreas is not producing enough insulin. The human body needs this hormone to allow sugar to enter the cells to produce energy. The cause of type 1 diabetes may be from genetics or an exposure to certain viruses. There is not a cure for diabetes, but it can be maintained with the right treatment. (Source:

BREASTFEEDING: Breastfeeding is the most favored form of feeding newborns and babies. Breast milk has been said to provide the most nutrients and benefits to help infants grow into healthy and strong toddlers. The nutrients in breast milk help fight off infections and illness that infants are typically susceptible to and offers beneficial value to moms as well. It is recommended that babies are breastfed until the six to twelve month mark to ensure the the health and well-being of your baby. (Source:

SOLID FOOD: Although breastfeeding has always been the recommended source of food for your baby, researchers are now saying that solid foods should be introduced to infants before the four to six month mark. This introduction to solid food is said to reduce the risk of infants developing type 1 diabetes. This doesn't mean that mothers should stop breastfeeding at this mark, but they should slowly begin to feed their babies with solid foods, such as barley, wheat, and rice. Late introduction to solid foods may also lead to a deficiency of nutrients that babies need. Breast milk may not provide the right amount of energy that solid food will. (Source:

Jill Norris, PhD, Professor and Chair of Department of Epidemiology, Colorado School of Public Health, talks about preventing type I diabetes at an early age.

Are these new findings?

Dr. Norris: The findings are not surprising because we've had hints of them with other outcomes in the past. This is the first study to look at type I diabetes in a prospective way where we followed at risk kids from birth to the development of diabetes. That's what makes these results new and exciting, because we have a clinical outcome of diabetes and it's relevant to the individuals who are worried about diabetes. We followed over 1800 kids from birth, they are at increased risk for diabetes because they have a genetic marker that put them at increased risk or they are related to someone who has Type 1 diabetes. We followed them and we asked questions about what their mothers fed them, how long they breast fed and we asked a number of other questions as well. What we found is that there's an increased risk of diabetes if we introduce solid foods prior to the four-month birthday compared to if you introduced them in the 4 to 5 month window. If you introduce solid foods after six months, in other words the first time you introduce them is after six months, you have a threefold increased risk of Type I diabetes compared to introducing them at 4 to 5 months of age.

How much of an increase is it to introduce solid food prior to four months?

Dr. Norris: It's a twofold increase risk. If mothers introduce solid foods before the four month birthday, there was a twofold increased risk of diabetes compared to introducing solid foods between four and five months of age. What we did is we used the American Academy of Pediatrics recommendations to introduce solid foods between four and six months of age. We used that as the norm and the question we asked is whether introducing solid foods before or after that norm increased or decreased the risk of diabetes.

Is it a very small window?

Dr. Norris: It is a very small window. It is not an unusual window because this is an established American Academy of Pediatric recommendation that between four and six months it's okay to start introducing solid foods.

Is it healthier to breast-feed for an extended period of time?

Dr. Norris: One of the most intriguing things of our study was the finding that if you introduced gluten containing solid foods while you are still breast-feeding you actually decreased the risk of type 1 diabetes. So the longer you breast-feed, and if you're breast-feeding while you're introducing solid foods there's a protective effect. How serious is diabetes? Dr. Norris: Type 1 diabetes is a serious childhood disease. It appears usually before the age of 20 and it is associated with the need to inject insulin or use an insulin pump every single day of your life. Even when you're controlling the diabetes, you are at risk for complications such as eye disease and kidney disease and cardiovascular disease, it's a lifelong condition.

Did you test people who are predisposed to type 1 diabetes?

Dr. Norris: Yes.

Does this hold true for the general population?

Dr. Norris: Because our population was genetically at increased risk for diabetes, we can't say whether our findings would apply to the general population or not. However, our findings align with the current Academy of Pediatrics recommendations which are supposed to apply to the general population.

What does that mean?

Dr. Norris: The bottom line is, is not to introduce solid foods before the four-month birthday and when the baby is ready, you should introduce solid foods preferably before the six month birthday and while you're still breast-feeding.

Are there specific kinds of solid food that are better to introduce first than others? Dr. Norris: Rice is typically recommended to be one of the first foods to introduce to the infant because it is not very antigenic. We found trends of increased diabetes risk for a number of different solid foods when introduced before the four-month birthday, which is why the current recommendation of not introducing solid foods until the four-month birthday is a general recommendation for all solid foods. We found increased risks associated with early introduction of fruit and increased risks associated with introducing gluten early. It is generally an overall recommendation that solid foods are not necessary or recommended prior to the four-month birthday.

Are there any foods they should not eat? Dr. Norris: I don't want to target any specific food because I think the general recommendation is that no solid food should be introduced prior to the four-month birthday.

Are there any foods that are better or worse after the four-month birthday? Dr. Norris: We didn't really look at the specific foods as which ones would be better or worse. We tried to explore that but we came down with a more simple explanation. That it's the timing of the solid food introduction which is the most important and breast-feeding while you're introducing specifically gluten containing foods such as wheat and barley.

Do you have an understanding of why this would occur if you would start solid food earlier or later that it has an impact? Is there a physical explanation to it?

Dr. Norris: The increased risk associated with introducing solid foods prior to the four-month birthday is probably related to the inter-relationship between an immature immune system and an immature gut. When foreign antigens or foreign foods are introduced into the diet, they may cross the gut and they may interact with an immature immune system and cascade into a reaction that may ultimately lead to an autoimmune disease like diabetes.