Don’t Wait too Long to Start Solids

Don’t Wait too Long to Start Solids

This is a guest post from A Mother in Israel’s Hannah Katsman:

There’s a lot of contradictory information out there about when to start offering your baby solid food. In this interview with Shoshi Belkowitz, a speech pathologist whom I met recently at a lactation conference, she talks about the ideal time for babies to start on solid.

How did you get involved in breastfeeding issues? SB: In my work in the hospital clinic, I often help babies whose developmental issues prevent them from breastfeeding correctly. The hospital lactation consultant I work with invited me to take a breastfeeding course, and the rest is history. I’ve since developed exercises for improved breastfeeding technique for babies with problems, and have lectured to lactation consultants. Currently, I see babies with swallowing and feeding problems at my private clinic in Raanana.

Hannah Katsman: How does breastfeeding affect infant development? Shoshi Belcovitz: Breastfeeding requires the use of all facial muscles. Bottle-fed babies only use some of the muscles, so the others don’t fully develop. This can affect orthodontia and speech.

If breastmilk is the best food, why not continue exclusive breastfeeding indefinitely? Delaying solid foods is risky. First of all, some nutrients need to be added to the baby’s diet at around six months, when iron stores from birth are starting to be depleted. While the iron in breastmilk is well-absorbed, iron is only present in small amounts. Also, at around this age, babies’ mouths and digestive system develop the physical ability to deal with solids. There is a psychological element too—at this age babies enjoy tasting, using their mouths, and experimenting with textures. Babies only offered solids for the first time at around a year of age often gag. I frequently see these babies in my clinic.

When should babies first get solid foods? According to the new health ministry guidelines, you can give baby “tastes” at four months or older. A taste means giving a little bit on the tip of the parent’s finger, and making sure there’s no allergic reaction.* Commercial, strained baby food shouldn’t be given until the baby can sit upright and swallow correctly. Most babies have enough control of their upper bodies by 5 to 7 months, although they may still need support while sitting.

Babies like to try eating by themselves, which is an important developmental step. They can coordinate talking and eating. Most babies are ready for spoonfuls at 6-7 months.

Is there a difference in timing depending on whether the baby is formula-fed or bottle-fed? No, these guidelines apply to all healthy babies.

What should babies be eating? Soup, meats, vegetables, fruits. Foods rich in vitamins. Babies’ gums are strong enough to chew most foods even without teeth.

What about the baby who refuses to eat solids? Exposing the baby to solids is what counts—even if the baby says no. A baby should never be forced to eat, because he needs the freedom to decide what he likes. Forcing solids can lead to a different set of problems.

Most babies who refuse solids are normal, even up to a year or longer. But sometimes there is an objective reason for the refusal. These include reflux, tongue-tie, sensory integration issues and hyper- or hyposensitivity to textures and tastes. I can spot hypotonia, or poor muscle tone, when it’s too easy to remove a bottle from the baby’s mouth.

What’s the most important message for parents? Starting solids should be a fun, social activity and should be started at the appropriate age—4 months for tastes via the parent’s finger and 6-7 months for spoon-feeding.

*An AAP report indicates that babies exposed to solids at 4-6 months don’t have more allergies than those who wait longer.

Shoshi can be reached at 052-222-0387

Hannah Katsman writes on parenting and Judaism at A Mother in Israel and helps home cooks save time and money at CookingManager.Com See more on starting solids at this link or in the series Feed Your Baby Frugally. Getting Enough Sleep without Crying It Out appeared at JewishMom.Com in February.

Image courtesy of Flickr.com user Geoff Livingston

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20 comments

  1. You got another winner, Chana Jenny!

    I very much appreciate Hannah Katsman’s work promoting and enabling breastfeeding, especially for babies with all sorts of challenges. The world needs more Hannahs doing this beautiful and life-giving work.

    However, her statements that babies “should” be offered solids between four and seven months old don’t jive with my own experience and much of my reading. (I am not talking about books by male doctors. I am talking about books by experienced breastfeeders.)

    Many of the babies in my extended family as well as babies of friends and acquaintances had their first taste of food other than breast milk at 10 months or so. Even if they gag at first they quickly get the hang of it. All the babies I know who didn’t eat til a year are now full size, healthy human beings. Breast milk is the best food in the world; why replace it with something inferior before it is absolutely necessary? I just don’t think the dire warnings (what will happen if you hold off with the food past 4 – 7 months) are useful or meaningful.

    The best rule for successful, healthy breastfeeding is to throw away the clock and throw away the calendar.

