When Should I Start Giving my Infant Solid Foods?
"When Should I Start Giving my Infant Solid Foods?" This is a question we hear a lot in parent groups.
While there is so much information out there not, all of it may be accurate or safe. This post will aim to summarize the various recommendations given by health organizations in Canada and from other organizations around the world.
This post will explain the following:
Scroll to the end for a summary
Guidelines for Introducing Solids in Canada
The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life. Complimentary foods should be offered at 6 months in order to meet increasing energy and nutrient needs and support growth.
Recommends that infants are introduced to solids at 6 months of age.
Gradually increase the number of complimentary foods that are offered while continuing breast/formula feeding.
Infants should be supervised at all times during feeding
Canadian Pediatric Society
Start at 6 months
Offer lumpy textures no later than 9 months
Offer iron-rich foods a few times a day
Avoid hard, small and round or smooth and sticky solid foods as they can lead to choking
Prepare food safely and do not offer food containing raw or undercooked meat, eggs, poultry or fish.
Dietitians of Canada
Iron rich foods should be the infant’s first complementary foods and offered a few weeks before or just after the 6th month
Common food allergens can be introduced from about 6 months and then continued to be offered regularly
Practice responsive feeding which is feeding that is responsive to infant’s satiety cues
It is also a good idea to offer finger foods when possible, to promote self-feeding
Guidelines for Introducing Solids in the United States
American Academy of Pediatrics
Exclusive breastfeeding for the first 6 months
Start with soft or pureed foods to prevent choking
Include foods that provide iron and zinc
Introduce one single ingredient new food every 3-5 days
Avoid hotdogs, nut, seeds, chunks of meat or cheese, whole grapes, chunks of PB, raw vegetables, fruit chunks such as apple or hard chewy or sticky candy.
Centre for Disease Control and Prevention
Start at 6 months
Look for signs of readiness
Start with mashed, pureed or strained food with smooth texture or foods easily dissolved with saliva and do not require chewing
By 7-8 months your child can eat a variety of different foods from each food group
Wait 3-5 days between new foods.
Start solids at 6 months
Exclusive breastfeeding for first 6 months of life
Not recommended to start before 4 months or after 6 months
First foods should include pureed meats, poultry, beans and iron fortified cereal, especially is baby is primarily breastfed
Start with pureed or mashed foods around 6 months then progress to soft finger foods as chewing and motor skills develop
DO NOT feed solid foods from a bottle
Guidelines for Introducing Solids in the United Kingdom
Scientific Advisory Committee on Nutrition
All infants require solid foods from 6 months for adequate nutrition
Exclusively breastfeed for 6 months when possible
Solids should never be introduced before 4 months
National Health Service (NHS)
No solids before 17 weeks of age
Guidelines for Introducing Solids in Australia
Eat for Health
At around 6 months infants are physiologically and developmentally ready for new foods, textures and modes of feeding
At 6 months infants need more nutrients than can be provided by breastmilk or formula alone
National Health and Medical Research Council
Introduce solids when the infant is physiologically and developmentally ready at around 6 but not before 4 months
Australian Society for Clinical Immunology and Allergy
Include common allergens before 12 months
Baby should start eating solids around 6 months and not before 4 months
Exclusive breastfeeding for the first 3-4 months of life has been shown to decrease risk of food allergies and eczema during first two years of life
Why do Some Guidelines Suggest Introducing Solids at 4 Months?
The consensus seems to be that starting solids at 6 months of age is ideal, yet many recommendations seem to mention the 4-month mark. Often parents get conflicting advice from different health professionals making this question even more confusing. Let’s explore some of the reasons for this discrepancy.
Most babies’ teeth appear between 4-6 months.
Teething is often mistaken as a sign of readiness for solid foods.
Some babies are actually born with teeth while others don’t get teeth until the 1-year mark.
It is important to look for other signs that your baby may be ready for solids.
The American Academy of Pediatrics indicates doubling of birth weight or hitting 13 lbs. to be a sign of readiness for solid foods and this most often happens, you guessed it, around 4 months of age.
