Introducing Solids

When is the right time to start?

Up to the first four to six months, your baby’s nutritional requirements are best met by breastmilk or formula. So while there is no fixed age to start solids, current recommendations suggest that baby begins solids at around or as close to six months (26 weeks) as possible. Many parents find the recommendations a little vague. Bear in mind that these recommendations are guides rather than rules and allow for some flexibility. After all, babies and families are all quite different.

Interestingly, you may find that some health care professionals will suggest a baby starts earlier.  This may be for health reasons, personal preference or insight in the potential changes looming in the near future.  It is likely the current recommendations will change back to four to six months given a tide of research into allergy prevention during the solids stage.  The rise in food allergies in western countries may be linked to the delayed method of introducing solids.  Stay tuned for more on this.

We also know that a baby’s stores of iron with which they are born become depleted by around six months; that’s why iron-fortified baby cereals are often recommended as a first food.

Ultimately the too-ing and froing of guidelines suggests that your best guide is the little person right in front of you.  Start your bay when he or she shows a number of signs of readiness sometime after four months.  

What signs of readiness should I look out for?

Today recommendations on starting solids are based on baby’s ability to move food around in their mouth in readiness for swallowing; this is why we start with runny purees and slowly progress to coarse foods and then chunks. Before embarking on solids, baby’s feeding and mouth motions are likely to have changed from sucking to chomping and progress to chewing, plus their tongue no longer protrudes in order to take fluids.

The World Health Organisation defines four phases in the introduction of ‘complimentary foods’, determined by baby’s motor development:

1.    Stage one is getting baby used to eating from a spoon, using pureed foods, once or twice a day.

2.    Stage two is becoming accustomed to texture because of improved motor skills.

3.    Stage three is the introduction of lumpy texture and thick consistencies, and again improved motor skills by allowing finger foods.

4.    Stage four is self-feeding and becoming ready for family meals.

So you can see why there is some variation in the exact ages for foods, quantities and timing depending on how these guides are interpreted and applied to each baby. Again, we need to keep in mind individual differences and that our own bubs are out best guides.

Other signs to look out for:

• Baby starts to show interest in the food you eat; you may begin to notice baby mimics chomping motions as you chew. This also signals your bub is moving from sucking to chomping motions.  Remember that even though babies younger than 16 weeks (for months) might seem curious about what you put in your mouth, to a baby their mouth is their whole world – if it goes into even your mouth it must be interesting. So alone this in itself, this isn’t necessarily a sign of readiness.
• Baby’s tongue extrusion reflex is reducing in readiness for swallowing over sucking
• Baby can hold his or head up well, this allows the easy progression of solids down the throat.
• Ideally, baby can sit unaided and grasp an object.
• Baby is at least 16 weeks.

Starting too early isn’t recommended

Solids is an exciting time for the whole family, if baby has been exclusively breastfeed it may mean that finally dad or nanna or poppa can get involved in feeding baby.  However, don’t be tempted to start too early. It appears that the healthy bacteria in a baby’s intestinal canal doesn’t really begin to take hold until four months.  Starting solids too early could be a challenge to baby’s young immune and digestive systems, increasing the risk of upset tummies and food allergies. Furthermore, starting on solids prematurely can also potentially play havoc with baby’s intake of breastmilk or formula, and could even upset maternal milk supply.

Don’t delay solids

On the other hand, some parents find the idea of delaying solids very attractive; after all, what can be more convenient than milk feeds! However, there is a downside to delaying… If you wait too long before starting your baby on solids, you can run the risk of compromising baby’s nutrition. Starting solids is also important for motor development skills, for example chewing.

What if it’s my baby who is delaying things?

Of course, for some babies mushy food just doesn’t measure up. Don’t worry, this is fine. Just be patient and keep trying. Some simply jump to finger foods at an appropriate age. Feeding meshes can be very useful here if you think you may have a bub who wants to self-feed.

If, however, feeding continues to be an issue – for example, if after seven months baby still rejects all solids, or baby doesn’t cope well with lumpy food after nine months – you may want to consult your child health nurse, Plunket nurse, GP or a feeding specialist such as a paediatric speech pathologist or deglutitionist.

What about starting solids to help baby sleep?

Starting solids to help baby sleep isn’t generally successful: the tiny amount that a baby will initially eat and the single foods such as fruit and veggies they start with simply don’t compare to the calories and nutrients they gain from a full breastfeed (containing around a whopping 54% fat) or formula feed. You may find introducing an additional breast or formula feed works better. If baby is temporarily unsettled or going through a fussy stage (which seem to occur at weeks 5, 8, 12, 17 and 26) try to return them to their usual routine with patience and consistency.

How often and how much

In some cases, a food can upset a tiny tummy or developing immune system. The culprit is much easier to pick out if you offer a new food for three or so days (you may find five days fairly slow-going) without introducing another new food.

