When Should Babies Start Solids, Really?

Is your baby ready for baby food? A new study says many parents are starting too early. Experts weigh in on when to start solids and what to start with. 

When to start solids Chubykin Arkady/Shutterstock
Is it time for your little one to start solids? The standard recommendations can seem confusing. The American Academy of Pediatrics (AAP) says to wait until about 6 months if you’re exclusively breastfeeding, while the American Academy of Allergy, Asthma, and Immunology says 4 to 6 months is okay.

What’s not okay, according to Natalie Muth, a pediatrician and co-author of The Picky Eater Project, is starting before four months. Yet a surprising number of parents do so according to a study in the Journal of the Academy of Nutrition and Dietetics.

Chloe M. Barerra MPH, the lead researcher at the Centers for Disease Control and Prevention, and her team looked at the food intake of 1,482 American babies from 6 to 36 months between 2009 and 2014. Of them, 16.3% started complementary foods prior to being 4 months old, 38.3% tried them at 4 to 5 months, and 32.5% began at about six months. And 12.9% started solids at 7 months old or later.

Dr. Muth says, “Definitely do not start solids before 4 months. It provides no benefit and can cause harm, including the increased risk of later weight problems, food allergies, and more risk of choking.”

Your Baby's Readiness

Guidance has gone back and forth over the past few decades as to when parents should start complementary foods, a.k.a. solids. Most pediatricians and pediatric dietitians agree babies should start between 4-6 months, depending on their readiness. According to Dr. Muth most babies show signs of readiness between 5-6 months.

How can you know if your baby is ready? Follow her cues, says Dina DiMaggio, a pediatrician from New York City and co-author of The Pediatrician’s Guide to Feeding Babies and Toddlers.

Signs of readiness include:

·      Having good head control

·      Being able to sit up with support

·      No more tongue thrust instinct (when a baby’s tongue automatically pushes food out of his mouth)  

·      Showing interest in trying food

“When your baby is staring at you while you are eating and trying to grab your food, it’s a good sign it's time to start solids,” Dr. DiMaggio says.

Dr. Muth adds, “There is no harm in waiting until 6 months, so exclusively breastfed babies should get as close to that time as possible.”

That said, parents should also be careful not to start complementary foods too late. After six months, breastmilk or formula alone may no longer be able to meet the nutrient needs of infants, so complementary foods can help, Barerra says. “Eating solid foods also exposes infants to textures and flavors, which may help them be more accepting of new foods later on.”

First Foods

Infant cereals are common first foods, but don’t need to be the only option; meats, vegetables and fruits can also be good choices, she says. As for the notion of offering vegetables first so your child doesn’t only like sweet fruits, Dr. DiMaggio says that's a myth that has never been tested.

"There is no proof that veggies work best. But we do know that it's important to expose babies to a variety of flavors, not just the sweet they already love," adds Natalia Stasenko, a London-based pediatric dietitian and co-author of Real Baby Food.

As for fruit juice, the AAP says not to give it to babies under a year old unless recommended by a doctor (say, for constipation), and to limit it to 4-oz. daily for toddlers. 

As always, if you have questions speak to your baby's pediatrician.