Starting solid foods

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Pediatrics

It is exciting to see babies try solids for the first time and then all the different foods that follow – watching all of the funny faces they make as they get to experience many new tastes and textures. Their faces may look sort of “scrunched” together, or sometimes they shake their heads back and forth or exhibit a little shudder.

But when can babies start eating solid foods?

The American Academy of Pediatrics recommends to breast-feed only until 6 months. However, your baby’s doctor may recommend starting solids earlier, especially for formula fed babies. Some babies may be considered ready to start solid foods when they are either 4 months old or weigh 14 pounds.
Another rule of thumb is that baby should be able to sit up in a high chair or infant seat with good head control before trying solid foods.
They should express interest in putting solid foods in their mouth, be able to move the food off the spoon into his or her mouth and throat, and turn their head to the side to let you know if they do not want something.

When in doubt, it’s always best to talk with your baby’s doctor.

Why should I wait and how do I know if my baby is ready?

A baby’s digestive tract is not fully developed enough to process solids until 4 months or older. Before 4 months old, their intestines are designed to digest and absorb breast milk or formula only. They do not have all the absorptive enzymes in their intestinal tract yet. Infants also need enough neck strength and head control to take in solids. They need to be able to lean forward and open their mouths in anticipation of what is on the spoon, and they need to be able to turn their heads away if they do not want another spoon full, regardless of the reason. This helps prevent gagging, choking or aspirating on food particles into their lungs.

Finally, babies have a reflex known as a “protrusion reflex,” or “tongue thrust.” This means before 4 months old, whatever you try and spoon into their mouth, they are probably going to push it back out with their tongues. If this happens, your baby is likely not ready to start solids and you shouldn’t force it.

In some instances, babies will weigh 14 pounds by 3 to 3.5 months of old. Because these infants are consuming so much formula or nursing constantly, pediatricians may allow starting cereal a little early. But only cereal, because we don’t want to challenge their tiny digestive tracts with anything else until baby is older and their digestive tracts are ready.

Note: sleeping through the night is a sign of mental maturity for children. When you do start solids, make sure your child does not eat solids before going to bed. Doing so can hinder the maturity process while adding unwanted calories to your baby’s diet.

How to start solid foods

The big question is what should come first? Your baby’s first foods are your choice It’s best to start with foods that are high in iron and zinc. The foods highest in these nutrients are iron-fortified cereals and meats. Foods should be soft or pureed to prevent choking. Introduce “single ingredient” new food from any food group every 3-5 days and watch for a reaction. Within a few months of starting solid foods, your baby’s daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; and fish. There is no need to wait to introduce any of these foods, and doing so has not been shown to reduce food allergies.

If your baby has severe eczema and/or another food allergy, testing for peanut allergy is recommended before giving peanut-containing products. Click here to learn more about food allergies and children.

How to start cereal

Begin by pouring a teaspoon of cereal into a bowl. Add a small amount of slightly warmed formula or pumped breast milk. Don’t add too much milk or formula, as you are trying to introduce the cereal so you’ll want some texture in the mixture. Feed the cereal by spoon, not in a bottle.

It is recommended to try cereal in the morning and at suppertime, then nurse or bottle feed in between. As your baby takes what you have made, you can gradually make more each time. By 6 months of age, most babies take between 2 and 3 tablespoons of cereal twice a day.

How to start fruits and vegetables

After introducing cereal, and as early as 5 months old, you can try fruits or vegetables. You may have heard that babies who try fruits before vegetables will refuse vegetables. This is not true.

Whichever you start with, fruits or vegetables, the main thing to remember to introduce only one type of fruit or vegetable at a time. Choose and stick to that fruit or vegetable and offer it with each meal for 4 or 5 feedings. This gives you a chance to see if baby likes your choice and if they will have any reaction to that particular fruit or vegetable before you move onto a new one. If you offer a different fruit or vegetable with each meal, you may confuse your baby, and they may refuse to eat.

Note: For vegetables, most babies tend to prefer the sweet yellow vegetables (sweet potatoes, squash and carrots) to the green vegetables. This doesn’t mean you need to start with sweeter vegetables first. It’s just something to be aware of.

How much should I feed baby?

As far as serving sizes, babies will take about the same number of vegetables as fruit. By 6 months, most babies are taking between one half and a full container of “first fruits” for breakfast, lunch and supper. There is no need for vegetables with breakfast. The schedule that you are developing will include

cereal and fruit for breakfast,
fruit and veggie for lunch, and
cereal, fruit and veggie for supper.

You should notice that your baby relies a bit less on formula or breast milk as they advance their solid food diet. This is to be expected. At 5 months of age, many parents will start offering a small amount of formula or breast milk in a sippy cup with meals. This is appropriate.

What if my baby spits out or gags when eating solid foods?

When moving from purees to larger pieces of food, some parents find that their baby will spit it back out or seem to gag instead of being able to swallow it. In this case, you can give your baby a little bit more time, maybe about a week, and then try again. You could also try switching the formulation of the food you’re offering, trying a different spoon or approach, but follow your baby’s cues.

It’s not a problem for babies to have several weeks, especially in that six to nine month range, of adjusting to new tastes and new textures. The only reason for concern if baby is not tolerating solid foods would be if their pediatrician expresses concerns based on their weight gain or the variety of foods that they're eating.

Starting solid food is a great developmental milestone for your baby to reach. It is an exciting time, but also a step towards future independence. So, get ready to have fun! Watch all the goofy faces and have baby food everywhere besides where it belongs, which of course is in your baby’s mouth.

If you have questions about solid foods, talk with a pediatrician. Meet ours!