I hear this question in my practice all the time. To this day it remains a controversial area with lots & lots of different recommendations. It is not an exaggeration to say that many doctors & nurses are as confused as parents as to the correct time & way to introduce solids.
Let’s assume that for the first four months of a baby’s life they are either exclusively breast or formula fed. At some point thereafter a baby will require solids in addition to breast milk or formula. We also know that at the age of 1 year an infant will only require about 400mls of milk a day and that many infants are transitioned from breast or formula to cow’s milk at 12 months of age.
Almost all paediatricians, nurses & dieticians agree that solids should commence somewhere between 4-6 months of age. But that is where the consensus stops. The current Australian Guidelines recommends 6 months to introduce solids. However there is a school of thought that believes that 6 months is too late to start solids. I am part of that school. I believe that solids should be introduced around four & a half months to five months depending on the baby. Many parents tell me that their children are hungry & looking at the rest of the family when they are eating a meal. That is one good sign that a baby is ready for solids! My other concern with starting at 6 months is that if a baby has difficulty with the introduction of solids it could mean that solids are only established at 7-8 months which is definitely too late.
In my practice I see lots of babies with severe reflux. Besides medication, the early introduction of solids results in a significant improvement in symptoms. As a result I recommend starting solids at 4 months in babies with severe reflux.
The next question is what to food to start with. I recommend starting with a rice cereal for the first 5-7 days. It is important to note that many of the rice cereals can cause constipation. That is why I recommend introducing fruits and or vegetables shortly thereafter. The first week or 2 is really about getting your baby used to the different textures & therefore does not have any great nutritional benefit. So 1-2 teaspoons 2-3 times a day depending on the baby is the typical starting pattern.
I have 3 golden rules for solids.
Otherwise the guidelines are pretty relaxed. There is very little in the way of food restriction in the first year unless there is a sibling with documented food allergy. Most of us would recommend protein at 6 months of age. This includes meat, chicken and line-fish that it should be finely diced so as not to be a choking hazard. Dairy products (not cow’s milk) can be introduced at about 8-9 months of age. At this age most children are also sitting in a high chair eating (and throwing) finger foods. Feeding time is really taking off!