Can My Baby Have Salt?
Eat Play Say’s Registered Dietitian sheds some light on a controversial topic: SALT.
Starting solids with your baby usually comes with a lot of questions. If you’re doing any form of baby led weaning and/or making purees at home, the question of whether to add salt to your baby’s food has probably come up. A quick Google search may leave you terrified to let even a grain of salt touch your baby’s lips. The good news is the fears around giving babies whole foods that have been salted are based on some not-so-good research.
Current Salt Recommendations for Babies
Pretty much anywhere you look, you’re going to find recommendations that tell parents not to add any salt to complementary baby foods and to avoid giving babies food with salt- basically to keep their sodium intake as low as possible. The World Health Organization states that “salt and sugars should not be added to complementary foods.” (1) But, is there any research to actually back up this recommendation?
A recent research review published in Nov 2023 surveyed the evidence and published research from 1904-2021 to find the reasons behind the “no salt” recommendations for babies 6-12 months (10). Historically, three of the main rationales that often accompany the “no salt” rule are:
1. Infants’ kidneys are too immature to properly process sodium.
2. Salt intake during infancy can lead to high blood pressure in adulthood.
3. Babies will have a preference for salty food in adulthood if fed salt in infancy. (2)
While all these arguments may sound reasonable, the NIH research review from 2023 found that they are lacking legitimate evidence to back them up (10). So, let’s break them down so you can feel good about how much salt you decide to give your baby:
Is it true that infants’ kidneys are unable to properly process sodium?
Turns out there is no data or research to support this claim.
According to Yang et al., “The notion that salt is harmful to infants is based on studies of neonates and infants up to 3 months of age in the early 20th century. In modern society, infants below 3 months of age are exclusively fed with breast milk and/or formula, without additional food. Therefore, the risk of high salt intake no longer exists in this age group.”(2)
It IS true that newborns have a lower capacity to process sodium, but that is for newborns - not babies starting solids around 6 months. There really isn’t enough evidence to back up the claim that baby’s kidneys are unable to handle a small amount of sodium added to their food.
Is it true that salt intake during infancy can lead to high blood pressure in adulthood?
Again, there are no valid studies to date that legitimately back up this claim. Lily Nichols, RDN, explains that, “The available studies primarily involve introduction to solids far too early, have significant flaws in methodology, and DO NOT follow the infants all the way into adulthood where correlation (let alone causation) could be implied.” (3)
On the other hand, one study compared two groups of 27 infants between 3 and 8 months of age - the groups were fed identical foods except one group had salt added to their food and one did not. There was a fivefold difference in sodium content. The children were followed until 8 years old and the study concluded that “a salt intake representing the 99th percentile of sodium intake by U.S. infants in 1969 had no hypertensive effect in infancy or at 8 years of age. Nor did it imprint a preference for salt at 8 years.”(4)
Of course, this does not mean that these children did not develop high blood pressure as adults, but it is helpful to see that the group of infants with a higher salt diet did not have high blood pressure later in childhood.
If you are starting your baby on solids around 6 months, there is no evidence that completely restricting sodium will prevent future hypertension.
Is it true that babies will have a preference for salty food in adulthood if they are fed salt in infancy?
Just like the first two claims, this one also lacks sufficient evidence to be valid. Notice that in the previously mentioned study, the group of infants fed a high salt diet for 5 months did NOT have a preference for salt at 8 years old. (4)
Interestingly, there is data that actually suggests the opposite is true. There is research showing that infants with exposure to low salt intake, including while in utero, may be predisposed to higher salt intake later on. (3)
Why Is Salt Necessary for Babies?
Despite all the vilifying of sodium for babies, it is actually an essential mineral that babies need in small amounts. Sodium is an electrolyte important for many bodily functions, most notably for maintaining fluid balance and pH levels of the body, regulating blood pressure, and influencing stomach acid which is important for digestion. It also promotes cell growth and protein synthesis. Hyponatremia, or low sodium levels, is actually far more common and more serious than high blood sodium levels in infants. (5)
The consequences of low sodium levels in babies are severe.
So How Much Salt is Okay?
Infant sodium intake guidelines have been set by both the World Health Organization (WHO) and the National Academies of Sciences, Engineering, and Medicine (NASEM). An Adequate Intake (AI) amount has been given at 370 mg sodium per day for infants 7-12 months old. This is the equivalent of about ⅛ teaspoon - a very small amount! This amount was set by estimating sodium levels in breast milk and solid foods. (6) Nichols says it best on her website, as she mentioned that it is flawed to have just one set number for an AI because the amount of sodium in breast milk can vary widely, especially between different locations and ethnicities of mothers. (5) Additionally, it is impossible to know exactly how much breastmilk a nursing baby is consuming. It seems that having an AI range would make more sense.
An interesting comparison is that in the UK, the NHS recommends that babies under 1 year old consume less than 1000 mg sodium per day. (7)
While having the Dietary Reference Intake guidelines can be quite helpful for certain nutrients (e.g. iron), this one for sodium in particular is not so useful. The consensus from the research seems to be that completely restricting sodium from complementary foods is not necessary and could actually lead to too low levels of sodium.
Additionally, whether your baby is breastfed, bottle-fed, formula-fed or a mixture of these, tracking how much sodium your baby is consuming (especially if breastfeeding!) would be really difficult and is usually not necessary.
