You may or may not know that I am a speech-language pathologist (SLP). Most people assume this means I help kids who stutter or have a lisp. While those are areas that SLPs work in, our scope is very broad and includes speech production, fluency, language, cognition, voice and resonance, hearing, feeding and swallowing. My specific area of expertise is paediatric feeding and swallowing. I am currently on maternity leave but work in a hospital setting with in-patients age birth to 17 years, with the majority of my patients being preemie to two years of age.
I love my career for a lot of reasons; feeding babies isn’t a bad way to spend your days after all. But I also love helping families during difficult times, playing a part in the growth of little ones, and working as part of an interdisciplinary team.
Through my blog and social media, I have become connected to many new mamas and babes in our city and beyond. Often times when my profession comes up, I am flooded with questions regarding introducing solids to their little ones. It can be a daunting task. There aren’t clear guidelines to follow and every mama just wants to do what’s best for their baby.
So today I’m writing this blog to use my education and professional experience to provide some guidance when introducing solids.
When to Start?
This is a common question I get, “when can I introduce solids for the first time?!” Usually followed by a comment about how their baby is interested in food or so big and strong. My answer is always the same. Babies are ready for solids when:
They are able to support their heads and have good neck strength. They should be able to or be close to being able to sit up. This shows that they have the proper muscular strength and support needed to safely swallow solids. With these skills mastered, babies are able to focus their attention on coordinating their new feeding skills, rather than struggling to stay upright.
They are around 6 months (corrected age). I know some (more dated) recommendations state 4-6 months, but my colleagues and I always recommend 6 months. That is if they are supporting their heads and necks (as stated above). I understand the excitement of wanting to introduce solids, but I promise you- it’s better to wait! There is no rush. Babies do not need the nutrition from solids at this point (they get everything they need from formula or breastmilk). And research shows that solids DO NOT help babies sleep longer at night- it’s a myth. If that’s not reason enough, just think, it’s only a short 6 months of your baby’s life that you don’t need to worry about making, packing, and feeding them solids- you should enjoy this time!
If your baby is meeting the above two milestones, you may also look to see if they are a showing an interest in food. Do they watch others eat and drink and reach for their food? While this is a positive sign, if they are sitting up and 6 months of age but NOT showing an interest, I still recommend introducing solids to ensure feeding skills do not become delayed.
What is Needed?
You can keep things simple or go all out when accumulating supplies for solids. At the least you should have:
A supportive and comfortable highchair. Look for a chair that supports your little one and keeps them secure and upright with good posture and alignment. They should be safe, strapped in, and not be able to move around much. Foot support is ideal. The best highchair, in my opinion is the Stokke Tripp Trapp highchair. This is the chair we use for Luca. It grows with little ones through all the ages and stages from birth (with the newborn set), right up until adulthood! It checks all the boxes and I can’t say enough good things about it.
Baby spoons. These aren’t hard to find- you can pick them up pretty much anywhere. I prefer silicone or bamboo over metal. Look for a spoon that fits the size of your baby’s mouth comfortably. Not too big or too small. Some of my favourites are the OXO TOT feeding spoon, the Replay Recycled Infant Spoon, and Beaba First Stage Silicon Spoon.
You Might Also Want…
Bibs. Ideally, your baby should be fed in just a diaper so they can be free to explore the food with all their senses, without the parents trying to keep them clean. As a parent to a baby myself, I know this is not always practical. Due to Luca’s eczema, sadly he can never be naked or else he scratches until he bleeds. Aside from skin conditions, there are times when you must feed your little ones while they are dressed. In these times, I like using a water-resistant wipeable bib like the Kushies or JJ Cole ones. It saves you from doing unnecessary laundry. Who has time to stain remove and wash 3 bibs per day?! Stay away from full sleeve plastic bibs as they can lead to babies being aversive when it comes to exploring foods and getting dirty.
Bowls. I like using small ramekins to heat up baby food and I stay away from plastic because I don’t like microwaving it.
Baby-Led Weaning or Purees?
Now this is a hot topic as of late. Baby-Led Weaning (BLW) is an increasingly popular method of introducing solids to little ones. With this method, babies are presented with cut-up pieces of soft-cooked solids, generally whatever the rest of the family is eating. BLW bypasses purees or mashed foods altogether. Both methods have pros and cons. You need to find what works best for your little one, but here is my two cents.
I favour the traditional method of offering increasingly thicker pureed foods (starting with thin, watery purees and gradually working up to thicker, mashed consistencies). From my experience, beginning with smooth, blended foods is more manageable for the oral skills of 6-month olds. Up until this point, babies have liquid consistencies exclusively, and a thin puree is just one step up in the hierarchy of texture. Jumping to a soft solid is a bit more challenging for the immature feeding skills of babies this age. Additionally, the puree method seems to allow for greater volume intake of solids. Babies are able to obtain more nutritionally with purees, than with BLW. This makes it easier to acquire adequate nutrition and iron. Furthermore, BLW allows for more opportunity for choking. If you subscribe to this method, you must be okay with coughing and choking. It is bound to happen, and (as with all feeding methods) requires constant supervision. I have had families who tried BLW but veered away from it because they couldn’t handle the choking. Lastly, in some cases, this choking may contribute to an increase in negative associations with feeding. Referred to as aversion, babies may begin to dislike feeding because they associate it with the discomfort of coughing and choking. This is not common but it can occur.
