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font size="4" face="arial, helvetica">Starting Solid Foods
by Jack Newman, MD, FRCPC
Health Canada and the Canadian Pediatric Society and the American Academy of Pediatrics and UNICEF and IBFAN and the Global Strategies on Infant Feeding recommend breastfeeding exclusively to about six months. Many health professionals suggest starting solid foods at four months of age; many now say you must not start before six months of age. However, most babies do fine with breastfeeding only to six months of age or even longer. You should start your baby on solids when s/he shows signs of being ready for solids, not by the calendar. See below.
Why start solid foods?
- Because there comes a time when breastmilk no longer supplies all your baby's nutritional needs. (This does not mean, as some uninformed people say, that there is no nutritional value in breastmilk after the baby is six months old.) A full term baby will start requiring iron from other sources by 6 to 9 months of age. The calories supplied by breastmilk may become inadequate by 8 to 9 months of age, although some babies can continue to grow well on breastmilk alone well past a year.
Because some babies not started on solids by a certain age (9-12 months) may have great difficulty accepting solid foods.
- Because it is a developmental milestone that your child passes when he starts solid foods. He is growing up. Usually, he will want to eat solids. Why stop him?
When to start solid foods
The best time to start solids is when the baby is showing interest in starting. Some babies will become very interested in the food on their parents' plates as early as four months of age. By five or six months of age, most babies will be reaching and trying to grab food that parents have on their plates. When the baby is starting to reach for food, grabs it and tries to put it into his mouth, this seems a reasonable time to start letting him eat. There really is no reason to start on a specific date (four months, or six months). Go by the baby's cues.
In some cases, it may be better to start food earlier. When a baby seems to be hungry, or when weight gain is not continuing at the desired rate, it may be reasonable to start solids as early as three months of age. Starting at three months of age when things are going well, however, is not recommended (see above). However, it may be possible, with help, to continue breastfeeding alone and have the baby less hungry and/or growing more rapidly. See Protocal to Increase Breastmilk Intake. See also handout Slow Weight Gain Following Early Good Weight Gain for reasons your milk supply may be down. Check the videos at www.drjacknewman.com so that you can use the Protocol better. But if the techniques used in the clinic do not deal with the problem, adding solids can help. There is no advantage to giving artificial baby milk (formula) and there may be some disadvantages, especially if it is given by bottle. The baby who is not satisfied completely at the breast may start to take more and more from the bottle, and end up refusing to take the breast.
The breastfed baby digests solid foods better and earlier than the artificially fed baby because breastmilk contains enzymes that help digest fats, proteins, and starch. As well, breastfed babies have had a wide variety of tastes in their lives, since the flavours of many foods the mother eats will pass into her milk. Breastfed babies thus accept solids more readily than artificially fed babies. Breastmilk is amazing stuff, eh?
How should solids be introduced?
When the baby is starting to take solids at about six months of age, there is little difference what he starts with or the order foods are introduced. It is prudent to avoid highly spiced or highly allergenic foods at first (e.g. egg white, strawberries), but if the baby reaches for the potato on your plate, make sure it is not too hot, and let him have the potato. There is no need to go in any specific order, and there is no need for the baby to eat only one food for a certain period of time. Some exclusively breastfed babies dislike infant cereal. There is no need for concern and no need to persist if the baby doesn't want the cereal. There is nothing magic or necessary about infant cereal. Offer your baby the foods that he is interested in. Allow the baby to enjoy food and do not worry exactly how much he actually takes at first. Much of it may end up in his hair and on the floor anyhow. There is no need either that foods be pureed if the baby is six months of age or older. Simple mashing with a fork is all that is necessary at first. You also do not have to be exceedingly careful about how much the baby takes. Why limit the baby to one teaspoon if he wants more? You do not need to waste your money on commercial baby foods.
- Be relaxed, feed the baby at your mealtimes, and as he becomes a more accomplished eater of solid foods, offer a greater variety of foods at any one time.
- The easiest way to get extra iron for your baby five or six months of age is by giving him meat. Infant cereal has iron, but it is poorly absorbed and may cause the baby to be constipated.
- There is no reason to introduce vegetables before fruit. Breastmilk is far sweeter than fruit, so there is no reason to believe that the baby will take vegetables better by delaying the introduction of fruit.
- Respect your baby's likes and dislikes. There is no essential food (except breastmilk). If your baby does not like a certain food, do not push it on him. If you think it important for him, wait a few weeks and offer it again.
- At about eight months of age, babies become somewhat assertive in displaying their individuality. Your baby may not want you to put a spoon into his mouth. He very likely will take it out of your hand and put it into his mouth himself, often upside down, so that the food falls on his lap. Respect his attempts at self-sufficiency and encourage his learning.
What if I am starting solids at 3 months?
At this age, it may be prudent to go a little more slowly. Start with ripe avocado or easily mashed foods such as banana, or homemade oatmeal. Sometimes a baby will eat better from your finger (or his!) than off a spoon. Go a little more slowly with quantities as well. But as the baby tolerates solids, both quantity and variety of foods can be increased, as the baby desires. Incidentally, why are you starting solids at three months? Many grandmothers are keen that the baby start "real food", but if there is not a good reason to start at 3 months, don't. (The most common legitimate reason to start earlier than five or six months of age is poor weight gain not corrected by correcting latch, using compression, switching back and forth, using Domperidone).
What If I Am Already Supplementing With Formula?
Starting solids early is a way to prevent supplementing the baby with formula by bottle. Formula may be added to solids so that baby consumes the extra calories (from the formula) by spoon instead of by bottle.
Solids or breast first?
There seems to be considerable worry when a child is starting solids about whether to give the breast first or give solid food first. If breastfeeding and the introduction of solid foods both are going well, it probably does not matter much. Indeed, there is no reason that a baby needs both breast and solids every time he eats.
Questions? see my book Dr. Jack Newman's Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)
Handout #16. Solid Foods May 2008
Written and Revised by Jack Newman, MD, FRCPC 1995-2005
Revised by Edith Kernerman, IBCLC, and Jack Newman, MD, FRCPC © 2008
This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated.
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