This is an exciting event in a new parent’s life, but it can
feel overwhelming and produce anxiety. There are different ways to introduce solid
foods, and each method has ardent supporters and vehement detractors. Five different sources may give you five
different “best” or “only” ways to do it.
My goal is to provide clear information based on the latest scientific
research. Evidence regarding solid food
introduction is evolving as new research takes place. Some information you find is based on old
research. The guidance I give is based
on my understanding of the most current research in this field. If I am stating an opinion that is not based
on solid current research, I will make that clear.
First and most importantly, you MUST discuss solid food
introduction with your child’s health care provider. Every child and every family has unique
characteristics and circumstances that must be accommodated. What I present here is an explanation of various
approaches and basic logistics. What you
need from your child’s provider is agreement on when your child is ready, and which
approach to use. If a biological parent
has food allergies, your child is much more likely to have them as well, so be
sure to discuss this in detail with your child’s provider. Remember, if your child has a reaction to a
food, your provider is the one you will call, so he or she must be on board
from the start and throughout the process.
Photo credit LB1860; downloaded from Flickr without amendment
Next, if you feel overwhelmed or anxious, don’t. Take a deep breath and remember that all
children learn to eat, regardless of what you do, or don’t do. My hope for you is that you will introduce
solids in such a way as to foster a love for healthy eating in your children. This is difficult to do when you are feeling anxious.
(This is my opinion; find more
opinions on this subject in “Growing Healthy Eaters”).
Finally, don’t forget about nursing (if your baby is formula
fed, skip this paragraph). I’ve seen it
countless times. We moms go from
obsessing about breastfeeding to obsessing about solid foods. This may result in a decline in
breastfeeding. Breastfeeding provides baby’s
primary nutrition until at least 9 months; after 9 months, it continues to be a
very important source of nutrition.
Also, breast milk contributes important immune support for as long as
it’s offered. The goal is to continue breastfeeding until at
least 12 months. Continuing to
breastfeed as solid foods are introduced may decrease the chances of developing
food allergies (evidence is conflicting on this subject). So be sure to keep some focus on
breastfeeding while you’re putting your energy into the introduction of solids.
Let’s cover some basic logistics now.
·
Infant
CPR: If do not already know infant
CPR, now is a great time to take a class (see below for resources). Your baby may never choke on food, but it’s
best to know what to do just in case. It
can be quite easy to save a life, if you’ve been properly trained.
·
How do
you know when baby is ready? Be sure
to discuss this with your child’s provider; this discussion is usually brought
up at the 4 or 6 month well child check.
Your baby will be around 6 months of age, but don’t go by age alone - it’s
more important to check the signs of readiness.
Once you see the signs, offer baby some food and see what happens.
o
Here are the signs:
§
Doubled birth weight
§
Sitting up and holding head steady
§
Possibly cutting teeth
§
Eating more frequently and still seeming hungry
§
Showing great interest in food (babies at this age
show interest in everything you do, but this is a more intense level of
attention)
o
Here are the signs that your baby is NOT ready:
§
When food goes in the mouth they spit it out
§
Baby keeps mouth closed when presented with food
§
Baby doesn’t look at you when you’re offering
food
·
How often
should I offer food?
o
Start with once a day. Eventually, your child will eat 3 meals and 1
to 2 snacks a day.
o
You know baby is ready for an additional meal
when:
§
Baby reliably eats the meal(s) you are already
offering
§
Baby seems hungrier
§
Baby has great interest in the meal you are
eating
·
When is a
meal over?
o
When baby spits the food out, or
o
Stops looking at you, or
o
Turns head away when you present food, or
o
Does not open mouth when you present food, or
o
Pushes food away
o
If you get these clear signals from your baby,
you know the meal is over.
·
Jars vs
pouches vs homemade vs Baby Led Weaning: How are you going to feed your baby? Hint: it may be a combination of these
options
o
Jars
§
Read labels – make sure you know exactly what you’re
giving baby. Jars typically come in 1st,
2nd, and 3rd foods options, which is primarily an indication
of how liquefied the food is.
§
Don’t double dip your spoon. If baby is not going to finish the jar, dump
some out into a bowl and spoon feed from there.
Double dipping the spoon introduces bacteria that can cause the contents
of the jar to spoil.
§
Keep open jars refrigerated. Discard open jars after 2 to 3 days.
o
Pouches
§
May be lined with BPA, although some claim to be
BPA free (for information on BPA and pthalates, see "Don't Drink the Water"). The packaging materials that
are used may or may not, in my opinion, be healthy for growing bodies.
§
Often have a mix of vegetables and fruit. The fruit content is often somewhat high,
meaning the sugar content is high.
Pouches bypass our normal eating mechanism – eating becomes slurping and
swallowing rather than chewing or gumming and swallowing. Slurping food that is high in fruit allows
the sugar to bathe the teeth and gums, thereby increasing the odds of dental
decay. Here’s a good article on this.
§
Are expensive
§
Can be handy to keep in the diaper bag for
emergency snacks
o
Homemade
§
First foods are runnier than you might
expect. Before making your own, I
recommend you buy one jar of 1st foods to see the consistency.
§
Add water or pumped breast milk to the food to
make it runny enough. Consider water
safety: Are you using water bottled in
plastic (for information on BPA and pthalates, see "Don't Drink the Water")? Do your pipes have lead in
them? How safe and clean is your tap
water? If you are using well water,
discuss this with your child’s provider.