Select just one meal of the day to start with, and offer breastmilk or formula first.  Most bubs will start out with just a teaspoon or two, but over a week or more will work up quickly to much greater quantities.  Again, baby is your best guide, you will find a full baby will quickly learn to turn their head away when they are full (or just not interested in the morsel on offer).  Babies and young children (up to about three years) are quite good at self-regulation of energy intake.  Honouring this appears important in establishing good hunger and satiety (fullness) cues.

Around 7ish months (depending on when baby started and how he or she has progressed) baby may be onto 2-3 meals a day plus meals can start to be fork mashed.  Other food groups will be creeping in such as yohgurt, cheddar cheese, fish and so on.  Around 8’ish months most bubs are on three meals and their food is roughly chopped.

Around nine months you may begin to notice some real changes in the way baby is eating.  Not only can you swap to solids before ‘milk’ feeds, but also baby may be eating a wide range of whole foods.  Many bubs will be enjoying three full meals and two snacks, and keep in mind that this can result in a drop in the number of ‘milk’ feeds.  Weaning is a whole entire other story.

Once you’ve successfully introduced a range of foods, make sure you alternate them frequently so that baby gains a varied diet. Variety at this early stage may also help you get through that fussy stage in the toddler years.

What to start with first

Keep in mind that the actual amount a baby eats in the early days of solids won’t provide significant nutrients. Babies will still rely primarily on breastmilk or formula for their nutritional and growth requirements.

Because of baby’s increased nutritional requirements for nutrients such as iron, iron-fortified baby cereals are recommended commonly as a starter. If you find that baby rejects infant cereal, (it isn’t the most interesting tasting food in the world), you can try a slightly different approach.  For example you may start off with avocado for three days, it has lots of lovely oils and nutrients.  Next, try sweet potato for three days, it is not only tasty but low GI. Once you have the thumbs up you can combine the rice cereal with these successfully trialled foods. Before you know it you will have some gourmet mixes in the bowl.

Ideally, start with vegies: it doesn’t take long for that innate preference for sweet foods to kick in. Encouraging baby to accept vegetables early on can help avoid the development of fussy eating habits later. 

How can I tell if baby is having enough?

Every baby is different: some will eagerly adapt to solids while others will take longer to come round to the idea. Your baby is your best guide. Generally, if your baby is growing and developing at a consistent rate and is happy and healthy then it’s likely you are both going great. If you feel your baby is not progressing well or that their growth and development are being compromised, consult your child health nurse or doctor.

Don’t confuse rejection with dislike

There are many reasons why a baby may reject foods. Be persistent. Studies show that it may take up to ten attempts to try a new food before baby accepts it. Don’t confuse rejection (due to texture, say) with dislike. Keep providing opportunities for baby to become accustomed to different tastes and textures, its all a process.

Fluid plus food

Babies’ kidneys are not as adept as ours at processing the waste products from food. Even the smallest sips of clean water (juice is not recommended for babies) from an age-appropriate sipper cup regularly throughout the day can go a long way to avoiding problems such as constipation. Even if baby rejects water at first, keep offering it as often as you can during the day (babies don’t have great thirst reflexes); they will eventually take to it.

Foods not for bubs

There are a few foods that aren’t ideal for bubs under 12 months (some aren’t ideal right throughout childhood). These include:

• Honey should not be given to children under twelve months.
• Tea which has tannin and caffeine-containing drinks such as coffee have a powerful drying effect on the body’s liquid stores and tannin reduces iron absorption.
• Small, hard foods should be avoided as they pose a risk of inhaling and choking, e.g. nuts, seeds, popcorn, whole grapes and whole beans.
• Spinach and other high oxalic acid-containing foods may also be a problem until later in the first year if your bub has had any renal (kidney) issues.
• Wholegrain products may not be suitable for very young babies due to the seeds, although light wholemeal bread is fine.
• Sugar and salt should not be added to food for children.
• Cows’ milk and other milk alternatives as a drink are not suitable for bubs under 12 months as their nutritional makeup won’t meet baby’s needs.
• Fruit juices are not recommended as they pose a risk of tooth decay and diarrhoea (especially apple and pear juice).
• Fizzy drinks or soft drinks contain a lot of sugar and some contain artificial sweeteners; none provide any nutritional benefit.

Looking after baby’s food

Most of us are fully aware of the importance of cleanliness when dealing with infant food. Keep all work areas clean, make sure utensils are clean (including your hands) and be aware of food contamination and storage issues.

Last word…

Most of all, remember to have fun and enjoy this time; food is not just about eating, it is nourishment for the soul and body.

Written by childhood nutritionist Leanne Cooper author of “What do I Feed my Baby; a day-by-day guide to starting solids”