Introducing Solid Foods to Babies: When to Start, First Foods and Safe Feeding

Starting solid foods, also called complementary feeding, is an exciting milestone. From about six months, breast milk or formula alone no longer provides all the energy and nutrients a baby needs, especially iron and zinc. The right foods, textures and timing support healthy growth, brain development and eating habits for life.

When to start

The WHO and Sri Lanka's Ministry of Health recommend exclusive breastfeeding for the first six months, and then adding safe, nutritious complementary foods while continuing breastfeeding up to two years or beyond. Do not start before 4 months, and do not delay beyond 6-7 months.

Signs your baby is ready (usually at around 6 months):

• Sits with support and holds the head steady
• Shows interest in food and opens the mouth when offered
• Has lost the tongue-thrust reflex that pushes food out
• Can move food from the front to the back of the mouth

How to start

• Choose a time when the baby is calm and not too hungry or sleepy, and give a small breastfeed or formula first if needed.
• Offer 1-2 teaspoons of a smooth, thick puree or mash on a clean spoon, once or twice a day.
• Be patient. Babies may need 10-15 tries to accept a new food. Spitting out or making faces is normal.
• Increase gradually to a few tablespoons, and then to 2-3 meals a day by 8 months.
• Sit upright and never leave the baby alone while feeding.
• Responsive feeding: watch for hunger and fullness signs, such as turning the head away, closing the mouth or pushing the spoon. Never force-feed.

Good first foods in Sri Lanka

• Rice kanda or rice porridge mixed with mashed vegetables, dhal or egg
• Mashed or pureed pumpkin, carrot, sweet potato, manioc, breadfruit and green leafy vegetables (mallum, thoroughly cooked and mashed)
• Mashed dhal, green gram or lentils
• Well-cooked and mashed egg yolk and white
• Fish (boneless, well-cooked, flaked), chicken or meat, minced finely
• Fruit: ripe banana, papaya, avocado, cooked apple or pear, mashed
• Plain full-fat curd (after 6 months)
• Rice flour or thriposha as per local advice

Choose foods with iron, such as meat, fish, egg, dhal, leafy vegetables, and add vitamin C-rich fruit alongside.

How much and how often (WHO guide)

• 6-8 months: 2-3 meals a day, plus breastfeeding on demand, starting with about 2-3 tablespoons per meal
• 9-11 months: 3-4 meals plus 1-2 snacks, about half a cup per meal
• 12-23 months: 3-4 meals and 1-2 snacks, about three-quarters to one cup per meal, plus continued breastfeeding

Textures and self-feeding

• 6-7 months: smooth purees and mashed foods
• 8-9 months: thicker, lumpy mashed food and soft finger foods
• 10-12 months: chopped family foods, soft finger foods and encouraging self-feeding with a spoon and cup

Letting babies hold and explore food, sometimes called baby-led weaning, can work well if foods are the right shape and size and the baby is supervised. Mixing spoon-feeding and finger foods is fine.

Fluids

• Breast milk or formula remains the main drink.
• From 6 months, offer small sips of boiled and cooled water from an open cup or free-flow cup, especially with meals.
• Cow's milk can be used in cooking from 6 months but is not a main drink before 12 months.
• Avoid juices, sweetened drinks, tea, coffee and soft drinks.

Allergy and introducing allergenic foods

Current evidence suggests that introducing allergenic foods early in small amounts, such as egg, peanut, fish and wheat, around 6 months, does not increase and may reduce allergy risk. Offer a new food at home early in the day, one at a time, and watch for reactions. Do not use whole nuts. Speak to your doctor first if your baby has severe eczema, a known food allergy or a family history of serious allergies.

Seek urgent help for swelling of the face or lips, difficulty breathing, widespread hives or repeated vomiting soon after a new food.

Foods to avoid in the first year

• Honey (risk of infant botulism)
• Added salt, sugar, stock cubes, soy sauce and salty or sweet snacks
• Whole nuts, whole grapes, raw hard fruit or vegetables, popcorn, hard sweets (choking hazards)
• Unpasteurised milk and raw or undercooked eggs, fish and meat
• Shark, swordfish and large predatory fish (mercury)
• Fizzy drinks, packaged juices and sweets
• Low-fat or diet products, as babies need energy-dense foods

Choking vs gagging

Gagging, where the baby coughs or retches, is a normal protective reflex. Choking, where the baby cannot cough, cry or breathe, and may go blue, is an emergency. Learn infant first aid, such as back blows and chest thrusts, and call for help.

Hygiene and safe preparation

Wash hands and utensils, cook foods thoroughly, store leftovers in the refrigerator and use within 24 hours, and never reheat food more than once. Do not feed from the jar if you plan to save the rest.

Growth and common problems

• Constipation: offer fluids and fibre-rich fruits and vegetables such as papaya.
• Fussy eating: keep offering without pressure, and model eating together as a family.
• Poor weight gain or very slow growth: see a doctor, and check growth using our child growth calculator.
• Iron deficiency: pale skin and tiredness may signal anaemia. Ask your clinic about iron supplements if advised.

When to see a doctor

See your doctor if your baby is not gaining weight, refuses all solids beyond 8-9 months, has persistent vomiting or diarrhoea (see diarrhoea in children), has an allergic reaction, or you have concerns about development or feeding.

References

• World Health Organization: complementary feeding guidance and infant and young child feeding recommendations
• Sri Lanka Ministry of Health, Nutrition Division: feeding guidance for infants and young children
• American Academy of Pediatrics: starting solid foods
• Du Toit G et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine, 2015