Nothing changes faster than advice on what first foods are best for baby. Holy Moly. I’ve been through a few iterations of Johns Hopkins University Feeding Guide. I’ve seen the old standby of rice cereal as a first food disappear. Lets not forget the huge pendulum swing from AAAAI (The American Academy of Allergy Asthma and Immunology) in 2016 telling us to offer peanut butter starting at 4 months vs 2 years of age. Whew! As a new Mom during these changes I was grappling with what to tell my patients AND what to feed my own children. I poured through the research and asked other Moms what worked for them. Combining the newest research with real life examples and experience provided me an amazing perspective, and (bonus!) super healthy kids. Below is what I’ve learned and I’ve included a link to a PDF Cheatsheet on Introducing Solids that summarizes everything into a printable resource for you!
Feeding Your 4-6 Month Old
The gut of an infant has matured to the point of being able to digest solids by 4 months, though it is safe to delay solids up until 6 months. After 6 months of age an infant should learn to eat food from a spoon in order to maintain an adequate calorie intake and because it’s a really important skill! Like talking and walking, eating solids will take practice on the part of your child and should be supported with regular opportunities to eat without the pressure to necessarily consume anything. This is why offering watery/soupy single ingredient purées between 4-6 months can help identify any challenges your baby has before they require more calories from food between 6-7 months.
Think of feeding purees to an infant at this age as more of a sensory experience than a nourishing one.
Let them sit in the high chair, play with a bowl and spoon, play with the baby food! Unless you and your pediatrician have concerns about your infant’s weight or reflux, there is no need to push for regular solid food feedings at this stage. If your infant still seems hungry (read: fussy!) even after 32+ounces of breast milk or formula a day, then it’s time to move onto the next stage of surviving solids…
Feeding Your 6-8 Month Old
Two meals a day, 2-4 tablespoons of purée at each meal.
1. Can your infant hold up their head without their chin falling to their chest?
2. Is the tongue thrust reflex fading? Meaning does your child automatically push food out of their mouth every time or can they move some purée from the front of their mouth to the back?
If the answers are Yes, then good news! You are free to start feeding your infant almost any type of purée. I liked using infant cereal at first (oatmeal, nothing rice or wheat based) because it’s a great practice food, and I’m not crying into my sink when my baby doesn’t eat the $5 avocado I’ve carefully prepared. However, unless there’s a concern for anemia, you do not have to start with iron fortified infant cereal.
Great first foods include sweet potato, squash, avocado, and banana.
Mix purees with formula, breast milk, or water. Offer one new food every 3 -5 days, watch for allergic reactions (hives on the face and body, vomiting, bloody diarrhea), and keep expectations low. You may have to offer a certain food and definitely different textures upwards towards 7 times before it is easily accepted. Don’t be disheartened 😊
What to AVOID: do not put any food into a baby bottle! It is common advice that a baby will “sleep longer” by adding infant cereals to the night time bottles. I implore you, do not do this. (The only exception is an infant that suffers from reflux, and a medical provider has specifically instructed to thicken the bottles with cereal.) Adding cereal does not teach a child the important skill of eating and reduces the amount of formula/breast milk they should consume. No good!
Avoid honey, cow’s milk, citrus, and egg whites. Honey (botulism! 😧), citrus fruits (face and diaper rashes! 😵), and cow’s milk (anemia!! 😲) can be introduced over age 1. Egg whites can be offered after a child has tried plain egg yolk without a reaction.
Avoid anything that has caused an anaphylactic allergic reaction in a sibling. This does not extend to any parent allergies; even if you have a peanut allergy, your child should still be offered peanut products under age 1.
Wait. What did you say? Peanut butter before the first birthday?
Yes friends. Shellfish, strawberries, nut butters. It’s all fair game now. Historically these foods were avoided often until age two. Then research showed that delaying the introduction of highly allergenic foods may increase a child’s risk of developing a food allergy, not the other way around!
Feeding Your 8-10 Month Old
Three meals a day, 2-4 tablespoons of purée at each meal, incorporate “finger foods”.
