I recently had a chance to interview one of the experts at Bundoo, Kristie Rivers, MD, FAAP, a Board Certified Pediatrician, about when you should introduce solid foods to your baby’s diet. I wondered what the current wisdom was since my kids were babies over 10 years ago. I was also interested in learning if there were any new “rules” about avoiding certain foods due to the bigger prevalence in food allergies and sensitivities, and was surprised to learn that there’s been a reversal of waiting to introduce eggs, peanuts, soy and fish!
1) How old should your child be before you introduce solid foods? Are there signs that show that your baby is ready to start solid foods?
Dr. Rivers: The American Academy of Pediatrics recommends that babies wait until 4-6 months of age to start solid foods. Babies are not developmentally ready to eat solid foods until that time. Before eating solids, there are a few things your little one needs to master first. He needs to have good head control when sitting in a high chair, which is not possible until at least 4-6 months of age. Also, he needs to be able to move a spoonful of food from the tongue to the back of the mouth.
You may notice that around this age, your baby will show interest in foods that you eat, even reaching for your food as if he wants to be fed.
2) Is there any harm in waiting to introduce solid foods and stay on formula or breast milk?
Dr. Rivers: Formula or breast milk meets all of a baby’s nutritional needs until around 6 months of age. You will not cause your baby any harm in holding off until then to give solids. After that age, solid foods need to be introduced to give your baby adequate nutrition such as iron, protein, and fat.
3) What are the best solid foods to start your baby on? Is there a progression like cereal, then veggies, then fruits, then meats?
Dr. Rivers: Often, by tradition, many parents will start their baby on a single grain cereal. Many parents may be surprised to hear, however, that there is no good medical evidence to support that starting one food over another is beneficial for your baby. Be sure that if you do start with cereal, it is fortified with iron. The old wives tale that starting your infant on vegetables over fruits is preferable is also not founded in evidence. Babies by nature prefer sweet foods, but introducing vegetables first will not change this preference and cause them to like vegetables over fruits.
Whatever food you decide to start with, be sure to wait a few days before introducing the next new food to make sure there is no reaction.
4) What foods should you avoid to prevent food allergies? Are there foods you should avoid altogether until your child is much older, say two or three years of age?
Dr. Rivers: There is no one particular food to avoid that will prevent food allergies. In fact, the American Academy of Pediatrics has determined that there is no good evidence to recommend delaying highly allergenic foods. Researchers believe that the early introduction of these foods may actually prevent food allergies in children. So the previous recommendations of delaying egg until 2 years of age and peanuts/fish/soy until 3 years of age may be of no benefit to your child.
Talk to your pediatrician to see what is the best choice for your child. However, if your baby already has been diagnosed with a food allergy, eczema, or has a strong family history of an allergic condition (such as food allergies, eczema, asthma, or allergic rhinitis), you may want to visit an allergist before introducing your baby to these foods as these conditions put your baby more at risk.
5) How do you manage older relatives when they tell you, “I used to give you such and such foods when you were a baby, and you turned out just fine!”
Dr. Rivers: If only there were a perfect answer to this question! Older relatives love to put in their two cents about everything from food to discipline to parenting styles. I think the best response to any parenting criticism is a gracious and respectful one. Perhaps say something along the lines of “Thank you, I really respect your opinion. Did you know that I just spoke with the pediatrician about this matter this week and there is all sorts of new research out there these days!”
Try not to get into a long discussion or argument, as it will likely lead nowhere. Sometimes, just a simple “Hmmm” and changing the subject works just fine. Remember, you are making the very best choices for your baby based on the information you have available, and no one, not even your relatives, has a right to criticize your choices.
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