When Should You Start Baby’s First Food?

When should parents start baby’s first food?  Some parents claim that babies can/should start eating food as early as a few weeks after birth.  Others claim that babies are best exclusively breastfed for a full year or longer.  Most doctors and official organizations recommend that babies start foods around 4 – 6 months.

So who’s right?!

When I started this research, I had a different idea of what approach I’d take and what I’d find and recommend.  But…you go with what the evidence actually says. 🙂

Keep reading if you want to know the truth about what to feed, when to feed, baby led weaning, and more!

What Babies Eat Doesn’t Matter…?

According to the mainstream view, a baby’s diet doesn’t matter a whole lot.  Choose breastmilk or formula, put rice cereal in a bottle, spoon-feed a 2-week-old pureed veggies, or even hand a 3-month-old a bottle of soda and a cookie.

Sure, some of that is extreme — most people don’t put soda in a baby’s bottle, and they hold off on the cookies until more like 8 or 9 months.  But the point is, the mainstream doesn’t have a whole lot of knowledge about optimal diets or how to best feed babies, so their choices are rooted more in what “feels” right to them, or what their families did and recommend.

Unfortunately, making choices without understanding the reasoning behind them isn’t safe or good.  Any legitimate medical professional, whether natural or mainstream, is going to recommend against feeding solids before 4 months, and will especially recommend against feeding junk food before a baby is at least 9 – 12 months (and preferably longer).  “My mom did it to me and I’m fine” is not an argument against this.

If you haven’t read the first post on infant feeding that deals with breast milk, formula, and mama’s diet, check that out here.

We’re diving in to the “baby’s first food” question today!

When Should You Start Baby’s First Food?

In recent years, there have been a couple different issues that have informed much of this debate.  The first is food allergies, and the second is gut health.  (Which are really related.)

Some believe that late introduction to solids is better to protect against allergies — and to promote gut health.  (And there’s no denying that breastfeeding promotes optimal gut health.  Learn more here.)

Others say that early exposure to solids helps to avoid allergies, and there is some new research showing this.

I’m going to divert from both of those, though, for the most part.  (We’ll get back to gut development later.)

In a historical society without many of the gut-destroying things we have today — frequent antibiotic use, processed foods, modern pharmaceuticals, pesticides on food, etc. — “gut health” wouldn’t have been much of a factor in starting solids.  When we put that front and center in the discussion, we’re looking at modern issues, not biological needs.

What we really need to know is, why do babies need to start solids, and when does that occur?

Why Babies Need Other Food

With gut health at the forefront of the discussion in the natural community, and with the benefits of breastfeeding for gut health and in general obvious, it has been assumed that “the longer you can exclusively breastfeed, the better.”

But…why do babies need other foods?  Obviously, they do.  People can’t survive on a milk-only diet forever.  They’re not designed to.

The reason babies need other food is because, after several months, they need more nutrients than breast milk can provide.  Now, don’t hear me wrong — breastmilk does not become “less” in any way, and is still greatly beneficial well into childhood.  But baby is rapidly growing and developing, and his/her needs increase.

The major nutrient baby will need more of, is iron.  If a baby doesn’t get enough, this can have long-lasting impacts on growth and neurological development, so this is kind of important.  At some point generally between 6 and 9 months, baby will actually need an additional source of iron, beyond mother’s milk. (source) I personally think that low iron levels may be partially responsible for the “sleep regression” that happens so commonly in this period…. (This study backs up that idea.)

But back to iron itself.  Between 6 and 12 months of age, a baby’s requirements for iron are greater than at any other point in life.  They need approximately 0.9 – 1.3 mg/kg each day.  (source)  For a 15-lb. baby, this translates to around 7 mg/day.  For a 20-lb. baby, about 9 mg/day.  The official recommendation is 11 mg/day.

Breastmilk constains only about 0.5 mg/L, and a baby will only drink about 1 L a day, so this is not even close to meeting their needs. (source)  Prior to 6 months, babies don’t need a lot of iron, because they are born with iron stores of approximately 75 mg/kg.  Babies born to anemic mothers usually have lower stores. (source)

Please note that this only applies to infants born at full-term and healthy…preterm infants do not have such stores, especially prior to 34 weeks.  Iron stores generally run out somewhere between 6 and 9 months.  In one study, most babies by 7.5 months. (source)

By the way, delayed cord clamping has a huge impact on iron levels in babies.  One study showed that babies were almost 8 times more likely to be anemic when their cords were clamped immediately vs. delayed! (source)  (A 2011 study also shows the benefits of delayed clamping and lower incidence of anemia.)