    The clock: don’t time the feedings. When the baby lets go, it’s time to offer the other one. When s/he lets go again, it’s time to lay him/her down – not before. And don’t decide by the clock when it’s time to nurse. When the baby cries… go for it, even if it’s only an hour or two since the last time. It is painful to watch a baby fuss at the “wrong” time, and the whole family starts dancing around the house with the baby and pacifier trying to hold it off til the “right” time by the clock for that baby to be nursed. It’s not liquid gold. Give freely.
    Throw out the calendar: never mind how old the baby is. If s/he indicates a need or desire (same thing – if they desire it, they need it) for food, give it. Til then, don’t.
    This old grandma has given her share of unasked-for advice for the day.

    • Dear wise old grandma,

      I wholeheartedly agree that the rule should be that there is no rule.

      With my first, she truly preferred to nurse until she was 14 months old with a taste of solids here and there. And she was quite the content little girl, slept beautifuly, etc.

      Come my fourth and at five months old she seems constantly searching, despite me being a stay-at-home mom and available to nurse her on demand, often. So, funny that Mrs. Weisberg should post this article now, I think I am inspired to will attempt at some tiny spoons or licks at solids and see if that calms her seeming desire for a fuller belly.

    • Hi Rishe,
      Thanks for the compliments! I want to make it clear that this is an interview with Shoshi Belcovitz and she made the statement that babies should get tastes from 4 months. I don’t think that is necessary, as I wrote here: http://www.amotherinisrael.com/babies-start-solid-foods/
      You wrote: “Breast milk is the best food in the world; why replace it with something inferior before it is absolutely necessary?”
      Breastfeeding has its place and I nursed most of my children for several years. But healthy solid foods are not “inferior.” Humans are designed to be *exclusively* breastfed only as long as they are unable to eat and digest other foods. After that point they still need breastmilk but with the gradual addition of other nutritious foods.
      Yes, many babies do fine if they are first offered solids at ten months. That doesn’t mean they all will. And what is wrong with offering the solids earlier? The babies can always say no.
      I do agree with you about the clock and the calendar, but only up to a point. Many mothers, especially first-timers, need more guidance.
      Why do the mothers in your extended family wait until 10 months? Isn’t that also looking at the calendar? Most babies are ready to experiment with solids at a younger age.

  2. with my 3rd we delayed solids and were told by a speech therapist that giving solids, and trying ones with different textures, is necessary for proper speech development. Hashem created breastmilk but he also created us with the instinct to eat solids, so we can’t delay it indefinitely…

  3. Tamar Miller

    to the old & wise grandma – once one introduces solids, it doesn’t mean that breastfeeding has to dwindle. it shouldn’t and the people who recommend introducing solids at around 4-6 months are not advocating to stop breastfeeding. evidently, most babies are usually ready to eat a bit more and need it too.

    I have witnessed from many of my neighbors and friends who hold off introducing solids to their babies (mainly from laziness b/c its much easier to just nurse all day) and then later complain that their baby doesn’t eat anything. They either begin solids when they are much older or gave up trying solids b/c their baby just doesn’t want.

    in my own experience, everyone has always been amazed at how much my babies love to eat. all 3 of mine began solids between 4-6 months (of course each baby at his own pace) and from then on they were excellent eaters. always curious to try some new texture. of course, i can’t say as they grow older that they have remained such great eaters. but at least they started out well!

    • Interesting, Tamar. It’s hard to know, though, why some babies grow up to be pickier. A lot has to do with attitudes of parents.

      • I have the pickiest eaters – all 3 of my kids. What is this attitude of the parents that you’re talking about?
        (You can email me at roundrobinmom@gmail.com)

        • No need to keep the conversation private. For the record, I have six kids and almost all of them have things they won’t eat–except for my youngest so maybe I learned more by then? Or it was just coincidence.
          I think that we as parents subconsciously send the message that some foods, like vegetables, are less attractive than others. Some vegetables are slightly bitter and apparently some people are more sensitive to it–we have no influence over that. But when parents say you can’t have dessert until you eat your peas, the child understands that peas are not something he is expected to enjoy. Another example is when an adult says, “I really shouldn’t be eating (this unhealthy food).” I could go on but I think you get the idea.

          • I’m so happy you didn’t tell me I need to force them to eat! I hate the advice “they’ll eat when they’re hungry” cuz mine don’t! they just get worse and worse and cry and scream and I feel helpless unless i offer something that they like.

  4. Why delay solids? Because a young baby’s digestive system is not yet fully developed to handle solids, and those solids can therefore “leak” and cause problems later on.

    The rule of thumb I got (and like) is that you don’t deny a baby solids past 6 months if they’re asking, but no need to offer until they can sit up themselves and hold the solid food themselves.

    • N,
      You wrote:
      “The rule of thumb I got (and like) is that you don’t deny a baby solids past 6 months if they’re asking, but no need to offer until they can sit up themselves and hold the solid food themselves.”
      Yes, and most babies hit these milestones by 6 or 7 months.

