Katherine B. Patrick, M.D.

One common question faced by new parents is “how should my baby start baby food?” Initiation of solids (meaning any nutrition except breastmilk/formula, often referred to as pureed “baby food”) can raise a lot of questions but can also be a very fun activity to experience with your child.

The goal with the introduction of solids is to expose your child to lots of tastes and textures. Remember to start simple with single ingredients without added sugar, salt or other spices. You want to wait at least 3 days between each new food to watch for any reaction, such as diarrhea, rash/hives or vomiting. Babies often refuse their first foods due to new taste and textures. Don’t force the food. Remember that it could take many attempts before acceptance of a food, so try it again later. Know what is off-limits; do not feed your baby honey before they are 1 year old and don’t offer foods that could cause your baby to choke.

One aspect of solids introduction that has undergone significant changes in recommendations over the past decade is at what age to start foods, particularly common allergens. The American Academy of Pediatrics currently recommends exclusively breastfeeding (or formula feeding for those unable to breastfeed) for the first six months. However, most babies between 4-6 months are ready to start pureed baby food due to progression in coordination of tongue movements/swallowing. There are multiple motor development milestones that are looked for to indicate readiness for solid food introduction. The traditional idea that delaying the start of more allergy-prone foods (such as peanuts, eggs, etc.) decreases the allergy risk has been debunked. Many more recent studies, particularly the 2015 LEAP study, have shown significant reduction in food allergy with early introduction for specific foods. However, introduction before 4 months has been associated with increased weight gain and adiposity, in both infancy and early childhood. Given current changing recommendations in introduction of solid food to infants, it is best for parents to talk with their regular pediatrician at the baby’s 4-month check-up to determine if motor skills and medical history support start of foods at that age.

Enjoy experiencing this milestone with your child, and don’t forget the bib!

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