Dr. Lee A. Savio Beers ponders a question we often get asked: “When can I start feeding my baby (“complementary”) foods?”
Of course, breastfeeding is recommended as the primary source of nutrition for the first 6 months of age, then adding in solid foods. Many of the families I take care of are very anxious to begin “baby foods” – I tell them there is no benefit (and some potential risks) to beginning complementary foods before age 4 months. Between 4-6 months of age, the evidence is a bit unclear for most children (there are, of course, exceptions), but according to the American Academy of Pediatrics Committee on Nutrition (Pediatric Nutrition Handbook, 6th ed., Elk Grove Village, Ill.: AAP, 2008, p. 128]), “there is no significant harm associated with introduction of complementary foods at 4 months of age.” For families eager to start with solid food, I still encourage waiting until their infants are closer to (or at) 6 months of age, but don’t fuss much if they want to start a bit earlier.
I agree that starting at six months is ideal, but I will start babies sooner if they (not their parents) show readiness. Which foods to start first is the inevitable next question:
The traditional recommendation has been to start with an iron-fortified infant cereal, and then progress to fruits and/or vegetables – with some recommending fruits first because of palatability and others recommending vegetables first so that babies don’t get too used to the sweet taste of fruit (and then reject the vegetables).
There really is no single or best way to introduce solid foods to babies. It’s a lot of trial and error. Here are some of my basic recommendations:
- Have fun! Your baby may like these first foods. Or she may not. No biggie!
- It’s going to be messy!
- Try to schedule infant feedings for traditional times, when everyone in the family is eating together. I usually recommend starting the very first meal at dinner, when it is more likely that families will be sitting together. Young babies and even older children pay attention to what and how others eat.
- Start at dinner with rice cereal, then add orange and yellow veggies first (squash, sweet potatoes, carrots). Add a second meal (breakfast) using rice cereal and fruits. Then try other cereals (oatmeal, mixed grain). Once babies are tolerating two meals a day, lunch can be added (green veggies and some more fruit).
- By 6-9 months, most babies are ready to move onto meats, and then multi-ingredient dinners.
- If parents prefer to make their own baby foods (which I encourage), they should NOT add salt, sugar, or honey to the puree. A small splash of 100% apple juice can be used as a thinning and sweetening agent for the puree if plain water won’t do.
- By 9 months, it’s time to transition away from baby foods and onto table foods. This is accomplished in two ways. First, take table food the rest of the family is eating and mush it up before serving on a spoon. And second, introduce finger foods (start with cheerios and then move on to small pieces of whole wheat toast. They practically melt in the mouth and require really no chewing, which is good, considering babies have no chewing teeth yet at this age). As you move on with table foods and finger foods, it’s important to focus on simple and healthy ingredients. Again, no added salt, sugar, or honey! This is a good time to start dairy (good quality cheeses and yogurt). Put butter (not margarine), cream cheese, or fruit preserves (no added sugar) on toast. Make a grilled cheese sandwich and tear off small pieces. Move onto small pastas and small pieces of cooked veggies and soft fruits.
- By 12 months of age, these kids are toddlers, not babies. Most will be pushing away the spoon and feeding themselves with their fingers and hands. We’ll talk to you at this visit about getting rid of the formula AND the bottle. At this age, toddlers can drink whole milk (or NO milk) in a cup. But the formula is no longer necessary now, and the bottle must go.
Your pediatrician may have other thoughts regarding how best to begin feeding your baby. There is plenty of other advice we give, like foods to avoid to prevent choking (peas, corn, whole grapes) or allergies reactions (fish, nuts, peanut butter, eggs). Like I said, there is no single way to do this. You can wing it if you must, as we all do. As Dr. Beers more elegantly puts it:
So, when parents ask me which should be first, I tell them whichever they prefer, and commend them for wanting to feed their child fruits and vegetables, and encourage that as a lifetime goal. I find that families today are so inundated with information about what they should and shouldn’t do, that most like hearing that the choice is up to them.
Read Dr. Beers article from Pediatric News here.