While there are many people with strong opinions on baby led weaning versus purees, that’s not what this post is about. This is focusing more on how exactly you introduce solids to babies. First we need to determine if they are developmentally ready to start solids. Then there are a few key nutrients that we should focus on. Lastly, there are a couple of things that we should avoid.
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How to know when a baby is ready for solids?
Starting solids can be a super exciting (and terrifying) time for parents! Often at a 4 month well-visit, the pediatrician says go ahead and start solids as they’re walking out of the office. Um ok, but what? And how? And how do you know your child is ready? First off, there is no magical age that children are ready. We look for certain signs that generally appear between 4 and 6 months. Once babies are hitting all of these milestones, we can begin introduction of solids.
Most babies master this around 6 months. They do not need to be able to get into a seated position, but should be able to sit when placed for at least a few seconds, preferably completely upright, not in a tripod stance. Having that good core and neck stability decreases the risk of choking. Choosing a good high chair with appropriate support is important to help new sitters stay balanced.
Bringing Hands to Mouth
No matter the feeding method you plan on using, your child should be able to bring their hands/an object to their mouth. If they are self-feeding (such as with baby led weaning) the reason for this is pretty obvious, but even if you are spoon feeding, that coordination should be present.
Many children start showing interest in food around 4 months. This doesn’t mean they are ready to start eating at 4 months! They still need to have the other indicators as well. You can definitely start bringing them to the table before actually offering them food. They may enjoy the experience of a family meal.
Integration of the Tongue Thrust Reflex
This one may be a little harder to spot. When you (or your baby) put something in their mouth, initially they will block it with their tongue. As they get older, they lose this reflux, meaning they can put things in their mouth. This is not something that magically goes away. It should start integrating somewhere around 6 months, meaning your child will be ready to start eating.
Once your child has met these criteria, they may be ready to start solids! Fair warning, you will notice some poop changes when you start introducing solid foods.
What type of solids should I start with?
There are a few key nutrients to make sure you’re providing in your baby’s diet: zinc, iron, vitamin D, and fat (specifically DHA). No matter which method of feeding you plan on using (baby led weaning, spoon feeding, combination), it is crucial to make sure that your child is getting these nutrients. While it is crucial that your baby gets these nutrients, you don’t need to force feed them! It’s all about the Division of Responsibility. Your job is to offer these foods often to give your child ample opportunities to eat them.
Zinc is required for proper growth and development. It is naturally found in animal products such as beef, pork, and chicken. It is also found in nuts, chickpeas, and dairy. Some breakfast cereals will have added zinc as well.
Iron helps our blood carry oxygen throughout our bodies. Your baby’s iron needs increase dramatically at 6 months. Babies fed FDA approved formula (pretty much anything you’ll find at the store) will be receiving iron through their formula. Breast milk contains less iron, but the iron in breast milk is very well absorbed. The best sources of iron are animal products, such as beef, chicken, or fish, but if you’re vegetarian, you can definitely still provide adequate iron! The key is to pair an iron-containing plant food, such as soy, lentils, beans, spinach, etc with a source of vitamin C, such as bell pepper or citrus foods.
Breastfed babies should be supplemented with vitamin D from the start, unless mom is taking large doses. Vitamin D is involved in many different functions throughout the body, it actually acts as a hormone! Most people are vitamin D deficient due to being indoors more and having limited sun exposure without sunscreen. Generally a vitamin D supplement is recommended throughout childhood. It is added to milk and some milk alternatives and can also be found in fatty fish and some mushrooms.
Fat is a key energy source for rapid growth in babies. This does not mean we should be serving up french fries with every meal. We really want to focus on the fat profile. It’s important to get a variety of fats like those found in avocados and in fatty fish. DHA specifically is especially important for brain and eye development. This is generally found in fatty fish and fortified eggs. Plant sources of omega 3 fatty acids tend to be poorly converted into DHA, so vegetarians may need to supplement. Some plant sources are flax seed, walnuts, chia seeds, and some beans.
So how does this translate to actual meals? Try to offer an iron containing food with every meal. Many iron containing foods also contain zinc. Make sure there is some fat with every meal. As much as possible, try to get a fat with some omega 3 fatty acids in it. A serving of fatty fish will contain iron, zinc, vitamin D, and omega 3 fatty acids. I go over all of this in more detail in my Starting Solids Made Easy Course and E-Book.
What do I need to avoid?
All foods fit in a healthy diet. That being said, when first introducing solids to your baby, there are a few things you should avoid: sodium, added sugars, and honey.
Sodium is an essential nutrient that is needed in only small amounts but we tend to get in large amounts. Babies only need a tiny amount and too much can put extra stress on their kidneys. There is already some in breast milk and formula, so we don’t need to worry about getting any in the rest of the diet. That being said, babies also tend to eat very little. If your baby eats a little salt now and then, it will be ok. We just want to avoid giving very salty foods a lot of the time. When shopping, look for lower sodium alternatives when available. Try not to add salt when cooking. Use plenty of herbs and spices to give flavor. Babies don’t need bland foods.
The American Academy of Pediatrics recommends no added sugars before the age of 2. The sugars that are naturally occurring in fruits and dairy are fine. It tends to be very difficult, if not impossible, to actually have zero added sugars in the diet, so I recommend just limiting as you can. Really try to avoid hypersweet foods like cakes and candies. Babies already have a preference for some sweetness in food as breastmilk tends to be sweet, but they are used to naturally sweet foods like bananas. Introducing them to high sugar foods will make bananas seem not as sweet. Babies also have very tiny tummies so if they are eating foods like cakes and candies, they may not have enough room for foods containing the nutrients they need to grow. Agave, honey, maple syrup, coconut sugar, etc. are all sugars.
Honey is an added sugar, so fits into the above category. It gets it’s own section, however, because there is an additional safety component. Babies under the age of 1 should not have any honey. Their immune system is not fully developed and they run the risk of developing botulism. An adult immune system would easily destroy botulism spores, but babies are not able to. Because they are spores, they are not easily killed, so even foods that are cooked or baked can still contain the spores.
When do I introduce allergens?
Recommendations for allergen introduction were recently updated. Current recommendations are based on studies done in peanuts that showed early introduction was beneficial.
Any baby with an existing food allergy or severe eczema is considered at high risk for peanut allergies. For these babies, it is usually recommended to do an allergen test prior to introducing peanuts, then to introduce peanuts between 4-6 months. Babies with moderate eczema should introduce peanuts somewhere around 6 months. Babies at low risk for peanut allergies did not get as specific guidance, but could also introduce around 6 months.
Generally, we recommend to not introduce one of the top 9 allergens as a first food, in case there is a reaction. We don’t want your baby to associate all solids with that reaction. We do want to introduce the allergens early though, so usually within the first month. Introduce them with foods that you have already introduced your baby to so that if there is a reaction, you know which food caused it. My Introducing Allergens Handbook provides a guide for introducing allergens.
Krystyn Parks is a Registered Dietitian and Lactation Consultant who specializes in feeding children. She has a Master’s Degree in Nutritional Science from California State University Long Beach. She is an International Board Certified Lactation Consultant and has been registered with the Commission on Dietetic Registration since 2013.