As you contemplate starting your baby on solid foods, it’s important to note what various medical organizations recommend. The American Academy of Pediatrics (AAP), along with many other health agencies such as the World Health Organization and UNICEF, states that breast milk and/or formula should provide all the nutrition your baby needs during the first six months of life. However, the AAP Committee on Nutrition also notes that introducing solid foods between four and six months is perfectly acceptable; introducing babies to solids prior to four months is not recommended. Regardless of whether you start at four, five, or six months, or even later, keep in mind that solid foods will not make up a large portion of your baby’s nutrition for quite a few weeks after you start. Remember that you are introducing your baby to solid foods, not suddenly changing your baby’s diet. At this point, the term complementary foods is often used instead of solid foods, and this term best describes the early role of solids. In the beginning, you are complementing breast milk and/or formula with solid foods, not replacing them. The first few weeks should be a time to take it slow, keep it simple, and stay relaxed. Explore and enjoy the experience of watching your baby touch and taste his or her way through the wonderful world of food!
How will I know when my baby is ready to eat solid foods?
When a baby hits three or four months of age, many parents start to feel that he or she may need “something more” than formula or breast milk. Your baby may suddenly be waking up more often at night or eating more often than has been typical. But it’s important to remember that while waking at night for a feeding could indicate that your baby is ready for solid food, there might be another reason: the growth spurt that typically occurs between three and four months of age. This growth spurt often accounts for your baby’s increased appetite but is not necessarily a sign that your baby needs solid foods. You see, babies have a tremendous ability to know just what they need and when they need it. These demands for increased feedings are your baby’s way of obtaining the crucial nutrition his or her body needs during this time of rapid growth. Remember, during these early months, formula and/or breast milk are your baby’s most important source of nutrition.
Studies show that babies are highly individual in developing a readiness for solid foods. One baby might seem to be ready at four months, while another shows no signs of readiness until around six or seven months. Since appetite alone is not a reliable indication, here are a few key signs to look for when trying to determine if your baby is ready to begin the journey into solid foods:
Has baby lost the tongue thrust reflex? In the first four months, the tongue thrust reflex prevents a baby from choking on foreign objects. When any unusual substance is placed on the tongue, it automatically protrudes outward rather than back. Between four and six months of age, this reflex gradually diminishes. Until the reflex is gone, solid foods won’t have a chance of making it into baby’s belly.
Has baby developed the ability to signal that she is full? Your baby will develop the ability to let you know that she is full from a “meal” with signs such as turning away from the bottle or breast and/or clamping her mouth shut. This signaling ability is critical for allowing her to regulate the amount of food she is eating and helps her avoid overeating.
Is baby able to sit up and hold his head up unassisted? This milestone is important because babies who must be reclined to be fed are at greater risk of choking. Also, the ability to sit up and have head control has long been associated with the physical maturity that might indicate baby is ready to eat solids. Most pediatricians are in agreement that this milestone is a clear indicator that a baby is ready to begin solid foods.
Has baby’s birth weight doubled? The doubling of birth weight is a rough rule of thumb that baby is ready for solid foods. It’s far from an exact rule, though, so you should consider the other signs as well.
Some infant developments that are traditionally viewed as a sign of readiness for solid foods are less reliable:
Interest in your food. This could signal a readiness for food but it may not be the best sign: when a baby reaches four to six months of age, he is interested in putting everything in his mouth!
Frequently waking in the middle of the night when a consistent sleeping pattern had been established. As noted earlier, although frequent waking could be a sign of readiness for solids, it’s not a reliable sign. Baby may be waking (and nursing/feeding) for any number of reasons: illness, teething, or even a growth spurt. Unfortunately, as you will learn over the coming months and years, sleeping patterns are often disrupted for all sorts of reasons even long after your child is on a solid food diet.
