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When to Introduce Cereal to a Baby

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Starting solids is a huge milestone for your baby. But before you break out the pureed peas and sweet potatoes, make sure she’s ready and know which foods to offer her first. Here’s what to know before you start.

When should my baby start solids?
The American Academy of Pediatrics (AAP) recommends starting solids between 4 and 6 months of age, but it also advocates exclusive breastfeeding for the first 6 months. “This makes the recommendation a bit confusing for many parents, so I tell my patients to consider solids between 4 to 6 months while paying attention to readiness signs,” explains Alanna Levine, MD, a pediatrician in New York and New Jersey. “The timing will be different for every baby, so ultimately you and your pediatrician need to make the right decision for your child.”

But don’t start too early: Babies have a natural inclination to suck milk from a nipple, so up until about 4 months, if you put a spoon or food on a baby’s lips, her tongue-thrusting reflex will push it away. Plus, a newborn’s stomach and intestines are not yet ready to digest solid food; so offering it too soon can cause discomfort and constipation. For this reason, never put cereal in your baby’s bottle, unless directed by your pediatrician to treat a medical condition such as reflux.

How will I know she’s ready to start solids?
Between 4 and 6 months of age, look for the following signs (premature babies may start a little later):

· She has good head control and can sit up alone or with little support.
· She shows interest. She may begin to watch you closely as you eat, open her mouth when she sees food, and lean in or reach out to touch it.
· Her appetite is increasing and she seems as if she could eat even more after a nursing session or full bottle.

What foods should I offer first?
Most parents traditionally begin with single-grain cereals, followed by vegetables and fruits. “Some people might start with meat and veggies first because they have more calories per bite than fruits,” says Andy Bernstein, MD, a pediatrician in Evanston, IL and a staff member at Lurie Children’s Hospital in Chicago. “But today there’s no official recommendation as to which food you should offer first.”

Always give your baby one new food at a time for at least two to three days to watch for possible signs of an allergic reaction (vomiting, diarrhea or a rash). If you notice these, stop the food and talk with your baby’s doctor. And be sure the food is pureed and isn’t a choking hazard, says Levine.

You can offer jarred baby food, homemade purees, or baby cereal. If you’re starting with baby cereal, add a few teaspoons of breast milk or formula to a teaspoon of dry cereal. Begin with thinner cereal and then thicken it as your baby gets better at swallowing and note that she may only take a few bites at a time.

How much will my baby eat?
Keep in mind that during your baby’s first year of life, breast milk or formula is still her main source of nutrition. “The biggest mistake parents make is getting so excited about real food, either due to the newness or the hope for better sleep, that solid feeding becomes more important breast milk and/or formula, which are still vital in the first 12 months of life,” reminds Bernstein.

When you start solids, your baby will continue to drink about the same amount of breast milk or formula; by 12 months, she should be eating a balance of solid food and breast milk—three meals a day and between 16 to 24 ounces of milk or formula. But watch out for juice, says Levine. “I tell parents to avoid giving children juice as a beverage. But if they do serve it, to limit it to 4 ounces of 100 percent juice per day,” she recommends.

What’s the best way to feed her?
Offer your baby her first solids at any point in the day when she seems to be receptive and in a good mood. You might try giving a small bottle or one breast to take the edge off her hunger first—otherwise she might become too frustrated to focus on what you’re about to introduce. Also keep the following in mind when offering your baby solids:

· Make sure your baby is sitting up to prevent choking. She can perch on your lap or, in an infant seat or a high chair.
· Expect a mess—food smeared on her face, hands, hair, clothes, the high chair, the floor, and even you! It’s okay to let her touch and explore the food. Be prepared with a bib, a plastic mat on the floor, and a damp face cloth for clean up (she may even need a bath).
· Show your baby how to open her mouth and talk up what a great job she’s doing!
· Use a baby spoon and start with ¼ or ½ spoonful of cereal. Hold the spoon about a foot from her face and wait for her to see it and open her mouth.
· Look for signs that your baby’s done. She may lean away from the food, purse her lips, shake her head, push the food away with her hands, or start fussing. Don’t continue to feed her if she’s showing these signs.
· Your baby might wrinkle up her face, spit out the food, or even gag a bit at first. Don’t be alarmed—it’s a normal reaction to new tastes and textures. Give it another try later and she may be more willing.
· If, after a few tries, your baby still isn’t accepting the food, she might not be ready. If that’s the case, wait a week or so and try again.

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