Salt at Home is Okay
If you are mostly preparing meals for your baby from scratch and seasoning them yourself, then yes - go ahead and add a small pinch of salt to baby’s food! Salt your meals as you normally would, and you can feel good about giving that same food to your baby. Salting your food makes it taste better and can help with better acceptance of the food and reduced picky eating. (Would you eat plain smashed peas without any seasoning? Yeah, probably not…So why would we expect baby to?)
On the other hand, if your baby is eating a lot of processed foods (which are best to limit or avoid if you can in infancy) then it is probably necessary to pay attention to the amount of sodium in these foods. Typically, overconsumption of sodium comes from eating too many processed foods. According to the FDA, over 70% of of dietary sodium intake comes from packaged and prepared foods. (8)
Salt in Processed Foods
Let’s look at some examples of processed baby foods, processed “kid foods,” and some other items.
My Serenity Kids Squashes Pouch - 0 mg per pouch
Gerber Rice Cereal - 5 mg per ¼ cup serving
My Serenity Kids Beef Pouch - 25 mg per pouch
Gerber Carrot Baby Food Puree - 40 mg per 1 serving
My Serenity Kids Roots Pouch - 40 mg per pouch
Thrive Market Sweet Potato Chips - 125 mg per 1 oz serving
Annie’s Organic Ketchup - 130 mg per 1 Tbsp serving
Kettle & Fire Classic Chicken Bone Broth - 155 mg per 4 oz serving
Kettle & Fire Classic Beef Bone Broth - 185 mg per 4 oz serving
Annie’s Cheddar Bunnies - 200 mg per 1 packet
Annie’s Organic Cheddar Cheese Puffs - 220 mg per serving
Applegate Organic Chicken Nuggets - 410 mg per serving
Applegate Genoa Salami - 420 mg per 1 oz serving
Amy’s Organic Cheese Pizza - 590 mg per serving
Amy’s Organic Canned Vegetable Barley Soup - 750 mg per 1 cup
Thrive Market Organic Tamari - 890 mg per 1 Tbsp serving
As you can see, all the “baby foods” have minimal amounts of sodium. The processed foods marketed more towards children have increasing amounts of sodium. Then there are the foods that are highest in sodium, such as condiments, canned soups, tamari/soy sauce, chips, deli meat/salami, etc.
A Note About Bone Broth
Something to note is that store bought bone broth does have some sodium. Yes, it is a great part of a healthy diet. However, if you’re home making a lot of your baby’s purees and thinning them with bone broth and it continues to be a regular part of your baby’s diet, just make sure you factor that into their overall sodium consumption. You are likely only adding a small amount to their foods so it’s not something to worry about, just to be aware of. You can always try making homemade bone broth as well - then you can control the sodium content. It’s easier than you think!
What Type of Salt is Best?
An unprocessed salt, such as natural sea salt, celtic salt, or Himalayan salt is a better option than iodized table salt. These salts are less processed and have a higher trace mineral content. The only caveat is they don’t have iodine added, so feeding your baby enough foods rich in iodine, such as seafood, is important. And it is important to k know that unprocessed salts are also more likely to contain heavy metals, such as lead. (9)
Hopefully some of your questions and fears around giving your baby sodium have been put to rest. The bottom line is: there is not enough research behind the recommendation to restrict baby’s sodium intake. In addition, the research that has been used to support this recommendation is extremely flawed. The 2023 NIH review of all evidence surrounding recommending no added salt for babies revealed there is no significant evidence to support the claim (10).
If you are giving your baby mostly whole, real foods prepared by you and salted by you, then there is no need to worry about them over-consuming sodium.It’s okay to prepare homemade food as you normally would by seasoning to taste and offering this same food to your baby.
If you’re gearing up for solids or you already started offering bites, this one is for you:
Sources
https://www.who.int/news-room/fact-sheets/detail/healthy-diet
https://www.sciencedirect.com/science/article/pii/S0929693X23001562#bib0020
https://lilynicholsrdn.com/salt-baby-food-infant-sodium-requirements/
Whitten, Charles F., and Robert A. Stewart. “The effect of dietary sodium in infancy on blood pressure and related factors: studies of infants fed salted and unsalted diets for five months at eight months and eight years of age.” Acta Pædiatrica 69 (1980): 3-17.
Strazzullo P, Leclercq C. Sodium. Adv Nutr. 2014 Mar 1;5(2):188-90. doi: 10.3945/an.113.005215. PMID: 24618759; PMCID: PMC3951800.
Gowrishankar M, Blair B, Rieder MJ. Dietary intake of sodium by children: Why it matters. Paediatr Child Health. 2020 Feb;25(1):47-61. doi: 10.1093/pch/pxz153. Epub 2020 Feb 6. PMID: 32042243; PMCID: PMC7002818.
https://www.nhs.uk/live-well/eat-well/food-types/salt-in-your-diet/
Di Salvo E, Tardugno R, Nava V, Naccari C, Virga A, Salvo A, Corbo F, Clodoveo ML, Cicero N. Gourmet Table Salts: The Mineral Composition Showdown. Toxics. 2023 Aug 15;11(8):705. doi: 10.3390/toxics11080705. PMID: 37624210; PMCID: PMC10459412.
Yang S, Wang H. Avoidance of added salt for 6-12-month-old infants: A narrative review. Arch Pediatr. 2023 Nov;30(8):595-599. doi: 10.1016/j.arcped.2023.08.009. Epub 2023 Oct 5. PMID: 37805298.
