When to begin feeding baby solids


When, What, and How to Introduce Solid Foods | Nutrition

For more information about how to know if your baby is ready to starting eating foods, what first foods to offer, and what to expect, watch these videos from 1,000 Days.

The Dietary Guidelines for Americans and the American Academy of Pediatrics recommend children be introduced to foods other than breast milk or infant formula when they are about 6 months old.  Introducing foods before 4 months old is not recommended. Every child is different. How do you know if your child is ready for foods other than breast milk or infant formula? You can look for these signs that your child is developmentally ready.

Your child:

  • Sits up alone or with support.
  • Is able to control head and neck.
  • Opens the mouth when food is offered.
  • Swallows food rather than pushes it back out onto the chin.
  • Brings objects to the mouth.
  • Tries to grasp small objects, such as toys or food.
  • Transfers food from the front to the back of the tongue to swallow.

What Foods Should I Introduce to My Child First?

The American Academy of Pediatrics says that for most children, you do not need to give foods in a certain order. Your child can begin eating solid foods at about 6 months old. By the time he or she is 7 or 8 months old, your child can eat a variety of foods from different food groups. These foods include infant cereals, meat or other proteins, fruits, vegetables, grains, yogurts and cheeses, and more.

If your child is eating infant cereals, it is important to offer a variety of fortifiedalert icon infant cereals such as oat, barley, and multi-grain instead of only rice cereal. Only providing infant rice cereal is not recommended by the Food and Drug Administration because there is a risk for children to be exposed to arsenic. Visit the U.S. Food & Drug Administrationexternal icon to learn more.

How Should I Introduce My Child to Foods?

Your child needs certain vitamins and minerals to grow healthy and strong.

Now that your child is starting to eat food, be sure to choose foods that give your child all the vitamins and minerals they need.

Click here to learn more about some of these vitamins & minerals.

Let your child try one single-ingredient food at a time at first. This helps you see if your child has any problems with that food, such as food allergies. Wait 3 to 5 days between each new food. Before you know it, your child will be on his or her way to eating and enjoying lots of new foods.

Introduce potentially allergenic foods when other foods are introduced.

Potentially allergenic foods include cow’s milk products, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and sesame. Drinking cow’s milk or fortified soy beverages is not recommended until your child is older than 12 months, but other cow’s milk products, such as yogurt, can be introduced before 12 months. If your child has severe eczema and/or egg allergy, talk with your child’s doctor or nurse about when and how to safely introduce foods with peanuts.

How Should I Prepare Food for My Child to Eat?

At first, it’s easier for your child to eat foods that are mashed, pureed, or strained and very smooth in texture. It can take time for your child to adjust to new food textures. Your child might cough, gag, or spit up. As your baby’s oral skills develop, thicker and lumpier foods can be introduced.

Some foods are potential choking hazards, so it is important to feed your child foods that are the right texture for his or her development. To help prevent choking, prepare foods that can be easily dissolved with saliva and do not require chewing. Feed small portions and encourage your baby to eat slowly. Always watch your child while he or she is eating.

Here are some tips for preparing foods:

  • Mix cereals and mashed cooked grains with breast milk, formula, or water to make it smooth and easy for your baby to swallow.
  • Mash or puree vegetables, fruits and other foods until they are smooth.
  • Hard fruits and vegetables, like apples and carrots, usually need to be cooked so they can be easily mashed or pureed.
  • Cook food until it is soft enough to easily mash with a fork.
  • Remove all fat, skin, and bones from poultry, meat, and fish, before cooking.
  • Remove seeds and hard pits from fruit, and then cut the fruit into small pieces.
  • Cut soft food into small pieces or thin slices.
  • Cut cylindrical foods like hot dogs, sausage and string cheese into short thin strips instead of round pieces that could get stuck in the airway.
  • Cut small spherical foods like grapes, cherries, berries and tomatoes into small pieces.
  • Cook and finely grind or mash whole-grain kernels of wheat, barley, rice, and other grains.

