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Posted by on May 23, 2011 in Children's Health, Help for Parents, New Parents, The First Year of Life | 28 comments

6 Myths: Starting Solid Foods

At the 6-month check up, nearly all of my patient families want to talk about starting their babies on solid food. The conversations usually start like this…

“I go get all of Gerber stage 1 foods and then do all the greens, then the yellows, then the fruit. After she eats all of the stage 1 foods, then she goes on to stage 2, right?”

Or this…

“I have gone to the farmer’s market and bought all organic produce to make his baby food. I am following the [insert name here] recipe book that I got from a friend, and their baby is such a great eater. Do you think bulgar wheat or quinoa is better?”

Or this…

“I have already given some rice porridge with scrambled egg, and some broth with root vegetables. Can I start tofu now?”

As these real-life conversations demonstrate, the plan and expectation for introducing solid food to babies is different for every family. The food items that parents first feed children is influenced more by culture and generational upbringing, than by any scientific research or product marketing plan.

And, that’s OK!  In fact, it’s wonderfully liberating news for parents who are really stressed out about first foods.

So, what are my general guidelines when it comes to starting infants on solid foods?

  • I encourage the families of healthy, normally-developing children* to start solids near or after 6 months of age.
  • I want parents to give babies a great variety of real food, in a safe way.
  • I think of pureed foods as practice and play to develop the skill of eating; nutrition is still from breast milk or formula.
  • I try to challenge my families to think outside of the Gerber-defined box and give babies interesting tastes, but no raw honey until after the first birthday.

That’s it. Go. Eat.

Wait a minute…. There has to be more. What about the rule about veggies first? Babies can’t have dairy, right? What about spicy stuff? They aren’t supposed to have strawberries or oranges, either!? My mom wanted to give her yogurt, and I told her “no.” Please don’t tell me she is right!?! And you have said nothing about rice cereal.

OK, so maybe there is a little bit more. But, likely not what you expect. When continuing the food conversation with families, some common myths creep to the surface.

It’s tIme to bust some common “starting solid food myths” … for good!

Myth #1: Rice cereal must be first.

Rice cereal has traditionally been the first food for babies in the United States for generations. But, why rice cereal? It is convenient – easy to obtain and easy to feed. Baby cereal is also fortified with iron and other nutrients. This promoted as a benefit for those infants who need some supplemental vitamins and minerals in their diet. Click here for information about iron recommendations for infants.

Giving rice cereal as a first food is under active debate. Specifically, Dr. Alan Greene is noted for starting a “White Out Now” movement. He encourages families to feed infants whole, natural first foods instead of rice cereal. Dr. Greene discusses how the food industry has marketed and advertised to parents so heavily, the industry has created doubts in our minds regarding what is best to feed babies. We, as parents, start to believe that the healthy foods that we eat are not “good enough” for our babies.

Dr. Greene’s is also concerned that rice cereal primes infants to crave only carbohydrate-rich foods, contributing to the obesity epidemic. Other physicians have debated his theory,but I think his general concern for the quality of first foods is worth notice.

For the first few months of eating solids, an infant’s nutrition is still based upon the healthy calories given by breast milk and formula. That allows pureed foods of all forms to be first foods, as they have for centuries.

Expand beyond the rice cereal “default”. What about some pureed red meat as a first food? What about whole grain cereal, oatmeal, or a pureed fruit or veggie?  Maybe, something you have in the fridge? (see #2)

Myth #2: Making baby food is hard (A.K.A. I don’t have time to make baby food.)

I hear this a lot; mainly from parents whose only experience with baby food making is observing a few moms with fancy baby-food makers, complicated recipe books, and bags of locally-sourced organic ingredients. This “all-in” approach to pureed food making can seem overwhelming and unreachable.

But, let me offer a suggestion…

In my clinical experience and personal experience, the earlier you get your baby eating the healthy meals that you provide your family (in a safe, modified way), the better they will eat as toddlers. So, I challenge all my families to try to make some first food… simply.

