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Ready To Start Solids for Your Baby?

Updated: May 8, 2021

Starting solids is a huge milestone for babies and parents alike... here are the answers to all the questions you may have:

When should we start?

The American Academy of Pediatrics recommends waiting until between 4-6 months of age. Babies younger than 4 months of age are not developmentally ready. The baby should be able to sit upright and steady and should not automatically thrust the food out with his tongue. If he does so, it’s a sign that he may not be quite ready. Try again in a week.

How do we start?

I usually recommend starting around 2-3 weeks before the 6 months mark but if your baby is showing interest beforehand, please take the plunge! Start giving solids once a day for 3-4 weeks, then twice a day for the next 3-4 weeks, then three times a day from then on. You may not notice a significant difference in milk intake in your child even after starting solids. Most still rely on either breast milk or formula as their primary nutrition until age 8-9 months. Most babies start transitioning to a more “solid” diet around that time with an obvious decrease in milk intake to 16-24 oz/day. In the beginning, some babies may be content with just a spoonful or two of solids. There is no need to push it beyond what your baby seems ready for - think of this time as practice for familiarizing him to new tastes and textures. If he no longer opens his mouth or turns his head away as the spoon nears him, then he's signaling that he is done.

What should we start with?

Traditionally, it was recommended to start with baby cereal but now, it’s advised to start with vegetables and fruits instead. Baby cereals are fortified with iron which is important in preventing anemia (at around 6 months, your baby has depleted most of the iron stores he was born with, so iron must be replaced in the diet). So we still encourage parents to add it to whatever pureed foods you are offering starting with 1 tablespoon (the consistency should be loose but thick enough to stay on the spoon easily). Work up to approximately 2-3 tablespoons per serving. There have been concerns about small amounts of inorganic arsenic detected in commercially prepared rice cereal (both white and brown). While intermittent exposure to trace amounts are not considered dangerous, you can further decrease your baby's risk by offering a variety of foods and offering other types of baby cereal (oats, multigrain).

There are no studies indicating that starting vegetables is better than fruits. However, we’ve found that some kids fare better with vegetables if started before the “sweet” fruits. Start slowly with 2-3 tablespoons and work your way up to the typical serving size of 2-4 oz. Some examples of good vegetables include: squash, carrots, sweet potatoes, peas, green beans. Give each new food 3-5 days to ensure that allergic symptoms do not develop. If you don't observe any reaction, you can move onto the next one. Once you’ve tried several, you can start mixing them to make it more interesting for your child. I recommend "chunking it up" every 2-3 weeks to get your baby used to more textures. If your baby tolerates it well, keep moving ahead with slightly chunkier versions of the food every couple of weeks. If your baby seems not quite ready for it (gagging, coughing, spitting out the chunks), then go back to the texture you were giving before and try again in another 1-2 weeks. There is no "deadline" that you have to meet - let your baby lead the way!

* Even if you are preparing the vegetables on your own, it is best to use commercially prepared beets, turnips, carrots, collard greens, and spinach. These vegetables have high nitrate content which can lead to anemia. Baby food companies screen for this chemical in their foods but you cannot test for it at home.

How about fruits?

After introducing 2-3 different vegetables, you can start offering fruits. It doesn’t have be cooked. As with veggies, start with one new fruit at a time and advance to a new one every 3-5 days. Mesh baby feeders can be an easy and safe way to feed a variety of fruits without having to puree or mash. Avocados are often great first fruits to start with. Generally citrus and berries are considered more “allergenic” and acidic (so more likely to cause mild irritation of skin) so you may want to try other fruits before introducing these.

How about meats and seafood?

You can start meats early on – they are a good source of iron and zinc for your baby. Just be sure to keep them soft and mince/shred in the beginning. Gradually offer bigger pieces as your baby becomes older. Flakey fish is also okay and easy to cook. Avoid fish considered to have high mercury content such as shark or swordfish. It's fine to offer shellfish (without the shell of course!) as long as it's not too chewy.

Which other foods should we avoid?

Some foods are considered more allergenic than others. We recommend holding off on cow’s milk until age 12 months although it’s fine to introduce other dairy such as yogurt and cheese between 6-9 months of age. Shellfish and nut butters can be started after age 6 months but you should avoid actual nuts (unless finely chopped) as they pose a choking hazard for your baby. If there is a strong family history of food allergies, speak to your pediatrician. She/he may recommend allergy testing prior to starting certain foods.

What are the signs of food sensitivity and allergy?

True allergy typically involves a diffuse rash, hives, and/or swelling of the face and hands/feet, and/or breathing problems/wheezing. Some people can present with recurrent vomiting following ingestion of an allergic food. You should seek medical care if allergic symptoms are observed as they can rapidly progress. Sensitivity typically involves a mild rash at the sites touched by the food (most commonly around the mouth) which resolve quickly (typically < 1 hour) or loose, watery stools. Most children outgrow food sensitivities as they grow older. Some may also outgrow food allergies, especially if mild.

When do we start “table foods”?

Start small bits of "real food" around age 8-9 months. Some babies show readiness earlier than others but you should always be mindful of potential choking hazards. Ensure foods are cut into sizes and shapes that will not increase this risk. Examples of good table foods to start with include cut up or sliced fruit, slightly mashed cooked vegetables, Cheerios, soft pieces of bread or pancakes, cooked egg, and cheese. Allow your child to try picking it up on his own (it will be messy!) as this helps develop his fine motor skills.

When can I start adding salts and spices?

Do not add additional salt or strong spices to your baby’s food in the beginning. Minimizing salt is particular healthy and should be encouraged. Once your child transitions to more “table foods,” you can start using mild seasoning as needed. By age 1, expect your child to be eating the same kinds of food you are eating with the caveat that you are eating healthy too! There is never a need to add sugar to any of the food that you are offering your baby. He will get plenty from the fruits he eats.

Can I offer water and juice?

Start offering your baby water (2-4 oz/day) or extra breast milk or formula once you start solids. Offer them in a sippy cup so that your baby can start practicing using one. Juice can be started around 6 months of age but is not a necessary part of an infant’s diet. In fact, even 100% juice has a lot of sugar and we encourage children to eat the actual fruit than drink the juice.

What if he doesn’t seem interested in solids or keeps spitting it out?

There’s no absolute schedule you need to follow in terms of introducing solids. The goal is to establish healthy eating habits and make meal times pleasant. Do not force-feed your child as this may lead to him developing negative associations with feeding. Do not give up on a particular food because he doesn’t seem to like it initially. It may take up to 10-12 times of trying a new food before a child accepts it. Try preparing it differently or taking a break from it. Try to eat with your child (as opposed to just feeding him) so that you can model healthy eating and the social (fun) aspect of eating together.

Will my baby become constipated once he starts solids?

Once you start solids, your child’s stool will become more formed and variable in color. It may also have a strong odor due to the added sugars and fats. All of these changes are normal. If he is straining more than usual, you can try increasing his fluid intake and adding more “P” fruits (prunes, peaches, pears, plums) which help move the digestive system along. Contact your pediatrician if his stool is rock-hard, coated in blood, or obviously painful (these may be signs of true constipation). Remember, the frequency of stools is not an indication of constipation as some children naturally have infrequent stool (1-2 times per week).

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