Time for solids? Here’s some food for thought

Introducing solids is one of the more fun developmental milestones for baby’s first year.  It is fun to watch your baby’s personality start to shine through. “He loves avocado.” “She hates blueberries.”

It is also the start of introducing your baby to family meal times.  Parents often have questions about when and how to start solids with their babies and how to encourage healthy eating habits as those babies turn into opinionated toddlers.  There are many right ways to go about introducing your baby to solid foods and this should be a fun process for everyone involved.

When to Start: Most pediatricians recommend starting solids sometime between 4 and 6 months Luke-FoodFaceof age. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about 6 months and then introduction of solid foods.  For formula fed infants it is appropriate to consider introducing solids slightly sooner.  You can discuss with your pediatrician the best plan for your child.  Until 4-6 months of age your baby’s nutrition should come only from breast milk or formula.  Signs that your child may be ready for solids include having good head/trunk control, showing interest in food, and the ability to eat off a spoon and manipulate food with tongue.  Some babies have met all of these criteria at 4 months of age, but most infants develop these skills closer to 5-6 month of age.

What foods to start first: There is no one “magic” first food.  Many people start with cereals, although many pediatricians now suggest fruits or vegetables.  In general, it does not matter. It is more important to remember that the goal is to develop a positive interaction with food and to choose foods of appropriate consistency and texture.  Initial foods should be pureed to a smooth consistency.  As your baby becomes comfortable with feeding you can begin to introduce foods with more textures and small finger foods.

At 6 months most babies are eating solids once daily and by one year most babies are eating three meals and 1-2 snacks per day.  Over the first 1-2 months of solid food feeding it is best to start slowly and let your baby lead the way.  Some babies will love eating and be excited to try new foods and new textures; other children will be more hesitant.  Feeding time should not be a battle – allow your child time to taste and experience new foods (remember, they’re  getting all the nutrition they need at this point from breast milk of formula).

Home-made versus store-bought baby foods: Baby food can be easily made at home.  You can steam or cook foods and then puree in a food processor or blender.  Do not add any salt to baby food and initially avoid extra seasoning.  As your baby becomes more accustomed to eating and begins eating a wider variety of foods, you may start to add some seasonings.  Benefits to home-made baby food include decreased cost of food and the ability to serve your baby the same foods the family is eating.  There are a wide variety of commercially prepared baby foods also available.  These foods meet safety standards and are a good, healthy, and convenient option for many families.

Baby-led weaning: Bab- led weaning is a method of introducing foods the family is eating to the baby.  Some families will skip purees all together and just start offering appropriate textured/sized foods off the family table.  Generally this delays introduction of solids, as babies are not ready for thicker consistency and table foods until they are a little older.  Bab- led weaning can be a nice complement to traditional feeding practices.  In our home we started with purees, but as soon as our son was able to finger feed we began offering the same foods we were eating.  To safely do this foods must be cut into small pieces to prevent choking and foods may need to be steamed or cooked to a softer consistency.

Preventing allergies: Recent studies have shown that early rather late introduction of a variety of foods is the best strategy to lessen risks of food allergies.  If food allergies run in your family, however, you may want to discuss your baby’s feeding plan in more detail with your pediatrician.   The only food that needs to be completely avoided is honey (this is due to risk of botulism).  Honey can be safely introduced after 1 year of age.  Cow’s milk should also be avoided until at least one year of age; however, it is appropriate to introduce other dairy products including yogurt and cheese during the first year.  Children may also have nut butters and eggs during the first year.  (It  previously  was advised to avoid these foods until after one year of age).

Preventing Choking:  Some foods such as whole nuts, grapes, hot dogs, string cheese, and popcorn can be high risk for causing choking.  Make sure to cut grapes and other fruits into small pieces.  Foods including hot dogs and string cheese should first be cut lengthwise and then into small pieces.

Have fun with feeding your baby and remember that there are a lot of “right” ways to introduce solids.  Choose a plan that works well for you and your baby and don’t be afraid to try something new if your current strategy is not working.

Sarah Lenhardt, MD About Sarah Lenhardt, MD

Sarah J. Lenhardt is an Instructor in Pediatrics at Washington University School of Medicine. She cares for children at St. Louis Children’s Hospital, Missouri Baptist Medical Center, and at Progress West Healthcare. She attended the College of Saint Benedict in St. Joseph, MN and Creighton University in Omaha, Nebraska. Dr. Lenhardt completed a residency in Pediatrics at the University of Minnesota and worked as a general pediatrician in Minnesota before joining the faculty at Washington University. She is a board Certified pediatrician and a member of the American Academy of Pediatrics. Her special interests include preventative care, integrative medicine, and breastfeeding. Dr. Lenhardt enjoys spending her free time with her husband and 1 year old son.

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