Introducing Solid Food & Feeding Guidelines

Why Starting Solid Food Matters

We as humans have always used food for more than just sustenance. We use food and meals to celebrate, provide comfort and enrich personal bonds. Food is an integral part of any society and culture.  A child develops a fundamental relationship with food early in life. For better or for worse, we all have a relationship with food, so let’s start off this critically important part of life on the right foot!

There is a lot to cover here. I want to state, first and foremost, that the feeding process should not be causing mom or the family any additional stress. So, if you find yourself overly stressed by trying to prepare only home cooked meals or you’re riddled with guilt about giving your baby only store-bought food, let that stuff go! Parenting is hard enough, and my goal with these guidelines is to simply provide you with science-based information on the subject.

How to Know When to Start Solids

The World Health Organization (WHO) as well as the American Academy of Pediatrics (AAP) both agree that babies should be exclusively fed breastmilk or formula for the first 6 months of life. This means they need no additional foods or fluids unless medically required until 6 months old. 

However, you will still find some traditional medical practices that continue to advise adding solids early to help a child sleep or to help with reflux. Some even go as far as to recommend adding cereal to the bottle directly, which has become a major health and safety risk. I would never recommend adding anything to a bottle of milk nor would I recommend starting solids before 6 months of age unless recommended by a pediatric specialist.

The WHO guidelines are quite extensive regarding when and how a baby should be introduced to solid food. This means that feeding your baby solids is about more than just when or what to feed him/her (which I touched upon above). Although I will cover the basics about feeding in this document, you may want additional information about how, when, and why feeding your baby is so important. I highly recommend that you check out Dr. Amy Brown’s “Why Starting Solids Matters.” It’s a super quick read that is thorough and full of scientifically based guidance when it comes to feeding your baby.

Now, let’s talk about physical readiness cues that your baby will show when ready to start solids:

  • Being able to stay seated upright unassisted. 
  • When the tongue-thrust reflex has stopped (this reflex is when a baby pushes anything other than a nipple out of his/her mouth). 
    • If you are trying to feed your baby and he/she keeps pushing the food out of his/her mouth, he/she is not ready for solids!
  • Being able to grab food and bring it to his/her mouth.  
  • Jaw and mouth can chew and not just suck/swallow.

Waiting until you see these physical developmental markers is the best way to know if your baby’s gastrointestinal tract is ready for solid food digestion. 

My baby is ready.  Now what?

What foods should I start my baby with? This is a hotly debated topic amongst mom groups everywhere. Another popular question is: should I start with finger foods or purees?

Ultimately, while everyone has an opinion on the subject, there are no rules as to “the best first food” for babies. There are plenty of websites that cover the best first foods to start with but the most important part of introducing your baby to solids is to have diversity. Cycling through a wide variety of foods is the best way to introduce your baby to many different flavors and textures while ensuring they are getting a range of nutrients.  Consuming a limited, repetitive set of foods has been shown to have negative effects on the GI tract and overall health (this is also true for adults). So, make sure you are providing a wide diversity of foods.

Too many choices…Purees or finger foods? Store-bought or homemade? 

Purees vs. Finger Foods

While there is a lack of formal studies on the topic of purees versus finger foods, based on what is available, there doesn’t appear to be any significant advantage or disadvantage to starting with purees or finger foods. However, there is an argument to be made that what your child experiences early in life will give him/her a preference for things later in life: we all tend to prefer familiar things since new things can be “scary”. Thus, introducing your baby to a wide range of textures and flavors prepares your child’s palate for a healthy variety of foods whether in the puree/mashed or finger food form.

I recommend offering both from the start since grabbing and self-feeding are such important skills. However, if purees are your preference then consider introducing finger foods closer to 8 months when your child is developmentally prepared for self-feeding at this point (I will discuss self-feeding in a subsequent section).

Homemade vs. Store-Bought 

There are two major points to cover here. First, homemade purees will be less smooth than store-bought options which could be an argument for why homemade food would provide a better range of textures for your baby. This wider range of consistencies, as we discussed above, could help your baby become familiar and comfortable eating various textures.

Secondly, store-bought food has been shown to be half as nutritionally dense as homemade food. Research from Glasgow University determined that commercially made food had 50% less protein than the homemade equivalent and 10 times the amount of sugar. In addition, commercially processed food on average has also been shown to have significantly more sodium and sugar. This will appeal to a baby’s palate, which means the baby will eat more and the parents subsequently will buy more.

Side note – commercially marketed food is sold in portion sizes usually too large for the age of the child, which would encourage overeating (which we will discuss in more detail below).

Responsive Feeding

Responsive feeding is a key phrase used to describe a method to feed your baby/child in response to hunger. It’s important to note you can focus on responsive feeding when breast or bottle feeding. The WHO lists specific attributes of responsive feeding that promote healthy independent eating habits. These attributes will encourage mother and baby to learn hunger and satiety allowing the child to develop a healthy food relationship. 

  • Finding a balance between giving assistance with feeding and encouraging self-feeding (as appropriate to child’s level of development)
    • Meaning you offer assistance when feeding but also giving your baby opportunities to try feeding himself whenever possible
  • Feeding with positive verbal encouragement but without any verbal or physical coercion
    • Do not use distraction techniques, bribery, or consequences when feeding. These will all create a negative relationship with food/caregiver.
  • Responding to early hunger cues
    • Paying attention to and anticipating hunger signs 
  • Feeding in a safe and comfortable environment
  • Offering meals and snacks in a consistent familiar location will help your baby feel secure and encourage healthy eating.
  • Fed by someone who the child has a positive relationship with
    • Baby needs to feel safe to want to eat. Unfamiliar people will struggle to feed your child, so developing a positive relationship with the child will encourage healthy eating.

A recent study found that mothers who showed high levels of controlling feeding practices had babies with slowed weight gain, as opposed to those mothers who followed responsive feeding practices had babies with healthy weight gain and regulated weight for their baby’s age.

Protecting your baby’s ability to regulate their own appetite, alongside fostering positive emotions around eating and exposure to a range of healthy tastes will set your baby on the right path to long term healthy eating habits.

Dr. Amy Brown

Main Take-Aways

  1. Wait to start solids until 6 months as there are generally no benefits to starting earlier.
  2. First couple months of solids are mostly about tastes and textures, not calories!
  3. Milk (breast or formula) should still be the main source of calories until 1 year old. There is no need for milk beyond the first year, particularly no need for “toddler formulas”.
  4. Commercial baby foods are okay but high in sugar and sodium, lacking in textures and in the greater nutritional value of homemade foods.
  5. Whichever approach you take when introducing solids, try to remember the importance of Responsive Feeding!
  6. Solid food is not magical. It will not make your baby sleep longer or feel better.
  7. Your baby knows how much they want to eat. Trust your baby! They are eating enough!

Additional Resources:

*It’s important to note that when making any changes to a child’s diet (formula or otherwise) you should always talk to your child’s doctors first.