The Real Scoop on Solids
After a perfect start with nature’s best food, there comes a time when your baby will be ready for other foods. Your Baby’s gut has been soothed and coated until this time, and his nutritional needs were perfectly met by breast milk. It is an ideal food – unsurpassed in quality and nutrition – which makes it a hard act to follow!
It stands to reason that when it comes to starting solids, mothers have many questions: Why? When? What?
Why Solids?
Why in the world would we start adding something to Baby’s diet that is going to cause more work for Mom (stinky diapers, changes in the perfect GI flora, and possible allergies or tummy upsets)? The main reason is iron.
At some point, the iron supply your baby was born with will begin to dwindle, and breast milk has easily absorbed but low iron content. Iron needs to be added to your Baby’s diet to assure that his iron levels stay at a healthy level. As he becomes more active, he also needs more protein and calories to help with weight gain.
When Solids?
When to start solids is the million-dollar question. Even the experts disagree on exactly the best time.
The World Health Organization and the American Academy of Family Physicians recommend starting solids at six months. The American Academy of Pediatrics Breastfeeding Committee recommends exclusive breastfeeding until starting solids at six months. However, the American Academy of Pediatrics Committee on Nutrition encourages parents to begin solids between 4 and 6 months. (Many pediatricians have learned the 4- to 6-month rule in medical school.)
These medical groups agree that it is wise to wait until the baby is at least four months before starting any solid food. There is no nutritional advantage to starting solids sooner. Starting sooner may lead to an increase in allergies and obesity.
Before this age, a Baby’s intestines lack the enzymes to digest complex proteins and starches. Studies have shown that foods other than breast milk before four months increase the likelihood of Mom’s milk supply decreasing and Baby having more ear infections and diarrheal illnesses.
If the wisest medical experts on earth can’t exactly agree on when the perfect age is to begin solids, how are new parents supposed to know when to start? Fortunately, it’s not so hard. The key is in knowing your Baby’s developmental cues. These will clue you into when he is ready to begin foods other than breast milk.
Rather than looking at the calendar – as many pediatricians and experts suggest – the wise parent observes Baby for these readiness cues. Cues may begin at four months, six months, or even later. (Children prone to allergies seem to understand that they should start solids later instinctively.)
Cues for Solids
Here are a few things to look for when you are trying to assess Baby’s development for clues to begin solid foods:
- Is your healthy Baby nursing more and more but doesn’t seem to fill up on breast milk alone?
- Can your baby sit up well?
- When offered food, does your Baby open wide and readily accept the food rather than push it back out with his tongue?
- Does your baby show an interest in what you are eating?
- Can your baby pick up small bits of food and propel them toward his mouth?
If your baby shows these developmental signs, it is probably about time to think about offering solids.
What Solids?
Remember all those charts and food pyramids you had to memorize in high school? Remember the fruits and the vegetables and the dairy and the protein groups? Well, guess what? As a parent, you are in charge of the pyramid. Oh my gosh! Even if you have lived on fast food and frozen dinners for the past few years, you now have the responsibility to feed your Baby healthy foods and teach him good eating habits to last a lifetime. (All of a sudden, breastfeeding seems so easy!)
This is a perfect time to improve your diet and take charge of your pyramid as well. (If you take care of your pyramid, you will most likely take care of your spouse’s pyramid, as well.)
When it comes to healthy eating, do you hightail it to the grocery store to stock up on those colorful little jars of baby food? How do you know which ones to buy? Perhaps you will buy them, and perhaps you will decide not to buy them.
Many moms skip over the colorful little jars entirely and prepare their Baby’s food. It isn’t difficult. Home-prepared food is also very nutritious and fresh. It has less water and is much less expensive. You can omit salt and sugar, and preservatives.
But where do you start? How about with a fresh banana? A slice of a real fresh banana mashed with a fork and offered to your baby is a sweet, fresh first food. Some moms will cook a sweet potato or yam and offer a spoonful of that as the first food. Your Baby’s diet can even be careful portions of the family’s diet. If your baby has met the list of developmental cues, he will probably be pleasantly surprised to be getting something a little different.
By the way, breastfed babies are much more accepting of different flavors than their artificially-fed buddies because breast milk changes flavors constantly, preparing Baby for a whole range of different foods.
La Leche League, who has been teaching parents how to start solid foods for more than 48 years, suggests this progression when starting solid foods:
- Ripe banana, avocado, yam, or sweet potato (sweet and mild)
- Meat (Remember the need for iron?)
- Whole-grain bread and cereal (not sweetened, mixed with a little breast milk)
- Fresh fruits: grated apple, apple sauce, pear or peach (fresh or cooked)
- Vegetables: grated raw carrot, cooked potato, chopped green beans, or squash
- Cottage cheese, unsweetened yogurt, and soft cheeses (after 9 to 10 months of age)
Are there any foods to avoid in the early months of solids? The “allergic” types of foods are best to wait on, such as egg white, cow’s milk, peanut butter, peanuts, and honey. Foods that you already know aren’t good for you – fried foods, soda, sugary foods, and salty foods – should also be avoided.
