Why 6 Months is the Recommended Age for Starting Solids

Hi, I’m Cinthia Scott, The Baby Dietitian.

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Why 6 Months is the Recommended Age for Starting Solids 

On the basis of recommendations from many national and international health organizations, solid food introduction should occur around 6 months of age, and not before 4 months of age. Solid foods, also referred to as complementary foods, are defined as any foods other than breast milk or formula, including purees.

What The Experts Say About Starting Solids

“Health experts and breastfeeding experts agree that it’s best to wait until your baby is around six months old before offering any food other than breastmilk. There has been a large amount of research on this, and most health organizations have updated their recommendations to agree with current research. Unfortunately, many health care providers and written materials are not up to date in what they are advising parents.” –Kellymom

Recent reviews of literature show that exclusively breastfeeding (or formula feeding) for the first 6 months of life provides all the nutrients necessary for proper growth and development, as well as allows the baby to develop from an oral-motor perspective prior to introducing solids.

Note: the one exception that breast milk may lack is the need for vitamin D. Vitamin D should be supplemented from birth, or mothers should take a high-dose vitamin D supplement themselves to be able to transfer appropriate amounts to the baby through breast milk (discuss with your pediatrician or primary care provider for your vitamin D needs).

How Recommendations For Starting Solids Evolved

Before 2001, the World Health Organisation (WHO) global recommendation was that infants be exclusively breastfed between 4 and 6 months, before the introduction of complementary foods. That same year, Kramer and Kakuma published an analysis comparing exclusive breastfeeding for 6 months vs 3–4 months. The WHO commissioned an Expert Consultation to review this work, which led to the recommendation for exclusive breastfeeding for 6 months, with introduction of complementary foods and continued breastfeeding thereafter. This recommendation has been adopted widely by countries around the globe. 

In 2008, the ESPGHAN (European Society for Paediatric Gastroenterology and Nutrition) issued a position statement, focussing on healthy infants in Europe. It stated that while exclusive breastfeeding for ∼6 months is a desirable goal, all infants should start complementary feeding by 26 weeks (but not before 17 weeks).

“According to recommendations from the World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the American Public Health Association (APHA), human milk is the only food that healthy, full-term babies need for about the first six months of life.”  – La Leche League International

The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. Children can be introduced to foods other than breast milk or infant formula when they are about 6 months old. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months.

Both WHO and UNICEF recommend exclusive breastfeeding for the first 6 months of life and introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.

Organizations that recommend starting solids at 6 months

New guidance from leading medical organizations – the American Academy of Allergy, Asthma, and Immunology (AAAAI), the American College of Allergy, Asthma, and Immunology (ACAAI), and the Canadian Society of Allergy and Clinical Immunology (CSACI) – recommends that in order “to prevent peanut and/or egg allergy, peanut and egg should be introduced around 6 months of life, but not before 4 months”. 

Other organizations that support starting solids at 6 months include:

ORGANIZATIONAGE RECOMMENDED FOR STARTING SOLIDS
American Academy of Family Physicians6 months
Australian National Health and Medical Research Council6 months
Health Canada6 months
Canadian Pediatric Society6 months
The AAP Section on Breastfeeding6 months
American College of Obstetricians and Gynecologists6 months
Academy of Breastfeeding Medicine6 months

Linked Here: 

Note: For those at high-risk for peanut allergies (infants with severe eczema), once developmental signs of readiness to start solids have been seen (more on this below), introduction of these foods can be provided between 4-6 month of age to prevent food allergy development.

More great articles on this topic by healthcare professionals can be found here: 

Why Should You Wait Until 6 Months? 

“When you breastfeed your baby frequently, starting foods earlier than 6 months is not necessary and can even be harmful.” – UNICEF

According to The Breastfeeding Answer Book, medical scientists agree that human milk is nature’s complete food for at least the first six months for the healthy, full-term infant, and significant disadvantages have been found to introducing other foods before that time.

“Baby’s insides are designed to be ready for solid foods once his outside has developed enough for him to eat it on his own. If he can’t pick it up, get it in his mouth, and chew it without choking, then he is just not ready for solids, and his tummy probably isn’t either.” – La Leche League 

The normal infant’s need for foods other than milk, his ability to digest them, to chew, and to pick pieces up and take them to his mouth have all been shown to converge at around 6 months, indicating that developmental readiness for solid foods coincides with readiness for self-feeding. In addition, Baby Led Weaning (BLW) is widely recognized as something that has been practiced in many families for years, albeit without a name, with no indication that it is harmful.

