Introducing Solids - The Basics
Introducing solids to baby can be such a fun time, but caregivers are often also wary. The topics of concern from caregivers that I hear about include choking, allergenic foods, and what to start with. Below is a brief starting point, based on the most up-to-date evidence from Health Canada, Dietitians of Canada, The Canadian Paedeatric Society, and the Canadian Society of Clinical Immunology. For more detailed support and information specific to your baby and your family, consult with one of our dietitians for one-on-one support.
When is truly the best time to introduce solids to baby?
Around 6 months an infant shows true, physiological signs of readiness. At this time she is sitting up on her own, reaching out to grab things, and bringing items to her mouth. The best sign is when baby starts to bring food to her mouth all by herself. Around 6 months the immune system, digestive system, and oral muscles are developed enough to tolerate solids (infants lose their tongue thrust reflex and have a developed gag reflex), and absorb nutrients. By 6 months of age, the infant's iron stores are depleted and iron sources must come from food.
What are the best first foods for baby?
Start with nutrient-rich family foods, particularly from the Meat and Alternative group. These foods are rich in iron, zinc and protein to support healthy growth and development. Meat and Alternatives include cooked beef, de-boned chicken and fish, legumes (e.g. chick peas, kidney beans, and lentils), tofu, and whole cooked eggs. Iron-fortified infant cereals are also an acceptable first food, but not necessary. They don't provide the array of nutrients that whole meat and alternatives do. If starting out with infant cereal, be sure to introduce other meat and alternatives as well.
Along with meat alternatives, introduce a variety of vegetables and fruit (in no particular order!) such as carrots, sweet potato, squash, green peas, avocado, mango, bananas, peaches, etc. These are rich sources of vitamin C, which helps the body to better absorb iron. They are also good sources of beta carotene and fibre important for your growing baby.
But aren't fish, eggs and other allergenic foods supposed to be delayed until 12 months old?
We once thought that introducing potentially allergenic foods (such as egg whites, fish, wheat, peanuts, or soybeans) before 12 months would increase the infant's risk of developing an allergy. Research is now showing that there is no evidence to support that delaying these foods will prevent your child from having an allergy. Rather, early introduction (around 6 months of age), may have a protective effect. If your child is at higher risk for developing a food allergy (ie. one first-degree relative such as a parent or sibling with an allergic condition), continue to introduce those allergenic foods, watching for reaction. Talk to a dietitian for more support.
Progressing type of food and texture
Introduce one new food every 2-3 days to watch for signs and symptoms of food allergy, such as, hives, rashes, lip swelling, wheezing, vomiting, diarrhea, or blood in the stool. Keep in mind that food reactions are rare.
Foods can be pureed or cooked until very soft but still formed (e.g. a whole carrot stick that is steamed long enough you can press your thumb and finger through it easily). It is now acceptable to skip pureed foods altogether offering lumpy, lightly mashed foods. A fork works great! No expensive blenders necessary. Be sure to introduce lumpy, more solid textures no later than 8-9 months. Texture is important for developing oral-pharyngeal muscles and increasing the infant's palate for a variety of foods.
Gagging is normal, and infants are less likley to choke if they feed themselves at their own pace. Allow the infant to self feed as much as possible. You may help them, but be sure to respect their hunger and fullness cues. Refer to www.ellynsatterinstitute.org for more information on feeding dynamics and caregiver versus infant roles - defined as Division of Responsibility.
Start with a few teaspoons, twice a day. Baby may have more than this, or less than this but he will let you know how much he wants. In the beginning, feed from their milk supply first (breast or formula), then sit them in the high chair for some solids. Baby's primary source of nutrition at 6 months is still breast milk or formula.
What about other beverages?
At 6 months, infants can be introduced to water from an open cup (moving away from sippy cups and bottles). Delay the introduction of fruit juice. Fruit juice lacks fibre, infants can learn to prefer the sweet taste of juice, and juice can put the infant at risk for tooth decay. If juice is being introduced, only offer 100% pure unsweetened fruit juice, limiting to 4 ounces per day (1/2 cup).
Although plain yogurt and natural cheese can be introduced before 9 months of age, it is advised to delay 3% cows or goats milk until 9 to 12 months of age (preferably closer to 12 months). Milk is low in iron and may distplace the intake of iron-rich foods such as meat and alternatives. Introducing milk before 9 months of age may also put baby at risk for gastrointestinal bleeding and blood loss in stool.
Plant based milk beverages such as almond, rice, soy, etc. should be delayed until close to 24 months due to the inadequate fat content and overall nutritional inconsistencies from product to product. Speak to a dietitian if you're considering feeding your child plant based beverages.
Have fun, and take the pressure off you and your baby! Take it one day at a time, because each day may be different. And finally, talk with family and friends but don't compare or compete - every baby is different!
Brooke Bulloch, RD