  5. I think the interview pretty much represents the conventional advice about starting solids. There’s nothing terribly wrong with it, and certainly countless babies have been raised with this approach and are now healthy and happy. However, I disagree with the comment that delaying solids is “risky” and that parents “shouldn’t wait too long.” A parent that is tuned in to her baby will know whether nursing alone is still meeting her baby’s needs.

    My children generally started solids between 8 and 10 months, but my youngest showed zero interest (and yes, by around 10 months I did try introducing food). She never put toys or teethers or anything else in her mouth either. It wasn’t until she was about 14 months old that her interest/ability kicked in – which bought me a call to social services by my family doctor because in addition to not eating “on time,” my baby was a tiny (but healthy) peanut. (Details are on my blog if anyone is interested.)

    Once she did start to eat, it was only a matter of about three weeks until she was eating absolutely everything, like any other toddler. At that age, they learn fast. 🙂

    At age 2.5, she loves all kinds of food, eats plenty, still nurses, and is still a tiny-but-healthy peanut who finally hit 20 pounds around her second birthday.

  6. I totally agree with Rishe Deitschs comments. She is right on the money… As a International Board Certified Lactation Consultant I have worked with Thousands of babies over the past 18 years and do not believe that babies need any solids what-so-ever before 9 months. Babies may be orally excited and want to put things into their mouths but if you put an old shoe and a piece of bread in front of a 6 month old the shoe will definetly win as a visually and orally exciting treat. Just because babies are orally excited and need to explore the world thru their mouths does not mean they are hungry. Oral stimuli is a normal part of development and it should me honored. Babies will be just as happy with a spoon, cup or toy to lick and bite. Lets not confuse brain delvelopment with filling up a stomach when breast milk has all the vitamins and nutrients that are needed for proper growth. Oh, about the iron…If I take 450 babies that are nine months and gave them blood tests they would all appear anemic. Now who is incorrect the blood levels doctors want to see or Hashem? I believe it is totally healthy for babies to have low iron levels at nine months…if you leave it alone the levels will rise by themselves around twelve months…..I’ve seen this for eighteen years….

    • Yael, I agree that not all babies are ready by 7 months. You watched your babies for signs, and you tried and saw they weren’t interested. That is not the same as a mother withholding all solids until a relatively late age because she believes that the more breastmilk, the better.

    • Sara Chana,

      While I respect your experience and intuition, I would like more evidence for your point of view.

      The WHO recommends waiting a full 6 months but not later, in order to prevent malnutrition:

      http://www.who.int/child_adolescent_health/topics/prevention_care/child/nutrition/comp_feeding/en/index.html

      The USDA is more liberal about possibly starting at four months, especially in developed countries, but also writes that there is no evidence of benefit to delaying longer than 6 months except in individual cases:

      http://www.nal.usda.gov/wicworks/Topics/FG/Chapter5_ComplementaryFoods.pdf

    • My little boy is now 7 1/2 months old. I started giving him tastes at 5 1/2 months, more to see his reaction than anything else (his siblings started solids much later). While breast milk is still (and by far) his main food, and will probably remain it for a good few more months, there is no misunderstanding the squeaks he gives when he spots food he likes (Or the kiddush cup, for the matter…). He will get very exited when seeing a banana… and so will he when seeing me getting ready for nursing. He will NOT have the same reaction when given a toy – even a well loved one, and this is an infant who likes to chew on everything in sight.
      But then again, I can’t really argue with your experience- just giving my 2 cents from my personal one…

  7. It is interesting to see that sometimes women can’t accept that the way Hashem made it is exactly the way it should be. as a culture we are so dominated by the the bullying of the medical establishment. We Westerners are raised and groomed to truly believe that if we leave things the way nature intended there will be dire consequences. it’s the same with pregnancy, birth, breastfeeding, shots, and old age.

    • I am not sure what you mean, Rachel. Ancient cultures started solids at different ages, in different ways, and with different foods. There are still “primitive” cultures where babies receive different types of liquids right at birth, even though this has shown to increase the risk of illness and death especially where sanitation is poor. Human behavior is influenced by many things and it’s not always easy to determine the most “natural” way.

  8. Some women delay giving solids because they are relying on nursing to avoid becoming pregnant and fear that eating food will diminish the nursing and bring on their period. Since they won’t use other forms of contraception, the nursing takes on more significance than just food for baby.

    • Yes, Yehudis, that is a common reason. But the baby’s needs must come ahead of the mother’s. Nursing just before offering solids, nursing frequently and for comfort, offering solids gradually, continuing to nurse at night, avoiding pacifiers, and lying down for at least one nursing during the day are all ways to extend breastfeeding infertility. Timing of starting solids is only one factor. At some point fertility will return whether the mother offers solids or not.

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