At what age can solids be safely introduced to a baby's diet?

Introduction of Solid Foods to Infants: Timing and Safety Guidelines

Solid foods should not be introduced before 4 months of age, but should be introduced between 4-6 months when the infant shows developmental readiness. 1

Optimal Timing for Introduction of Solid Foods

• Introduction of solid foods should occur between 4-6 months of age, not before 4 months, based on the infant's developmental readiness 1
• Delaying introduction of solid foods beyond 6 months can lead to inadequate nutrient intake, growth deficits, and feeding problems 1
• For infants at high risk of allergic disease, the same timing (4-6 months) applies, with no benefit to delaying introduction of potentially allergenic foods 1, 2

Signs of Developmental Readiness

• Good head control is essential for safe consumption of solid foods 3, 4
• Ability to sit upright with support 3
• Loss of tongue thrust reflex (pushing food out of the mouth) 3
• Interest in food and watching others eat 3
• Opening mouth when food approaches 3

Introduction Strategy

• Start with iron-rich foods, especially important for preterm infants who are at higher risk of iron deficiency 3, 5
• Introduce one new food at a time and wait at least 4 days before introducing another food to observe for potential reactions 3, 5
• Allergenic foods (peanut, egg, dairy, wheat) can be introduced at the same time as other complementary foods, between 4-6 months 1
• For infants with severe eczema or egg allergy, evaluation by allergist may be warranted before introducing peanut 1

Normal Responses vs. Warning Signs

• Initial hesitation or refusal of new foods is common; infants may need multiple exposures (8-10 times) before accepting a new food 3
• Mild changes in stool consistency, color, and frequency are expected as the digestive system adapts 3
• Warning signs requiring medical attention include:
  • Persistent vomiting, especially projectile vomiting occurring 1-4 hours after eating 3
  • Severe diarrhea, particularly with blood or mucus 3
  • Skin rashes, hives, or facial swelling occurring shortly after food introduction 3
  • Respiratory symptoms such as wheezing or difficulty breathing 3

Special Considerations for Preterm Infants

• For preterm infants, introduction of solid foods at around 3 months corrected age (13 weeks) may be appropriate 5, 6, 4
• Preterm infants have increased nutritional requirements and may benefit from nutrient-dense solid foods 6, 4
• Developmental readiness, particularly head control, is especially important to consider in preterm infants 5, 4

Common Misconceptions and Pitfalls

• Introducing solids before 4 months is associated with increased risk of childhood obesity and eczema development 4, 7
• Delaying introduction of allergenic foods beyond 6 months does not prevent food allergies 1, 8
• Perceiving infant hunger, lack of sleep, or unsettled behavior as signs of readiness for solids before 4 months is incorrect 7
• Signs of readiness may be misinterpreted, particularly in younger infants 7

Continued Importance of Milk

• Breast milk or formula should remain the primary source of nutrition during the first year of life 3, 2
• Solid foods complement rather than replace milk in the first year 3, 8