Everything You Need to Know About Starting Baby on Solids with Speech-Language Pathologist Catherine Callahan
Starting solid foods is a big milestone, and it can bring both excitement and a little apprehension. In this episode, speech-language pathologist, pediatric feeding therapist and certified lactation counselor Catherine Callahan, co-author of the new American Academy of Pediatrics book Baby Leads the Way, shares her approach to starting solids. She talks about when to begin, which textures and foods she suggests at different stages, how she recommends introducing common allergens, and how parents can follow their baby's cues through family meals.
What you'll learn in this episode
Watch for readiness around 6 months. Catherine says she recommends starting solids around 6 months of age, when baby can sit up independently with their head upright. She describes this as being able to sit for about 2 or 3 minutes on the floor before tipping over.
Let development guide textures. Catherine says she looks at a baby's overall development, not only their age. At around 6 months, she suggests purees loaded onto a spoon, soft foods in a stick shape, and foods that are easy to squish between your fingers. Around 9 months, when babies are crawling and using a pincer grasp, she says small cubes and more challenging textures can be offered.
Keep milk the same and add solids slowly. Catherine says breast milk and formula should stay about the same in volume through the first year, because milk remains the primary source of nutrition. She suggests one solid meal a day around 6 months, about an hour after a bottle or breastfeed, two meals around 8 months, and three meals around 9 months.
Offer variety from the start. Catherine calls the old advice to introduce one new food every 3 days a myth. Her program suggests a goal of 101 different foods before baby turns one, which she says helps set baby up for toddlerhood.
Introduce the top nine allergens one at a time. Catherine names them as peanuts, eggs, wheat, soy, cow's milk, tree nuts, finfish, shellfish and sesame. She says to offer each one on its own the first time, starting with about a teaspoon, watching for about 10 minutes for signs such as swelling, hives, an itchy nose or throat, or runny eyes, then serving the whole portion and waiting about two hours.
Ask your pediatrician about higher-risk babies. Catherine says that for a baby with eczema or an existing food allergy, the recommendation is to introduce the top nine allergens earlier, at four months, especially peanuts and eggs. She says anyone who is worried should ask their pediatrician how and when to start.
Teeth are not required for chewing. Catherine calls it a myth that babies need teeth to chew. She says the gums are very strong, so babies can use them to chew and grind food.
Use family meals and follow baby's cues. Catherine suggests taking foods your family already enjoys, such as salmon, pasta or chicken, and making a little extra so leftovers can be baby's lunch. She says a turned head, a grimace or wanting out of the chair shows baby is done, while leaning in, opening the mouth and reaching shows they want more. She also suggests planning about three foods per meal and teaching baby sign language.
Bigger pieces are easier to handle. Catherine says larger pieces, such as a chunk of sweet potato, are easier for baby to pick up, feel and bite. She says baby should put food in their own mouth, because she says there is a higher risk of choking if the food is put in for them, and she says apple is a choking hazard food she does not recommend until after age four.
Early variety can help, but it is not a guarantee. Catherine says babies are generally more open to variety from about 6 to 10 months, and pickiness and fear of new foods often appear closer to 10 to 12 months. She says she cannot promise this prevents picky eating, since genetics, motor skills and temperament also play a part, but it can set kids up for success.
About the guest: Catherine Callahan
Catherine Callahan is a co-author of the new book Baby Leads the Way: An Evidence Based Guide to Introducing Solids, which is designed to help parents navigate the journey of starting solid foods with confidence and clarity. She is a speech-language pathologist, pediatric feeding therapist, certified lactation counselor and mother based in Chicago, and she has spent years studying the intricacies of infant nutrition and feeding behaviors. She holds a degree in Nutrition Sciences and has completed extensive research in pediatric nutrition, and her work has been featured in numerous scientific journals. Her Instagram page, chikidsfeeding, has over 102k followers.
Website: chikidsfeeding.com
Instagram: @chikidsfeeding
Pinterest: chikidsfeeding
TikTok: @chikidsfeeding
This episode is for general information only and is not medical advice. Every baby is different, so talk with your baby's pediatrician before starting solid foods or introducing allergenic foods, especially if your baby has eczema, a food allergy or any feeding or swallowing concerns.
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Full episode transcript
Read the full transcript
Intro (recorded)
Entering the world of solid foods is a monumental milestone in a baby's development. The transition from milk to solids is filled with excitement, curiosity, and a bit of apprehension. Today's guest on the Teaching Your Toddler Show is Catherine Callahan. She's one of the co-authors of a new book, Baby Leads the Way, an evidence-based guide to introducing solids, which is a book designed to help parents navigate the journey of starting solid foods with confidence and clarity. Catherine brings a wealth of knowledge and experience to the book. As a speech language pathologist, pediatric feeding therapist, certified lactation counselor, and mother based in Chicago, Catherine has spent years studying the intricacies of infant nutrition and feeding behaviors.
