Starting to feed a baby solid foods is an exciting milestone for baby and parents. However, it's often a confusing time, more so if you receive conflicting advice on when to start and which foods to give.
When to start solids
You will find that there are many different opinions regarding the best time to start your baby on solid foods. Up until recently the recommended age to commence solids was 4 months. However, as a result of extensive research into this area, many health professionals and health agencies such as World Health Organization (WHO) and the American Academy of Pediatrics are now encouraging parents to wait until their babies are closer to 6 months of age before starting solids.
Although, some babies may benefit from solids earlier than 6 months, it's generally not recommended to commence solid foods before 4 months of age except in special circumstances. Your child's pediatrician will guide you regarding the need for early introduction to solids.
How to tell when your baby is ready for solids
- Interest: Does your little one stare at every bite of food that goes from your plate into your mouth? Does she try to grab little pieces from your plate? Does she open her mouth when food approaches?
- Head support and control: Can she hold her head steady and sit with support?
- Extrusion (tongue thrust) reflex: Has she lost her extrusion reflex? This means she no longer automatically pushes solid foods out of her mouth with her tongue.
- Weight gain: Has she doubled her birth weight?
How to start solids
- Choose a time when your baby is quiet and relaxed.
- Sit her in a semi upright position, either on your knee or in a high chair.
- Offer solids 15 or 20 minute following her milk (breast or formula).
- Introduce only one new food at a time, in small amounts. New foods should be introduced several days apart, so that if any allergic reactions occur you can identify the exact food.
- Initially, only start with one teaspoon of food and increase the amount according to her appetite.
- Offer foods separately rather than all mixed together, so that she can enjoy individual flavors.
- If your baby isn't interested in eating solids, wait a few weeks before trying again.
- Throw out any unused food on her plate. Don't reheat and offer at another time.
- NEVER force your child to eat when she doesn't want to.
- Don't add solids to your baby's bottle. Babies need to learn the difference between eating and drinking.
Reasons to NOT start before 4 months
Milk (breast or formula) is the most important food for young babies and provides all the calories and essential nutrients for healthy growth until 6 months of age.
1. Decrease in milk consumption (breast or formula)
Milk is more easily digested than solids. Because solid foods provide a sensation of fullness, this can interfere with the amount of milk (breast or formula) your baby will drink and she may not get as much milk as she needs for healthy growth.
Large amounts of solid foods can affect the nutritional balance of her diet. Starting solids too soon could potentially affect her overall weight gain, because solids will not satisfy her energy and growth needs in the same way that milk can.
Early introduction of solids can interfere with successful breast-feeding! Because she feels full from solids, she's likely to drink less breast milk. As a result your breasts will make less milk. If then, enough breast milk is unavailable to her to satisfy her it will be tempting to give her even more solids to fill her, which in turn may mean she takes less breast milk and so on.
2. Increased risk of allergies
Because a baby's immune system is not fully developed, studies suggest the younger a child is exposed to a food the greater the potential risk of an allergic reaction to that food. It's difficult to predict which children are at risk. Certainly, children with a family history of allergies are at greater risk, but even those without a family history can also develop an allergy.
It's estimated somewhere between 8 - 10% of children are affected by either one or multiple food allergies. The majority of these children will outgrow their food allergy as their digestive and immune system mature, but for some it can become a life long condition and in rare situations it can be a life threatening condition.
3. Increased risk of diabetes
A study published in the Journal of the American Medical Association found that cereals introduced into the diets of babies before the age of 4 months or after the age of 7 months increase the risk of insulin-dependent diabetes in susceptible children.
4. Stomach and bowel discomfort
Babies less than 4 months of age have immature digestive systems, where their little tummies lack the necessary enzymes to adequately digest solid foods. Early exposure to solid food can result in stomach ache, gas, constipation or diarrhea. Very young babies often lack the ability to recognize when they've had enough and this can potentially lead to over feeding, tummy distention and spitting up.
5. Increases work load on kidneys
A child's internal organs are growing and maturing even after birth. Solid foods make extra work for your baby's kidneys.
6. Risk of choking
No doubt you have experienced food going down the "wrong tube". This can happen to even experienced eaters. For a baby getting the food into the right tube can be a real challenge. Up until around the age of 4 months babies have an extrusion (tongue thrust) reflex that assists them with breast feeding. This reflex disappears around the age of 4 months. For some it's still present for a little longer.
While a baby still has the extrusion reflex, she lacks the coordination to move semi solid foods safely to the back of her throat before swallowing. This lack of coordination increases the risk of choking. Early choking experiences can make babies tense when faced with a spoonful of food. This tension can make the process of accepting food more difficult later on.
Reasons to start NO LATER than 7 months
1. Need for additional iron
A healthy full term baby is born with a supply of iron stored in his/her liver. By around the age of 6 months this iron supply is starting to deplete and the need for additional iron from solid food becomes more important. Although breast milk and formula are still the most important food for a baby over 6 months of age, they do not always provide have enough iron for the second 6 months. Babies who are not given solids until much later may miss out and not grow as well as they should.
2. Development and learning
Food and the feeding process are a new experience for babies and are an important stage for their development. The act of chewing helps a child develop the muscles necessary for speech development.
Some babies who are not given solids before 7 or 8 months (when they're reaching out and wanting to try things) may not be so willing to try new tastes and foods later on. After 9 or 10 months, babies who have not become comfortable with the process of eating solid foods may find it harder to learn these skills at this later age. So it's best not to wait too long.
6. Increased risk of diabetes
A study published in the Journal of the American Medical Association found that cereals introduced into the diets of babies before the age of 4 months or after the age of 7 months increase the risk of insulin-dependent diabetes in susceptible children.
Myths
1. Solids help a baby sleep through the night
RARELY: Many parents are often anxious to start solids believing a full tummy will help a baby sleep through the night. However, this rarely helps. Early introduction of solids increases the risk of creating additional problems (as listed above) which could potentially further disturb your child's sleep or health.
2. Solids will satisfy a hungry baby
RARELY: Solid foods are often given at an early age in the hope of solving problems thought to be linked with hunger, such as irritable behavior, sleeplessness or a thriving baby who wants to breast or bottle feed more often than would be considered normal for her age.
Milk (breast or formula) provides a baby with all the necessary calories and nutrients needed for healthy growth up to 6 months of age. If increasing the amount of formula or number breast feeds offered, your baby is still not satisfied, then her behavior may be due to one of number of other possible causes which result in her looking for comfort from feeding. (See our article on Hungry Baby).
3. If a baby has reflux solids will help
TRUE & FALSE: Solids may reduce the amount of milk that comes up, but starting solids too soon could create additional problems for your baby. There are many more effective ways of reducing spitting up that don't involve the risks associated with early introduction of solids, as listed above. (See our article on Reflux for tips to reduce spitting up).
4. Solids are necessary if weight gain slows down
FALSE: Parents often become concerned when their little one's rate of growth slows. For a healthy thriving breast fed or formula fed baby a decrease in the amount of weight gained each week will occur naturally around the age of 5 - 6 months. For bigger babies, who were off to a very good start in the early months, this slowing of weekly gains can occur from around 3 months of age.
If you're concerned about your child's weight, discuss this with a doctor. Avoid starting solids too soon because solids can lead to a decrease the amount of milk (breast or formula) she drinks. Milk will provide more calories than solids at this age, so starting solids too soon could further affect her growth.