Learn more about potential choking hazards and how to prevent your child from choking.

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When Can My Baby Start Eating Solid Foods? (for Parents)

A friend just started giving her 3-month-old applesauce and rice cereal. My son is just 2 weeks younger than hers, and I am wondering if I should be introducing solids soon too. When should I start?
Taylor

Doctors recommend waiting until a baby is about 6 months old to start solid foods. Starting before 4 months is not recommended.

At about 6 months, babies need the added nutrition — such as iron and zinc — that solid foods provide. It’s also the right time to introduce your infant to new tastes and textures. 

Some babies may be ready for solids sooner than 6 months, but don't start until your baby is at least 4 months old.

How do you know it’s the right time to start solid foods? Here are some signs that babies are ready:

  • They have good head and neck control and sit up in a high chair.
  • They're interested in foods. For example, they may watch others eat, reach for food, and open their mouths when food approaches.
  • They don’t push food out of their mouths, which is a natural tongue reflex that disappears when they’re between 4–6 months old.
  • They weigh twice their birth weight, or close to it.

Talk to your doctor about the right time to start solid foods.

How Should I Start Solids?

When the time is right, you can start with a single-grain, iron-fortified baby cereal. Start with 1 or 2 tablespoons of cereal mixed with breast milk, formula, or water. Feed your baby with a small baby spoon. Don’t add cereal or other food to a baby's bottle because it can lead to too much weight gain. Let your baby practice eating from a spoon and learn to stop when full.

When your baby gets the hang of eating the first food, introduce others, such as puréed meat, fruits, vegetables, beans, lentils, or yogurt. Try one food at a time and wait a few days before trying something else new to make sure your baby doesn't have an allergic reaction.

Foods that are more likely to cause allergies can be among the foods you introduce to your baby. These include peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy. Waiting to start these foods does not prevent food allergies. Talk to your doctor if you are concerned about food allergies, especially if any close family members have allergies, food allergies, or allergy-related conditions, like eczema or asthma.

Infants with severe eczema or egg allergies are more likely to have allergies to peanuts. Talk to your doctor about how and when to introduce these foods to your child.

When starting your baby on solids, avoid:

  • foods with added sugars and no-calorie sweeteners
  • high-sodium foods
  • honey, until after the first birthday. It can cause botulism in babies.
  • unpasteurized juice, milk, yogurt, or cheese 
  • regular cow's milk or soy drinks before 12 months instead of breast milk or formula. It’s OK to offer pasteurized yogurt and cheese.
  • foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts

Also, do not give fruit juices to infants younger than 12 months old.

Over the next few months, introduce a variety of foods from all the food groups. If your baby doesn't seem to like something, don’t give up. It can take 8 to 10 tries or more before babies learn to like new foods.

Reviewed by: Mary L. Gavin, MD

Date reviewed: February 2021

what products are possible, features of complementary foods

It is no secret that young and not very experienced mothers receive information on the nutrition of an infant, including recommendations on how to introduce the first complementary foods, mainly from two sources: grandmother's stories and from the Internet. Unfortunately, both of these respected sources of information may voluntarily or not voluntarily, but be very mistaken, since grandmothers grew up in a more prosperous time in terms of environmental conditions, and the Internet is littered with various articles that are rarely written by professionals, moreover, they rely either on explicit outdated guides on baby food, or frankly on unverified information. nine0003

In this article, I will try to combine the latest scientific data and recommendations on how to introduce the first complementary foods with many years of observations from the experience of a practical pediatrician and an allergist-immunologist.