Catherine's journey into the world of infant nutrition began with her academic pursuits. She holds a degree in nutrition sciences and has completed extensive research in pediatric nutrition. Her work has been featured in numerous scientific journals reflecting her commitment to advancing knowledge in this field. Her Instagram page, Chi Kids Feeding, has over 102,000 followers. Please welcome Catherine to the Teaching Your Toddler Show.
Marijo: Hello, this is Marijo from the Teaching Your Toddler Show. Today we have a great guest. Catherine Callahan is with us to talk about an amazing book that has just come out. But first, Catherine, welcome to the show. Tell us a little bit about yourself.
Catherine: Thank you. Thanks for having me here, Marijo. So I am a speech language pathologist. I have been working for about 17 years in my practice. I am specialized in feeding and swallowing and I'm a certified lactation counselor and I'm also a mom of three. I work part-time at a hospital here in Chicago, Lurie Children's Hospital. I work with infants and children with feeding and swallowing difficulties. And then I have a private practice and run my own social media business, Chi Kids Feeding, all about how you know supporting children and their families and you know, any feeding questions they may have. And then I also work with families just locally and actually around the world virtually.
Marijo: Oh, fantastic. So as a lactation expert do you work with moms then also?
Catherine: Yes. So I work in the hospital I work in the NICU the neonatal intensive care unit where I work mostly with moms and babies. We do work on breastfeeding if that's part of their goal. And then I also support families and infants locally who are infants who are struggling with breastfeeding. More on the swallowing or the latching end versus the lactation end because my specialty is more in based in the speech pathology realm.
Marijo: Gotcha. Awesome. That's that's that's so great. We've recently had a couple of shows that are similar to that and talking about how important it is for that whole development area with your with your mouth and I had no idea the impact that that that has. So that's that's great. So I understand that you were part of writing a book that has just come out. So tell us a little bit about that.
Catherine: Yeah, so the book is called Baby Leads the Way. It's published by the American Academy of Pediatrics. I wrote it with a group of five authors. All of the five of us work together for a company called 101 before one. It's a starting solids program company that's online. And we have published a couple books within that group. So we are a team of all medical professionals and moms. We have a pediatrician on our team, a pediatric allergist, a registered dietician, me a speech language pathologist, and then we also have a home chef. And we have worked together for almost about four years now. Two years ago, the AAP reached out to us and asked if we would publish or write a book for them all about starting solids.
So, we kind of all came together to write this. We each talk about or wrote about our specialty areas. And the idea of the book is really like babies are leading the way in feeding themselves and in choosing what to eat and how much to eat. So it is the idea is kind of parents are you know parents decide what foods to offer where and when and then the child decides how much to eat and what foods to eat and it's all kind of responsive feeding. So we're responding to what the baby's eating and how much they're eating by giving them more or giving them less stopping the meal.
A lot of what I focus on in the book is how to help babies learn to pick up food and feed themselves and then also the textures of the food. How do we decide which textures are safe for a baby at which stages of their development? So, I look at a baby not necessarily just based on their age, but on their overall development. So, what developmental skills are we looking for to help guide what textures we're going to serve our babies? And then I think another big you know portion of the book is all about building meals or off serving baby through family meals. Family meals are going to be much easier for moms and dads at home who are making the food.
So it's how do we modify the family meal so that it is safe for baby to eat too.
Marijo: Oh my gosh. Okay. Definitely want to unpack that a little bit. But I know that the first question is always for moms, especially firsttime moms, like what do I do? You know, they there's these things that they tell us, we've got to start these specific kinds of foods, soft foods, whatever it is. So, tell us how does how does this all get started?
Catherine: Yeah, so we recommend starting solids around 6 months of age, and we want baby to be able to sit up independently. So they're holding their head upright independently. Usually, if you put them on the floor, it's going to be about 2 or 3 minutes before they tip over. That's about the right time to start solids. Want babies to have that good like core stability to be able to pick up food, control the movement of their hand, and control the movements in their mouth for chewing. And you're going to start with food. Our approach is very much purees and table foods because if you look at the diet of even us as adults, today I ate yogurt for breakfast and I had eggs.
