The information included in our Dear Steph series is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your child’s healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding your child’s healthcare plan. Have a question for Steph? Send her an email.

The AAP recommends breastfeeding  as the sole source of nutrition for your baby for about 6 months. Check with your child’s doctor about the recommendations for vitamin D and iron supplements during the first year. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.

Dear Stephanie: What are some good options for first foods? Should I be worried about allergies? – HMHB Mama Pakikes S.

Dear Pakikes,

Introducing solids is an exciting milestone for you and your baby! Once your pediatrician gives you the green light, and your little one is showing signs of readiness (usually around 6 months) you have lots of options and strategies for introducing solids, including baby-led weaning (self-feeding) or purees. As a mama I have personal experience with this topic, and as a registered dietitian I’ve counseled many mamas as they introduce solid foods to their babies. Most real food mamas have the same 6 questions about this topic; I hope my answers help you determine the methods and foods that work best for your sweet baby.

Question One: Which Foods Should I Introduce First?

Around six months of age, most breastfeeding babies’ iron and zinc stores start to diminish and they need more than what can be provided through breast milk alone. This  Journal of Nutrition article puts the iron and zinc needs of infants into perspective with this incredible statistic: “Infants need complementary foods with much higher nutrient density than is required for adult diets. For example, per 100 kcal of food, a breast-fed infant at 6–8 mo needs 9 times as much iron and 4 times as much zinc as an adult male.”

This is why iron-fortified infant rice or oat cereal is often recommended as an appropriate first food. However, current recommendations suggest that foods rich in heme iron (such as meat, poultry, and fish) are an excellent choice for first foods. They contain more bioavailable sources of iron than rice cereal and provide other important nutrients such as zinc, B6, and B12.

Since your little one may not be interested in or able to consume more than a few tablespoons, you want to make each small bite worth it! You can do this by choosing the most nutrient-dense options such as meat, fish, eggs, fruit, and vegetables.

Best first foods include those rich in iron, zinc, and omega-3 including:

[one-half-first]

  • Liver (Very small amounts are needed.)
  • Beef
  • Lamb
  • Bison
  • Poultry
  • Sardines

[/one-half-first]
[one-half]

  • Oysters
  • Salmon/salmon caviar (Very small amounts are needed. My favorite brand is Vital Choice, and if you use the discount code LEANCHOICE you can get 10% off your order!)
  • Eggs (Especially the yolk from pasture-raised eggs, which contains DHA) [/one-half]

If your little one isn’t interested in meat, make sure to include foods rich in vitamin C with your plant-based source of iron to boost iron absorption. For example, pair a source of non-heme iron such as cooked, dark leafy greens, legumes, or fortified bread/grains with a side of sweet potato, mango, or cooked broccoli.

With any of these options you can choose to puree them or serve them baby-led weaning style. For example: blend chicken, beef, or lamb with breast milk, water, coconut milk, or broth as a puree or simply offer soft pieces of chicken or flaky salmon that’s easy to hold and chew.

You can also try making beef/chicken/salmon meatballs, offer a piece of lamb on the bone, chicken thighs or drumsticks (making sure small bones are removed), shredded meat, or slow cooked meat.

Soft or cooked fruit and vegetables that are generally well-tolerated by infants include: 

[one-half-first]

  • Sweet potato
  • Winter squash
  • Carrots
  • Beets
  • Mango
  • Papaya

[/one-half-first]
[one-half]

  • Banana
  • Avocado
  • Kiwi
  • Plums
  • Peaches
  • Apricots
  • Pears [/one-half]

If those go over well, you can advance to options a little higher in insoluble fiber such as soft or cooked:

[one-half-first]

  • Broccoli
  • Cauliflower

[/one-half-first]
[one-half]

  • Cooked leafy greens
  • Berries (you may choose to delay strawberries) [/one-half]

If you’d like to use purees, you can make them at home, purchase them at a grocery store, or buy them online from our new Whole30 Approved partner, Serenity Kids. You’ll love their purees that include protein, veggies, and healthy fats!

Simply mash softer foods with a fork, or use a blender/food processor to provide the texture appropriate for your baby. They’ll progress from more watery purees to thicker, chunkier purees.

If you’re doing baby-led weaning, you can offer baked, roasted, or steamed vegetables that are soft enough to mash between two fingers, served as long, holdable pieces. Feel free to add oil and spices, but limit added salt since high levels of salt can harm developing kidneys.

Question Two: How Should I Introduce Dairy and Grains?

If you’re interested in introducing dairy, you might try fermented diary first. Fermentation reduces the amount of lactose, which some babies respond negatively to. Organic, unsweetened, full-fat kefir and yogurt are great options. Hard cheese is great, too. Similarly, high-fat dairy options reduce the amount of lactose and casein, which can be an issue for some babies. You might choose to include high-fat dairy foods like ghee and butter.

