Starting your baby on solid foods

Starting your baby on solid foods can leave you wondering when the right time is and how to begin. The term "solid foods" means foods for baby other than breast milk or formula. These foods are soft, liquid or pureed. (The word puree refers to a paste or thick liquid that is made by grinding up certain foods.)

When to start solid foods

There's no exact time when your baby should begin solid foods. Every baby is different. But moms and dads can look for certain signs (developmental cues) that will help you know that your baby is ready.

In the first 4 months of life, babies only need breast milk (if they are breastfed) or formula (if they are bottle fed). In fact, the American Academy of Pediatrics recommends that breastfed babies get only breast milk for the first 6 months of life and continue getting breast milk along with solid foods for up to age 12 months. But some babies might be ready to start some solid foods between 4 to 6 months of age.

During pregnancy, your baby got all of her nutrients and vitamins from the food you ate and the vitamins you took. Once your baby was born, all those extra vitamins and nutrients were stored in her body to help her grow. As your baby gets bigger, those extra vitamins start to lessen. When your baby is between 4-6 months, she may begin to show signs that she is ready to try some solid foods. However, don't rush to start your baby on solid foods. Just watch for her developmental cues and she'll let you know when she's ready.

When introducing solid foods to your baby, it's important to know that solid foods are meant to complement your baby's overall nutrition, not replace breast milk or formula. During this transition, your baby's primary source of nutrition should still be breast milk or, if he is bottle-fed, formula.

Learning baby's signs

As you spend time with your baby, you will learn to read her developmental cues. These cues are signs that tell you how your baby is growing, both mentally and physically. Understanding your baby's developmental cues is an important step in knowing when she is ready to begin eating solid foods. Remember: Even after your baby begins solid foods, she should continue eating breast milk or formula for the first 12 months.

To help you find out if your baby is ready for solid foods, use this guide to learn about your baby's developmental cues.

0-4 months of age

Developmental cues for baby

• The baby turns his head toward anything that brushes his cheek.
• He has a strong reflex, called extrusion, to push things out of her mouth with his tongue. This tongue-thrust reflex means he's not ready to eat anything other than breast milk or formula.

What baby can eat

• Breast milk or infant formula only (no solid foods)

How much baby can eat

• Newborns typically want to eat every 2 to 3 hours.
• By the end of the fourth month, your baby may want to eat every 4 hours.
• When he's full, he will stop sucking and he will be relaxed and sleepy.

4-6 months of age

Developmental cues for baby

• The extrusion reflex goes away. The baby develops the ability to eat non-liquid foods.
• She may show a desire for food by opening her mouth, drooling and leaning forward.
• She begins to chew and brings her hands to her mouth.
• She begins to handle objects with the palm of her hand.

What baby can eat

• Iron-fortified cereals (such as rice, barley and oatmeal) mixed with breast milk or infant formula (It's best to start with rice cereal, since it's less likely to cause an allergic reaction.)
• Breast milk or infant formula

How much baby can eat

• Your baby will only eat a little bit of solid foods at the beginning.
• Start with 1 tablespoon of cereal combined with 3 tablespoons of breast milk or infant formula once a day.
• Little by little, increase the amount of cereal to 3 to 4 tablespoons mixed with breast milk or infant formula once or twice a day. Remember: You can choose how thick to make the mixture by adding more breast milk or infant formula.

6-8 months of age

Developmental cues for baby

• The baby begins to sit upright with support.
• He feeds himself finger foods.
• He develops the ability to pick up foods with a pincer (finger-to-thumb) grasp.

What baby can eat

• Pureed and textured cooked vegetables and fruits (start baby on one food at a time to see if there are any allergic reactions)
• Unsweetened, non-citrus juices, such as pasteurized apple or grape, mixed with water from a cup
• Breast milk or infant formula

How much baby can eat

• Begin with 1 tablespoon of a fruit or vegetable once a day.
• Slowly increase to three solid foods meals a day, with each meal being about the size of baby's fist.
• Mix juices with water (1 part juice and 1 part water). Do not substitute breast milk or formula for water.
• Do not give your baby more than 4 ounces of juice per day.

8-10 months of age

Developmental cues for baby

• The baby begins to hold her bottle.
• She reaches for and grabs food and her spoon.
• She sits upright unsupported.

What baby can eat

• Breads and cereals
• Yogurt
• Soft, cooked vegetables, such as squash, peas, green beans and carrots
• Cooked fruit, such as peaches, apples and pears
• Very finely cut or pureed meats, fish, casseroles, cheese, cooked egg yolks as well as mashed legumes
• Breast milk or formula

Note: If you give your baby canned fruits or vegetables, be sure they come with no added salt or sugar.

How much baby can eat

• When you first introduce meat and fish to your baby, expect her to only eat about 1 teaspoon a day.
• Little by little, offer more meat and fish to your baby, giving her as much as 1 to 2 tablespoons of meat a day.
• Baby can eat small portions (1 teaspoon to 1 tablespoon) from the other suggested foods each day.
• Feed baby three solid foods meals a day, with each meal being about the size of baby's fist.

Note: Watch for signs of food allergy when first introducing fish and wheat-containing products, such as bread and crackers.