I do not talk about making baby food with the claims that it is of greater superiority to jarred baby food. There are some great commercial baby foods on the shelves today. But, babies have survived for many years before infant food was available in aisle 4B of the grocery store; and I think only offering what a food company can put in a jar is actually quite limiting to a baby’s early taste experiences.

To make baby food, you need soft foods (fruits, veggies, whole grains, meats), a little water, and a machine to puree. The machine could be a food mill, a blender/food processor, or a strong arm with a fork. Voila! Simple as that. I bet there is something in your kitchen right now that you could whip up for baby. Last night’s grilled chicken breast? Leftover green beans? Melon? Avocado?

As a working parent, I certainly bought prepared baby food. But, I made a lot of food for my infant, too. For me, it was easy, cheap, quick, and just part of the routine.

So, I challenge you to try to make some of your baby’s first tastes. Experiment and have fun! Decrease your family’s food cost, decrease shipping and packaging waste, and increase the palatable options for your baby to try.

Myth #3: Starting solids will help my baby sleep through the night.

Nope. It doesn’t.

Starting foods too early may actually have some negative consequence including obesity, food allergy, and decreased sleep!

Yikes!

Currently, it is recommended that first foods should be started around 6 months of age. This age is preferred for both the developmental ability of an infant to take food off a spoon, in addition to decreasing the risk of food-associated allergies and obesity.

Eating solid foods is a developmental skill, not a way to “fill baby up” to sleep longer. So don’t let this myth determine when you start solid food.

Myth #4: Greens, then yellows, then oranges.

There is no evidence to suggest that if you offer baby fruits first, she will never eat veggies. Regardless of what order food is introduced, kids (and adults!) will always prefer sweeter-tasting food items. Offer your baby foods of all colors of the rainbow, in no specific order.

Myth #5: My baby can’t really have the food that I am eating.

I think the origin of this myth/concern stems from parents knowing the kind of diet they have. Feeding our children is often an examination of what we, as parents, feed ourselves.

If a parent’s diet consists of fast food, takeout, and late-night snacks then the thought of feeding baby exactly what you eat is ridiculous. Agreed. But, if you are not willing to feed what you eat to your baby, maybe it’s time to think about the nutrition and healthy eating choices for the entire family.

If a family eats a healthy, well-rounded diet then the concept of offering baby what you eat is not such a scary idea. Make healthy, positive food choices, include your baby, and see the long-term benefits for the whole family.

Myth #6: Oh, no.. baby can’t have that.

Currently, for healthy babies who are not in a family with significant food intolerance and allergies, the only thing babies under the age of 12 months cannot have is raw honey. Honey may contain harmful botulism spores that could make small babies very ill.

That’s it.

The research regarding introducing solid foods is actively changing. This means the foods that have been traditionally restricted until later in toddlerhood (eggs, shellfish, peanut butter) are no longer on the “Do Not Have” list. In fact, some recent data suggests that delaying the introduction of high-allergy foods (shell fish, nuts, eggs) actually increases the risk of developing a food allergy. Other studies do not show an increase in allergic disease by starting allergenic foods early. In addition, adding dairy sources (cheeses, yogurt) and animal proteins (meat, chicken, pork, fish) can be added at any time.

Expand the box. Think about your own diet, and what you want your kids to eat. What is acceptable for your family, your culture? Don’t let Gerber or Earth’s Best or [insert baby food company here] make those definitions for you.

Your baby just might surprise you… mine certainly did. Within a very short period of time, my 8-month old son’s favorite food was my husband’s recipe for chili (pureed) – extra spicy!

Have fun!

* Starting solid foods may be very different for children with a significant personal or family history of allergies, milk intolerance, or skin issues. It may be very different if a sibling had challenges with foods. It certainly will be unique if a child is not growing correctly. If your child has any of these issues, or you have specific concerns about your child, please ask your pediatrician for guidance.