So, I'm eating all those textures now. So, babies can have those same textures from the beginning. And it's all about if you're doing a puree, it's going to be loaded onto a spoon. So, parent is helping baby loaded onto the spoon. Baby's picking up the spoon and bringing it to their mouth. And then soft food at six months when baby is going to have a whole hand palmar grasp we call it. They can pick up food with their whole hand. So, you're going to serve food in a stick shape that's easy to pick up. And then at you're also around six months going to serve food that's easily squishable between your fingers so that baby can squish it with their jaw.
So babies at six months have a munching movement with their jaw. So anything soft and squishy they can squish with their up and down motion and as they do that it's going to turn into almost a puree in the mouth.
Marijo: Whoa. That's
Catherine: So those are kind of where you start. And then as baby moves towards 9 months is when they start crawling. And that's when your babies are also using more diagonal movement with their jaw. They're grinding a little bit more so they can handle more of little bit more challenging textures and smaller pieces. They're also getting a pincer grasp at that age where they can pick up food between their two fingers. So you can serve food in little small cubes.
Marijo: Awesome. So, I would think that like the stick shape, the smasher, I mean the first thing that comes to mind is like an avocado. Is that
Catherine: Yeah. Yeah. Yes. Uhhuh. Like an avocado is a great example. Sweet potato in the a kind of a stick shape. We even recommend things like chicken, like a soft cooked chicken, something in the slow cooker would be great. Fish salmon is a really easy one. Sardines is one of my favorite first foods, which sounds very gross, but sardines are super iron dense. They're also nice and soft. They're really flavorful. And then they come in a little they're kind of a stick shape. I recommend you buy the ones that are boneless and you know, no salt added, but they're come in a little stick shape or you can mash them on a utensil with some avocado.
Makes a really good you know, nutrient-dense meal.
Marijo: And tell us a little bit about how do you balance the food, the solids versus like weaning and milk, whatever you're doing for that.
Catherine: Yeah. So really the breast milk and the formula should stay the same in volume through the first year. So babies start to, you know, spread out their bottle or their breastfeeds as they get older, but really the volume stays about the same and that's going to be their primary source of nutrition because it's a complete nutrition. But the food is going to supplement that and it isn't. You know, sometimes people say it's food is just for fun. It's not really just for fun. I mean there are a lot of core nutrients that babies need in that food and the exposure to the food is so good for building their fine motor development and building their oral motor development.
Desensitizing their mouth are a lot of benefits. But the milk food should stay the same. We usually say around six months. You think about offering solid foods once a day kind of an hour after a bottle or breastfeed. And then as baby's skills build and as they enjoy it more, maybe they're starting to intake more volume, then you increase to two two meals a day, you know, usually around eight months or so, and then three meals a day around 9 months or so. And those are the solid food meals, but you're keeping all the bottle and the breastfeeds the same.
Marijo: Is there any correlation between this and having teeth or not?
Catherine: No. So, that is a myth that you need teeth to be able to chew. Actually the underneath where the teeth come out and your gums is very strong so babies can use that to chew and grind the food.
Marijo: That's excellent. That's a dispelling a myth there.
Catherine: Yes.
Marijo: Fantastic. Here's a question. What about new foods and like how do how do you make sure that like they're not allergic for or that they just don't like them? I mean how do you how do you sort of judge? And you talked a little bit about texture. I know one of our kids had a had a real texture issue about certain things and others they the others just didn't care. It didn't matter.
Catherine: Yeah. Yeah. Every baby's a little bit different that way. But so the I think it used to be a thought that you had to introduce one new food every 3 days. That is now kind of a myth that's dispelled. We can introduce as much food as you want from the beginning and we actually encourage that variety from the start. So that then by the time the baby has reached age one, they have already eaten a wide range of foods. So in our program, we recommend a goal of 101 different foods, it just helps set baby up for success when they head into toddlerhood and they are already, you know, used to eating all of these different flavors and textures.
So that we call it diet diversity. That diet diversity is super important early in life. But that said, the top nine allergens are a little bit different. So when you introduce those, you should introduce them one at a time the first time they're offered. And that's just so you know, you know which allergy if they do have a reaction they're having a reaction to. But you can introduce one different food each day. You don't have to wait in between. If a child's going to have an allergic reaction, they're going to have it immediately, usually within one to two hours. So by the next day, you know, you don't have to worry about it.
So those top nine allergens you're going to introduce. Usually we say about a teaspoon first. You watch for about 10 minutes to see if there's any reaction, could be some swelling, could be some hives, itchy nose, itchy throat, runny eyes. If you're noticing any of that, then of course you would stop. But if not, then you continue and then you serve baby the whole portion and wait about, two hours to make sure that they look okay. M and if if you have a child who is at a higher risk of food allergies, that would be a baby who has eczema or any prior existing food allergies, then you do want to introduce them a little bit earlier.
