PAMF Health Blog

Be Well, Be Well Informed

Introducing Your Baby to Solid Foods

Posted on Apr 17, 2014

A father feeding their baby.

Watching the changing – and often comical – expressions on your baby’s face when they first try solid foods is a delightful and exciting time for many parents. It’s also a time when parents have many questions for their child’s doctor: when to start, what foods to begin with and how much to feed.

“In the beginning, it’s important to remember that starting solid foods is all about learning for the child,” says Katharine Padrez, M.D., a pediatrician at the Palo Alto Medical Foundation. “Keep the experience fun and enjoyable. Your baby is learning about new flavors, different textures, how to move solids from the front to the back of the mouth and how to take food from a spoon.”

Starting solids does not mean that your baby will finally sleep through the night or need less milk during the day, Dr. Padrez adds.

“The majority of your baby’s calories will still come from breast milk or formula for at least the first few months after starting solids,” says Dr. Padrez.

Here are answers to some of the most common questions parents ask Dr. Padrez about introducing their child to solids.

When is the right time to start solid foods?

There’s much debate among experts about the optimal time to introduce solids and the recommendations have changed over the years. What your pediatrician recommends may be different from what your mother did or your next door neighbor thinks is best. In general, most babies are ready to start solid foods sometime between 4 and 6 months. However, age is less important than whether they meet the following developmental milestones:

  • Your baby has to be interested. Babies need to willingly open their mouths when presented with a spoonful of food. Never force your baby to eat. You can gauge their interest by observing what they do when you eat. Do they intently watch your food as you move it from your plate to your mouth? Do they reach out for your fork as you go to take another bite?
  • Your baby should have excellent head control. Babies should be offered solid foods while sitting in your lap or in a high chair. Therefore, they need to be able to hold their heads steady while sitting with support.
  • Your baby’s tongue thrust reflex should be gone. All infants have a protective reflex to thrust their tongues forward when anything is placed on the tongue. This reflex usually disappears between 4 and 6 months when most infants are double their birth weight. If you find that all solid food you are feeding is ending up on your baby’s chin with very little being swallowed, you may want to wait another week or two to ensure the reflex has disappeared.

What foods should I start with first?

There is no right or perfect order. Since breastfed babies will need more iron in their diet going forward (formula-fed babies get plenty of iron from their formula), it’s a good idea to start with iron-rich foods. Fortified baby cereal (rice cereal or oatmeal) contains extra iron and can be mixed with breast milk, formula or water to your desired consistency. In the beginning, you can make the cereal quite runny, then as your child gets used to the new texture, you can incrementally increase the thickness. Other iron-rich foods are beef or turkey (yes, you can start with pureed meat), sweet potatoes, tofu, prunes and dark leafy green vegetables.

It is best to stick to single ingredient foods (no fruit salad or chicken dinner), and introduce one new food every two to three days. That way you can identify if your child has any symptoms of a food allergy.

How much and how often should I feed my baby?

In the beginning, a couple of teaspoons once a day may be all your baby wants. Gradually, by following your baby’s cues, you can increase the amount and frequency of feedings. By the time your baby is eight or nine months old, he or she should enjoy eating a wide variety of foods two to three times per day.

Should I be concerned about food allergies?

In the past, many pediatricians recommended delaying highly allergenic foods (eggs, peanut butter, shellfish, soy and wheat) until babies were older, often even after they were 1 or even 2 years old. Current research shows that this does not decrease the chance of allergies. In fact, the new data shows that earlier introduction of allergenic foods leads to less allergies in children. Of course, anytime you are introducing a new food to your baby, you should watch for a rash, changes in bowel movements or vomiting as these could be signs of an allergy. In extreme cases, an allergic reaction can cause lip or tongue swelling and difficulty breathing. If this occurs, call 911 immediately.

Are there any foods I should avoid?

Make sure you don’t give your baby foods that may cause him or her to choke such as nuts and seeds, chunks of meat, cheese or raw vegetables and whole grapes. This is an excellent time to start your baby on a healthy diet: avoid desserts and sweets, salted and fatty foods. Also avoid highly spiced foods.

What other changes can I expect when my child starts solid foods?

Your baby’s bowel movements will become harder (and smellier) as you introduce solid foods. If the stools become very hard or pellet like, you will want to ease constipation by offering the “p fruits” such as: prunes, peaches, pears or plums. Foods that tend to be more constipating are bananas, apple sauce and rice cereal. It is also important to offer your baby water once he or she starts eating solid foods. This will also help ease constipation. Try giving your baby water in a sippy cup. This may also make it easier for you to wean your child off the bottle (if he or she uses one) around 12 months.

Katherine Padrez, M.D.Katharine Padrez, M.D., is a pediatrician at the Palo Alto Medical Foundation.