Is my baby ready for solid foods?

During the first few months of their lives, breast milk or formula provide all the nutrition most babies need. But around the halfway point of their first year, it’s time to consider solid foods.

“We start to introduce whether a child requires it or not,” says Beny Rub, MD, a pediatrician in Aventura, Florida. “If we do not give complementary nutrition, then the child does not develop or grow.”

Those initial feeding experiences can help shape kids’ eating habits for life. And while every baby is different, there are some general guidelines caregivers should be aware of. Here’s the lowdown on introducing solids, including tips for when and what to eat, the latest research on allergies, and strategies to make mealtime a more enjoyable experience for everyone.

Though introducing solids is crucial to child development, food is pretty complementary at first. The American Academy of Pediatrics (AAP) recommends breastfeeding as the sole source of your baby’s nutrition for the first 6 months of their life.

Even after you begin introducing solid foods, your baby will continue to need breast milk or formula through the first year, as it provides many essential nutrients. So, as you begin experimenting with food, continue to nurse or offer bottles. As time goes by and your baby eats more, their breast milk or formula intake will likely decrease.

At 12 months, your pediatrician may approve cow’s milk in place of formula. If you breastfeed, you can choose whether to continue. Whatever your decision, remember that every family is different and you and your pediatrician know what’s best for yours.

The AAP recommends that babies begin eating solid foods around 6 months of age, though some can start as early as 4 months if they show signs of being ready.

Those signs include:

• Growing to twice their birth weight
• Sitting up on their own without much assistance
• Holding their head upright and steady
• Showing interest in or grabbing at others’ food
• Disappearance of the extrusion reflex, where babies push food from their mouths with their tongues
• Refusing breastmilk or formula or showing signs of hunger after being nursed
• Putting hands, toys, or other objects in their mouths

Introducing solids before 4 months is strongly discouraged, as babies can choke. The coordination necessary for swallowing doesn’t typically kick in until they’re 4 or 5 months old. Starting too soon may increase allergy risk, as well, and could affect your baby’s ability to gauge appetite. Important to know: There’s no scientific evidence that introducing food early will help babies sleep through the night. If you think your baby is ready to start eating, speak with your pediatrician. They can verify your suspicions and start you out with a few tips, including those that follow.

There’s no scientific consensus about which solids to introduce first or in what order to give them to your baby. With exceptions, it doesn’t particularly matter, as long as it’s a soft, smooth, single-ingredient food they can swallow without chewing. Many parents choose to begin with the following:

• Cereals: iron-fortified and made from oats, barley, or rice, mixed with water or breast milk
• Vegetables: cooked and puréed sweet potatoes, squash, carrots, peas, or green beans
• Meats: cooked and puréed turkey, chicken, beef (which are particularly valuable sources of high-quality protein, iron, and zinc), pork, and fish
• Fruits: mashed banana or avocado; cooked and puréed apples, pears, plums, apricots, or peaches

Foods shouldn’t have added salt or sugar. They should be introduced one at a time, every three to five days, so you can pinpoint the source if there’s an allergic reaction. Once you know your baby can tolerate foods individually, it’s okay to start combining them. As babies age, they can be offered a larger variety of foods with slightly firmer textures. Around 8 to 10 months, many can have small pieces of soft items, like pasta and beans. “When they have at least 4 to 8 teeth,” says Dr. Rub, “it’s easier for them to chew the food—so they can puree the food themselves and swallow it.” By 12 months, as they develop better coordination, many babies can partly feed themselves, and their foods can become firmer, larger, more plentiful and more diverse. They may eat three meals a day, plus snacks. 

Since they’ll still get most nutrients from breast milk or formula, your baby likely won’t eat much at first. Start small, with half-spoonfuls of food—and anticipate a mess, at least initially. If they close their mouths or turn away, stop; don’t force the feeding. Full, regular diapers and on-track development are good signs they’re getting enough.

If your baby rejects a food at first, try it again later. “Just because they didn’t like it one time, it doesn’t mean they’re not going to like it,” says Rub. Some babies need up to 15 attempts before they’ll accept a new food.

