Getting Your Baby Started on Solid Foods

Before you know it, your snuggly little newborn is smiling, laughing, communicating, and maybe even sitting! What comes along with this is moving from a breastmilk and/or formula-based diet to incorporating some big kid foods. It’s an exciting and fun time for kids and parents alike.

When can we introduce solids to our baby? A lot of major health organizations such as the American Academy of Pediatrics have recently revised their starting solids guidelines to reflect the growing evidence that it is best to wait until baby is 6 months of age to start solid foods - even purees.

It’s thought that baby’s digestive system isn’t ready for additional foods yet, and high intake of solid foods could displace the complete nutrition baby gets from breast milk or formula when they need it the most. 

Choking prevention is also a concern, and it’s crucial that they are able to hold their head steady and sit with some support in order to properly swallow their food.

What’s the best food to introduce?: Not too long ago, it was thought that babies should start with cereals, then move on to veggies, then fruits. In reality, there is no reason to proceed in a prescribed order*. You have the full range of foods to choose from, as long as they are a texture your baby can handle (more on that below):

• Infant cereals
• Pureed fruits, vegetables, meats & beans
• Mashed and thinned banana and avocado

*The only caveat to this is that if your baby is exclusively or mostly breastfeeding, then it might be helpful to introduce some higher iron foods such as fortified infant cereals, meats, and beans sooner rather than later.

When to feed baby: At the beginning, 1-2 meals per day is appropriate, as we still want them to be getting the majority of their nutrition from breastmilk or formula.

By the time baby is one year old, 3 meals and 2-3 snacks per day is a typical pattern.

Allergens: While in previous decades it was considered important to wait until one year or later to introduce common allergens like peanuts or egg whites, newer research has shown that the earlier the exposure to the foods, the less of an allergy risk there is. 

Discuss introducing allergens with a dietitian or your baby’s doctor, as it may be preferred that the first introduction is done in a doctor’s office if your baby is at very high risk of a reaction.

Some families prefer waiting a couple of days between the introduction of new foods or ingredients so it can be more easily determined what the cause of any potential reaction was.

Textures: As your baby is given the opportunity to develop their feeding skills, it’s important to advance them as time goes along to continue to help baby learn how to swallow food and eventually chew.

After thin purees, you can move onto lumpy textures and soft finger foods, such as mashed beans, shredded cheese, small shreds of chicken, or teether crackers. 

Once baby has mastered these items, continue to offer firmer, but still very soft and mashable foods as baby moves toward one year of age.

Choking: Choking is usually one of the top concerns when introducing solids, but keeping the following in mind can help minimize the risk:

• Keep textures appropriate for your baby, but don’t hold off too long on advancing them as baby gets used to the textures given.
• Let baby have control of their intake, as we will discuss below.
• Make sure baby is sitting upright but supported, with their legs supported. If your baby’s high chair does not have a leg rest, you may need to get creative with rigging something to the high chair or placing a stable stool or chair under their feet. 
• Do not offer hard foods like popcorn, tough meats, or nuts. 
• Avoid very sticky or thick foods like large amounts of peanut butter or large pieces of bread.
• Remember that gagging is protective against choking and that baby’s gag reflex is farther forward on the tongue than adults. In other words, it takes a lot less to make your baby gag than it may for you! Try not to panic if your baby is gagging as this could scare them. If they are still able to breath and make noises, they are not choking.
• Signs of actual choking are: blue lips or skin, baby is unable to make any noises, baby is unable to breathe, signs of panic, and baby going limp or unconscious.

While this can be a scary topic, taking an infant CPR class can help you stay confident in an emergency.

Final rules of the road: While there aren’t a lot of rules around solid food introduction, there are a few more key rules to keep in mind:

• Avoid honey until after one year. Honey can harbor a form of botulism that is harmful to babies under one.
• Limit high sodium foods and don’t add salt to baby’s food.
• Avoid added sugars and sweets. Juice is not necessary.
• Baby can have up to 1 cup of water per day.
• Continue to nurse or bottle feed on demand until 1 year. Nursing can continue on demand beyond one year. Sometimes baby does better with solids when milk and foods are separated by at least ½ hour, but don’t worry if this isn’t always possible.

Most importantly, have fun!: While introducing solids can be quite daunting, it’s also something parents have been doing for thousands of years. It’s an opportunity to introduce your baby into your family’s or culture’s common foods. It’s also an opportunity to practice lots of helpful new skills. 

• Let your baby have the spoon. It will make a mess so get baby down to their diaper and protect the floor!
• Eat with your baby, ideally as a family when possible.
• Don’t feel as if baby has to eat a certain amount. Offer the food and baby can decide the rest.