§
Once you know baby likes a food, make a large
batch and freeze in small portions.
o
Baby Led
Weaning
§
“Weaning” is used here with the British meaning
of introducing solid foods
§
You provide baby with appropriate sized pieces
of the food you are eating. For example,
a whole carrot cooked thoroughly enough that it’s easy to smash between your
fingers. Baby gnaws on the food with the
idea that he won’t be able to dislodge a piece large enough to choke on.
§
The theory is that babies learn how to eat like
an adult, bypassing the puree phase.
§
Can be very empowering for babies.
§
Is fairly easy, but messy.
§
Can be a problem with choking babies, or with
babies who don’t master the skills quickly enough to keep up with their
nutritional needs.
§
See http://www.babyledweaning.com/
for more information
Now let’s discuss the million dollar question – what foods
and when? You have 3 main options to
consider: table food, the 3 day wait, and
a delayed food schedule. Choose your
approach after discussing your options with your child’s provider. Remember, if a biological parent has food
allergies, your child is much more likely to have them as well; you must
provide this family history to your child’s provider. Also consider family dynamics when making
your choice; most importantly, who will be feeding the baby?
·
Table
food: Whatever the family is eating
gets pureed and fed to baby. Likely the
easiest option.
·
The 3 day
wait: Give one food at a time and
wait 3 days to see if baby has a reaction to the food. (Reactions are described below.) If there is no reaction, give a new food on
day 4. Wait 3 days, and so on. If there is a reaction, it will be clear what
food caused it. Take that food out of
baby’s diet. Wait for the reaction to
clear completely before introducing any new foods. While you are waiting for the reaction to
clear, continue to breastfeed (or give formula if that’s what you were doing
before) and give foods that baby has not reacted to. If the reaction was mild, reintroduce the
food in 6 months, and it will likely not reoccur. If the reaction was severe, discuss it with
your child’s provider. The 3 day wait
plan can be continued for as long as you feel it’s necessary. Just know that once you go to table food, if
your child has a food reaction, it will be harder to determine which food was
the culprit.
·
The food
schedule: Until recently, most
parents were advised to follow a strict food schedule that delayed allergenic
foods like shellfish, strawberries, nuts, etc until a certain age. The logic for the delay was that babies have
immature gastrointestinal tracts, and allowing them to mature before
introducing the allergenic food would decrease the chances of an allergic
reaction. The idea did not pan out in
research. Not only does the delay not
decrease the chances of an allergic reaction - it might even increase them.
Why follow a food schedule now that we have
this research? Some practitioners,
especially Naturopathic Doctors, still advise a delayed schedule as a way to
prevent food intolerances. Foods that
are commonly delayed are gluten, soy, dairy and corn. Additional foods may also be delayed. Food intolerances are similar to food
allergies, but there are important differences.
Food allergies are scientifically proven immune mediated reactions to a
food that the body believes to be an invader.
Food intolerances are not scientifically proven, and the mechanism for
them is not well understood. They may
include but are not limited to: constipation, gas, bloating, increased mucus or
phlegm, changes in personality, and changes in energy level. The idea is the same as it was for food
allergies: allow the gastrointestinal tract to mature before introducing
potentially problematic foods to decrease the odds of intolerances. The problem is this: by following the delayed
schedule, you are not doing everything you can (based on the research we have)
to decrease your child’s chances of developing food allergies. This option should only be chosen after
careful consideration by you and your doctor.
See my upcoming post on food quality for more
information on first food choices.
Food Reactions
Some babies react to many foods, some react to nothing, and
some react to a few foods in a minor way, or one food in a bigger way. You won’t know which baby you have until you
start introducing foods. If you are giving
table food and baby starts exhibiting signs of a food reaction, it will be
harder to determine what food might be causing the reaction. If you are using the 3 day wait plan, eventually
you will decide to abandon it – either because everything has been introduced,
or because you realize that your child doesn’t tend to react to foods.
Signs of a food reaction include but are not limited to:
Diarrhea / mucous
in stool / green stool
|
||
Constipation
|
Runny or stuffy
nose
|
|
Vomiting
|
Ear infections
|
|
Skin reactions
|
Allergic shiners
(dark circles under eyes)
|
|
Hyperactivity or
lethargy
|
Cough / Sneezing
|
|
Change in
personality
|
Watery eyes
|
|
Note that these signs may mimic a virus, so it might not be
initially clear.
Lip or tongue swelling, hives, wheezing or difficulty breathing or swallowing indicate
anaphylaxis – seek medical attention immediately and avoid repeating
that food.
Miscellaneous
Information
·
AVOID
o
Honey until 1 year of age due to risk of
botulism
o
Choking foods
§
babies under 9 months of age tend to choke
easily
§
finger foods should be introduced around 9
months of age, but these can be choking hazards so use caution
o
Raw meat, fish, eggs, dairy
o
Sugar substitute (stevia ok)
o
Limit salt
o
Caffeine, preservatives
o
Artificial colors and flavors, caution with natural
flavors
o
Be careful with dried fruit – it’s high in sugar
and sticks to the teeth, thereby increasing the chances for tooth decay
o
Juice, soda, high sugar / carb drinks (rice
milk)
·
Offer water from a cup often (throughout day). As above, consider water safety.
·
Dairy products should be whole until 2 years of
age.
·
Strive for organic as much as possible: babies have immature detoxification systems,
and their brains and nervous systems are still developing, so they may be
particularly susceptible to toxins.
Animal products especially should be organic as the toxins they eat bio-accumulate
into the flesh that we eat. Fish should
be low in mercury. “Dirty dozen” produce
should be organic. (See resources for
more information.)
Resources:
Infant CPR classes:
The Dirty Dozen produce list:
Mercury levels in fish:
http://www.nrdc.org/health/effects/mercury/guide.asp
More on food allergies:
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