Watch Your Baby, Not the Calendar
As you know, all babies are different individuals. Don’t worry if your baby does not take to solid foods “on schedule,” and don’t let others try to convince you that your three-month-old looks hungry and needs to eat some cereal. Pay attention to your baby’s signals and cues, and “watch your baby, not the calendar” when thinking about starting solids. Most important, don’t let others make you feel guilty or second-guess your decisions. You know your baby best! Don’t be pushed into starting solids early, and don’t ever feel you are a “bad” parent if you believe your baby is or is not ready for solids before he or she is six months old.
Discuss the pros and cons of introducing solid foods with your pediatrician—and don’t be afraid to voice your own views and concerns. If your pediatrician insists that you start your four-month-old infant on solids and you don’t feel your baby is ready, voice your concerns and ask the pediatrician to explain his or her recommendation. The ensuing discussion might surprise you and help you make a decision.
Is it ever too late to introduce solid foods to a baby?
There are two reasons babies can indeed be introduced to solids “too late” (the term late here means later than six months of age):
Allergies. Since 2007, several clinical studies have pointed to the possibility that the late introduction of solid foods might increase the risk of allergies both to foods and to airborne substances such as pollen. While research in this area is not yet conclusive, risking an allergy to certain foods is one reason not to wait longer than approximately six months of age to introduce solids.
Iron Requirements. Babies are born with iron stored in their bodies. Around six (and some say up to eight) months of age, these iron stores will become gradually depleted and leave your baby at risk for iron-deficient anemia. While your baby’s iron will not disappear completely, her levels may fall significantly. So waiting too long to introduce solid foods may put her at risk for anemia.
You may have heard that there is a “window of opportunity” for a baby to learn how to chew and eat solid foods. This is more myth than fact. There is no evidence that babies who are started relatively late on solids have any trouble learning to chew and swallow. When your baby is ready, he will eat! If a baby has reached the age of seven to eight months and continues to have no interest in eating solid foods, you should consult with your pediatrician, as there may be developmental or other issues going on.
My baby is ready to eat solid foods; how should I start and what should I feed?
There are a few things to keep in mind as you begin the transition to solid foods. Two of the most important are to (1) take it slow; and (2) keep it simple. Choosing which food to start your baby on is one of the fun aspects of beginning solid foods. Here are a few great choices for nutritious and tasty starter foods for your baby.
First Foods
Why These Are Good Choices |
| Fruits |
|
avocados, bananas, pears, apples |
Smooth, creamy, and lightly sweet, these fruits are loaded with important nutrients, and they are also easily digested. |
| Vegetables |
|
sweet potatoes, acorn or butternut squash, green beans |
Orange vegetables like sweet potatoes and squash are really tasty; they can be made smooth and creamy, and they’re packed full of vitamin A, vitamin C, and even some iron. Green beans also make a great first food for those who wish to start with vegetables that are green.* |
| Grains |
|
rice, oats |
Rice and oats are two traditional starter grains for babies. They are not highly allergenic and are relatively easy to digest. Brown rice and steel-cut oats may be easily made into “baby cereal” and offer the most nutrients. |
Isn’t rice cereal always the first food?
As you can see, there are many nutritious food options for your baby’s first food besides rice cereal. While rice cereal has been the traditional first food, there is no reason that you absolutely must start solid foods with rice. Many pediatric resources are starting to acknowledge that avocado, banana, and sweet potato make great first foods for babies. The AAP now states, “For most babies it does not matter what the first solid foods are. By tradition, single-grain cereals are usually introduced first. However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby.” Rice cereal can be a good starter food because it is low on the allergen list, is relatively easy to digest, and provides additional iron. However, skipping the cereal and starting with a tastier fruit or vegetable might be perfect for your baby. In a 2009 interview with Pediatric News, Dr. Frank Greer, of the Committee on Nutrition at the American Academy of Pediatrics, indicated that solid foods for babies should be introduced based on their nutritional makeup and not on simple tradition. In fact, offering rice cereal as a first food does not make a lot of sense because it is low in protein and high in carbohydrates.
Is there a risk of iron-deficiency anemia if fortified rice cereal is skipped?
