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How to Introduce Solid Foods to Your Baby

Starting solids is an important aspect of your baby’s development, but knowing when they’re ready and how to do it can be tricky.

This guide was originally published on Aug. 22, 2019 in NYT Parenting.

I should have been confident about introducing solid foods to my baby, but even with a Ph.D. in nutrition, I was anxious about this stage of my first baby’s life. How would I know that she was ready to eat solids? Which foods should I give her? What if she choked or had an allergic reaction?

In the end, reading the scientific literature helped me feel prepared. And, as so often happens in parenting, I found that a little experience went a long way. By the time my second child was ready for solids, I looked forward to watching him explore his first foods.

To give you the information you need to feel similarly at ease, I reviewed the science and talked with a pediatrician, a pediatric dietitian and an allergist to create a simple plan for starting solids with your baby.

Starting solids is an important aspect of your baby’s development — not only because it provides her with the nutrients she needs, but because it helps her learn about different tastes and textures, and practice essential motor skills required for eating.

“It sets the basis for a lot of stuff later, from the way you feed your child, how you interact and support him or her around eating, to food preferences, to self-regulation,” said Jill Castle, R.D.N., a pediatric dietitian in private practice in New Canaan, Conn.

While expert health organizations agree that breast milk or formula (or a combination) should be the foundation of your baby’s diet through their first year, they differ on when they recommend introducing solids into the mix. The World Health Organization, for instance, has advised introducing solid foods at 6 months, while the American Academy of Allergy, Asthma and Immunology recommends starting solids between 4 and 6 months. Either way, it’s a good idea for them to start no later than 6 months, since that’s when breast milk alone no longer meets growing babies’ nutritional needs. And starting before 4 months is ill-advised, since their digestive systems aren’t yet mature enough to handle solid foods, and there’s even some evidence that doing so might raise their risk of obesity.

But all three experts I interviewed for this guide emphasized that the most important indicator is whether your baby is developmentally ready: Can she sit up, with or without support, and hold her head up? Can she open her mouth to take a bite of food, close her lips around the food and then swallow at least some of it? Does she express interest in eating?

“When you’re eating and they’re kind of grabbing at your plate and staring you down – that’s the best sign,” said Dr. Dina DiMaggio, M.D., a pediatrician at Pediatric Associates of NYC and a clinical assistant professor of Pediatrics at NYU Langone Medical Center.

Some babies will display readiness at 4 months, and some not until 6 months or even a bit later. “Every child is different,” said Castle, who cautioned against pressuring your baby to eat, which can backfire and make her less willing to eat or try new foods.

“The bottom line is you want to keep the interaction around food and feeding very positive and nurturing and really follow the baby’s lead as opposed to some set of time principles,” Castle said.

Traditionally, pediatricians have recommended starting with thin fruit or vegetable purees or baby cereals, and then gradually advancing in texture to soft finger foods, like pliable pieces of fruit, cooked vegetables, scrambled eggs or tender chunks of meat or fish over the course of a few months.

But interest in “baby-led weaning,” in which babies skip the purees and start feeding themselves solid foods straight from the family table, is growing. Some proponents believe that this approach encourages more adventurous eating, as well as an improved awareness of fullness cues which may even decrease the risk of obesity.

But those benefits are still up for debate. A recent clinical trial of 206 mothers in New Zealand, for instance, found that babies who started solids around 6 months with the “baby-led” approach were similar to those who started with purees in terms of weight, appetite regulation, and calorie- and nutrient intake at 12 or 24 months. Those in the baby-led weaning group did seem to enjoy their food more at 12 and 24 months and were less fussy about food at 12 months (but not 24 months) compared with the group that started with purees.

The trial also assessed the risk of choking, which is a common concern about baby-led weaning. At 6 months, the baby-led weaning group experienced more gagging than those who were fed purees, but were not more likely to choke. (Gagging is a normal reflex, while choking — which means that a piece of food is blocking the airway — is much more serious.)

The parents in this study were given advice about how to prepare safe baby-led weaning foods, and without that, choking might have been more common. So if you use this approach, your baby’s first foods should be reasonably soft, like banana, slices of ripe pear or sticks of toast with nut butter or hummus spread on top; and served in pieces that babies can grasp and manipulate. Whichever approach you use, always monitor your baby for signs of choking and know how to respond if you spot them. Because baby-led weaning requires more advanced motor skills than the puree approach, you’ll need to wait until around 6 months to try it.

If you decide to start with spoon feeding your child purees, let your baby control the pace of feeding and decide when she wants another bite and when she’s full. “It’s very tempting if there’s two bites left in the jar to make sure that your child eats those last two bites,” said Castle. “That’s overfeeding.” If your baby is signaling that she’s done by closing her mouth, turning her head away or fussing, respect those cues and end the meal on a happy note.

Dr. DiMaggio added that there’s no one right approach to starting solids, and that you can try offering a mix of purees and finger foods. Do what works best for your family.

There’s nothing magical about your baby’s first food. Dr. DiMaggio’s suggestion? “Open your fridge and see what you have and make life easy.”

