For introducing solids to breastfeeding babies there is no one-size-fits-all approach. Often, families research extensively to find the best way to navigate this milestone. In this article, I aim to simplify the process and make it a joyful experience.
You have done an amazing job by focusing on exclusive breastfeeding for the last 6 months. Now, it is time to provide your little one with additional nourishment from complementary foods.
In this article, we will look at my top tips for things to remember when approaching this exciting milestone.
How can I determine if my baby is ready to start eating solid foods?
Before introducing solid foods to your baby, it is important to ensure that they are developmentally ready for this milestone. There are a number of signs that indicate readiness, which include:
- Baby is 6 months old
- Infant can sit unsupported or minimally supported
- Little one has good neck control
- Loss of “tongue extrusion” reflex (push food out with tongue)
Things that are not necessary:
- Teeth
Some parents worry about giving solid foods to babies without teeth. However, there is no need to wait to introduce soft complementary foods. These foods can be easily mashed and eaten without teeth. If you feel more comfortable, you can start with pureed foods instead.
Iron is Important
There are multiple methods for introducing solid foods to your baby, such as baby led weaning, pureed spoon-fed foods, or a combination of both. It is important to note that there is no scientific evidence to support one method over the other. However, it is important to consider that the iron stores in a breastfeeding baby begin to decrease between 4-6 months of age. This makes it essential to start introducing iron-rich foods into your baby’s diet as soon as possible.
In the past, pediatricians suggested rice cereal or infant cereal as a first food due to its ease of feeding and inclusion of fortified iron. However, contemporary recommendations encourage starting with other iron-rich whole foods like meat and/or iron-rich vegetables.
You may be feeling confused since I said that teeth are not important. How is a baby supposed to eat meat without teeth?
One way to introduce meat to your baby is by offering finely ground or shredded meats like chicken or ground beef. Another option is to offer pureed meat from a baby food jar or using your own home blender.
As your baby’s motor skills continue to develop, you can offer larger pieces of meat or incorporate meat into lumpy foods like stew.
Sometimes, it is not love at first bite
Babies have opinions and express them more as they grow. They won’t love every food or accept it right away. It may take several tries. Be patient and don’t lose hope.
My child had difficulty adjusting to solid foods and rejected most of what I offered for the first two months.
It is important to provide a diverse range of food options in order to introduce children to different flavors and textures. This can include fruits, vegetables, grains, and proteins. For example, you can blend vegetables and fruits into purees or cut up soft fruits and cooked vegetables into small, manageable pieces.
Understanding Baby’s Abilities
Babies will reach developmental milestones while introducing solid foods. At first, you can start your baby with one “meal” per day and then increase to several meals per day as they show interest. Eventually, the ultimate goal is to incorporate them into family meal times. While you can start with pureed foods, eventually you want your baby to be eating the same food at the rest of the family.
At around 6 months old, babies exhibit the palmar grasp. This allows them to grab objects with their palm. At this stage, food can be cut up into long “sticks” so that the baby can use their palm to pick it up. By about 9 months old, they develop the pincer grasp. This type of grasp enables them to pick up smaller items between their thumb and their second finger. At this age, you can cut food up into bite sized pieces. No matter what size, always make sure that food is soft enough for your baby not to choke on.
Gagging is a typical occurrence during the initial stages of introducing solid foods, especially when starting with baby led weaning. However, choking is not normal and should be prevented.
Ways to prevent choking:
- Cut up round foods like grapes and hot dogs into fourths
- Don’t serve raw crunchy vegetables
- Make pieces of meat small and soft for your baby
When introducing solids to your baby, pediatricians recommend offering a diverse range of foods. In the past, we have encouraged parents to wait several days between new foods. This is not necessary and the recommendations have changed. Certainly, avoid foods that your baby has reacted to, but if they tolerated it well the first time, then move on to the next food.
Allergy & Food Intolerance
Several years ago, a study found that introducing peanut protein early reduced peanut allergies in children. This information was also applied to other allergenic foods, such as tree nuts, egg, cow milk products, wheat, crustaceans, fish, and soy. It is important to introduce these foods to your baby’s diet as soon as possible. By introducing them individually, you can watch out for any allergic reactions like hives, vomiting, or difficulty breathing.
In order to introduce these foods safely, you should avoid offering whole nuts or a spoonful of sticky peanut butter.
Safer ways to introduce peanut protein:
- Mix powdered or regular peanut butter into yogurt
- Thin peanut butter with breast milk, formula or water
- Peanut puff snacks
Finally, if you have a strong family history of food allergies, consult your baby’s pediatrician before introducing typical allergenic foods. We may send you to the allergist first or advise you to start other foods in the beginning.