At what age is it time to introduce the first complementary foods

According to the recommendations of the Research Institute of Nutrition of the Russian Academy of Medical Sciences, the first complementary foods can be introduced from 4.5 - 5 months, regardless of the type of feeding. This is "average". In practice, the choice of when to start introducing complementary foods still depends on the individual characteristics of the child. For example, for a child with widespread atopic dermatitis (diathesis), we will not introduce complementary foods until at least acute skin symptoms, such as cracks, weeping or secondary eczema, have steadily disappeared. Increased dryness and flaking of the skin, of course, require constant application of moisturizers to the skin, but in no case are they a contraindication to the start of the introduction of the first complementary foods. nine0003

Another important point when choosing the time to start introducing complementary foods is the dynamics of the child's weight gain. The more intensively the child gains in height and weight, the sooner he may need additional calories, since the energy value of breast milk or artificial formula alone will most likely not be enough for a child who grows faster than his peers by 4 - 5 months. We must not forget that natural products contain a fairly large range of minerals and vitamins, and a mother’s body, alas, cannot be an eternal and bottomless source of useful nutrients, somewhere something will gradually begin to be missed. nine0003

In addition, the nature of lactation in the mother has a great influence on the timing of the introduction of complementary foods. If a nursing mother begins to feel a lack of milk, I would prefer to first give her advice on stimulating lactation, and at the same time begin to introduce complementary foods. It will be better than introducing an artificial mixture. But I repeat that the earliest start date for the introduction of the first complementary foods is the age of 4 months, before the child's body is not yet ready, the risk of developing allergies is also high.

So, we agree with you that the first complementary foods can be introduced no earlier than 4 months of a child's life.

First complementary foods: Which foods to choose?

The first complementary foods, as a rule, should consist of vegetable or fruit purees, but in no case juices. Still, juices, even for children, are highly filtered, mainly contain a large amount of organic acids and “light” carbohydrates (that is, sugar, to make it clear to everyone). I will not waste time explaining why juices are harmful to an infant, but I will describe a clinical case from practice. nine0003

Parents with an 8-month-old girl came to the reception. Somewhere from 5 months she practically did not gain weight, although before that all indicators were normal. In the analyzes, apart from visible signs of iron deficiency, slightly reduced hemoglobin, no pathology was also detected. The main complaint: "does not eat anything." And when I began to find out what she still eats, it turned out that the child drinks half a liter of juice every day. But porridge or cottage cheese, or mashed potatoes cannot be forced together, they spit everything out. I don't like the taste. And so - for three months. The child, of course, became very nervous, yelling at night, demanding juice. nine0003

So draw your own conclusions and be careful.

For the first feeding, this is now recognized by everyone, the best dishes are vegetable purees from green varieties of vegetables: zucchini, cauliflower, broccoli. The first complementary foods are introduced, starting with half a teaspoon, in the morning for three days, then gradually increase the amount of the product to 40-50 grams per week. Supplemented with breast milk or formula.

For problems with stools, constipation, it’s good to start introducing prune puree, green apple, you can try pumpkin, even apricot puree, but in no case start with carrots. Beta-carotenoids, which are abundant in carrots, are generally poorly absorbed and can cause allergies in a child. nine0003

Second food. Porridge or meat?

Even 5 - 6 years ago, we taught students at the medical institute that from 5 - 5.5 months old, an infant should begin to give cereal porridge for complementary foods. This is rice, buckwheat, corn. The first week you can cook 5% porridge: 5 grams of ground cereal per 100 ml of water. Then the porridges are cooked already denser: 10 grams of cereal per 100 ml of water. But now, basically everyone uses instant (soluble) cereals, which are diluted with water according to the instructions on the package. In addition, ready-to-eat liquid cereals are on sale: for example, Bellakt, Frutonyanya, etc. nine0003

Why meat? You ask. According to modern recommendations (they really began to change quite often), but in this case I support: if a child has a pronounced decrease in hemoglobin in the blood below 100 g / l by the age of 5 months, it makes sense to start introducing fruit or vegetable purees as a second types of complementary foods - meat purees as a source of the most well-absorbed heme iron. You need to choose from varieties such as turkey, rabbit, lamb. Beef and veal can only be offered to children who did not have red cheeks and diathesis. nine0003

