Ask Dr. Mom: How to Start Your Child on Solid Food

Common sense rules when it comes to feeding your baby table food. Here’s expert advice on the basics, plus how to deter picky eating and prevent obesity.
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Illustration by Alexander Vidal

Knowing how to best feed your growing child is a common concern. How can you safely introduce solids and encourage healthy eating habits? Pediatrician Roohi Kharofa of Cincinnati Children’s Hospital’s Center for Better Health and Nutrition—and a breastfeeding mother of two—shares practical advice every parent (and grandparent) will appreciate.

When should parents introduce solid food?
Most babies are ready for solid food between 5 and 6 months of age. Signs of readiness include an ability to hold the head up independently, sit up in a high chair, and close their mouth around a spoon, and when they no longer reflexively push things out of their mouth with their tongue. Babies are born with a preference for sweet. It is important to consistently serve vegetables separately (vs. combined in jars with fruit) in order to encourage an appreciation of tastes that are not sweet. When introducing foods, remember to only provide one new food every three days so that if an allergic reaction occurs the trigger can be easily identified. Babies at high risk for peanut allergy due to family history or those with severe eczema may need testing before trying peanut.

Please explain the recommendations for baby-led weaning (BLW).
BLW is a newer concept in the U.S., despite being utilized in other countries over the past decade. BLW can help support the development of motor skills and foster a baby’s awareness of personal hunger cues. There is some concern within the med- ical community that BLW can lead to increased choking. The most recent data supports that choking risk is not increased when BLW is done correctly. Parents need to educate themselves on the types of foods that are appropriate to o er early on. Food has to be presented in thin, soft, easy-to-hold pieces. Additionally, parents should be sitting with their child the whole time. With traditional BLW, parents skip the purees altogether. Many pediatricians, myself included, promote a combined approach to food, starting with spoon-feeding purees but moving on to BLW as a component of feeding when it is developmentally appropriate for the child. An advantage of this is the ability to introduce many tastes and textures prior to 9 months old, which is key to preventing picky eating.

How can parents prevent picky eating?
Babies who eat a variety of food between 6 and 9 months of age are less likely to be picky eaters. Many babies need to be exposed to foods multiple times before accepting them—up to 20! If you exclude foods because they are rejected the first couple of times, you can unintentionally support picky eat- ing. Also, children imitate the behaviors they see, so eat the same foods you want your children to eat. Other suggestions for preventing picky eating include resisting the temptation to make alternative child-friendly meals, not using treats as a way to get children to eat fruits and vegetables, and cutting off snacking one hour before meals.

What are infant feeding recommendations for obesity prevention?
Studies support that breastfeeding reduces the risk of childhood obesity and introduction of solids prior to 4 months of age increases the risk of obesity. All infants should be monitored closely for feeding cues (hands in mouth, rooting, suckling noises). When infants cry, parents often think of hunger first. This is natural—just remember to assess an infant’s other needs as well so as to not get in the habit of soothe feeding. Other suggestions for obesity prevention include making fruits and vegetables part of every meal; minimizing the use of typical child snack foods, as fruits, vegetables, and low-fat dairy are ideal snacks; avoiding juice because infants do not need any; and setting up a routine for meals and snack times to avoid constant grazing throughout the day. Finally, understanding appropriate portion sizes for your child’s age is key.

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