9-12 months of age

Developmental cues for baby

• The baby begins to use a spoon correctly, but spilling may still occur.

What baby can eat

• Each solid food meal should have iron-fortified cereal, a fruit or vegetable and some finger foods
• Breast milk or formula

How much baby can eat

• Offer your baby 1 tablespoon of each food group at each meal. The main food groups are grains, vegetables, fruits, milk, and meat and beans.
• Feed baby three solid foods meals a day, with each meal being about the size of baby's fist.

First foods

When picking foods to feed your baby, make sure they are foods that he is able to eat and digest. Cereals are easy for babies to digest and can be mixed with breast milk or infant formula to be thick or thin, depending on what your baby is able to eat. Again, it's best to start with rice cereal because it is gluten-free. This means there is less chance of causing an allergic reaction.

Once your baby is ready for finger foods, try giving him:

• Crackers
• Cooked macaroni
• Bread
• Well-cooked and cut-up potatoes
• Small pieces of cooked soft vegetables
• Small pieces of soft fruit
• Small pieces of meat

Sweets and salts

Avoid giving your baby too much sugar. Excess sugar can cause tooth decay and adds unnecessary calories. Every food you give your baby should be nutritious to promote healthy habits. If your baby gets used to sweet flavors, she might reject healthier food options later on.

Also, keep baby away from foods with added salt or seasoning. Although the foods may taste bland to you, she will find the natural flavors stimulating!

Making the transition

It's important for your baby to feel comfortable sitting up, eating from a spoon, taking breaks between bites and stopping when he feels full.

Use a spoon.

• Make sure to start with a quarter to half of a teaspoon of food per bite.

Talk to your baby.

• Your baby needs to hear your encouragement so that he knows he's doing it right.
• Tell your baby "Yummy, this tastes so good!" and have a bite yourself.
• When you show your baby what to do, he is more likely to understand and follow your behavior.

Be sure the baby is sitting comfortably.

• Try to find a place where you and baby can both be comfortable.
• If baby is already sitting up, you can put him in the high chair.
• If he is still learning how to sit upright, try having him sit on your lap.
• Seating him in an infant carrier or motionless swing can also work.
• It's fine if he is slightly reclined, but make sure he is upright enough to avoid choking.

Introduce new foods slowly.

• It's a good idea to wait 4 to 5 days before you introduce a new food to your baby.
• By giving your baby one kind of food at a time, you'll be able to tell which food caused an allergic reaction if one occurs.
• Introducing new foods slowly allows your baby to become comfortable with the new foods.

Offer appropriates sizes.

• Give your baby the right size and amount of food that you want him to eat.
• In general, this means baby should eat solids around three times a day, and each meal should be about the size of his fist.
• Meats, fruits, vegetables and anything large can cause choking. Cut food into small pieces that he can manage.
• Make sure foods that need to be cooked are cooked thoroughly.

Watch for signs of fullness.

• Your baby will let you know that he is full by turning away or leaning back.
• He may also start to fuss if you force him to eat when he is no longer hungry.
• Follow your baby's cues to avoid overfeeding or underfeeding.
• This will also help avoid a pattern of overeating (and potentially being overweight) in his childhood.

Foods to avoid

Some infants may feel ill or have allergic reactions to foods that don't affect your other children. After you introduce a new food, watch for signs like diarrhea, rash or vomiting. If your baby has any of these signs or any other signals that concern you, speak with your baby's health provider before giving her this food again. The health provider will help you find out if your baby is allergic to this food.

In your baby's first year, avoid feeding her:

• Egg whites
• Citrus fruits or juices
• Cow's milk
• Honey (this may contain bacteria that can develop into a toxic illness called botulism, which can be very dangerous to infants)

Prevent choking

To prevent choking, do not feed your baby:

• Uncut or large foods (all foods should be cut or mashed into very small pieces for baby)
• Raw vegetables
• Raisins
• Cherries
• Gum
• Hard candy
• Hot dog slices
• Marshmallows
• Nuts
• Peanut butter
• Popcorn
• Whole beans
• Whole grapes

In general, it's best for children under age 4 to avoid foods that are round and firm, unless these foods are cut into very small, chewable pieces.

Be sure to keep your baby away from:

• Coins
• Small balls
• Balloons
• Pen tops
• Other potential choking hazards

Remember

• Although you're starting your baby on solid foods, you don't need to wean him from breast milk right away. Some babies may no longer have an interest in breastfeeding after 1 year of age. But breastfeeding can continue beyond the first year of life if mother and child wish.
• Don't feed your baby solid or pureed foods through his bottle. This takes away from your baby's overall learning about how to hold and eat foods. It can also put him at risk for eating too much and becoming overweight. It's best to use a teaspoon to feed your baby solid foods. Also, feeding baby with a spoon plays an important role in your baby's language development.
• Do not give your baby cow's milk until he is at least 1 year old. At age 1, cow's milk can become a major source of essential nutrients for your baby. Babies should be given whole milk until age 2.
• Do not give food or sweets to your baby as a reward for good behavior. Instead reward him with praise, kisses, love and attention.
• Practice good oral hygiene for your baby right away. As soon as he has teeth, start cleaning them with a small wet washcloth.