Introducing solids to your infant

Introducing solids to your infant

By Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

As your baby grows, you’ve probably started wondering when and how to start feeding your infant solid foods. Here are some general tips to consider:

Is there a safe age to start feeding solid foods to my infant?

Yes, most infants this is between four and six months of age.

Why is there a ‘safe’ age to start feeding solids?

There are a few reasons why this age is safest. The first reason is because prior to four months of age, an infant is not developmentally ready to safely eat from a spoon.

To be able to swallow solids safely, an infant needs good head control; to be able to sit well with support; and to have lost the “extrusion reflex” (the reflex which enables newborns to tightly latch and suck from a nipple, but makes them shove a spoon out of their mouth).

The second reason an infant should be fed solids between four and six months is something many families are not aware of: it is also a strategy to prevent common food allergies. This is one of the strongest reasons I passionately advocate for infants to be exposed to as many foods as possible during this crucial three-month window.

Starting solids and preventing food allergies:

In the past, healthcare providers have advised parents to avoid potential allergens such as peanuts, eggs, and milk. New evidence is now showing that this practice might have played a role in the increased incidence of childhood food allergies in the U.S

Why might this occur? The gastrointestinal tract is a vital part of the immune system. And this gut immunity is sort of “ripening” when an infant is between four and six months of age. I want to have infants exposed to as many new foods (especially the allergenic ones) during this “window of opportunity”. Exposing an infant to new foods when the immune system is already mature or “set in stone” (i.e. waiting until a child is 4 years old to have him taste his first peanut) could be just as harmful as feeding an infant a food that his system is too immature to accept in the first few weeks of life.

How do I start feeding solid foods to my infant?

You will start with slightly thick textures, like pureed foods, and as your infant’s teeth and chewing and swallowing skills mature, you will advance to more chunky textures, even tiny bite size foods eventually, under the guidance of your baby’s doctor.

(Whenever starting solids, wait at least 2 or 3 days between new foods, and never add any flavoring, additives, or spices to the food, to keep the new foods as “pure” and simple as possible. That way, if your infant develops any sign of a food allergy, you won’t get confused about which ingredient might have caused the reaction. For more information about starting solids and food allergies, click here to read this great resource from the National Institute of Health)

How will I know when my infant is ready to start solids?

For most infants, as long as they are over four months of age, parents should pay attention for a few signs that tell them their infant is ready to try solids:

  • Curiosity about what others are eating. Your infant may start eyeing your plate of food or reaching for a taste as your spoon travels from your bowl to your mouth at dinner.
  • Appetite: Your infant seems hungry even though he’s being fed his usual eight or 10 breast milk/formula feeds per day. I tell parents that after a baby has reached about 32 oz of formula/breast milk per day, but is still hungry, that’s a good sign he’s ready for solids.

How do I know how much to feed?

The rule of thumb for all infants is that solids are not meant to replace the nutrition from breast milk or formula. Breast milk and formula are the only sources of “complete” food for infants. Other than just calories, breast milk and formula are the primary sources of important vitamins, iron, and protein that solids cannot reliably provide. The general rule of thumb I tell parents is that an infant should probably get no less than “a quart” of breast milk/formula per day throughout his first year of life and to consider solids “icing on the cake”.

What else should I know about feeding solids to my infant?

Each infant is unique, and there are occasional exceptions to these general principles. So start early, and get the conversation started between you and your infant’s physician about how to best start solids for your baby.

Ed. note: Dr. Pisharody spoke about a recent CDC study that says some moms are feeding infants solids too early - click here to read the news story.

Comments
Uma Pisharody, MD, FAAP
Although there may be more learnt from future research, current data does not support any increased risk of food allergies for children born to mothers with history of gestational diabetes mellitus (GDM). Thus, there is no need to change the way solids are introduced to an infant solely because the mother had GDM. There are some studies that find that children born to mothers with GDM may have a higher risk of overweight and obesity later in life, but other studies show that this risk may be due to life style habits rather than intrauterine factors. Mothers should always talk with their child’s health care provider to find out what best steps should be taken according to individual risk factors.
8/8/2013 3:41:55 PM
Stephen in Miami
Now, I was wondering if there is any differences that need to be considered if the mother of the child developed gestational diabetes during her pregnancy? I know that this can result in giving birth to a larger than normal baby, which could lead to complications during the delivery. However, I felt that this may only increase the baby's risk of developing type 2 diabetes down the road. I know that having gestational diabetes would increase the risk of developing T2D for the mother.
8/7/2013 2:09:18 PM
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