I get asked all the time, “Dr. Hoyt, how and when should I start feeding my baby solid foods?”
Starting solids can be exciting and, well, kinda scary, for parents. It's natural to contemplate when's the right time for your baby to start something new. And with something as important as eating, the nerves can sometimes hop into the front seat of your mind!
The First Foods Journey Begins!
Starting new foods is an important milestone, and because early introduction of foods can help prevent food allergies, it may seem even more important. This may ring especially true to parents who have older kiddos with food allergies as they often are especially attuned to trying to prevent food allergies in their babies. So when should babies start trying foods other than breastmilk or formula?
Look for Signs of Physical Readiness in Baby
Most doctor groups recommend that babies begin trying developmentally appropriate foods between 4-6 months of age. This, like almost everything with little ones, will vary by kiddo. Here are some signs your baby is ready for food beyond breastmilk or formula:
Sits up alone or with assistance
Has good control of head and neck
Brings objects to his/her mouth
Grasps at objects
Swallows foods (as opposed to still having the tongue-thrust reflex, which pushes food out of the mouth)
What to Feed Baby First
Okay, so now you know when your little one is ready physically to try foods. But what foods should you introduce first? Great question! There have been many recommendations over the years about what foods to introduce. Rice cereal was once recommended, and some groups recommend (and still do recommend) fruits and veggies be introduced first. Well, there really isn't much data to support any of this, so then what do you feed first?
Baby Will Tell You When It's Time!
When a pediatric GI colleague asked me what I tell parents about first foods, I said, “Start when the baby wants to eat with whatever the baby wants – within reason!” So what does that mean? It means that babies can try foods when they begin to express interest and when they are physically able to do so (per the list above).
You will see babies express interest when they begin looking at you while you are eating, then they smack their cute little mouths and look you in the eyes, seemingly saying, “May I try that?” Whatever food they try needs to have both a developmentally appropriate texture and flavor profile. This means a well pureed or very soft texture to make it easy for a baby to swallow. This also means a flavor profile that isn't too strong – not spicy or tart or otherwise strongly flavored or overly seasoned.
Can I Prevent Food Allergies?
Some food allergies can be prevented through early introduction of commonly allergenic foods. This means allergens, such as peanuts and eggs, are introduced around 4 months of age. These foods, of course, should only be given to babies in developmentally appropriate forms. The reasoning behind early introduction is that it teaches the immune system to tolerate the food.
Babies with known risk of food allergies should begin introducing allergens around 4 months of age. This is especially important for babies at risk of peanut allergy. All babies, regardless of their risks of food allergies, should begin trying commonly allergenic foods. These earlier-than-we-previously-recommended practices and the continued, regular inclusion of these foods in the baby's diet can help prevent the development of food allergies. Ask your pediatrician for recommendations, and, if at any point you feel that your baby is not tolerating a food, let your pediatrician know immediately.
What Foods Should Baby Try?
Okay, now let's talk more about actual foods. What was my daughter's first food, you may wonder? Peanut butter diluted with breastmilk! Peanut butter is too thick and sticky for a baby, so it needs to be thinned with a liquid. Diluting with breastmilk allows for excellent thinning of the peanut butter, plus you retain all the benefits of that breastmilk.
Don't Overthink Baby's First Foods
You'll notice that peanut butter isn't a fruit or veggie, but it was my daughter's first food. That's because, as mentioned before, there really isn't good data on starting with fruits and veggies. I personally prefer and professionally recommend to most patients that they feed their babies developmentally appropriate versions of what they're eating at mealtime. So if string beans are on the menu, then puree string beans to a developmentally appropriate texture and feed away. Eating yogurt in the morning? Give baby a bit of that.
Old School Isn't Always Bad!
And, hear me out on this: I have been known to endorse the baby-bird method. When you are chewing up something baby seems to really want, then baby-bird it: chew it very well to a consistency you know your baby tolerates, then offer it to him. In a way, this approach can make digestion easier of baby since you have started the process: saliva has enzymes that begin to break down foods, and there are good immunoglobulins in saliva that coat food and may make it kinder to the baby's immune system. Maybe this isn't the approach you use when eating at the country club, but it's been around for thousands of years and is definitely food for thought (pun intended)!
Baby Led Weaning
We should be mindful to follow baby's lead on introduction of foods. One way to do this is called baby-led weaning. This means that you are offering baby soft foods that he can pick up and eat by himself. Examples can be soft, small bits of banana and avocado. Also foods like steamed carrots cut into small strips. So the idea of needing jars and jars of processed (expensive) baby food in the pantry shouldn't wreak havoc in your mind. Having a few on hand – and having pouches, of course – is definitely helpful in a pinch, but that doesn't need to be the majority of a baby's diet.
Have Fun With Baby's First Foods
Overall, we have over-medicalized feeding our babies. It should be a fun, bonding experience! Don't overthink it. I know first-hand that moms have an intuition about these things, and we should listen to those voices while also asking questions and getting answers from reputable sources. One of those best resources is, of course, your baby's doctor. Never hesitate to reach out to them. This is, after all, a pediatrician’s bread and butter (pun intended, again!).
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A note from Dr. Hoyt
I have talked about a non-profit…
Pam and I volunteer with the non-profit The Teal Schoolhouse. Its primary program is Code Ana. Code Ana equips schools for medical emergencies like anaphylaxis.
Code Ana’s Online Epinephrine Training Program helps support that goal. Through this program, you will educate yourself while you support this important mission!
A medical emergency response plan is important for everyone at any school. Code Ana's program Med-E Ready is a comprehensive approach to school-focused medical preparedness. This program guides schools through the process of creating a medical emergency response plan. A response team is also developed! This is one of the most important components of a school's food allergy policy!
Does your kiddo’s school have Code Ana?
You've just read our post “Baby's First Foods: How, When, and What to Feed Your Baby.” Remember, Dr. Hoyt is an allergist, but she isn't your allergist, so talk with your allergist about what you've just learned!