In the absence of problems with low hemoglobin, feel free to introduce porridge as the second meal of complementary foods, especially if the child is small and does not gain weight very well. In this case, we can recommend breeding cereals with the addition of breast milk or a mixture (Nan, Nutrilon, Celia, Nanny). With mixtures based on goat's milk, parents of children with a predisposition to allergies should be very careful. Goat milk formulas are not the best choice for babies who are allergic or intolerant to cow's milk protein, whatever the internet says. Believe me, there are serious scientific articles by foreign authors, which provided data on a very high frequency of cross-allergy between cow and goat milk proteins in children who were transferred to goat milk mixtures. And I saw it myself in my practice, when a child with dermatitis was transferred to a mixture of goat's milk, there was a clear improvement for a month or two, and then all over again and with a doubled degree of allergic skin damage. nine0003

Introduction to fermented milk products

This is the most difficult question. I am sure that most of our grandparents demand that their stupid parents start drinking milk and kefir as soon as possible. In a number of cases, children really start to absorb sour-milk products quite well after 6 months, but before this age I am very careful even with sour-milk Agusha, and even introducing milk or kefir before 6 months is a bad form, believe me, and can lead to very bad consequences for the child. I understand the Western European medical community, which has recently banned its pediatricians from recommending fermented milk products for complementary foods for children under 3 years of age, just imagine! nine0003

They (the Europeans) need to do something with their artificial milk mixtures. Even 20 years ago, we did not know other mixtures after the "two", that is, the second formula for children from 6 to 12 months. Then there were formulas for children from 1 to 2 years old, then from 2 to 3 years old, and now there are already mixtures for children up to 4 years old, and I think if this goes on, then until the age of sixteen there will be their own milk substitutes. Dismiss me, I don't think this approach is correct. But the fact is that our grandparents had much better genetics than the generation of our children, alas. In the context of the growth of medical capabilities, genetically determined diseases are also growing, and in this case, intolerance to cow's milk protein, and with every 10 years there are more and more such people among us. But if a child really suffers from an allergy to cow's milk protein or is severely deficient in enzymes, then he will carry this peculiarity through his whole life, and most likely he will not drink milk or kefir himself, and there is no need to force him if he himself won't want to! nine0003

But you are lucky with genetics, and no one in the family has ever had an allergy (which is hard to imagine nowadays), and most importantly, if your child has always had perfectly clean skin, then the first of the dairy products - cottage cheese, you will begin to offer your child with 7 months, kefir - from 10 months. Milk - after a year. It will be better this way.

But if your family does not have a very close and joyful relationship with milk, then it is better to postpone even the introduction of kefir and yogurt into complementary foods for a child until the age of 18 months. nine0003

Fish day and first meal

Fish is a very healthy product, rich in vitamins and antioxidants, but it must also be introduced carefully. I advise you to start introducing the first fish food at about 7-8 months. It is better to start with species such as cod, hake, haddock. The rules are the same: the first three days on the "gram," then slowly add. If there are no problems in a week or two, you can try such delicacies as tuna or salmon, of course, canned children, if you can find it. It is better not to mess with trout and salmon in the first year of life, this fish is all stuffed with dyes and antibiotics. nine0003

No matter how hard I tried, the article about the first complementary foods turned out to be long. Thank you for reading to the end, I hope it will be useful. If you have questions about the introduction of complementary foods, you can write your appeals on our website in the question to a specialist section. A short answer can be obtained via the Internet, but in order to make a diagnosis and give a detailed consultation, of course, you need to come to a face-to-face appointment with a pediatrician and a pediatric allergist.

Diet for a child aged 4-6 months

Your baby is already 4 months old. He has noticeably grown up, become more active, is interested in objects that fall into his field of vision, carefully examines and reaches for them. The emotional reactions of the child have become much richer: he joyfully smiles at all the people whom he often sees more and more often, makes various sounds.

