The first few years of a baby’s life are filled with so many exciting little milestones. Lifting her head, smiling, sitting, and crawling! One of the biggest milestones, of course, is introducing your child to solid foods. Some parents find introducing solid foods to be an exciting step forward, where others feel a little sad because it’s a reminder that their little one is growing up (don’t worry, she’s probably not ready for college quite yet!). But all in all, solids aren't too much of a big deal.
However, solids aren't easy for everyone. When you have a little guy or gal with a food allergy, like a cow milk allergy, this transition can cause a lot of angst. “How do I avoid an allergic reaction?” and "What foods should I start with?" come up early in the process. Then “How do I make sure my baby’s getting enough to eat?" and "How can I be sure she's getting the proper nutrition?” are also questions parents ask us a lot.
With so many questions and concerns, some parents in your shoes wonder if they should take the risk of introducing solid foods at all! Unfortunately, it’s not that simple. Solid foods actually provide a benefit in helping your little one to start developing the motor skills needed for chewing, biting (food, not people!) and swallowing. The motor skills she develops related to solid foods can also help with speech development. So how can you safely begin introducing solid foods to your baby?
We're going to walk through 6 important things that can be helpful when introducing solid foods. But first, discuss introducing solids with her healthcare team! They are the experts, they're familiar with your little one's medical care, and they can provide you with the best guidance.
1. Wait until your baby is at least 4 months old, and ideally closer to six months old, to introduce solid foods.
The major goal is to give your baby solids when she has the right skills for swallowing. Advice varies, so rely on your healthcare team to help guide you on what signs to look for to tell when she’s ready to start solid foods.
2. Ask your healthcare team when to introduce common food allergens.
You want your little one's first experiences with solid foods to be positive! You might be tempted to avoid common food allergens out of fear that your little one might be allergic to them. However, it's important to let your baby's healthcare team help you decide which foods to start first. Your baby's healthcare team has experience working with families in similar situations, and can guide you based on their wisdom.
In the past, we used to think that it was best to wait until the first birthday or even later to introduce common food allergens (like peanut, wheat, and soy). However, some of the latest research suggests that it's best to introduce those foods around the same time that you introduce other foods that are not common allergens. Doing so may actually DECREASE the risk of developing food allergies to those foods. So if your little one only has an allergy to cow milk, ask the healthcare team when they recommend you should introduce other common allergens.
Beyond when to introduce common allergens, what foods should you start first? Even for healthy (non-allergic) infants, there is no one go-to, best "first" solid food. Nobody can say with any certainty what food is "best" for your child - certainly not us! Some healthcare professionals suggest cereals first, others suggest meats, and some suggest fruits and/or vegetables. Ask your - you guessed it - healthcare team what they suggest!
3. Wait a day or two after introducing one new food before adding another new food.
This is to ensure your baby does not show signs of an allergic reaction to the new food, because some food allergy reactions can be delayed. That means that a reaction takes several hours or even several days to show up. This is certainly different from the typical "immediate" allergic reaction a lot of us think of.
By waiting a few days, you ensure that any suspected allergic symptoms can be clearly linked with the newest food. If you introduce 3 new foods in one day, and then see a potential symptom that night, who's to know which food(s) might have been the problem food?
4. Give your baby time to adjust to each new change.
Think about it, your baby has been taking the same nutrition the same way several times a day, every day, for her whole life! It's important to allow her time to get used to new experiences.
What do we mean by "new things?" Well, your baby will need time to get used to new tastes, new textures, as well as feeding from a spoon. A lot of parents become frustrated when their baby makes a funny face or pushes the spoon away. That's perfectly normal! Research shows this is normal, we didn't just make it up! (Thank you, scientists!) Keep at it if your baby isn't a big fan the first time she tries a new food - it can take up to 15 to 20 tries for her to become a fan.
5. Introduce new textures in stages.
For most infants, it's best to start "simple" and advance to more "complex" textures. Again, check with her healthcare team for their guidance, especially if your baby has any feeding or swallowing disorders or has ever worked with a Speech and Language Pathologist or Feeding Specialist. In general, here are the stages that most babies follow for new textures, from simple to complex:
Stage 1: thin and smooth
Stage 2: lumps and chunks
Stage 3: finger foods
6. As your baby gets older, solid foods will meet more and more of her nutritional needs.
Eventually, most children will get all nutrition from "normal" foods and beverages - formulas are typically phased out of the diet. While formula like Neocate might be the sole source of your baby's nutrition, eventually it will be a supplement to solid foods, and eventually she'll be able to stop using formula.
Talk to her healthcare team about how much formula she needs, and what foods will help most to meet her nutritional needs. For babies with a cow milk allergy who aren't breast feeding, the consensus guidelines are that they should keep taking formula until 2 years of age. This helps to meet her needs for important nutrients like protein, calcium, and vitamin D which would otherwise come from milk.
If you are nervous about allergic reactions as you plan to introduce new solid foods, consider discussing Neocate Nutra with your little one's healthcare team. Neocate Nutra is a hypoallergenic, amino acid-based semi-solid food that is intended for children over six months old. The texture when mixed with water is similar to pudding or infant cereal, so it's perfect for spoon-feeding. Prepared Neocate Nutra can be eaten by itself or you can mix it with other foods (one of our favorites is mixed with apple sauce!).
We've walked you through 6 tips that can help as you plan to start introducing solid foods. Remember: check with your healthcare team! We hope these are helpful.
What tips do you have for transitioning to solids that you want to share with other families? Let us know what you think below!
-Rob McCandlish, RDN
How do we have so much information to share? Sarah is the mom of 2 children who each had a need for Neocate in infancy, and Rob is a registered dietitian nutritionist who has a nephew who needed Neocate for a cow milk allergy. And we both have YEARS of experience following food allergy research, working with Neocate products, and talking with parents like you!