Starting solid foods earlier than six months

Why start solids earlier than six months?

No major health group recommends starting solid foods before four months. Babies aren’t ready for solid foods at that stage, and starting solid foods that early may increase the risk of obesity and food allergies. Babies between four and six months with a high risk of peanut allergies may benefit from being given peanut-containing foods. On the other hand, starting solids at four months instead of waiting to six months can decrease the amount of breast milk a baby takes in and increase the risk of various health problems.  

A) Avoid starting solid foods before four months

No major pediatric or health group recommends starting solid foods before four months of age, because babies at that stage are not developmentally ready to eat them.

Putting cereal in the baby’s bottle will introduce solid foods early and is not recommended. 

Giving babies solid foods earlier than four months may increase the risk of the following:

  • Obesity (English 2019; Fewtrell 2017; Wood 2020)
  • Food allergies (Fewtrell 2017; Muraro 2014; Thorisdottir 2019)
  • Cow’s milk protein allergy (Zhang 2020)
  • Earlier weaning (Scott 2019)
  • Less healthy eating habits (EFSA 2019)

B) Reasons for starting solid foods between four and six months

Even if solid foods are started before six months, breastfeeding will still be the main source of a baby’s nutrition for most of the first year of life (Fewtrell 2017).

The number of children with food allergies has been increasing.There is some evidence that babies at high risk of peanut allergy may benefit from their introduction between the ages of four and six months. The recommendations on this vary as does the definition of high risk.

C) Evidence against starting solid foods before six months

In high-income countries, babies who are breastfed by healthy mothers exclusively to six months appear to grow just as well as babies who are given solid foods at four months (Fewtrell 2017; Kramer 2012; Wells 2012).

In low-income countries starting solid foods early may result in malnutrition. Studies of babies in Ethiopia and Bangladesh found that early solids resulted in more than a doubling in the number of underfed babies (Khan 2017; Nigatu 2019). Early solid foods appear to decrease the amount of breast milk that a baby takes in (Wells 2012).

Starting solid foods at four months instead of six may increase the baby’s risk of (Fewtrell 2017; Rippey 2020):

  • Infections:
    • Stomach infection and diarrhea (Richard 2018; Kramer 2003; Nigatu 2019).
    • Infection by parasites present in contaminated solid foods (Palmieri 2018).
    • Colds and ear infection.
    • Pneumonia (Richard 2018).
  • Fever (Nigatu 2019).
  • Cough, wheezing, and asthma (Lossius 2018).
  • Hard stools.
  • Having more feeding difficulties when older (Hollis 2016).
  • Being prescribed medication.
  • Obesity (Araújo 2019; Mannan 2018; Sirkka 2018).

One study (Gupta 2017) showed starting premature babies on solid foods before six months of corrected age increased the risk of hospitalization.

Mothers who start solids before six months may have their periods (menses) start earlier and thereby lose the contraceptive benefit of breastfeeding. They may also lose less weight.

Some authorities have concluded that there is not enough evidence to support routinely giving eggs or peanut products before six months to prevent allergies (SACN 2017; SACN 2018).


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