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20 years
My baby is 4 month old and i want to start feeding her solids i bottle feed her tell what should i feed her and how to combine thw milk bottle with solids?
Dec 18, 2014

Dr. Zakia Dimassi Pediatrics

According to the latest research reviewed by the World Health Organization (WHO), during the first 6 months of life, babies need nothing but milk (be it breast milk r or infant formula). During this time period, a baby's digestive system can develop in order to be able to cope fully
with solid foods. This includes solid food made into purees and cereals added
to milk.

So I recommend that you wait till your baby is at least 5.5 months of age before starting to experience with solid food. And know this: the latest research has found no benefit in early introduction of solid food in terms of protecting children against developing allergies.

The timing of introduction of solid food is determined based on the following (while keeping in mind that each child's readiness depends on their own rate of development):
- The baby's ability to hold her head up: your baby should be able to sit in a high chair, feeding seat, or infant seat with good head control.
- Your baby opens her mouth when food comes her way: if your baby, when watching you eating, reaches for your food, and seems eager to be fed, then she is ready.
- Your baby can move food from a spoon into her throat: if you offer your child a spoon of cereal and she pushes it out of her mouth and it dribbles onto her chin, she may not yet be able to move the food backwards to her throat to swallow it. This is perfectly normal because she is used to milk which is more fluid than food of course, so it may take some getting used to. What you can do is diluting cereals in milk the first few times, then gradually thicken the texture. You may also want to wait a week or two and try again.

As a rule of thumb, when the baby doubles her birth weight (typically at around the age of 4 months) and weighs at least 6 kg, she may be ready for solid foods. Start with half a spoonful or less, and talk to your baby through the process (Yumm, this is very good!). Your baby may not know what to do at first. She may look confused, roll the food around her mouth, or spit it out. To facilitate eating solid foods the first time, give your baby a little breast milk and/or formula first, then switch to very small half-spoonfuls of food, and finish with more breast milk and/or formula. This will ease your baby's fussiness when she is very hungry.

You should expect that most of the first few solid-food feedings will end up on your baby's face, hands, and bib. Do not despair. You should slowly and gradually increase the amount of food, starting with just a teaspoonful or two in order to allow your baby time to learn how to swallow solids.

If your baby cries or turns away her head when you are trying to feed her, do not force it. Go back to nursing or bottle-feeding exclusively for a couple of days, then re-attempt giving solid food.

Start with single-grain cereals, rice 1st because of its low content in protein so it won't burden your baby's kidneys, then are usually introduced first. However, there is no medical evidence that
introducing solid foods in any particular order has an advantage for your baby.

We usually recommend starting vegetables before fruits to avoid having your baby getting used to sweets and then probably refusing salts, but there is no evidence that your baby will develop a
dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this.

Once your baby becomes used to eating one type of food, gradually introduce other food items, and make sure you give her one new food at a time, and wait at least 2 to 3 days before starting another. After each new food, observe for any allergic reactions such as diarrhea, rash, or vomiting. If any of these events occur, stop using the new food and talk to your baby's pediatrician.

Under the age of one year, you must NEVER give the following food items: nuts, fish, citrus, strawberries, kiwi, exotic fruits and fruit juice (risk of food allergies); and honey (risk of botulism, a serious bacterial infection).

Regarding eggs: you may introduce egg yellow as of the age of 8-9 months, then after the age of one year, egg white.


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