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For Your Health: Safely introduce solids to baby’s diet

by Jenna Laubert | March 22, 2022 at 4:00 a.m.
Jenna Laubert

Do you know if your baby is ready for solid foods? It can be an exciting time for both the caregivers and the baby to reach this milestone. For some, it can also be a daunting process when conflicting information or opinions of others may cause confusion. As research develops, recommendations change, and it is likely different from what your parents were told or may have even changed from when you had your first baby.

So, when is the right time to start solid foods? Both the age of the baby and their development are the two factors combined that determine their readiness. Most full-term healthy babies are developmentally and physiologically ready for solid foods at six months. The American Academy of Pediatrics, U.S. National Institutes for Health and the World Health Organization all recommend exclusive breastfeeding for the first six months of life including no solid foods, infant cereal or juice. For women who can't or choose not to breastfeed, formula would be given instead of breastmilk. Often, babies are starting solid foods at four months, and health experts have found starting solids even between that four- to six-month time frame may still be too soon.

Early introduction of solid foods, especially before four months, will put the baby at risk for choking and compromise their nutritional needs. Those tiny baby bellies fill easily, and starting solids too soon interferes with adequate consumption of breastmilk or formula. It may also impact their health later on in life as studies show these babies have a higher risk of developing obesity or other chronic diseases.

For babies born prematurely, it is a good idea to wait until their six-month adjusted age along with showing developmental readiness. Those developmental signs are sitting with minimal support, good neck and head control, reaching and grabbing for objects and bringing them to their mouth, and showing interest in food. It is always recommended parents and caregivers talk with their baby's pediatrician for guidance before introducing solid foods.

There are different methods on feeding a baby. Some caregivers like to start with purees, while others use the baby-led weaning technique, or some do a combination of both. All methods have their pros and cons, and it is up to the caregivers on which method works for them.

At six months, breastmilk or formula is still their main source of nutrition, and solid foods are meant to complement, not to replace. Start slow, and there will be a natural progression to a variety of foods that exposes the baby to different tastes, textures and temperatures. Babies who are offered a variety of foods from six months to one year are more likely to meet their nutrient needs and accept new foods later on than babies who may have been fed bland or same-textured foods.

Traditionally, infant cereal was commonly the first food to start with, but the American Academy of Pediatrics does not recommend a particular order. Babies will need more iron in their diet at six months, so be sure to offer iron-rich foods, like meat, dried beans, whole grains or eggs. It is also safe to start small amounts of water, typically 2 ounces every time solids are given. Offer water in an open cup or straw cup, but do not exceed 8 ounces per day.

As solid foods are introduced at six months, it is also encouraged to offer high allergen foods. With food allergies on the rise, more and more evidence shows early introduction of common food allergens, especially eggs and foods containing peanuts, will decrease the likelihood of a baby developing an allergy to those foods. There is no evidence avoiding any allergen prevents food allergies. There are some risk factors that may put a baby at a higher risk for food allergies so talk to your pediatrician before doing so.

The following are general guidelines for a feeding schedule. A baby may eat less or more, which is fine if they are in good health, growing well, and have adequate wet and dirty diapers.

• Six to seven months old: Breastfed babies will continue to feed eight or more times on demand. Bottle-fed babies with expressed breastmilk or formula eat about 24-32 fluid ounces per day. Offer solids one to two times daily with 2 ounces of water from an open or straw cup.

• Eight to nine months old: Breastfed babies will eat six or more times on demand. Bottle-fed babies with expressed breastmilk or formula eat about 24-32 fluid ounces per day. Offer solids two times daily with 2 ounces of water at each meal-time.

• 10-11 months old: Breastfed babies will eat five or more times on demand. Bottle-fed babies with expressed breastmilk or formula will eat about 20-30 fluid ounces. Offer solids three times daily with 2 ounces of water at each meal.

A few tips:

• Start simple with single-ingredient food.

• Follow the baby's lead and watch for signs of fullness.

• No honey or cow's milk until after age 1. Dairy products like cheese or yogurt are fine.

• Avoid foods with added sugar and salt.

• Know and avoid foods that pose high choking hazards.

• Never add infant cereal to the bottle unless under the direction of the baby's pediatrician. Adding infant cereal does not help babies sleep longer.

• Do not give teas, coffee, juice or soda. The only fluids a baby needs under 12 months is breastmilk or formula. Water can start at six months.

Starting solid foods when the baby is developmentally and physiologically ready is critical for their development. Parents and caregivers should talk with their baby's pediatrician to assess their readiness before introducing solid foods. As a dietitian for the WIC program at the Cole County Health Department, it is a privilege to sit down will families and educate on introducing solid foods as their baby approaches this exciting milestone.

Jenna Laubert, RD, LD, has been with the Cole County Health Department for seven years and serves as a WIC Dietitian.

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