Sippy cups, plates that suction to the table, itty-bitty spoons.
Baby food makers. Baby-led weaning books.
Purees in hair. Crumbs everywhere. 
A suddenly overweight dog and a vet who looks at your baby and says “I understand how this happened, but it’s not good.”

That last one might just be me, but I know I’m not the only parent who has found some (or many) challenges moving our babies from breastmilk & formula over to solid food. 

Most of our challenges boiled down to a couple questions:

• Am I doing the right thing? (there’s so much conflicting information out there! Should I make sure every grown-up around us knows how to do baby heimlich? Maybe the way [insert friend’s name] is selecting & preparing avocados is better? Read as: lack of confidence & comparison trap.) 
• Is my baby’s feeding journey normal? (Is s/he eating enough? Should I be worried that my milk supply suddenly tanked? Are we exposing him/her to a good enough variety? How will we know if an allergy presents? Is that face my baby makes when eating normal?) 

After months of focusing on breastmilk supply and scrutinizing bottle ounces on the daycare hand-off, introducing solid food was a mix of fun (smushed raspberries are so cute!) and stress (as perhaps evident from my inner parent monologue above). Kelly Lonergan, a Speech-Language Pathologist (SLP) and owner of Pediatric Feeding Therapy sums this up well: 

“One of our most primal instincts as mothers from the moment our babies are born is to make sure they are fed, whether it be nursing, drinking from a bottle or getting them to eat their fruits & vegetables. Most of us enter parenthood assuming that our children will know how to eat and drink, but this is not always the case.”

Did you know 1 in 5 kids struggle with eating at some point before they're seven? That's a lot!

89% of parents with young kids stress about something related to dinner. That's almost everyone! 

Let's try to make that a little bit easier, because eating is pretty important, and we don't want meal time to have to be stressful…at least not all the time. Here’s more from our conversation with Kelly (you can view the full conversation from our events page):

Why is it important to eat solid foods?

As babies age, their iron stores decrease, requiring additional nutrients not provided by breastmilk or formula. (Breastmilk or formula should remain the primary source of nutrition until the age of one).

Managing solid foods takes a complex mix of skills - chewing, swallowing, and managing food in their mouths. Eating involves sensory aspects like smell, appearance, taste, and texture, as well as factors like hunger and discomfort.

Exploring food through play helps babies understand different aspects of food, such as temperature, smell, and texture. Timely introduction of solids can also reduce the risk of food allergies.

When to Start

The American Academy of Pediatrics recommends starting solids at about 6 months of age, and then as a supplement to breast milk or formula. Readiness signs that we're looking for:

• Can they sit up in a highchair?
• Do they have good head control?
• Are they bringing everything to their mouth?
• Do they swallow food instead of pushing it out? When babies are first around the 4-5 months, food put in a baby's mouth usually comes right back out. That's a typical reflex. When they move closer to the 6-month range, we put something in their mouth, they swallow it.

What tools do you need?

Your baby doesn’t need a lot of fancy things to eat! Basically: spoons, cups, and a highchair.

Spoons, so many spoons...

The best spoons are ones that we're looking for that are narrower, and they're flatter than a normal spoon. Some good examples include Munchkin White hot safety spoon, Olababy, NumNum baby spoon, Munchkin silicone scoop.

Pro development tip: pull the spoon straight out so that the baby learns how to use their lips to get food off the spoon.

Cups – what's the best?

Sippy cups, Straw Cups, Open cups

There are pros and cons to all cup types, so you'll want to look at what makes sense for you and your baby over time. 

• Sippy cups are mostly spill proof, similar sucking to a bottle, and allow your baby to be more independent with drinking. At some point, you'll need to transition to a straw or open cup.
• Straw cups also allow more independence, and encourage a more "mature sucking pattern." You can stick with a straw cup for a long time. Spill risk is higher compared to the sippy cup, and the straws can be annoying to clean. Some good examples: Take N' Toss Straw cups with disposable or silicone straws, Thermos Funtainer, Lola Cup, ez-pz Mini cup & training system, Olababy Silicone Training cup.
  • Note: avoid straws that require biting
• Open cups are the easiest to clean, and what most of society uses (so no transition "away" needed). But, learning to drink from a cup compared to a bottle will take time, development, and practice; with a fair amount of spills along the way. Some good examples: a medicine cup, Munchkin Splash Open Toddler cup, Silicone Training.
  
  • Note: look for cups without a thick ridge or lip.

Pro Cup Practice tip: the bathtub is a great place. It might sound gross, but the tub is a great place to practice with a cup. If (when) it spills everywhere, it's okay.

Seating Scene

Consider the scene:

• Make sure your baby can see you.
• Make sure baby’s back, hips, and (especially) feet have a place to rest.
• The tray should be somewhere between baby’s belly button and chest.
• Look for 90/90/90 - hips, knees, and ankles should all be at 90 degrees. If a child doesn't have all those places of support, they're going to try to figure out how to support themselves in another way. If they're trying to keep themselves upright, they are going to struggle to focus on drinking/eating.

You don't have to go out and buy a new highchair – you may just need to figure out how to modify what you already have.

Is there a right way to introduce solids?

Purees v. Baby Led Weaning

Nope. There is no right or wrong way.

