Parentpedia

What Experts Say

Out of seemingly nowhere, your breast- or bottle-fed baby suddenly locks her gaze on your hand as you spoon cereal from your bowl. What's going on here? As early as 4 months of age and usually by 6 months, babies begin to notice food. It's a clue that while breast milk or infant formula will continue to be her mainstay, she's ready to supplement her liquid diet with solid foods.

Opinions vary on the ideal first food for babies. The American Academy of Pediatrics (AAP), the Association of Family Physicians, and other experts have long recommended iron-fortified infant rice cereal. Most babies digest and tolerate it well, and it's easy to mix the cereal to the consistency she needs, plus it contains key vitamins and minerals plus iron. However, the AAP is rethinking its stance on this.

"Red meats are a much better source of iron than iron-fortified rice cereal, and some nutritionists are suggesting that red meats may be a better source of nutrients for infants than rice cereal," reports Frank Greer, M.D., chairman of the AAP's committee on nutrition.

Natural and holistic health parenting experts often promote mild fruits and vegetables such as pureed banana, avocado, or sweet potato as good starter foods because they are easy to digest. Some advise holding off on all grains, including rice, because of concerns of allergy and digestion trouble. Still others advise parents to choose a food that's similar in taste to what your baby is used to drinking.

"If your baby is used to the sweet taste of human milk, start with mashed bananas," recommends Williams Sears, M.D. "If baby is used to the more bland flavor of formula, try rice cereal mixed with formula."

Whatever you intend to start with, consult your doctor before introducing solid foods. Expect a range of opinion on exactly when this should happen. The AAP, the Association of Family Physicians, and some natural parenting experts advise parents to wait until your baby is 6 months of age. Babies get all the nutrition they need from breast milk or fortified formula, and, by waiting, your baby lowers her chances of developing a food allergy. Others say it's okay to start as early as 4 months if your baby's developmentally ready and interested.

How will you know? Before she can safely start solids, your baby should be sitting securely and have control of her head and neck. Look for the tongue thrust reflex (a touch on the lips results in the tongue pushing out of her mouth) and the gag reflex (coughing if a foreign object like a spoon moves into her mouth) -- two reflexes that prevent choking -- to diminish, usually between 4 and 6 months. She should also show an interest in food by watching you eat or reaching for your meal.

When you start, keep the focus on introducing new tastes, not filling her up. She'll continue to get most of her nutrition from her liquid diet, so take it slow, and follow her cues. Repeatedly pushing food out with her tongue, closing her mouth, or pushing away the spoon are signs to give it a rest and try it again in a few days.

Some recommend offering first foods by your (clean) finger before introducing a small, baby-size spoon.

Once you have the go-ahead from your pediatrician, here's how to get started.

• Introduce one new food at a time, and wait three days to one week before adding another. Watch for signs of an allergic reaction, which may include crankiness, gassiness, vomiting, or an increase in spit-up, diarrhea, rashes, and, in severe cases, difficulty breathing or shock. Post a list of the foods you've introduced on your fridge to help you keep track.
• Set your expectations for meal number one. Your baby needs time to practice taking food from a spoon or your finger. More will wind up on her lips, chin, and bib than in her mouth, but if she?s ready and interested, she'll learn quickly.
• Start small. Your baby needs only small amounts -- a teaspoon or two -- at first. You can gradually increase servings over time to about 1/4 cup.
• Start with solid food just once a day, when you've got plenty of time. By 9 months of age, most babies are eating solids three times a day.