You are still breastfeeding your baby or have had to switch to mixed or formula feeding. The child is actively growing, and only with breast milk or infant formula, he can no longer always get all the necessary nutrients. And that means it's time to think about complementary foods. nine0003

The optimal time to start its introduction is between 4 and 6 months, regardless of whether the baby is receiving breast milk or formula. This is the time when children respond best to new foods. Up to 4 months, the child is not yet ready to perceive and digest any other food. And with the late introduction of complementary foods - after 6 months, children already have significant deficiencies of individual nutrients and, first of all, micronutrients (minerals, vitamins, long-chain polyunsaturated fatty acids, etc.). In addition, toddlers at this age often refuse new foods, they have delayed development of chewing skills for thick foods, and inadequate eating habits are formed. It is important to know that, no matter how strange it may seem at first glance, with a delayed appointment of complementary foods, allergic reactions more often occur on them. nine0003

When is it advisable to introduce complementary foods as early as 4 months, and when can you wait until 5. 5 or even 6 months? To resolve this issue, be sure to consult a pediatrician.

As a rule, at an earlier age (4 - 4.5 months), complementary foods are introduced to children at risk of developing iron deficiency anemia, as well as children with insufficient weight gain and with functional digestive disorders.

The optimal time to start complementary foods for a healthy baby is between 5 and 5.5 months of age. nine0003

The World Health Organization recommends that breastfed babies should be introduced to complementary foods from 6 months of age. From the point of view of domestic pediatricians, which is based on extensive practical experience and scientific research, this is possible only in cases where the child was born on time, without malnutrition (since in these cases the mineral reserves are very small), he is healthy, grows well and develops. In addition, the mother should also be healthy, eat well and use either specialized enriched foods for pregnant and lactating women, or vitamin and mineral complexes in courses. Such restrictions are associated with the depletion of iron stores even in a completely healthy child by 5-5.5 months of age and a significant increase in the risk of anemia in the absence of complementary foods rich or fortified with iron. There are other deficits as well. nine0003

The first complementary food can be vegetable puree or porridge, fruit puree is better to give the baby later - after tasty sweet fruits, children usually eat vegetable puree and cereals worse, often refuse them altogether.

Where is the best place to start? In cases where the child has a tendency to constipation or he puts on weight too quickly, preference should be given to vegetables. With a high probability of developing anemia, unstable stools and small weight gains - from baby cereals enriched with micronutrients. And if you started introducing complementary foods with cereals, then the second product will be vegetables and vice versa. nine0003

If the first complementary food is introduced at 6 months, it must be baby porridge enriched with iron and other minerals and vitamins, the intake of which with breast milk is no longer enough.

Another important complementary food product is mashed meat. It contains iron, which is easily absorbed. And adding meat to vegetables improves the absorption of iron from them. It is advisable to introduce meat puree to a child at the age of 6 months. Only the daily use of children's enriched porridge and meat puree can satisfy the needs of babies in iron, zinc and other micronutrients. nine0003

But it is better to introduce juices later, when the child already receives the main complementary foods - vegetables, cereals, meat and fruits. After all, complementary foods are needed so that the baby receives all the substances necessary for growth and development, and there are very few in their juices, including vitamins and minerals.

Juices should not be given between feedings, but after the child has eaten porridge or vegetables with meat puree, as well as for an afternoon snack. The habit of drinking juice between meals leads to frequent snacking in the future, a love of sweets is instilled, children have more tooth decay and an increased risk of obesity. nine0003

With the start of the introduction of complementary foods, the child is gradually transferred to a 5-time feeding regimen.

