Starting Solid Food

The AAP and PAMPA recommend exclusively breastfeeding infants until the age of 6 months.

Important: No solids (including rice cereal) should be added to bottles unless prescribed by the doctor or nurse practitioner for treatment of swallowing problems or gastroesophageal reflux.

How to Determine Infant Readiness:

1. Infant is approaching 6 months of age,

2. Infant sits alone or very well with minimal support,

3. Infant shows interest in parental foods and eating habits,

4. Infant opens mouth for spoon.

Reasons to delay starting solids:

1. Increased risk of food allergy,

2. Increased risk of obesity later in life,

3. Frustrating feeding difficulties result from immaturity. If solids are started too soon, infants are likely to tongue thrust and push food outward. This action decreases with age.

Infant Foods

Cereals: rice, oatmeal, barley and mixed

Stage 1 food: smaller jars, thinner purees, single ingredients (fruits and vegetables)

Stage 2 food: approximately twice the volume of Stage 1 foods, thicker, often two or more ingredients

Stage 3 or Graduate food: softer finger foods or textured “dinners”

Starting Solids

Rice Cereal:
Dry, iron-fortified rice cereal is often started between 4–6 months, but closer to 6 months is preferable. Single grain cereal is recommended and parents should avoid mixed cereals at this time. Most parents begin with an evening feeding. Initially, rice cereal 1 should be mixed with breast milk or formula and be relatively thin (⁄2 –1 tablespoon per ounce of liquid). Once the infant is opening his mouth eagerly and swallowing the cereal consistently, the rice cereal may gradually be thickened to a pasty consistency. Parents may then increase the amount offered and increase to twice daily feedings as the infant’s interest increases.

Infant Vegetables and Fruits
After 6 months, Stage 1 or homemade pureed vegetables and fruits may be started. When adding new foods, it is advised to wait 3–5 days between adding new foods to allow observation for allergic reactions such as rash, loose stools, or vomiting.

Stage 2 foods:
These are designed for older infants (greater than 7–8 months) who have already tolerated a large number of the single ingredient foods. These include the infant meats.

Finger foods
Once infants are able to pick up pieces of foods in a pincer (thumb and index finger) grasp, they may try some finger foods. This is usually around 8–9 months. Infants do not have molars to grind and chew these foods. Infants will swallow food after only sucking on the food or compressing it between their gums. Such foods may include Cheerios, pieces of banana or other soft fruits, green beans, or peas. Avoid giving tough meats, nuts, popcorn, raisins, raw carrots, large hot dog pieces, whole grapes or hard candies before 3–4 years of age (these can cause choking).

Water
Water alone should be limited to less than 4-8 ounces per day for infants younger than 4 months of age. Infants do require fluoride for tooth enamel development so tap water should be used to prepare formula and offered alone after 4 months.

Juice
Juice is not required in an infant’s diet. It should not be offered to infants under the age of 4 months (unless prescribed for constipation). It offers minimal or no nutritional value (depending on the juice) and is essentially just sugar water. It can fill the infant’s stomach up and cause less interest in more nutritional calorie sources. If juice is used, parents should limit it to 4 ounces per day.

Reminders for parents:
Do...

1. Make eye contact while feeding your baby.

2. Make mealtime pleasant.

3. Breastfeed or use iron-fortified formula for the first 12 months.

4. Remember that stool color, consistency and frequency may change with dietary changes.

5. Begin to offer a cup by 6-9 months. Initially, the infant may only play with it but they will gain practice.

6. Feel free to make your own baby food.

7. Offer a variety of plain fruits and vegetables; avoid fillers.

8. Expect your infant’s appetite to decrease with increased mobility, usually around one year of age.

Don’t...

1. Change to whole cow’s milk before one year of age.

2. Give your baby goat’s milk.

3. Put your infant to bed with a bottle (this may cause dental cavities and ear infections).

4. Force your baby to finish every bottle. Appetites may vary from feeding to feeding.

5. Prop the bottle.

6. Put cola, fruit drink, tea, Jell-O or cereal into a bottle unless directed by your physician.

7. Dip nipple into honey or add honey to formula or water. It can place the infant at risk for botulism.

8. Add salt or sugar to homemade baby food.

9. Give more than 32 oz. of formula a day after 6 months of age.

10. Offer these foods in the first year: nuts, peanut butter, chocolate, strawberries, and shellfish (they are more allergenic than other foods).

Download and Print as Adobe PDF

•  Starting solid foods for infants