Infants are also supposed to be born with stores of zinc and copper.  (Zinc deficiency may lead to IUGR.  (source))  Zinc also plays a huge role in the growth and development of basically every body system, so a deficiency is bad in an infant.  Phytic acid in whole grains blocks its absorption. (source)

With other metals, like selenium, amounts available to the infant depend directly on maternal diet. (source)

What About Gut Development?

Let’s talk about the gut.  It’s common in the natural community to talk about “open gut” and how babies can’t eat solids before a certain age because this open gut will lead to the development of food allergies.

There is nothing the published literature at all about “open gut.”  My best guess is that it comes from intestinal permeability studies.  Essentially, immature guts are more permeable (that is, food can seep out of the gut, in a way) for a little while.

But, the process of maturation, or “closing,” seems to complete somewhere between 3 weeks and 2 months of age. (source)  It’s not a significant factor in the timing of the introduction of solids.

I should note, it is a bigger deal in pre-term infants, and can take longer.  These infants, especially if not breastfed, are more at risk for serious illness in the first months of life. (source)

What about virgin gut?  It’s related and many use it interchangeably.  But it’s different.  Virgin gut is the idea that the gut is sterile at birth and needs time to colonize with optimal microbes, while open gut is intestinal permeability.

Well, virgin gut isn’t true either.  A 2016 study shows that infants’ guts are most likely colonized beginning in utero.  (By the way, a 2013 study shows that pre-term infants’ birth flora was different.)

Additionally, a 2017 study showed that the gut flora was relatively stable by 1 week of age, and remained that way through 24 weeks — if a baby was breastfed.  (It was more variable when a baby was pre-term or formula fed.)  The flora starts to change again once complementary foods are introduced, and continues to change until age 2 – 3 years, when it is basically like an adult’s flora. (source)

So!  With all that in mind, where does that leave us on starting solids…especially given our diet-doesn’t-matter culture?

When Do Babies Really Need to Eat Food?

Somewhere between 4 and 9 months, for most babies.

It truly is not optimal to continue to exclusively breastfeed for a full year.  (The phrase “food before one is just for fun” needs to die.  Now.)

If baby is born early, had health issues, if mom was deficient in key nutrients during pregnancy, then complementary foods may be needed sooner.  Although if your baby has health concerns, talk to your doctor, as supplements may be needed at younger ages.  (It’s just a totally different situation than a healthy, full-term baby, so we can’t really cover that here.)

A 2018 study looked at the timing of introducing solids, and found that exclusive breastfeeding for longer than 7 months was associated with a greater risk of childhood obesity.  So was stopping breastfeeding after 6 months.  The optimal situation seemed to be introducing solids around 6 months, while continuing to breastfeed (after breastfeeding exclusively for 6 months).  Although, interestingly, when babies were not exclusively breastfed, earlier solids introduction (4 months) was better.

Most babies will truly need to eat — and have a desire to do so — between 6 and 9 months.  That is, if they’re breastfed.

If they’re formula-fed, they really may need to start complementary foods by 4 months, because formula is a substitute for breastmilk, but it is not functionally the same.  Metabolism, gut development, etc. are already different than the biological norm, so the introduction of solids is, too.  (We’ll cover this in a separate post.)

There is no reason to delay beyond 6-ish months, and possibly detriments to doing so.  (But continuing to breastfeed with complementary foods is very important through the third year.  We’ll get to that in another post.)

What Should Baby’s First Food Be?

Our culture gives a lot of advice about babies’ first foods that is rather…odd, honestly.  It’s all based on whether or not a food is allergenic (well, mostly).

Rice cereal is recommended because it’s supposedly easy to digest, low allergy possibility, and because it’s fortified with iron.  (Ah, iron again!)

Our goal with complementary foods is to meet an infant’s specific needs, not just to introduce “something to eat.”  Too many babies are under-nourished because of poor quality weaning foods. (source) The foods that are introduced should be nutrient-dense, and rich in iron, zinc, and copper (much lower amounts of copper as human requirements are lower and toxicity of any metal is possible in high amounts).

Many say that we should not give babies grains too young, because they don’t produce amylase.  But a 2009 study shows that babies’ amylase production is fairly good by 6 months of age.  Another study shows that amylase activities increase rapidly from birth through 3 months. (source) Additionally, there is a good amount of amylase in breast milk. (source)

There’s no real reason to avoid grains after 6 months, due to amylase concerns.  However, since grains are rich in phytic acid, which blocks the absorption of the key nutrients babies need at this age, it’s best to avoid those grains.  It’s also best to avoid refined grains, which are low-nutrition and not what babies need.

