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Starting Baby on Solids: Q&A with a Nutritionist Mom

Starting Solids Q&A with a Pediatric Nutritionist Mom

By Bailey Koch, Mom & Board Certified Specialist in Pediatric Nutrition, Registered Dietician & Food Allergy Specialist, RD, CSP, LP

When do I introduce solids to my baby? 

The American Academy of Pediatrics suggests introducing solids between 4-6 months, though it’s different for every baby depending on their development and readiness.

How do I know if my baby is ready for solids? 

Some signs that your baby may be ready for solids include good head control, being able to sit up without support and losing that tongue-thrust reflex that tends to just push food out of the mouth. Another sign that your baby may be ready is that they show interest in your food. They might reach for it or open their mouth and even chew like you do!

How should I go about first introducing solids to my baby? 

Current guidelines recommend introducing new foods one at a time, every 3-5 days, however in healthy babies without food allergies, I usually suggest speeding this process up to every 2 days, as long as parents are comfortable with that. Aim to increase the variety by rotating through different food groups (grain, veggie, fruit, protein, etc).

What first foods do you recommend? 

I like to recommend iron fortified cereals or meats as starting foods because babies need iron. After the successful introduction of other solid foods, it's also important to incorporate baby-safe foods containing peanuts and other common food allergens into a baby’s diet, regularly.

How do I know when my baby is ready for MightyMe puffs?

Your child may be ready for MightyMe puffs when he or she sits up in a high chair, picks up pieces of food and brings them to the mouth, and can manage dissolvable textures (typically around 6 months). For younger infants starting as early as 4 months, puffs may be softened with water and spoon-fed.

Any tips for getting babies to eat solids?

My first tip is to make meal-time a fun and no-pressure event! Don’t force it if they are not interested. And don’t assume baby doesn’t like a food just because they don’t take to it initially. Keep offering it in a zero-pressure way, because it can take multiple tries for them to accept something new. Sitting with them and eating with them during mealtime, is also a great way to get them interested in food.

How do I introduce potential food allergens? 

After the successful introduction of other solid foods (and assuming no allergies exist), you can introduce all common food allergens and include them as a regular part of baby's diet. Research has shown that early peanut introduction can significantly reduce the chance of developing a peanut allergy and according to the American Academy of Asthma, Allergy and Immunology, “delaying the introduction of allergenic foods may increase your baby’s risk of developing allergies.” New American Academy of Pediatrics Guidelines recommend peanut introduction in infancy, and not to withhold other allergenic foods. However, many allergens (like peanuts and tree nuts) cannot be given to babies in their natural form due to the choking risk. You can use a blender to make your own purees or use products like Mission MightyMe that contain nuts in a baby-friendly form.

What are the signs of an allergic reaction? 

Mild to moderate symptoms include hives, eczema, redness of the skin, particularly around mouth or eyes, itchy mouth or ear canal, nausea or vomiting, diarrhea, stomach pain, nasal congestion, sneezing, slight dry cough or an odd taste in the mouth. Severe signs include swelling of the lips, tongue, and / or throat that blocks breathing, trouble swallowing, shortness of breath or wheezing, turning blue, a drop in blood pressure (feeling faint, confused, weak, passing out), loss of consciousness, chest pain and weak pulse. Anyone experiencing severe signs needs epinephrine and should call 911 or go straight to the emergency room.

What do I do if my child has an allergic reaction to food? 

Stop feeding and consult with a doctor immediately. Severe symptoms (listed above) require epinephrine. If the symptoms are severe, call 911 or head to the Emergency Room immediately.

Do I continue breast feeding or formula feeding after introducing solid foods? 

Yes, your child will still get their primary nutrition from breast milk or formula for the first year of life.

How many times a day should my baby eat solid foods initially? 

Start off offering solids once a day until they are readily accepting the foods, then you can move to twice a day. We usually recommend offering 3 solid meals around 8-9 months. As they approach 12 months, baby should be eating 3 meals + 2-3 snacks a day. Formula and milk can be considered a snack with or without solids depending on the age.

How much solid food should my child be eating around 6 months, 9 months and 1 year? 

This really depends on the size of the baby, but an easy guide would be to go by the size of a child’s fist as an appropriate portion size. At 4-6 months you could expect 2-4 oz per sitting, 1-2 times a day. Around 8 months they will have increased to 4-8 oz per sitting, 2-3 times a day. And by 1 year, we encourage 3-4 food groups per meal, which translates to about 8-10 oz per meal (which can be all table foods or a mix of some purees and some table foods).

Do you have any other tips for parents?

I always tell parents to start offering a cup with meals when solids are offered. Initially, just put a small amount of water in the cup because they will likely only play with it. Once they start taking the water, you can put some formula or breast milk in the cup.  This will help make the transition from bottle to cup easier. I would not heat any formula or breast milk that is put in a cup because you don’t want to have to heat whole milk once you transition away from formula or breast milk!