A: During your baby’s first few months, the only food he needs is breast milk or formula. Milk provides all the nutrition babies need, and it’s the only food that their mouths and digestive systems are designed to handle. But between 4 and 6 months of age, babies become more physically active. That’s when they first become hungry for, and developmentally ready for, solid foods.

Why shouldn’t I give my baby solid food in the first few months?
Newborns have a natural reflex to suck milk from a nipple. Up to about 4 months of age, if you put a spoon or food on a baby’s lips, his tongue-thrusting reflex will push out the food. This is his natural way of showing that he’s not ready to swallow solid food because he could choke on it. In addition, newborns’ stomachs and intestines are not yet ready to digest solid food. If you give your baby solid food too early, it can cause abdominal discomfort, constipation and a greater chance of developing food allergies. Don’t put cereal in your baby’s bottle, unless your doctor tells you to because your baby has a special medical condition such as gastroesophageal reflux.

How do I know when my baby is ready for solid foods?
Most babies are ready to start eating solid foods between 4 and 6 months of age. Premature babies may be ready a little later. Since each baby’s development is different, look for the following signs that your child is ready:

• Her head control is good and she can sit up alone or with support.
• She shows more interest in food. She may start to watch you closely when you eat, open her mouth when she sees food and lean forward and reach out toward your food.
• She can close her mouth around the spoon and use her lips and tongue to swallow the food rather than spitting it out
• Her appetite is increasing and she seems hungrier than before.

What solid foods should I feed my baby first?
For most babies, the first solid food is baby cereal. Baby cereal is nutritious and gives your baby good practice eating from a spoon. Be sure to buy iron-fortified baby cereal, since your baby needs the extra iron to grow. Start out with rice cereal, then oatmeal and barley cereals; try wheat and mixed cereals later, since they can cause allergies. Give your baby only one new food at a time for at least two to three days to watch for possible signs of allergic reactions such as vomiting, diarrhea or a rash. If you see any of these signs, stop the food and talk with your doctor.

You can give your baby cereal that is pre-mixed in a jar or you can mix your own from dry baby cereal. Start by adding 4 to 5 teaspoons of breast milk or formula to 1 teaspoon of dry cereal, and adjust the amount of liquid to get the thickness that’s easiest for your baby to swallow. Begin with thinner cereal and then thicken it as your baby gets better at swallowing. Your baby may start eating only a few spoonfuls at a time, but may later increase to eating about ½ cup or 4 ounces, the amount in a small jar of baby food.

How should I feed my baby?
You can start feeding your baby cereal at any time of the day. To encourage your baby to eat, you can begin the meal with a few spoonfuls of cereal when your baby’s hungry, and give him breast milk or formula afterwards.

Here are some tips for feeding your baby cereal:
Make sure he’s sitting up to prevent choking. You can seat him on your lap, in an infant seat or in a high chair propped up with some pillows, if necessary.

Expect a mess—food splattered on his face, hands, hair, clothes, the high chair, the floor and even you. Let him touch and explore the food if he wants. Be prepared with a bib, a plastic mat on the floor and a damp face cloth for clean up. You may even need to give him a bath.

Face your baby, show him how to open his mouth and talk with him encouragingly about how good the food is, and what a good job he’s doing.

Use a baby spoon and start with ¼ or ½ spoonful of cereal. Hold the spoon about a foot from his face and wait for him to see the food and open his mouth to eat it. Feed him as quickly or as slowly as he wants to eat.

Look for signs that your baby’s done. He may lean away from the food, close his lips tightly, shake his head or turn it away, push the food away with his hands or start fussing. That’s when you know it’s time to stop feeding him. In the first few feedings, your baby might wrinkle up her face, spit out the food, or even gag. Don’t be alarmed; it’s her normal reaction to a new taste and texture. Try again later as your baby is more likely to accept it with practice. If, after a few tries, your baby still can’t swallow the cereal, she might not be ready. If that’s the case, try again in a week or two.

What about the breast milk or formula?
In your baby’s first year of life, breast milk or formula is still his major source of nutrition. When your baby starts eating cereal, he may continue to drink about the same amount of breast milk or formula for a while. But over the next six months, as your baby eats more solid food, he’ll get more nutrition from his food and less from milk. By the time he’s 1, your baby should be eating a balance of solid food and milk— three meals a day and no more than 16 to 24 ounces of milk.

What about my baby’s bowel movements?
When your baby starts eating cereal and solid food, his bowel movements will naturally change. You might notice that his bowel movements become more solid, darker colored, or that they change colors (greenish when he eats peas, for example, or reddish when he eats beets). The stools will also have a stronger odor. All of this is normal and nothing to worry about. But if your baby develops diarrhea (watery stools), constipation (hard, painful stools) or blood in his stools, be sure to contact your doctor.

How do I advance to more baby foods?
Once your baby can eat cereal from a spoon, he’s ready to start other pureed foods such as fruits, vegetables, and meats. For more information on this stage, read my article titled “Advancing Baby Foods: Fruits, Vegetables, and Meats.”