Q&A: introducing solids

Cat writes:

"How about a primer on introducing solids? Like...

You know how the general rule is 4-6 months? What if you wait six months and he doesn't like it right away and you have to put it away for a week or more. Are you screwed? Should you start at five in case things don't go well or quickly?

I'm a sucky cook, but I feel like I might be able to handle boiling and mashing food matter. Can I do it with my handy dandy hand blender or do I have to buy a real food processor? Which books or web sites would you recommend for recipes? Does one even need recipes to mash up some veggies?

What should I know that I can't even think to ask about?"

Americans are totally neurotic about introducing food to babies.

There, I said it.

We've concocted all these rules for ourselves, some of which are based on research, some of which are almost sort of based on research, and some of which appear to originate from the vicinity of the gluteus maximus of the teller.

And yet, even though we follow all these rules with a religious fervor not seen since the Crusades, our kids (and adults) aren't any healthier than people in any other developed country. In fact, we're probably less healthy than most of them. So let's take a look at some of the things you hear all the time and whether they're based on facts or hearsay. (And remember that I'm no expert either. I'm just someone who reads a lot and is extremely skeptical. So if you think what I'm saying sounds fishy, look it up.)

#1: You have to introduce solids within a certain time window or your child won't learn to eat them. Really? You mean my kid won't learn to eat if I don't introduce rice cereal on Day 183 and pears on Day 192? That's funny, because my mom never gave me any Guinness, spicy kimchi, or coconut curry soup as a baby, but I sure learned to put those away. (Mmmm....forbidden kimchi...) This one is just plain dumb. People all over the world introduce different foods on different timeframes to their kids, and yet we all manage to eat successfully (barring any actual eating or digestive disorders, of course).

If you don't want to start food until your kid is 6 months, or 6.5 months, or even 12 months, your child will be fine. Breastmilk or formula should make up the bulk of your child's nutrition for the first year anyway. Before that eating's mostly just for fun.

#2: You shouldn't introduce solids before 6 months. This one's actually based on some recent research. Before 2005, the guidelines were to introduce foods at 4-6 months. The AAP changed the recommendation to advise waiting until 6 months. A study showed a correlation between children who started solids earlier than 6 months and an increased rate of diabetes later on. Bear in mind that a correlation is just that, but unless you have a strong reason to introduce solids sooner, you might as well wait until 6 months. I'm guessing we'll have more of the story on this in another 5-10 years.

#3: Always start with fortified rice cereal. It's non-allergenic, and babies (especially breastfed ones) need the iron. This one's part old wives' tale and part incomplete science. Some people do have allergies to rice. Also, rice is extremely constipating, so if you have a baby who already has pooping problems, you absolutely don't want to start that baby on rice (or bananas or applesauce, either). There's also some recent thought that even though breastmilk has a low iron content, babies are able to process all the iron in it, so they actually absorb more iron from breastmilk than they do from other sources. Once they start eating things that have been fortified with iron, though, they lose this ability to process the iron in breastmilk as efficiently. So giving breastfed babies things fortified with iron may actually impede their ability to absorb iron. Not at all what you want to do.

This also just doesn't make any sense logically. If you had to start with rice, wouldn't all cultures across the world start their babies on rice? Some do, definitely, but not all of them by any shot. And even the ones that do are more likely just to cook down regular rice instead of using processed fortified rice powder.

#4: Start with rice cereal, then do that for 3 days, then introduce a new food only every three days. That way you'll know if your baby is allergic to something and it'll help prevent allergies. Unless you have a history of food allergies in your family, there's no need to do this. Most other countries have no higher rate of food allergies than the US does, and they don't wait three days between new foods. It's the kind of thing that makes us feel good about how vigilant and structured we're being, but is just extra busywork.

#5: After you've gone through the cereals, introduce vegetables next. If you start with fruits your baby will develop such a taste for sweet things that s/he will never want to eat anything savory. On the surface, this sounds like it makes sense. But I think the person who came up with this one had never tasted either breastmilk or formula as an adult. Short of pure sugar water you could hardly come up with sweeter liquids than those two. I'm betting that almost everyone reading this spent weeks or months consuming nothing but sweet breastmilk or formula, but I'm also betting almost everyone reading this loves savory things like hot buttered popcorn, crispy green beans in sesame oil, a huge chilled Cobb salad, spicy Buffalo wings, and, well, I'd better stop now before my drool shorts out my keyboard.

