Ask a Dietitian: What Should Be My Baby’s First Food?

Babies. They eat, they sleep (jk), they poop. Whether or not you’re a parent, one truth remains: feeding a baby can be a big cluster of fun, mess and excitement. One of the most frequent questions I receive as a pediatric dietitian is “What should be my baby’s first food?”. I’m increasingly convinced there is no one right answer, but there are a few not-so-right ones. The fact is, your child will grow up to eat what you eat and how you eat. So if your veggie intake is sparse and you eat on the run, don’t be surprised if you have a picky, restless eater. A child’s preference and taste for nutritious foods is 100% influenced by what they are exposed to. So let’s spend some time discussing ideas for starting a baby off right when it comes to table foods.

Let’s start simple. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first year of life. Breast milk not only provides unique antibodies not present in formula, the fats and proteins are perfectly balanced and easily digested by tiny tummies. Additionally, breast milk provides a long list of non-nutritional benefits available to both baby and mother. However, if for whatever reason breastfeeding isn’t what you choose, don’t fret because formula has come a long way! Honestly, there are some incredible formula options on the market, so don’t feel discouraged (Holle and Plum Organics are at the top of my list). Breastfeeding was hard for me and I kind of beat myself up over it. When I was able to begin offering real foods around six months, it felt pretty empowering to know that I could invest my energy into another route of nutrition. This blog post will be specifically geared towards just that—food. Bottle or breast, fed is best.

How do you know when baby is ready for solids? Let readiness lead the way, not age, but I usually recommend starting no sooner than six months as starting prior to this has been associated with increased food allergies. Around six months start looking out for a few developmental milestones to suggest baby is ready. These might include:

-Sits up by self (in a bumbo or something similar)
-Good head control
-Opens mouth to food
-Moves tongue up, down and side to side
-Loss of extrusion reflex (aka tongue thrust)  

Babies have this crazy ability to … wait for it … stop eating when they’re full! That’s right, their hunger and fullness cues are hardwired from the get-go, so try not to overcompensate by forcing more when they’re really just done. Similarly, if your baby isn’t very interested in food around six months, that’s okay too! Ellyn Satter, pediatric feeding expert and my personal hero, says it best, “The parent is responsible for what the infant eats, while the infant is responsible for how much they eat (and everything else).” Remember, breast/formula feeding should be offered before meals and should remain the primary source of nutrition until age 1. Putting too much stress on introducing foods could backfire and create aversions, so as long as baby is growing appropriately and your physician has no major concerns, don’t fret if you have a slow eater on your hands.

Pressing on. So baby is developmentally ready and suddenly crazy interested in that sandwich you’re holding. What now? Cereals? Fruits? Meats? To determine the “best” first food let’s take a look at my six “nutrients of concern,” if you will. These are macro/micronutrients that are often overlooked or inadequately consumed in infancy, and super important for growing babes.

Iron

Why?

Iron stores are used up quick when you’re growing at the speed of light like a baby. Fun fact: If a baby maintained the same rate of growth throughout life as his first year he’d be 170 feet tall by adulthood.

How much?

Shockingly, 14% of U.S. children are iron deficient by age 2. Side effects of iron deficiency include decreased immunity and delayed mental development. For breastfeeding mamas, the iron content of your breast milk really starts to deplete around 6 months. Thus, the AAP recommends an giving an iron supplement to exclusively breastfed babies starting at 4 months. (Formula babes, you’re cool—no supplements for you unless doc says so).

0-6 mos AI: 0.27mg/day

6-12 mos RDA’s: 11 mg/day

First food recommendations:

Ground beef or turkey, tuna, chicken for meat eaters. For plant eaters, I’d suggest something like quinoa, beans or lentils with a good source of vitamin C (kiwi, strawberries) to promote absorption.

Zinc

Why?

Inadequate zinc intake can contribute to poor growth and (interestingly) poor appetite (this goes for adults too). Similar to iron, if breastfeeding, the zinc content of mother’s milk drops around 6 months while baby’s zinc needs increase.

How much?

0-6 mos DRI’s: 2 mg/day

6-12 mos DRI’s: 3 mg/day

First food recommendations:

Red meat, seafood, mashed beans, fortified infant cereals * note: organic infant cereals do not contain additional zinc.

Fat

Why?

Brain and cognitive development (Did you know our brains are primarily composed of fat?) and promoting absorption of fat soluble vitamins. Babies require about 50% of their calorie needs to come from fat—hence the recommendations for whole milk after age 1.

How much?

0-6 mos DRI’s:  31 g/day

6-12 mos DRI’s: 30 g/day

First food ideas:

Avocado, yogurt, cheese, butter, coconut oil

DHA

This omega-3 fatty acid specifically promotes brain, psychomotor and vision development. (It’s super important for all babies, but especially those born premature).

How much?

USDA recommendations:

0-6 mos: 0.1-0.18 mg/day

6-12 mos: 10-12 mg/kg/day

First food ideas:

Fatty fish, oils and egg yolks fortified with DHA

Vitamin D

Why?

Promotes bone development by ensuring calcium is carried to the bones. Inadequate intake can lead to poor immunity and rickets which, unfortunately, is on the rise.

How much?

0-12 months AI’s: 400 IU/day (or 5 mcg/day)

*For breastfed infants, this is especially important. Continue supplementation until baby is consuming 32 ounces a day from either formula or vitamin D milk.

First food ideas:

Besides ensuring your breastfed baby is receiving a daily vitamin D supplement, the next best sources include cooked mushrooms, egg yolks and salmon. Fortified juices, like orange juice, will also supply a hearty dose, but I typically don’t recommend juice for children under 1.

