by Amy Spangler
March 04, 2010

A carrot-filled spoon zooms overhead as a mother mimics the sound of an airplane. “Just two more bites,” she cajoles. Her two-month-old baby, positioned upright in an infant seat, clamps his lips shut. He doesn’t want the vegetable. But she persists until the last of the carrots are consumed. To even the casual observer, it’s obvious the baby doesn’t share his mother’s enthusiasm for carrots. At least—not yet.

Many moms across America will recognize this ritual—one that is repeated three times a day in their homes. It is the transition from breast or bottle to solid foods—one that all babies will inevitably make. And it is a milestone that can be, at times, frustrating, with your baby seeming to refuse everything that’s offered. While no one questions the need for transitioning to solids foods, there is little consensus as to its timing.

Two months? Three months? Four months? Six months? Is there an ideal time to introduce solids—a window of opportunity that shouldn’t be missed? If your baby refuses to eat his carrots, does it mean you introduced the vegetable too early? Too late? And, does it matter?

If you are confused about when to start introducing solid foods to your baby’s diet, you are not alone. The American Academy of Pediatrics’ (AAP) Committee on Nutrition recommends starting solids between the ages of 4–6 months, but its Work Group on Breastfeeding along with the World Health Organization (WHO) recommends that parents breastfeed for the first six months of life and wait until the second half of the first year to introduce solid foods. The controversy surrounding the introduction of solid foods continues unabated, leaving parents with no choice but to guess… and hope their baby doesn’t clamp up. But timing does matter.

When is the best time to introduce solids?
Numerous studies have looked at how the timing of the introduction of solid foods affects allergic disease. Investigators in Belarus found no reduction in the risk of asthma and other allergic diseases at 6 1/2 years of age in children who were exclusively breastfed for three months. Finnish researchers found that late introduction of solid foods (after seven months) may actually increase the risk for food allergy.

In a 2007 clinical report, the AAP states that there is insufficient evidence to support delaying the introduction of solid foods beyond four to six months. But adds that breastfeeding is the best protection against allergic disease, even though breastfeeding cannot prevent food allergy in high risk children.

There is data that also suggests a relationship between the timing of the introduction of solids and obesity. Parent surveys of more than 12,000 children at the age of 9 months, 3 years, and 5 years (as part of the UK-wide Millenium Cohort Study) prompted the recommendation that solid foods be introduced no sooner than 4 months of age. They found that when solids were introduced before four months, children (26 percent) were more likely to be overweight or obese at three and five years of age compared to babies given solid foods after four months (22 percent). Researchers also concluded that children who were not breastfed were more likely to become overweight (23 percent) compared with those breastfed for at least four months (18 percent).

Is six months ideal? Why not five months? Human milk provides all the nutrients babies need for about the first six months, including iron. But once the iron stored during pregnancy is used up, at about 6 months of age, iron-rich foods such as meats or iron-fortified cereals need to be added to babies’ diets. In addition, most babies are developmentally ready for solid foods around 6 months of age.

The bottom line
Delaying solid foods until seven months may increase a baby’s risk for allergies. And introducing solids foods before the age of four months may increase the risk for obesity, no small concern, given that a staggering one out of every three U.S. children is overweight. The ideal time to introduce those sweet-smelling carrots is sometime between the ages of 4–6 months. Is it a sure bet your baby will unclamp his jaws at four months? Not really. The only way to determine whether he’s ready for solids is observation. Remember this motto: Watch your baby, not the calendar.

Signs that your baby is ready for solid foods include the ability to sit up with little support, hold his head up, pick up soft foods, and put those foods in his mouth. And if your baby doesn’t react willingly to a spoon touching his lips, it is likely he’s trying to communicate that he’s not ready.

Patience is one of parenting’s few prerequisites. If you don’t have it, you will acquire it. And don’t worry, every baby—including yours—will eventually chow down on carrots (and peas and bananas and pears…).

Editor’s Note—February 27, 2012
The American Academy of Pediatrics (AAP) issued a policy statement reaffirming its prior recommendation that babies be exclusively breastfed for the first six months of life. The prior policy statement issued in February 2005 acknowledged a “difference of opinion among AAP experts on this matter,” with the Committee on Nutrition supporting the introduction of complementary foods between 4 and 6 months and the Section on Breastfeeding recommending 6 months. The current policy statement, however, contains no such variance, a reflection of the evidence showing a greater incidence of lower respiratory tract illness, otitis media, and diarrheal disease in babies exclusively breastfed for 6 months compared to those exclusively breastfed for 4–6 months. The AAP also recommends that breastfeeding continue for at least the first year and beyond as mutually desired by mother and baby. View the revised policy here.