Updated article on April 2022.

Parents often get anxious and worried about introducing solid foods to their baby’s diet. How are they supposed to do it? Is it the right time? What food should they start with? What quantities? And so on…

In this article:

• What we know today
• When to feed the baby
• Foods to start with in your baby’s diet
• Daily meal schedule
• How much solid food should the baby get?

Solid food diets for babies have changed over time as additional research comes in. But one fact remains—exclusively breastfeeding up to six months is an essential complete element for a baby.

Health Canada and the World Health Organisation recommend exclusively breastfeeding up to six months, with the progressive addition of solid foods after.

If your baby is bottle fed and doesn’t ask for more food and their growth curve is stable, we also recommend giving them milk exclusively up to six months.

What we know today

• Starting from four months, the baby’s digestive and renal system is more mature and can handle solid foods such as cereals, vegetables and fruits, but no meat. Before four months, the baby doesn’t have certain digestive enzymes. So they can’t digest solid foods. This also overloads the kidneys which are immature. Starting from four months, no danger exists giving solid foods to a baby.
• Starting from six months, you should quickly introduce foods rich in sources of iron in the baby’s diet. Perhaps baby cereals, if they haven’t already started, and meat. This is to prevent newborn anemia as the iron absorption is efficient. Breast milk doesn’t fulfill their basic iron needs for their rapid growth. An iron shortage harms their development, and that is why they should consume two iron sources a day to meet their needs.
• If you delay the introduction of different food groups after six months, caloric, protein, zinc, calcium, vitamins A and C and folate deficiencies can occur. Some children can even develop oral hypersensitivity which makes it difficult to consume solid foods.
• Iron is absorbed better when consumed with vitamin C (citrus, green vegetables, etc.) and other non-animal-based sources of iron, like tofu, legumes, cereals and eggs. It can be added to the baby’s diet as part of their meals and snacks.
  • Hint: add baby iron-enriched baby cereals in a muffin, crepe or oatmeal mix. This increases iron sources without changing the taste.
• Some doctors prefer prescribing an iron supplement to certain children as a preventative step based on their medical history or situations arising during the first year (ex.: prematurity).
• Restrictions for introducing potential allergens in the baby’s diet after 6 months have been removed. Now you can introduce allergens such as fish or peanut or almond butter, eggs, legumes from 6 months.
• Even for the breastfeeding mother, no dietary restrictions to prevent allergies in her baby exist. These directives are associated with the 2015 LEAP studies.
• If there are serious allergies in a high-risk family: brother, sister or parents, it is possible to give an allergen to a baby from 4 months with advice and competent supervision in the matter (nutritionist, doctor, allergist…) according to the comfort of the parents, of course. With the recent recommendations published in the fall of 2021 by the Pediatric Society, early exposure from 4 months of an allergen known to be high risk in a family, can better prevent allergy in children. The most documented allergens in this situation are eggs and peanuts (peanuts given in powder mixed with compote or baby cereals). It is preferable to repeat 2 to 3 times that exposure during a week, in small quantities, to maintain tolerance and prevent allergy. See the details directly in the scientific article at the following link: https://cps.ca/en/documents/position/dietary-exposures-and-allergy-prevention.
• The new recommendations mention that there is no longer any order in which foods are introduced, taking into account that the sources of iron are counted there. Also, it is not necessary to give all foods from one food group before switching to another. It is better to vary by introducing a new food every 2 or 3 days, after 4 months (if possible). If the integration is done after 6 months, we can go more quickly without problem, if it is a healthy term baby. Since it is rare for a baby to develop intolerances or allergies to a vegetable or fruit, several new foods could be given at the same time. On the other hand, if a reaction occurs, we will have to look for the potential food originating from this reaction, which can sometimes be a little more complicated than going there one food at a time for at least 2, 3 repeated exposures.
• For meats and game given to a baby, not before six years if the animal was killed with lead ammunition. Check with the hunter.
• Don’t give them chicken liver before 6 months, and beef or game liver, and blood pudding before 10 months.
• For shellfish, wait until six months and cook thoroughly using proper hygiene and cleanliness. This is because these foods accumulate contaminants. But there are no restrictions after six months. However, you shouldn’t give them shrimp or clams as a first food if you start them at six months. Give them another food to see your baby’s reaction to them.
• A vitamin D supplement is essential for a baby year-round when breastfeeding. It will prevent a shortage and impacts on growth and development because vitamin D helps absorb calcium in the intestine, promotes calcium exchanges for bone formation and helps reabsorb calcium and phosphorous in the kidneys. 400 International Units (UI) per day are necessary for their first year. Even if the baby gets light outside (without direct exposure to the sun), the absorption isn’t sufficient, even during the summer. Officials don’t recommend vitamin D supplements for babies fed formula, as it already contains it. However, some nutrition experts suggest giving them a supplement given the high amounts they need to consume to get the recommended dose. You should also continue giving it to them up to one year. Studies have also shown that it’s better absorbed if taken daily. Vitamin D doses can be increased for some babies, such as premature or babies that are allergic to dairy products or on a vegetarian diet. But you have to avoid overdoses and the toxic effect it can have. Vitamin D in drops is the easiest to absorb because it’s mixed in coconut oil which dilutes it (fat-soluble vitamin which dilutes in fat) and improves its absorption. Later in the baby’s life, you can give it to them in different types of fish (salmon, herring, halibut, tilapia), hard-boiled eggs, enriched orange juice, enriched yogurt or margarine, or chewable vitamins. Vitamin D levels in the baby’s blood will be influenced by their geographical location (Northern Quebec), sunscreen and wearing clothing, exposure time, skin pigmentation, age (newborn, premature), and pollution.

To continue reading, go to the next article When Should the Baby Eat?