This post was originally published in September 2011 but is updated to reflect the American Academy of Pediatrics’ new policy statement on Breastfeeding and the Use of Human Milk, published online February 27, 2012. It is available in free full text online, and it includes a nice summary of the research supporting breastfeeding and the Baby-Friendly Hospital Initiative.
Starting solid foods is one of the major landmarks of a baby’s first year. You play a very active role in your child’s experience with food, and your goal is to make that experience healthy, fun, and safe.
Here are 10 tips to get you off to a good start.
1. Introduce your baby to solid foods around 6 months of age. The World Health Organization and the American Academy of Pediatrics recommend that babies be breastfed exclusively for the first 6 months. Around 6 months, they recommend that you begin introducing complementary foods but continue breastfeeding through the end of the first year and longer if desired. For formula-fed babies, it is probably less-important to wait until 6 months to introduce solid foods, but there is also no reason to jump the gun. Solid food should never be introduced before 4 months of age, and your baby should display the following signs of readiness before trying his first bite:
- Your baby should be able to sit up in a high chair and hold his head up on his own.
- He should show signs of interest in food and open his mouth when it is offered.
- He should be able to move food from his mouth into his throat. If you offer a spoonful of food to your baby and he seems to push it right back out of his mouth, give him a few more practice bites, but also consider waiting another week or two. He just might not be ready yet.
I can remember being really concerned about the decision of when to start BabyC on solid foods. In hindsight, I wish I had relaxed a bit more. She didn’t really start eating more than a few nibbles until around 6.5 months, and there was no rushing the process. Besides, life was easier before solid foods! Breastfeeding was simple and not nearly as messy as solids. That being said, it is important that your baby have opportunities to try solid foods around 6 months, because around this age, breastfed babies in particular need to start eating iron- and zinc-rich foods.
2. You can skip the white rice cereal. Yes, it is fortified with iron, and that is a good thing, and yes, it is easy to digest. On the other hand, white rice cereal is pure starch (refined rice flour) and not that tasty or nutritious, except for the added iron. Try whole grain baby cereals like oatmeal, barley, or brown rice cereal, which are also fortified with iron. Just start with single-grain cereals so that you know the culprit if your baby has an allergic reaction (see #4). There is also no reason that cereal has to be your baby’s first food. Whoa, you say, now you’re really blowing my mind. I know, keep reading…
3. Focus on meats, legumes, veggies, and fortified cereals. Meat is a great complement to breastfeeding in older infants, because it is a good source of iron and zinc, both of which are low in breast milk (Krebs and Hambidge, 2007). However, there is a common misconception among parents that meat should not be used as an early food for infants. In a 2008 survey of the dietary habits of infants and toddlers, only 8% of 6-9-month-old infants ate meat or poultry at least once per day (more ate those jarred baby food “dinners” which contain some meat but also a lot of crap) (Siega-Riz et al. 2011). There is no reason to wait on meat – you can make it one of your baby’s first foods. Eggs and fish are also a great choice. Legumes are packed with protein and fairly high in iron – try lentils, mashed chick peas, or beans. Vegetables are nutritious and usually well received by your budding foodie. Offer some fruits, but know that they don’t give you as much nutritional bang for your buck, being higher in sugar and water. Including two daily servings of fortified cereal in your baby’s diet will help ensure that he is getting enough iron, but check out my recent post (5 Practical Ways to Increase Iron in Your Baby’s Diet) for other tips. Dairy products such as cheese and yogurt are also fair game but should be fed in limited amounts.
4. Wait 2-3 days between introducing new foods. This gives you time to watch for symptoms of a food allergy, and if those symptoms should appear, you will know that they are likely due to the new food. Symptoms of food allergy include diarrhea, rash, and vomiting. Common food allergies include egg white, fish and shellfish, wheat, cow’s milk, soy, citrus, and berries. Pediatricians used to recommend delaying the introduction of egg whites, fish, and peanuts, but the AAP now gives these a green light at 6 months. In fact, delaying the introduction of these foods may increase the chance that your child will develop an allergy to them. However, if you have a history of food allergies in your family, talk with your pediatrician about the timing of introduction of high allergy foods. For all babies, avoid honey until the first birthday. Honey can be contaminated with botulism spores, and the risk of botulism is greatest in infants.