Up until now baby has been eating semi solid/ purée foods. You can recognize readiness for more solid or “finger foods” if your infant:
1. Sits up unassisted and does not fall over.
2. Opens mouth wide and swallow purees easily.
3. Is showing interest in other foods and enjoys meal time.
The best trick for assessing whether or not a food is appropriate at this age is the Mash Test; can you easy mash a piece of that food with your fingers? Soft tofu? Check. Roasted beets? Check. Carrot stick? Nope. Over cooked pasta? Check! Another way to think of this process is: will it be difficult to wash this food out of my child’s hair? If the answer is yes, then it is likely soft enough to offer.
If you have concerns about your child choking, then good! You’re a good parent. While I’m sure most parents are aware that hot dogs are dangerous, what you may not realize is there are ways you can introduce finger foods that reduce your anxiety and allow your infant to gain this important skill. One is to offer small pieces of food after a good nap and after they’ve had a bottle or nursed. This way they have the energy to try a new skill and aren’t so hungry that they can’t control the process. Start with something you know will melt in the mouth or throat so, if your baby coughs or gags a bit, you know the food will be in liquid form in a moment. Gerber makes ‘yogurt melts’ that serve this purpose, or you can make your own! Place 1/2 tsp dollops of applesauce or yogurt onto wax paper on a cookie sheet and freeze. Give a few frozen ‘melt-aways’ to baby as a fun afternoon snack!
Continue to offer a wide variety of fruits and vegetables at this stage and include pureed beans and meats for iron and protein. Baby is not expected to self-feed at this age, though it is important to provide opportunities for your child to pick up food of any texture and bring it to their mouth. This is a fine-motor skill they’ll need to get down to business of eating your food in another few weeks!
Feeding Your 10-12 Month Old
Three meals a day with some texture, 2-3 snacks.
Let’s celebrate having more time playing and learning, and fewer bottles or nursing sessions! This occurs as you consolidate liquid nutrition with your baby’s meals. Meaning, offer formula/breast milk close to the time of breakfast, lunch, and dinner. Then, incorporate 2-3 snacks as the number of times a child nurses or bottle feeds goes from 5-7 to 3-4. This sets the stage for a sustainable schedule of feeding through the age of 3! There is nothing I like more than a good foundation for an easier future. In this case, working towards eliminating bottles between meals makes the transition to a sippy cup at meals simple. It also reduces the risk of cavities, since teeth that are constantly exposed to food/formula/breast milk are more likely to decay than if meals and snacks are limited to certain times of day. Snack options at this age include baby food “pouches”, plain whole milk yogurt, Cheerios (or any small vitamin fortified cereal), small pieces of cheese, any small pieces of ripe fruit or soft vegetables like tomatoes. Avoid “cereal bars” and cookies, as these have unnecessary amounts of added sugar.
By 11 months you’ve likely introduced most of the food you commonly prepare meals with. This is an ideal time to put your dinner (for example, low sodium spaghetti and meatballs) into a blender/Magic Buller/etc and let baby enjoy! I advise against ‘Stage 3’ foods at this age because honestly? They’re gross. You can get the same experience of chunky/puree combination by mashing up your dinner and giving 1/3 to 1/2 cup to your child to eat. If they finish that amount? Then give them more! Infants self-regulate, and unless you’re force feeding them, they will eat when hungry and stop when full. No need to worry at this stage if they’re eating too much. Are they refusing to eat this new concoction? Then go back to a puree or finger food you know they do enjoy and try again another day.
Too soon, the first birthday arrives. Congratulations on all you’ve learned, and how far you’ve come!
I hear from many families how challenging it can be to start introducing solids! I’ve put together a one page cheatsheet the includes all the important tips I’ve listed above. This is the resource I WISH I had when I first started feeding my baby!
I’ve combined years of professional experience, expert opinion from other pediatric providers and first food trials from Moms of the patients I care for to bring this resource to you. Enjoy meal times with your baby and feel confident in the choices you make!