Divining the Mysteries of Infant Solid Foods (1): Puree Beginnings

If you are reading this, you are likely the parent of a 3 to 4 month old baby, alternately thrilled, then terrified at the prospect of introducing solids. You are not alone! I would submit that even my professional organization, the American Academy of Pediatrics, (AAP) has repeatedly revised its recommendations. 🙂

Let’s start with “when?” Over the course of my career, experts have said “start” as early as 2 months, and as late as 6 months. The consensus now seems to be about 4 months, but I recommend watching for two developmental signs before starting solids. First, Natalie will start watching food as it whizzes past her face on the way from your plate to your mouth (visual interest). Soon thereafter, she will start reaching for that spoon of food (motor interest). Those two milestones of visual and motor interest suggest readiness for pureed solids and usually occur around 4 months in full-term babies.

Now “what?” For years, Rice Cereal has been the go-to first solid. Alas, life is complicated: In the 1950s, when iron-fortified formula wasn’t widely used, the Federal Government mandated that rice cereal, along with all other cereals marketed for infants, be fortified with iron. Now, all infants who aren’t breast-fed have access to iron-fortified formula. If your son is strictly breast fed, the AAP recommends he receive iron supplementation starting at 4 months of age. Iron stores transferred from mom to child in the last 6 weeks of pregnancy are depleted by then, and there is insufficient iron in either breast milk or cereals to replace it. Infants who got daily supplementation with iron drops, called ferrous sulfate, had higher intelligence and visual scores at 13 months of age. Ask your doctor about this. 🙂

Now on to the good stuff: Until 6 months, Breast Milk or formula should be the primary nutritional source for your baby, but purees, offered once a day, will be a source of pure joy for most infants. Many parents puree their own fruits and vegetables (no added salt or sugar please) and freeze them in ice-cube trays. You’ll quickly figure out if one or two cubes a day will keep Rebecca happy.

If you buy commercial products like Gerber, a 2-ounce jar will typically be enough for two days. The AAP suggests waiting a full week between each new food. I ask if there is any family history of food allergy, especially in siblings or parents, and if so, definitely recommend waiting a week until the next food. But if there is no family history of allergy to foods, one could introduce a new solid every other day. So 2 days on that jar of peaches, then 2 days on the squash. 🙂 Grandma may tell you always start with boring vegetables first, as the baby may treat fruits like candy. It turns out that all infants will learn to like virtually any food after 10 tastes. So if sweet potatoes are a bust the first time, simply keep them in your ever-expanding rotation, and soon, they will be a joy for Melissa to behold.

Now this will blow you away: Highly allergic foods, like eggs, and peanuts and nuts, strawberries, wheat, fish, shellfish and cow’s milk have long been excluded from infants’ diets until a year of age. Early introduction was believed to increase the risk of allergy. It turns out that the opposite is true: children introduced as early as 4 months of age to these as complimentary foods (that is, not the bulk of the diet) are, in fact, LESS likely to later develop allergy to those foods. So once your baby has handled a variety of pureed baby foods, slipping in a few spoonfuls of scrambled egg, or your cornflakes with cow’s milk, or clam chowder would be fine. However , honey, which contains spores which can cause paralysis from botulism, should not be introduced until 1 year of age.

A final thought: Introduction of infant solids should be an absolute joy for baby and parent. If you feel like Andrew was ready for solids (reaching for your food), yet every time you introduce a spoonful of food to his mouth, he seems to avoid the spoon, it may be that he clearly wants to spend quality time with you, but isn’t yet ready for the solids. No worries: wait a week and try it again. 🙂