Breast milk or formula is the only food babies need for the first 6 months of life, at which point solid foods can be gradually introduced. Ideally, your baby will be fed only breast milk until 6 months of age. Some babies may be ready for solid foods at 4 or 5 months. Ask your doctor when you can start feeding your baby solid foods. He or she will want to be certain that your baby is physically and developmentally ready. And if a family member has food allergies, ask whether and how to start foods that might cause allergies. Most allergic reactions in children are caused by eggs, milk, wheat, soy, and peanuts.
Although breastfed babies get the best possible nutrition, they will probably need certain vitamin or nutritional supplements to maintain or improve their health. Breastfed babies need 400 IU of vitamin D each day from a supplement. Formula-fed babies may also need a vitamin D supplement, depending on how much formula they drink each day. Talk with your doctor about how much and what sources of vitamin D are right for your baby. After 4 months of age, your baby will probably not get enough iron from breast milk alone. Your doctor may prescribe a liquid iron supplement until your baby gets enough iron from iron-fortified formulas or foods high in iron. Breastfed babies born prematurely may be prescribed a liquid iron supplement by 1 month of age.
Your baby may be ready to start eating solid foods if he or she:
- Is 6 months old.
- Demonstrates a curiosity about solid foods and your family's eating behavior.
- Has started to transition from using the sucking reflex to swallowing and does not push a spoon or other object out with the tongue when it is placed in the mouth.
- Can sit with support.
- Has good head and neck control.
When you and your doctor have determined your baby is ready to start eating solid foods, keep these general guidelines in mind.
- Typically, iron-fortified, single-grain infant cereal is offered first. Then pureed or mashed fruits, vegetables, and meats are offered. The order in which foods are introduced is not critical. But only add one new food at a time, and wait a few days before you add the next new food. Do not add cereal to bottles. Instead, spoon-feed your baby a mixture of cereal and breast milk or formula, gradually making the mixture thicker. Be sure to include foods rich in vitamin C, which helps your baby absorb iron.1
- Feed your baby a small amount—about 1 tsp (5 mL) to 2 tsp (10 mL)—of a new type of food for a few days along with foods he or she has already been eating. Observe your baby before introducing another new food. This is especially important if any family members have food allergies or other allergies.2 This strategy helps you quickly identify a food that may be causing a reaction, such as a rash, vomiting, or diarrhea. Eggs, milk, wheat, soy, and peanuts cause most of the allergic reactions in children.
- If your doctor thinks your baby might be at risk for a peanut allergy, ask him or her about introducing peanut products. There may be a way to prevent peanut allergies.1
- Make sure foods are strained or mashed and that there are no pieces that could cause your baby to choke.
- Begin offering finger foods when your baby has started eating solid foods well. Examples include dry cereal, crunchy toast, well-cooked noodles, small pieces of chicken, scrambled eggs, and small chunks of banana.
- Do not feed your baby directly from the food jar. Instead, put some of the food onto a small dish. That way, germs from your baby's mouth won't get into the jar and spoil the food that is left in the jar.
- When you first start, don't choose foods with mixed textures, such as broth with vegetables. These kinds of meals are the hardest for a baby to eat.
It's best to keep these specific guidelines in mind, too:
- Don't add spices, salt, or sugar to your baby's food.3
- Don't give your baby cow's milk or honey until 1 year of age.
As you introduce new foods, it is important to pay attention to your baby's cues. When your baby's head turns away from a spoonful of food, don't force it. But try again later. Let your baby tell you when he or she is full. Also, it may help to introduce new foods when your baby is well rested and there are no distractions, such as a TV.
As your baby learns to feed himself or herself, keep in mind that your job is to provide a variety of nutritious foods, but your baby will decide how much to eat. It may take more than 10 times before your child accepts a new food.4
Your baby will quickly gain new eating skills, such as chewing, swallowing, and using cups and utensils, at about 6 to 12 months of age. Offer your baby a variety of nutritious foods and gradually allow him or her to explore different tastes and textures. Try to be patient as your baby experiments and learns, and be tolerant of messes. Your baby will likely enjoy playing with a spoon, but most of the food will fall off it. It's natural for your baby to "make a mess" while learning about food. Until your baby can handle a spoon better, you can give your baby a clean spoon to hold while you feed him or her with a different spoon.
To help reduce your cleanup, use a child's high chair that has a detachable tray and raised rims. The rims on the tray help keep dishes and food from sliding off. And you can carry the tray to the sink for cleaning. Cover the seat with a removable, washable pad. Also, think about covering the floor around the high chair. Remember—your child is learning by experimenting.
- American Academy of Pediatrics (2009). Age four months through seven months. In SP Shelov et al., eds., Caring For Your Baby and Young Child: Birth to Age 5, 5th ed., pp. 217–247. New York: Bantam.
- Stettler N, et al. (2011). Feeding healthy infants, children, and adolescents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 160–170. Philadelphia: Saunders.
- Kimmel SR, Ratliff-Schaub K (2011). Growth and development. In RE Rakel, DP Rakel, eds., Textbook of Family Medicine, 8th ed., pp. 421–441. Philadelphia: Saunders.
- American Academy of Pediatrics (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics.
Other Works Consulted
- American Academy of Pediatrics (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics, 126(5): 1040–1050. Available online: http://pediatrics.aappublications.org/cgi/content/full/126/5/1040.
Current as of: December 17, 2020
Author: Healthwise Staff
John Pope MD - Pediatrics
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine