Introducing solids: professional guidance

The good news is that introducing solids doesn’t have to happen quickly. You and your baby need to be ready. As with any baby or parenting style, there isn’t a one-size-fits-all. There are certainly guidelines and preferences, but in the end, there is a unique family with everyday demands and traditions.

Your baby’s readiness, your preference and your child’s health needs will impact the method you choose. Before 12 months of age, the main aim of solids is to help babies develop a positive relationship with food and develop the oral motor skills needed for managing food. 

When should I start introducing solids?

A baby needs to start solids by 6 months of age. Before this age, your baby gets all their nutrition from milk. A baby may start solids sooner than six months, but this must not be before the age of 17 weeks.

No solids before 17 weeks means that granny’s advice to give a baby cereal in the bottle from 6 weeks of age so that baby will sleep better or to give them pap (mielie meal) to fatten them up is a definite NO! There are specific signs for readiness, which should be adhered to so that your baby develops a healthy relationship with food and consciously leads the process.

If you start your baby earlier than 6 months, it is usually just for exposure to food and a sensory experience rather than for nutrition but they must display signs of readiness. It also provides time for the caregivers to introduce the allergy foods early and to take things slowly.

How do I know if my child is ready for solids?

Your baby must have developed the skills necessary to eat safely. Babies develop at different rates, but ensuring the baby can:

• Hold their head up while seated in an infant feeding seat.
• Open their mouth when food comes close to the mouth.
• Bring objects to their mouth.
• Try to grasp small objects like toys.
• Move food from a spoon into their mouth. A baby who is not ready for solids will most likely let a spoonful of cereal dribble out of their mouth. This is because the skill to move food to the back of the mouth to swallow has not developed. Wait a week or so, and then try again.

Why are solids important from 6 months of age?

Solids play an important role in your child’s health especially when it comes to iron and zinc. I find nature fascinating in this regard. A baby is born with good iron stores in their blood and bones. These stores were acquired in the womb from mom. By 6 months of age, these stores have pretty much been depleted. While there is some iron in breast milk and formula, it is insufficient. Your baby now needs food to provide these essential nutrients for growth and development.

A baby also needs to experience solids so that they learn to eat. Exposing a baby to a variety of tastes and textures is critical to establishing a good balanced diet and a tolerance to various foods. This means food with a variety of textures and tastes.

Chewing solids is also crucial for the development of the jaw, tongue and facial muscles. Learning to use the jaw and tongue effectively is necessary for swallowing solid food and speaking. 

What are the different methods for introducing solids?

There are various methods for introducing solids. Whichever way is used, it is essential not to use a cell phone or the TV as a distraction. Never force-feed a baby. Your baby must be engaged with the food and have fun exploring the food and making a mess. There’s no need to worry about quantity but focus on the baby enjoying the experience.

Spoon feeding

In this method, the adult is in charge! The caregiver puts food onto a spoon and offers it to the baby. It usually starts with pureed foods followed by lumpy mash. The baby then progresses to soft finger foods and then soft family meals.

If your baby is in a daycare facility, then it is most likely that this approach will be used as they have plenty of babies to feed. However, the baby must always be willing to participate and not tricked into eating. 

Tips for spoon feeding baby:

• Babies who are breastfed are more open to increased flavours as they are used to varying flavours from their mom’s milk. Formula always tastes the same, and babies on formula may struggle with strong flavours at first. Formula-fed babies may benefit from responsive spoon feeding to allow them to explore more flavour in their food. 
• The baby must show an interest in the food. They must lean towards the spoon and open their mouth for the food. If baby shows no interest, then wait a week or so unless instructed otherwise by your healthcare provider. 
• The baby must be sitting upright. A child who is lying back or is unsupported is more likely to choke. 
• It’s a good idea for the parents to decide on the timing and to try baby on solids at home first. Choose a weekend when everyone is relaxed and has time to allow baby to have a positive experience.
• Follow the baby’s cues. If baby turns away from the spoon, pushes the spoon away or clamps those little gums closed, they have had enough. Don’t force your baby! In this method, babies are often overfed because they are not in control
• Have two spoons. Then, if the baby wants to play with one spoon, you can use the other to continue feeding. You can also preload a spoon and offer it to them to feed themselves so that they feel in control and experience success. 
• Let the baby go at their own pace. This is usually slow, so please allow enough time.
• Model eating from a spoon and talk to baby while you feed.

Baby Led Weaning (BLW)

In this method, the baby is in charge. It is better suited to children 6 months and older. The conventional purees and mashed whole foods are bypassed, and the baby starts with finger foods that need to be chewed, as well as natural purees, such as yoghurt, porridge or soup.

The baby sits at the table with the family and gets to choose the food and quantity of food they want to eat. You would provide several items for baby to choose from, but you should not interfere with their choice.

You can support baby if they struggle with grasping the food or managing a spoon. Babies use their oral reflexes (which are lost at around 9 months of age) to learn how to chew and tolerate diverse textures in their mouth.