28 Comments

  1. Dr. N – Thanks for this post and I couldn’t agree more, our second child has eaten better and faster and we saved time and money not preparing and buying “baby” food. Can you do a post on potty training? I am dying to get my three year old to sleep dry at nap time and at night :) She is potty trained during all other times but just seems a bit lazy when it comes to night time . . .

    • Thanks for reading, and your comment. Great idea for a post.

  2. Dr. N;

    I am thoroughly enjoying reading through your blog. I especially found your post about introducing solid foods very informative an interesting. Coincidentially I addressed a related topic on my blog that i have recently started for the bilingual community. I would be thrilled to have your input, comments or feedback. I have included the link below.Thank you

    MagdalenaSPalencia.blogspot.com

    • Thank you for reading. Your bilingual blog will be great for the community you serve. I think your “respect” piece is great. Wonderful concepts to think about when starting first foods, besides focusing on what actually is on the spoon. Well done. NB

  3. I couldn’t agree more! We did Baby Led Weaning with our son and I recommend it to my clients. It was one of the best parenting decisions my husband and I have made.

  4. Hi there, You’ve done a great job. I’ll definitely digg it and personally suggest to my friends. I am sure they’ll be benefited from this web site.

  5. Thank you for this great info, Dr. Natasha! I am not stressed about this first food thing anymore, thanks to you! I linked to your article on my blog too!

    Kristyn and Hensley Jones

    • Great – you shouldn’t be stressed! Have fun!

  6. Hi, thanks for the post? I have a query. My mother in law says that she did not start solids for either of her 3 childrens until they were a year old. Its all ‘now-a-days’ that people give solids to there 6 months old. I am giving my 8 months old pears in the morning, some veggies and rice/lentil in afternoon and yesterday started oat in the evening apart from milk(5 times a day). Is it ok?
    Also, it becomes 8 times a day. because if i give her solids with milk, she wont take enough milk. I have not tried solids just after milk yet.

    • Thanks for the comment. Your MIL’s experience is so reflective of how we feed our kids – by tradition! Sounds like you have some great starts with solids for your daughter. Most kids are getting ready for finger foods close to 9 months. Once she is able to eat more calories with healthy finger foods, I would imagine she may be able to decrease her milk needs and tighten up her feeding schedule a bit. Talk to your doc at the next checkup and see what they suggest. Have a lovely Holiday season with your little one! NB

  7. Hi! I enjoyed reading this, it was informative and written with a sense of humor. Thanks! I have a relative that just started her baby on rice cereal before he was even 3 months old! Her doctor told her to wait until the baby was either 4 months or 14lbs to start. He is 16lbs. Their doctor said it will help with spit-up. Is this true? It seems to me that it is not necessary since he was growing just fine. He was gaining weight so rapidly it makes me wonder if they were over feeding him and making him spit up by overfilling his small stomach. I have a son who is 6 weeks older and exclusively breastfed. He weighs 17.5lbs at 4.5 months. I plan to start introducing solid food at about 6 months. I can’t help but feel pressured since the younger baby is rapidly catching up to my son’s size and will probably soon surpass him. I know it’s silly. Will my son end up being smaller because he was breastfed? It makes me feel like I’m under-nourishing him.

    • Thanks for taking the time to comment, Jessica. For a few kids, rice cereal has been used for the symptoms of reflux in the past. So, discussing clearly the introduction of solids is not a “concrete” decision for all kids. Although it sounds like your relative’s baby is larger, I would not feel pressured to start solids AT ALL. Every person (even little ones) grow at unique rates. Your breast milk is the perfect food for your baby and supplying everything he needs. If your son ends up being smaller, it is because he is made his own unique, perfect size. Enjoy starting solid foods closer to 6 months!

  8. Hi Doctor,
    I have been reading many articles and talking to many moms on what to start as a first food. I love the idea of my dtr eating what we are eating as my husband and I try to eat as healthy as we can…with the odd treat here and there! :)
    My dtr is 5 1/2 months and I am just starting to think about solids for her. She is interested in what we eat but I think that it is because she is curious. I would love to just start her on veggies or fruit and skip the store bought cereals. I want to continue to breast feed. How do I know she is getting enough breast milk and food? I understand that the solids are not to fill her up but only to expose her to the concept of food. When do I start replacing a milk feed with food? Or do I? The articles I have found are often contridict each other. You have given some great advice already, just wondering if there is anything else for me to think about when giving first solids.
    Thanks!