“Specialists in infant oral motor development and therapy provide strong indication that under normal circumstances, oral motor function is developmentally ready for the introduction of semisolid and solid foods and thereby the discontinuation of exclusive breastfeeding between six and nine months of age. While infants can be offered such foods at an earlier age, their oral anatomy, reflexive responses and resulting oral motor function indicate that this is developmentally premature and may increase the risk of aspiration.” – Development Readiness from Oral-Motor Perspective 

Potential concerns with introducing solids before 6 months

  • Premature weaning from breast milk.

Some concerns include children consuming greater than the recommended calories from solid foods, and thus replacing the needed nutrients from human milk. This results in less breastfeeding and lower milk supply for the mother. By introducing solids too early, the mother substitutes a superior food with an inferior food. (This has been studied for formula-fed babies as well  – and formula, like breastmilk, remains superior to early solid foods).

  • GI discomfort/digestive issues due to immature digestive enzymes. 

At birth, your baby’s digestive system is still developing and maturing. At this point, he is not ready to accept other types of food besides breast milk. At about six months, your baby’s digestive system is mature enough to digest more complex and solid food substances, like starch, protein, and fat in a non-milk diet.

“The weaning process must progress in a timely manner to ensure that the digestive system matures properly. Pancreatic function, small intestine absorption and fermentation capacity are underdeveloped during the early weaning stages. While there are enzymes present in the saliva that help break down food, it is not until 6 months of age that the pancreas secretes enough enzymes including α-amylase to digest starches and proteins” (Moore and Townsend, 2019).

  • Potential for overeating contributing to obesity issues later in life. 

“Breastfed babies who are breastfed for at least 6 months are less likely to be overweight.” – American Academy of Pediatrics

If a child is not yet old enough to feed themselves, they may be pressured by caregivers to consume more than needed. Allowing them to self-feed when they are developmentally ready can prevent weight related issues and allow children to honor their hunger cues. 

  • Increased risk of choking.

If the child is unable to sit up unassisted with good head and neck control, they have a higher risk of choking. Proper core, head, and neck stability paired with proper positioning in a highchair can reduce the potential for choking episodes. 

Signs Of Readiness For Starting Solids

According to Amy Brown PhD, author of Why Starting Solids Matters, the guidance on introducing solid foods at around six months is primarily based on health evidence, but also takes into account a baby’s physical development. Developmental readiness means looking at how babies’ physical development – both internally and externally – can inform us about when they should receive complementary foods.

On a simple level, this theory suggests that when a baby is ready to feed themselves solid foods.. they are ready to start solid foods! These milestones don’t just apply if you are thinking about going down a baby-led weaning route, but applies for giving any and all types of solids.

It is quite possible to give a few week old newborn food, however, just because you can doesn’t mean that you should. “The fact that an infant may be ready from a neurodevelopmental perspective to progress to a more diversified diet before 6 months of age does not imply that there is a need to introduce complementary foods” (EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) et al., 2019). 

“Specialists in infant oral motor development and therapy provide strong indication that under normal circumstances, oral motor function is developmentally ready for the introduction of semisolid and solid foods and thereby the discontinuation of exclusive breastfeeding between six and nine months of age. While infants can be offered such foods at an earlier age, their oral anatomy, reflexive responses and resulting oral motor function indicate that this is developmentally premature and may increase the risk of aspiration” (Naylor and Morrow, 2001).

When you wait to introduce solids at 6 months, “your baby will be better at moving food around their mouth, chewing and swallowing it – this may mean they’ll be able to progress to a range of tastes and textures (such as mashed, lumpy and finger foods) more quickly, and may not need smooth, blended foods at all.” – National Health Services 

One of the main indicators of developmental readiness is being able to sit up well without support, which the majority of babies do by around six months. Continue to look out for other signs of readiness, including having good head and neck control, showing interest in food, and being able to bring food from hand to mouth.

Extra Sources:

Cinthia Scott is a Registered Dietitian (RD) and International Board Certified Lactation Consultant (IBCLC) , with over 7 years experience in the field of dietetics. Cinthia focuses on ensuring optimal nutrition in the first 1000 days of life to ensure optimal growth and development as well as set the stage for long-term health. Cindy is an author, starting solids expert, and advocate for caregivers receiving evidence based education and support surrounding breastfeeding and starting solids. 

Cinthia is co-author of the 101beforeone Starting Solids Book, “101beforeone -baby-led feeding cookbook,” and is the founder and owner of Cinthia Scott RD LLC which is her private practice built to provide virtual 1:1 services for caregivers surrounding infant nutrition, toddler nutrition, and breastfeeding support. Cinthia is also the creator of the Starting Solids 101 Program which provides caregivers 1:1 support from a Pediatric Dietitian on how to provide optimal nutrition from the start and create healthy eating habits that will last their whole lifetime. To work with Cinthia, you can access her services here. 

Cinthia provides tons of free information for parents on her social media accounts as well. 


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