Introducing Your Baby to Solid Foods

Introducing your baby to solid foods is an exciting milestone. Many parents delight in watching the changing – and often comical – expressions on a baby’s face when he or she experiences a new flavor for the first time. 

Besides being a great time to take photos and video, it’s also a time when you may have questions about which solid foods to feed your baby, when and how much.

“In the beginning, it’s important to remember that starting solid foods is all about learning for the child,” says Katharine Padrez, M.D., pediatrician at the Palo Alto Medical Foundation in Mountain View. “Keep the experience fun and enjoyable. Your baby is learning about new flavors, different textures, how to move solids from the front to the back of the mouth and how to take food from a spoon.”

Dr. Padrez shares her answers to the most common questions parents have about introducing solids to infants.

When is the right time to start solid foods?

There’s much debate among experts about the optimal time to introduce solids, and the recommendations have changed over the years. What your pediatrician recommends may be different from what your mother did or your next door neighbor thinks is best. In general, most babies are ready to start solid foods sometime between 4 and 6 months.

However, age is less important than whether they meet the following developmental milestones:

• Your baby has to be interested — Babies need to willingly open their mouths when presented with a spoonful of food. Never force your baby to eat. You can gauge their interest by observing what they do when you eat. Do they intently watch your food as you move it from your plate to your mouth? Do they reach out for your fork as you go to take another bite? 
• Your baby should have excellent head control — Babies should be offered solid foods while sitting in your lap or in a high chair. Therefore, they need to be able to hold their heads steady while sitting with support.
• Your baby’s tongue thrust reflex should be gone — All infants have a protective reflex to thrust their tongues forward when anything is placed on the tongue. This reflex usually disappears between 4 and 6 months when most infants are double their birth weight. If you find that all solid food you are feeding is ending up on your baby’s chin with very little being swallowed, you may want to wait another week or two to ensure the reflex has disappeared.

What foods should I start with first?

There is no right or perfect order. Since breastfed babies will need more iron in their diet going forward (formula-fed babies get plenty of iron from their formula), it’s a good idea to start with iron-rich foods. Fortified baby cereal (rice cereal or oatmeal) contains extra iron and can be mixed with breast milk, formula or water to your desired consistency. In the beginning, you can make the cereal quite runny, then as your child gets used to the new texture, you can incrementally increase the thickness. 

Other iron-rich foods are beef or turkey (yes, you can start with pureed meat), sweet potatoes, tofu, prunes and dark leafy green vegetables. 

It is best to stick to single ingredient foods (no fruit salad or chicken dinner), and introduce one new food every two to three days. That way you can identify the cause if your child has any symptoms of a food allergy.

How much and how often should I feed my baby?

In the beginning, a couple of teaspoons once a day may be all your baby wants. Gradually, by following your baby’s cues, you can increase the amount and frequency of feedings. By the time your baby is 8 or 9 months old, he or she should enjoy eating a wide variety of foods two to three times per day.

Should I be concerned about food allergies?

In the past, many pediatricians recommended delaying highly allergenic foods (eggs, peanut butter, shellfish, soy and wheat) until babies were older, often after they were 1 or 2 years old. Current research shows that this does not decrease the chance of allergies.

In fact, the new data shows that earlier introduction of allergenic foods leads to fewer allergies in children. Of course, anytime you are introducing a new food to your baby, you should watch for a rash, changes in bowel movements or vomiting as these could be signs of an allergy. In extreme cases, an allergic reaction can cause lip or tongue swelling and difficulty breathing. If this occurs, call 911 immediately.

Are there any foods I should avoid?

Make sure you don’t give your baby foods that may cause him or her to choke: nuts, seeds, chunks of meat, cheese, raw vegetables and whole grapes. This is an excellent time to start your baby on a healthy diet by avoiding desserts, sweets, salted and fatty foods, and highly spiced foods.

What other changes can I expect when my child starts eating solid foods?

Your baby’s bowel movements will become harder (and smellier) as you introduce solid foods. If the stools become very hard or pellet-like, you will want to ease constipation by offering the “p fruits” such as prunes, peaches, pears or plums. Foods that tend to be more constipating are bananas, applesauce and rice cereal.

It is also important to offer your baby water once he or she starts eating solid foods. This will also help ease constipation. Try giving your baby water in a sippy cup. This may also make it easier for you to wean your child off the bottle (if he or she uses one) around 12 months.

Remember that starting your baby on solid foods does not mean that your baby will finally sleep through the night or need less milk during the day. The majority of your baby’s calories should still come from breast milk or formula for at least the first few months after starting solids.