Starting solids

What signs should I look for to indicate my baby is ready for solids? Should we start with spoon-feeding? Pouches? Finger foods?

A: Solid food initiation, based on current recommendations from the American Academy of Pediatrics, should start at 4 to 6 months of age. Whether an infant begins solids at 4 months or waits until 6 months is based on individual maternal preferences and general growth and development.

Some infants may show signs of increased food needs by virtue of appearing hungry or not fully satisfied with feedings. Others may exhibit irritability. You may observe wakefulness in a baby who was previously sleeping well. If your little one is slow in gaining weight, he might benefit from receiving more calories through solid foods.

Single food groups can be added individually. For example, grains (cereals), vegetables, fruits, dairy products, and meats and poultry can be given by spoon, usually twice daily. Within each food group, individual components, like squash, may be added once the previously introduced food is tolerated.

It is important to understand that these new food groups do not replace the milk source but rather complement it. As infants grow, their calorie needs increase on the basis of weight gain, and this translates to requiring more food.

Once all food groups are introduced and tolerated, new food delivery techniques can be entertained. The food pouch trend is very convenient, less messy and more suitable to the “feed on the run” concept. Finger foods can start as early as 9 months if the child is neurodevelopmentally ready and inclined. Remember that there is no reason previously introduced finger table foods cannot be comingled with traditional baby foods in the same meal.

—Ralph E. Caprio, MD, senior attending physician in the department of pediatrics at St. Joseph’s Children’s Hospital and senior pediatrician at Notchview Pediatrics, LLC in Clifton, New Jersey


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