Introducing solids to your baby: when and how to start

Complementary feeding for infants, also called Beikost. It is the progressive introduction of foods other than milk from 4-6 months of life. A very important period that raises many questions, which is why the midwife team at Happymami has prepared the following post for you, with everything you need to know about introducing food to your baby.

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Introducing food to your baby

It is well known that the first 1000 days of life, which cover the foetal period and the first two years of life, are the most important stage in the formation of our body. It is the stage in which our organs develop at their fastest, creating the foundations of the body we will have for the rest of our lives. For example, 80% of our brain is formed during the first three years of life.

Our body adapts to its environment, and one of the most fundamental elements of that context is the food we have within reach. There has always been a wide variety of diets in the different cultures of the Earth. The human body, especially in the early stages of life, has the ability to adapt to all of them. That is why the nutrients ingested during this period influence the development and maturation of our body through adaptive changes.

When should you start introducing food to your baby?

You should never start the introduction of complementary feeding for your baby before 4 months. The digestive system is too immature and complementary feeding can be harmful. It also increases the risk of overweight or food allergy. Nor later than 7 months, since from six months exclusive breastfeeding, especially at the breast, is not enough to cover calorie needs, or certain vitamins and minerals such as iron, zinc, fluoride, vitamin B12 or vitamin D, among others.

So the right answer would be around 6 months of age. But most importantly, when to start is not only a question of timing; it also depends on the maturity of the baby, especially for the introduction of solid foods.

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Signs that your baby is ready

We will know that our little one is ready to eat foods other than milk when:

1. Sits up firmly, with good head and neck control, even if they need a little support.
2. Brings their hands or other objects such as toys to their mouth.
3. The extrusion reflex has now disappeared, the one with which they push any solid object placed between the lips outwards with their tongue. It usually disappears between 4-5 months of age, and it can be "trained" with a lot of patience, using semi-solid foods, without forcing and without giving in to frustration. Always bear in mind that this tongue movement is not voluntary, and therefore does not mean that your little one does not want to eat, or that they do not like that food.
4. And, above all, when they show an interest in food.

Foods to avoid

1. Until 12 months your baby cannot drink unmodified animal milk. This is due to the potential risk of anaemia. If breastfeeding is not possible, offer type 1 or 2 formula milk. Afterwards, try not to exceed 720 ml/day until the age of 2, and 500 ml/day from the age of 2, adding up the total amount of milk consumed in all the dairy products they drink or eat.
2. For the same reason, "anaemia", dairy products (yoghurt and cheese) should be avoided. As well as green leafy vegetables rich in nitrites (lettuce, chard, spinach, celery and beetroot), until 9 months, and they should be introduced in small quantities. Eat vegetables and greens as fresh as possible to prevent nitrates from turning into nitrites. And wash them very well with plenty of water, leaf by leaf (and of course do not smoke, as the greatest exposure to nitrosamines comes from the environment and tobacco).
3. Honey and canned foods should also be avoided until 12 months, due to the risk of botulism.
4. No salt should be added to food until 12 months, because the excretory system is not yet fully mature. This includes avoiding prepared products that contain salt (spice blends or stock cubes), or foods with a high salt content (salted and cured foods). From 12 to 24 months, small amounts of salt can be introduced. And from the age of 2, the same as an adult (3-6 g/day).
5. Sugar, sweeteners or foods containing them should not be given until the age of 2. Afterwards, these foods should not account for more than 10% of the diet (ideally less than 5%).
6. Liquids other than water or milk should be avoided. It is recommended not to give fruit juices, even if they are 100% freshly squeezed fruit or homemade. But if you do decide to give the latter, they should not exceed 120 ml a day.

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How to introduce foods

There is currently no evidence on the safest way to introduce foods to the baby. However, the most recommendable approach would be the one set out below:

1. For babies there are two types of food: new foods (that is, those they have never tried), and known foods (those they have already tried on several occasions).
2. When we want to introduce a new food, we have to do it initially in small quantities, and if there is no reaction we will increase the amount (this is especially important for foods with a high allergy risk, particularly if the baby is at high allergy risk).
3. For a few days (3 or 4), we can only give our baby a single new food, which we can mix with already known foods (this is because if they have a reaction we need to know which food caused it, and if several have been introduced it is difficult to tell which one or ones it was). Once you have made sure that your baby has no reaction to the food, it will move from the "new" category to the "known" category and we can start to introduce another new food.

It is important not to force your baby to eat. Feeding is a maturational process and, as such, every baby has their own pace. You should let your baby regulate the amount they want to take, while making sure they do not lose variety, and focusing our concern on the quality of the feeding.

It is important not to force your baby to eat

Also, bear in mind that feeding in humans is not only a nutritional process, but also a social one and part of socialisation. We should try to eat with our baby instead of just feeding them; it should be a pleasant moment of the day, a family activity of experimentation and discovery for our baby, without screens, televisions or distractions, which are also associated with a higher risk of choking and an unnecessary increase in intake and greater overweight/obesity.

Bear in mind that the biggest role models for babies are their own parents, so we should try to make sure that parents have as correct a diet as possible, because the best way to make a food appealing to your baby is for it to be on their parents' plate.

Certain foods may be rejected by your baby. Especially if they have been on a "hyper-tasty" diet rich in sugars, salt or saturated or trans fats (ultra-processed foods). These shift palatability, making other foods lacking these components seem bland and unappealing, but you should not despair or force the baby.

Bear in mind that for a baby to really be considered to reject a food, it must have been offered on fifteen different occasions (fifteen different meals). It is recommended that this food is introduced frequently, that it is of good quality and flavour, and above all that it is eaten by the parents in front of the baby. If your baby persists in their refusal, you should avoid negative behaviours such as punishment, shouting, anger or blackmail, which are counterproductive; you can offer healthy alternatives that complement the rejected food.

