Part 1: Steps to Introducing Solid Foods - Purees
It’s time to start introducing solid foods, where do you start? This can be an exciting time, but overwhelming if you’re not sure where to begin, or your baby isn’t taking to them as easily as planned. Keep reading to learn the whys and hows of introducing solids.
You will know your baby is ready to be introduced to solids when they:
Are able to sit upright
Babies should have good trunk control when in a supported sitting position when starting purees/mashed foods
Babies should be able to sit independently or with minimal assistance when transitioning to soft solids
Have head control and are able to hold their head upright for at least 15 minutes (the length of a meal)
Can grab toys and bring them to their mouth
They show an interest in food, such as watching you eat, leaning forward towards food, and/or opening their mouth for food
It is recommended that babies are introduced to solids between 4-6 months of age. As of now, the American Academy of Pediatrics and World Health Organization recommend introducing solids when your baby is around 6 months of age and showing the readiness signs listed above. When you first introduce solids, it should complement rather than replace human milk or formula until at least 12 months of age.
What is happening in your baby’s mouth that makes them ready for solid foods?
There are four natural reflexes that are occurring in your baby’s mouth as they are learning to eat solid foods. These include the tongue thrust reflex, tongue lateralization reflex, bite reflex, and the gag reflex.
Tongue Thrust Reflex
The tongue thrust reflex helps your baby push food out of their mouth that is too big when they are first learning to eat. As your baby touches food to the front of their mouth, they begin to learn to “override” this reflex, and learn a new motor pattern on how to control food in their mouth. The tongue thrust reflex typically integrates, or disappears, around 4-7 months of age.
Tongue Lateralization Reflex
The tongue lateralization reflex causes the tongue to move towards whatever touches the side of the tongue. This reflex helps babies learn to move their food over into their molar area to chew before this reflex integrates and disappears by 9 months of age.
Bite Reflex
The bite reflex causes babies to bite up and down when pressure is applied to their back gums. This helps baby learn to chew, and is integrated around 9-12 months of age.
Gag reflex
The gag reflex is a normal reflex in both babies and adults. As a 6 month old, the gag reflex is near the front of the tongue, and as your baby is exposed to new foods and textures, the gag reflex will be desensitized and moved further back in the mouth. When the gag reflex is still near the front of the mouth, it is easier to trigger. It is normal for babies to gag when they are first learning to eat, however, it should not be frequent or continuous. Together with the tongue thrust, it helps protect your baby’s airway and push food out of their mouth that is not chewed well, or is too big to swallow. If frequent gagging persists, it may indicate the need for intervention.
Learn more here about the difference between choking and gagging. It is important to remain calm while a baby is gagging so they do not become scared of solid foods. It is also a good idea to be prepared if your baby is choking, by taking an infant CPR course.
How should my baby be seated when introducing solids?
When babies, and adults, are eating, it’s important to have a supported body. Think about when you go to a restaurant and get seated at a table with barstools and there is no foot support. You feel uncomfortable, right? This is how our babies feel when their feet are dangling and unsupported, too. When our core is having to work overtime to support our legs while we’re eating, it makes it much more difficult to eat.
This position helps support your baby’s breathing (our body’s #1 priority), provides stabilization to the core, and allows for better hand-to-mouth coordination and chewing. My favorite high chairs are ones that have foot support, and can grow with your baby into childhood.
While most babies are ready for solids around 6 months of age, many babies are not sitting completely independently until 7.5-8 months of age. You may need to provide some additional supports, such as rolled towels in the sides of the chair, in order to make sure your baby is fully supported when starting solids, until they are sitting with more independence.
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It’s also great to have a removable tray that allows you to bring baby right to the table. This helps increase the amount of time they tolerate sitting in the high chair, because they feel included at the table. If your highchair does not have an adjustable foot rest, try placing yoga blocks, a step stool, theraband, or rolled towels under their feet to provide some support. It is also important for the tray or able to meet them between their breast bone and belly button, so they can easily reach for food. If needed, place towels on the seat to bring them to the correct height if the chair is not adjustable.
How do you introduce purees?
Step 1: Let them get messy
When you first introduce solids, I recommend first placing a spoonful of smooth puree (no pieces, lumps, or chunks) on your baby’s tray, and encouraging them to interact with it with their hands. Encourage this by modeling, placing your fingers and hands in the puree, and making it a fun experience, by laughing and smiling. This will help your baby feel more comfortable with the new texture. Let your baby get messy, this is an important part of learning to eat! By touching it with their hands first, they are learning what to expect in their mouths, and are able to smell the food through play first, to get their sensory system ready. Think about what you do as an adult before you try an unknown food. You will likely smell it first so you have an idea of what it will taste like, which is less shocking to the sensory system than going straight in for a bite. Your baby may get a first taste by placing their hands into their mouth after placing them into the puree. I recommend this step each time you introduce a new flavor/food.
