When Should I Introduce Solid Foods?

Q. Our first child is 4 months old. Some of my friends say they started their babies on solid food at 4 months. My mother wants me to start solid foods now. I’m breastfeeding, and my pediatrician says it’s best to wait until 6 months old. What can you tell me about adding solid food to a baby’s diet?

A. Several organizations have recommended that all babies be breastfed without anything else added until they are 6 months old. These organizations include the World Health Organization (WHO), the American Academy of Pediatrics and the American Academy of Family Physicians.

Certainly, breast milk is the best food for babies for many reasons, including immune factors in the milk, enzymes that aid digestion and breast milk’s ability to facilitate good bacteria to protect a baby’s intestines. While breast milk is best, not every mother wants to or can breastfeed. So let’s look at when to introduce solids for both types of babies.

Not all babies are ready to start solids at 4 months. Look for the following signs of readiness for solid foods:

• Can support the head. To eat solid food, a baby needs to be able to sit up and have good neck and head control.

• Has lost the tongue thrust reflex. If this reflex is present, the baby will push food out to keep from choking. If he pushes food out, he is not ready.

• Birth weight has doubled.

• The baby shows an interest in your food and opens his mouth when food comes his way.

Advocates of starting solid food at 4 months suggest that a baby will learn to accept a wide variety of foods and not become a “picky” eater. Proponents of starting at 4 months also suggest the baby will have fewer or no food allergies by starting solid foods early.

Dr. Lucy Cooke of the University College London says, “From 4 to 7 months, it seems there is a window when humans are extraordinarily receptive to flavor.”

During this time, it takes less exposure to get a baby to like a new flavor and this liking can be long lasting. On the other hand, proponents of waiting until 6 months point out that research has shown that most 4 month olds excrete poorly digested solids, with the stool containing undigested fats, protein and carbohydrates. The Princeton Center for Infancy and Early Childhood adds that solids can decrease milk intake and interfere with digestion. The reduction in milk intake can mean the mother produces less milk for the breastfed baby. Solids are blamed for upset tummy, constipation and gas. In addition, some research suggests that starting solids at 4 months increases body fat and shows up as overweight in adulthood.

Whether you introduce solids at 4 months or 6 months, the general consensus is to introduce one food at a time. There is disagreement on how long to wait between foods, with some experts saying one week and some saying one day. There is also disagreement on what foods to start. Many experts suggest a cereal first, while others suggest starting with naturally sweet well-cooked vegetables. More  “challenging” vegetables such as spinach and brussels sprouts may need to be introduced several times before the baby stops making a face and pushing them out.

Bottom line: you get to decide what’s best for your baby, what foods to introduce and when. For more information, you might check out a couple of the resources I used for this article: the book “First Bites” by Bee Wilson and the website kellymom.com.

Betty Richardson, Ph.D., R.N.C., L.P.C., L.M.F.T., is an Austin-based psychotherapist who specializes in dealing with the problems of children, adolescents and parents.