#6: Don't give your baby nuts, honey, egg whites, or shellfish until at least one year old, although two would be better. There's truth in this one. Nut allergies can be life-threatening, so you don't want to introduce them any sooner than you need to. There's a form of botulism in honey that toddlers on up to adults can easily process, but babies can't. Cooked honey is fine because the heat kills the botulism, but you should hold off on raw honey for a year or two. Egg whites can be allergenic, so you should probably wait until a year to give them. Shellfish (shrimp, lobster, etc.) can also be allergenic. And besides, wouldn't you rather save the lobster for yourself until your child is old enough and smart enough to ask for it?

So those are the things you hear most often about introducing foods. Other than that, the way you introduce foods should be a function of your personality more than anything else. Some people really want to cook and mash things. If you want to make all your baby's food, check out the books Super Baby Food (especially good for vegetarians), First Meals, or Mommy Made and Daddy Too!.

Some people really like doing jarred foods and advancing up the "stages." Yes, the stages are completely a marketing gimmick, but they aren't going to hurt, so if you like the ease and selection of jarred foods, go for it. Just make sure you read labels, because some jarred foods have tons of crap in them. (I even saw MSG--a neurotoxin--in one of the jars at my local grocery store. Not good.)

There are other people, though, that think babies will do perfectly well eating selected table food as soon as they start eating solids. With my first I did all the cereals first like a good little mommy (until I tasted one and vowed never again to serve my child anything I wouldn't eat, and rice cereal is pretty blechy) and then moved on to cooking and mashing all his food (I never used a food processor or blender--my old-fashioner potato masher did the trick). It turned into almost a full-time job. I'm pretty lazy, so I vowed just to let any subsequent children eat what they could manage on their own.

With El Pequeño, as soon as he was around 6 months I just stopped preventing him from grabbing things and putting them in his mouth. He tried bread, corn tortillas, apple, banana, mango, papaya, green beans, and a bunch of other things in that first week. Some things he'd chew for a long time. Others he'd spit out right away. He didn't really swallow much of anything until he was around 8 months old.

At about this point, someone left me a link here on Ask Moxie to this Dutch study: Guidelines for implementing a baby-led approach to the introduction of soild foods. Woo-hoo! Paydirt to justify my gut feeling that there was no need to spend hours mashing separate foods for my baby. It also explained why he wasn't swallowing--he just wasn't ready yet.

For those of you who aren't going to click over to read the whole article (in English, not Dutch, BTW), the money shot is that babies are actually less likely to choke if they control (with their own hands) what goes into their mouths and how. It also appears that no matter how early babies are allowed to pick up foods and stick them in their mouths, they won't start swallowing them (if they can control it) until closer to 6 months. Fascinating, isn't it? Seriously, go read the article, or at least scroll down to the bottom to the "DOs and DON'Ts" section.

So if you ask me what I do for my baby, I'll tell you that he eats what he wants to from whatever we're eating. (Today--he's 10.5 months--he ate a huge apple, half a whole-grain English muffin, turkey burger, lots of soup with barley and carrots and peas and kale, and part of a baguette.) But you should do what you want to with your own child. If you want the structure of following a schedule to introduce things, make one up (just consider your poor child's taste buds if you're thinking of starting with cereals--maybe sweet potato or banana would be more appetizing?). Go crazy cooking and mashing, or line up all the little jars in a neat row.

Just don't let yourself get tied up in knots about it. There will be plenty of time for that when he's a toddler and stops eating a bunch of things, and then again when he's 3 years old and only wants to eat bagels, French fries, and buttered toast. The best advice anyone's ever given me (and probably everyone else) about feeding is to offer a variety of nutritious foods, but let the child choose how much to eat. And don't take it personally when the child doesn't eat, because that can start a control game you don't want to get involved in.

Have fun starting foods. And make sure to take lots of pictures.

