Breastfeeding A to Z

Solid Food Introduction

The American Academy of Pediatrics (AAP) Policy Statement on Breastfeeding and the Use of Human Milk recommends waiting until 6 months to introduce solids foods. (1)   Delaying the introduction of solid foods past 6 months, is not recommended because there is an increased risk of micronutrient deficiencies, like iron and zinc. (1)(2)

Your baby will tell you when they are developmentally ready for solids foods when:

  • They are interested in what you are doing when you eat or drink
  • Example–they reach for your glass or utensil, try to mimic what you do with it
  • Sit supported in a high chair or on your lap
  • Can take food off of a spoon, move it around in their mouth and swallow it
  • Typically, until 4-6 months they won’t be able to move the bolus of food from the spoon, move it around in their mouth and swallow it.   (if they are pushing more food out than taking it in–their tongue thrust reflex is still strong–wait a few weeks–especially if they are upset when doing this)  You put it in, they give it back.
  • Their hunger increases, lasting more than 1-2 days like a normal growth spurt.

These developmental milestones, typically take place between 5-7 months of age.  Until your baby exhibits these signs of readiness, all they need is breastmilk to meet their nutritional needs.  Note: They can suck and swallow, usually from birth, but the motor skills to chew and swallow food take longer to develop.  You want them to have that ability to take foods safely from a spoon.

If you have well-meaning family or friends that suggest you should begin solid foods sooner than 5-6 months, it may have been because when they were feeding their little ones, the recommendations were different.  Thru the 1950’s and 1960’s, commercial formula was still not that common, and often if the baby wasn’t breastfed, it was given an evaporated milk formula mixed at home.  This formula did not contain iron or Vitamin A or C.  In order for their baby’s diet not to be deficient, solid foods needed to be added in order to meet their baby’s nutritional needs. (3)  That was then, this is now.

If you are breastfeeding, you are providing all the nutrients your baby needs.  Additional Vitamin D is now recommended as well, due to lifestyle habits and use of sunscreen. (1)  If you are giving formula, it also contains vitamins and iron your baby needs without the need to give solid foods.

Offering solid foods is often given with the idea that “it will help my baby sleep through the night”.  This has been researched and found not to be true. (4)(5)  It might make baby’s tummy feel full, but it puts your baby at risk for developing allergies.  This is because the intestinal tract is not fully developed yet.  In the early months the lining (on a microscopic level) is not as closely knit as it will be later.  Breastmilk contains things that protect your baby’s intestinal tract until it is more mature. (5).  If other foods are given in the first 6 months of life, the body may see them as foreign proteins and cause an allergic response.    Think of it as if your baby’s intestine was Swiss cheese (big holes) at 2 months and more like cheese cloth (very tight weave–little holes) at 6 months.  Waiting until your baby is older decreases the risk of developing allergies or sensitivities to food. (5)

An allergic reaction from solid food introduction can include one or more of the following (5):

  • a rash (including diaper rash)
  • hives
  • wheezing,
  • congestion
  • cold-like symptoms
  • red, itchy eyes
  • ear infections
  • irritability fusiness, colic
  • intestinal upsets, vomiting, constipation and/or diarrhea.

References:

  1. Policy Statement Breastfeeding and the Use of Human Milk, Pediatrics, 129(3) Mar 2012, pp e832, e835.
  2. Schanler, R, Dooley, S, Breastfeeding Handbook for Physicians, American Academy of Pediatrics, 2006, pp 112-14.
  3. Breedon, C. Michigan WIC Conference Presentation, Grayling, Michigan, June 24, 1998.
  4. Guthrie, H, Effect of early feeding of solid foods on nutritive intake of infants, Pediatrics, 38:879-885.
  5. Mohrbacher, N, Stock, J, La Leche League International The Breastfeeding Answer Book, 3rd revised edition, Schaumburg, IL, La Leche League International, 2003, pp 52-53, 181,