At what age can solid food be introduced to an infant?

Introduction of Solid Foods to Infants

Solid foods should be introduced to infants between 4 to 6 months of age, not before 4 months and not delayed beyond 6 months. 1, 2

Timing of Introduction

The optimal timing for introducing solid foods is guided by both infant developmental readiness and nutritional needs:

• The National Institute of Allergy and Infectious Diseases (NIAID) guidelines clearly state that introduction of solid foods should not be delayed beyond 4-6 months of age 1
• Introducing solids before 4 months is not recommended due to infant gastrointestinal and motor immaturity 3
• Delaying introduction beyond 6 months can lead to:
  • Inadequate nutrient intake
  • Growth deficits
  • Development of feeding problems
  • Potentially increased risk of food allergies 1, 2

Signs of Developmental Readiness

Before introducing solids, ensure the infant demonstrates:

• Ability to sit with support
• Good head and neck control
• Interest in food (watching others eat, reaching for food)
• Ability to move food from the front of the mouth to the back
• Disappearance of the tongue-thrust reflex 2

Introduction of Allergenic Foods

Recent guidelines have shifted toward earlier introduction of allergenic foods:

• Potentially allergenic foods (peanut, egg, dairy, wheat) may be introduced during the 4-6 month window 1, 2
• For infants with severe eczema or egg allergy (high-risk):
  • Consider evaluation by an allergist before introducing peanut 1, 2
  • Early introduction of peanut (between 4-11 months) has been shown to reduce peanut allergy risk 1
• For infants with mild to moderate eczema:
  • Introduction of peanut-containing foods around 6 months is recommended 1

First Foods and Progression

When starting solids:

• Begin with iron-rich foods (meat or fortified cereals) as iron stores begin to deplete around 6 months 2
• Introduce one new food at a time, waiting 2-3 days between new foods to monitor for reactions 2
• Progress from pureed to mashed to soft pieces as infant's oral motor skills develop
• Avoid honey before 12 months due to risk of infant botulism 2

Common Pitfalls to Avoid

1. Misinterpreting infant cues: Many parents introduce solids early due to perceived hunger, lack of sleep, or unsettled behavior, which are not reliable indicators of readiness for solids 4

2. Delaying introduction of allergenic foods: Contrary to previous beliefs, delaying introduction of allergenic foods does not prevent allergies and may increase risk 1, 2

3. Introducing solids before developmental readiness: Introducing solids before 4 months may increase risk for choking and has been associated with increased risk for overweight and obesity 3

4. Restricting food variety after 6 months: This can lead to inadequate nutrient intake and feeding problems 1, 2

Special Considerations

For preterm infants, timing should consider their corrected age:

• Around 3 months (13 weeks) of corrected age may be appropriate for most preterm infants 5
• Balance nutritional benefits with developmental readiness and potential risks 5

For high-risk infants (family history of allergies):

• Introduction of commonly allergenic solids at around 6 months, but not before 4 months 6
• Continue breastfeeding while introducing solids for its many health benefits 6

The evidence clearly supports introducing solid foods between 4-6 months of age, based on infant developmental readiness, with no benefit to delaying introduction of potentially allergenic foods beyond this window.