Tirzah Mae had her “4 month” appointment today (Born five months ago and due 3 months ago) – and her doctor went through the standard four month advice, ending with “You can also start rice cereal now.”
To which Tirzah Mae’s dietitian mother answered, “Thanks but no thanks.”
Despite what your next door neighbor, the label on the baby cereal, and maybe even your family doc says, you do not need to introduce solids at 4 months. Most babies don’t need anything but breastmilk or infant formula until they’re six months old – and both breastfed and formula fed infants are at a disadvantage if they start solids too early.
For breastfed infants, the risk of adding solids before six months is related to what we breastfeeding people call the “virgin gut”. As long as Tirzah Mae is only receiving breastmilk, her gut has a protective layer (a simplified explanation that isn’t precisely correct, sorry!) that practically sheds pathenogenic bacteria and other icky stuff. Once that layer has been broken, baby can get sick more easily (now, don’t get me wrong – this does not mean that breastmilk is no longer beneficial after the gut’s barrier has been broken – keep breastfeeding even if you introduced solids prematurely!) The longer the breastfed baby waits before breaking that barrier, the better off she is – to a point. That point is right about 6 months , when an infant’s iron stores from birth are depleted and she needs some extra iron (this is why iron fortified infant cereal is recommended as baby’s first food).
For the formula fed infant, there’s no gut barrier to break – it’s been broken long ago (after that first two ounces of formula), but that doesn’t mean that we should be gung-ho about starting those solids right at four months. A few babies are developmentally ready at four months – but the vast majority develop the head and neck control needed to safely eat solids later. And introducing solids too soon can risk replacing the relatively nutrient-rich formula baby has been receiving with the (mostly) “empty calories” of (most) “Stage 1” baby foods (as well as increase risk of allergies).
So, when SHOULD you start solids?
If you’re breastfeeding your baby, when your baby shows signs of developmental readiness, no sooner than six months. If you’re formula feeding, when your baby shows signs of developmental readiness, no sooner than four months.
What are these signs of developmental readiness I speak of? I’m so glad you asked.
First, your baby should be sitting up with minimal support. This means with a pillow behind him – not strapped into a seat with a five point harness or sitting in a Bumbo.
Second, your baby should be able to hold his head steady and make controlled head movements in the sitting position. If I had a dime for every parent who has told me their two week old already has great head control… Remember, I said “in the sitting position”.
Finally, your baby should open his mouth wide for a spoon of food and close it once the spoon’s inside. If your baby is still sticking out his tongue when the spoon touches his lips, he’s not ready for solids. His tongue is under reflexive control – it needs to be under his control before he starts eating solids.
As for Tirzah Mae? We’ll be breastfeeding with nothing else added at LEAST for another month (six months from her birthday) but probably closer to three more months (until six months after her due date).
I didn’t know that about the protective lining (being why they aren’t AS likely to get sick). Interesting! I think we began introducing solids around 4 months (slooooowly) but that’s primarily because we were on formula and for cost purposes as well as wishing them to eat “real” food as soon as possible, we made changes as soon as they were ready. (Which was really more completely changed over around 9 months or so.)