Should You Start Solids at 4 Months or 6 Months?

Families are sometimes so eager to transition to solid foods that they unknowingly expose their baby to unnecessary risk by starting too early. I have worked with numerous families that started feeding solids early to their baby (at 3-5 months of age), and unfortunately this has often resulted in choking episodes, outright food refusal, or picky eating. To avoid these risks, let’s explore what is recommended by the medical community; common reasons why parents unintentionally start prematurely; and the signals to look for to ensure you are not feeding your baby too early!

Medical Recommendations

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) encourage parents to wait until six months of age  before starting baby on solids. These relatively new guidelines are in place to keep babies safe from choking, having digestive issues or respiratory infections.

• Exceptions to the Rule: There are some rare medical exceptions that may require starting earlier than the suggested 6-month timeline. For example, I once received an  order from a baby’s pediatrician and surgeon to provide feeding therapy for a 4 month-old baby that had to safely increase his weight as a prerequisite to undergoing life-saving  heart surgery.

Common Reasons Parents Start Too Early

I think it is important to understand why some parents start introducing solid foods too early. Here are the four most common reasons I have encountered:

1. Pediatrician Told Them to: There are a lot of amazing pediatricians out there, but unfortunately some of them have not taken a continuing education course in feeding, swallowing, nutrition, or oral development in the last 10 years. So they are unknowingly giving outdated advice that differs from the recommendations by the AAP and WHO organizations.
2. Comparing with Others: Parents confess to me that they started solids too soon because they were comparing their baby to their first born. Others state that well-meaning family members, neighbors, friends, or even their spouse started comparing their baby to the “infant next door” and they felt coerced into starting earlier than they had otherwise wanted. Before we cave into peer pressure, we need to make sure your baby has the skills to safely eat solids.
3. Fussy Baby: Many families explain that they started solid foods early because they thought it might help calm their fussy baby. It’s important to remember that before we use food to comfort, we need to ensure your baby is developmentally mature enough to eat.
4. Mixed Signals: Parents tell me that they were confused about signs of readiness. Receiving mixed signals can be frustrating for both baby and parents. (Don’t fret –  keep reading as I share below my readiness checklist!) Remember, if your baby is only showing one of the many signs of readiness, then they are not quite ready… but they will be soon!

Developmental Recommendations

I encourage parents to wait until their baby is six-months of age before starting first foods as it helps establish a stronger and safer swallow for solids. To help parents understand what signs of readiness to look for, I’ve created a program called Ms. Dawn’s Checklist for Readiness:

• Hips: Can your baby sit up on their own in a high chair without losing their balance? 
• Arm: Does your baby reach for your food or drink and/or grasp objects? 
• Hand: Does your baby lift objects, toys, or their hand to their mouth? 
• Head: Does your baby have the head control to look up, down, right, and left without falling forward? 
• Mouth: Does your baby start to drool, gnaw on their hand, or open their mouths when watching you eat? 
• Tongue: Has your baby’s tongue thrust reflex diminished? 
• Eyes: Does your baby stare at you intently while you are eating and/or show an interest in food? 
• Brain: Is your baby at least six months of age? And has your baby mastered the other seven signs? 
• If you answered “no” to any of the above questions, then it’s too early to start solids…yet! Don’t worry you both will get there soon!

I hope these tips will help you make an informed decision regarding solids based on the development of your baby. Starting first foods is so much fun! Keep me posted on your feeding journey by commenting here in the blog!   #MsDawnSLP #startingsolids #blw

Happy Feeding,
Dawn Winkelmann, M.S, CCC-SLP
Speech Language Pathologist & Pediatric Feeding Specialist