How and when to start your baby on solids can feel confusing — you’ve likely heard the guidelines have changed dramatically over the past 10 years. I’ll highlight new guidelines and recommendations to bring you peace of mind and help you feel confident about your baby’s first feedings. In my opinion, feeding and nourishing our babies (at any age) is one of the most connecting things we do as parents.
The American Academy of Pediatrics (AAP) recommends starting your child on solids between 4 and 6 months of age. You may be thinking that seems young, but in a complete reversal from decades of advice from pediatricians to avoid the foods associated with food allergies, research now says early and regular dietary exposure to a food — speciﬁcally a food often associated with allergies, like peanuts — helps reduce the risk of a child developing an allergy to that food.
Why? It has to do with how babies’ and toddlers’ immune systems learn about food as they grow up. Somewhat incredibly, 70% of your baby’s immune cells reside in the lining of her stomach and GI tract. Consistently exposing your baby’s tummy to a food helps train her immune system to see this food as food, rather than as a threat or an allergen.
Research from the LEAP trial taught us that early introduction of peanut to infants at high risk for food allergy between 4-11 months of age, fed at least 3x a week, for five years was safe and reduced development of peanut allergy by 86%. It completely changed how pediatricians talk about peanut. The risk is not introducing it, the risk might be in NOT getting it into a baby’s diet early and often.
We also know from the EAT study, that 98% of babies who were fed foods like peanuts, sesame, eggs, fish and dairy by five months of age and who kept those foods in their diets regularly, did not develop a food allergy. Let your babies eat!
Signs your baby is ready for solids
All babies are different and therefore, it’s important to understand the signs of readiness to start solids. A few of the signs of readiness are:
- Able to sit up without support
- Able to maintain great head control when sitting
- Loss of the tongue-thrust reflex so they don’t automatically push food out of their mouth when offered and taken
- Follows foods with their eyes and shows eagerness and interest
- Opens mouth wide when you offer food on a spoon
How to feed your baby
I frequently get asked if you can offer your baby multiple foods at one time and the answer is, YES! You do not need to introduce foods to your child one a time, wait a few days, and then offer a new food. That’s old advice. Feel confident knowing you can introduce multiple foods at a time.
The newest edition of Caring for Your Baby and Young Child, Birth to Age 5, which is published by the AAP, states:
“In the past pediatricians recommended starting one new food every few days, so that you can see if a reaction occurs to that particular food. New research has shown that it is safe to start multiple foods at once. Within two or three months, your baby’s daily diet should include breast milk, iron-fortified whole grain cereals, vegetables, meats (including fish), eggs, fruits, and nut butters (but never whole nuts) distributed among three meals.”
What about breastfeeding? We recommend breastfeeding in partnership with food introduction. Exclusively breastfeed for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mom and baby. You can enjoy both and there is no need to wean your child off breastfeeding when you start including solid foods in his/her diet.
Best solid foods to start your baby on
There are so many foods that can be great to start your baby on solids. In addition to considering your family’s food preferences here are a few first foods (in very, very small pieces or puree):
– Soft cooked, sweet potatoes, squash and pumpkin
– Soft cooked apples
– Soft cooked carrots, green beans, zucchini, and beets
– Cereals that are thinned to a near-liquid consistency with expressed breast milk or formula
– Very ripe peaches and pears
– Peanut butter thinned with water and mixed into oatmeal
There are a few foods you should steer away from when introducing solid foods to your baby.
- Honey: rare risk for causing botulism, a serious illness, if introduced in infancy
- Cow’s milk: Stick with breast milk and formula as a primary liquid until your baby is a year old. Water okay after 6 months of age when starting solids.
- Nuts, popcorn, whole grapes, and thick/dense nut butters as they are choking hazards.
Feeding our babies can be an adventure but it’s one that is a serious reward to the soul. You can introduce foods to your baby with joy and confidence. I often say that feeding our children and nourishing them is one of the most soulful and spiritual things we get to do as parents.
Let your babies eat and enjoy!
In my next article, I’ll share the importance of keeping your infant’s skin healthy and protected and the role eczema plays in food allergies.
Dr. Wendy Sue Swanson is a pediatrician, mom to two boys, and the Chief Medical Officer at SpoonfulOne. SpoonfulOne is a line of nutritional products designed to help stop a food allergy before it starts.*
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