Comments

[Kate]

As usual, Moxie, so so smart! I (unlike the majority of moms in my immediate circle) waited until dd was 7 months to start--she was doing so well on breastmilk I hated to rock the boat.

Just one point I disagree with--based on a little Google research I did regarding a chicken dish, the botulism spores in honey will NOT be killed by the heat of a conventional oven. They can pretty much withstand a nuclear holocaust and still cause dangerous reactions in babies.

I also skipped the entire rice cereal bit. Reason? I don't enjoy food that has the look/consistency/taste (I'm guessing?) of wallpaper paste...why do I think my kid would? I also think baby food in general but cereals in particular are all about marketing. When I thought she was ready for it and would like it, I gave her regular Quaker oats, with cinnamon and a teeny bit of sugar. She still eats it like that now (at 21 months), albeit a bigger portion.

If I recall, her first food was banana, mashed and used as finger paint. Why on earth would you pay Beech Nut (or Earth's Best) to mash a banana for you when your 7-month old is thrilled to squish it through her fingers? We did cooked sweet potatoes this way too. Personally, I think one of the *greatest* foods for babies/toddlers is avocado--when was the last time you saw that in a jar?

I did a little bit of cooking, mashing and freezing, but ultimately it was easier to tailor what we were eating just a touch to her. So if we had grilled zucchini, I set aside a bit, shredded it with a grater and steamed it. There was a point where we were eating a lot of sweet potatoes because she wasn't interested in regular ones. Not a big deal.

The marketing aspect of this drives me a little batty--people I know are still feeding their 2 year olds "toddler biscuits" (aka cookies) or "veggie puffs." How isn't this junk food? I'm not saying my toddler doesn't eat a cookie from time to time, but more often than not it's one that I've made from scratch, so at least I know what's in it--definitely sugar, but it's also likely to have whole rolled oats and raisins. We also know people who give their kids candy before they know what it is or how to ask for it! WHY WHY WHY????? They'd be satisfied with a cracker or fruit! But I digress...

Oh, just to note, there are things she doesn't like, to be sure (like broccoli, no matter how hard we try). But in general she is a better eater than most of her playgroup peers; her menu includes fish, tofu, whole wheat pasta, and (a huge favorite) split pea soup. She eats steamed baby carrots like candy and is a general fruitaholic. Give the kids food with taste and it's all good!

[Moxie]

Here's the info I found with the easiest language about honey and botulism:
http://www.drgreene.com/21_1037.html.
I'm not sure it answers the question, really. It says that regular botulism spores can be killed by heating at 176 degrees F for 20 minutes (which is what I remembered from my food safety days). But it doesn't specifically address honey botulism. The other thing tot ake into account is that even if botulism spores are killed, there's still the poison they leave behind, which can make you really sick. This article is saying one year for the honey, though, not two.

[k]

so how about vitamin suplements?
i am getting widely different advice on this, the ped says yes to vit D and my ordinairy doc says no...
the little lady is 15 months btw... and a picky eater.
when can you introduce a general multi vitamin supliment? should you?

[Mykal]

Thank you for noting that rice can be allergenic. My brother had a rice allergy and I always get upset about how people talk about it like it’s the perfect food!

[Linda]

Don't forget to throw spices in there, too. Myth #7: baby food must be BLAND. Ug. We've given our kids garlic and onion and cumin and who knows what else from almost the beginning. I figured that kids in countries where spicy food is the norm seem to do fine.

[Amy]

Great post! I wish I'd read it a few months ago. The iron thing has been a bit of a concern to me. I'd much rather make my own cereals from whole grains a la "Super Baby Food", but I was nervous about the iron. There's a lot of conflicting info out there.

I read this AP story a few weeks ago:

http://abclocal.go.com/kabc/story?section=health&id=3523436

and it also makes the point that the edict to make baby food bland is more cultural than anything!

