Starting Solids: When, Where, & How to Begin
By Kerry Lett, MPH, RDN, LDN
Starting solids with your baby is an exciting time. It is fun watching them explore new foods and gain new skills. However, it can also be confusing with an overload of information and opinions that often conflict and differ.
So, when should you start solids and how do you even begin? Let’s dive in!
Is my baby ready for solids?
It is important to make sure that your baby is developmentally ready to start solids to ensure it is as safe as possible. According to the American Academy of Pediatrics (AAP), a baby is ready to start solids when they meet all of these criteria:
1. They are around 6 months of age. If your child was premature, they should be around 6 months corrected age. To calculate your baby’s corrected age, you start with the baby’s actual age in weeks and subtract the number of weeks your baby was preterm. However, if your baby was premature or has other medical concerns, talk to your pediatrician to better assess when your baby is ready for solids.
2. They have at least doubled their birth weight.
3. They can hold their head up well and are starting to sit up without support. Your little one should be able to hold their head upright and steady without slouching in any direction for the duration of the meal. If your baby needs support to hold their head upright, consider waiting to start solids until they are developmentally able and instead focus on activities that helps them work toward these milestones, such as tummy time.
4. They show signs of being interested in food, such as watching you eat or reaching for food when you are eating.
5. They can close their mouth around a spoon and keep food in their mouth when fed.
Remember there is no right way to introduce solids to your little one as long as the foods offered are safe. There are three general approaches to introducing solids: baby-led feeding/weaning (finger foods first), spoon-feeding, and combination feeding (a mix of purees & finger foods).
Where should I begin?
If your little one is showing all of the above signs that they are ready to start solids, then it is time to for your baby to start their food adventure! However, determining where to start is often the hardest part of any journey and starting to introduce solids to your infant is no different.
Remember there is no right way to introduce solids to your little one as long as the foods offered are safe. There are three general approaches to introducing solids: baby-led feeding/weaning (finger foods first), spoon-feeding, and combination feeding (a mix of purees & finger foods).
All three methods have been determined to be safe for babies.1 Therefore, what approach you take really is based on your personal preference and what you feed most comfortable and confident with. Regardless of what method you choose, your little one should be introduced to finger foods by at least 9 months of corrected age, if not sooner.
What are the best first foods to introduce?
Contrary to previous belief, infants do not need to have infant rice cereal as their first food. In fact, research has shown that infant rice cereals are often contaminated with heavy metals, such as arsenic, which is not good for anyone, especially developing babies.2
Instead, I recommend that families focus on nutritious, whole foods that include a variety of flavors, textures, and nutrients, with iron being one of the most critical nutrients for babies at this age. Some of my favorite first foods for babies are: oatmeal, sweet potato, avocado, and beans – all served in safe, age-appropriate ways.
After your little one has gotten a few foods under their belt, it is also important to start introducing the big 9 food allergens – eggs, cow’s milk, peanuts, almonds, soy, wheat, fish, shellfish, & sesame. Research has shown that introducing food allergies early and repeatedly has been shown to lower the risk of developing food allergies by 78-86%.3,4 If your little one has a known food allergen or eczema, make sure to talk to your child’s pediatrician or food allergist prior to introducing the big 9 food allergens.
How often should I introduce new foods?
While the AAP, Centers for Disease Control (CDC), and American Academy of Allergy, Asthma, & Immunology (AAAI) all recommend waiting 3-5 days between new food introductions, many health experts have begun questioning this recommendation. This is because having long periods of time between food introductions limits the number of new foods an infant can try during their first year of life, which can limit a baby’s diet diversity – a known risk factor for developing a food allergy – by only being exposed to 36-60 new foods in their first year of life.5
This is why I recommend most parents of healthy babies with no history of food allergies or sensitives or eczema try to introduce one new food every day once their baby is developmentally ready in the morning to allow time to watch for any potential food reactions throughout the day.
Once your baby is eating solids, you can start to gradually increase the number of meals you are offering every day. I typically recommend adding one additional meal every two months (e.g., at 8 months of age, go from one to two meals offered daily). Remember that solid foods should complement not replace any breastmilk or formula your baby is getting until they are at least one year old.
If you want help getting your little one started on solids or progressing to the next stage of starting solids, book a free discovery call to see how nutrition counseling could help your family.
References:
1. D’Auria E, Bergamini M, Staiano A, et al. Baby-led weaning: what a systematic review of the literature adds on. Ital J Pediatr. 2018; 44: 49.
2. Houlihan J, Brody C. Healthy Babies Bright Futures. What’s in my baby’s food. 2019. https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2020-04/BabyFoodReport_ENGLISH_R6.pdf
3. Tran MM, Lefebvre DL, Dai D, et al. Timing of food introduction and development of food sensitization in a prospective birth cohort. Pediatr Allergy Immunol. 2017; 28(5): 471-7.
4. Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk of peanut allergy. N Engl J Med. 2015; 372(9): 803-13.
5. Venter C, Maslin K, Holloway JW, et al. Different measures of diet diversity during infancy and the association with childhood food allergy in a UK birth cohort study. J Allergy Clin Immunol Pract. 2020; 8(6): 2017-26.
Kerry Lett, MPH, RDN, LDN is a Registered Dietitian with a Master’s degree in Public Health who is passionate about helping growing families navigate life and achieve all of their milestones along the way. She works with women who are trying to conceive, pregnant, breastfeeding, or postpartum and children to help manage medical conditions, tackle picky eating, and establish a good family relationship with food. With an overload of nutrition information available, Kerry understands how difficult it can be to know which foods are best for you and your family. Kerry owns a private practice called Milestones Pediatric & Maternal Nutrition.
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