Starting Solid Foods for Baby!

Starting Solids
 
It’s almost time for the next big baby milestone – starting solids! There’s no one right way to do this, and the experience can be totally different from family to family and even baby to baby in the same family. The main things to remember are simple: wait until they’re ready, offer a variety of flavors and textures, follow baby’s cues, and skip choking hazards. Within those guidelines, there exist a multitude of ways to introduce your baby to solid foods. In almost all cultures and societies, eating is a social experience in addition to a source of nutrition. Eat with your baby, include them in family meals, and celebrate the new experience together.
 
History of starting solids
In the United States, until about the mid-1900’s, at about the middle of the first year, infants were simply fed soft food, without added spices, from the family’s kitchen table. With the Industrial Revolution and introduction of packaged baby foods, families were taught by doctors and manufacturers that premade baby food was better for baby, and easier, too. Around this same time, babies started tasting their first bites of solids foods at very early ages, as early as six weeks old! Thankfully, we’ve again learned that six-week-old babies are too young for solid foods, and the consensus now is to wait until about six months of age. This message of the convenience of pureed baby food has now become part of our country’s social consciousness, and many of us grew up believing that feeding jarred baby food was a normal part of raising an infant.
In many cultures around the world, baby’s first bites of solid foods is symbolic, a ritual that brings the entire family together. Special first foods, often cereal or porridge types, are fed to baby. Starting solids is about more than simply nutrition, it’s a sign of familial and societal membership and community.
Over the past decade or so, there has been a slight shift back to feeding baby from the family’s meal, a practice often referred to as Baby Led Weaning. This practice is simple: allow baby to eat what the family is eating, provided it is soft and easy to pick up. The goal: by about 12 months old, baby eats healthy family meals. No spoon feeding required.
 
Organization recommendations
What do the experts say about starting solids?
The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby's diet, continue breastfeeding until at least 12 months or longer if you and your baby desire. (healthy children). The World Health Organization recommends exclusive breastfeeding for the first 6 months of life; and introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.
 