It is also important to consider other sign of readiness to be sure.
3. Risk of Allergies
Emerging evidence has shown that early introduction, between 4-6 months of age, of common allergens to high-risk infants may help prevent the development of food allergies.
There is limited information available on whether or not there is a benefit to introducing at 4 months vs 6 months.
The Canadian Paediatric Society recommends introducing non-choking forms of common allergens around 6 months of age.
Many of these guidelines also talk about assessing your child’s readiness. It would seem that the 6-month mark is more of a guideline as opposed to a hard and fast rule. As infants can differ in their rates of development, it is important to look for these signs to ensure they are ready:
· Sitting up with little to no support
· Holding up and controlling head and neck
· Taking an interest in food when others are eating
· Opening mouth and leaning forward when food is offered
· Reaching out and grabbing items and bringing them to their mouth
· When offered food on a spoon tongue does not thrust forward to push out food
Click here for more information on assessing baby's readiness for solids.
Pros. and Cons. of Introducing Solids Before 6 Months
There are some advantages and disadvantages to introducing solids to baby at 4 months of age.
It is a good idea to discuss the pros and cons with a doctor and dietitian to determine how to best meet your unique needs.
What the Research Says:
If your baby is showing signs of readiness at 4 months of age and they are not yet 6 months of age, it is ultimately up to you if you begin to introduce solids. It is important to consider your own unique needs as well as weighing the risks and benefits of your decision:
There are some studies that show the introduction of allergens like wheat or eggs at 4 months reduces the likelihood of the development of food allergies although there is not enough data to warrant recommending 4 months over 6 months.
Infants who experience sensory hypersensitivity may have increased food acceptance when introduced to solids earlier in the 4-6 months range rather than later.
A randomized control trial was conducted to compare iron intake and iron levels of breastfed infants offered iron rich complimentary foods at 4 months and infants who were exclusively breastfed until 6 months. The infants in the 4-month group were found to have higher iron intakes as well as increased hemoglobin, hematocrit and ferritin values than the 6-month group. However, in developed countries, iron deficiency is uncommon in normal birth weight infants who are exclusively breastfed for 6 months so introducing complimentary foods at 4 months may not be necessary.
Infants who are exclusively breastfed for 6 months are less likely to develop GI infections
Popular feeding techniques such as baby led weaning and other responsive approaches emphasize the importance of self-feeding finger foods as opposed to spoon feeding purees. Your baby may be more ready to self-feed closer to 6 months of age.
Mothers of infants who are exclusively breastfed for 6 months may experience prolonged lactation amenorrhea and more rapid postpartum weight loss
Ultimately, the safest option is to introduce solids at 6 months of age.
Emerging evidence found that introducing solids between 4-6 months may reduce the risk of developing food allergies, but the research is inconclusive.
If you feel your child is showing signs of readiness before 6 months, consult with your primary care provider to weigh out the pros and cons.
Disclaimer: All the advice shared here is general information. Consult your doctor for personalized health information. Compiled November, 2021
Special thanks to Sabrina Mastrangelo and Bavina Sivayogeswaran, nutrition graduates from Ryerson University who conducted the research and helped with content development for this post.
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Canadian Pediatric Society (2014). Nutrition for Healthy Term Infants, six to 24 months: An overview.
Cohen, J. (2018). These are the dangers with the new study on solids and sleep for babies. https://www.kidspot.com.au/baby/feeding/weaning/these-are-the-dangers-with-the-new-study-on-solids-and-sleep-for-babies/news-story/f30c0ff845851cb972c22343b7a664fb
Dietitians of Canada (2017). Feeding Infants and Toddlers.
Dietitians of Canada (2017). Food Allergy Prevention in Infants.
Health Canada (2015). Nutrition for Healthy Term Infants: Recommendations from Six to 24 Months.
Huh, Y. S., Rifas-Shiman, L. S., Taveras, M. E., Oken, E., Gillman, W. M. (2011). Timing of solid food introduction and risk of obesity in preschool-aged children. American Academy of Pediatrics. 127(3).
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