Use a bowl and spoon to feed your baby. If you spoon puree directly from a baby food jar, don’t put it back in the fridge, since it could harbor bacteria. Unless you’re instructed otherwise by a healthcare provider (HCP), never put food in your baby’s bottle. They can choke, and it may delay eating skills or encourage overeating. Contrary to popular belief, there’s no proof it will help them sleep at night.

During feedings, sit your baby upright in a lap, booster, or high chair. Reduce distractions and resist the temptation to entertain, so they can concentrate on eating. Lose the smartphone and focus on your child, too, says Rub.  “They need to know that when it’s time to eat, it’s time to communicate with each other.”

Though most solids are safe during their first year, babies should not eat certain foods before 12 months because of health concerns:

• Due to the risk of botulism, babies are advised to skip honey and foods containing honey, including graham crackers and some yogurts.
• Unpasteurized juice and dairy products carry an E. coli risk.
• Little bodies don’t need cow’s milk and can’t handle some of its nutrients. Drinking it can increase the chances of intestinal bleeding.
• Juice can reduce a baby’s desire for more nutritionally complete foods and lead to diarrhea, diaper rash, and weight issues. After 12 months, pediatricians suggest limiting intake to 4 ounces of 100 percent juice daily. Generally, drinks and sweets with added sugars should be avoided before 24 months.

Parents and guardians should also be aware of choking hazards. Any chunk of food can become lodged in a baby’s throat, including, but not limited to, grapes, cherry tomatoes, hot dogs, whole nuts, dollops of peanut butter, string cheese, popcorn, and marshmallows. Even as they start to feed themselves, give babies soft, small pieces they can swallow easily and supervise them at all times during meals.

Not so long ago, HCPs told parents to wait on giving babies highly allergenic foods for fear it would raise their chances of developing allergies. But recent research shows there’s no benefit to holding back on items like eggs, fish, shellfish, tree nuts, peanuts, milk, wheat and soy. In fact, early consumption of peanuts may help lower the odds of allergies, while holding out could increase the risk.

Your baby’s very first solids should be low-risk. Think mashed bananas, pureed peas, and infant cereal. But if they’re tolerated well and there’s no reason to believe your baby is at increased risk for food allergies, soft items like yogurt and eggs can be introduced shortly thereafter.

To be totally safe, start them with just a small taste, and do so at home versus at daycare or a restaurant—preferably with an oral antihistamine by your side. Rub recommends doing it in the morning, so your pediatrician or family doctor is available if an allergy manifests. Common allergic reactions include rash, welts and hives, swollen lips, watery eyes, itchy skin, vomiting, and diarrhea, though any suspicious symptoms should be quickly reported to an HCP.

Regarding peanuts, avoid feeding your baby whole nuts or straight peanut butter. Instead, try mixing a little bit of peanut butter into another food, like yogurt, or liquefying peanut butter puffs into breast milk or formula and serving it to your baby with a spoon.

If you have questions, speak with a pediatrician before starting babies on these foods. Always speak with them if food allergies run in the immediate family (which means your baby is at increased risk), or if your baby has eczema or a documented food allergy. Your HCP may recommend a different approach, including allergy testing.

If you have the time, inclination, and green light from your pediatrician to make your own baby food, go for it. Making your own baby food can often save money compared to buying it pre-made and it guarantees you know exactly what your family is eating. There are a variety of recipe resources online and the actual preparation may be simpler than you think. “You don’t need to buy organic food,” says Rub. “You can buy any food that you like, as long as it’s in a variety of forms.”

Just make sure the food is cooked, mashed, or pureed to a smooth consistency and refrigerated for storage. Be extra-aware of mold or other spoilage, too, since fresh foods tend to go bad faster than packaged ones.

One warning: If you decide to try making baby food at home, don’t give children under 4 months spinach, green beans, beets, squash, or carrots. These foods contain relatively high quantities of chemicals known as nitrates. They may lead to a condition called methemoglobinemia, in which the amount of oxygen carried by the blood is reduced.