Starting Solids: Baby’s First Foods

By Nicole Lattanzio, RDN, CSP, IBCLC

Introduction

Starting solids is an important time in a baby’s life – both developmentally and nutritionally. Babies begin showing signs of developmental readiness between 4-6 months of age, although some little ones may take a little longer! Ensuring the baby is developmentally ready to begin is important from a safety perspective along with creating an enjoyable eating experience rather than a frustrating one.

Nutritionally, solid foods begin to meet babies changing nutrient needs after 6 months of age. Foods rich in iron, zinc, calories, protein and more help to fill the nutrients that breastmilk and/or formula are no longer meeting solo.

Starting solid foods with your baby can be both exciting and intimidating as a caregiver. Preparing to start by learning when, what, and how to begin is key to building confidence!

Transitioning from Milk to Solids

There’s a variety of ways to start solid foods from the type of food to the texture. When babies drink their milk via breast or bottle, they are using different feeding and swallowing skills than they will with solid foods.

Sucking a bottle is a much different process than chewing a food! Given this, a natural step into solids can be starting with thin purees via a spoon. Many babies will try to suck the puree off the spoon before they learn how to eat off the spoon and maneuver the puree in their mouth.

Gradually advancing the textures to thicker purees, textured purees, mashes, soft solids, and eventually onto more complex foods allows the baby to learn how to eat and accept a wide range of foods.

Even more so, advancing the textures also allows for a wider range of foods to be offered which in turn brings more nutrients, flavors, temperatures, and sensory experience overall. These help make mealtimes an enjoyable experience and build curiosity in trying new foods as they grow up.

Starting Solids 101

When is best to start?

As mentioned above, babies begin showing signs of developmental readiness between 4 and 6 months of age, however, some little ones may take a little longer. Many families will notice their 4-month-old baby showing interest in foods however that is not readiness! Babies’ gross motor and fine motor skills are improving day by day through play and movement. Not only are these skills needed to allow babies to self-feed, but they’re also vital for safe feeding (i.e. trunk strength for choking prevention). Additionally, digestive systems are developing at this time which may impact tolerance of foods if started too early. As one would expect, a 4-month-old baby will have had less time to develop the above compared to a 6-month-old baby. With that said, waiting too long (7+ months) to begin may create feeding difficulties.

From a nutrition standpoint, breastmilk and formula meet the nutrient needs of infants under 6 months of age. Breastmilk and formula provide the perfect balance of energy from carbohydrates, protein, and fats along with vitamins and minerals. Changing these before 6 months of age may negatively impact growth and chronic disease risk in the future.

Given the above, the consensus by the World Health Organization (WHO) and other organizations is to begin solid foods around 6 months of age.

Starting solids <6 months                                    Starting solids ~6-months

              X  Higher choking risk                                              ✓ Better trunk support = safer!

              X  Higher constipation risk                                     ✓ More matured digestive system

              X  Imbalanced nutrition                                          ✓ Appropriate nutrients needed for growth

What can babies eat?

While it is no longer encouraged from an organizational standpoint to start solids before 6 months of age, it still happens at times. Pediatricians may recommend early introduction for a variety of medical reasons. Appropriate textures are key to safe feeding:

Foods fed to babies <6 months should be…

• single ingredient fruits, veggies, or baby cereal
• thin purees
• fed via spoon (not added to bottle)
• limited in amount and frequency by following infants’ cues

For infants 6 months of age and older, there are more options given they are ready! When initially starting, begin with one item at a time and build as the baby tolerates. Some early options include:

• Fruits and veggies (purees, mashes, soft strips)
• Iron-fortified baby cereals (oatmeal, multigrain, etc.)
• Meats &  legumes (pureed, minced and added to foods)
• Top allergens: egg and peanut products

How much and when do they eat solids?

When getting started, babies at 6 months of age need just 1 meal per day. That’s it! The first month or so of starting solids is a learning experience for babies and you may find they “play” more so than eat. This is perfectly normal and important as it allows them to explore foods and benefit from the sensory experience. Some babies will eat quite a bit from the beginning while others may just take a few bites. Following and honoring each baby’s cues for wanting more food versus being done eating is important to satisfy their appetite while providing a peaceful mealtime experience.

