What are the Best First Foods, Really?

Three friends share a lime
There are so many schools of thought on the introduction of solid foods, but I’m finding that there is a great deal of information out there that is perhaps only loosely, if at all, based on good science. I wanted to share a bit on what I have learned, and the resources I have found so far. I am, of course, neither a dietitian nor a health professional of any kind, so I present this to be a starting point for research and for discussion with other parents. I would be very interested in any resources others recommend on the subject.
One More Time: Wait Six Months to Introduce Solids At All
I say it all the time. Blah, blah, blah, right? Still, I think it is important to note that the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding until around six months of age and notes its importance throughout the first year and beyond (link).
Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life{ddagger} and provides continuing protection against diarrhea and respiratory tract infection.30,34,128,178184 Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.185 Complementary foods rich in iron should be introduced gradually beginning around 6 months of age.
Then, the World Health Organization (WHO) gives their guideline (link). See this link for guidelines for the feeding of non-breastfed infants.:
“Practice exclusive breastfeeding from birth to 6 months of age, and introduce complementary foods at 6 months of age (180 days) while continuing to breastfeed.”
These two sources, taken together with others, led me to the conclusion that there is no basis for the introduction of solid foods prior to six months of age. As I discussed before, I waited to introduce complementary foods until Annabelle was about six and a half months old.
After Six Months: Where to Start

While the above seems to adequately answer the question of when to introduce solid, or complementary foods, the question of what to introduce when is one I am still asking as we go. The traditional practice has been to introduce rice cereal first, but that appears to be terrible advice for a number of reasons, many of which are discussed in this article in Pediatric News. It also appears to be a common cause of severe Food Protein-Induced Enterocolitis Syndrome, as discussed in this study. Despite all this, it is still recommended by many misguided professionals and parents, and the below statement from the WHO’s Guiding Principles seems to be a reasonable explanation as to why.
A review of feeding guidelines promoted by various national and international organizations has shown that there are inconsistencies in the specific recommendations for feeding infants and young children (Dewey, in press). Some of the feeding guidelines are based more on tradition and speculation than on scientific evidence, or are far more prescriptive than is necessary regarding issues such as the order of foods introduced and the amounts of specific foods to be given. To avoid confusion, a set of unified, scientifically based guidelines is needed, which can be adapted to local feeding practices and conditions.” (emphasis added)
In looking around, I have found sources recommending egg yolk as the perfect first food, followed by liver, as well as others that say vegetables and fruits are a perfect way to start. Of course rice cereal still seems to dominate, unfortunately. The advice seems to vary depending on who you talk to. More important than looking for specific foods to offer, then, is considering what infants need and then determining what locally available foods that are enjoyed by the family will help them to get it. The WHO identifies several “problem nutrients,” based on those that infants tend to be deficient in most often. Below, I have listed these nutrients along with some of the most common sources of them in our home. This has really been helpful for me in planning meals for our family with optimal nutrition for Annabelle in mind. Keep in mind that ours is a mostly vegetarian household, so our sources of these foods will differ from those of other families. The WHO has another helpful resource for anyone trying to do the same for their family, called Complementary Feeding: Family Foods for Breastfed Children. I appreciate the fact that it is not prescriptive in terms of listing off specific foods that babies need, but it goes over categories and types of foods, with consideration given to the diets and staple foods of many different populations. Obviously the advice within should be checked with other sources before you radically change anything you are doing with your own family.
“Problem” Nutrients
Annabelle tries some fermented oats with
pumpkin, and hemp seed.
  • Iron: The RDA for infants 7-12 months is 11mg, from 1-3 years it’s 7mg, and for 4-8 year olds it is 10mg. Good sources of iron in vegetarian and vegan households include foods such as: quinoa, blackstrap molasses, tomato paste, white beans, peaches, lentils, and hemp seeds. While leafy greens are a well-known source of iron, the iron many contain is not particularly bioavailable. Iron absorption is enhanced by Vitamin C, but hindered by calcium. Using cast iron to cook can also increase the iron content of foods, particularly more acidic foods.
  • Calcium: The adequate intake(AI) from 7-12 months is 270mg/day, the RDA from 1-3 years is 500mg/day, and from 4-8 years the RDA is 800mg/day. Good sources of calcium that we eat include: broccoli, leafy greens (note that the calcium in some, including spinach, is not well absorbed swiss chard and bok choy are two of the best choices) dried figs, and various beans and seeds. Calcium is one vitamin that has been hotly debated in recent years, and many experts argue that exercise and Vitamin D intake are far more important to the building of strong bones than is calcium. See this letter from Harvard Health for more information. There’s also a great article on PCRM’s website that pertains to children specifically, but readers should note PCRM’s probable bias against dairy products when reading, as they receive a great deal of their funding from PETA.
  • Zinc: 7-12 month olds and 1-3 year olds meet the RDA with 3mg/day and 4-8 month olds with 5mg. Zinc is found in many grains, legumes, and nuts. One great source that has been a favorite in our house lately is shelled hemp seed.
  • Vitamin A: For infants aged 7-12 months 500μg/day is considered to be adequate intake, while the RDA from ages 1-3 is given as 300μg and for ages 4-8 the RDA is 400μg. Vitamin A rich foods in our diet include mango, carrots, pumpkin, and sweet potato.
  • Riboflavin (B2):  The RDA’s are .4mg/day from 7-12 months, .5mg/day from 1-3 years, and .6mg/day from 4-8 years. Sources eaten in our house include almonds, mushrooms, and quinoa. Riboflavin is also found in many fortified foods for vegetarians and vegans such as nut milks and nutritional yeast.
  • Vitamin B6: Between 7 and 12 months, .3mg/day is considered adequate intake and the RDAs for 1-3 and 4-8 years are .5 and .6mg/day respectively. Our favorite sources include chickpeas, bananas, brown rice, and sweet potatoes.
  • Vitamin B12: For ages 7-12 months, the AI is .5μg/day. For 1-3 year olds, the RDA is .9μg/day while it is 1.2μg/day for 4-8 year olds. B12 is a difficult vitamin for vegans to find in regular food sources, so a supplement is almost always recommended. Nutritional yeast is an excellent source.
(Adequate Intakes and Recommended Daily Intakes taken from the USDA’s Daily Recommended Intake Tables: http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140)

