When do babies start eating solids?
[mme_highlight] The American Academy of Pediatrics recommends that complimentary foods should be introduced when an infant is 4 to 6 months, being exclusive breastfeeding preferred in the first 6 months; the World Health Organization defends exclusive breastfeeding during the first 6 months of life.[/mme_highlight]
The American Academy of Pediatrics recommends that complimentary foods should be introduced when an infant is 4 to 6 months, being exclusive breastfeeding preferred in the first 6 months; the World Health Organization defends exclusive breastfeeding during the first 6 months of life.
Note that this recommendation is not solely based on age, but on other development milestones that should be met before the introduction of solids, such as sitting and supporting the head. Over time, you will notice your baby develops more refined skills to eat, like grasping, chewing and swallowing food at 8 to 10 months of age.
What’s the problem with introducing solids too early?
Premature introduction of solids, before a child is 4 to 6 months old, may:
- increase the risk of food allergies;
- Increase the risk of inhalation, as swallowing and other skills are not fully developed;
- increase the risk of obesity, although evidence from studies remains unclear;
- be a frustrating experience for both parents and children, as before 5 months babies still have the extrusion reflex, meaning that if an object – like a spoon – is placed between the lips it will be automatically pushed out.
What’s the problem with introducing solids too late?
On the other hand, the introduction of solids should not be postponed after the 6 months, as at this point the breastfeeding or formula alone may not provide children with the adequate amount of nutrients and calories, potentially leading to decrease in the growth rate, iron deficiency and complications like celiac disease, eczema and asthma.
How to start and progress with solid foods?
The first solid aliments that should be introduced are single-ingredient foods like cereals and puréed meats, as they provide zinc and iron. As these foods are accepted, you can introduce strained or puréed fruits and vegetables. It is recommended that at least one aliment containing C vitamin is given per day, because this vitamin promotes iron absorption, and thus prevents anemia.
The addition of salt and sugar should be avoided at all costs, as this does not increase the infant’s acceptance. Over time, children develop their motor skills for feeding and their acceptance of foods, so new textures and more complex food can be introduced.
Are there foods to avoid?
There are certain foods that should not be given to an infant prior to 12 months of age: foods that can lead to chocking (like nuts, round candies, grapes and raw carrots) and honey, since there can be an association with botulism. The American Association of Pediatric also recommends avoiding cow’s milk until the child is one year old.
What are the allergenic foods?
Eggs, fish, shellfish, cow’s milk, nuts and peanuts can be highly allergenic aliments and it has been suggested that delaying their introduction until an infant is four to six years old can prevent atopic disease in children who are at high risk – those with a first-degree relative with documented allergic disease. If your child is in this high-risk group, there are some precautions to take introducing the foods cited above:
- give a first taste of the aliment to the infant at home, which is preferable than a restaurant or a day care;
- if you cannot see any reaction, introduce the aliment gradually and in increasing amounts;
- if some reaction occurs or if you see a skin rash after giving the aliment it is recommended to take your child to see a doctor:
- if previous food allergies have occurred or if the infant has a sibling with food allergy it is recommendable to have an allergy evaluation before introducing those aliments.
Summary and Recommendations
- AAP recommends start introducing solid foods between 4 to 6 months, while WHO puts the recommendation on 6 months to ensure exclusive breastfeeding during these first months.
- To start solids, there are some motor milestones that should have been attained, like supporting the head and sitting without support.
- Starting solids too early can increase the odds for allergic reactions, inhalation and obsesity.
- Starting solids too late can lead to a failure to thrive or anemia due to iron deficiency.
- Start with cereals and puréed meats; then introduce vegetables and fruits.
- Do not add sugar or salt to your baby’s food.
- Avoid in the first year aliments that have a shocking risk, like nuts, round candies and grapes. Also avoid honey because of the danger of botulism.
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References
- Jonsdottir OH, Thorsdottir I, Hibberd PL, et al. Timing of the introduction of complementary foods in infancy: a randomized controlled trial. Pediatrics 2012; 130:1038.
- Agostoni C, Decsi T, Fewtrell M, et al. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2008; 46:99.
- Underwood BA, Hofvander Y. Appropriate timing for complementary feeding of the breast-fed infant. A review. Acta Paediatr Scand Suppl 1982; 294:1.
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