What’s the rush? Solid foods can wait

We know infants exposed to solid foods prior to 4 months have an increased risk for chronic diseases like obesity, diabetes, eczema, celiac disease, and wheezing. In the last 10-15 years, much has been learned in terms of infant and child nutrition. Medical providers used to readily promote solid food supplementation at a young age, and some may still be mistakenly making these same recommendations. This brings up a major point: we tend to feed our babies by tradition, even if that tradition has no root at all in scientific evidence. Dr. Alan Greene, a pediatrician from California, has started a “WhiteOut” campaign against white rice “cereal” (flour) as baby’s first food. Instead, he recommends a whole grain (whole oats or brown rice), vegetable, or fruit. I vividly remember my daughter taking her first bite of solid food: mashed avocado.

Introduction of solid foods to infants before 4 months of age is common, though the American Academy of Pediatrics (AAP) has long recommended waiting until 6 months. A study on introduction of solid foods by the Centers for Disease Control and Prevention (CDC) published in Pediatrics in 2013 found that as many as 40 percent of parents were feeding their babies prior to 4 months of age (with 9 percent of those parents feeding solids before 4 weeks of age). According to the study, parents often said they feed their babies this early because “My baby seemed hungry” and “I wanted my baby to sleep longer at night.” Others reported they were instructed by a doctor or other healthcare professional to do so.

Why are parents feeding their babies solids too early? Many believe the myth that solid foods help infants sleep better. Others merely think it’s the right thing to do or that the baby likes it. Maybe someone suggested adding rice cereal to a bottle to control symptoms of gastroesophageal reflux. Or your mom did it for you, so now it’s your turn to do it, too.

There is no “magic age” when it comes to readiness for solid foods. Many 4-month-olds and most babies under 4 months old are not developmentally ready for solid foods. A baby should not be pressured into eating solid foods. In general, solids should be offered when:

  • Your baby is showing visible interest in eating solid foods.
  • Your baby has good, independent control of his or her neck and head.
  • Your baby can sit upright with just a little support.
  • Your baby can open his or her mouth when food comes, and he or she can show you they are full by pulling away when you offer food or by shutting his or her mouth.

Infants receive adequate nutrition from either breast milk or formula. Solids merely complement the calories from each. So even though your little one “seems ready to eat [solids],” hold off until 6 months. Look for readiness cues, and don’t rely on the calendar to tell you when to begin feeding your baby solid foods.

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About Dr. Justin Morgan, Bundoo Pediatrician

Justin Morgan, MD, FAAP, is a board-certified pediatrician who practices general pediatrics in Louisville, Kentucky. He cares for children of all ages.


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