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When Should Babies Start Solids? How About Allergenic Foods?

January 27, 2023

Have you changed your advice to parents about when they should start “solid foods” (anything except for human milk or formula)? How about allergenic foods, such as nuts, eggs, milk, and wheat?

The evidence underlying these recommendations has evolved in recent years, so the Review Article by Victoria Soriano PhD and colleagues from the University of Melbourne and Deakin University in Australia – and accompanying video abstract - that is being early released this week by Pediatrics, entitled “Complementary and Allergenic Food Introduction in Infants: An Umbrella Review” (10.1542/peds.2022-058380) will be important for all of us to read.

The authors analyzed 32 systematic reviews to examine whether the timing of introduction of “complementary foods” (what most US parents call “solid foods”) or peanut, egg, wheat, or gluten is associated with food allergy, eczema, celiac disease, obesity, or several other health outcomes.

Some of the major findings:

  • The age of complementary food introduction was not associated with food allergy or eczema.
  • There was moderate evidence that egg and peanut should be introduced at 4-11 months to prevent allergy to those foods.
  • There was high evidence that age of gluten introduction was not associated with celiac disease.
  • There was low evidence that complementary food introduction before the age of 4 months was associated with childhood obesity.

There is much more detail in this Review Article about the association or lack of association with introduction of foods and other health outcomes.

This Review Article is helpful when parents ask specific questions about the introduction of foods. However, you can be reassured that, if you recommend starting solid foods at around 6 months and encourage introduction of peanut- and egg-containing foods before 11 months, you are following evidence-based guidelines.

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