One of the most confusing things for many parents is figuring out when exactly to start solids. You may receive the ok from your pediatrician at 4 months, but you may also hear to wait until 6 months. There’s also information about introducing allergens between 4-6 months, so which is right? For the most part, we look for signs of readiness more than a certain age.
As with all things parenting, there are exceptions to every rule. These are the general guidelines we use to assess whether or not a child is ready to start solids, but there are reasons that certain children may need to start solids earlier or later. If you are ever concerned, you can work with a pediatric dietitian or feeding therapist who can familiarize themselves with your individual situation.
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In an ideal world, all children would meet the following signs of readiness prior to starting solids, however that’s not the case. There are certain situations where parents may need to start solids sooner or later. I cannot address every possibility, but here are some examples.
Both the American Academy of Pediatrics Guidelines and the American Academy of Allergy, Asthma, and Immunology Consensus Statement recommend introducing some of the top allergens to children early.
The AAP recommends introducing peanuts to children at high risk of developing peanut allergies between 4-6 months. The consensus statement recommends introducing eggs and peanuts to all children, regardless of risk, around 6 months, but not prior to 4 months. It also recommends not delaying the introduction of other commonly allergenic foods.
For some children, especially those at the highest risk for developing food allergies, it may make sense to introduce allergenic foods prior to all signs of readiness being displayed. In these cases, it may be helpful to work with a medical team to help reduce any possible risks associated with feeding, like increased risk of choking.
Baby Led Weaning
For parents and children who are doing baby led weaning (BLW), it is especially important to make sure that all signs of readiness are displayed. While there is no increased risk of choking with BLW versus purees when parents are properly educated and foods are served correctly, there is an increased risk if the child is not developmentally able to self feed.
There is adapted/modified BLW for children with medical conditions who may not develop along the same timeline. It may be appropriate to utilize these methods if a child is delayed in hitting milestones, but parents would like to try baby led weaning.
While we don’t make general recommendations based on ages, it is important to note that with premature infants, we expect there to be a delay in some of their milestones. We basically start the clock at their due date and count from there. If your child was born 3 months premature, we wouldn’t expect for them to be ready for solids until closer to ~9 months of age.
It’s better to watch your child’s development than worry about their age. Every child develops on their own timelines and this is even more so apparent with premature babies.
Signs of Readiness
Sitting (Somewhat) Unsupported
Our goal is not for your child to be able to get into a seated position by themselves, but they should be able to sit, without help, when placed. We don’t want them falling forward into their tray or slouching off to one side in their high chair.
Eating takes a lot of muscle coordination. We want baby to be able to focus on all the new things they will be learning to do while eating and not so much on the sitting upright. The better they are at this task, the easier it will be for them to focus on the smaller muscle movements.
As one of my favorite pediatric physical therapists says “proximal stability allows for distal mobility.” Basically this means when the torso/trunk is stable, baby will be able to move their hands more freely.
Some babies will need additional support to be able to sit in their high chair appropriately. If your child is following their own timeline with milestones, you can work with a physical therapist or occupational therapist to come up with options to support your child so that they can sit safely in their high chair during meals.
Bringing Toys to Mouth
Whether your planning on spoon feeding your child or letting them self feed, they should be developmentally able to self-feed. One way they can show this is by being able to bring their toys to their mouth. If they can get toys to their mouth, they can get food there (with some practice).
Integrating Tongue Thrust Reflex
This is a protective reflex that babies are born with to prevent them from choking. If you stick something in their mouth, they stick out their tongue, trying to get rid of it. This reflex obviously makes it very difficult to feed a baby.
Usually this reflex integrates somewhere around 6 months. It’s more noticeable if you are spoon feeding your child, so you can try letting your baby self-feed if you notice the other signs of readiness in place.
Not Signs of Readiness
This isn’t a sign of readiness, but it will make mealtime more enjoyable. Often, around 4 months or so, babies start to get very interested in everything you do, including eating. This doesn’t mean they are ready to eat.
If your baby seems very interested in mealtime, then you can include them in the meals. You can place them in their high chair with a toy to play with. I like giving them long spoons. It allows them to trigger their gag reflex and let everyone get more comfortable with the sight of them gagging. You can also make breastmilk or formula pops for them to suck on.
Baby Reaches a Certain Weight
Just like there isn’t a certain age where we recommend starting solids, there isn’t a certain age. Often with very big babies, parents worry that the breastmilk or formula won’t be enough anymore. Conversely, with very small babies, they worry that they need solids to gain more weight.
All babies and children grow on their own curve. As long as your child is following theirs, there isn’t a reason to worry. If you are concerned, speak with your pediatrician about seeking additional support.
You do not need to wait for your child to get teeth prior to starting solids. When we chew, we use our back molars. Those don’t usually come in until closer to 18 months-2 years. We aren’t going to wait until then to offer solids.
Make sure that the foods you are offering are soft and smooshable. They should be developmentally appropriate for your baby. Whether your baby gets their first tooth at 4 months or 12 months, you can start solids whenever they show the true signs of readiness.
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.