• You can begin introducing a cup or straw around 6 months of age
• You can use formula or breastmilk.
• You can add some purees to the cup, so sometimes it slows it down a little bit. (think of drinking a smoothie out of a cup versus a versus water; the smoothie moves slower). For babies it can be a little bit easier to manage that.
• You can introduce a variety of tastes. In our culture, baby foods tend to be bland. It's okay to try a variety of tastes – like garlic powder, herbs.
• We want to avoid salt, sugar, and additives.

Baby Led Weaning

The concept – babies are in charge to feed themselves, they eat what the family eats with modifications. When it's done correctly, the choking risk is not higher than that of the traditional method or purees.

Caution: Don’t just skip purees completely. Things like applesauce, thick soups, etc are part of life! Babies still need to learn how to manage those things in our mouth.

Traditional methods of introducing solids:

• Start with purees
• Move to mashed foods
• Move to soft foods

There is no right or wrong way. It's what works best for you, for your baby, and oftentimes …a combination of both.

Whichever path you navigate, it can be tricky to successfully introduce new foods (harder with some kids than others, and you can't predict or control if your baby will be a naturally adventurous eater or a gagger). But you can implement some strategies to make the journey of exploring new foods more enjoyable & successful. Check those out in our "10 strategies for introducing your baby to new foods" post.

My baby coughs with cup drinking

I am worried about flooding them! What should we do? 

Coughing tells us that things are going down the wrong way.

Coughing helps your baby get the food or liquid out. Some coughing, gagging, spitting up – all normal in the beginning. These are the body's way of protecting your baby's airway. Consistent coughing, gagging or spitting up needs attention.

Resist the urge to tap the baby on the back or reach in the mouth that can push things further down.

But it's still scary as a parent and not what you want as the norm forever, right? Strategies you can try out:

• Use a thicker liquid, like a puree that slows the flow down (it's hard to slurp a thick smoothie through a straw)
• Have your baby take a sip and pinch the straw off, so you're controlling how much they get. You can talk it through: "we're going to take a sip. And then we're going to pause. 1, 2 pause." So you are helping teach regulation. 
• Alter the temperature (for instance, add ice to it to make the drink cold). Sometimes that's enough for baby to recognize "Oh, there it is. Okay. Yep."
• If coughing is something that is consistent, despite trying modifications, then talk to your pediatrician and ask for an evaluation. 

Choking is Bad.

Choking means the baby is unable to breathe, something is blocking the airway. This requires infant choking first aid with back blows & chest thrusts, and calling 911.

Signs of choking:

• Inability to cry
• Difficulty breathing
• Skin tugging into the chest
• Look of terror
• High-pitched sounds
• Skin color changes (blue/purple/ashen)

How do you know your kid is getting the right amount of food?

In general, babies, kids are good at identifying if they are hungry or not. Trust that when your baby comes to the table and you give them food, that they are done when they're done.

Like all of us, some meals we eat more, some meals we eat less.

Weight gain tells us if they are at least getting enough calories. As long as your child is continuing to gain weight they're continuing to grow. Then there's a variety of foods that they're eating. In the baby phase, we're not as concerned with how much food they are eating, because the majority of their nutrition comes from breastmilk and/or formula.

If your baby is eating really fast, you can slow the meal down/take breaks by handing the baby a spoon and letting them do some of the feeding. With purees we can sometimes go too quickly or go too much. Slowing it down should help them register that they're full or still hungry.

Expert Evaluation

If you’re worried something’s not right, get an evaluation - then you know! Eating shouldn’t involve a complex song and dance (I have to hold her a certain way, bounce her a certain way, and give her the bottle a certain way). Here are some signs that your child might benefit from Feeding Therapy:

• Chokes, gags, vomits, coughs during and/or after eating/drinking 
• Struggles to gain and/or maintain weight
• Gets tired or falls asleep when eating or drinking
• Refuses to eat or drink
• Only eats under certain conditions (see song & dance above)
• Only eats a limited number of foods consistently, avoids certain textures or food groups
• Is difficult to feed by anyone other than you
• Is significantly behind feeding milestones (ex: not eating soft table foods by 9-10 months old).

This questionnaire can help you understand if your baby may need more help based on their age (and can also be a useful tool for discussing with your pediatrician). 

Resources

General feeding resources:

• How to Introduce Solids & Raise a Happy Eater - articles & app: www.solidstarts.com 
• Feeding Littles-Online feeding courses and resources for caregivers of babies, toddlers, and kids: www.feedinglittles.com 
• Support, resources, and questionnaire: www.feedingmatters.org 
• Picky eaters v. Problem eaters: www.sosapproachtofeeding.com 

Evaluation questionnaire:

https://questionnaire.feedingmatters.org/questionnaire 

Gagging/Coughing/Choking info:

https://solidstarts.com/gagging/ 

What to do if you're baby is choking: https://www.redcross.org.uk/first-aid/learn-first-aid-for-babies-and-children/choking-baby 

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Kelly Lonergan is a licensed Speech-Language Pathologist certified in Neuro-Developmental Treatment (NDT) and trained in Supporting-Oral-Feeding in Fragile Infants (SOFFI) method, SOS Approach to Feeding, Beckman Oral Motor, amongst many others. She’s been helping infants, children and adults with feeding, swallowing and speech issues for 15+ years and is passionate about helping families with babies & young children (with & without complex medical needs) get the help they need to overcome feeding challenges. You can find her at Pediatric Feeding Therapy in Wisconsin.