5. Experiment with different textures. Your baby may prefer a thinner or thicker puree. Or he may prefer to skip the purees altogether. We tried giving BabyC purees very little success, but then we discovered that she loved finger foods and moved straight to those. Soft fruits, avocado, cooked vegetables, and pasta were a big hit. There is a movement called Baby Led Weaning that advocates for skipping purees all together. A recent study found that toddlers that were initially introduced to solids with a baby-led finger-food approach had a lower incidence of obesity (Townsend and Pitchford, 2012). It was a small study with a few limitations, but the results are interesting nonetheless.6. Let your baby set the pace of meals. Whether you start with purees or finger foods or a combination, your baby should decide how fast and how much food to eat. This comes naturally when your baby eats finger foods. If you are spoon-feeding, be sure to stay tuned in to your baby and enjoy the meal together. Wait for your baby’s cues that he wants more before pushing the spoon into his mouth. Let him lean forward and open his mouth to show you that he’s ready for the next bite. By being responsive to your baby in this way, you are teaching him to listen to his body and honor his own cues of hunger and fullness, a skill that will serve him well throughout life.
7. Do you know what to do if your baby starts choking? Make sure you do. Learn the baby Heimlich maneuver. The Heimlich is easy enough, but if you haven’t already, this is a good time to take an infant/child CPR class, which will include handling a choking emergency. At this age, any number of things in your house and the world, including food, can be choking hazards, and you should be ready. Obviously, avoid giving your baby foods that are small and firm such as raisins, popcorn, and nuts.
8. Start slow. Start with one solid meal per day, which may be just a tablespoon or two at first. As your baby starts to show more interest in food, gradually increase the amount offered and the number of meals up to three solid meals per day around nine months of age. Think of this time as a gradual transition towards more solid foods, but let your baby set the pace. At first, your baby will not be eating enough solids to affect breast or bottle feeding, but you will gradually decrease the number of milk feedings as your baby gets more and more calories from solids.
9. Know that every baby is different. Some babies will eat like a pro on day one. Ours did not. If your baby is slow to start solids, don’t worry and don’t rush him. Just trust that he’ll get it eventually. Meal timing may be important to your success. If your baby is too hungry or too full, he may not be interested in solids. Many parents find that nursing on one side, then trying some solid food, then returning to nurse on the other side, works well.
10. Set your baby up for a lifetime of healthy eating by modeling healthy eating habits. Your baby will reach an age when he wants to eat what is on your plate, so if there are french fries on your plate, that’s what your baby will want. Babies are remarkably adept at recognizing hypocrisy when they see it. Make an effort to sit down to eat as a family, with your baby included. Make mealtime a social, pleasant time. It should never be rushed or forced. For more ideas, check out my recent post – Enjoying and Exploring Food with Baby.
I hope these tips help as you embark on your baby food adventure! But like I said, every baby is different. If you are just beginning this process, what other questions do you have? Experienced mamas and papas – what did I leave out?
American Academy of Pediatrics. Breastfeeding and the Use of Human Milk, Policy Statement. Published online February 27, 2012. www.pediatrics.org/cgi/doi/10.1542/peds.2011-3552
Krebs, N.F. and K.M. Hambidge. Complementary feeding: clinically relevant factors affecting timing and composition. Am J Clin Nutr. 85(2): p. 639S-645S. 2007.
Siega-Riz, A.M., D.M. Deming, K.C. Reidy, M.K. Fox, E. Condon, and R.R. Briefel. Food consumption patterns of infants and toddlers: where are we now? J Am Diet Assoc. 110(12 Suppl): p. S38-51. 2010.
Townsend E. and N.J. Pitchford. Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled sample. BMJ Open Feb 6;2(1):e000298. 2012.