Mashed squash, pureed peas, banana, avocado — oh, yes — the good stuff. You may be looking forward to the moment when you can give your baby these solid foods for the first time. But when is the best time to begin? What foods should you start with or avoid? What changes can you expect during the transition?

In this article, we will answer each of these questions in turn and provide the most up-to-date recommendations for starting your baby on solid foods.

When should you start?

Although there has been some discussion about starting babies on solid foods earlier, the American Academy of Pediatrics (AAP) has reaffirmed that it should begin at six months. Babies at this age should be able to keep their heads up and sit up in a high chair or feeding chair. Signs of readiness include showing interest in foods, reaching for foods and being excited to eat. They should also be able to remove food from a spoon with their mouth and swallow it without struggling. If more food seems to end up in their lap than in their mouth, don’t worry — messiness is normal!

If your baby does not seem ready, give it a few more weeks and try again. If there is still no improvement, then it is time to see a pediatrician.

Which foods should you introduce?

In short, you can start with any food you choose. The only exception is honey. We recommend avoiding honey until one year of age to avoid infant botulism. In addition, be sure to include meat and iron-fortified cereals to ensure your baby gets enough iron.

In terms of consistency, start with pureed or soft foods to prevent choking. Once your baby is comfortable with pureed foods, pay attention to the signs that they are developmentally ready for finger foods. Signs of readiness include the ability to bring their hand to their mouth and the ability to pick up small foods, like puffs or cheerios. These signs show your baby should be able to eat finger foods without choking. However, we still recommend cutting foods into small pieces and choosing soft foods that are less likely to cause choking.

What about allergies?

When it comes to allergies, it is recommended to start with a wide variety of foods early on — especially peanuts, eggs, dairy and fish — as children are less likely to develop an allergy if they are exposed sooner rather than later. It is also recommended that you introduce a new food every three to five days. That way, if your baby does react to something, you can identify which food caused the reaction. If your baby has severe eczema, or if there is a family history of an allergy, you might want to do allergy testing before starting those foods. 

How should you alternate with breastfeeding?

While introducing solid food, your baby should continue to drink either breastmilk or formula until at least one year of age. Avoid other types of liquids unless directed by your pediatrician. Follow your baby’s cues: Some babies will want to eat large amounts of solid foods, while others will take more time. It is usually best to start a feeding session with solid food and then top it off with breastmilk or formula until the baby is content. If your baby is hungry or fussy, it could be helpful to start with breastfeeding or formula, pause to offer solid foods, then return to breastfeeding or formula. The best indicator your baby is getting enough nutrition is appropriate weight gain.

What changes can you expect?

Don’t be surprised to see — and smell — certain changes in your baby’s stools. When starting solid foods, stools often become more solid and have a stronger odor. Additionally, there is usually a change in color, depending on the foods your baby eats. This is normal. However, if the stools become red, bloody, dark black or colorless, there is cause for concern and you will need to see the pediatrician. 

Further, constipation may occur when starting your baby on solids. Signs of constipation include hard or large stools as well as discomfort or straining with stooling. Call your pediatrician if this occurs.

These recommendations should guide you on your journey of starting your baby on solid foods. However, if you ever have questions or concerns or seem to be having trouble with the transition, Utah Valley Pediatrics is here to help. Give us a call to schedule a visit with one of our top-notch pediatricians. We will gladly assist!

Dr. Scott Stroshine is a pediatrician at Utah Valley Pediatrics, which serves Utah families in nine locations throughout Utah Valley.

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