The Pediatrician’s Guide to Feeding Babies & Toddlers by Porto & DiMaggio

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The Pediatrician’s Guide to Feeding Babies & Toddlers
Anthony F. Porto, MD, MPH & Dian M. DiMaggio, MD
Ten Speed Press
Many positive book reviews praise The Pediatrician’s Guide to Feeding Babies & Toddlers as “systematically organized, practical and up-to-date” and “a wonderful guide for young parents.” Reviewers claim the book is an easy and understandable guide for their fast-paced lives. One review summed up these affirmative reviews by adding “Porto and DiMaggio address dietary hot topics—including dairy-free formulas, vegetarian diets, organic foods, gluten-free diets, and food allergies—with a calm clarity that accommodates parents’ preferences without giving in to bad popular science.”

To me, “accommodating parents’ preferences” is code for giving the parents an out not to do more research, and “bad popular science” is code for any theories that contradict the American Academy of Pediatrics (AAP) in collusion with government food and nutrition standards, which have been prescribed by the agriculture, processed food and pharmaceutical industries.

Although this book does contain some good sections, such as sound breastfeeding techniques, helpful parenting tips and child development progress charts, it is sorely lacking in the main emphasis, nutrition, and in even more instances, gives bad advice and anti-nutritious recommendations.

The book is broken down into five different age groups, the first being birth to three months. What struck me first is that Porto and DiMaggio neglected the nutritional needs for the first nine months of the baby’s development in the mother’s womb. Unborn babies and mothers have very high nutritional needs, and neglecting this facet of development is unconscionable. Maybe being baby doctors, they should have consulted an OB/GYN to help develop guidelines for the baby and mother-to-be.

Another key issue lacking in this book is advice on what a nursing mother should eat to ensure that she is delivering the proper nutrients, through her mother’s milk, to her baby. The only question answered concerning mothers’ eating habits is regarding allergies: “Should I avoid certain foods while breastfeeding to prevent allergies in my baby?” The authors “short answer is no…” They go on to say, “At this point large studies have not shown any allergy-prevention benefits from altering nursing mothers’ diets…” The studies are not listed and the subject of mom’s nutritional needs is totally skirted.

The no-proof-to-date justification seems to be a recurring theme for Porto and DiMaggio. When they discuss giving babies organic food, they start the conversation with: “To date there are no human studies [are there animal studies?] that directly show the health benefits of an organic diet or prove it to be nutritionally better than conventional foods.” So, parents get a quick off-the-hook that makes little sense, because then they give some very sound reasons to eat organic food and even share the Environmental Working Group (EWG) Dirty Dozen and Clean Fifteen lists of conventionally grown fruits and veggies with the most and least amount of herbicide and pesticide chemical input. Later in the book, they recommend not giving children organic junk food because organic doesn’t necessarily mean healthy. This is true.

Throughout the book, the authors use the USDA RDA as the basis for their recommended calories, vitamins, nutrients and overall nutrition. Unfortunately, the source of their recommended nutrition is the Standard American Diet filled with refined sugar, flour, processed meats, processed fruits and processed vegetables. The recommendations given, compared with those given by the Weston A. Price Foundation, are very low in animal fats, protein, cholesterol, fat-soluble vitamins and minerals. Porto and DiMaggio do not cover superior foods such as grass-fed meats, pastured free-range poultry and eggs, organ meats or cod liver oil. I could not find one mention, pro or con, of goat’s milk, raw cow’s milk or raw milk cheeses in the book. Maybe to the authors, including the team’s dietician and chef, the topic of raw milk was too controversial or “bad popular science,” which they have avoided altogether for the sake of book sales.

The recipes given push soy, vegetable and corn oil, and none of the recipes call for animal fat or butter. Many of the so-called high-protein recipes are based on incomplete plant protein sources such as legumes. One of these recipes, to be given to seven- and eight-month-old children, is called Blueberry-Pear Protein Puree, which calls for fruit, water and cooked quinoa. It is said to be an “excellent source of vitamin K” and a “good source of protein, folate and potassium.” One serving is four tablespoons of the fruit and four teaspoons of the quinoa, which provides 4.8 mcg of vitamin K (K1 not K2), 1.2 grams of protein, 8 mcg of folate and an unmentioned amount of potassium. I suppose that depends on the fruit itself. I’m sure the child would love to eat this sweet treat, but to avoid the 7.9 of grams sugar, a simple scrambled egg, fried in pastured butter, would give the child as much vitamin K (K2 not K1) , almost three times the protein, plus as much folate.

A couple things I found amusing were the directions on how to cut up a hotdog properly and the advice to avoid Honey-Nut Cheerios until after age one because children cannot properly digest honey. There was no advice to avoid the heavily processed, cheaply made hotdogs full of nitrates and chemicals, or to avoid Cheerios altogether because they are bad for children. Because I kept bees and because I know the attributes of honey, I’m not sure how much of the honey would remain after such heavy processing anyway. Better snack and protein foods for kids would be small cheese cubes and naturally cured salami.

Being pediatricians, and possibly receiving a nice income stream from the pharmaceutical companies, Porto and DiMaggio completely avoid the subject of vaccines, except to advise avoiding the oral form of flu vaccine for the 2016-2017 flu season. No reason is given for the rise in autism spectrum disorders (ASD). The authors see little connection between diet and the rise in ASD, nor do they see any connections between vaccinations and ASD. Along those lines, they don’t believe childhood food allergies have much to do with the Standard American Diet, the increased use of vaccinations, nor the child being overloaded with chemicals such as fluoride. They blame food allergies on the “hygiene hypothesis.” The hygiene hypothesis states that a lack of early childhood exposure to infectious agents, symbiotic microorganisms (such as the gut flora or probiotics), and parasites increases susceptibility to allergic diseases by suppressing the natural development of the immune system. Despite the fact that fluoride is an enzyme inhibitor and thyroid suppressor which can cause a lot of problems in a developing child, such as mottled teeth, weak bones and a sluggish metabolism, Porto and DiMaggio advocate fluoride drops and treatments for children with teeth because a city water system will not provide enough fluoride to protect against cavities adequately.

Overall, I found The Pediatrician’s Guide to Feeding Babies & Toddlers lacking in the traditional common sense which has been passed from generation to generation. I feel the authors also violate their Hippocratic oath to “Do no harm,” by recommending a diet for children that lacks wisdom and could unwittingly cause harm if followed by their intended audience of young parents.

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2017.

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