My last post went into great detail about the research on age of starting solids and health outcomes, including nutrition, growth, illness, and allergies. If you read that post, you know that there are small risks and benefits of starting earlier or later (in the range of 4-6 months), but there’s no evidence for an optimal age of starting solids for all babies. Here’s what to look for instead, starting with a brief summary of the data on age:
1. Your baby is at least 4 months of age.
Read my post on this if you want to know the details and see the references. If not, here’s a summary:
- There is good evidence that it’s best to wait until at least 4 months of age to start solids, unless advised otherwise by a doctor for a specific medical reason.
- Starting solids between 4 and 6 months of age may give babies a boost in iron nutrition, assuming they’re getting some good dietary sources of iron. Exposure to potentially allergenic foods, such as wheat and eggs, by about 6 months may reduce the risk of allergy to those foods.
- Exclusive breastfeeding until 6 months of age may reduce your baby’s risk of minor gastrointestinal infections, although this isn’t shown in all studies. For moms, it may also result in greater weight loss and prolonged lactational amenorrhea.
Whether or not you start solids at 4 months, 6 months, or somewhere in between is up to you and your baby. The research on this topic is still evolving, and either is a fine choice. In fact, given that babies develop at different rates, it seems unlikely that all babies would be ready to start solids the moment the clock strikes midnight on their 4-month birthday or 6-month birthday.
This was the same sentiment eloquently expressed in a 2009 editorial by British pediatrician Martin Ward Platt, using the term “weaning” to mean starting solid foods:
“The weaning debate has been largely predicated on the notion that there is some magic age at which, or from which, it is in some sense ‘‘safe’’ or ‘‘optimal’’ to introduce solids. Yet it is highly counterintuitive that such an age exists. In what other area of developmental biology is there any such rigid age threshold for anything? We all recognize that age thresholds are legal inventions to create workable rules and definitions, and have no meaning in physiology or development, yet when we talk about weaning we seem to forget this.”1
Given this, it’s really up to you to follow your baby’s lead, watching for the developmental signs discussed in the rest of this post.
2. Your baby can sit upright and hold his head up straight.
These gross motor skills signal that your baby has the core body strength and stability needed to eat solid foods. Pediatric feeding specialist and certified speech language pathologist Melanie Potock explained why this is so important on my Facebook page:
“Gross motor stability (in this case trunk stability) provides the support for fine motor skills. It’s very hard to learn to eat purees off a spoon or do any sort of self-feeding of soft solids if the trunk is not supported. Try it yourself by letting your trunk relax and fall into the back of your dining chair, slightly slumped. Now stay that way and try to bite, chew and swallow. Imagine if you were just learning to eat this way!”
[I’m thrilled that Melanie Potock wrote a guest post explaining more about why stability is so important and how to best seat your baby comfortably at the table here: S.I.T.! Feeding Your Child Using Stability and Independence at the Table]
In other words, when babies have gross motor stability in place, they’ll have a much easier time with the fine motor and oral motor skills needed for feeding. That means that baby should be able to sit comfortably upright, on his own or with a little support, and hold his head up to face you. In one study, babies were able to sit in a caregiver’s lap without help at 5.5 months, on average, but this milestone was quite variable (standard deviation of 2 months).2
Trunk stability is also important because it allows you and your baby to be able to be face-to-face during feeding and for your baby to be an active participant in deciding whether, how much, and how fast to eat. You offer baby a bite, and he leans forward and opens his mouth if he’d like to accept, or he turns his head away to say no thanks. With good trunk stability, a baby can communicate his wants and needs to you, and you can be responsive to them. This way, feeding becomes a respectful and pleasant conversation between the two of you.3
3. Your baby has the oral motor skills to handle solid foods.
At birth, most babies are already skilled at sucking. Sucking is an involuntary reflex that develops around 32 weeks of gestation, and babies practice it in utero before birth. Sucking gives them the skill to efficiently transfer milk through a nipple, whether from breast or bottle.
To eat from a spoon, a baby needs a different set of oral motor skills. Continue reading