Bread

Many kinds of bread can be served around 6 months, once baby is ready. Still, bread carries choking risk, and some kinds are riskier than others. Bread usually contains wheat. It may also contain other common allergens such as dairy, egg, sesame and soy. Avoid bread containing honey before 12 months, because honey carries a risk of infant botulism.

Origin

Bread is a basic food made from flour, water and heat. Around the world there are many hundreds of sweet and savory breads. Afghan bolani, Chinese laobing, Indian papadum and Jamaican bammy are examples, along with Nepali sel roti and Mexican pan dulce.

Nutrition

Every bread gives plenty of carbohydrate plus some fiber and protein. Nutrition varies widely by bread. Some are fortified with vitamins and minerals. Whole grain and sprouted breads usually hold more protein and fiber. In sourdough, nutrients are easier to absorb because of fermentation. Manufacturers often add folate and iron to white bread.

For the youngest babies, toast is safer. Bread that is not toasted may become a sticky lump that is awkward to move around the mouth. That mass could plug the airway and cause choking.

Very soft breads (brioche, challah, packaged sliced sandwich bread) turn into a sticky ball with saliva and cause gagging. Serve them as toasted strips. You can spread mashed avocado, fresh ricotta, hummus or yogurt on top. A smooth butter made of nuts or seeds can be thinned and spread in a very thin layer. Bread may break as baby chews. If a piece makes you nervous, take it away and put something else in its place.

Cracker-hard breads are risky. So are loaves with candied citrus, dried fruit, bits of nut or big seeds mixed in. After 18 months, as chewing improves, you can begin these.

Bagels: can be served after 6 months if honey-free. Toast one and cut half into a half-moon. A bagel is hard to tear and chew. Before 12 months it is more a skill tool than a filling food. Serve it with a soft spread such as labneh, ricotta or yogurt.

Flatbreads: crisp, cracker-like ones are for older children. Soft ones can be served after 6 months. Injera, roti and wheat tortillas can turn gummy in the mouth. Toast them lightly, or wait until around the first birthday. For a baby still learning to pick things up, roll soft flatbread into a stick.

At 18 months you can serve it any way you like, sandwiches included. A child may take a sandwich apart and eat the parts separately. If mixed textures are new to your child, watch closely.

Breads that are very soft, and breads that are very hard and cracker-like, both raise the choking risk. So do loaves with dried fruit, bits of nut and big seeds. Soft bread turns into a clump with saliva that clings to the tongue and palate and causes gagging. Toast it and serve strips or small pieces as the age cards describe.

Bread contains wheat. Wheat, along with other gluten-containing grains, is on the World Health Organization's global priority allergen list. It ranks high among food allergens in children. About two thirds of children outgrow it by age 12.

Wheat allergy and celiac disease are two different things. Wheat allergy can pass. People with celiac disease must follow a strict gluten-free diet all their lives. What people call gluten allergy often means celiac disease. Gluten is a protein in wheat, barley, rye and some oats. Celiac disease is an autoimmune condition in which gluten damages the small intestine. Some people are gluten-sensitive without allergy or celiac disease. If you worry about gluten and digestion, talk to a health professional.

In rare wheat-dependent, exercise-induced anaphylaxis, exercising within a few hours of eating wheat brings a severe reaction. Such people should not eat wheat for four hours ahead of hard exercise.

People with pollen food allergy syndrome, especially grass pollen allergy, may react to wheat. The sign is a short spell of burning, itching or tingling in the mouth. Sometimes there is belly pain, bloating or diarrhea. A dangerous reaction is not expected.

If you suspect a wheat allergy in your baby, talk to your pediatrician before offering bread.