Which foods are best to start with?

There are no optimal food introduction calendars. The baby's diet should be as similar as possible to that of their family context; therefore, the first foods to introduce are those most consumed at home, logically taking into account the foods restricted by age.

It is important that your baby has a varied, high-quality diet within reach and, in particular, from six months it is advisable to introduce a source rich in iron and zinc such as blood, meat, offal, shellfish, oily fish, pulses, nuts and fortified cereals.

Foods rich in vitamin C, such as berries and citrus fruits, raw pepper or parsley, favour iron absorption; in fact, it is recommended that at least one meal a day is rich in vitamin C.

The quality of feeding matters so much. Nowadays we are bombarded with ultra-processed foods and refined flours that provide a lot of energy, but nothing or very little of the other nutrients we absolutely need to grow or live in full health. That is why these products have acquired the popular name of "empty kilocalories", because, despite their high calorie content, they have a very, very low nutrient density and nutritional value.

Children decide the quantity, and adults the quality

On the other hand, in many societies including our own, there is an unnecessary concern about quantity. Sometimes obsessive, as reflected in the fact that 95% of consultations for supposed childhood hyporexia (poor appetite) are false hyporexias caused by a mistaken perception on the part of caregivers.

Remember that the amount of food we eat is regulated according to our energy needs. These in turn are highly variable, changing radically in the same individual depending on their needs at any given moment.

Our country, as we have said, is among the European countries with the most childhood overweight and obesity (even surpassing the US in some statistics), and that is partly because many people have given up quality in favour of an unnecessary quantity. But paradoxically, most of those children who are overweight or obese will be malnourished, as they lack all the nutrients they need.

Therefore, babies should not be obliged or forced to eat (except on medical indication for a justifiable pathology), since as well as being counterproductive, it is unnecessary. We must shift that historical concern for quantity towards a worthwhile concern for quality, a concept summed up by the following golden rule: children decide the quantity, and adults the quality.

And at what time of day?

As for what time of day to start, the answer is similar. Every home, and every family, has its own timetables. Ideally, start with one meal a day. Whichever is the largest meal at home, except dinner, which will be the last to be introduced. Then, if it is well tolerated, move on to two meals a day. And increase progressively during the first months until adapting to the family rhythm, at around 12 months. This progression depends more on the baby than on a set of guidelines, and cannot be generalised, since every baby has their own developmental pace.

From the first year of life your baby should already be more or less adapted to the family's eating routine. Both in terms of schedule and quality. As salt can now be used in small doses, it is easier to cook for everyone. It is recommended to maintain breastfeeding, and if this is not possible, we can replace it with unmodified animal milk, or type 3 formula. Regarding unmodified animal milk, it is worth noting that sheep's milk has approximately 50% more calcium than cow's or goat's milk. Regardless of the animal of origin, if there is no problem of overweight or obesity, whole milk will have a better nutritional content. At the age of two, milk is not a compulsory food as long as we replace it with foods rich in calcium, such as oily fish (sardine), wholemeal bread, seeds, almonds, figs, broccoli or pulses.

Are vitamin supplements necessary?

Initially, if the diet is correct and varied, they are not necessary. Remember the need to provide foods rich in iron and zinc from 6 months. From birth until 6 months of age, a vitamin D supplement is advisable (400 IU/day), especially bearing in mind that we should avoid sun exposure during the first year of life.

Later on, if your baby has a balanced diet together with 10-30 minutes of sun exposure a day. That is more than enough to cover vitamin D needs. If the baby does not drink tap water, but bottled water instead, a fluoride intake adapted to their age is recommended, from 6 months. If the baby follows a vegetarian diet, or even more so a vegan one, it is important to give a vitamin B12 supplement.

Quality diet:

The diet set out below is a reference for the most optimal one for human beings. According to current evidence, from 2 years of age. This diet is not 100% transferable to babies, since they have their own needs. But it does serve as an orientation and guide for the feeding of the youngest members of the household:

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A balanced diet consists of

1. The basis of feeding is vegetables and fruit, preferably raw, although also cooked. Whenever possible, eat this type of food with the skin on, well washed. Do not ban but do avoid starchy vegetables, especially potato and maize. If they are cooked, do so with foods that lower their glycaemic index, such as foods rich in fat, fibre or protein.
2. Complement with pulses and 100% wholegrain cereals (avoiding flours where possible).
3. Do not forget: pure spices, seeds, and raw or roasted nuts.
4. Add to this virgin olive oil, egg, fish low in the food chain (cod, monkfish, grouper, sea bream…) or seafood.
5. White meat (or, more occasionally, red meat) can be added once or twice a week, along with milk and dairy products. For dairy products to be healthy: milk should only have one ingredient, with nothing else added. From the age of 2, animal milk or its derivatives are not compulsory, and if they are consumed they should not exceed 500 ml/mg per day in total.
6. To drink, only water or plain milk.
7. Always cook at low temperatures: raw, steamed, stewed, griddled, oven-baked with little oil. Avoid fried food or barbecue.
8. Avoid free sugars: not only white sugar, but also honey, unrefined cane sugar, brown sugar, syrups, treacles and fruit concentrates or juices.
9. You should avoid refined cereals. Especially flours, and processed products or those with a poor lipid profile.
10. Not recommended: foods that are not very filling, such as juices, smoothies, jellies…

Conclusion: introducing food to your baby

Every baby is unique, so try to adapt to your own situation. These are stages, and often the most important thing is to be patient. Remember that there are two methods of introduction by texture: introduction with purées, or directly with solids (BLW or BLISS), with no medical advantages or disadvantages demonstrated in current studies. What really matters is not the method but offering a quality diet and avoiding foods with a high risk of choking.