As solid foods are introduced, parents often worry that their baby is not getting enough iron. Rest assured, the vast majority of babies will not become iron-deficient if they do not eat a fortified baby rice cereal, nor will they become iron-deficient if they do not receive supplements. Even if the iron content of a mother’s breast milk is lower than that in formula, a baby who is exclusively breast-fed is seldom at risk for iron-deficiency anemia because the iron in breast milk is absorbed at a higher rate. And babies who are formula-fed are also seldom at risk for iron deficiencies because most formulas are iron-fortified. The best thing you can do is consult with your pediatrician about your baby’s need for additional iron. Your pediatrician is likely to test baby’s iron levels as part of his or her regular checkups at six and/or nine months.
It is true that iron-deficiency anemia is the number one nutritional concern in infants, but the babies most at risk fall into the following categories:
Babies who were born prematurely (iron stores build in the last few months of pregnancy)
Babies who had a low birth weight even though they were born “full term”
Infants whose mothers had iron-deficiency anemia, were of poor nutritional status during pregnancy, or had diabetes
The importance of consulting with your baby’s pediatrician about the need for iron-fortified cereal and/or iron supplements cannot be stressed enough. All babies are different, and generalities may not apply to your baby.
The Four-Day-Wait Rule
Whether you choose to make baby food or purchase commercial baby food, it is best to abide by the “four-day-wait” rule: introduce your baby to one food at a time and wait approximately four days to introduce the next food. That way, if your baby has a negative reaction to a food, you’ll be able to quickly pick out the offending food and eliminate it from baby’s diet. Once you have introduced several new foods without a reaction, you can begin to mix them together.
When your baby is around eight to ten months old, you will have introduced many new foods and will have a good idea which foods may be allergenic or cause your little one digestive upsets. At this stage you can be less strict about applying the four-day-wait rule. However, it is still important to pay attention to the new foods you offer your little one, especially those that pose an allergy risk.
A few pediatricians have suggested that there is no need to wait between introducing one food and another and that it is fine to introduce baby to several foods at a time. On balance, though, there is no downside to following the rule, especially during the first few weeks of beginning solids. You should decide whether you want to follow, or not follow, the rule based on your baby’s family history of food allergies and your baby’s overall digestive behaviors. In particular, babies who have a family history of or a particular risk of food allergies will benefit most from the four-day-wait rule.
Introducing Solid Foods: Food Stages and Developmental Stages
As your baby matures, she will continue to develop and reach many wonderful milestones. Feeding stages are part of this process, of course, and the variety of reactions you will encounter at each stage will often delight you even as they prove challenging. For example, two of the most popular are the “I want to feed myself!” stage and the “refusal to eat” stage. Just remember that you are fostering and building healthy eating habits for your little one. This knowledge should help keep you moving happily forward, even if your baby refuses to eat her favorite food and you are cleaning up the fourth spilled bowl of yogurt and fruit in one day.
Keep in mind that the ages listed for each stage are ranges, and there is a fair amount of overlap for the different phases. It is impossible to pinpoint the specifics for all infants because, as noted, infants begin solid foods at different ages, so their progression through the various solid food stages may differ greatly. Part II of this book provides plenty of easy and delicious recipes for you to try in each of these stages.
Four to Six Months—Let’s Start Eating!
You have already read a bit about good first food choices and foods to avoid; now let’s talk a little about feeding. When baby is first starting solids, the food you offer should be relatively thin and a bit runny. Start out slowly and prepare one or two tablespoon-sized portions of whatever food you have chosen to start with. To take the edge off baby’s hunger, nurse or bottle-feed before offering your little one solids. Milk continues to be more important than any solid foods at this age. Some parents begin offering their babies solid foods by using their (clean and washed) finger as a spoon. They say that this helps their babies enjoy and take to solid foods more easily. They feel that introducing the “new” spoon and the “new” food all at once can confuse or overwhelm their baby.