You also need to avoid “choker” foods. Choker foods are hotdogs, popcorn, nuts, whole chunks of fruit, hard candies, and vegetables that can be bitten off in chunks. Be vigilant because little fingers are quick to grab these kinds of foods (or at my house, find them on the floor) and choke before you know it.
Because of this, it’s a good time to learn or refresh infant CPR techniques. Contact your local Red Cross or Heart Association to find out where these classes are taught in your area. Your local hospital may also be able to help you out.
How to Do It
Before you give any meal, it is important to breastfeed first. Solid food is only an addition to breast milk, the best food in the world.
Start slowly, just a teaspoon or less of each new food, and then you can observe your baby for any allergic reaction. By starting one new food a week, you can carefully observe signs of an allergy: sand-paper rash on the face, hives, runny nose, watery eyes, diarrhea, constipation, crankiness or gassiness, and bloating. This is particularly important if there is a family history of allergies on either side.
If all goes well, new food can be added each week. If there are signs of problems, that food should not be offered again for a few weeks. You might want to keep a food diary to help you remember any reactions your baby has to a new food.
At an early La Leche League meeting, I remember hearing a leader say, “Never wheedle, force or cajole your baby to eat!” These words were kind of catchy and have stuck with me all these years. It is important to offer a variety of foods to your baby, but if Baby gives you “stop signs” such as turning her head, pushing the food out of her mouth, or fussing, it is time to move on to another activity.
Hungry babies will usually eat. In most cases, they will automatically balance their diets if offered the right foods. They will also learn to stop eating when they are no longer hungry – something many adults have forgotten how to do. Adults have been taught to finish what’s on their plates, and they will eat until that time and ignore the cues their stomach sends about satiety. Just like when they are full of breast milk, and babies come off the breast, babies will also naturally “come off” the plate when they are done eating solid foods.
If you are using the jarred food, watch your baby and not the jar. Just because it’s there doesn’t mean it is the right amount for your baby at this meal.
Mealtime should be pleasant and unhurried. You don’t have to be on a strict schedule with meals. Be flexible, and you will teach your baby flexibility, too. The process of beginning solid foods is a natural progression. When done with care, it is easy. Think of it as a time of learning for both of you as you learn to creatively plan healthy meals for your baby and your whole family.
So now you know. Is your baby ready – or not?
Both the American Academy of Pediatrics and the World Health Organization agree that solid foods should be started around six months – when your baby shows an indication that he is ready. These experts stress that several developmental signs should be met before starting solids:
- Is your well-baby nursing more and more but doesn’t seem to fill up on breast milk alone?
- Can your baby sit up well?
- When offered food, does your Baby open wide and readily accept the food rather than push it back out with his tongue?
- Does your baby show an interest in what you are eating?
- Can your baby pick up small bits of food and propel them toward his mouth?
In most cases, when these developmental steps are met and foods are offered, babies around six months of age will begin to accept small amounts of new foods – but it might not happen this way.
My children all seemed ready by 6 or 7 months and began eating small bits of various foods. However, over the years, I have talked to mothers whose babies refused solids. These babies were growing well and were happy as clams, but they said YUCK when a spoonful of solid foods approached their tightly-clenched lips. These mothers continued to offer various solids to their little ones, but the babies would turn away and refuse. One mother reported trying to push food into her child and getting violently ill afterward and vomiting for hours.
If this happens to you and your baby, what do you do? Do you keep pushing, or do you wait and see? Should you try to trick Baby into eating? Can any harm come from spooning food into an unwilling baby? Can any harm come from not spooning food into an unwilling baby? What’s a parent to do?
The Medical Research
According to Dr. Ruth Lawrence’s book, Breastfeeding: A Guide for the Medical Profession (Mosby, 1998), a group called the Maternal and Young Child Nutrition of the United Nations/American College of Cardiology Subcommittee on Nutrition reported on just this subject. Dr. Lawrence summarized their findings by writing: “Although practice depends on many biologic, cultural, social and economic factors, when Mother’s milk fails to meet the energy and nutrient needs of an infant, inadequate growth and development threaten the child’s health and survival. In general, the subcommittee declared that children who are not receiving complementary feeding beyond 6 months do not maintain adequate growth but that infants should not receive it before 4 months.”
Oh my gosh.
Intrigued, I sent out an inquiry to mothers in parenting groups and lactation consultants who had breastfed their babies. I was seeking mothers whose little ones said no to solid foods at six months of age. I received 32 replies from mothers scattered throughout the world about their 38 children who “just said NO.” Here is the information they shared.
The Maternal Research
Health care providers stress that the main reason solid foods must begin by six months is that iron stores may decrease as babies reach this age, and iron deficiency anemia may occur.
Three mothers indeed had their babies’ iron levels tested, and the levels were low. Two of them gave an iron supplement for one month, and then iron levels were normal again. One of them added more iron-rich foods for a month, and her Baby’s iron levels were normal before the next checkup. The other 35 children did not have a problem with their iron levels being low. They were all within normal limits.
