During a recent six month well child visit a mother was going through her plans to begin feeding her healthy infant. As we discussed a reasonable schedule to begin the introduction of vegetables and fruits mom shared that she was planning to make her own baby foods. I supported her and shared some ways to get started. The quantities of food she would be giving her baby need to be monitored as well as the signs to look for in order to detect an allergic reaction.
In the midst of the discussion mom confidently stated,”…but of course I won’t make my own carrots…because of the nitrates.” She went on to explain that many books had advised parents to avoid a certain list of vegetables to prevent them from harming their children with nitrates. These books suggested that jarred organic forms of these vegetables would be a better alternative. I told mom that I disagreed with this line of thinking. Here are the facts regarding nitrates and baby foods:
Nitrates can be harmful because excessive consumption may lead to the nitrates being converted to NITRITES which, if not properly excreted, may lead to the production of methemoglobin. Excessive methemoglobin may lead to methemoglobinemia, or “blue baby syndrome.” Newborns and infants under three months are at increased risk of this dangerous transformation for various reasons.
Two more commonly recognized explanations involve the persistent presence of fetal hemoglobin and the high gastric ph of newborns and infants--two factors which allow nitrates to more easily be converted to NITRITES, and subsequently produce methemoglobin. As the infants age, fetal hemoglobin disappears. Gastric ph normalizes and gains helpful digestive flora, largely decreasing the risk of nitrate poisoning.
Newborns and infants receiving formula mixed with well water may be at risk for nitrate poisoning. The water may be contaminated with excess nitrate, absorbed from fertilizer used in the vicinity. Nitrates naturally occur in green beans, carrots, squash, spinach and beets. This is true regardless of whether the vegetables are home grown or from the store in a jar. The difference is that mass produced baby food forms of these foods should be screened for their concentration of nitrate. It is a procedure most families do not practice at home. This provides a number to look at as a gauge, but these foods still contain nitrates. As stated by the American Academy of Pediatrics, these foods are believed to be safe for infants as long as they are not introduced prior to age six months--the recommended start time for initiation of solids of any kind.
This brings us back to my visit with the healthy six-month-old infant, who hopefully is happily enjoying squash and carrots as we speak…
Take home points: