How To Start Your Baby On Solid Foods

The American Academy of Pediatrics, World Health Organization and Academy of Nutrition and Dietetics recommend starting solids at about 6 months of age when babies are showing developmental signs of readiness for solid foods. However, some sources suggest it’s possible to try introducing solid foods earlier than that. Boston Children’s Hospital states that “generally, when infants double their birth weight (typically at about 4 months of age) and weigh about 13 pounds or more, they may be ready for solid foods^[1]Starting Solid Foods. Boston Children's Hospital. Accessed 08/04/2022. .”

However, introducing solid foods sooner than 4 months of age is not advised, explains Minghua Tang, Ph.D., a clinical researcher specializing in complementary feeding at Children’s Hospital Colorado and an associate professor at University of Colorado School of Medicine.

“There is some research showing that introducing solids before 4 months could potentially increase the [baby’s] risk of becoming overweight. But anything after 4 months doesn’t seem to have any obvious negative impact,” says Dr. Tang.

There are key developmental signs to look for that will indicate whether your baby is ready for solid foods. According to the Centers for Disease Control and Prevention (CDC), these developmental steps include:

• Adequate control of their head and neck
• Ability to sit up alone or with some support
• Can swallow food instead of pushing it back out
• Moves food from the front of the tongue to the back in order to swallow
• Opens their mouth when food is offered
• Brings objects to their mouth
• Tries to grab small objects

Stephanie P. Gilley, M.D., Ph.D., a pediatrician specializing in growth and nutrition at Children’s Hospital Colorado and an assistant professor at the University of Colorado School of Medicine, also encourages families she works with to observe whether their baby seems interested in food.

“I remember having my 4-month-old on my lap at one point. We were eating spaghetti, and I looked down and he just had a fistful of spaghetti in his hand because he was so excited to try to engage with the food and try to put it to his mouth,” says Dr. Gilley. “And so those are all really good signs.”

As you start your baby on solid foods, you can expect them to eat “as little as 1 tablespoon or even just a few bites,” says Dr. Gilley. They’ll still be getting the majority of their food from either breast milk or formula.

The balance between formula or breast milk and solid foods will start to shift as your baby gets older. “At 6 months they might be eating one or two portions a day, and then by 12 months, the baby is probably eating [solid food] closer to three to five times a day,” says Dr. Gilley.

The Importance of Repeated Exposure

When you’re introducing foods that might not be sweet or salty, such as green leafy vegetables, repeated exposure is important, says Dr. Tang.

“You probably would see the baby at the first exposure—or the first few exposures—just play with it, put it in their mouth then spit it out, drop it on the floor and pick it up again or play with it in their hands,” says Dr. Tang. She stresses this is a normal reaction and for caregivers to “be persistent and keep offering it to them.”

For parents who are feeling overwhelmed and unsure where to turn for information online—Dr. Gilley recommended two different Instagram accounts: @feedinglittes and @kids.eat.in.color. Both accounts are run by pediatric dieticians and offer tips on introducing foods, making eating fun and what behaviors are normal.

Foods to initially feed your baby include infant cereals and purees made with vegetables, fruits or meats, or tender-cooked finger foods from the family table for self-feeding (otherwise known as baby-led weaning), or a combination of both, although finger foods are not recommended until babies are about 6 months and showing the developmental signs of readiness.

Also at around 6 months of age, most babies’ iron stores are low and they need to start getting iron and zinc from complementary food sources, so it’s helpful to make it a priority to offer iron-rich foods (such as meats and eggs) in infant-safe forms.

Two foods that you should not introduce to your baby before 12 months are honey, as it could cause infant botulism, and cow’s milk (as a beverage, although small amounts in recipes is fine), because a baby should still be taking human milk or formula to get the proper nutrients. Take care to avoid even products that simply contain honey, such as cereals or crackers that have honey in them.

According to Dr. Gilley, the appropriate method for how to feed your baby solid foods depends on each child. “Even within the same family, I think any parent who has more than one child will say that every child is very different. So it’s hard to make a blanket recommendation,” she explains.

For parents who are looking for some general guidelines, the Children’s Hospital Colorado recommends introducing spoon feeding for babies between the ages of 4 and 6 months and for the caregiver to feed the baby^[2]Pediatric Feeding Development. Children's Hospital Colorado. Accessed 08/04/2022. .

The caregiver should be feeding the baby responsively. Responsive feeding means learning a baby’s cues for hunger and fullness and responding to them right away in a warm and positive manner, which supports a child’s ability to self-regulate.

While they are eating, the baby should either be sitting in a highchair that offers support or be supported by the caregiver. As the child gets older, parents may move them to a highchair with head and foot support.

Gagging is a common, noisy part of the process of learning to eat. If, when feeding your baby, you notice them begin to gag, splutter or cough, it’s best to stay calm and coach the baby to chew and swallow the food on their own. Choking is when a piece of food blocks the child’s airway and requires intervention. Signs that your child is choking include high-pitched sounds while trying to breathe, clutching at the throat or even no sound at all.

If a baby is around 4 or 5 months old and simply doesn’t seem interested in solid foods, Dr. Gilley recommends giving it a bit more time. But if the baby is 6 months old—or particularly if they’re nearing 7 or 8 months in age—Dr. Gilley advises caregivers to try feeding more frequently and with the food presented in different ways.

For babies who are 7 or 8 months and still not accepting solid foods, Dr. Gilley suggests that parents reach out to their pediatrician. Some babies may have an oral aversion, which causes them to struggle with putting things in their mouth outside of breastmilk or a bottle. The pediatrician can evaluate your baby’s growth and make sure they’re on track developmentally, she says.

Hives and vomiting are the most common signs that your baby may be having an allergic reaction to a new food. Shortness of breath, coughing or wheezing could also occur, though older children are more likely than babies to display these symptoms.

Oral allergy syndrome is another reaction to watch for, according to Dr. Gilley. This syndrome can cause an itchy sensation in the mouth but is not necessarily dangerous to the child.
However, it’s important to introduce highly allergenic foods early on, starting at around 4 to 6 months—especially for children who are at risk for developing allergies. Previously, it was suggested to wait until a child was at least a year old to introduce this group of foods, but research has since shown this delay increases a child’s risk for developing allergies.

Some of the most highly-allergenic foods and food groups include:

• Cow’s milk
• Soy
• Eggs
• Wheat
• Tree nuts
• Peanuts
• Shellfish
• Fish
• Sesame

It is helpful to introduce the top nine allergens one at a time, either alone or with foods the baby has had and tolerated before. This way, if there is a reaction, it’s easier to determine which food is responsible.

It’s also important to introduce an appropriate amount of the allergen at a high enough frequency to determine a baby’s tolerance to it. According to Dr. Tang, you should provide a child with “at least 2 grams per allergen per week to have it be effective” when introducing something like peanut butter, for example. It’s suggested that a child should be served this quantity at least three times a week to ensure adequate exposure.