How do you know if it’s finally time to start solids?
“By waiting for him to be developmentally ready, he becomes an active participant in eating, rather than merely a passive recipient” (LLL).
For the first six months of life, the AAP recommends exclusive breastfeeding if possible. Otherwise, donor milk or formula should be baby’s main diet for the first half of their first year. Studies have shown that “babies who start eating solid food too early are more likely to be overweight or obese in childhood and adulthood.” (AAP).
The AAP recommends introducing solids foods around six months of age, exposing baby to a wide variety of healthy foods and a variety of textures. In the first days and weeks, baby may only eat a small amount of food. As they get older, they’ll increase the amount of solid foods, up to three meals a day plus snacks at about 12 months old. However, “your milk remains the single most important food in your baby’s diet until the first birthday”. (LLL).
For various reasons, in our culture, “At 9 months, there is a considerable drop in fruit and veggie consumption, and an increase in non-nutritive finger and snack foods.​” (AAP). Be aware of this possibility and plan to keep offering fruits and vegetables at almost all of baby’s meals and snacks.
Let’s get to the fun part! What to feed to baby?
There are lots of options available. Most organizations, including the American Academy of Pediatrics and the World Health Organization, recommend starting solids one food at a time, to allow time to observe any possible reactions to that food. After baby is eating a small variety of foods, “Try giving her a new food once or twice a week along with foods she regularly eats.” Healthy Children. This allows baby to experience new tastes and textures while still having the familiar foods available. Many families have found that “a baby might have to try a new food 10 to 15 times over several months before she’ll eat it” (Healthy Children).
Some excellent ideas for first foods include ripe avocados, bananas, baked sweet potatoes, steamed or grated carrots and other vegetables, baked apples, and plums with the seeds and peel removed. Other popular foods are broccoli, cooked beans, flaky fish, and scrambled eggs. Avoid choking hazards like popcorn, nuts, hotdogs, and grapes until baby is older. Honey should also be avoided until after the first birthday. Focus on iron-rich foods, such as meats, poultry, fish, egg, tofu, and legumes, as baby’s iron stores tend to drop in the second half of the first year.
So, let’s get started! At the next family mealtime, plop baby in a highchair or hold them on your lap. Put small pieces of your mushy food of choice in front of them and see what they do with it. Watch them explore with all their senses and enjoy the changes you’re seeing in your baby. Don’t forget to take lots of pictures!
As baby gets older and more mature, “gradually increase food consistency and variety” (WHO), while “allowing baby to control the amount he eats” (LLL).
Purees – easy to make and easy to find.
Should I feed my baby some of these, too? Many foods can be made into a puree at home, with nothing more than a fork. Other foods need a little more work to make into a puree, but it can be done with a blender. Of course, it’s easy to find pureed baby food in jars at the store, in a variety of flavors and flavor mixes. However, baby has a hard time feeding themselves with these, and generally must be fed by a parent, which takes away opportunities to experience textures and work on fine motor skills. In addition, some commercially made baby foods have added ingredients, and there are many flavor mixes available that adults simply wouldn’t eat.
Few rules exist for baby led weaning. Healthy Children gives the following recommendations: Sitting with little support, having good head control, trying to grab your food, and turning away from the breast or bottle when not hungry. It is not necessary for teeth to have erupted. “Babies are encouraged to use spoons and fingers to feed themselves” (AAP). Don’t put food in their mouth for them. Foods should be soft and squishy, and mushy enough to squish between their fingers. Babies don’t need added salt or sugar, they’ll enjoy the new tastes and textures just as they are. Finally, eating is a social experience, so eat your meals with your baby! “Never leave a baby or young child alone with food in case they begin to choke” (LLL). Don’t forget to take lots of pictures – starting solids can be messy but make for some excellent photo opportunities!
Because starting solids can cause a change in bowel habits for almost all infants, “Babies are encouraged to drink from a cup starting at 6 months of age” (AAP). A sippy cup set out with the solids provides another opportunity for exploring textures and allows baby to drink to thirst. If they have troubles figuring out how to drink from it, try removing the valve inside the cup. Potential for a bigger mess, but easier for baby to learn.
“The key difference between BLW and traditional weaning, when you think about it, is in the order that children learn to eat. With a puree, they learn to swallow first and then chew, which works fine until they meet a lump. With BLW, the babies learn to chew first and swallowing might come some time later.” (Babyledweaning.com).
What about infant cereals? They seem so common!
Many families start their solids journey with the infant cereals marketed directly to new parents. These are often nothing more than processed grains, with added vitamins. They are hard for baby to digest, typically cause constipation, won’t help baby sleep longer, and baby can’t absorb the artificial additives anyway. Baby cereal is a bland gelatinous mess, it’s something baby won’t ever eat again in their lifetime and isn’t something an adult would particularly enjoy eating. Giving baby real foods is much better way to get needed calories and nutrients into your baby.
A common old wives tale suggests putting cereal into baby’s bottle, to help them sleep longer. Many desperate parents, wanting a few more minutes of sleep, have tried this with little success. “Putting cereal in your baby’s bottle will not help her sleep through the night.” Healthy Children and adds extra empty calories to your baby’s diet, when they should be getting breastmilk or real solids. If baby does happen to sleep more after getting cereal in their bottle, it may mean his body is diverting energy resources from growing to digestion. Not a great thing.
Some families prefer to use expressed milk in their baby’s foods. It can be added to baked goods or added to other recipes in place of water or milk. Great in pancakes, muffins and more. You can even make a batch of muffins or pancakes, freezing most of them for baby’s later use. This can be a good way to use up an aging freezer stash and can turn an already delicious recipe into an excellent recipe baby will love!
For leftovers, follow general food safety guidelines. Use cooked foods within four days and use leftovers that include fresh milk within 24 hours. If baby’s mouth has touched the food, bottle, or even the spoon that goes in the food, use the leftovers at the next feeding. Defrosted foods or milk cannot be re-frozen, they must be used or discarded.
At about a year, many professional organizations recommend that toddlers transition from breastfeeding or drinking formula to drinking whole fat milk. For nursing toddlers, this may not be necessary. Calcium and calorie needs can be met by breastfeeding and offering a variety of whole foods like yogurt, cheeses, broccoli, and kale, among other things. If your toddler is nursing often, you may not need to offer milk at all! If you choose to offer milk to your toddler, stay with whole fat milk products until at least the second birthday. Growing toddler brains need the fat content. If your little one is rejecting whole milk, try mixing it with expressed breast milk until they become accustomed to the flavor and texture. Don’t let baby fall asleep with a sippy cup in their mouth, as milk can drip from the cup and pool in their mouth, raising the risk of cavities.
 