    • I love how you are thinking of a family-centered approach for your daughter’s first foods. I always think of first foods as “experiences” rather than a source of nutrition, so keep breastfeeding! Your daughter will grow and thrive by continuing to breastfeed as often as your current schedule. First foods are “gravy on top”, just an additional experience for your daughter. Most kids don’t replace breast milk for food until drinking from a sippy cup is well-established, and eating finger foods. This is generally after 9 months of age. Be sure to ask your pediatrician what seems reasonable for your daughter based on her eating habits and growth patterns. Have fun, and good luck! Thanks for your comment. NB

  9. Really enjoyed reading this. I want my son to grow up to be an adventurous eater, and appreciate good real food, and it just makes so much more sense to me that starting him out on real foods will increase the odds of that. I read about a recent study linking celiac disease with babies introduced to cereals in the winter time, the theory being that the presence of infection when wheat is introduced could dispose the child to developing celiac disease, and as infections are more prevalent in the winter time timing could make a difference. Have you heard of that study? What are your thoughts on that? My son is 5 months old and still exclusively breastfed. We are planning on introducing solids around 6 months, which will be in December. My husband has a gluten sensitivity, so with that in mind and this information I was thinking of holding off on cereals until spring time… Does that make sense?
    Thank you!

    • Sounds like a well thought-out plan for your family’s history. Cereals do not have to be part of the first foods until you are ready, regardless of the season. Check with your pediatrician to see if he/she has a different perspective to offer. Good luck! NB

  10. Dr. Burgert,

    Thank you so much for writing this page! I exclusively breastfed my son (now 10 months) until he was about 8 months, and now he’s eating pureed foods as well as chunkier mashed veggies and lentils and rice and fruits…and small pieces of bread and biscuits to keep him entertained, of course! He’s growing well, happy, and healthy, and this is what has worked for us.

    I have two questions I hope you can help me with.

    First, the chunky vs pureé issue.

    My husband thinks that ALL of his foods must be pureéd because he didn’t start solids at 6 months (the logic being that his body still isn’t ready for chunkier foods because it hasn’t had time to adjust to digesting them yet), whereas I was under the impression that the texture of the food he can eat has more to do with his biological age and motor skills at this point– plus his preferences! Since my son loves picking up pieces of food and feeding himself (we haven’t mastered the pincer grasp, but it isn’t far off!) and he can manipulate food quite well with his tongue–and he has six teeth with more on the way– I think that small pieces of finger foods, and lightly mashed foods should be fine.

    Am I doing something wrong? Does my son’s body need time to adjust to chunkier foods, or is this fine? (He gets gassy and fussy at night, but this is nothing new for him…there haven’t been any distinct changes that I can link to food)

    Second question- what about salt?

    I read that babies are quite sensitive to salt, and that too much could cause renal failure. Because of this, unless the rest of the family is on a low-salt diet, the family food isn’t automatically ok to mash and feed to the baby. Is this true?

    Thank you so much for your advice and for the informative web page. I eagerly await your response!

    Best from Portugal,
    Megan

    • Great questions, Megan.

      First, it is my opinion that chunkier foods are a *developmental skill* rather than a digestive issue. I would agree that if your son is doing as well as you describe with the finger foods you have offered, you could continue transitioning from purees to finger foods. His body will improve “digesting” these newer foods with increasing number of exposures – expect the gassiness until this takes place.
      Secondly, as long as your son is growing and developing well, there is no reason to specifically avoid salty foods. We all know that excessive salt is not good for our bodies (kids AND adults) and that lower-salt options are preferred. However, with moderate exposure and a bit of common sense, I would mash and feed away!

