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Breastfeeding Breastfeeding Management Information

Starting Solid Foods

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?

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 to Manage 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 ibconline.ca so that you can use the Protocol better. But if the techniques described here, 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. Some exclusively breastfed babies of 6 months of age or so, dislike infant cereal. There is no need for concern and no need to persist if the baby doesn’t want the cereal. There is nothing magic or necessary about infant cereal. Offer your baby the foods that he is interested in. Allow the baby to enjoy food and do not worry exactly how much he actually takes at first. Much of it may end up in his hair and on the floor anyhow. There is no need either that foods be pureed if the baby is six months of age or older. Simple mashing with a fork is all that is necessary at first. You also do not have to be exceedingly careful about how much the baby takes. Why limit the baby to one teaspoon if he wants more? You also do not need to waste your money on commercial baby foods.

What if I am starting solids at 3 months?

At this age, it may be prudent to go a little more slowly. Start with ripe avocado or easily mashed foods such as banana, or homemade oatmeal. Sometimes a baby will eat better from your finger (or his!) than off a spoon. Go a little more slowly with quantities as well. But as the baby tolerates solids, both quantity and variety of foods can be increased, as the baby desires. Incidentally, why are you starting solids at three months? Many grandmothers are keen that the baby start “real food”, but if there is not a good reason to start at 3 months, don’t. (The most common legitimate reason to start earlier than five or six months of age is poor weight gain not corrected by correcting latch, using compression, switching back and forth, using domperidone).

What If I Am Already Supplementing With Formula?

Starting solids early is a way to prevent supplementing the baby with formula by bottle. Formula may be added to solids so that baby consumes the extra calories (from the formula) by spoon instead of by bottle.

Solids or breast first?

There seems to be considerable worry when a child is starting solids about whether to give the breast first or give solid food first. If breastfeeding and the introduction of solid foods both are going well, it probably does not matter much. Indeed, there is no reason that a baby needs both breast and solids every time he eats.


Starting Solid Foods, 2009©
Written and revised (under other names) by Jack Newman, MD, FRCPC, 1995-2005©
Revised by Jack Newman MD, FRCPC, IBCLC and Edith Kernerman, IBCLC, 2008, 2009©
This handout may be copied and distributed without further permission, on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated.

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© 2002-2017 Dr. Lenore Goldfarb, PhD, CCC, IBCLC, ALC and contributing authors to AskLenore.info. All rights reserved.


Disclaimer: All material provided in asklenore.info is provided for educational purposes only. Consult your physician regarding the advisability of any opinions or recommendations with respect to your individual situation.

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