So, you want to you the recommendation is four months with those top nine allergens, especially the peanuts and the eggs. But anyone who, you know, is worried about that or wondering should ask their pediatrician. Their pediatrician can guide them and how to do it and when to start. But we do have a whole chapter in our book all about this step by step
Marijo: Okay. So besides peanut and eggs, what are the other seven?
Catherine: Yes. So wheat, soy, cow's milk, tree nuts, finfish, shellfish, and sesame.
Marijo: I know sesame is so weird. I've heard that one before and it's like, oh well. But yeah. Okay.
Catherine: Yeah, that's the newest one. Yeah.
Marijo: Finfish and shellfish. Okay. Gotcha. Very good. Thank you very much for reviewing that. That's that's very helpful. You talked a little bit about the portion size. One of the things you noted in the beginning was, I mean, it sounds like a lot of what you just described is real food and so it's going to be a little easier to integrate it in as a family for the meal, but tell us a little bit about that.
Catherine: Yeah. So, I think really you know it within the book and with our within our 101 before program, we do have recipes that are you know designed to be safe for baby and can the whole family can enjoy. But really I suggest families take take the food they like to eat. Like if you and your partner like to eat salmon once a week, then that's going to be a great food to serve baby because you could just buy a little bit extra and plan that within the meal. Or if you like pasta, something you can give baby, chicken. Really kind of think about what like what your favorite foods are.
I always start by asking if families are like, "What should I do give my baby for their first food? I ask what they what do they usually eat for dinner during the week. And one thing that comes up a lot is you know parents work late or babies with a nanny. How do you know incorporate them into the family meal? I always say make a little extra and save the leftovers and that can be baby's lunch the next day.
Marijo: Oh yeah. Yeah. They're not They don't care if they have eggs for lunch or whatever.
Catherine: Yeah, that's good.
Marijo: I with our kids, we taught we taught sign language, so they were able to tell us if they wanted more if they were finished and it was so helpful. But how do how can you kind of tell if that's not a choice that parents make?
Catherine: Yeah. So, you're really going to watch for babies just watch baby's facial expressions and their body movements. So, if they are like, you know, making a face and turning their head away or they're starting to want to get out of the chair, okay, those are signs that they are done with the meal or maybe that specific food that you're offering is not what they really want. I usually tell families to plan about three foods for each meal. So, if you start with one and baby's kind of turning away or starting to throw the food, that would be a good time to maybe pull out one of those other foods that you've already set aside and planned for the meal.
And then I think, you know, if they are like leaning forward and opening their mouth and reaching their hands towards the food, well then that means they want more and they're still hungry. So, really watching for those you know, those physical cues. But I really think teaching sign language is super important and that is really a big part of responsive feeding. You're you're kind of responding to what the baby asks for. The baby is learning to respond to you by by communicating with you with their body.
Marijo: It helped so much. I mean, my daughter just she was she ate so much and I just kept like, "Okay, okay. And then she would finally say, "Yeah, like I was finished. But we I had no idea if I would have massively underfed her thinking, "Oh, she doesn't want, you know, but she kept telling us more and more and then she would tell us when she was finished very expressively. So, it works very well if anyone's wondering. I It worked very well for our family
Catherine: For sure.
Marijo: I love this idea. Go ahead.
Catherine: I was going to say this something then they can keep building on you know through their through toddlerhood learn you know learning sign language actually helps promote language development so it's a great thing to start early. Yeah.
Marijo: Yeah. Yeah. It was very good for all of our kids. In fact we just recently found a little video of my son who is now 17 and he was stomping on a flower and he was tell he was asking me in his sign language he was asking me to please help him cuz he wanted help stomping the little flower. I was like, "Oh my gosh, they're so cute. Anyway, so tell us I understand that the group that put this book together is actually 101 before one. So, I mean, do you have a list in the book? Is there like some ideas for the 101 foods?
Catherine: Yeah. So, in our program, the 101 before one program, we have a fridge magnet and also a printable list of all 101 different foods that are all sorted by category. It also the list includes the top nine allergens at the top so families can check all of these foods off as they go and reach their goal. And then at the end, you know, usually there's a celebration and you can, you know, you can get a balloon and a and a little onesie. Just a nice way for families to kind of I think keeping track of the progress really, you know, helps to motivate you to keep going.
You keep exposing baby to a variety.
Marijo: Wow. I would think that this approach would help prevent pickiness. Is that true?
