Last week I said that Alice was ready to start eating solid foods, that she was showing many of the “classic signs and reached the physical milestones” typically used as examples that a baby is ready to taste solid foods. How did I know that? What are those “classic signs” everyone refers to? There are many out there, some physical and mechanical which tend to be a little easier to observe, while others are emotional in nature, and might be more difficult to identify. Let’s take a closer look at each one.
Signs, signs, everywhere there’s signs
Age – Numerous agencies in the US and Europe including the World Health Organization (WHO), the American Academy of Pediatrics, and governments in most countries of the European Union recommend nothing but breast milk (ideally, or formula for the non-breast fed baby) for the first 6 months of life. This recommendation, first made by the WHO in 2002, is based on a large body of evidence which examined optimal infant growth and development of illness and infection in babies with differing durations of breast feeding. These agencies concluded that breast milk was adequate to provide all the nutrients needed in the first 6 months of life (except in very particular circumstances) after which point solid foods may be necessary to ensure proper consumption of all nutrients, vitamins, and minerals.
Physical ability – It is no coincidence that 6 months is the age used as a suggestion for the introduction of solid foods because it coincides, approximately, with the growth and neuromotor development that is considered necessary before infants can safely and adequately consume solid or semi-solid foods. There are several cues that can be used as signs that your baby is ready including:
Sitting up – I have done a lot of research trying to find a reason why being able to sit up unassisted is a sign of developmental readiness and all I am able to find is that it’s because it suggests that they are developmentally ready; which is circular logic. However, every website, blog, official and unofficial agency says that being able to sit unassisted is a key indicator of readiness. Most likely it has to do with safety, and an indication that other aspects of development are in place (like swallowing and the loss of the tongue thrust reflex), but I can’t find scientific evidence that this is the case. I’ve seen other, also unsupported, recommendations that a baby does not need to be able to sit unsupported, but he does need to be able to hold his head up and sit supported without slumping over. This most likely occurs for children well before 6 months of age, and, depending on the child, may occur before other signs of readiness appear.
Tongue thrust reflex – Tongue thrust is a normal occurrence in infants and describes the reflex – the involuntary movement – in very young babies that causes their tongue to come forward when something enters their mouth. This reflex helps produce the sucking action which is necessary for breast or bottle feeding, and is why your son is always pushing his tongue out of his mouths when anything goes into it. In time, this reflex begins to disappear and a spoon, for example, put into his mouth is not immediately pushed back out. This often coincides with the ability to actively use his tongue to move food from the front to the back of the mouth and down the throat. (Believe it or not, this has to be learned. Practice makes perfect!) From what I can tell, there seems to be a lot of confusion about how to know if this reflex is gone. Here’s how: try touching a spoon to your little one’s lips. If his tongue comes out, pushing the spoon away, he still has a strong reflex. Wait a little while – a few days to a week – and try again. Or try this tip by pediatric occupational therapist and SEFK contributor, Mara Levin.
Pincher grasp – When babies first learn to grab for things they use their whole hand, fully palming an object in order to pick it up. Eventually, your baby will develop the more nuanced and careful pincher grasp, picking things up with her thumb and finger(s). This pincher grasp generally develops between 7 and 12 months of age, but there seems to be a large (and normal) range of ages when this first appears and is mastered.
Digestive tract – Although not a sign of readiness that can be observed, I think it’s important to include a discussion of the growth and development of the digestive tract. At birth the infant’s digestive tract is not fully developed, meaning that the enzymes needed to digest and fully absorb nutrients, although it is mature, is not very efficient. So although young babies are able to handle various nutrients they are not able to fully absorb them. Even breast milk is not fully absorbed in the very young, for example only about 96% of triglycerides (a type of fat molecule) in human milk are absorbed at 1.5 months of age. Most cooked starches are digested and absorbed almost completely, but that which isn’t digested in the intestine continues to be digested further down the digestive tract by microbiota living in the colon. (Interestingly, the microbiota necessary for such digestion seems to increase as more demands are made on it, suggesting that the introduction of a variety of carbohydrates is necessary for full maturation and digestion.) Beginning around 4 months of age, infants begin to secrete the enzymes necessary to digest proteins, but their capacity to do so is limited, ranging from 38 to 76 mL in term neonates to about 20 mL/kg body weight in toddlers (which is the equivalent of 5.5 – 7.0 ounces (160-200 g) per meal for a 6-8 month old).
Interest and imitation – One of the surest signs that your baby is ready for solid foods is her “asking” for it. Your child may intently watch as you eat, following the fork as it moves from the table to your mouth. She might open her mouth when you do, especially when prompted to do so, or try to grab at the muffin you’re eating for breakfast. The more you allow your infant to be a part of meal time – sitting at the table with you while you eat – the more likely you are to observe this interest. With Alice, she eagerly grabs for our cups, silverware, serving dishes and plates… as well as the food on the plate! There is no doubt she is interested in doing what we are doing when it comes to meal time.
You are ready! – This may seem silly, but your readiness (and willingness) to begin the process of introducing solid foods to your baby is going to be one of the best predictors of success. The transition from breast or bottle feeding to eating solid foods can be an emotional time for parents as it signals the end of one period of infancy and the beginning of another. Moms who are breast feeding, especially, may struggle with letting go of being the person that your baby relies on most for sustenance. Introducing foods also requires patience: it’s going to get messy (literally) and there will be times when your baby (and toddler!) is not going to want to eat the food you make for them. But, if you can remain calm, are consistent with how you offer foods and continue to patiently introduce a variety of foods to your baby, you will both find the process more enjoyable.
So is YOUR baby ready?
It’s all well and good to talk about the host of signs which may appear in any baby, but what about your baby? What if your son is reaching for your food, clearly watching and interested while the family eats dinner, but he’s not yet able to fully support himself sitting and still grabs for objects with his whole fist? Does this mean that he can’t start experimenting with solid (or semi-solid) food?
Of course not! Children develop at different rates and physical milestones will be reached in different orders and at different times. I’ll use my own experience to highlight this. When my oldest started on solids she was very interested in the food that her dad and I were eating, but she was still learning how to sit unsupported and her early meals were on our lap. With my second child, he was not interested in food until he was a fair bit older, and by the time he started eating solid food he was sitting on his own, had a fully developed pincher grasp, and was in a chair at the table with us. As I mentioned, Alice is extremely interested in what the rest of us are eating and is fully able to support herself sitting up, but she does not have a finely developed pincher grasp.
Remember, at this point the act of introducing solid food is not about getting them to eat the food as much as it is about getting them to experience the food. Let them partake in family mealtimes by joining you at the table, having them sit on your lap if they can’t sit by themselves; give them (appropriate) spoons and cups to hold; let them play with pots on the kitchen floor while you cook. Infants are extremely attuned to emotional cues at this age as well, so if you are tense and anxious around food your baby is likely to be tense and anxious as well. Try to relax; you and your baby are likely to have a lot more fun that way!