With that begin said, there are babies who much prefer the BLW method. In fact, I’ve had patients who out right refuse any purees and will only accept finger-foods. My best advice is to be flexible and see what works for your baby. If you choose BLW and he is coughing, pushing food away, and fussing every time you present food, try offering purees! If you choose the puree method and she keeps closing her mouth and turning her head away from the spoon, try offering some small, soft finger foods on the high chair tray. I encourage parents to be open-minded when it comes to feeding their babies and I do the same. No judgment here on whichever method you subscribe to!
My son Luca is 8 months and our current feeding routine involves starting with some soft cooked foods on his highchair tray (cut up blueberries, soft black beans, small cubes of avocado, etc.) while I prepare his purees. He works on his pincer grasp and it keeps him busy while I’m getting the rest of his meal ready. He misses his mouth and drops the food about 50% of the time but he’s learning and having fun! After about 5 minutes of this I come in and spoon feed the little tank some thicker purees and fill him up! That is working well for us right now!
What foods to start out with? What if they don’t like a food?
Canadian recommendations are to focus on offering iron-rich foods, since iron stores are depleting at this time and is essential for optimal growth and development. Iron-rich foods include beans, lentils, eggs, tofu, meat, and fish. Iron-fortified infant cereal is also a common choice. Some sources of iron (animal sources) are more easily absorbed by the body than others (plant sources).
When introducing foods, it is best to offer a single food at one time. Offer one food for three days, without introducing other new foods at this time. This makes it much easier to determine if your baby is having a reaction or allergy to a specific food. Stay away from honey and cow’s milk until the baby is over 12 months as they are not safe for those less than one year old.
I suggest offering a variety of vegetables, fruits, and protein sources to promote a diverse palate. Think outside the box and try foods that you might not normal reach for like bok choy, turnips, papaya, sweet potatoes, parsnips, etc. I also recommend mixing fruits with vegetables and/or proteins, rather than offering pure fruits as in some cases babies develop a taste for ‘sweet’ flavours and refuse more savoury flavours. If your tiny one at first appears to dislike a food, continue to offer it on a regular basis and chances are they will change their tune!
Furthermore, it is completely normal developmentally for babies to ‘spit out’ or tongue thrust their food out of their mouth at first. It takes some skill development for babes to be able to coordinate their oral structures and properly move a bolus of food posteriorly in order to be swallowed. Pushing the food forward does not mean they don’t like it, it is just reflexive at this point. The same goes for gagging. Continue to offer these foods to your little ones and don’t be alarmed by these normal reflexes.
Should I make my own baby food or buy it?
This is up to you! There are a lot of great options for ready-made baby foods these days. Pouches seem to be most popular, but jars are also available. If using pouches, I recommend squeezing the contents onto a spoon, to encourage normal skill development (versus sucking directly out of the pouch). To start with, offer single foods (i.e., sweet potato) rather than blends (i.e., sweet potato, mango, and rice). Be sure to check the ingredients. The other day I picked up a ‘Turkey and Vegetable’ pouch and later noticed it contained whole milk powder (which my son is allergic to).
Making your own baby food is a bit more time consuming but can be less expensive. As well, you are able to more closely control what your little one is eating, which is especially important in the case of allergies. I make the majority of Luca’s baby food at home, but stash pouches in the diaper bag for days out, snacks, and emergencies. If you decide to make your own, steaming is the preferred method of cooking baby food as it preserves the most nutrients in the food. All that is really needed it a stove top steamer, pot, water, and blender. I have also used a Baby Brezza Baby Food maker, which makes things even easier. I’ve linked my favourite products to make baby food here.
How often to feed?
To begin with, you can offer one meal of solids per day. Do this for a few days, then offer it twice per day, gradually working up to 3 meals per day. You can also incorporate two snack times throughout the day. Ideally, your baby should eat meals at the same time the family is eating. It is a positive experience for the whole family, and the baby can observe and imitate other’s feeding and chewing skills.
When to feed?
In order to optimize your sweet pea’s appetite for solids, it is best to offer solids prior to liquids. When they wake up in the morning, first offer breakfast, then offer a bottle. Otherwise, if they just took a bottle or breastfed, they are likely full and less likely to be interested in their meal. They should be hungry but not starving at meal time. If they are too hungry they become fussy and are unable to focus their attention on feeding. If your little one is having weight gain issues, your paediatrician may recommend first offering liquids for hydration and growth, followed by solids.
Where can I go for more help?
There are a number of professionals available to assist you in feeding your babies. Registered dietitians can help with ideal caloric intake and ideas of foods to offer. Occupational Therapists can assist with proper seating, posturing, utensils, and cups. Lactation Consultants are useful in aiding in breastfeeding. Speech-language pathologists that specialize in this area can help with feeding and swallowing. Family physicians can also help and refer you to a specialist if needed. If you have questions or concerns, or would like to request an assessment, feel free to contact me via email at firstname.lastname@example.org
Happy feeding mamas and dadas!