Hey, it’s Zoe here. I’ve been a pediatric nurse for over a decade, specializing in early childhood development, and I’m also a mom of two.
Starting solids is a monumental moment in you and your baby’s life. It’s an exciting time but nerve-wracking for us parents. But it doesn’t have to feel so overwhelming. Here’s some information from the American Academy of Pediatrics to help you prepare for your baby’s transition to solid foods.
When can my baby begin solids? Remember that each child’s readiness depends on their own rate of development. Look for signs that your baby is ready for solids: they will open their mouth for the spoon, sit with support, show good head and neck control, and be interested in the foods that you are eating.
Also, ask yourself these questions: Can your baby hold their head up? Your baby should be able to sit in a high chair at a feeding seat or an infant seat with good head control. Does your baby open their mouth when food comes their way? Babies may be ready if they reach for your food and seem eager to be fed. Can your baby move food from a spoon to their throat? If you offer a spoon of rice cereal and they push it out of their mouth and it dribbles down onto their chin, they may not have the ability yet to move it to the back of their mouth to swallow it. That’s normal; remember, your baby’s never had anything thicker than breast milk or formula before, and this may take some time and some getting used to. You can try diluting it the first few times and then gradually thicken the texture. You may also want to wait a week or two and try again, diluting it with either your breast milk or your formula.
Is your baby big enough? Generally, when infants double their birth weight, typically at about four months of age and weigh at least 13 pounds or more, they may be ready for solid foods. The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about six months. They also recommend formula if you choose formula for the first six months. When you add solid food to your baby’s diet, you should continue breastfeeding or using formula until at least 12 months. New guidance actually recommends that you should breastfeed your baby for at least 24 months or two years. Now there is new research coming out that the earlier you expose your baby to allergens, the less likely they are to develop a food allergy. So talk with your pediatrician and see if you want to start at four months of age if your baby is hitting the proper developmental milestones and if they are developmentally ready to start introducing food. There is research showing that the sooner you introduce the allergens, the less likely they are to have those allergies, but that is definitely on an individual basis, and you should be discussing it with your pediatrician if it’s okay to start your baby on any solid foods before six months of age. You also should check with your child’s doctor about the recommendations for Vitamin D supplements during the first year of life.
When starting solids, you want to introduce one new food at a time, use foods with good sources of iron and zinc, such as iron and zinc fortified cereal, pureed red meat such as beef or lamb. The American Academy of Pediatrics recommends introducing fruits and vegetables after a baby eats iron and zinc fortified cereal or purified meat. Offer solid foods two to three times per day and let them decide how much they want to eat. If you wait to that six-month mark recommended by the American Academy of Pediatrics, you’re going to want to start introducing the list of allergens we’re going to be going over later in this article. You’re going to want to start introducing them as soon as you start solids. Research shows the earlier you introduce the allergens, the better. You don’t want to start solids at six months and only be doing avocado and low allergen type foods. You want to be introducing those allergens on that list and going through that list. You’re also going to want to avoid raw honey or large chunks of food that could cause choking.
Consider introducing all other foods such as eggs, peanut butter, and all the allergens we’re going to go over later because research shows that they may actually prevent individual food allergies. You’re going to want to wash fruits and vegetables before serving, and you’re also going to want to introduce your baby to a cup with water, breast milk, or formula. Typically, if they’re younger than 12 months of age, you’re going to want to just introduce breast milk or formula in an open cup, and once they turn 12 months, you can start introducing some water or whole milk as well. Avoid feeding your baby too much. Follow your baby’s signs of fullness, such as leaning back, turning their head away, and don’t force your baby to eat or finish foods. It may take 10 to 15 times of offering your baby a type of food before they actually like it.
How can you prevent food allergies? Early allergen introduction is recommended for all babies, but especially those with eczema (atopic dermatitis), and this is not just for peanut; it’s at least for peanut, milk, egg, and cashew, and likely other allergens too. I’ll make sure to share this list from the American Academy of Pediatrics on all the allergens you should be exposing your baby to.
Ideas for introduction:
- Peanut-containing products should be introduced around six months of age for all infants.
- Cashew-containing products should be introduced in the first year of life, such as milk baked in foods or yogurt and cheese (you can start introducing after seven months).
- Egg can be given fully cooked or baked in something; raw and undercooked eggs are not recommended for infants.
- You should be introducing your baby to soy (soy milk, soy yogurt, or tofu).
- You should be introducing your baby to fish or shellfish, as these also comprise potential allergens.
- You should be introducing your baby to sesame, which is another common allergen. You can find this in hummus and tahini.
- Wheat: We want to make sure the baby is not allergic to wheat, so we want to be introducing them to maybe some soft-cooked pasta or oatmeal.
So when are you supposed to try introducing these common allergens? Well, you need to talk to your pediatrician about your individual baby and when they are developmentally ready and when it’s appropriate. But typically, we start introducing these allergens early between four months (if your baby is approved to start solids at that age) to six months, which is the common widespread recommendation. That’s when you’re going to be introducing these allergens. Some evidence shows that earlier is better, especially for the egg. And how often you want to be frequently feeding each food at least three times per week for three to six months. It’s also reasonable to refer infants with severe eczema to an allergist if you’re struggling with that.
It’s also really important to consider the child’s developmental and textural acceptance. You can utilize peanut or tree nut butters, thin them with breast milk or formula to prevent choking, or use nuts ground to a powder and sprinkled into foods. Whole nuts should always be avoided; they pose an extreme choking hazard. It is important to keep any of those foods away from a family member as well who has any of those allergies.