If you’re interested in introducing grains, soaked and/or sprouted grains are a great option; however, please make sure you’re offering a variety of other nutrient-dense foods along with grains. Many mamas I work with choose to wait until their baby is over a year to introduce grains so that they can focus on meat, fruits, veggies, and healthy fats.

You may wish to avoid all dairy and grains, which is totally okay. Consider working with a nutritionist or dietitian trained in pediatric nutrition to make sure your little one isn’t missing out on important minerals.

I didn’t give grains or dairy to my older son Otto until well after his first birthday and plan on doing the same with my second son Leo; however, you may find that your infant does well with these foods and you feel comfortable serving them, after first introducing iron-rich foods. It’s totally your call!

Question Three: Are There Any Foods I Should Completely Avoid?

You’ll want to avoid cow’s milk until at least 12 months of age since early introduction may lead to to iron deficiency (anemia), displace other important nutrients in the diet, and cause early cessation of breastfeeding. Honey should also be avoided until 12-months as honey may contain substances that can lead to infant botulism.  Obvious choking hazards, such as raw nuts, should also be avoided. Ask your provider about any other foods that are recommended to be avoided, delayed, or introduced with caution.

Question Four: Should I Introduce New Foods On a Specific Schedule?

Just like the reintroduction period following a Whole30, it’s generally recommended to “go slow” when introducing new foods. By giving your baby one food at a time, every 3-5 days, you can more easily identify any food that may cause a reaction (such as gas, irritability, fussiness, excessive spit up, or skin irritations). Once your baby has tolerated a variety of foods and/or a few months have passed, you may choose to introduce combinations.

Of course, there are no set rules. If you’d like to introduce combinations of foods earlier on and have the go ahead from your pediatrician, feel free! This makes it easier for parents who choose the baby-led weaning approach to offer food from their plate, which likely includes meals made with multiple ingredients.

Question Five: How Much Food Should My Baby Eat?

Don’t be surprised or feel defeated if your little one refuses solids or eats a tiny portion during the first few attempts. This is totally new for them! My first son had no hesitation and leaped right into solids, but my second son took his time and started welcoming solids into his diet after a month of attempts. Both situations are totally fine! Your job is to offer. Their job to accept or decline and decide how much.

The WHO recommends that “infants start receiving complementary foods at 6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months with additional nutritious snacks offered 1-2 times per day, as desired.”

You may find that more food ends up on the floor than in your baby’s stomach. Don’t worry if your little one is only taking in a few teaspoons of solid foods each day (if any!). Keep offering, stay patient, and know it will come with time. They’re all so different!

If you’re nursing, it’s generally advised to offer solids after a nursing session to help maintain your supply and to prevent meltdowns from being overly hungry. Learning how to navigate solids is hard work for a baby, so make sure they’ve got at least a little energy in their system before letting them practice eating solid foods.

Question Six: What About Highly Allergenic Foods?

In the past, experts have recommended that highly allergenic foods (such as eggs, peanuts, tree nuts, cow’s milk, soy, wheat, fish and shellfish) not be introduced until after an infant’s first birthday. According to the American  Academy of Allergy, Asthma, and Immunology, “evidence has shown that there’s no reason to delay introduction of the highly allergenic foods beyond 4-6 months of age. In fact, delaying the introduction of these foods may increase your baby’s risk of developing allergies.”

Of course, please talk to your baby’s pediatrician before introducing these highly allergenic foods especially if your infant has a reaction to any food, allergies run in your family, or if your infant has persistent skin issues (such as moderate to severe eczema) despite treatment.

If you’re concerned about introducing allergenic foods, you can always choose to introduce them during your child’s well-visit, so you’re near a healthcare provider in case something happens. You could introduce the food to your infant right before your visit (potentially even outside the building), since you’ll likely have to wait for your appointment. This will allow extra time for you to observe your baby’s reaction and you’ll be near help.

I’m offering a free baby-led weaning workshop on Thursday, August 17th at 11 am PST. I’m partnering with another dietitian who created a baby-led weaning online course to share our experiences with baby-led waning and answer questions. We will cover more information on first foods, how to deal with choking and gagging, and how to decide if baby-led weaning, purees, or both are best for your family. The seminar will be live for the first 100 registrants and afterwards as a recording for anyone who registers. Click here to register!

Our Healthy Mama, Happy Baby program provides information, resources, and support for mamas in every stage of the journey. When you join our program, you gain access to our private Facebook group. We have many women in the group who are thinking about how best to feed their little ones and who would love to support you and share their insight.  I think you’ll find the community support a valuable asset along your journey and I hope to see you there soon!

 


Steph(hi)-6Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice, RockYourHormones.com.