Starting solids is an exciting milestone for your infant. It’s also a great opportunity to start good habits for a lifetime of healthy eating.
The American Academy of Pediatrics (AAP) recommends waiting until at least 4 months of age, preferably 6 months, to start to give your baby solids. You can look for the following signs that your infant may be ready to start solids:
- Can sit with little or no support and has good head and neck control
- Is interested in what you are eating
- Opens mouth or leans forward when interested in food and turns away when not interested
I often discuss signs of readiness for solids at the four-month checkup, anticipating that most infants will be ready to start solids between 5-6 months. Your child’s primary care provider will have a number of helpful tips for you, but these are some of the common questions parents ask:
What foods can I give my baby when they start eating solids? How much should they eat?
Your infant’s primary source of nutrition will remain breast milk or formula. When babies start eating solids, it is mostly a developmental process of exposing them to new tastes and textures and helping them to become familiar with swallowing purees or soft foods. Eating should be a fun, pleasurable experience for them. Every baby is different with regard to how much they want to eat at the start, but for most it will be just a few spoonfuls.
Infant cereals are a common first choice because they can be mixed with breast milk or formula (familiar tastes) and made to thinner consistencies to start. Smooth purees of vegetables and fruits are other good options, and I especially like avocado because it is easy to mash and contains healthy fats.
If your infant is breastfed, they will start to need more iron than breast milk can provide at about 4-6 months, which coincides nicely with starting solids. Infant cereals are fortified with iron. Other foods rich in iron include beans and lentils (which mash nicely), certain green vegetables, and meats (which you can puree with fruits or vegetables). If your baby is formula-fed, there is iron in their formula.
Many pediatricians recommend trying one new food every 2-3 days. I am comfortable with babies trying one new food every day if their family and I have spent time discussing signs and symptoms of allergic reaction and parents know what to be watching for.
Are there any foods to avoid with babies?
Infants younger than 12 months should not have honey because it may contain a harmful toxin (botulism). Babies should drink breast milk or formula. They should not drink cow’s milk until they are 12 months old, as it can cause intestinal irritation and interfere with iron absorption. It is fine for them to have yogurt and cheese before 12 months, but wait for cow’s milk until their first birthday.
Avoid adding additional salt or sugar to your infant’s food.
Choking hazards include:
- Foods that are round, such as grapes or sliced hot dogs — they can lodge in a baby’s airway
- Foods that are small and hard, such as nuts or seeds, hard candies, raw vegetables like carrots, etc.
- Things with two textures, like a muffin with nuts or popcorn with kernels
Should I be worried about food allergies?
With the marked increase in food allergies in children in the U.S. over the past few decades, this is something I discuss with every family as they prepare to feed their infant solids for the first time. The foods that are considered to be higher risk for allergic reaction (“highly allergenic”) are egg, peanuts and tree nuts, soy, fish and shellfish, wheat, and cow’s milk.
NOTE: If you have a family history of food allergies or your infant has had issues with eczema, talk to your child’s primary medical provider about the safest way to introduce potentially allergenic foods into their diet.
There are growing scientific data that earlier introduction of the highly allergenic foods is not harmful and may be helpful in preventing food allergies.
I give families a few tips about starting the highly allergenic foods:
- Try the first tastes of these foods at home on a quiet day when you can watch your infant’s response.
- Start with a few tastes, and if there is no sign of reaction, gradually give in increasing amounts.
- If you notice a rash, take a cell phone picture of it if you have camera phone available. You can bring it to your next visit to show to your child’s care provider.
There is a helpful article on the AAP’s parenting website about signs and symptoms of food allergy.
What if my baby doesn’t like what I am offering?
If your infant refuses a certain food, don’t worry! Just try it again in a week or so. Often they won’t want something one week but will happily eat it the next. This should be a fun, new experience for them, and they will take their cues from you. You probably will see them grab at their spoon, stick their hands in their food, rub it on their face and in their hair and generally make a big “mess.” Letting them explore their food and new textures is an important part of the process.
Good luck, and have fun.
Other resources, from HealthyChildren.org:
- Starting Solid Foods
- Bite-sized Milestones: Signs of Solid Readiness
- Choking Prevention
- Food Allergies in Children: How do I Know if My Child Has a Food Allergy?
Molly Martyn, MD, is a primary care provider on the Minneapolis campus of Children’s Minnesota.