Extra Nutrients
While, I typically do not recommend a multi-vitamin for healthy growing babies, vitamin D and iron are something that I recommend. Babies have specific needs for iron and vitamin D. In order to provide these nutrients to your growing baby, offer a variety of foods in addition to breast milk or formula.
Before beginning complimentary foods, babies who are exclusively breastfed need to receive 400 IU of Vitamin D daily in the form of a supplement. On the other hand, if mom is taking extra vitamin D, you may be able to skip supplementing the baby. Research shows that if a breastfeeding mother consumes 6400 IU of Vitamin D daily, her baby will receive enough of this nutrient through breast milk.
Once you start feeding your baby from the table, vitamin D can also be obtained from foods. Fish is a good source of vitamin D as well as dairy foods and other things that are fortified with vitamin D.
Additionally, premature babies may require additional iron due to low stores even in early life. The amount of extra iron needed depends on their diet. Formula contains enough iron, while breast milk is typically low in iron (though it is more easily absorbed by the baby’s body). Once you start complementary foods, it is important to offer iron-rich foods like meat and certain vegetables to your former preemie as part of a nutritious diet. For families looking for a convenient way to increase iron in their baby’s diet, rice cereal or other single-grain, iron-fortified baby cereal can be mixed with human milk and added to their baby’s diet.
Avoid Certain Foods
There are certain foods that you need to avoid at first. For example, babies under 1 year old should not eat honey. It may contain spores of Clostridium botulinum, which can cause infant botulism. Avoid giving your baby anything that is raw or under-cooked, including raw milk. In addition, babies need fat. You can provide extra fat by offering full fat dairy products, like yogurt and cheese. Lastly, as we mentioned earlier, be cautious of foods that babies can choke on easily. This includes round foods like grapes, blueberries and hot dogs. Cut these foods into fourths or smash blueberries with your finger before offering them to your baby. Finally, avoid giving whole nuts and popcorn to your child until they are much older.
I need to emphasize that unpasteurized milk is not recommended for babies or even adults for that matter. This is due to the presence of harmful bacteria like E. coli, salmonella, and Listeria. Pasteurization kills these bacteria while preserving the nutrients in the milk. In order to minimize the risk of food-borne illness, it’s advisable to choose pasteurized milk.
In addition, pediatricians recommend avoiding sugar sweetened foods such as candy, cake and cookies to young babies. We also recommend avoiding juice as well. An occasional indulgence like a smash cake on their birthday is acceptable, but their diet should primarily consist of whole nutritious foods.
When introducing solid foods to your baby, it is important to prioritize their safety and health by avoiding potential risk foods. It is recommended to consult with a pediatrician or healthcare professional for personalized recommendations.
What is the appropriate beverage for babies who are breastfed?
Babies can begin drinking small amounts of water from a sippy cup at around six months old. It is important for infants under the age of one to primarily receive hydration from breast milk, infant formula, and water.
Cow’s milk is not recommended as a beverage for babies until they reach 12 months. It lacks essential nutrients and can be challenging for their digestion. However, other dairy products like cheese and yogurt can be included in a well-rounded diet.
It is best to avoid fruit juice unless it is advised by your baby’s pediatrician for occasional constipation relief. Instead, consider offering mashed or pureed fruits like apples, bananas, and pears, which provide natural sweetness and essential vitamins and fiber.
Keep Breastfeeding
Breast milk or infant formula is recommended as the primary source of nutrition for your baby in their first year. Introducing healthy foods gradually helps them explore diverse tastes and textures while introducing new nutrients.
Breastfeeding should continue past six months for the health benefits of both you and your baby. If you decide to wean at this point, it’s okay. However, the AAP suggests breastfeeding until at least 12 months or longer. Your milk supply may change as your baby begins eating more solid foods. While food for babies is important, they still get most of their nutrition from human milk.
The benefits of breastfeeding are extensive, and the nutrition provided by breast milk remains essential even after 6 months and beyond.
How Can 127 Pediatrics Help You?
At 127 Pediatrics, we offer concierge level pediatric and breastfeeding care. If you are near Colleyville, Texas and would like to know more about our in person services, fill out a contact form on our website for a free meet and greet. If you are not close to our practice, but would like breastfeeding support, we offer an array of services. From free resources like this blog or our YouTube channel all the way up to paid resources such as our online breastfeeding overview course. We would be honored to be part of your breastfeeding journey.
© 127 Pediatrics, January 2024
Please note that this article is purely for informational purposes and should not be interpreted as medical advice.
Dr. Andrea Wadley owns and operates 127 Pediatrics, a pediatric and lactation practice in Colleyville, TX. She specializes in pediatrics, breastfeeding medicine and offers house calls only. Additionally, Dr. Wadley is the owner of the 127 Pediatrics Online Breastfeeding Medicine and Education Center. We have many free resources for breastfeeding mothers. Subscribe to our YouTube channel or download a free breastfeeding checklist.
