Working with families around infant feeding – whether it’s breastfeeding, formula feeding or a combination – some of the most common questions I’m asked are “when will my baby be ready for solids?” or “when do I start feeding my baby solid foods?”.
It’s also topic that families are getting mixed messages about – from health care providers, the media, family & friends – and those mixed messages are consistently perpetuated in online forums and groups for parents.
One of my key intentions is ensuring you have clear, reliable information for your mothering journey, so let’s dig into the current recommendations from health and medical organizations & dispel some myths (or false signs of readiness) around a when your baby is ready for solid foods.
Introducing Solid Foods: Current Recommendations
The Canadian Pediatric Society, Health Canada & the World Health Organization ALL recommend exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with the introduction of solid foods beginning around 6 months. If for some reason, a baby is not able receive breast milk, commercially produced formula is recommended as a substitute and formula fed babies are to begin solid food introduction around 6 months as well.
Why 6 months?
Three key reasons for these recommendations include:
1. Protection from Illness.
Breastfeeding provides immune protective factors for the entire time a child is breastfed. The more breast milk a baby has, the more immune factors they’re provided. (Early introduction of solids can reduce the amount of breast milk that a baby takes.)
2. Maturation of the gut.
The digestive system is incompletely developed when we’re born. Introducing solid foods before the gut is ready, increases the likelihood those foods will be incompletely digested, triggering irritation & symptoms such as gas, bloating, constipation or diarrhea. In addition, spaces between the cells of the intestines – also known as leaky gut – can allow things to pass through the gut barrier & trigger immune responses. The closure of this leakiness occurs around six months of age.
3. Developmental readiness.
In order for babies to be ready to manage semi solid and solid foods (versus liquid foods), they have to have developed a certain amount of postural control and gross & fine motor skills, which for full term infants, doesn’t occur until 6-8 months of age. (Baby arrived before 37 weeks of your pregnancy? Chat with your health care provider or book a consultations to discuss possible adjustments to these guidelines.) Key developmental signs include the ability to sit up unassisted and the ability to hold the head up straight.
Not long ago I met with Jane and her beautiful boy Max. Max was 4.5 months old and had just has his 4 month well baby check up with their family doctor. During the speedy visit, the doctor mentioned to Jane that Max shouldn’t need night feeds after four months and if he’s still waking to feed, she can start giving him rice cereal. After the appointment, when Jane was recording Max’s weight in his baby book, she noticed he’d gained less in the last month than in previous months. “Maybe he’s not getting enough breastmilk.” she thought. As a Mama who aims to make informed decisions, she hopped online to find out more information about solid food introduction. She felt so overwhelmed by the conflicting information she was hearing and reading and she needed help sorting out what was truth and what would be best for Max.
“I’m so overwhelmed by all of the conflicting information” she sighed. “Max is waking 2-3 times through the night, so the doctor says introduce solids. The lower weight gain has me thinking we should. Then I see recommendations from the WHO that say 6 months. And other sources that say 4 months. Max is watching me like a hawk every time I have something to eat. Is that another sign he’s ready? I have no idea what to do.”
When it comes to mixed messages about the timing solid food introduction – Jane was in the thick of it! And she’s not alone. Three to four months postpartum, is the most common time for moms to encounters these mixed messages, relating to what I call the false signs of readiness for solids.
False Sign of Readiness #1 – A baby waking (frequently) through the night, after 4 months.
There is no evidence to support a recommendation to begin introducing solids at four months when a baby is (still) waking through the night. In fact, clinically, in some instances, I’ve seen things move in the opposite direction – baby wakes more often! Why? Introducing something other than a milk feed (breast milk or formula) to an underdeveloped digestive system has a high likelihood of irritating the gut, triggering discomfort that could wake the infant.
And, the reality is, babies wake through the night after 4 months for a variety of reasons, beyond hunger, including the need for comfort & connection with a caregiver & to soothe pain (from teething or other sources).
So, was Max’s waking 2-3 times per night at 4.5 months old a true sign of readiness for solids? Nope. Yes, he may be hungry. He’s expected to triple his birth weight before 12 months – that’s rapid growth that requires energy! – AND breast milk can provide all of those calories. Also, when he wakes in the middle of the night, alone in his crib, his biology tells him he’s alone and defenseless in the dark and the best way to feel comfortable and safe is to call out (cry) for snuggles from a caregiver he knows and trusts.
False Sign of Readiness #2 – Slight slowing of weight gain at 4 months, after gaining well up until that point.
This can be a normal shift in baby’s development. Take a look at the growth curves – they shift at this time and don’t climb as steeply as in the first 3 months. As long as your little one is maintaining their own curve, this slowing isn’t something to be concerned about.
A slowing of weight gain that shifts a little one down off of their growth curve, can be a sign of delayed onset low milk supply for breastfeeding mothers. Assessment by a health care provider well versed in breastfeeding is important. There are ways to support mom’s milk supply, if needed. Early introduction of solid foods has the potential to irritate baby’s gut and lower mom’s milk supply even further (replacing calories that would otherwise come from breast milk and potentially reducing an infants’ time at the breast, reduces the demand for breast milk which reduces supply).
For Max, his weight gain had, indeed, slowed compared to previous months, but when Jane and I looked at his growth curve, he was right on track.
False Sign of Readiness #3 – Watching his/her parents eat.
A baby’s awareness of their environment and the actions of those around them increases greatly around 4 months of age, during and after the week 19 mental leap. They become more interested in parents’ and siblings’ daily activities, in general. It’s a sign of overall development, not a sign of readiness for solids.
When Jane reflected further, she realized that Max’s eagle eye on her during mealtime was the only time of the day he’d been watching her intently – it was just on of the more obvious ones!
As our conversation progressed, I could see relief settle in for Jane – her shoulders relaxed, her speech slowed and she smiled. Max was right on track in his growth and development and she felt clarity and confidence about when to move forward with solid food introduction.
What else might you be hearing or reading that will have you question what the best timing for introducing solids to your little one?
Solids need to be introduced before 6 months to prevent allergic responses. Is it true?
Recent research (over the last 7 years or so) has, indeed, shown a reduction in allergic responses for infants introduced to solid foods as early as 4 months BUT what wasn’t made clear to parents in the media coverage of this information was:
- The primary foods studied have been peanut and egg, with little to no attention on other foods.
- The infants studied were at high risk of allergic response, based on their family and personal health histories – they had immediate family members with severe allergy to peanut or eggs or had been diagnosed with severe eczema themselves.
- Previous research showing the potential protection that breastfeeding (for the first 6 months of life and continued with food introduction) provides against the development of allergy.
Because there hasn’t been enough research completed to understand the impact of early introduction of solids to infants who are NOT at high risk for allergic responses, there have been no changes to the recommendations from health & medical organizations.
If your child has severe eczema or a close family member (parent or sibling) with a severe food allergy, talk with your health care providers about whether to make changes to the standard approach to food introduction.
Want to dig into reliable information about these false signs of readiness or the research about food introduction and allergies even further?
Check out the resources I’ve included below.
xo Dr. Sarah