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Why this naturopathic doctor recommends introducing solid foods at FOUR months.

Why this naturopathic doctor recommends introducing solid foods at FOUR months.

Dr. Erika Krumbeck


First of all, I want to say I am SO excited to get back to blogging. I’ve spent the last year working on my Vaccines Demystified course, and then the My Infant Health Binder, plus seeing patients (my real job!), plus editing Naturopathic Pediatrics.  All this to say – I had to take a major break from blogging.  Not to mention last year at this time I was still pretty heavily sleep deprived (I was never blessed with good sleepers). So now that my kids are (gulp!) six and two (!) I’m super excited to start regularly sharing with you again.

It feels SO good to be back!

Why introduce solid foods at 4 months?

Yes, yes, I am completely aware that the guidelines suggest exclusive breastfeeding until 6 months of age. And no, I promise, I’m not being irresponsible by suggesting that infants should be exposed to complementary foods “early.”

Here’s why:

New research shows that infants who are exposed to potentially allergenic foods early (often even before 4 months) are less likely to develop serious allergies. Much of the research has involved peanut products, eggs, or milk. These are the most common serious allergens in children.I do want to be very clear – not all the research is consistent, and many of the studies used different parameters. Here is a good summary of the research. But there is a very strong trend here that early solid food introduction is important to prevent allergies, particularly with peanut products.

Do not wean early!

I HIGHLY and I cannot say this strongly enough – HIGHLY recommend continued breastfeeding even after the introduction of solid foods. In fact, this whole idea of “early” solid food introduction actually depends on continued breastfeeding for good immunity. Breastfeeding provides super important nutrients that simply cannot be found in commercial formula or with solid foods.

The whole reason that most pediatric authorities continue to advocate “exclusive breastfeeding” to 6 months is to extend the duration of breastfeeding as long as possible. They know that when parents hear “introduce solid foods” many parents think that this is an acceptable time to start weaning from nursing. So again, I am NOT saying to wean your baby at 4 months. The World Health Organization recommends breastfeeding until age 2, and I highly agree. Remember that breastmilk should be the primary source of calories until age 1. (From age 1-2 breastmilk is supplemental, and solid foods should be the primary source of calories.)

Babies in developing nations, or in areas with LOW likelihood of allergies should continue exclusive breastfeeding (with no solid food introduction) until at least 6 months to reduce the risk of infections.

And this is not to place blame or lay guilt on any of you who were unable to continue to breastfeed. I know that many women in my office tried so hard to continue nursing, and have a lot of guilty feelings for being unable to continue.

What we used to do (and why it doesn’t make much sense)

Okay so here is how we used to introduce solid foods: “Wait.  Wait.  Wait.  Wait.  Wait.  Okay – you can have as much as you want!”  Basically there was some “magic” age of 6 months (regardless of whether the child showed any signs of food readiness), and parents were given the go-ahead to introduce solid foods in virtually any amount.  We even advocated introducing one food at a time, often waiting in between foods to see if there was a “reaction” to the introduced food.

This virtually guarantees food allergies and intolerances in susceptible children.  Why?  The immune system has no warning; it is bombarded with a foreign substance in large amounts – it isn’t surprising it creates antibodies to foods it hasn’t seen before! Furthermore, the digestive system is suddenly overwhelmed by complex carbohydrates, fiber and sometimes proteins or fats it has never had to digest or absorb before.

And worse, in the past parents were sometimes advised to wait to introduce potentially allergenic foods like peanuts and shellfish until after 12 months of age.  It turns out this actually increased the risk of allergies!  In early infancy the immune system is rather flexible – we can often “tell” it what is safe and what is not safe by exposing it to little tiny amounts.  But if we miss that window of opportunity the immune system sets, and is much less flexible.

How this naturopathic doctor recommends to introduce solid foods.

I consider the time between 4 and 6 months to be the “tasting” time. So hear me out, you guys, I do NOT recommend taking your 4 month old home and feeding her an entire jar of baby food. In fact, this is exactly what is likely to cause problems.

So here’s what I recommend: I recommend letting your 4 month baby “taste” everything that you eat! Simply dip your finger into whatever you are eating and let him lick it off. You don’t need to puree your food, it’s just going to be a “taste.”  Continue nursing (if at all humanly possible), especially around the time of those little licks (either before or after is fine).

Why “tastes?”

Tasting small amounts of food primes the immune system and the digestive system.   Having small bits of food – especially small bits washed around with lots of breastmilk and saliva – helps the immune system know that a certain food is “safe.”   Small amounts of food allow the digestive system to slowly release more and more digestive juices (good enzymes, stomach acid, and hormones that tell the gall bladder and stomach what to do).

Tastes are also super fun because it means the baby can be a part of the family mealtime.  The baby gets to lick the finger or spoon and feel like he’s a part of the family! This is a very important part of raising a healthy eater!

Finally, I find that babies that are introduced to solid foods early seem to make the transition from drinking to eating.  By about 9 months of age it becomes extremely difficult for Moms to produce enough milk to keep up with their infant’s higher caloric demands.  I have seen a few exclusively breastfed babies also struggle with eating solid foods because they have issues with textures or tastes, so greatly preferring to consume all their calories from Mom.  Early solid food exposure seems to help those very picky breastfed babies transition more easily.  This is very important as babies become toddlers and need to eat all different types of foods. (Like crunchy veggies, fibrous grains, etc.)

How to progress after 4 months

By about 5 months of age I tell parents they can start feeding spoon-sized portions, rather than just licks and tastes.

At six months you can then assess true “food readiness” to see if the baby is ready  to progress to 1/4, 1/2 or full “jar-sized” portions.  (Jars are a convenient measuring device, though I usually prefer families to make their own food or move on to Baby Led Weaning quickly.) I usually use purees for the first 1-2 feeds at 6 months, simply to assess if babies are ready. (It is easier to see with purees.)  Signs of food readiness: sitting up on her own, reaching for food, no longer spitting out food. (I.e., the baby has lost the tongue-thrust reflex that causes her to spit out all food placed on her tongue. This is super important and is easier to see with purees than Baby Led Weaning.)  If your child does well with the first 1-2 feeds with purees then please feel free to move on to Baby Led Weaning!

Remember that a “one-size-fits all” approach is not always appropriate.  Make sure you talk this through with your child’s provider before you try the Dr. Erika method.

What NOT to let her taste:

  • Honey or corn syrup (until at least 12 months of age. This is due to a concern about botulism in infants).
  • Anything chokeable. At four months it should truly be a “taste” – no chunks or bites of any kind.
  • Soda, juice or caffeinated beverages. I think this should be obvious, but you guys, do NOT give your infant any of these. Ever. They have no nutritional value and are likely to lead to obesity and multiple health problems.

What do YOU think?

Does this make sense?  It’s always easier to explain in my office when I really have a family sitting in front of me. Let me know your thoughts and how you approached solid food introduction for your kids!

Some fun studies:

–  Children that were introduced to solids right after 6 months exclusive breastfeeding and continued to receive breastmilk (≥12 months) were less likely to become overweight/obese (OR: 0.67, 95% CI [0.51, 0.88]) compared to children that discontinued to receive breastmilk.

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