STARTING SOLIDS Pedia

WHAT YOU SHOULD KNOW

A Pediatrician’s Guide to Starting Solids

Starting baby on solid foods is a milestone that quickly creeps up on you as a parent and while introducing purees and finger foods is no new concept, it is a topic that still comes with a great deal of uncertainty and a mountain of questions. We asked Dr. Wendy Sue Swanson, pediatrician and CMO of SpoonfulONE, for the new list of rules when it comes to feeding your baby.

5M I N I 6 s p r i n g ‘22

DR. SWANSON

ON HOW TO INTRODUCE BABY TO NEW FOODS...

First feeds are a monumental step for both baby and parents. All babies are different when it comes to the right age to start and how quickly they start eating a variety of foods. It’s important to understand the signs of readiness to start solids.

A few of the signs are: • Able to sit up without support • Able to maintain great head control when sitting • Loss of the tongue-thrust reflex so they don’t automatically push food out of their mouth when offered and taken • Follows foods with their eyes and shows eagerness and interest (sometimes babies even lick the air when they smell delicious food!) • Opens mouth wide when you offer food on a spoon

There are so many foods that can be great to start your baby on solids. In addition to considering your family’s food preferences, here are a few first foods (in very, very small pieces or puree): • Avocados • Banana • Soft cooked, sweet potatoes, squash and pumpkin • Soft cooked apples • Soft cooked carrots, green beans, zucchini, and beets • Cereals that are thinned to a near-liquid consistency with expressed breast milk or formula • Very ripe peaches and pears • Peanut butter thinned with water and mixed into oatmeal

ON THE AGE TO START SOLIDS AND ALLERGENS LIKE EGG, PEANUT, AND FISH...

The American Academy of Pediatrics (AAP) and the USDA recommend starting your child on solids between 4 and 6 months of age. You may be thinking that seems young, but in a complete reversal from decades of advice from pediatricians to avoid the foods associated with food allergies, research now says early and regular dietary exposure to a food — specifically a food often associated with allergies, like peanuts — helps reduce the risk of a child developing an allergy to that food.

There are 16 common allergens that make up 90% of food allergies. Feeding these allergens early and often is key to reducing food allergy risk. If preparing 16 different foods feels overwhelming, there are solutions to help make it safe and convenient for parents. SpoonfulONE provides gentle daily exposure to 16 food allergens and is backed by multiple research studies.

ON FOODS TO AVOID WHEN STARTING SOLIDS...

Yes, there are a few foods you should steer away from when introducing solid foods to your baby: • Honey: rare risk for causing botulism, a serious illness, if introduced in infancy. It’s safe after 1 year of age. • Cow’s milk: Stick with breast milk and formula as a primary liquid until your baby is 12 months-old. • Water is okay after 6 months of age when starting solids (2-4 oz servings). • Nuts, popcorn, whole grapes, and thick/dense nut butters as they are choking hazards so avoid or cut into tiny pieces or thin appropriately.

ON THE IDEAL DIET FOR BABIES...

Your baby’s diet should be diverse and robust. I often say try to get in 100 new foods in 100 days. Most parents do a great job getting in fruits and vegetables, but don’t forget things like meat and fish. You want your baby to be exposed to lots of different textures and flavors.

ON THE BIGGEST MISCON CEPTIONS ABOUT FOOD ALLERGIES IN KIDS...

• Genetics. Food allergies are not always genetic, in fact, 2 out of 3 children with a food allergy, do NOT have a parent with one. • You only need to worry about peanut. Simply not true. Peanuts are the “celebrity” of food allergies, but a single allergy to peanuts only accounts for 7% of all food allergies. So get peanuts into the diet, yes, but don’t forget all the others as well. • You do not need to go slow and wait days in between feeding new foods. This is completely outdated advice. Parents should feel comfortable introducing multiple foods at a time. Or at least 1 new food every single day! Studies have shown that it is safe and in fact, going slow and delaying eating certain foods increases food allergy risk.

ON HOW TO REDUCE FOOD ALLERGY RISK...

There are 3 main things parents can do to reduce their child’s food allergy risk:

• Introduce common allergens around 4-6 months of age. • Keep common allergens in their diet on a consistent basis for about 1 year. • Let your child be exposed to things like dogs and dirt in the environment.

ON HOW TO IDENTIFY FOOD ALLERGIES...

The most common presentation is an allergic reaction which typically involves hives and/or vomiting within 2 minutes to 2 hours after eating a food.

TO PARENTS WORRIED ABOUT INTRODUCING ALLERGENS...

I completely understand why it can feel scary to parents. Rather than worrying, try to focus on the profound benefit you’re offering your child. We want babies to be able to experience all foods and flavors and textures without limitations. Feeding our babies can be an adventure but it’s one that is a serious reward to the soul. You can introduce foods to your baby with joy and confidence. I often say that feeding our children and nourishing them is one of the most soulful and spiritual things we get to do as parents.