Guidelines to Introducing Solids in Infants

The introduction of solids is a controversial topic and advice has changed several times over the last few decades. Currently solids should be introduced between 4 and 6 months. This advice is consistent with guidelines from America, Europe and the Australasian Society for Clinical Immunology and Allergy. In parts of the World where hygiene is a much bigger concern the WHO (World Health Organisation) advises no solids until 6 months.


Introduction

babyspoonIn hindsight, the most important person to decide when solids should be introduced, is the infant. Mother nature is pretty adapt at telling us when it is ok to feed an infant solids, and perhaps science and medicine should have simply left this alone. This article attempts to follow the latest guidelines which really are ‘common sense’.  It is important to  remember breast milk or suitable infant formula continues to be the most important source of nutrition for the first 12 months of life. The goal of introducing solids should be to:

  • Experience new tastes and textures.
  • Helping with speech, teeth and jaw development.
  • Exposing the immune system to new proteins which may decrease future food protein allergies.

When Should I Start Solids ?

The  correct age is probably between 4 and 6 months, but more importantly it is when your infant  appears to be ready. This means that there is good head control,  no issues swallowing liquids and the infant looks interested in food. In addition the infant has lost the tongue thrust reflex. This means that up until 4 months the tongue will push out anything that comes into contact with it to prevent choking. This reflex will lessen around this age and the tongue will start moving the food to the side and back of the mouth.

Which foods ? 

The most important advice is to be patient, expect mess, and keep it fun. If the infant is becoming upset then do not persist. Start with anything that is pureed.  This means anything that is either vegetable, meat, or fruit. The NHMRC guidelines correctly identify that the most important micro nutrient deficiency seen in Australia is iron. Hence they emphasize that pureed red meat should quickly become part of an infants meal. Many commercial infant meals will have added iron, and other vitamins as a selling point. But if parents prefer to make their own food, adding pureed red meat is important. Note the iron in leafy green vegetables such as spinach is not well absorbed and does not replace iron found in red meat.[quote style=”boxed” float=”right”]Pureed red meat should be introduced early due to it’s iron content. [/quote]

Remember it takes 6 – 8 times for an infant to get used to a new taste, so expect lots of mess, and lots of rejection. This is normal as remember this is not the main source of  nutrition, it is simply to ensure new tastes and textures become learned experiences.

It is wise to avoid spicy foods, or foods that contain caffeine or excess sugar, but otherwise there really are no exceptions to what you can give as long as it is not a choking hazard.

What about allergy to foods ?

In the past it was advised to avoid potentially allergic foods, such as egg white, peanuts, tree nuts. However this advice has no scientific basis. In fact some studies have suggested that early introduction of such foods may in fact induce a tolerance. Even if a sibling is allergic there is only 7% chance that this will have been passed on. The advice is to try a small amount on the lips, such as smooth peanut butter, or scrambled eggs, then next time a small taste and slowly increase amounts. If there is a reaction it will be obvious and immediate, but never life threatening. Reactions include rash around mouth, slight swelling of lips and immediate spitting or even vomiting. In this instance do not repeat giving the particular food. If there is a rash take a photo and consult with local GP.

If your child already shows signs of allergy, such as eczema then it may be prudent to discuss this with your GP. However even in this instance there is no strict policy on avoidance of any particular food. For more information on this consult the Australasian Society of Clinical Immunology and Allergy on their infant feeding advice. 

What if the infant refuses ?

This can be particularly stressful. There maybe advice  from well meaning relatives, friends, and even nurses which places you and the infant under pressure to ‘make him or her feed’.  Sometimes this leads to a negative experience as a frustrated parent tries to ‘force’ an infant to accept food. In this situation the infant will feel anxious lessening the chance of successful feeding. This will lead to ‘oral aversion’ and in this instance it is wise to remember the following.

  • Nutrition is primarily from the breast or formula so consuming solids should be more for experience than nutritional necessity
  • Ensure there is no medical causes, such as oropharyngeal abnormality or a neurological or developmental cause, or a food protein intolerance or allergy
  • Apart from rare medical instances all toddlers will eventually learn how to feed.
  • If you are really concerned it is worth seeking out professionals who are trained in the SOS approach to feeding. Many paediatric speech pathologists, occupational therapists and dietitians are now trained in this technique of improving the amount and variety of food that an older infant and toddler consumes.

What about……?

  • Low Fat products? Fatty acids are essential for the development of the nervous system and should be given until two years of age.
  • Microwaves? Be wary of unevenly distributed heat. Stir food once removed from the microwave.
  • Supervision? Avoid small hard foods such as nuts and carrot rings which your baby may choke on, and ALWAYS be with your baby while they are eating!
  • If your baby wont eat? Babies take a little while to learn to eat. If at first they spit the food straight out again, or are simply not interested, don’t force it. Try again in a few days.
  • Commercial tins of baby food? Contain similar nutrients to fresh food and be handy in an emergency or while travelling. However, these products are expensive and tend to contain several foods mixed together. (It is important that your baby learns to enjoy tastes and textures of individual foods).
  • Fruit Juice? should not be given due to it’s sugar content. Water is preferable.

 

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