What is the recommended approach for introducing solid foods to a healthy 6-month-old infant?

Starting Solid Foods in Infants

Begin introducing solid foods at approximately 6 months of age, when your infant shows developmental readiness including good head control and ability to sit with support. 1

Timing Guidelines

• Do not introduce solid foods before 4 months of age due to gastrointestinal and motor immaturity 2, 3
• The optimal window is between 4-6 months, with 6 months being the preferred target 2, 1
• Delaying beyond 6 months increases risks of iron deficiency anemia, inadequate nutrient intake, growth deficits, and feeding problems 2, 1

Signs of Developmental Readiness

Your infant is ready when they demonstrate:

• Good head control - can hold head steady without support 1, 4
• Ability to sit with support in a high chair 1, 4
• Interest in food - watches others eat and reaches for food 4

First Foods to Introduce

Prioritize iron-rich foods first, as your infant's iron stores from birth are now depleted 4:

• Iron-rich vegetables: broccoli, cauliflower, squash, carrot, white potato (smooth, thin purees) 1, 4
• Meats: finely ground beef, lamb, chicken, or fish 4
• Iron-fortified infant cereals 4
• Fruits and vegetables can be introduced alongside these foods 1

Introduction Strategy

• Start with 1-2 teaspoons per feeding and gradually increase amounts 1, 4
• Introduce one new food at a time and wait at least 4 days before introducing another to watch for reactions 1, 4
• Offer 2-3 times per day initially at 6-8 months, increasing to 3-4 times daily by 9-11 months 4
• Continue breast milk or formula as the primary nutrition source throughout the first year 4

Allergenic Foods

Do not delay allergenic foods - this is a critical point where older recommendations have changed:

• Introduce peanut, egg, dairy, and wheat at the same time as other complementary foods around 6 months 1, 4
• For standard-risk infants, these can be introduced at home without specialist evaluation 1
• Delaying allergenic foods beyond 6 months does not prevent food allergies 1
• For infants with severe eczema or egg allergy, consult an allergist before introducing peanut 1

Texture Progression

• Begin with smooth, thin purees at 4-6 months 1
• Progress to thicker purees and mashed foods at 6 months 1
• Advance to soft-cooked, bite-and-dissolve textures at 8 months 1
• Offer modified family foods that are table-chopped and soft-cooked by 12 months 1

Normal Responses (Reassure Parents)

• Initial refusal is normal - infants may need 8-10 exposures to accept a new food 1, 4
• Facial expressions of surprise, confusion, or disgust are expected reactions to new tastes 1
• Small gagging episodes may occur as infants learn oral motor skills 1
• Mild changes in stool consistency, color, and frequency are expected 1
• Small amounts of undigested food in stool are normal as the digestive system matures 1

Warning Signs Requiring Medical Attention

Watch for these abnormal reactions:

• Persistent vomiting, especially projectile vomiting 1-4 hours after eating 1
• Severe diarrhea with blood or mucus 1
• Skin rashes, hives, or facial swelling shortly after food introduction 1
• Respiratory symptoms - wheezing, persistent coughing, or difficulty breathing 1
• Lethargy or significant behavioral changes following food introduction 1

Critical Pitfalls to Avoid

• Never introduce juice before 12 months of age - it provides no nutritional benefit and increases risk of dental caries, diarrhea, and malnutrition 2
• Avoid added salt or sugar in complementary foods 4
• Never give honey before 12 months due to botulism risk 4
• Do not use whole cow's milk as main drink before 12 months 4
• Ensure appropriate textures to prevent choking hazards - avoid hard, round foods that can obstruct the airway 1, 4
• Do not offer juice in bottles or allow continuous sipping throughout the day, as this promotes dental caries 2

Special Considerations for Premature Infants

• Use chronological age (not corrected age) for timing - still aim for 6 months chronological age 4, 5
• Iron-rich foods are especially important as preterm infants have higher risk of iron deficiency 5
• The same developmental readiness signs apply 5