March 2004

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Ask the Midwife
Starting Your Baby on Solid Food
Ingrid Andersson, CNM

Why an “Ask the Midwife” column in the Reader?

Because the food choices we make go right to the source of human health. Everything women take into their bodies goes into forming the first ecosystem for human life. As embryologist Sandra Steingraber puts it, the fetus sits at the top of the food chain. As a midwife, I help protect the ecology of the first human ecosystem, for the sake of women, their babies, and our collective quality of life.

Defining True Health

But this column might also be called “The Midwife Asks.” I am not an expert with answers in nutrition, biochemistry, embryology, or neonatology. I am a Certified Nurse Midwife with a culturally diverse private practice and personal background that has taught me to question health care norms and assumptions. Despite local, state, and national policies of health care, I believe there is no one true definition of health. It is neither fair nor effective to leave the responsibility for our health to experts, be they obstetricians or the FDA. Together we can ask questions, share research, and tell stories toward defining true health and well-being for ourselves and our communities.





I was wondering when you start babies on solids. What foods do you start them with? There’s so much different info out there and a part of me wants to wait as long as possible, because I feel like it’s the beginning of weaning!

Whenever I get confused or overwhelmed by too much information, I try to remember to return to the source of the issue at hand—in this case your baby. Watch your baby. Is she starting to study your eating movements, mimic your chewing, grabbing for your food? Is your baby able to pick up small objects and put them in her mouth? Is your baby able to sit upright in your lap or a highchair? Has your baby begun to teethe?

Interest and Ability
Interest combined with ability is a good sign that your baby is ready for solid food. While it takes several years for the digestive enzymes to become fully developed, most babies’ gastrointestinal tracts are developed enough at six months of age for cautious feedings. Some babies clearly desire solids earlier, while some want to breastfeed exclusively for a year. I suggest letting your baby guide you. Most babies want to continue to nurse long after they begin eating solids, for reasons of comfort and security as much as for food.

Whether you are breastfeeding or artificially feeding, it is now universally recognized that the young human infant is designed to suck rather than to chew. Teeth don’t usually appear until six or seven months of age. Prior to four to six months, babies have a tongue-thrust reflex, where the tongue automatically pushes out any foreign substance placed upon it. This reflex no doubt protects the infant from choking. Immature intestines do not secrete enough of the protective protein, immunoglobulin A (IgA). IgA coats the intestinal walls and prevents irritation of the mucosal lining and prevents the passage of harmful allergens into the blood. IgA reaches peak production around seven months of age.

Choosing First Solids
As the intestines mature they become better filters against allergens. Cow’s milk, wheat and soy are common allergy-causing substances when introduced too early. This is one reason why the World Health Organization and the American Academy of Pediatrics recommend breast-milk for the first year of life. Babies in allergy-prone families actually may show delayed interest in solid foods. It’s okay to resist what I call the “hurry or worry pressure” from society, family, or friends.

Once your baby seems ready for solid food, what foods?
I remember buying jars and jars of a premium pureed organic baby food for my baby when it went on sale, only to find that he wanted nothing to do with mushy, unidentifiable stuff. He preferred garlicky pastas, black olives, plain organic yogurt, and baked beans for first foods. He generally coveted whatever he saw on his parents’ plates and had the stomach to handle it, probably through breast-milk conditioning. It quickly dawned on me that introducing solids was going to be easier and more fun than I imagined.

“Baby food” is whatever your baby likes to eat, which is probably what you like to eat. Even in the absence of full teeth, gums and little teeth buds can handle tiny pieces of most foods. In fact some rigorous gumming is probably comforting and useful to those teething tissues.

So there is lots of room for variety and individuality in what foods you introduce, on the other hand, here are some common allergens and other problem foods to avoid or limit:

Common Allergens

Corn, citrus, cow’s milk, cheese, wheat, soy.

Chocolate and Caffeine
These are bitter stimulants that require lots of sugar to taste good to an infant. Sugar and caffeine both challenge circulatory and immune systems.

Heavily salted foods can interfere with immature kidney function and natural appetite.

Raw Honey
Unpasteurized honey can contain botulism toxins in amounts harmful to infants.

Refined sugar consumption can lead to tooth decay and learning and behavioral difficulties early in life, as well as replace foods with genuine nutritional value. If a sweetener is needed, try barley malt, brown rice syrup, maple syrup, or natural fruit concentrates, none of which deplete essential vitamins and minerals, as refined sugar does.

Chemical Additives
There is more and more research indicating that early behavioral and immunological problems may be linked to synthetic colors, flavorings, and preservatives. Artificial food dyes (such as FD&C Yellow No. 5 or Red 40) are made from petroleum. Artificial flavors are basically unspecified, unregulated and can be made from anything. The preservatives BHA, BHT, TBHQ are all made from petroleum.

A Variety of Wholesome Foods
In conclusion, let’s go back to the source of the issue at hand again. Offered a variety of wholesome foods, your baby will know how to meet her needs by exercising an exquisitely fine-tuned interplay of appetite, taste, and capability. She will use solid foods to supplement her primary nutritional source, breast milk. What does “wholesome” mean? Did your grandmother eat it when she was a child? If you made it at home, would it look like that? If it’s advertised on television it is probably an overpriced food product—such as Kraft cheese slices—that uses cheap additives in place of more expensive, real ingredients. How else could they afford the advertising?

This column offers an on-going forum for your reproductive and family health questions. It is intended to promote informed choice, not to give medical advice. Please email all questions and topic suggestions to .