When To Introduce Solids – From Confusion To Clarity

With so many conflicting recommendations from health professionals and organizations, about when to introduce solids, it’s no wonder parents are confused.

The latest media flurry about this topic stemmed from the recent Centre for Food & Allergy Research Australian Infant Feeding Guidelines Summit in Melbourne, Australia, where leaders in child health and nutrition discussed ways to minimize the risk of babies developing food allergy.

So, what information for parents came out of this summit with regard to the timing of introducing solids?

When Should I Introduce Solids?

This article will help take parents from confusion to clarity about when to introduce solids to their baby.

The National Recommendation When To Introduce Solids

The National Health and Medical Research Council (NHMRC) is Australia’s leading health organization. The recommendations in the 2012 NHMRC infant feeding guidelines are still current.

The NHMRC recommends exclusive breastfeeding for around 6 months and then for solid food to be introduced and breastfeeding to continue, for at least one year, or for as long as the mother and child desire.

Some key points from the NHMRC infant feeding guidelines are:

1. “From around 6 months, infants should be offered a range of foods of an appropriate texture and consistency for their developmental stage”
2. “First foods should be iron-rich and an increasing range and quantity of foods should be introduced so that by 12 months the infant is consuming a wide variety of family foods”
3. “the AAP [American Academy of Paediatrics] and the EFSA [European Food safety Authority] also concluded that there is no reason to delay the introduction of foods to prevent allergies, including nuts in suitable form”
4. “Breastfeeding should be continued while solid foods (allergens) are introduced to the infant, and has many advantages to the health of the infant”
5. For babies who are formula-fed, and from an allergy prevention perspective, the NHMRC indicates “different infant formulas have been considered for this purpose, including amino acid-based formula, hydrolysed formula, soy formula and milk from other animal species. However, the evidence is mixed and routine use of special formulas for preventing allergy is not recommended”

It’s important to note that allergy risk is not the only factor to consider when it comes to the timing of the introduction of solids. The NHMRC recommendation to introduce solids around 6 months is based on all the available research (up to 2012) and takes into account not only allergy risk, but also the risk of infection, too little breastmilk, and obesity, as well as developmental readiness.

The information that has come out of the infant feeding summit supports the above recommendations, but places further emphasis on points 3 and 5 above.

Three Main Points Have Come From The Infant Feeding Summit

The three main points that have come from the infant feeding summit are:

1. When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron-rich foods, while continuing breastfeeding
2. All infants should be given allergenic solid foods, including peanut butter, cooked egg, and dairy and wheat products, in the first year of life. This includes infants at high risk of allergy
3. Hydrolysed (both partially and extensively) infant formula is not recommended for prevention of allergic disease

From the summit, then, it has been established that hydrolysed formula does not help prevent allergy, and that when solid foods are introduced (around 6 months) it’s important for the main food allergens (in their appropriate form) to be introduced before 12 months, even for babies at high risk of allergy. If a child already has a food allergy, or severe eczema, advice should be obtained from a doctor.

So, the take home messages include:

1. Breastfeed exclusively (no other foods or liquids) for around the first 6 months
2. Introduce solids around 6 months, but not before 4 months, when your baby shows signs of developmental readiness
3. Continue to breastfeed once solids have begun, and continue for at least one year
4. Introduce your baby to major food allergens (e.g. peanut butter, cooked egg, and dairy and wheat products) by 12 months

This should provide further clarity, so you are less confused about when to introduce solids to your baby.

For more information, you can read the following Belly Belly articles:

• 6 Unreliable Signs That Your Baby Is Ready For Solids
• How Often Should I Give My Baby Solids?
• Rice Cereal – 4 Reasons Why It’s Best To Skip It