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THE FAMILY GROOVE: When is a good time to first introduce solids?
DR. REVA SNOW: Most doctors recommend first introducing solids to babies anywhere between 4 to 6 months old, with current thinking being closer to 6 months for breast-fed babies so as to maximize the time of exclusive breast-feeding. There are at least three reasons for starting solids in this age range. Developmentally, babies this age are, in general, ready for solid food; they have good head and neck control and their tongue-thrust reflex (which will push out something, like a spoon, that is put into the mouth) is mostly gone. Infants’ energy needs tend to increase around this time, and while those energy needs could certainly be met by breast milk or formula, their desire to have more calories makes this a good window for adding in solid food. There also may be an immunologic reason for starting solids in this window. There seems to be an association between starting cereals earlier than 3 months and the development of celiac disease, an autoimmune intestinal disorder. Babies who start cereals earlier than 3 months or later than 7 months may have an increased risk of developing type 1 diabetes.
TFG: Which foods do you recommend introducing first and why?
RS: Most babies are started on infant cereal first, with rice cereal being the most common, probably because it is the least potentially allergenic. However, oat or barley cereals are also fine, and I will often recommend them as first cereals for babies who have previously tended to be infrequent poopers, as rice cereal can be constipating. Parents should look for iron-fortified versions of these cereals, particularly for breast-fed infants, because the iron availability in mom’s milk decreases around 4 to 6 months, while the baby’s need for iron increases along with her energy needs. But while breast-fed infants definitely need an iron source at this age and onward, cereals do not have to be the first food introduced. Pureed or strained fruits, vegetables and meats are all options for first foods. Texture is the most important variable. Foods should be well-pureed/mashed or finely strained.
When choosing a first food to introduce, steer clear of cow’s milk and related dairy-based foods like cheese and yogurt; fish/shellfish; eggs; honey (which should never be given to infants under 1 year of age because of risk of botulism); and home-cooked beets, turnips, carrots, collard greens and spinach. These last foods can contain high amounts of nitrates, which can cause anemia if ingested by young infants. Companies that make baby food screen for nitrates and avoid buying produce from areas where high levels of nitrates have been detected, so canned baby food containing these foods are safe. Citrus fruits can be irritating to the baby’s skin around the mouth or in the diaper area, so some doctors will recommend avoiding these as first foods.
New foods should be introduced individually, rather than in blended products, so that allergies or intolerances can be identified. It is generally considered a good idea to space out introducing new foods, with one added every few days or so, for the same reason. Allergic symptoms might include diarrhea, vomiting or rash (particularly hives or eczema). If you notice one of these symptoms after feeding a particular food to your baby, discontinue feeding it to your child and notify your doctor. Once individual foods have been tried without problems, mixtures of those foods can be given.
TFG: If baby rejects the food, what do you recommend doing?
RS: If baby cries or turns away from feeding the first few times you try solids, go back to bottle or breast-feeding, and then try again in a week or two. He might not be developmentally ready just then. If she has been taking solids for some time and then rejects a newly introduced food, but doesn’t have an allergic-type reaction to it, try a different food for the time being and reintroduce the rejected food at a later time. Introducing a variety of tastes in infancy is thought to lead to acceptance of wider varieties of food later on, so don’t be afraid to offer an assortment of foods throughout this introductory period.
TFG: After introducing food, how often should it be given to baby?
RS: Start off giving the baby solid food once a day. As he gets used to it and enjoys it more, increase to two to three “meals” per day over two to three days. Babies’ preferences for food and their ability to warm up to its acceptance vary. A meal for a 4- to 8-month-old baby might consist of as little as a spoonful and as much as a 4-ounce jar of baby food. Let your baby lead by offering her more if she still seems interested, and backing off if she’s clearly done, signs of which include persistently thrusting food out of her mouth, turning away from the spoon and crying.
As with so much in basic baby care, there is no right answer for whether or not to give solids with a bottle or a breast-feeding. Some babies will consistently refuse solids if bottle or breast are readily available instead. Others will be more accepting of solids if they are given a little milk (breast milk or formula) first so that they are not so hungry and so that they associate solids with something they already know and like.
TFG: Any other tips, thoughts, etc?
RS: Something I wondered when I was about to start solids with my son was how exactly to make the cereal and feed it to him. So, in case anyone else out there is wondering, here goes: Take a spoonful of dry cereal and mix it with enough breast milk, formula or water to make it about the consistency of thin Cream of Wheat. Adjust the thickness to suit your baby’s taste. Always feed baby off of a small spoon while sitting either in your lap or in an infant seat (bouncy seat)—most 4- to 6-month-old babies don’t have the trunk and head control to sit comfortably in a high chair. And be prepared for a lot of mess and some good photo ops.
—Chelsea Kaplan
Chelsea Kaplan is the Deputy Editor and Beauty Director of THE FAMILY GROOVE, and also hosts fashion, beauty and parenting segments for Sirius and XM Satellite Radio. Despite having two sons (born 10/05 and 3/08), she still can’t believe she’s somebody’s mother. Check out her blog, The Momtourage, here.
