By Jack Newman, MD, FRCPC

Here's What You'll Find Below:Why start solid foods?
When to start offering solids
How should solids be introduced?
What if I am starting solids at three months?
Solids or breastmilk first?

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.

Why Start Solid Foods?

• 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?

When To Start Solid Foods

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.

But if the techniques used in the clinic, which nevertheless will increase your baby's intake of breastmilk, do not deal with the problem, adding solids can help also. Increasing the baby's intake while breastfeeding is the first step and best step. There is no advantage to giving artificial baby milk (formula) and there definitely are some disadvantages, especially if it is given by bottle. The baby who is not satisfied completely at the breast may start to take more and more from the bottle, and end up refusing to take the breast completely.

The breastfed baby digests solid foods better and earlier than the artificially fed baby because breastmilk contains enzymes that help digest fats, proteins, and starch. As well, breastfed babies have received a wide variety of tastes in their lives in the breastmilk, since the flavours of many foods the mother eats will pass into her milk. Breastfed babies thus accept solids more readily than artificially fed babies. Breastfeeding is amazing, eh?

How Should Solids Be Introduced?

When the baby is starting to take solids at about six months of age, there is little difference what he starts with or the order foods are introduced. It is prudent to avoid highly spiced or highly allergenic foods at first (e.g. egg white, strawberries), but if the baby reaches for the potato on your plate, make sure it is not too hot, and let him have the potato. There is no need to go in any specific order, and there is no need for the baby to eat only one food for a certain period of time.