Getting started on solid foods

One source of parental angst that seems to bridge most cultural and generational gaps centers around what our children do -- or do not -- eat. These concerns, which often persist long after our children have moved out of the house for good, generally crop up during the first year, as baby is taking her first bites.

But while our worries may have remained the same over time, the recommendations for new eaters haven't. Here is what today's specialists have to say about getting a child started on the road to healthy, independent eating.

When to start

"A generation ago it was a source of pride to get your baby on solids earlier than your neighbor," says Dr. Benci Franklin, a pediatrician at Swedish Physicians Childrens' Clinic. "But today, we recommend starting at around 6 months." Before then, Franklin explains, the child's system isn't as capable of breaking down foods. "So there's greater potential for allergies."

There are also certain signs indicating a child is ready for more than just milk or formula. Jean Westerlund-Rice, a nutritionist with the Public Health -- Seattle & King County WIC (Women Infant and Children) Program, says that for one, the baby will start to show a strong interest in the family's food. It's also important that she be able to sit up, and can move food from the front to the back of her mouth without gagging.

"A young baby has a natural tongue thrust when they put something in their mouth," she says. "They'll push it forward to keep things out of the back of the throat."

So which should a parent concentrate on: the child's age, or the signs of readiness? "My personal recommendation is never before 4 months," says Westerlund-Rice. "Even if the food goes down, we're not ready to digest it" before then.

Just as introducing solids too early can cause problems, waiting too long can also have adverse affects. "You have a window of opportunity between 6 months and 1 year where you're ready to learn to eat," says Lori Brizee, M.S., R.D., a clinical dietician at Children's Hospital and Regional Medical Center, "and you need to be receiving solid foods and getting more texture" during that time.

Franklin agrees. "If they don't learn (to eat) during this period, they often have problems later on. They need to develop the oral skills required for eating."

Foods to start with

When first introducing solids, the baby's primary food source will still be breast milk or formula. Yet there are certain nutrients, particularly iron, that a 6-month-old breastfed baby needs from outside sources (this isn't as much a concern for formula-fed babies, as most formulas today are iron fortified). "A mild iron deficiency might not show up in a blood test," says Franklin, "but it can affect brain development, and can show up in IQ points and overall intelligence."

The standard recommendation for baby's first food is iron-fortified infant cereal. But, according to Westerlund-Rice, "Some research questions the absorption of the iron from these sources. Starting with a more absorbable iron -- meat broth or highly pureed cooked meat or beans -- may be a better source."

Brizee also points out that some kids won't eat rice cereal. So "pureed peas or beans...make great first foods." Other foods she suggests are ground-up zucchini, squash or mashed bananas, or microwaved yams or sweet potatoes.

And what about the claim that one should introduce vegetables before fruit, since a preference for sweets may turn the child off other foods? "I don't think there's any proven research on that," Westerlund-Rice says, "but I recommend people start with vegetables because they're more nutritious."

"It doesn't matter what you introduce first. The important thing is (to introduce them) one at a time," adds Brizee, noting to wait three to seven days in between to detect any potential allergies.

Brizee also advises moving from spoon-fed to finger foods as quickly as possible. "Children," she says, "won't learn to feed themselves with fork and spoon until they learn to feed with their hands." To that end, she recommends "any food you can squish between two fingers or that dissolves with saliva." Cooked green beans, as well as broccoli spears and carrots that have been cooked until soft, are examples.

Foods to avoid

Due to a pervasiveness of allergies, Franklin recommends withholding seafood, egg whites and strawberries for the first year. He also counsels parents to avoid peanut products until kids are around age 2.

If a baby develops a rash, vomits excessively or has major diarrhea after eating something new, Franklin says you shouldn't automatically assume it's the food. "Stop the food, wait a couple of weeks to let the symptoms settle down, then try again." So many things get blamed on food allergies, he says, when the baby might have simply had a virus at the time. "But if it happens two times, then you can assume it's not good for the baby."

Other foods worth minimizing are those without a lot of nutrients, such as fruit juice. "It's glorified Kool-Aid," Brizee says. "By the time you squeeze the juice and throw away the pulp, you have sugar and water left." And, she adds, juice fills kids up, so they may not have an appetite for the healthier foods they need.

With obesity being the number-one health issue in this country, should sweets be avoided altogether? "My rule is, don't give them sweets until they're old enough to ask for them," Brizee says.

She adds that meat is also something we don't need to overdo. "Make sure your first order of feeding is getting in fruits and vegetables," she says. "Meats are good source of iron and vitamins. But... we don't need as much meat as the average child eats." It's a good idea, she adds, for families to have a few vegetarian meals a week.

Laura Fine-Morrison is a mother and Seattle-based freelance writer.


All three individuals interviewed for this article recommended Ellyn Satter's books on feeding and nutrition:
Child of Mine: Feeding With Love and Good Sense (good nutrition book for new parents) and How To Get Your Kid To Eat... But Not Too Much (feeding young children through adolescents)

Web-based resources on nutrition and children:

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