Doctors’ Notes

Solid Foods: Feeding & Transitioning

Plenty of information exists about when to transition babies to solid foods. There’s no shortage of guidelines from websites and books, and parents and grandparents often have suggestions for “what works best.”

Still, transitioning babies to solid foods can be a confusing and anxiety-ridden time for parents. (I’ve been there myself!) So this Note tries to bring some clarity to the process, with a few basic guiding principles — most importantly, patience, and flexibility.

This Note tries to bring some clarity to the process, with a few basic guiding principles — most importantly, patience and flexibility.

First Signs

From birth to 4-6 months, baby should only get breastmilk or formula.

Between 4-6 months of age, your little one may be ready to take the next step if she can sit up with some support, show interest in food, hold up her head, seem hungry after the normal feeding schedule (8-10 feedings, or 40 ounces of formula) and move her tongue back and forth. Just remember — there’s no rush to starting solid foods.

First Foods

Start “meals” with breast milk or formula, since they’re nutritionally superior to solids. We want to make sure baby is getting that complete nutrition and not filling up on solids quite yet.

Over the years, advice about how to start feeding your baby has certainly varied. As science progresses, there are only a few hard and fast rules. Otherwise, have fun feeding your little one!

Two Important Rules:

1. Do not give honey before 1 year of age (because of the risk of infant botulism)

2. Do not offer anything your baby could choke on (think whole grapes, raw carrots, whole nuts, hot dog slices)

That’s about it! As for allergenic foods, recent research shows it is better to introduce these foods (eggs, nut butters) at an earlier age. So, whenever your baby is developmentally ready to eat them, go ahead and offer them, and keep them in the diet regularly. Peanut butter can be a choking hazard if it is too thick, so try thinning it with warm water or mixing it with yogurt or baby cereal. You could also consider baby food products that contain peanut.

Have fun with it. The experience of eating is important for baby. Let her be messy, play with food with her hands (really great for her development!, and swallow some of it. As long as it is fun for her, keep it going.

Babies can sample lots of food that you are eating- soft fruits, vegetables, soups, stews, beans, pastas and other grains, eggs…and the list goes on! You don’t have to keep food “bland” for your baby. However you season it for yourself is fine, including some added salt.

We don’t recommend offering a lot of foods that are high in salt, like canned products or other highly processed foods. Remember, your baby is learning what food tastes like. The heathier the better, to start them off on the right foot for good eating habits for life!

If your child doesn’t seem interested in solids, it’s ok to stop and wait a couple of weeks and then try again. We’ll be asking at all the well visits how they are doing as they transition. It’s not unusual for babies to occasionally gag while they are learning to eat solids. Always stay with your baby when they are eating, in case they have difficulty swallowing something. If they have persistent gagging or difficulty transitioning to solids, please let us know.

If you want to make your own baby food, this is the time to start. The book Cooking for Baby, with recipes by Lisa Barnes, is a fantastic guide.

How Much?

At first, your baby may only eat several bites of food, or may eat a lot. It’s ok to let him be the guide. Babies need to learn to stop when they are full, and eat when they are hungry. Offering food once a day at first is fine. Usually by about 9 months babies are eating 3 meals a day. Between 9-12 months their solid food intake goes up, and their breastmilk or formula intake may go down. Offer a variety of foods, including iron-rich foods if baby is breastfeeding. As baby approaches 1 year, he will be getting more and more calories from solid food, and we want to ensure he is getting everything they need.

Next Steps

6-8 MONTHS is the time to start introducing more protein foods — pureed meats (i.e., chicken, beef), tofu, beans, and legumes (black beans, edamame, chickpeas, lentils). At this stage, most babies will eat pureed foods over the course of 2-3 meals per day, including cereal, fruit, vegetables, and a small amount of protein foods.

Each baby is different as far as the amount they eat. Total amounts per day tend to range between 3-9 tablespoons of cereal, ¼ – ½ cup of fruit, and ¼ – ½ cup of vegetables.

For most babies 8-10 MONTHS of age, mashed (instead of pureed) fruits, vegetables and beans, and small pieces of finger foods such as, ripe banana, cooked pasta, and O-shaped cereal are new opportunities. While cow’s milk is still discouraged, soft cheese, yogurt and cottage cheese are often welcome additions.

Total amounts per day tend to fall in the ranges listed here:

¼ – ½ cup iron-fortified cereal

¼ – ½ cup fruit

¼ – ½ cup vegetables

¼ – 1/3 cup dairy

1/8 – ¼ cup protein foods

Closing on one year (10-12 MONTHS), babies will continue to eat approximately the same amount of food throughout the course of a day, with the addition of some combination foods, such as macaroni & cheese or casserole-type foods (about 1/8 – ¼ cup). They may even try to start using a spoon. Eggs and boneless fish are good additions now, as baby enjoys finely ground meats and mashed beans, and bite-sized veggies and fruits.

What About Food Allergies?

Postponing foods like eggs, fish and peanuts does NOT prevent food allergies. However, you may want to delay their introduction if your family has a history of food allergies or your child has eczema. (For more info, see our Note on Common Infant Food Concerns.)

In Summary

Introducing solids and trying new foods is an adventure for everyone. Recall the first time you tried sushi or perhaps another, more unusual food – it’s a lot like that for your little one, on almost every one! Most importantly, be patient and flexible. Baby’s growth and development don’t follow an exact time line — so we, as parents, shouldn’t either.

For additional guidance, check out this web site from the American Dietetic Association.

Anne Marie Kuchera is a registered dietician and board-eligible national certified counselor.