Rules for the introduction of complementary foods:

  • preference should be given to baby products of industrial production, they are made from environmentally friendly raw materials, have a guaranteed composition and degree of grinding
  • Complementary foods should be offered to the baby by spoon at the start of feeding, before breastfeeding (formula feeding)
  • the volume of the product increases gradually, starting with ½ - 1 spoon, and in 7 - 10 days we bring it to the age norm, subsequent products within the same group (cereals from other cereals or new vegetables)
  • can be entered faster, in 5 - 7 days
  • start introduction with monocomponent products
  • it is undesirable to give a new product in the afternoon, it is important to follow how the child reacts to it
  • do not introduce new products in the event of acute illnesses, and before and immediately after prophylactic vaccination (should be abstained for several days)

When introducing a new type of complementary food, first try one product, gradually increasing its amount, and then gradually "dilute" this product with a new one. For example, vegetable complementary foods can be started with a teaspoon of zucchini puree. During the week, give the baby only this product, gradually increasing its volume. After a week, add a teaspoon of mashed broccoli or cauliflower to the zucchini puree and continue to increase the total volume every day. Vegetable puree from three types of vegetables will be optimal. The portion should correspond to the age norm. Over time, you can replace the introduced vegetables with others faster. nine0003

After the introduction of one vegetable (bringing its volume to the required amount), you can proceed to the intake of porridge, and diversify the vegetable diet later.

If the child did not like the dish, for example, broccoli, do not give up and continue to offer this vegetable in a small amount - 1-2 spoons daily, you can not even once, but 2-3 times before meals, and after 7 - 10, and sometimes 15 days, the baby will get used to the new taste. This diversifies the diet, will help to form the right taste habits in the baby. nine0003

Spoon-feeding should be done with patience and care. Forced feeding is unacceptable!

In the diet of healthy children, porridge is usually introduced after vegetables (with the exception of healthy breastfed children, when complementary foods are introduced from 6 months). It is better to start with dairy-free gluten-free cereals - buckwheat, corn, rice. At the same time, it is important to use porridge for baby food of industrial production, which contains a complex of vitamins and minerals. In addition, it is already ready for use, you just need to dilute it with breast milk or the mixture that the baby receives. nine0003

Children suffering from food allergies are introduced complementary foods at 5-5.5 months. The rules for the introduction of products are the same as for healthy children, in all cases it is introduced slowly and begins with hypoallergenic products. Be sure to take into account individual tolerance. The difference is only in the correction of the diet, taking into account the identified allergens. From meat products, preference should first be given to mashed turkey and rabbit.

Diets for different age periods

Explain how you can make a diet, it is better to use a few examples that will help you navigate in compiling a menu specifically for your child.

From 5 months, the volume of one feeding is on average 200 ml.

Option 1.

If your baby started receiving complementary foods from 4-5 months, then at 6 months his diet should look like this:

Breast milk or VHI* 200 ml
II feeding
10 hours
Dairy-free porridge**
Supplementation with breast milk or VHI*
150 g
50 ml
III feeding
14 hours
Vegetable puree
Meat puree Vegetable oil
Supplemental breast milk or VHI*
150 g
5 - 30 g
1 tsp
30 ml
IV feeding
18 hours
Fruit puree
Breast milk or VHI*
60 g
140 ml
V feeding
22 hours
Breast milk or VHI* 200 ml

* - infant formula
** - diluted with breast milk or VHI

Option 2.

I feeding
6 hours Breast milk or VHI* 200 ml II feeding
10 hours Dairy-free porridge**
Fruit puree 150 g
20 g III feeding
14 hours Vegetable puree
Meat puree Vegetable oil
Fruit juice 150 g
5 - 30 g
1 tsp
60 ml IV feeding
18 hours Fruit puree
Breast milk or VHI* 40 g
140 ml V feeding
22 hours Breast milk or VHI* 200 ml

* - infant formula
** - diluted with breast milk or VHI

Option 3.

:

I feeding
6 hours
Breast milk
II feeding
10 hours
Dairy-free porridge**
Breast milk supplement
100 g
III feeding
14 hours
Vegetable puree
Meat puree Vegetable oil
Breast milk supplement
100 g
5 - 30 g
1 tsp
IV feeding
18 hours
Breast milk
V feeding
22 hours
Breast milk

** - diluted with breast milk

Up to 7 months, increase the volume of porridge and vegetable puree to 150 g and introduce fruit puree.


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