I am breastfeeding my three-month-old son and am wondering when we should start solid foods and what should be introduced first?
There is a good deal of debate on this subject. I’m happy to provide an outline for a jumping off point, but you’ll also want to get your pediatrician’s opinion about solid foods and do some reading. Then enjoy the trial and error. Take lots of video. This is a fun time.
What to read: Guide to Your Child's Nutrition published by the American Academy of Pediatrics (AAP) is a good place to start gathering information. What to Expect the First Year includes a good nutrition section and The Super Baby Food Book is helpful particularly if you are interested in making your own baby food.
When to start: The AAP Committee on Breastfeeding recommends that breast milk be the exclusive diet for the first six months and the Committee on Nutrition says solids can be introduced between four and six months. If there is a family history of food allergies, the AAP recommends waiting until six months to add solids. Your pediatrician will guide your decision about when to start.
Some signs that your son is ready for solids are that he:
· shows interest in your food
· has good head control and can sit with minimal support
· awakens for night feedings having previously slept through the night
Which food is first? Iron fortified cereal (rice or oatmeal with nothing added) is an excellent first food because most breastfed babies' iron stores begin to decrease at about six months. Mix cereal with breast milk or water. Formula can also be used, but avoid mixing with juice as this just adds empty calories and encourages a sweet tooth. Start with a thin consistency and thicken as the baby tolerates thicker foods.
A few spoonfuls of cereal may be enough for the first feedings. Once he is doing well with cereal, you can begin to add vegetables and fruits one at a time and waiting several days before introducing another. Meats are not added until 7-9 months.
Which order works best? There is also discussion about whether to offer solids before or after the liquid feeding. I would suggest offering solids after breast feeding for the following reason: if you offer the solids first, you won’t know how much to offer. If solids follow breast feeding, then you can continue to offer the solids until the baby turns his head away or appears disinterested. Then you will know that he is full and you have used the solids truly as supplement to the breast milk.
Exception to the rule: If your baby is struggling with weight gain, your pediatrician may encourage you to offer the solids first. Also, some babies would rather breastfeed 10 times a day than eat their solids. In this case it is also appropriate to offer the solids first.
Do what works. You may have to experiment and will get to know your baby along the way. Have fun with it. Life is never the same again after starting solids…….and neither is the poop.
Gloria Dudney, RN, IBCLC, RLC is a Board Certified Lactation Consultant and has taught new parent classes for more than 10 years.
Gloria Dudney, RN, IBCLC, RLC