When to start a baby on solids is an issue that never gets old. I have been giving advice on the subject since the 1970s. Of course, the advice does change from time to time. What I want to emphasize now is that what you do may depend on your baby’s risk for allergies. After years of advising parents to wait before adding certain foods, we’ve learned from patiently studying many infants over several years that starting a particular food early can actually reduce the risk of allergies. But there’s a problem. This new guideline only works if the child isn’t already allergic!

The first step in starting solids is determining if the baby can take solids. The parent and the pediatrician need to make an evaluation of head and neck control as well as have a discussion of what a baby needs to do to keep solid food in the mouth. After all, babies thrust their tongues forward when they suck, and they must learn a new technique for solids. If they are ready, they can start solids between 4 and 6 months.

Next, we want to take advantage of what we have learned about avoiding allergies. For a peanut allergy, we give small amounts of peanuts from 4 to 11 months. Similarly, we can give yogurt or cheese and cooked eggs to reduce allergic responses to dairy and eggs. But there is a very important consideration to make before giving these foods because – surprisingly to me – household dust sometimes has significant amounts of peanut or other foods, and that dust can lead to an allergy if the baby has inflamed skin.

Thus, when evaluating a baby for readiness to take solids, we must also look for signs of eczema and ask if any family members have food allergies. And if we’ve tried egg and there appears to be a reaction, that’s also a red flag. If any of these are present, the baby may be a candidate for testing by an allergist. By following these guidelines, we can reduce the risk of food allergies in both at-risk and not-at-risk children.

Bring this article to your baby’s four-month visit to begin an important discussion about starting solids.

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit their website at https://centerforpediatricmedct.com.