It is possible to reduce phytic acid in foods through traditional preparation methods, like soaking, sprouting, or souring — which we’ll discuss later. (source)  Foods high in phytic acid include nuts, wheat, corn, rice, oats, barley, soy, legumes/beans, peas. (source)  These are not good options for early infant foods.

So, if these are not good…what should we feed babies?

We need foods that are iron-rich.  (source)  Good early choices include:

• Egg yolks
• Liver
• Muscle meat (especially beef or turkey)

Vegetarian sources of iron, which will not be as easy to digest, include:

• Broccoli
• Kale
• Tomato
• Potato

Other vegetarian sources that are higher in iron (soy, seeds, legumes) are also high in phytic acid, which is why they’re not recommended.  Spinach is high in oxalic acid, which can block the key nutrients, just like phytic acid.

Baby’s first food should ideally be small amounts of the first group — liver, egg yolk, muscle meat.  They can be pureed with breast milk or bone broth and fed with a spoon or as a “smoothie” of sorts.  Muscle meat can also be cut up small or ground and offered to the baby to eat on his/her own.

Other good foods to introduce by 8 – 9 months include:

• Avocado
• Sweet potato
• Apples
• Pears
• Bananas
• Other squash (butternut, summer, zucchini, acorn, pumpkin, etc.)
• Peaches

Basically, any fruit or veggie not high in oxalic or phytic acid is fine to include.  Bone broth is also beneficial.

Fermented foods can be added closer to the end of the first year.  Some are high in salt, which can be hard on immature kidneys, so only small amounts and around 12 months.

As far as dairy, small amounts of cultured dairy are fine after 8 – 9 months.  Milk never needs to replace breastfeeding in any way, at any age.  (Too much dairy, too early is not good because the calcium blocks the absorption of iron and because it is high in sodium.)

For those with food allergies, this study addresses new guidelines.  No need to wait on specific foods to prevent allergies developing.

By the way, there’s no actual evidence that foods need to be introduced one a time, with several days in between.  It was suggested to help identify/prevent allergies but there are no actual studies showing that this is necessary or beneficial.  It may become necessary if your baby shows signs of reactions to foods, but not necessary for the average baby.

In a follow-up post, we’ll discuss what to feed babies in the last few months of the first year and into the second year, as well as looking at weaning and the eventual introduction of phytic-acid containing foods.

Baby Led Weaning?

I haven’t specified, for the most part, how to feed the recommended foods.  Baby-led weaning is extremely popular in the natural community, because it’s assumed that this was how all ancestors fed babies, and therefore, it’s the most natural.

However, ancient cultures probably did things like pre-masticating (i.e. pre-chewing) for their babies, which no one does today.  We’re not really being true to ancient practices.

A 2017 meta-analysis of the modern practice shows it will meet most babies’ needs…but not all.

It is likely best to introduce a few early foods with a spoon or other type of “assistance” around 6 – 7 months, but give baby as many opportunities as possible to self-feed, especially as baby gets older.

There is nothing wrong with homemade purees.  Even older kids and adults enjoy blended soups, smoothies, fruit sauces, and so on.  Instead of thinking of purees as “baby food,” think of them as a variation on normal household meals.

Baby really will need small amounts of food at first, as long as they are nutrient-dense foods.  There is no reason to offer low-nutrition processed food “for the experience,” such as common refined cereals.  These products also have either refined grains or phytic acid, and most are fortified with synthetic vitamins.  Skip them.

Good items to offer as finger foods:

• Small pieces of meat
• Small pieces of well-cooked or soft fruits and veggies
• Large pieces of peeled, hard fruits/veggies (carrots, apple slices) — watch babies with teeth so they don’t bite chunks off
• Small pieces of cheese (8 – 9 months)

Items to offer as a puree or on a spoon:

• Fruit sauces
• Smoothies
• Bone broth with liver and/or veggies pureed in it
• Plain yogurt
• Boiled egg yolk (plain or mixed with breast milk)

A combination of feeding methods makes sure that baby gets the nutrients he/she needs, while also giving him/her a chance to explore different textures and flavors and learn to self-feed.

Well!  That was a lot.  And we’ll tackle more in future posts too!

When did start baby’s first food?