Starting solids with your baby

When can my baby begin solid foods?

According to the American Academy of Pediatrics and the American Academy of Allergy Asthma and Immunology, the ideal time to start solids is between 4 ½ to 6 ½ month of age. Breastmilk or formula should be the sole source of nutrition until this point, and even once solids are started, breastmilk or formula is still a baby’s main source of calories and nutrition for the next several months.  Look for these signs that your baby is developmentally ready to start solids:

  • Can they hold their head up? Your baby should be able to sit in a high chair, feeding seat, or infant seat with good head control.
  • Do they open their mouth or get excited when food is near? Babies may be ready if they watch you eating, reach for your food, and seem eager to be fed. 
  • Can they move food from a spoon into their throat/no longer have a strong tongue thrust reflex (pushes tongue out)? If you offer a spoon of food and your baby pushes it out of their mouth, they may not have the ability to move it to the back of the mouth to swallow it. Remember, they have never had anything thicker than breast milk or formula before, and this may take some getting used to. You may want to wait a week or two and try again.

How do I feed my baby?

Start with half a spoonful or less and talk to your baby through the process (“Mmm, see how good this is?”). Your baby may not know what to do at first. She may look confused, wrinkle her nose, roll the food around her mouth, or reject it altogether.

Do not be surprised if most of the first few solid-food feedings wind up on your baby’s face, hands, and bib. Increase the amount of food gradually, with just a teaspoonful or two to start. This allows your baby time to learn how to swallow solids.

Do not make your baby eat if she cries or turns away when you feed her. Go back to nursing or bottle-feeding exclusively for a time before trying again. Remember that starting solid foods is a gradual process and at first your baby will still be getting most of her nutrition from breast milk and/or formula.

NOTE: Do not put baby cereal in a bottle because your baby could choke. It also may increase the amount of food your baby eats and can cause your baby to gain too much weight. Rarely, cereal in a bottle may be recommended if your baby has reflux. Check with your child’s doctor.

Which food should I give my baby first?

There is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. In the past, single-grain cereals (rice, oat, barely) have usually been introduced first, however for most babies it does not matter what is given first. Nowadays we generally recommend avoiding rice cereal because of possible arsenic contamination and because it tends to constipation.  The American Academy of Allergy & Immunology suggests introducing single-ingredient infant first, such as apples, pears and bananas, green vegetables, sweet potatoes, squash and carrots, and cereal grains one at a time.

There is no evidence that your baby will develop a dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this. They will not necessary love vegetables if given veggies first!

If your baby has been mostly breastfeeding, he may benefit from baby food with iron (meat, or iron-fortified cereal) early on.

When can my baby try other food?/Is anything off limits?

Once your baby learns to eat one food, gradually give him other foods. Give your baby one new food at a time, and wait 1 to 3 days before starting another. After each new food, watch for any reactions (may be allergic or just digestive reactions such as diarrhea, vomiting, or rash). If any of these occur, stop using the new food and consult with your child’s doctor.

There is no evidence that introducing any particular food after 6 months of age determines whether your baby will be allergic to them. Egg, dairy foods (cheese, yogurt), peanuts, tree nuts, fish, shellfish, and strawberries can be gradually introduced during the first year after less allergenic foods have been tolerated. In fact, delaying the introduction of these foods may increase your baby’s risk of developing allergies.

Sips of water may be introduced after 6 months.

*Off limits: No cow’s milk or milk substitutes (almond/soy/rice) to drink before 12 months. Drinking cow’s milk will make your baby drink less of the breastmilk or formula that is so important for your baby’s growth and development. After 12 months baby may switch to whole milk (24 oz or less is ideal, otherwise they fill up on milk and may miss out on certain nutrients).

*Off limits: No honey before 12 months. This is not because of allergies; Honey might contain spores that can cause a serious illness known as infant botulism.

*Off limits: No juice. Your baby does not need juice. Older toddlers and children do not need juice. Older children may enjoy juice occasionally, but in small quantities (4 oz. or less per day) - think of it as a treat. 

When can I give my baby finger foods?

Once your baby can sit up and bring her hands or other objects to her mouth, you can give her finger foods to help her learn to feed herself. To avoid choking, make sure anything you give your baby is soft, easy to swallow, and cut into small pieces. Some examples include:

  • Pieces of banana
  • Wafer-type crackers or biscuits
  • Scrambled eggs
  • Well-cooked pasta
  • Well-cooked chicken finely chopped
  • Well-cooked and cut up yellow squash, peas, and potatoes
  • Muffin/patty/pancake type textures (can make savory or vegetable versions too!)

Limit giving your baby foods that are highly processed, as these foods often contain more salt, sugar, and other preservatives.

NOTE: Do not give your baby any food that can be choking hazards, including hot dogs (including meat sticks [baby food “hot dogs”]); nuts and seeds; chunks of meat or cheese; whole grapes; popcorn; chunks of peanut butter; raw vegetables; fruit chunks, such as apple chunks; and candy.

What changes can I expect after my baby starts solids?

When your baby starts eating solid foods, his stools will become more solid and variable in color. Because of the added sugars and fats, they will have a much stronger odor too. Peas and other green vegetables may turn the stool a deep-green color; beets may make it red. (Beets sometimes make urine red as well.) If your baby’s meals are not strained, his stools may contain undigested pieces of food, especially hulls of peas or corn, and the skin of tomatoes or other vegetables. All of this is normal.

Your baby’s digestive system is still immature and needs time before it can fully process these new foods. If the stools are extremely loose, watery, or full of mucus, however, it may mean the digestive tract is irritated. In this case, reduce the amount of solids and introduce them more slowly. If the stools continue to be loose, watery, or full of mucus, or if there is ever blood in the stool, consult your child’s doctor to find the reason. 

Good eating habits start early

It is important for your baby to get used to the process of eating—sitting up, taking food from a spoon, using their hands to feed themselves, resting between bites, and stopping when full. When you can, the whole family should eat together. Research suggests that having a meal together as a family on a regular basis has positive effects on the development of children.

Remember to offer a good variety of healthy foods that are rich in the nutrients your child needs. Watch your child for cues that he has had enough to eat. Enjoy!

You may find helpful ideas at the Ellyn Satter Institute.

As always, please contact your Concord Pediatrics provider at (603) 224-1929 with any questions!