Tips for baby lead weaning:

• This method should ideally only be used from approximately 6 months of age, or when the baby displays signs of readiness.
• The baby must have the necessary trunk and neck control and be able to sit up in a feeding chair. Baby must be upright at all times while eating.
• Ensure that the foods baby is getting have sufficient iron and zinc. Remember that your baby needs these nutrients, but it isn’t easy for a six-month-old baby to chew a piece of beef.

Green vegetables, fortified cereals and pureed meat would provide these enzymes but are not part of the initial BLW plan. You need to give a supplement if you are strictly following this method.

• Most of the food must be kept soft. Whatever food is offered should be soft enough to squash between your fingers. Foods such as a spare rib bone or a fleshy mango pip are also great for jaw and tongue movement and development. 
• Your baby must be capable of grabbing and holding onto food.
• Food must be prepared appropriately for your baby’s age. A 6-month-old baby needs thick strips or sticks of food. The baby will hold the food and bite down on it. From about 9 months of age small pieces of food can be offered once your baby has a good pincer grip.
• Be careful of choking. Since your baby will be handling the food and biting pieces off, there is a chance that they may take a larger piece than they can handle, and this may be difficult to chew.

In BLW, the caregiver must always be present and watching. Don’t offer foods that are choking hazards. These include whole grapes or cherries, nuts, hot dog sausages, globs of nut butter, hard chunks of meat and so on.

• Offer the baby a variety of foods on their plate. Food with different colours and textures will encourage adventurous eating and hopefully avoid picky eaters.
• In this method, the caregiver may not put food into the baby’s mouth. The baby must self-feed.
• It is a good idea to observe baby for signs of being full. If they are crying, throwing the food or messing it all over the place, it’s better to end the meal and try again at a later stage rather than trying to get them to finish the meal.  

A combination of spoon feeding and BLW

I prefer to advocate a combination of the two. If you want to give your baby cereal or yoghurt, BLW just isn’t practical until they are old enough to hold the spoon and get the food to their mouth.

Over and above this, feeding a child that is taking time to master self-feeding with iron-rich porridge, puree or strained meat will ensure that these vital nutrients don’t go lacking.

Combining the two methods often leads parents to question whether a baby will know what to do with the food or choke. Chew or swallow? Lumpy purees are more difficult to manage than smooth purees, as a baby needs quite advanced skills to sort through a mix of purees and lumps once in their mouth. However, the lumps and solid food help baby to learn about texture within the mouth and how to use the jaw and tongue to control the various textures. 

Some parents want a set of rules or prescription on how to introduce solids. For these parents, I generally advise that they follow the guidelines set out by The American Academy of Paediatrics (AAP), which still advises that caregivers begin with adults initiating spoon-feeding and progress to soft finger foods later when the child can handle them on their own.

However, the danger with only the spoon-feeding method is that parents areafraid to move from purees to mashed and finger foods. This results in a child who refuses lumps, gags when anything other than a puree is in their mouth, and has a very restrictive diet. Remember, the key is to progress, and yes, a child can chew on those gums. Teeth are not a prerequisite for chewing. 

Other parents are happy with their baby leading the way. In this case, try the BLW method which is becoming more popular around the world. There appears to be a lot less resistance to food when adopting this method, and parents find it easy to allow the child to eat whatever they like and whatever the family eats (minus salt, sugar, honey, etc.) in whichever order as long as it is presented in a safe form, and that the baby is seated safely and monitored at all times. 

Ultimately, we want a child who has a healthy attitude to food, eats a wide variety and what the family eats by 1 year of age. There are no rules as to what order you need to give the foods in as long as the baby is having a variety by 7 or 8 months.

This includes sugar-free cereal (whole grain), meat or other protein, grains, vegetables, fruit and sugar-free, full-cream yoghurt. Remember to start the potential allergy foods early. If you’re starting at 17 weeks, introduce the allergy foods along with all other foods. This includes peanut butter, well-cooked eggs, wheat, soy, cow’s milk and fish. 

The most important point about introducing solids is that you must be relaxed, the baby must be ready and you must happily engage in the process. Don’t be afraid to feed your child a wide variety of food. Nothing is off limits as long as it is prepared in a safe and healthy way. There are a number of apps with wonderful tips and recipes. Find what works for you, and let’s get children eating healthy meals and enjoying food with their families. 

References

• https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Starting-Solid-Foods.aspx
• https://solidstarts.com/how-to-do-baby-led-weaning/
• https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/when-to-introduce-solid-foods.html
• https://www.aap.org/en/patient-care/newborn-and-infant-nutrition
• https://feedinglittles.com/benefits-of-baby-led-weaning/
• https://newwaysnutrition.com/babies/combine-traditional-baby-led-weaning/
• https://solidstarts.com/tongue-thrust-and-starting-solids/