Ready for Solids?
As beautiful (and portable, and inexpensive and simple...) as nursing was, eventually I knew there'd come a time when my little ones would be ready for solid foods! I’d like to share a few queues to watch for, so that when your baby is showing signs, you'll be ready to read them.
The World Health Organization1,2, the American Academy of Paediatric's3 and many other medical and scientific experts4,5,6 recommend feeding babies only breast milk until 6 months. However, the AAP suggests delaying until 4–6 months for infants who are formula-fed.7 There are typically two camps: they either recommend starting between 4 and 6 months OR at 6 months. As you see, there is no solid consensus between public health and professional organizations when it comes to the timing of food introduction.
Why delay solids?
Research shows that being ready for solids is dependant on both the maturity of baby’s GI tract, and baby’s developmental readiness for solids. I know we can’t really take a peek inside to see how our little ones’ digestive tracts are maturing, but research indicates that holding off on solids until 4-6 months appears to be ideal for avoiding increased illness and other health risks of too-early solids.8,9 In fact, studies show that introducing solids before 3-4 months can increase the risk of eczema at age 10, celiac disease, type 1 diabetes, and increase the risk for obesity in childhood.10,11,12,13 It can also cause poor digestion, which results in gas, constipation or other unwanted symptoms.
Keep in mind, during the 4-6 month window, babies are ready for solids at different times. Said best by British pediatrician Martin Ward Platt: “The weaning debate has been largely predicated on the notion that there is some magic age at which, or from which, it is in some sense ‘‘safe’’ or ‘‘optimal’’ to introduce solids. Yet it is highly counterintuitive that such an age exists. In what other area of developmental biology is there any such rigid age threshold for anything? We all recognize that age thresholds are legal inventions to create workable rules and definitions, and have no meaning in physiology or development, yet when we talk about weaning we seem to forget this".14
At the end of the day, it really depends on the individual child. At Little Warrior Nutrition we recommend looking out for Signs Of Readiness as a better indication of when to start solids, instead of using a specific age.
From our experience, the sweet spot when babies are ready tends to be close to the 6 month mark, although some kids may be ready sooner. That being said, based on the current research, we would not suggest solids before 4 months and we wouldn’t suggest waiting much longer than 6 months. Waiting longer than 6 months for a breastfed baby could be detrimental. This is because breast milk is not a great source of iron. Babies before 6 months of age thrive off of the iron stores they saved up from birth. Babies who benefited from delayed cord clamping will have even more iron stores to benefit from. Sometime around the 6 month mark, this critical nutrient needs to start coming from their food.15
Now let’s talk Signs Of Readiness so you know what to look out for and when your baby is ready.
Signs Of Readiness
Key developmental signs to watch for, to know your baby is ready to unleash their inner foodie.
1) They can sit up on their own, with minimal support and hold their head up.16,17
2) When something comes towards their face, they open their mouths (sounds like a no brainer, right?!).
3) Seems interested in what you're eating, and will watch the food travel from your plate to your mouth, may even make chewing gestures.
4) They can communicate with you when they're all done by turning their head away from food.
5) Continues to be hungry despite more frequent nursing (not related to illness or teething).
6) Your baby has the oral motor skills to handle solid foods. Baby doesn't push solids out of their mouth - they've lost their tongue thrust.18 (Note: Some baby's are still learning this skill when they start solids, however, if you start solids earlier than 6 months and notice them struggling with this, wait a little longer and try again)
7) They can pincer grasp - pick up foods with their finger and thumb. (optional)
In conclusion, when to start feeding solids is your choice and depends on your little one! It has to feel right to you, and your baby. I was pressured to start earlier, but knowing the Signs Of Readiness helped me stay strong and wait until my little ones were truly ready.
Sources:
1. Breastfeeding. (2018, August 02). Retrieved from http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/
2. Global Strategy for Infant and Young Child Feeding. (2010, December 07). Retrieved from http://www.who.int/nutrition/topics/global_strategy/en/
3. Breastfeeding and the Use of Human Milk. (2005). Pediatrics,115(2), 496-506. doi:10.1542/peds.2004-2491
4. Infant Nutrition. Health Canada. (2014, April 08). Retrieved from https://www.canada.ca/en/health-canada/services/infant-care/infant-nutrition.html
5. Breastfeeding, Family Physicians Supporting (Position Paper). (2017, May 17). Retrieved from https://www.aafp.org/about/policies/all/breastfeeding-support.html
6. Australian National Health and Medical Research Council file:///Users/estherepp/Desktop/infant-feeding-guidelines-summary.pdf
7. Slade, H., & Schwartz, S. (1987). Mucosal immunity: The immunology of breast milk. Journal of Allergy and Clinical Immunology,80(3), 348-358. doi:10.1016/0091-6749(87)90041-8
8. Breastfeeding and the Use of Human Milk. (2012). Pediatrics,129(3). doi:10.1542/peds.2011-3552
9. Developmental Readiness of Normal Full Term Infants to Progress from Exclusive Breastfeeding to the Introduction of Complementary Foods Reviews of the Relevant Literature Concerning Infant Immunologic, Gastrointestinal, Oral Motor and Maternal Reproductive and Lactational Development (April 2001) Retrieved from https://pdf.usaid.gov/pdf_docs/Pnacs461.pdf
10. Fergusson, D. M., Horwood, L. J. & Shannon, F. T. (1990). Early Solid Feeding and Recurrent Childhood Eczema: A 10-Year Longitudinal Study. Pediatrics 86, 541–546
11. Norris, J. M. (2005). Risk of Celiac Disease Autoimmunity and Timing of Gluten Introduction in the Diet of Infants at Increased Risk of Disease. Jama,293(19), 2343. doi:10.1001/jama.293.19.2343
12. Norris, J. M. (2003). Timing of Initial Cereal Exposure in Infancy and Risk of Islet Autoimmunity. Jama,290(13), 1713. doi:10.1001/jama.290.13.1713
13. Wilson, A. C., Forsyth, J. S., Greene, S. A., Irvine, L., Hau, C., & Howie, P. W. (1998). Relation of infant diet to childhood health: Seven year follow up of cohort of children in Dundee infant feeding study. Bmj,316(7124), 21-25. doi:10.1136/bmj.316.7124.21
14. Platt, M. P. (2008). Demand weaning: Infants answer to professionals dilemmas. Archives of Disease in Childhood,94(2), 79-80. doi:10.1136/adc.2008.150011
15. Institute of Medicine (US) Panel on Micronutrients. (1970, January 01). Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK222310/
16. Carruth, B. R., & Skinner, J. D. (2002). Feeding Behaviors and Other Motor Development in Healthy Children (2–24 Months). Journal of the American College of Nutrition,21(2), 88-96. doi:10.1080/07315724.2002.10719199
17. Black, M. M., & Aboud, F. E. (2011). Responsive Feeding Is Embedded in a Theoretical Framework of Responsive Parenting. The Journal of Nutrition,141(3), 490-494. doi:10.3945/jn.110.129973
18. Carruth, B. R., & Skinner, J. D. (2002). Feeding Behaviors and Other Motor Development in Healthy Children (2–24 Months). Journal of the American College of Nutrition,21(2), 88-96. doi:10.1080/07315724.2002.10719199
