Guide to Introducing Solid Foods

The first year of life holds many challenges for infants and their parents as each day presents a new learning skill for both. Carolyn Vaughn, RD, LDN and Clinical Dietician at Le Bonheur Children's Hospital took time to provide her expertise. Here's what she had to say.

"I like to equate learning to eat with learning a new sport such as snow skiing. Some people learn to ski within their first day of effort while others are on the bunny slopes for a week. This too is how it is with babies and advancing their diets. Some learn to eat with little effort; however, others take much more time and seem to fall down much more often. The goal is to have all children eating a wide variety of foods in a safe manner. To achieve this goal, consider the following recommendations.

The progression of the diet varies depending on whether a baby is breast or formula fed. Babies should breastfeed exclusively for the first 6 months (while taking 400 IU of supplemental vitamin D). This is due to the benefits of consuming the maximum amount of breastmilk during this time period.

Formula fed babies may begin advancing their diets between 4 to 6 months as developmentally appropriate. You can tell if your infant is ready to advance his diet if he has trunk stability and can sit with support, shows an interest in eating and is able to refuse the food offered. A good first food is rice cereal due to the fortification of iron. Add a little breastmilk or formula to the cereal and feed with a spoon adjusting the consistency as your infant learns to manage the textures. Babies do not need any water. As a matter of fact, too much water can lead to serious consequences such as failure to thrive, fussiness and seizures. Cereal should, however, never be added to the bottle due to the risk of excessive weight gain.

After learning to eat cereal, babies are tried on a variety of store bought or homemade baby foods. One new food should be added at a time waiting 4 days in between to make sure no allergies are present. Some recommend giving vegetables before fruits; however, babies will learn to eat both if both are offered consistently. Just remember, this is all new to your infant and like skiing some learn slower than others. It could take 10-12 exposures to a new food before a child will learn to like it. Babies do not need juice, but if you choose to give it, limit the amount to 2-4 ounces per day.

Starting at 8-9 months babies can begin taking meats, yogurts and cheese. Once starting solids, the increase in textures is entirely dependent on your baby's abilities. Some babies advance more quickly than others. Each should be allowed and encouraged to explore new tastes and textures at their own rate. This can be done by putting a small amount of food on your baby's lips. If he wants more, he will let you know by turning to the spoon and opening his mouth.

Don't be discouraged if he refuses more, he might not be hungry or might just need to get used to the taste. Try again several times over the course of the next few days. Once your baby can begin feeding himself, give small pieces of foods that are too small to obstruct his airway but big enough for him to hold onto.

Gradually offer more and more variety eventually giving foods that you are eating. Babies enjoy using spoons, so give them a spoon even if they can't use it on their own. Try getting behind them and holding your hand over theirs to help. Expect your baby to gag and throw up occasionally while learning to eat solid foods. This is normal. Like learning to ski, sometimes we fall down. As the parent, try not to express openly your concern. Just clean up the mess and give it another try.

Some parents ask about putting babies on a schedule to eat. Until babies are eating meals with the family, it is best to let his appetite determine when to eat and how much to eat. Babies know how much they are hungry for and should never be encouraged to finish a jar of food or a bottle of formula. This is one benefit to breastfeeding - babies eat when hungry and stop when full. Parents learn to trust their baby's appetites. Babies should also be fed in a high chair once they can sit up alone. Avoid all distractions and make mealtime a pleasant occasion.

Parents also ask about how to avoid allergies. New recommendations have been released addressing this issue. Formula feeding increases the incidence of developing allergies. Previously it was recommended to wait until at least 12 months before introducing common food allergens. However, this has changed. Delaying introduction of solids until after 6 months of age does not provide a protective effect and this includes potentially allergenic foods (eggs, peanut and fish). There is lack of data to support a protective effect of any dietary intervention in infants after 6 months of age for prevention of allergies.

After 12 months, whole milk can be offered instead of formula as long as the baby's diet consists of at least 50% of solid foods and a wide variety. Babies are developmentally ready to advance to a cup starting around 6 months. Work on getting your baby off the bottle and on to a cup at this time. Remember that babies advance with this at different rates as well. Some will take several months to get on a cup and others will go straight to a cup. This is especially helpful for exclusively breastfed babies who do not take a bottle.

To sum it up, all babies are different and advance in acquiring eating skills at different rates. Follow your baby's cues to determine how quickly to advance the diet. Before you know it, your baby will be eating a wide variety of foods with the family and loving it."