The day after her son Ronan turned six months, Suzanne Ricard, a professor in Toronto, decided to start him on solid food. He showed all the signs of readiness: an interest in food, good head control and the ability to sit up and lean forward. He had also started picking food up from Ricard’s plate and trying to put it in his mouth.
But when Ricard offered Ronan his first spoonful of rice cereal mixed with breastmilk, he pushed it all back out with his tongue. She waited a week and then tried again—and again, he tongue-thrusted the food back out. So she experimented with different consistencies and temperatures. Oatmeal made him throw up; bananas left him blotchy; he gagged on eggs and flat out refused sweet potatoes, peas and butternut squash.
“At first we thought it was no big deal,” says Ricard. “But we soon started to worry that there was a physiological reason he couldn’t eat.” As the weeks went by, Ronan seemed hungry all the time, wanting to breastfeed every two hours. Then he began losing weight. “That’s when I started freaking out,” says Ricard. She consulted Daniel Flanders, a Toronto paediatrician who specializes in infant and child feeding, and is the owner and director of Kindercare Pediatrics.
Why babies refuse solids
Ricard had done everything right—doctors generally recommend starting solids when the baby is developmentally ready, which is usually somewhere between four and six months. And, she discovered, spitting out food is a common reflex in infants under six months. Gagging is normal and is often triggered by feeling food unexpectedly at the back of the mouth, which makes the body try to vomit. (It’s not to be confused with choking, a life-threatening condition caused when something blocks the air passage and restricts the ability to breathe.)
“It’s very common for babies to refuse food when solids are introduced,” Flanders says. “And it’s important to respect their decision to refuse it.” Never force your kid to eat. “Forcing sets up a power struggle around eating and can undermine the health of the feeding relationship,” Flanders says. Whether he refuses food or just seems uninterested, Flanders recommends giving your child a break of about a week before trying again. Eating, chewing and swallowing are not things babies are instantly good at, he adds—they’re learned skills.
Some doctors recommend baby-led weaning, which forgoes purées, allowing infants to control what and how much they eat.
How to introduce solid food
There is no “best first food.” A good place to start is with iron-rich foods, such as fish, meat, eggs, tofu, legumes and iron-fortified cereal, because a liquid diet of breastmilk or formula alone may not provide enough of the mineral, especially by the time a baby is six months old. Although not all doctors believe in this practice, research in the Canadian Medical Association Journal recommends introducing new foods one at a time and waiting three to five days before trying another. That way, if your baby has a sensitivity or allergy to a food, it will be a lot easier to identify the culprit.
The key is perseverance, says Ali J. Chernoff, a Vancouver-based dietitian and co-author of Good Food Baby and Good Food Toddler. “You can’t determine if your baby dislikes a particular food until it has been introduced at least 15 times,” she says. It’s often a texture issue, so try to provide a variety of consistencies. Chernoff recommends items that are tender-cooked, finely minced, puréed or mashed, as well as soft finger foods, such as bite-sized pieces of soft-cooked vegetables, mushy fruits like ripe banana, deboned fish and scrambled eggs. These are more consistent with a baby-led weaning approach to starting solids. Foods should progress in texture as the baby develops his oral motor skills, and portion sizes should be small.
When offering something new, it helps to use eye contact and verbal encouragement (not verbal or physical coercion), and to minimize distractions during meals and snacks. Don’t be tempted to put on the TV or trick your kid into taking one more bite.
If your baby is still resisting solids at seven or eight months, chat with a healthcare professional. “Between six months to a year is when kids develop eating skills, and if they’re still refusing solids, they could miss that window,” says Flanders. “It’s more challenging to teach a child who is past one year old how to eat for the very first time.”
Ronan finally started accepting solids at almost nine months, beginning with strawberries. From there, it was rice cereal, bananas, apples and mango, turkey and vegetable soup. “He didn’t begin the way most babies do,” says Ricard, “but he’s eating and gaining weight well now.”