Special Circumstances
If your baby was born prematurely, more than 37 weeks early, starting solids brings more questions, and requires a little extra vigilance. Solids should not be started before four months actual age, or three months corrected age. Often, this means starting solids somewhere around five to seven months actual age. As with other infants, continue nursing first, then offering solids after. Breastfeeding should still be baby’s primary source of nutrition until about a year old.
For premature infants, choosing when to start solids is more about development than age. Baby should be able to sit unsupported, show interest in others eating, put toys and fingers in their mouth, and lean towards food and open their mouth.
Because these infants often miss out on extra iron stores gained at the end of pregnancy, it’s important to focus on iron-rich foods when starting solids. Continue any supplements as recommended by baby’s doctor, especially iron supplements. Baby led weaning is an excellent option for these infants, as it helps reinforce motor skills.
Occasionally, infants aren’t quite gaining weight as fast as expected. For these infants, starting solids can be a time to finally gain some weight. Even in these cases, solids should not be started before six months, except when working closely with medical professionals. As we’ve mentioned before, continue nursing first, then offering solids after. Focus on high fat foods in baby’s diet – avocados, butter or oil on almost everything, nutrient dense foods of all types. Skip the empty calories of baby cereals and juice. If baby food recipes call for water, use expressed milk for the extra calories. Increase the frequency of solids relatively quickly, still giving baby time to get used to new foods yet adding in extra calories and fat where possible.
Allergies
Do allergies run in your family? Heard some horror story about allergies?
The good news is that most children do not have allergies to foods. It’s simply not that common. However, everyone should know what to watch for, in case they think a potential allergic reaction is occurring.
The top eight allergens in the United States are milk, egg, peanuts, tree nuts, fish, shellfish, soy, and wheat. Possible mild symptoms of an allergic reaction include a rash on the face or around the anus, or a suddenly runny nose. More serious reactions include trouble breathing, wheezing, swelling of the lips or face, or even severe vomiting or diarrhea. For mild reactions, rinse with cool water any skin touched by the food and eliminate the food until you can talk to the child’s doctor. For severe reactions, immediately call 911 for assistance.
“If there is a family history of food allergy, consult your doctor or allergist for advice on when to start your baby on foods that tend to be more allergenic as it may differ from recommendations for babies without allergic history.” (LLL). Unless you’ve already seen baby react to the food in question, there is no need to avoid feeding baby certain foods. Start the solids journey with less allergenic foods, and once those are established, add in small amounts of the more allergenic foods one at a time. If there’s no reaction, continue exposing baby to that food regularly. If you’re feeling extra worried, try rubbing a small amount of the food inside baby’s lip, and watch for a reaction. Offer new foods during the daytime, so you can watch for a reaction.
 
A few final words
Like many other milestones in baby’s life, starting solids is highly anticipated by parents and caregivers, and often extensive thought goes into that first bite of solids. Relax, enjoy the moment, take some pictures. Your family is entering a new adventure, and by following some basic safety guidelines, it can be a very enjoyable adventure indeed.
 
Not intended as medical advice.

​By Shannon Heindel 2023

 
References:
 
American Academy of Pediatrics. (2018). Infant Food and Feeding. Retrieved November 18, 2018 from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx.
 
Australasian Society of Clinical Immunology and Allergy. (2018). Allergy Prevention. Retrieved November 18, 2018 from https://allergy.org.au/patients/allergy-prevention.
 
Baby Led Weaning. (2011). Getting Started. Retrieved November 19, 2018 from http://www.babyledweaning.com/some-tips-to-get-you-started/.
 
HealthyChildren.org. (2018). Food and Feeding. Retrieved November 18, 2018 from https://www.healthychildren.org/English/healthy-living/growing-healthy/Pages/baby-food-and-feeding.aspx#none.
 
La Leche League International. (2017). Starting Solids. Retrieved November 19, 2018 from https://www.llli.org/breastfeeding-info/starting-solids/.
 
United States Department of Agriculture. (2015). Basics for Handling Food Safely. Retrieved November 18, 2018 from https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/basics-for-handling-food-safely/ct_index.
 
World Health Organization. (2018). Infant and young child feeding. Retrieved November 18, 2018 from http://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.

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