      Hope that is helpful to you – and thanks for your readership from Portugal!
      NB

      • Fantastic! It’s a relief to have your feedback. Thank you so much for the advice–I’ll share it with my husband and we’ll keep working with finger foods!

        Again, thank you!
        Megan

  11. Hi, I love this article. You said everything goes except for honey, but what about introducing foods one at a time (with a new one every week?) to see if any allergies are developed. What are your thoughts on this?

    • If you have a family history of food allergies, food introduction should likely be slower. Waiting 3, 7, or 9 days between new foods, however, is an arbitrary amount of time and most often unnecessary. Talk to your pediatrician to see what they recommend. And, as always, proceed with new foods in a fashion you feel most appropriate and comfortable for your baby. Have fun! NB

  12. Hi Dr. Natasha! I work for another ped in town, but you saw my 3 kids as newborns at St. Luke’s, as my ped doesn’t have privileges there. I thought you were fantastic when we saw you in the hospital, and really enjoy reading your blog. Your take on introducing solids is awesome. I love that you give parents permission to have food be fun and social and not bound by rules. Every time I work in triage, I get a couple of calls from moms stressing about the order of introducing food, how many little jars to feed a day, etc. I hope many new parents will find this post and take some if the pressure of themselves to do it “right.” Thanks for a great post- I always enjoy what you have to share.

    • Thanks so much for the kind words and your readership, Betsy. Hope your little ones are well! NB

  13. I’m so glad I came upon this article about introduction of solid food. My parents and parent-in-laws would like me to introduce my 3.5 month old son to solids,but I’m reluctant to until the 6 month when I feel he is more ready for it. My mother said that she gave me and my brothers smashed yam and congees between milk feeding when we were that young. I will, however, wait until he is 5.5-6 months and will definitely feed him pureed table food. I feel also that introducing him to all different tastes and food of every colors of the rainbow will make him a less picky eater as he grow older.

  14. Great post! Our doc gave us some strange recommendations (At 6 months, going straight from formula to 6oz of fruits and veggies per meal!). It was obviously ridiculous, so we have started with a couple of tablespoons of oat cereal mixed with a couple of globs of fruit (so far we tried bananas one week, and peaches the next). He seemed to dislike the cereal without the fruit mixed in. We give him bottles the rest of the day until the one he eats around our dinnertime, and for that one, we give him most of the bottle and then a few bites of a veggie (started with sweet potatoes) after the bottle. He is a great eater, and seems very happy with the introduction of solids. Does this sound ok? I guess to progress from here, giving him some additional bites, maybe at lunch? We are first-time parents and are terrified of either over-feeding or under-feeding our little guy!

    • I think that plan sounds great. First foods are just experience and experiments, not nutrition. Continue those bottles and try all the food colors of the rainbow over the next few months. As long as he is drinking his bottles, he can have as much food as he wants. Have fun! NB

  15. hi great post. my daughter just turned 6 months we passed on cereals and we have been experimenting with making our own veggie and fruit foods and have been doing great but we are concerned with the meats. I’m kind of freaked out by meat in a jar but her daddy has a concern about salmonella he’s scared we will poison her lol. I explained that the meat would be fully cooked and then pureed but he thinks the jar stuff would be better for now. she is also exclusively breastfed. I have been reading that she needs water now is this true I thought she would be getting her fluids from my milk? also what are your opinions on baby lead weaning? I want to try this but im scared she may choke. we are very good eaters and we want her to be too.

    • All great questions. Jar or fully-cooked pureed meats are fine. If your husband feels strongly, certainly not a battle I would fight. :-) No additional water necessary, but she can start playing with water in a sippy cup. No specific opinion on baby-led weaning. I have a few families who have been very successful with this introduction method, but it is not that common in my community. Regardless of whole food introduction or purees, I have seen no difference in the 2 approches with regards to ultimate toddler eating behaviors. They all seem to end up the same… Good luck, have fun, and be don’t hesitate to ask your pediatrician his or her opinions about first foods. NB

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