By Jack Newman, MD, FRCPC
Health Canada, the Canadian Pediatric Society, the American Academy of Pediatrics, IBFAN, UNICEF, the WHO Global Strategies on Infant Feeding and most paediatric societies around the world recommend exclusive breastfeeding to about six months. Many health professionals suggest starting solid foods at four months of age; many now say you must not start before six months of age. However, most babies do fine with exclusive breastfeeding to six months of age or even a little longer. You should start your baby on solids when s/he shows signs of being ready for solids, not by the calendar. See below.
• Because there comes a time when breastmilk no longer supplies all your baby's nutritional needs. (This does not mean, as some uninformed people say, that there is no nutritional value in breastmilk after the baby is six months old.) A full term baby will start requiring iron from other sources by 6 to 9 months of age. The calories supplied by breastmilk may become inadequate by 8 to 9 months of age, although some babies can continue to grow well on breastmilk alone well past a year. But just because they can grow well on breastfeeding alone is not a reason to delay introduction of solids when the baby is obviously ready for them. See below about the baby's cues that he is ready to eat.
• Because some babies not started on solids by a certain age (9-12 months) may have great difficulty accepting solid foods.
• Because it is a developmental milestone that your child passes when he starts solid foods. He is growing up. Usually, he will want to eat solids just as you do. He is ready to participate with the rest of the family in this family activity. Why stop him?
The best time to start solids is when the baby is showing interest in starting. Some babies will become very interested in the food on their parents plates as early as four months of age. By five or six months of age, most babies will be reaching and trying to grab food that parents have on their plates.
When the baby is starting to reach for food, grabs it and tries to put it into his mouth, this seems a reasonable time to start letting him eat. There really is no reason to start on a specific date (four months, or six months). Go by the baby's cues.
In some cases, it may be better to start food earlier. When a baby seems to be hungry, or when weight gain is not continuing at the desired rate, it may be reasonable to start solids as early as three months of age. Starting at three months of age when things are going well, however, is not recommended (see above). But, it may be possible, with help, to continue breastfeeding alone without any addition of solids and have the baby less hungry and/or growing more rapidly. See the information sheet Protocol for Managing Breastmilk Intake. See also the information sheet Slow Weight Gain Following Early Good Weight Gain for reasons your milk supply may be down and what you can do about the decrease. Check the videos at nbci.ca so that you can use the Protocol better.