Solid Foods Parents often ask for the equation: what order of foods, how many times per day and exactly how much. Do you want to know the secret formula to starting solids? Here it is: there isn’t one! Pediatricians used to give handouts on the order of foods, how much a baby should be eating and how many servings per day. Doctors weren’t the only ones in on it of course. Everyone seems to have an opinion when it comes to telling you how to take care of your baby. Here is what I advise parents: Watch your baby. A baby may be ready to try a solid food when they are strong, rolling over and holding their head up well. They may seem very interested in what everyone else in the family is eating. If these things are happening, a baby might be ready to start (usually between four and six months) but don’t expect it to go too well: babies have a natural tongue thrust reflex to help them with breastfeeding and this usually pushes solid foods right back out. If your baby isn’t getting it, don’t worry and don’t fight! They are still getting all the calories they need from breast milk or formula. Early Food Introduction and Obesity A few points on bottle feeding and solids to point out: New research is pointing to a link between starting solids early and obesity later on in formula fed babies (the correlation doesn’t seem to cross over to breast fed babies). As we are in the midst of an obesity epidemic in this country, this is important research. Of course good diet and exercise are critical at all stages of life, but are we starting some kids off at a disadvantage during the first year of life? Based on this research I wouldn’t be in a rush to start solids. I said there is no secret formula but we are evolving some basic rules. So the first of these is, ‘don’t rush it.’ This is particularly true when grandma or a friend down the street urges you to put some rice cereal in the bottle to help the baby sleep. There is no need for these extra calories (unless it is a plan you have made with your doctor) and it may be putting a child at an unfair disadvantage for life by increasing the risk of obesity. The Order to Start Foods So we don’t start too early and we watch the baby for signs of readiness but when we do start, there is an order, right? White rice cereal, then veggies, then fruits, then meat after 9 months and hold off on anything that might cause an allergy, right? Wrong. I can’t point to any concrete research to tell you what order to start foods because there isn’t any. If you want to breastfeed a baby through the six month mark without any other foods, this is perfectly fine and is probably a very healthy choice. At some point a baby will start reaching for solids. Common sense tells us it is probably a good idea to go one at a time in case the baby has an allergic reaction so we know what caused it. I would also urge you to use natural fruits, vegetables and grains, not refined white cereal to start. As a baby develops, we add textures and soften table foods. A six month old can’t eat a pork chop obviously but there is no reason not to introduce a baby to real foods, foods that you as parents eat, when they are ready. Why are we brainwashed by food manufacturers into feeding children a ‘kid’s diet’ of refined sugar and carbohydrate? Our collective nationwide taste for refined carbohydrates, simple sugars, and fats are a big part of the obesity problem. I recently saw a seven year old boy who, according to mom only ate four foods (I had already guessed two of them before she opened her mouth): chicken nuggets, pancakes, frozen pizza and juice. He refused any other kind of food. This otherwise healthy child had been labeled failure to thrive before his second birthday so mom would do whatever was necessary to get him to eat and this meant caving in to an atrociously unhealthy diet. When I talk to parents about attention and behavior I refer to television and video games as short circuits: things that short circuit a developing mind with instant stimuli and rewards making the real world drab by comparison. These refined unhealthy foods are the same thing for our taste buds: short circuits that override our enjoyment of the types of food nature intended us to consume. Breast fed Babies and Iron For a breast fed baby, iron stores can begin to run low over the second half of the first year. More than likely, a baby will show interest in foods by this point and the introduction of green leafy vegetables and meats (in puree form) can shore up these stores. Juice While juice is technically not a solid food, it is one of the sources of calories parents often ask about. The AAP says you can start juice at 6 months, if you want to, and from a sippy cup only. My question is, ‘why would you want to?’ Juice is sugary and delicious and infants and toddlers would love nothing more than to run around all day with a bottle of juice in their mouths. Overuse of fruit juice comes with a stiff price tag: lots of unnecessary calories, dental caries, and the replacement of other more nourishing foods the child should be consuming instead. Why offer juice in a sippy cup when you can offer something healthier like pumped milk or water. These are better options and do not turn toddlers into ‘juice addicts.’ Too much juice also leads to diarrhea. Enough said. Allergenic Foods When it comes to food allergies, opinions are shifting here as well. If there is a family history of food allergies, I would hold and consult with a doctor but the old advice to delay allergenic foods for all babies is out the window and may have been contributing to the problem of increasing rates of allergy. Summary Babies really are not ready for solids before four months but after that it is up to you. Avoid honey and cow’s milk in children under one year. Avoid foods that you know there is a history of food allergy to in the family. You don’t have to, but I recommend avoiding juice. Beyond that, it is really up to you: you decide how and when to feed your own baby. There are no set ounces or servings per day. Make good choices and introduce your baby to natural foods when they are receptive. For more, see Sarah’s Guide to Starting Solids. Matthew Toohey, MD. July 2011.