Baby cereal and soft-cooked, thinly pureed fruits and veggies should be baby’s first solid food experiences. Offer your baby single ingredients only, and offer each new food four days apart (remember the four-day-wait rule). You may skip the cereal and begin with a fruit like avocado or with a veggie like butternut squash or sweet potato. Try the avocado recipe here or sweet potatoes here.
Six to Eight Months—We’re Moving On!
If your six-to-eight-month-old baby is just starting solids, the food you offer should still be relatively thin and a bit runny. Again, start slowly and prepare one or two tablespoon-sized portions of whatever food you have chosen to start with. Your baby might be crawling and trying to pull herself up as she nears eight months old. If she has been eating like a champ and now suddenly refuses to eat, you may wonder if you’re raising a picky eater. Don’t worry: at this stage baby is simply too busy exploring her world to stop for anything else. In fact, she may get quite miffed when you put her in her high chair to have a meal.
With her independence growing, she may also begin to show preferences for certain foods and may start refusing to be spoon-fed. Why not give her the spoon and let her start to practice? Take heart—this stage of baby feeding, while challenging, will soon pass. Let your baby be your guide and try not to get frustrated. It’s important for her to feel that she has some say in which foods she eats, so offer a healthy variety and rest assured she will get everything she needs.
This age/stage also ushers in the dawn of spices (see here), textures, and adventure. Start cooking with some spices and slowly add mashed or chopped bits of fruits, vegetables, and meats. Remember, baby will not have molars until sometime around twelve months of age. Foods should be easily squished between the gums. If you haven’t done so yet, try offering raw fruits (pureed or mashed and carefully peeled, pitted, and seeded as needed) at this stage. (Try Mango Madness, here.) While you may have already introduced yogurt, cheese makes a great addition to baby’s diet. See, for example, my recipe for Cottage Peaches here. This is also a great time to try pasta and myriad grains such as quinoa and kamut that are super-tasty and nutritious. Pasta, veggies, and fruit should all be soft-cooked and possibly mashed with a fork or masher. Meats and proteins such as egg yolk should be cooked and pureed or chopped into small, soft bits. If offering tofu, you need not cook it first.
Eight Months and Up—We’re Almost Toddlers Now and We Want Grown-up Foods!
By this age/stage, your baby is on the brink of, or may already be, eating “table foods.” He may love self-feeding and enjoy a variety of tasty spices and textures in his cuisine. Check out the popular Apple Turkey Loaf or Sticks recipe here for a great combination of protein, vegetables, fruits, and spices. Now is a great time to encourage a healthy exploration of new foods, tastes, and textures as well as eating utensils. At this time, your baby has likely found a few favorite foods. He may also have developed a preference for feeding himself and a distaste for thin, runny purees. Like the six-to-eight-month-old baby, he may suddenly refuse to eat, but it is rarely a cause for concern. He’s simply too busy playing and exploring to stop and eat. Trust your baby’s hunger instincts and watch his cues; babies will never starve themselves, so don’t worry too much about this refusal to eat.
With his independence growing, baby may begin to show a strong preference for certain foods and may even start refusing anything but his favorite foods. Continue to expand his palate by offering new foods and flavors, and don’t get stressed about how much is being eaten. Experiment with new spices and new flavorful combinations, like the Dirty Rice recipe here and others in stage three. Offer your budding foodie a yummy chicken curry or tasty fish, for example! (An all-time favorite, Simple, Fantastic Fish, is here.)
In the appendix of this book, you will find charts of the foods that are appropriate for the different stages and ages. And the recipes in part II have been presented in three sections corresponding to each of the stages (with their appropriate age ranges).
Now that you have read all about introducing solids, the various first food choices, and the stages of progression, it’s time to actually feed your baby. Just remember: Take it slow, keep it simple, and have fun! Your baby will make all kinds of faces that you may not have seen before, and you will probably go through the motions of scraping the food off her chin and back into her mouth quite a few times (not to mention off the high chair, the floor, your clothes…). Keep your cool and your sense of humor—it can come in very handy. Many parents like to capture these moments in photos, so have your camera ready as well. Lights, camera, action!