The main point seems to be that regardless of what specific foods you choose to feed your infant, you can provide perfectly adequate nutrition with careful planning and consideration of their dietary needs. No child has to eat any one food to be healthy – it is possible to meet the growing infant or toddler’s needs with foods that are available locally and enjoyed by your family.

What first foods did, or will you offer? Would you do the same with future children? What advice or information did you rely on in choosing your children’s diet? I would love to hear from you! 


**I put a great deal of time, research, and thought into this article, so I would love to see others benefit from it. If you have friends who you think may benefit from it, please feel free to email it, share it on facebook, blog it yourself – use it as you see fit!**

6 thoughts on “What are the Best First Foods, Really?

  1. Amy

    Thanks so much for this post. My son is 4 months old, and, while we are planning to wait till at least 6 months to introduce solids, I keep thinking I should find time to really look into infant diet. You have just made my job much much easier!

    Reply
  2. Amy

    Thanks so much for this post. My son is 4 months old, and, while we are planning to wait till at least 6 months to introduce solids, I keep thinking I should find time to really look into infant diet. You have just made my job much much easier!

    Reply
  3. Elizabeth Stone

    Very informative. Thanks for sharing. I like the idea of including foods in your family's diet that are good for your little one. If you are eating things that are 'good' for little ones, think of how easy it would be to let them try your food as they become curious. With all that said, I do not have kids of my own, but I will definitely consider this when I do.

    Reply

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