An iron-fortified infant cereal, like oatmeal, mixed with a little breast milk or formula, is a popular first food. (Try to limit rice-based baby cereals and foods, though, since those have been found to contain high levels of heavy metals such as mercury and arsenic.) Pureed or mashed fruits or vegetables can work just as well, and if you’re doing baby-led weaning, you might start with something like avocado or cooked carrots.

Introduce new foods one at a time, so that if your baby has an allergic reaction, you’ll know the culprit. Hold off on introducing common allergens such as peanuts and tree nuts, dairy, eggs, wheat, soy, sesame, shellfish and fish until your baby has tried a few other foods first, said Dr. David Fleischer, M.D., a pediatric allergist at the University of Colorado Denver School of Medicine. Pediatricians have traditionally recommended waiting three to five days between introducing new foods, but that’s not necessary; what’s important is working toward a varied diet, Fleischer said.

Castle said she sometimes sees parents get into a rut of feeding just fruits, vegetables and grains, but variety is key. Getting your baby used to eating beef, poultry and other types of meat early on can be helpful, said Castle, because they tend to become pickier about meat later on. Meat also provides healthful nutrients, such as protein, fat, zinc and iron. (Iron is especially vital for breastfed babies, because after about 6 months, they need more iron than breast milk can provide.)

If you’re vegetarian, fortified baby cereals can provide iron and zinc. Castle also recommended including a variety of fat sources (nut butters, avocado, eggs, and veggies cooked with olive oil, for example) and working in sources of calcium and vitamin D, such as yogurt, cheese, fish and milk.

There are only a few foods that are off limits: unpasteurized or undercooked foods (because of the risk of foodborne illness) and honey if your baby is under 12 months (honey can potentially contain Clostridium botulinum spores, which can multiply in a baby’s immature digestive system, raising the risk for infant botulism). You’ll also want to wait until your baby is 12 months old before using whole milk as their main source of milk. For younger babies, whole milk is not as nutritious as — and harder to digest than — infant formula or breast milk.

Dr. DiMaggio advised using salt and sugar sparingly when preparing food for your baby, so that your child doesn’t get used to eating foods that are higher in those ingredients. Too much salt, for instance, can raise the risk of high blood pressure later on; and sugar can increase the risk of cavities and heart disease. But don’t be afraid to add herbs and spices to make the flavor more interesting.

Scientists have learned a lot about food allergies in recent years, and that’s changed the recommendations for introducing allergenic foods like peanuts and tree nuts, dairy, eggs, wheat, soy, sesame, shellfish and fish. Between 2000 and 2008, the American Academy of Pediatrics recommended that if your child was at high risk for allergies, you should delay introducing such foods until they were 2 or 3. In 2008, they said there was no reason to wait that long, but didn’t offer a specific recommendation on when to offer these foods.

Now, newer research on peanut allergies in particular has suggested that introducing peanuts as early as 4 to 6 months in high-risk babies may actually be best for reducing their risk of developing peanut allergies; and that there may be a similar window of opportunity for other allergenic foods.

That led the National Institute of Allergy and Infectious Diseases to issue the following recommendations in 2017, which were re-affirmed by the A.A.P. in 2019:

  • If your baby has severe eczema or an egg allergy — meaning she’s at heightened risk of developing a food allergy — you should introduce peanut products between 4 and 6 months (though check with your pediatrician before doing this).

  • If your baby has mild-to-moderate eczema, she should start eating such foods around 6 months.

If your baby is considered low-risk for food allergies, meaning she doesn’t have eczema or an existing food allergy, you can start trying peanut products along with other solids whenever you prefer.

There isn’t enough evidence to recommend a specific time frame for introducing other common allergens — such as dairy, eggs or wheat — but there also isn’t evidence that delaying their introduction beyond 4 to 6 months is beneficial either, according to the A.A.P.

Dr. Fleischer’s recommendation? “Try to get all those major allergens in before a year of age if you can,” and “if they like it, let them eat it often” for continued exposure, he said.

For more tips on how to introduce allergenic foods, see our guide to food allergies.

When introducing new foods, it’s best to do so in the morning or daytime so that you can monitor your baby for a reaction. It’s also a good idea to keep liquid Benadryl on hand (and to know your child’s dose) in case you need the drug fast, Dr. DiMaggio said.

Babies tend to have milder allergic reactions to foods than older kids, and symptoms like rash, hives around the face or vomiting (which aren’t life-threatening) are most common. Severe reactions — which can involve symptoms like wheezing or trouble breathing — are uncommon in babies, but not unheard of, Dr. Fleischer said. Don’t hesitate to call 911 or go to an emergency room if you’re concerned.

If you think your child had an allergic reaction, stop feeding the food in question and make an appointment with your child’s physician, who may refer you to an allergist for further testing. Skin contact with acidic fruits or vegetables can also cause skin redness, which is not an allergic reaction but is often mistaken as one by parents.

If your baby is much older than 6 months and is struggling to eat solid foods, isn’t progressing beyond purees by 8 or 9 months or is falling off the growth curve, discuss it with your pediatrician.

[Read more about the milestones your baby should reach at certain ages.]

Alice Callahan is a health and science journalist, a mom of two and the author of “The Science of Mom: A Research-Based Guide to Your Baby’s First Year.”