Calcium

Why?

Bone growth and development. If you are breastfeeding, be sure you are consuming enough calcium so that your body doesn’t resort to pulling from your own bones to ensure baby receives enough.

How much?

0-6 mos AI’s: 200 mg/day

6-12 mos AI’s: 260mg/day

Recommended first foods?

Spinach, broccoli, yogurt, cheese

Information overload? I get it. That’s why I’ve created this handy chart of my favorite first food ideas. If you’ll notice rice and oatmeal cereals are not on my list. This is because they’re kind of nutritionally blah and frankly, nature gives us so many more colorful, delicious alternatives. These aren’t in any order but I will say avocado and carrots have gone over quite well in my house.

Avocado

Butternut squash

Sweet potato

Carrots

Spinach

Beets

Apple

Pears

Organic eggs

Ground beef, turkey or chicken (I suggest dark cuts of meat—to increase acceptance mash with squash, carrots or sweet potato once introduced and tolerated)

Despite all this information, it can still be tricky to decide where to start when considering safety. Can baby handle the texture? Will the food be potential allergen? What if my baby doesn’t like vegetables?

Here in the U.S., spoon feeding pureed or blended food has long been considered the “normal” way to start solids. Nothing says bon appetit like a hot, steamy plate of pureed peas, right?

Pros of pureed/spoon feeding →  

  • Sneaking or hiding healthy ingredients with funny textures (spinach, mushrooms, turnips etc.)
  • Seemingly safe with minimal choking hazards
  • More control for parent which often equals less mess

Cons of pureed/spoon feeding →

  • Greater time spent in prep (wash, cut, cook, blend, freeze, thaw, etc.)
  • Less sensory experience as food is delivered directly to the mouth with no chance for baby to touch, feel and manipulate textures

On the contrary, here in the U.S. we’re seeing a resurgence of what’s called baby-led weaning (BLW).  Baby-led weaning is essentially where you skip the pureed, blended foods and go straight to soft, cooked, easy-to-eat foods in their actual form—think small chunks of avocado or sweet potato.

Pros of BLW →

  • Meals are simple and often mirror what other family members are eating
  • Less prep needed which equals more family-style meals
  • Encourages self regulation, less pickiness and development of self-feeding skills

Cons of BLW →

  • Possible choking hazard if foods are not prepared properly (Thus, always chop into small pieces, cook to doneness or select naturally soft foods.)
  • Possibly more messes

Either way, I don’t think you can go wrong as long as you’re making mealtimes as engaging and stress-free as possible. On a personal note, I chose to incorporate more baby-led weaning with my second child whom has, so far, shown a much broader interest in foods.

Other rules to be aware of:

  1. No honey until at least age 1 due to risk of botulism. If you’re offering a more “sour” vegetable like brussel sprouts or spinach, try drizzling a tiny bit of date syrup on top to increase acceptance. Our personal fave is roasted carrots with just a drizzle of Date Lady syrup on top. Delish!
  2. Watch the added salt (rinse and strain any canned veggies) to avoid excess sodium for tiny baby kidneys.
  3. Avoid excess sweets which will fill up baby’s tummy on empty calories and start to steer those taste buds in the wrong direction.
  4. Use breastmilk or formula as the primary energy and fluid source for the first year. A sippy cup of water can be introduced around the time you start foods, not to exceed 4-8 ounces/day.

In closing, I can only reiterate, try to have fun and keep meal times stress-free. This is baby’s first introduction to what will hopefully become a healthy, vibrant relationship with food. Let them get messy and explore the various textures and sensations of food as this only increases their acceptance. If they don’t like a food the first time, keep offering it over and over again. Godspeed moms, dads and caretakers—you are all doing a great job!

A note from Lindsey:

Such an enlightening post, Sarah! Nice work! Sarah asked me to write about food allergies—a concern for many new parents. Food allergies are scary. Eight foods are responsible for 90 percent of food allergies in children: milk, wheat, eggs, soy, peanuts, tree nuts, seafood, and fish. Berries, seeds, corn, and other foods can also be a concern. Thus, in order to easily identify the culprit, it is recommended to introduce new foods 3-4 days apart. For years here in the U.S., we thought that avoiding the introduction of common allergens like peanuts, tree nuts, seafood and eggs would prevent the onset of food allergies. Meanwhile, countries like Israel were introducing peanuts before 9 months of age with reduced cases of peanut allergies. Groundbreaking studies like the LEAP study support early introduction of peanuts, which has led the AAP to also begin recommending the introduction of peanuts between 6-12 months of age. Just be careful with nut butters as their natural sticky consistency can present a possible choking hazard—mix into a simple fruit smoothie or spread a thin layer on some banana slices, common sense tips 🙂 Of course, as always, talk with your pediatrician first if you have any major concerns about food allergies. – Lindsey

Credits // Author: Sarah O’Callaghan with contributions from Lindsey Kelsey. Photo: Laura Gummerman, Graphic: Mara Dockery.
References: 1. Bunting, K.D., Mills, J., Phillips, S.,  Ramsey, E., Rich, S., Trout, S., (2010). Texas Children’s Hospital Pediatric Nutrition Reference Guide, 9th Edition 2. Castle, Jill. (2017) The Smart Mom’s Guide to Starting Solids 3. Ellyn Satter Institute. Website available at https://www.ellynsatterinstitute.org  4. National Institute of Health Office of Dietary Supplements. Website available at https://ods.od.nih.gov 5. USDA National Nutrient Database. Available at https://ndb.nal.usda.gov/ndb

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