Starting solids
Introducing solids is an exciting time for any parent – but it can be a bit scary too! There is a lot of advice available but like anything to do with parenting, the right approach will be the one that works best for you and your child. Here is some info to answer the most common questions or issues that arise for families, and some pitfalls to avoid too!
Why?
All a healthy baby’s nutrition needs can be met by milk for the first months of life, whether this is breast milk or infant formula. (Other types of milk such as standard cow’s milk, or plant milk are not suitable for infants). Even once other foods are introduced, milk will provide most of your baby’s nutrition until close to 12 months of age.
Once a baby is born, their digestive system and kidneys continue to develop. From sometime around four months of age, enough digestive enzymes are produced in a baby’s gut and saliva for them to digest foods other than milk. Babies are born with some stored nutrients, in particular iron, but these iron stores start to run low around six months of age, requiring them to get nutrients from other foods.
When?
The right time for introducing foods to babies is somewhere around four to six months of age (there may be some differences if your baby was born premature). There is no great hurry and the correct age for your baby might not be the same as your friend’s baby. Some signs that your baby is ready to be introduced to solids are:
They can hold their head up well and can sit upright with some support
They seem interested in food – watching you eat and they might reach out to try and grab your food
They make chewing actions
They are frequently putting objects in their mouth
They seem hungry after milk feeds
If you put some food in the front of their mouth, they don’t push it out with their tongue
If you try introducing food and your baby becomes distressed, turning their head away or pushing the food away, stop and wait a few days before trying again.
Remember, the goal is for your one-year-old to be eating family foods so it’s a big transition over a six-month period, but it doesn’t have to happen all at once!
What?
Solids (also called complementary foods) are usually started by offering 1-2 teaspoons of thin puree at one meal per day. This is done after a milk feed sometime in the middle of the day. Start with one food at a time and introduce a new food every 2-3 days. It is a good idea to start with vegetables or iron fortified baby cereal e.g. pureed carrot, pumpkin, broccoli or kumara. If you need to thin the puree, use breast milk or formula. Once you have introduced vegetables individually, you can combine them e.g. kumara and broccoli together.
It is important to introduce high iron foods early on. Examples include:
Cooked pureed meat, chicken or fish
Cooked and mashed tofu, beans or lentils (you might need to sieve these)
Iron-fortified cereals
These could be mixed with pureed vegetables once your baby is familiar with eating these.
Remember, when foods are first being introduced, it is all about learning – what food smells like, feels like and tastes like. Don't expect your baby to like every food every time, they may need to try a food up to 15 times before it becomes familiar and ‘safe’ to them.
Finger foods – Baby-led feeding
Some people prefer never to introduce pureed food, instead choosing to offer soft finger foods right from when solids are introduced. This allows babies to feed themselves and self-regulate their food intake. If you choose to follow this approach, you must wait until your baby is six months old to ensure they can safely eat like this. Offer soft foods in strips that are about 7-8cm long (about the size of an adult finger). This shape allows your baby to hold on to the food in their fist and bite off a piece and start learning to chew. For the first couple of months, food should be soft enough to be squashed on the roof of the mouth with the tongue.
There are some concerns that baby-led feeding can lead to a lower iron intake so it is important to include high iron foods every day. These could include bread with iron fortified spread or pate, soft meat/fish/chicken or bean/lentil patties.
You don’t have to choose only one style of feeding, it’s okay to start with pureed food and offer soft finger foods early (after six months). Whichever way you choose, it’s important to let your baby stop eating when they have had enough – don't force ‘just one more mouthful!’
How much and how often?
Initially start with one meal a day of a couple of teaspoons of food. Once your baby has become used to this, you can add in a second meal at a different time of day. It’s important to watch your baby for signs of having had enough, don’t encourage them to eat more than they want.
As babies get older, the amount of food they want to eat will increase and they will gradually transition between drinking less milk and eating more food. The rate at which this happens can be variable, don’t be alarmed if your baby’s food intake varies a lot from day to day! As a guide, by about 9 months of age, a baby should be having 2-3 meals and 1-2 snacks per day. Be aware that babies can revert to drinking more milk and eating less solid food when they are feeling unwell or are teething.
Moving through the textures
It’s important for a baby’s tongue and jaw development to move them through different textures of food. Once your baby has the hang of thin purees, you can progress to thicker purees. After pureed food, move on to:
Mashed texture – around 7-8 months (milk feed first). Don’t be alarmed if your baby gags a little bit, this is their normal reflexes developing. It’s a good sign!
Mixed textures – around 8-9 months (can start offering food before milk feed). This can include minced, grated, finely chopped dishes and soft finger foods if you haven’t already introduced these. It is important that babies are introduced to lumpy foods and foods that need to be chewed by 8-9 months of age.
Drinks
From around six months of age, you can introduce water as a drink to your baby. While sippy cups can be useful to reduce mess, babies can be taught to drink from an open cup. Initially they are likely to need some help to control the cup, but they can learn to bring the cup up to their mouth for themselves using two hands. Learning this skill helps a baby’s swallowing to develop and mature.
Introducing common allergy foods
The good news is that allergy research now tells us that early introduction to all types of food (before 12 months of age) is useful for allergy prevention. There are no more rules to remember about which foods to introduce at which age! Once your baby has started solids, almost all foods can be safely introduced as long as they are of a safe texture e.g. nut butter or ground nuts, not a whole nut which is a choking hazard. The one food which should be delayed until after 12 months is honey, as it can contain a toxin which can make babies sick. If you are worried about introducing foods because your child is at high risk of food allergies, this information may be useful:
If you are concerned, I would be happy to see you (in person or via video link) to provide specific advice for your baby.
Choking concerns
To reduce choking risk, babies and young children should eat only while they are seated and it is important that an adult stays with them while they eat. Some foods are more likely to cause choking and should be avoided (e.g. whole nuts and large seeds), or the shape of the food should be altered (grated, cooked until soft, finely chopped, mashed, skins removed) before giving them to your baby or young child.
For example, round foods such as grapes, blueberries, potatoes, and hard-boiled eggs should be smashed, flattened, or cut into quarters before serving. Skins may need to be removed e.g. apple, or leaves chopped up e.g. spinach or lettuce.
This link has more useful information or you may like to do a baby first aid course.
https://www.kidshealth.org.nz/what-do-if-your-baby-chokes
Pitfalls to avoid
Don’t be concerned if your child appears not to eat very much. Children are very good at learning to manage their food intake if food is offered when they are hungry but they aren’t pressured to eat more than they want. If their growth is affected, please contact your GP or Plunket nurse or book an appointment to see me.
Don’t add fruit to everything! Babies can quickly learn to prefer only sweeter flavoured foods, it’s important that they get familiar with some of the more challenging flavours of other foods.
Don’t only provide your baby’s favourite foods – introducing solids is about introducing your baby to a range of flavours – and eventually different textures – of food.
Don’t introduce a new food in the evening, do it earlier in the day – you want to be able to watch for any possible reactions to a new food.
For more info, have a look at these websites:
https://www.healthykids.org.nz/eat/infant-feeding
https://www.kidshealth.org.nz/tags/nutrition-0-12-months
https://www.plunket.org.nz/caring-for-your-child/feeding/solids/introducing-solid-foods/
If you would like to read more thorough background information:
If you would like advice that is personalised to you and your baby, please reach out to book an appointment, I would be happy to help you.
Image on blog front page: Me with my son Max having his first solids of mashed avocado. He was just over 5 months old and was showing all the signs that he wanted to eat like the rest of us!