Step 2: Model an open mouth position
If your baby is tolerating the sensory play, and tolerating any tastes they have gotten from their hands, get a small spoonful and hold the spoon in front of your baby’s mouth level, while you model an open mouth position for your baby to imitate.
You can even model, “ahhh.” Wait for your baby to open their mouth, and/or lean forward towards the spoon. Place the spoon in your baby’s mouth when they indicate they’re interested (by opening their mouth to accept the spoon). You can then model saying, “mmm,” while closing your lips together, to help teach your baby to close their lips onto the spoon to clear it.
This takes some practice! I recommend using a spoon with a flatter bowl shape, so it is easier for your baby to clear it with their top lip. If your baby doesn’t open their mouth at first, you can put a small dab of puree from the spoon into their lips to let them taste, and again wait for them to open their mouth to receive the spoon. We want to avoid forcing the spoon into baby’s mouth. Trust is extremely important while learning to eat. Your baby may “spit” out the food at first, which is typical due to the tongue thrust reflex.
While many purees come in pouches these days, it is important for babies to learn spoon feeding skills. Squeezing food directly from a pouch into their mouthes takes much less effort, so wait to serve foods directly from the pouch until your baby is a bit older and has learned how to use the spoon, and continue to squeeze the food out onto a spoon when possible.
Step 3: Repeated exposures to a variety of flavors
When first starting off, introduce one new puree every 3 days to watch out for any signs of allergic reactions. Check the CDC here for latest information on introducing allergens, and other safety precautions when introducing solids. Speak to your pediatrician about incorporating food allergen introduction mix-ins. Continue to introduce flavors repeatedly, while also introducing a variety of flavors. Research has shown that there is a “flavor window” that starts to close around 18 months of age. The more repeated exposures to a variety of flavors you are able to provide, the more likely your child will continue to accept a variety of foods. While your baby may not appear to like a flavor the first time they try it, it can take 10+ exposures and tastes before starting to like and accept a new food. When introducing solids, patience is key! Continue to offer small tastes of new foods, and continue to offer more bites if your baby accepts it. Continue to allow your baby to play with new and non-preferred purees on their tray with their hands and with a self-feeder spoon, before they start to accept larger quantities. You can also try mixing a small amount of a new flavor with a flavor they already seem to like (e.g. apple and mango puree).
At 6-7 months of age, you can include 1-3 solid “meals” per day. Your baby may not get that much volume at first, but that’s okay, because their main source of nutrients is still human milk and/or formula. Follow your baby’s lead on how much they want to eat, and meals should last under 30 minutes total.
What do you do after introducing purees?
It is important to start introducing textured foods as soon as your baby is tolerating smooth purees. Some babies will be ready to move straight to meltable solids (e.g. puffs/melts, teething wafers), and soft solids. Other babies may need a little bit more time with purees, thickened purees, and mashed foods, before transitioning to soft solids. That being said, research has shown there is a critical window of time between 6-9 months of age when children are most receptive to textured foods, reflexes are being integrated (as we discussed above), and babies should be introduced to foods that require some chewing (e.g. lumpy mashed foods, meltable solids, soft cubes) during this window of time. According to research, being introduced to foods with texture that require chewing during this critical window results in a greater likelihood of accepting a larger variety of foods as a toddler, and, children that are not introduced to foods that require some chewing until 10 months of age or later are at an increased risk for developing feeding difficulties, such as poor chewing skills and picky eating.
Check out Part 2 of this blog to learn what to do after introducing purees, and continue your baby’s solid food journey.
Check out my guide to feeding supplies for starting solids here!
When to get help from a professional
If by 9-10 months of age your baby is having difficulty transitioning to solid foods, speak to your pediatrician and ask for a referral to a feeding therapist (feeding therapists have the title of speech-language pathologist or occupational therapist). Some babies may benefit from an evaluation even sooner if you’re seeing frequent gagging, vomiting, and/or coughing, limited chewing, or rejection of purees and/or solid foods.
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This website and information on this blog post is provided for educational purposes only. It is not meant as medical advice, intended to replace a speech-language or feeding assessment, therapy from a speech-language pathologist, or serve as medical or nutritional care for a child. It is recommended that you discuss any concerns or questions you might have with your Speech-Language Pathologist, pediatrician, and medical team, and develop an individualized team plan specifically for your child.