Introducing babies to solid foods: What you need to know

Guest blogging today with regular contributor Mario Cruz, MD, is Regina Vince, DO, a pediatric resident at St. Christopher's Hospital for Children.

Peas, carrots, squash? Oh, my!  Ready to start feeding solid foods your infant and feeling confused? It is not surprising. This is the biggest period of transition in diet over a lifetime. Here are some helpful tips from two pediatricians who recently made this transition with their own kids!

When do I start solid foods? For babies who are not breastfeeding, the ideal time to start is between 4 and 6 months. You’ll know that your child is ready to eat solid foods if they can sit comfortably in a high chair without slouching over. Babies who are exclusively breastfeeding should wait until at least 6 months.

Why do I have to wait so long? I know other babies who ate solid foods at an earlier age. The most important risk of starting solid foods too early is choking. Swallowing is a complex and coordinated process; if the child is not ready then the food may accidentally go into the lungs. Additionally, starting solid food, even infant cereal, before 4 months can lead to an increased risk of food allergies.

But doesn’t cereal in the bottle help babies sleep better at night? A common misconception is that adding rice cereal to the bottle before bed can increase the quality of a baby’s sleep.  Unfortunately, for new parents, research shows that cereal in the bottle has no effect on sleep! Even worse, cereal in a bottle can put babies at risk for becoming overweight. For each teaspoon of rice cereal that you put into a bottle, you would add an extra 14 (unnecessary!) calories to your baby’s diet.

Does cereal in the bottle help babies that spit up a lot (reflux)? Yes, it can help, but talk with your doctor before doing this. Spitting up is normal for young babies and in most cases, treatment is unnecessary. If you decide to thicken your babies’ formula, be careful not to use too much cereal or else the milk will become too thick. One teaspoon for every 2 ounces is good enough.

My baby keeps spitting out the food. What does that mean? Spitting food out of the mouth during first introduction of a new food does not necessarily mean that your child is not interested.  It may just be that the texture and taste are unfamiliar.  It takes many, many introductions of a new food (sometimes more than 10!) before it might be accepted.  Don’t give up!  Be patient!  Pay attention to the cues! You know your child best.

What food should I give first?  We recommend rice cereal as a good first food for many reasons.  It is unlikely to cause an allergic reaction.  It can be mixed with breast milk or formula so that the taste is not new to your baby.  You can also make it as thick or thin as desired.  Additionally, it is a good source for iron and zinc.  When you first start feeding rice cereal, your child may only take a few spoonfuls. That is just fine! It is a whole new way of eating, a new texture and a new taste.  Take it slowly.  Start with once a day.  Add more food as you and your baby get more comfortable. 

Rice cereal is boring, when can I introduce something else? Introduce one new food at a time.  Wait a few days after each new food so if there is a bad reaction, you can pinpoint the cause. You can try fruit or vegetables or meat!  Your child is more likely to like fruit more than vegetables because they are sweeter.  Unfortunately, there is no proof that giving vegetables before fruit will make your child eat his or her vegetables when they are older!  Meat may seem like an unusual first food to give, but just like fortified rice cereal, it is full of that important zinc and iron!

This period of transition to solids foods is very important.  It is the first step to lifelong healthy habits.  It is also a fun period of new experiences for you and your child. It will be messy. It will be full of funny faces. Grab your camera and enjoy it!


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