This 1 meal will evolve over the first couple weeks of starting. At first, it may be 1 single food and look more like a snack than a meal. Over time, work up to offering about 3 different foods at a meal of different nutrients (ex. a fruit, an iron-rich food, and a veggie).

Breastmilk and formula will still provide the vast majority of their nutrition and hydration. The schedule of milk and solid day of a 6-month-old may look like…

6:30 am: breast/bottle feed (wake up)

8 am: Solid food offered of iron-fortified baby cereal, yogurt, and fruit/veggie puree

10 am: breast/bottle feed

1:30 pm: breast/bottle feed

4:30 pm: breast/bottle feed

5:30 pm (optional): Solid food #2 at family dinner of blended soup and applesauce

7 pm: breast/bottle feed (before bed)

Night: breast/bottle feeds as desired

With time, the baby will progress to more meals and the introduction of snacks while milk feeds decline. Generally, at 7-8 months infants will eat 2 meals, 9+ months will eat 3 meals, and gradual introduction of snacks in addition to 3 meals starting 10+ months.

More insights in our Feeding Schedule for a 6 Months Baby and Working Together: Breastfeeding and Solid Foods.

Considerations for Introducing Snacks

“Snacks” may bring a couple of concepts to mind– “snack time” vs “snack foods.”

When discussing snack times, these can be gradually started as the baby is older and eating regular meals. Snack time progression for babies may look like:

10 months old = 3 meals + 1 snack

11 months old = 3 meals + 1-2 snacks

12 months old = 3 meals + 2 snacks

Snack times serve as an opportunity to provide some additional nutrition while filling their tummies enough to get to the next meal. Snack times will be needed when your baby drops milk feeds and a nap or so. As a rule of thumb, babies need to eat every 3-4 hours. For example, if they eat lunch at noon but dinner isn’t until 5 pm, they’ll most certainly need either a milk feed or a snack (or both!). A snack may include 1-2 food items for babies like a “mini meal”.

“Snack foods” may include baby snacks such as Little Bellies puffs and meltables. These snacks can be great for practicing pincer grasp, chewing, and overall oral motor development. Snack foods can be offered at meals or snack times – no need to wait until your little one has a scheduled snack time to offer! Offering snack foods at meals can help to keep them a neutral food and even complement meals by acting as a familiar and safe item.

Food Allergies & Digestive Issues

There are unknowns and worries with introducing new foods to babies:

              Will they have a food allergy?

              What if they don’t tolerate it?

              Will I know what to do if something goes wrong?

First and foremost – know that food allergies and sensitivities/intolerances are not the same.

Food allergies are caused by an immune system’s response to a food protein. They can occur within minutes to a couple of hours after eating a food. Symptoms may include hives, rash, swelling of lips or tongue, itching, breathing changes, or severe vomiting/diarrhea. Food allergies can be life-threatening and progress to something called anaphylaxis. If your baby shows any symptoms of food allergy, seek medical attention immediately. Foods that have caused an allergic reaction must be strictly avoided unless otherwise recommended by an allergist.

Food intolerances or sensitivities are more benign. They are not caused by the immune system and therefore are generally not an emergency. Symptoms of intolerances or sensitivities are commonly gastrointestinal and milder in nature including bloating, diarrhea, abdominal pain, or indigestion. They may be caused by components of food such as protein (ex. gluten), lactose, or food additives. At times the cause may be challenging to identify. Working with the pediatrician to identify which food/ingredient is causing digestive issues is important for unnecessary diet restrictions.

Does this mean every digestive issue in babies is an intolerance? Of course not! Digestive adjustments will undoubtedly happen as your baby eats new foods. It takes time for their tummies to adjust and learn to digest and process new foods. The majority of the time, these challenges are transient and improve over time.

In Conclusion…

Nurturing healthy and positive eating habits starts from the beginning. You can foster a positive relationship with food and mealtime by:

• offering a variety of foods that are safe for your baby
• creating a positive mealtime environment
• respecting your baby’s cues
• providing opportunities for learning and interacting with foods
• encouraging autonomy where appropriate

As the caregiver, it’s in your hands to build a happy and confident eater! You got this!