I have some instructions for you for home feeding of peanut protein for infants at a low risk of allergic reaction to peanut. So this is just an infant who doesn’t have any family history of a peanut allergy, and you’re going to introduce it to them for the first time at home. And these recommendations come from the American Academy of Pediatrics. The first thing you want to do is you want to feed your infant only when he or she is healthy and do not do the feeding if he or she has a cold, vomiting, diarrhea, or other illness. We want to make sure when introducing peanut that there’s nothing else going on underlying with your baby. The second thing is that you’re going to want to give the first peanut feeding at home and not at a daycare facility or a restaurant. You also want to make sure at least one adult will be able to focus all of his or her attention on the infant without distractions from other children or household activities. You’re also going to want to make sure that you’ll be able to spend at least two hours with your infant after the initial feeding to read for any signs of an allergic reaction.
What are some symptoms of an allergic reaction, especially when you’re introducing peanuts, and what should you look for? With all allergic reactions, the first is mild symptoms, which can include a new rash or a few hives around the mouth or face. More severe symptoms of an allergic reaction can include any of the following, alone or in combination: lip swelling, vomiting, widespread hives or welts all over the body, face, or tongue swelling, difficulty breathing, wheezing, repetitive coughing, change in skin color (if they start to turn blue or pale), not in tiredness, lethargy, or seeming limp. That’s why it’s important to introduce high allergen foods when your baby is alert and awake and not right before bedtime. And you also want to make sure that if you have any concerns about your infant’s response to peanut or other allergens, you seek immediate medical attention and call 9-1-1.
How do you feed your baby? Start with a half spoonful or less and talk to your baby throughout the process. “See how good this is, baby?” Your baby might not know what to do at first. They may look confused, wrinkle their nose, roll their food around inside their mouth, or reject it altogether and spit it out. One way to make sure eating solids for the first time is easier is to give your baby a little breast milk, formula, or both first, and then switch to very small spoonfuls of food and finish with more breast milk or formula. You also don’t want to feed the baby when they’re super hungry. So you want this to be more of an experience for your baby in learning new textures and flavors. You don’t want them super hungry for this; you want them content and happy so that they’re more open to exploring these new flavors, textures, and sensations. This will prevent your baby from getting frustrated when they are very hungry. Do not be surprised if most of the first few solid food feedings wind up on your baby’s face, hands, and bib. Increase the amount of food gradually with just a teaspoon or two to start. This allows your baby time to learn how to swallow solids. Do not make your baby eat if she cries or turns away when you feed her. Go back to breastfeeding or bottle feeding for a time before you try again. Remember that starting solid foods is a gradual process. At first, your baby will be getting most of his nutrition from breast milk, formula, or both. Also, each baby is different, so readiness to start solid foods may vary.
Another important tip: Do not put baby cereal in a bottle because your baby could actually choke. We do not recommend this as healthcare professionals, so please don’t add cereal to your baby’s bottle.
Another common question is, which food should I give my baby first? Your baby’s foods are your choice. Whether you decide to make your own baby food or buy pre-made baby food, you have many options. However, keep the following in mind: food should be soft or pureed to prevent choking, introduce one single ingredient new food from any food group every three to five days, and make sure to start off with some of those common allergens. You also want to look out for any reactions. It’s important to introduce one thing at a time and give it three to five days to make sure there’s no allergic reaction to that. So if you start with spinach and there’s no reaction, you do that for three days, and then you decide to add in an iron-rich food, puree chicken, some sort of meat with a lot of iron in it (red meat or fish), then you’re going to want to do that three days later, and now you can introduce spinach and fish, and there’s no reaction. So then you would move on to your next thing, maybe some egg from the allergen list and so on and so forth. And wait three days after adding each thing, but they can have all the other things you already added if there’s no allergic reaction to them. As you’re moving along, there is no evidence that waiting to introduce baby-safe foods, such as eggs, dairy, soy, peanut products, or fish beyond four to six months of age, prevents a food allergy. Again, in recent years, the guidance has changed to recommend the sooner these allergens are introduced when starting solids, the better. However, testing for peanuts G is recommended for babies with severe eczema and/or egg allergies. Be sure to include foods that provide iron and zinc, such as baby food made with meat or iron-fortified cereals. Once your baby hits that six-month mark, especially if you’re exclusively breastfeeding, your baby is not getting enough iron through the breast milk, and they’re also not getting enough iron through the formula. So that’s why it’s important when you’re starting solids to really focus on those allergens and those iron-rich foods for baby. If you feed your baby pre-made cereal, make sure it is made for babies and is iron-fortified. Baby cereals are available pre-mixed in individual containers or dry, to which you can add breast milk, formula, or water.
Within a few months of starting solid foods, your baby’s daily diet should include a variety of foods, such as breast milk, formula, or both, meat, cereal, vegetables, fruits, eggs, peanut butter, and fish.
So when can I give my baby finger foods? Once your baby can sit up and bring her hands or other objects to her mouth, you can give her finger foods. Help her learn to feed herself to prevent choking. Make sure anything you give your baby is soft, easy to swallow, and cut into very small pieces. Some examples include small pieces of banana, wafer-type cookies or crackers, scrambled eggs, well-cooked pasta, well-cooked finely chopped chicken, and well-cooked cut-up potatoes or peas. At each of your baby’s daily meals, he should be eating about four ounces or the amount in one small jar of strained baby food. Limit giving your baby processed foods that are made for adults and older children. These foods often contain more salt and other preservatives. If you want to give your baby fresh food, use a blender or food processor or just mash softer foods with a fork. All fresh foods should be cooked with no added salt or seasoning, although you can feed your baby raw bananas mashed up; most other fruits and vegetables should be cooked until they are soft. Refrigerate any foods you do not use and look for any signs of spoilage before giving it to your baby. Fresh foods are not bacteria-free, so they will spoil more quickly than food from a jar.
I hope this article was helpful and helps make you feel more confident and prepared in going into starting solids with your little one.