As for the amount of time it takes to make your own, I am not a cheerleader or anything, but IF and only if you are interested (you being fellow reader, not you, Moxie!) in the homemade route, the time it takes is pretty minimal if fresh frozen is OK with you. Once every couple of weekends I bake a giant sweet potato, a winter squash, steam a head of broccoli, whatever. Two, maybe 3 things at a time. Each one goes through the little baby food mill someone loaned me, then gets frozen in ice cube trays. Then, the next day, put into freezer bags. Super Baby Food, the book, takes about 200 pages to tell you what I just did (that book is nutty but I like it). I think it tastes better and I like that I can choose organics if budget allows. I won't need the food mill much longer, either, though I confess I find it weirdly satisfying smooshing up that food.

I must say, though, I am still confused about iron. Now that I have possibly impaired her ability to use the iron in my milk, I feel I should continue with the store-bought baby cereal.

Another nice book on the subject is Child of Mine, Feeding with Love and Good Sense by Ellyn Satter. I don't agree with everything she says, but her basic philosophy is CHILL OUT! Offer lots of nutritious foods at mealtimes, give your child what you eat at the dinner table, don't make food a battle or a reward, and your child will learn to feed himself. Given that family dinners could be stressful times in my childhood household, and given my own flawed ability to regulate how much I eat, this all resonates with me in a huge way.

I know I shouldn't need a book to tell me what must seem obvious to others, but I do.

[Monica]

Thank you so much, Moxie! I started Madam on solids are trifle early (at five months) because she was so fascinated with everything we put in our mouths. I use jars, for the most part, but I am beginning to start making my own food for her. I tried that whole "wait three days" thing too, but Madam got bored eating the same thing every day for three days, so we ended that experiment quickly.

One question based on a comment above--is giving an arrowroot cookie a problem? She gets a cookie a day. Should I put a stop to this?

And one more question--I made her a lentil and brown rice mixture (based loosely on one of the jarred ones she loves) and she liked it, but then she had to poop a lot more than usual. It wasn't the runs or anything like that, but does this mean it hurt her stomach?

[Em]

Thanks so much for the link. I did the jarred food thing with #1, the homemade thing with #2 and I've been putting off starting with #3 (6 months old next week) as I've always found the whole thing to be such a chore. I like the idea of a baby-led approach. I found it interesting that it isn't clear whether a baby-led approach is suitable for babies who are bottle fed (mine is). I guess I'll check with my GP at my daughter's 6 month check up.

[Moxie]

Em, what I got from the article was that breastfed babies were used to controlling their own feeding mostly. The researchers couldn't assume that bottlefed babies were being fed on demand. I think if you feed mostly on demand (with breast or bottle) then the child-led approach to eating would work, because the baby would be used to regulating his/her own intake.

Monica, is it a problem for you to eat a cookie or two every day? Probably not, but if you were eating meals of cookies that would be a problem. I think it's the same with kids. Snacks are one thing (arrowroot cookies, Veggie Booty, goldfish crackers, etc.), but when people convince themselves that those things are adequate meals it's a problem. I mean, we've all had days in which we eat popcorn for dinner, and an occasional snack meal for a kid isn't a problem, but there are people who feed their kids almost nothing but snack foods and think it's healthy because they're organic or have vegetable ingredients.

I think she pooped so much because lentils and brown rice have a lot of fiber in them. It's good for her to have a lot of fiber. No worries.

K, if a baby is drinking breastmilk or formula, she doesn't *need* vitamins. (Unless you live in a place with not much sun, or you put so much sunscreen on her that she never gets enough sun to make Vitamin D herself.) But if you want to give them, it won't hurt her. Personally, I'd stay far away from those gummy vitamins (there are safety concerns that some independent labs have been testing but that probably won't come out until/unless something happens to a child, and I have no written source for that, so I can't say any more on the internet), but regular chewables are fine. Stay away from artificial colors/flavors, yada yada.

[Mama C-ta]

I had posted the baby led approach link on my site a few months back before we were ready for solids. I had every intention on doing it that way and started off doing so. But after dealing w/endless unknown food allergies in my exclusively breastfed baby I was a little worried. And I keep hearing people say "if you don't have a family history of allergies, don't worry..." but we don't have a history and I ended up living off of turkey and rice in order to keep breastfeeding. Just b/c you don't have a family history doesn't mean it can't start. Not that I think you need to follow the one food a week rule but there still needs to be caution.

