Introducing Foods: The Confused Parent’s Guide

If you’re confused about starting solid foods with your baby, you are not alone. Parents run into a lot of different answers—on the internet, from friends or family, and even at the pediatrician’s office. Trying to decide what to believe can be overwhelming. So I wanted to take some time to go through some of these issues and let you know what the most current evidence has to say.

When to Feed a Baby

The timing question is relatively straightforward—it’s usually around 6 months of age. At this point, the vast majority of typically-developing babies have reached the milestones necessary for safe and successful feeding. This timing also works well nutritionally because there’s no reason prior to this point that infants need anything besides breast milk (or formula, if that doesn’t work out). And for moms who are able to breastfeed, there are some significant health advantages to waiting until 6 months to introduce supplemental foods—a change from the previous recommendation to introduce foods between 4 and 6 months.

What to Feed a Baby

What you should feed your baby is a more contentious question. Ask a dozen pediatricians, and you’ll get a dozen different answers. (Ok, maybe more like 8 or 9…but we certainly wouldn’t be in complete agreement.) Whenever that’s the case, it’s usually either because the recommendations have changed over time or because we don’t have very good reasons for the advice we give. In this case, it’s a bit of both.

Traditionally, parents have started with rice cereal, and many doctors still recommend this as a first food. There’s some history to dissect here. A few decades ago, when a much higher percentage of babies were formula-fed (and not all formula was iron-fortified), there were a lot of babies with iron-deficiency anemia. That’s a big deal, because low iron levels have a huge developmental impact—we’re talking lost IQ points. To combat this, iron was added to rice cereal, which was already a popular baby food. That was helpful, but iron is available from a lot of other sources as well, including breast milk or iron-fortified formula, meats, legumes, and certain vegetables. It’s also really easy to check for anemia and to make dietary changes or add an iron supplement if needed.

Another reason for rice cereal’s popularity is its low potential for allergic reactions. The thinking used to be that postponing the introduction of potentially allergenic foods would keep children from developing food allergies. But there’s some really convincing evidence from recent studies (with peanuts in particular) that early introduction can teach the immune system to tolerate these foods and actually reduce the risk for allergy. There’s no longer any reason to think that parents need to wait until a child is older than 6 months to introduce peanut products or other potentially allergenic foods (like cow’s milk, eggs, tree nuts, wheat, soy, fish, or shellfish).

So while rice cereal isn’t necessarily wrong, it’s also not necessary. There are better nutritional choices, and especially with the recent concerns about arsenic content, I’d recommend starting with something else.

But what should you feed a baby? Well—aside from breast milk or infant formula—pretty much the same things you should feed yourself. Basically, you should be shooting for a good mixture of:

  • Vegetables and fruits of varied flavors and textures
  • Meats, fish, poultry, and eggs
  • A variety of whole grains (not exclusively rice)

Dairy products like yogurt may be introduced, but cow’s milk should not take the place of breast milk or formula until 12 months. Parents should avoid choking hazards and honey (due to a rare but real risk for infantile botulism). Beyond that, there’s not a lot of magic, and it really doesn’t make much of a difference which food you pick first.

How to Feed a Baby

No matter which foods you start with, you should feed it to your baby with a spoon—putting food in baby bottles is so 1980’s. It’s also associated with childhood obesity, and it doesn’t actually help babies sleep through the night (sorry). Unless your pediatrician specifically recommends adding cereal to a bottle for a medical reason, you should steer clear of “baby smoothies” and stick with the spoon. Remember, one of the goals of infant feeding is to teach your baby to eat–a skill that will remain quite important for the next 80 years or so.

A lot of doctors advise parents to start with vegetables—because what kid in his right mind would eat squash after tasting pears? There’s zero science there, and it probably doesn’t really matter. It is important to remember that just because a baby refuses a food once doesn’t mean he’ll never like it. Research has shown that it can take between 10 and 15 attempts over several weeks for some babies to accept a certain food. Trust me, it’s a lot harder with a 3-year-old, so stick with it. It’s a good idea to avoid feeding directly from the jar until you know they’ll eat it all—that way, you can refrigerate the rest of the jar for later.

It’s helpful to introduce single-ingredient foods one at a time, adding a new food after several days if your child doesn’t develop a rash or other concerning symptoms. Honestly, this plan doesn’t make reactions any less likely—it just makes it easier for you (and your pediatrician) to figure out what might be causing a potential problem. After this trial, you can mix and match however you please.

As your baby continues to grow and develop, you can begin to introduce soft foods like cut-up bananas, small pieces of well-cooked vegetables or meat, scrambled eggs, or pasta. And then, one day, you’ll realize that she’s eating pretty much the same foods that you are—which is a great reason to make sure you’re setting the right example by making good nutritional choices for yourself, as well. The early nutritional habits we instill in our children will last a lifetime, and there’s no better time to start than with the first foods they eat.

As always, your comments are welcomed (even if you happen to disagree). I'll get back to you as soon as I can. Please try to keep it civil--I reserve the right to delete comments that are offensive or off-topic.

4 thoughts on “Introducing Foods: The Confused Parent’s Guide

  1. Overall great info! I humbly disagree on the timing, though. Some babies are developmentally ready closer to 4 months, and denying them the exploration based on calendar time is counterproductive. Also there are increasing data gathering that introduction of complementary foods earlier and more broadly can improve tolerance. It’s harder to explain readiness than to set a time, but I believe we owe it to the babies to try. That is the beauty of primary care- getting a chance to know families and tailoring the general advice to their needs!

  2. What do you recommend when baby dislikes ALL solids? (On attempt 15-20 with bananas, avocado and more recently with sweet potato and zucchini.) We gave our son egg yolk at around 4.5 months which he loved and ate well for a week. On day 8, he began throwing up after eating egg…and the vomiting lasted for hours. Needless to say, we removed egg (and all other solids) from his diet and opted to wait until he was 6 months. The time has arrived! It is strange, he seems to actually really enjoy the first several bites of a new food…then, once it settles in, he refuses it (about bite 5 or 6), and will NOT eat it again. The only food we have found be absolutely loves is homemade bone broth. At first we figured temperature and texture might be the issue since he hoards the broth, but no matter how thin or warm the foods are, after several bites he just won’t continue eating in that sitting, or any after. Our pediatrician offers no help and we are truly stumped. Thoughts???

    • Carissa–sorry it took a while to get back to you. I can’t offer specific advice, but a couple ideas that may be helpful…some kids have issues with texture and can benefit from feeding therapy offered by a speech therapist or occupational therapist. Occasionally food allergies can look like this–a child will like the food until it makes him feel funny, then stops. (Admittedly, it’s unlikely for that to be with every food.) Or he may just not be developmentally ready (not sure how old he is now). I would try to get some more traction with your doctor–wish you the best! -Chad

  3. I’m a little surprised you didn’t mention baby led weaning which seems pretty popular in UK. What do you think of it?

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