Starting Solids

I want to offer some guidelines for introducing solids to your older infant. Note there’s no exactly “right” way to do this. Some improvisation is ok.

1. When-Generally no earlier than 4 months; recent data suggests closer to 6 months. Doubling of birth weight. Starting earlier does not help your baby sleep through the night, and can increase the risk of immune disorders including asthma and eczema(starting after 6 months does not provide any benefits). Starting earlier can cause constipation and may be associated with increased risk of obesity. Other milestones indicating readiness are better head control, sitting stable with assistance, and ability to hold food in the mouth.

2. What do you need-High back chair on a stable surface, plastic bibs, unbreakable plastic plates and bowls.

3. How-Start feeding once daily (generally in the evening, but this isn’t essential). Feed small amounts first-a teaspoon or two to start, increase as she finishes what’s offered. Generally we now recommend vegetables, meat, cereals , then fruit (nutritionally rich before more calorically dense). In fact there is no evidence that the order of food introduction has any direct influence on later dietary preferences.

Some other tips:

  • With some infants (like mine long ago) giving a spoon of food and then quickly offering a nipple (pacifier or bottle) may assist your child in “mastering” swallowing solids.
  • I recommend allowing 4 days or so from “food A” before progressing to new “food B”. Use single ingredient preparations first to avoid confusion in case of problem reactions.
  • Generally by 7-8 months your baby will advance to two meals daily and to 3 by about a year. (This is very variable).
  • Avoid small hard foods like nuts, popcorn, chicklets, life savers, jellybeans, m&m’s , raw vegetables like carrots or celery ( generally I tell parents that if you need  molars to crush the food it’s a no, and if you can mash the food morsel between your tongue and palate it’s okay)-until at least age 4 years and a more mature gag reflex.
  • Highest incidence of allergies associated with cow’s milk, chocolate, fish, citrus (including tomatoes), egg white, berries. Introduce these foods latest.

Late in your child’s first year you may begin “finger foods”-bite sized pieces of soft foods that your baby will work to pick up with her hands. This also assists in development of milestones like pincer grasp and hand to eye coordination.

It is acceptable to make your own baby food. Puree and add water only ( no sugar or salt). Avoid spinach, beets, green beans, squash and carrots here as they contain nitrates which can cause anemia. Commercially made products of these foods have the nitrates removed.

Rashes, diarrhea, or vomiting that develop after introducing a new food may be from intolerance or allergies and you should call, but please note that it is not unusual to see a few little red spots on face or mouth: if this happens and resolves in short order it can be tolerated and may not indicate a reason to avoid that food going forward.


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