Q&A: How to tell if your little one is ready to start solid food

Question: When will our baby be ready to start eating solid food? What foods are best to feed a child at this early stage of development?

Answer:

There are no hard-and-fast rules here, but most babies are given their first taste of foods other than breast milk or formula somewhere between four and six months of age. Before you decide to let your baby try something solid, make sure that he is developmentally ready for the transition. Here are some signs to watch for:

• While sucking at the breast or bottle, a newborn first protrudes his tongue, pushing it against the nipple as he sucks and swallows. This tongue-thrusting reflex, which gradually subsides over the first six months, interferes with the process of taking food from a spoon and moving it into the throat. A baby who repeatedly pushes his tongue against the spoon probably isn't ready for solids.
  
  
• Accepting food from a spoon is much easier for a baby who can control his head position, a skill which will be far better developed after six months than at three or four. A young baby whose head flops everywhere if not supported should be given more time with just breast or bottle feedings.
  
  
• By six months of age, your baby will be happily grabbing everything in sight and putting it into his mouth. This suggests that he will find a spoon worth exploring as well.
  
  
• If a couple of teeth erupt before six months of age (the usual time of the first appearance of teeth), this in itself is not necessarily a sign that your baby is ready for something like pizza. He won't use his teeth to chew food yet for some months. On the other hand, even if he still doesn't have teeth at the six-month mark, he will be quite able to swallow the mushy solids you'll be feeding him.

Setting the stage

If all these signs are present, you should take a few moments to consider the timing and setting of your child's first experience with solids. Pick a time when you aren't going to be rushed or hassled. Turn off the phone for good measure. Your baby shouldn't be tired, cranky, ravenously hungry or completely full. Provide a partial feeding of breast milk or formula before trying the new stuff. Remember that when you begin solids, they will only supplement milk feedings, not replace them.

What food and how much?

What should you start with? The general consensus is that rice cereal specifically formulated for babies is best. It is easily absorbed, contains iron and rarely causes allergic reactions. Whether premixed in a jar or prepared by you with water or formula, it can be adjusted to whatever thickness your baby prefers. You can obtain many foods in a prepackaged form at the store, or you can prepare them yourself. Foods do not need to be hot; room temperature or slightly warm is just fine for most babies.

To begin with, offer your child about half of a small baby spoonful (about a quarter teaspoon or one ml). He may not know what to do with it, and may even appear to reject it with a grimace. Talk to him in soothing tones throughout the process. When he gets the hang of swallowing this amount, he'll start opening his mouth in anticipation of more. Aim for a total of about one tablespoon (15 ml) once a day, gradually increasing to two or three tablespoons (30 to 45 ml) per feeding once or twice a day. If he simply refuses or repeatedly thrusts out his tongue, don't force the issue. Simply wait and try again in a week or two. Refrigerate whatever remains in the jar – it will be good for a day (or a month if left in the freezer). Whatever he leaves on his plate should be thrown away.

Introducing other foods

When you've been successful with the rice, you can try other cereals. Oats and barley are good for the next round, but check with your pediatrician before trying corn or wheat cereals, which may provoke digestive problems in some infants. After that you can think about moving on to vegetables and fruits. Meats should be introduced last. Let your baby try each new food (one to three tablespoons or 15 to 45 ml) for a few days before introducing another. Watch for signs of a reaction: diarrhea, irritability, runny nose, coughing or wheezing, or a rash. If any feeding is followed by a more severe reaction, such as an immediate rash or difficulty breathing, contact the doctor right away. Fortunately, sudden and intense reactions to foods are very uncommon at this age.

Here are a few additional cautions about foods and feeding:

• Do not feed honey to your baby. Infants younger than twelve months who eat honey may develop infant botulism, a form of food poisoning that can cause serious damage to the nervous system and, in rare cases, death.
  
  
• Keep your baby on breast milk or infant formula rather than milk from the dairy case.
  
  
• Steer clear of fruit juices, punch or other sweetened drinks. Some babies may become so enamored of sweet liquids that they will favour them over more nutritious sources of calories.
  
  
• Don't feed your baby foods with added salt or sugar or spicy flavours.
  
  
• Avoid feeding your baby certain vegetables that you have prepared yourself. Commercial baby food preparations of these vegetables are made from produce that has been screened for nitrates, which can be toxic to young infants.
  
  
• To avoid excessive weight gain, don't let your baby become a grazer. Instead, keep him on a regular feeding schedule.