I'm actually very, very stressed about solids right now since everything seems to be causing him to spit up (sign of an allergic reaction). I'm now able to eat whatever I want and still BF but solids are still a struggle. So now he's getting rice cereal, the ONE thing I never wanted to feed him seems to be the only thing he doesn't spit up. And rice cakes...and bread. I guess just anything w/nutritional value he can't handle. Sigh. I'm actually been trying to write a post on our struggle w/solids and I don't even know where to begin!

[Brooke]

I don't think MSG is a neurotoxin.

It does seem surprising to find it in baby food, since it's a flavor enhancer, and baby food doesn't have much flavor to enhance.

[Moxie]

Brooke, this is all I can find on MSG that's not on consumer-written migraine or anti-additive sites:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6145582&dopt=Abstract

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2879275&dopt=Abstract

It may not be a really *strong* neurotoxin, but I definitely don't want to give it to my baby.

Mama C-ta, one of our friends was in the same boat you are. Her daughter could eat basically nothing but rice and potatoes and apples until she was 18 months or so. (It obviously wasn't an option for her to stop nursing!) She was extremely vigilant about everything her daughter ate until she was 3 or 3 1/2. Now at 4, her daughter has no food allergies at all, to dairy or nuts or the things that gave her nasty hives when she was a baby. Hang in there.

[Christine]

One comment about the food introduction/diabetes link. A good friend has her daughter in that study (she was contacted with these results - they are VERY early, the study is still ongoing). Anyway, all of the kids in the study have to have a full sibling that is diabetic AND have a gene that predisposes them to diabetes. It's an extremely high risk population.

We gave Max risotto the other day. We rocked his baby world with that stuff.

(before anyone yell at me, there was no wine in it)

[Michelle]

I'm so glad you addressed starting solids. My peditrican recommended starting DS at 3 months. it just didn't feel right so i held off until 6 months. He was thriving without the solids and he just didn't seam interested in rice ceral mush. Not that i can blaim him, it's gross. But he didn't like ground-up brown rice, either.

I'm doing organic jars until i rule out allergies. I'm allergic to most fruit. So far he's allergic to apples and he hated peaches. Now i'm going to stick with tring veggies and meat, and skip fruit until he's older. Once i get allergies ruled out, i'll grind up our homemade meals for him.

Is there truth to the nitrates claim for green beens?

I also am not going to give him juice. i think i read somewhere that it can lead to tooth decay. Plus it's so much healthier to have a piece of fruit.

thanks for the tip to wait on cookies until he can ask. i'll hold off on the food puffs and teething cokkies, too.

[Mykal]

Mama C-ta here's another reassuring story. I had a severe allergic reaction to something my mom ate when I was 6 months old and exclusively nursing, I had to go to the hospital couldn't breath ect. from what I hear it was very scary and all. But growing up after that I never had any food allergies and still don't. I have tons of other allergies(mold, pollen, animals), but I can eat whatever I want!

[Cat, Galloping]

Thanks Moxie! That takes some of the pressure off.

I really like the idea of letting Gatito eat table food when he's interested. If only the kid didn't need to go to bed so freakin' early.

Incidentally, I find it funny that there's an assumption that bottle fed babies are not fed on demand and breast fed ones are. Since breast feeding involved *me* (and all my issues) I could not deal with feeding on demand. That's one of the reasons I love bottle feeding-- it's all about meeting his needs, never mine, so he can eat on demand. (Oh god will I ever be able to let this formula thing go?!)

[Michelle]

Here's a link for "Adding Solid Foods for the Allergic Infant" http://www.hallpublications.com/title2_sample2.html
i looked at it again today. i see i should of waited on the apples. darn it.

[Her Bad Mother]

We just started Baby on rice cereal one week ago (at 4 and a half months, just one small serving mixed with breastmilk per day) because she was just so aggressively interested in what we were doing while eating. And so far she loves it. LOOOVES it. Opens her mouth up like a little bird and leans into it and tries to grab spoon, etc, etc. We'll watch and see how it goes - I still want breastfeeding to be her primary source of nutrition as long as possible.