How to start solid foods

How do I start my baby on solids?

If the baby is around six months of age, interested in food, able to hold the head up, and able to chew and swallow, it is time to introduce solid foods. All food groups should be started at this age, but if there are foods that are likely to cause allergic reactions, caregivers should try them one at a time and wait two days before introducing the next such food. That allows caregivers to see how the baby reacts. The type of food that is given first doesn’t matter, as long as it is healthy and safe. Foods rich in iron, such as red meat, legumes, green vegetables, and iron-fortified cereal should be started at six months and offered daily. Babies should be breastfed when they show breastfeeding hunger signs and offered solid foods at the family's meal times. They may need to be fed by spoon or may insist on feeding themselves. Babies should not be forced to eat if they are not hungry.

A) Readiness for starting solid foods

All babies should start eating solid foods around six months of age. Those who are at high risk of food allergies may start between four and six months. Some babies may refuse solids until they are a little older. Forcing them to eat can be stressful for both mothers and babies (Brown 2011).

Before starting solid foods, ensure that the baby is:

  • Able to hold their head up.
  • Able to sit without support.
  • Interested in food.
  • Able to open their mouth when food is offered.
  • Able to take food in and swallow.
  • Can turn their head to refuse food.

If started too early, babies are likely to accept only very small amounts (Hörnell 2001). 

B) How babies eat

Some babies need help taking in solid foods and can be fed with a spoon. Others eat only if they can feed themselves and some do best with a combination of both.

Self-feeding allows babies to respond to their hunger but can be messy. It is much easier for the baby when the food is not pureed. Food mills can provide food that babies can pick up and eliminate the risk of choking.

Caregivers should follow the babies' hunger signs for the amount of solid food. Just like us, it’s normal for babies to vary the amount of food they eat at each meal. Babies should not be coaxed to eat more by games or sweetening their food. They should not be forced to eat if they are not interested.  

Babies may benefit from being taught sign language for “more”, “all done”, “milk” and so on. This allows for more communication between caregivers and child, allows the caregivers to respond to the child’s needs, and may prevent obesity (Paul 2019).

Once babies start eating foods that are drier, such as bread, they may need a small drink with meals. This can be sips of expressed breast milk, watercow’s milk, or infant formula.

C) Feeding bags and food pouches

Feeding bags with teats have become popular. These are designed to allow babies to suck solid foods through a nipple or to strain them through a mesh. There are concerns about these delaying the introduction of solid foods with texture. The popularity of these bags represents a big change in the way babies eat solid foods and there is limited information about their safety or the effects on the growth of the baby (Theurich 2018).

Food pouches have raised similar concerns. Food pouches contain commercially-produced foods and in order to consume their contents, babies suck on straws or spouts.

D) How to combine breastfeeding and solid foods

To combine breastfeeding and solid foods:

  • Mothers should breastfeed their babies when they show hunger signs and want to breastfeed.
  • Solid foods are offered at the family’s mealtimes, allowing the baby to join in the family’s activities.

Some mothers will try to time the baby’s breastfeeding to increase the amount of solid food the baby takes in. They may force the baby to breastfeed or prevent the baby from doing so. This is not advisable and the baby will often be upset by this approach. Just like us, babies vary the amount of solid food they eat from meal to meal. 

E) The first foods

In the past, it was recommended that only one food group, such as vegetables or starches, be started at a time. Babies were given foods from only this group for weeks at a time until the next food group was started. This does not make biological sense. If babies are ready for one food, they are ready for all foods. Mix it up!

The type of food that babies are first given varies greatly around the world. It is usually determined by what is available locally and by family and cultural traditions. If you are trying to decide what to give your baby first, simply pick a food and see how the baby likes it. It can be a fruit, vegetable, starch, or meat, as long as it is healthy and safe.

A baby’s foods can be homemade and there are numerous reasons to avoid commercially prepared baby foods. 

Babies can be given one new food each day. The exception is foods that are more likely to cause allergic reactions. Different organizations have different recommendations on how long to wait between introducing allergenic foods. Once started, these foods should be offered several times each week.

Your local health agency likely has more information about what is available and recommended in your area.

F) Iron-rich foods

Foods rich in iron should be started right away and offered daily. Examples of iron-rich foods include:

  • Eggs
  • Grains and iron-fortified cereal (Finn 2017)
  • Legumes (chickpeas, lentils, dried peas and beans, tofu)
  • Green vegetables (spinach, broccoli, green peas, beans)
  • Meat
  • Fish

Iron in meat is in a form that is more easily absorbed compared to other foods, including iron-fortified cereal, but all contribute to a baby’s iron intake. Vitamin C helps the body absorb iron, so it is a good idea to offer fruits and vegetables that are high in vitamin C along with iron-rich foods.   

The types of iron-fortified infant cereal should be varied to minimize the amount of arsenic the baby takes in.

Meat, legumes, and fortified cereal will also provide zinc.

G) Dealing with solid food rejection

Breastfed babies are more likely to accept a variety of foods compared with babies who are fed infant formula. However, every baby is different and they may reject foods because of the taste or texture. 

Don’t be afraid to experiment with different foods. Sometimes babies need to get used to certain foods, so offer rejected foods again at other meals or add them to more acceptable ones (Barends 2019; Remy 2013).  

References

Barends C, Weenen H, Warren J, et al. A systematic review of practices to promote vegetable acceptance in the first three years of life. Appetite. 2019 Jun 1;137:174-197
 
Brown A, Lee M. A descriptive study investigating the use and nature of baby-led weaning in a UK sample of mothers. Matern Child Nutr. 2011 Jan;7(1):34-47
 
Finn K, Callen C, Bhatia J, et al. Importance of Dietary Sources of Iron in Infants and Toddlers: Lessons from the FITS Study. Nutrients. 2017 Jul 11;9(7). pii
 E733
 
Hörnell A, Hofvander Y, Kylberg E. Introduction of solids and formula to breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatr. 2001 May;90(5):477-82
 
Paul IM, Hohman EE, Birch LL, et al. Exploring infant signing to enhance responsive parenting: Findings from the INSIGHT study. Matern Child Nutr. 2019 Feb 27:e12800
 
Remy E, Issanchou S, Chabanet C, et al. Repeated exposure of infants at complementary feeding to a vegetable puree increases acceptance as effectively as flavor-flavor learning and more effectively than flavor-nutrient learning. J Nutr. 2013 Jul;143(7):1194-200
 
Theurich MA. Perspective: Novel Commercial Packaging and Devices for Complementary Feeding. Adv Nutr. 2018 Aug 11