When should solid food be introduced to babies? Most pediatricians recommend starting solid food between four and six months of age. Mothers who are having good success with breast feeding might reasonably wait until six months of age to start solids.
The moment a family first introduces solid food is an incredible opportunity to set the tone for a lifetime of healthy eating. At the age of four to six months, a child’s palate is a blank slate. His/her taste buds can be trained to like anything.
Pediatric studies have shown it can take up to 10 tries to get a child to like green vegetables. Therefore, don’t give up if your child grimaces the first few times you offer her peas! If at first you don’t succeed, try again. And again. In my practice, I’ve witnessed parents abandon greens when a baby spits them out once or twice. Through repetition, all children can learn to like green vegetables.
When starting solid food for the first time, I generally recommend offering babies green vegetables for two solid weeks before giving any fruit. The baby should be fed sitting up in the high chair, wearing a bib. Solid food should be offered on a spoon, not in a bottle. Each time you introduce a new food, wait about three days before offering other new foods, to help rule out any food allergies. Feel free to recycle foods you know are safe.
Once the initial two weeks have passed, you can start introducing fruit, but be sure to continue to feed your child green vegetables at least once daily. Repetition prevents children from forgetting about those delicious vegetables. As your child gets older, try to offer fruit or vegetables with every meal. Naturally, parents should model healthy eating behaviors themselves.
Parents can offer infant cereals (rice, barley, and oatmeal) either before, after, or during the introduction of fruits and vegetables. The timing for introducing cereals and other solids is definitely more of an art that a science, with plenty of room for individual choice. Because infant cereals are fortified with iron, they are particularly useful for babies who are breastfeeding. After four months of age, all infants require some source of iron to prevent iron-deficiency anemia. Although formula contains adequate iron, breast milk does not. Infant cereals, therefore, are an excellent food choice for breastfeeding infants over the age of four months. Breastfeeding mothers who choose to wait until six months to introduce solid food can supplement their babies with vitamins containing iron, such as polyvisol, starting at four months of age. If a baby is suffering from constipation, or constipation develops after starting rice cereal, I generally recommend switching to oatmeal. Meats represents a highly bioavailable source of iron and can be offered to infants if adequately pureed.
For babies who are struggling with significant eczema, food allergies, and/or diarrhea, Beech Nut brand baby foods are a good choice because they don’t contain additives that can potentially worsen symptoms.
At four months of age, a sippy cup with water can be offered with each meal. The AAP has recommended that NO juice be given to young children.
After four to six months of age, almost any food that is not a choking hazard can be offered, including foods commonly associated with allergic reactions. The one exception to this rule is honey. Because honey can cause botulism, it should be delayed until one year of age.
To prevent the development of allergies, foods like eggs, peanuts, tree nuts, fish, and strawberries can, and should, be offered at a young age—as early as four to six months. Children with a strong family or personal history of allergies/eczema may require allergy testing prior to eating allergy-causing foods. If a child develops a severe allergic reaction following introduction of a new food, call 911 without delay. The only first-line treatment for anaphylaxis is epinephrine.
Dr. Allison Beitel's Pedi Blog 