There were 19 boys and 19 girls in this group. All of them were full-term babies. Interestingly enough, many of them were a week or two late. Most of the babies are exclusively breastfed for at least one year. The babies ranged from eight to 18 months of exclusive breastfeeding. Some of them started solids reluctantly at 8 or 9 months old but only ate small amounts a few times a week.
I asked these mothers if their babies were healthy or suffered from allergies. One theory I have heard for children refusing solids is that they instinctively know they are allergy-prone and need to delay starting solid foods. Here is what mothers told me:
- One child suffered ear infections the first year.
- Two were diagnosed with severe reflux in the first year.
- Twenty of the children had no allergic symptoms during their first year.
- Eighteen of the children exhibited signs of allergy. (Nine exhibited dairy allergy, two gluten allergy, and one had a peanut allergy. Two experienced asthma. Two others had eczema. Two of the children showed an allergic reaction to medications.)
All of the children continued to grow at steady rates on the growth curve. Some of them grew rapidly, but many of them grew slowly.
The smallest was 15 pounds at one year; the largest was 33 pounds at one year. Most of them were approximately 20 pounds at 12 months of age. (It is normal for breastfeeding children to slow their growth rates between 6 and 12 months.)
Many mothers reported that their children were small due to family growth patterns, but they reported that their babies achieved excellent developmental milestones. Most of them reported that their children were advanced in development for their age.
Once solid foods began, most of these children ate various foods and did not particularly show any problems accepting foods. Several of the children disliked “mushy” foods. Two of the children wanted only to feed themselves and would not accept food from a spoon.
When the Worlds Collide
What did health care providers say about these children exclusively breastfeeding? Four mothers had very concerned health care providers. One mother had a very concerned health nurse.
“My pediatrician at the time felt that Ruby would ‘never learn to eat anything but liquids and mushy foods’ if she didn’t get solids before 1 year,” says Joi Straaten of Sandy, Utah, the mother of two late starters.
One mother reported that in her experience, public health nurses were a real problem, pressuring for the introduction of solids no later than 4 to 6 months from the initial postpartum home visit and reiterating this at every immunization appointment.
The other 27 babies who started solids late had health care providers who did not get upset or overly concerned and observed the babies for normal growth and development instead. One mother, who had gotten advice from a health care provider that resulted in the premature weaning of her first child, did not share this information with her Baby’s health care provider.
True Stories
Chris Kaden’s first child was a slow starter with solids. The Bordentown, N.J., mother had many concerns. When her second child was born, she felt more relaxed.
“With starting solids, as with all aspects of parenting, I truly believe that parents must follow their hearts,” she says. “I have felt best about the decisions we’ve made where we trusted our baby to know what she or he needed. By doing our own research, we felt confident that what we were doing was right for our child. Of course, we often found ourselves defending our choices to doctors, family or friends. This wasn’t always easy, but for my children’s sake, I would do anything. I never knew I had a backbone until I became a mother! I am actually very glad and thankful for the difficulties we had with our babies. I think it has made me a better and a stronger person, and I wouldn’t have missed that opportunity for me to grow as an individual and a mother.”
Rebecca DeYoung Daniels, a dietitian and mother of five from Overland Park, Kan., also learned a thing or two about mothering as she had more children. “I believe that all of my children learned to self-regulate their intake through breastfeeding and that they now have very healthy attitudes toward food and eating,” she says. “I was also a lazy mother … after No. 1 rejected mushy baby food, I didn’t bother with the mess with subsequent children. They ate things they could feed themselves or small bites of what we were eating. As a dietitian, I was frustrated with all of the ‘rules’ and reacted by throwing them all to the wind and letting my children set the pace.”
Medical Support
Several of the mothers who wrote had been supported in allowing their children to wait on solids until they were ready by California pediatrician Dr. Jay Gordon.
“I have countless babies in my practice who have been exclusively breastfed beyond 6 months,” says Dr. Gordon. “They are all very healthy. These families tend to be pretty intelligent, nutritionally aware and therefore present a skewed segment of the population – tough to study or publish. Slower weight gain is often good, not bad … and underweight is almost always healthier than overweight in humans of all ages. I don’t believe that anemia or B12 deficiency pose a significant risk to exclusively breastfed babies through the first 12 to 20 months of life. Mother Nature and evolution rarely make mistakes that large. The seminal ‘research’ about anemia and other ‘problems’ with longer exclusive breastfeeding would not have been done without the encouragement and funding of the formula and baby food industry.”
You Be the Judge
These are the stories I received. This is not a scientific study. It is simply sharing the experiences of real nursing mothers and babies.
Many of the children in this article are adults now. Their mothers found that no short-term or long-term ill effects came from waiting until their children began to show signs of readiness for solid foods. All of these mothers felt comfortable with the way their children ate. All have lived to tell about it. None of these babies are still living on mushy foods, refusing to accept various foods or depending on breast milk for their total sustenance. I hope that their stories are useful to other mothers living with babies who “just say NO.”