Catherine: Yeah. So, you the how could I say this? The idea is that you introduce baby to a variety early on when they are more susceptible to eat a variety. So, in that like 6 to 10 months month range, babies are pretty open in general to accept a variety of food. Now, there's always going to be some that are a little bit different, but in general, that is kind of an like a window of opportunity for exposing baby to a variety. As you get closer to like 10 to 12 months is when some of that like pickiness and neophobia, fear of new foods comes in. So, the idea is you expose babies to a variety foods early on that when they reach toddlerhood, the food isn't going to be as new.
So, it's not like all of a sudden, you know, they've been eating smooth baby food and then all of a sudden they're going to have a piece of chicken on their plate and they're going to be very scared of what it is. I always tell families like if it's like if you went to a different country and somebody put like you know let's say a cricket on your plate and they said okay now you eat the cricket. You would definitely it's going to be really hard to eat it. But if you had if they exposed you to that cricket like for a long time putting it on the table, putting it in front of you, you're going to get used to seeing it.
You're going to watch other people eat it, right? Because you're exposing through a family meal. So it's going to be easier to try it versus just that surprise.
Marijo: That's a that's a good analogy for sure.
Catherine: Yeah. So the so yeah the idea is you expose them to this variety early on when they reach toddlerhood they're going to be less likely to be picky. Now picky eating is caused by many different things. So you know it can be some genetic factors or it can be motor factors how babies can handle food in their mouth. It can be personality and temperament. So, we can't say that this is going to prevent it completely, but it can certainly set your kids up for success when they reach toddlerhood.
Marijo: Is there an for something that's harder like an apple, is it better to give them a bigger piece and let them suck on it or is it something that you would like cut into tiny pieces or is that really like you got to just kind of see what your child can handle?
Catherine: Yeah. So, in general, bigger pieces are going to be easier. They're going to be easier for baby to pick up and control. We always want baby to put the food in their mouth themselves. You have the higher risk of choking if you put the food into baby's mouth. Something like an apple is actually a choking hazard food. So an apple specifically we don't recommend till after age four. But something let's say like that sweet potato, it's going to be easier for baby to handle in a bigger chunk. When they put it into their mouth, they're going to be able to feel it more. It's heavier.
It's going to be easier to bite. It requires less precise motor movement in the mouth. So, bigger is always easier and better.
Marijo: Gotcha. Thank you. Wow, that's that's good. Before I let you go, so tell me a little bit about the work that you do with if a child has a has an issue with like sucking or or chewing, what what kind of work would you be doing?
Catherine: So a lot of it is modifying how we're presenting the food. So, I work with families one-on-one. I see them, you know, in their homes and I watch them eat a meal and then I help families to choose foods that are going to help promote or develop their chewing skills and then I help like teach families how to serve those foods so that they are easier for babies to handle and chew. We also do things like little exercises in the mouth to help them kind of learn more different motor patterns with their mouth for chewing and swallowing. And then similarly with sucking in infants it's a little bit different but it's working on kind of practicing that sucking motion and giving them those positive oral experiences early on.
Marijo: I remember hearing about like the tongue thrusting and then they couldn't latch and all the things like that and it was so very stressful as a mother to think about all those possibilities.
Catherine: Right. Definitely. Yes.
Marijo: Well, Catherine, thank you so much for joining us today. It's been such a pleasure and such I mean so eye opening. I think there's a lot of things you brought up today. Tell us how to find you and then also how to find the book and of course we'll include all of this in our show notes and so that people can find you.
Catherine: Awesome. Yeah, so I have a website. It's called chikidsfeeding. It's C-H-I like Chicago kidsfeeding.com. So I have a lot of information about the services I provide there. And then they can also find me on Instagram chikidsfeeding. I have tons of videos and reels with simple tips that families can use right away if their little ones are having difficulty or if they just want some inspiration for meals or how to serve foods. And then you can find us also at 10141.com and at 10141 on Instagram. And then the book Baby Leads the Way is on Amazon. It's on Target. Pretty much anywhere you can get your books online.
Marijo: Excellent. Thank you. Thanks so much for the conversation today. It's been a pleasure to speak to you.
Catherine: Thank you. You, too. This was so nice.
Marijo: Thank you.
Outro (recorded)
This has been the Teaching Your Toddler Show with Marijo Tinlin. Thank you so much for joining us today. If you enjoyed today's show, please leave a five-star review or a thumbs up so we can reach more parents like you. To be notified when new shows post, please subscribe by sending an email to subscribe@teachingyourtoddler.com. For more expert interviews, fun activities, and storytime podcasts, please visit our website at teachingyourtoddler.com. All of our shows are also posted as videos as well on our YouTube channel at Marijo Tinlin. Find us on Facebook at TeachingYourToddler, X at TeachingToddler, Instagram at TeachingYourToddler, and make sure you check out our past shows.
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