Children's Health Newborns and Toddlers

First Foods for Baby: Life Without Peas is Still Worth Living

Ask any new parent: When it comes to infant care, everyone has an opinion, and they're not afraid to share it. One issue that often sparks heated debate among friends and family is when to add solid foods to a baby's diet.

About 30 years ago, parents tended to introduce solid foods in the first few months, or even in the first weeks. Today, the American Academy of Pediatrics recommends beginning solid food much later. Although there are exceptions to the guidelines, starting solids early can increase the risk for obesity, and some studies suggest that it might be linked to type 1 diabetes.

Below, Dr. Lorraine Stern, a clinical professor of pediatrics at the University of California Los Angeles, discusses the rationale behind this recommendation and how best to gradually introduce solid food so that feeding is a healthy and fun experience for both baby and parent.

At what age do pediatricians generally recommend parents introduce solid foods?
For healthy, growing infants, the American Academy of Pediatrics recommends starting solid foods at 6 months old.

Children are born with something called an extrusion reflex. This is a survival mechanism where they instinctively push out of their mouth anything that's semisolid, anything that isn't the consistency of breast milk or formula. They usually aren't even ready to accept pureed foods until they're at least 4 to 6 months old.

The reason to withhold solids until a baby is older is that researchers know that early feeding is associated with obesity later on in life. Theoretically, the only thing infants need for the first 6 months is breast milk or formula. In one report from the Journal of the American Medical Association researchers studied children with a family history of type 1 diabetes from birth until age 4 or 5, and those who were fed solids earlier had a higher risk of developing diabetes.

What is rationale for beginning solid food?
Nutritionally, infants need to have additional food by 6 months. At that age, the main concern is iron because they start to outgrow the iron stores they are born with, and need food to replenish them. The first food parents feed infants is iron-fortified rice cereal. In the second half of the first year, they start needing a greater variety of nutrients and a wider selection of food.

At what point can one forego formula or breast-feeding?
There are two different things. Infants can give up formula and be given regular cow's milk after they turn 1 year old. How long do you breast-feed? That's a different issue. The American Academy of Pediatrics recommends that women breastfeed for at least a year. That means that women can nurse for longer than a year if they want, but they don't have to. However, breast-feeding for at least 4 to 6 months has been associated with a long list of benefits, such as decreased risk of asthma, allergies and obesity.

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