Starting Solids
Principles, the current allergy-prevention guidance, paediatric red flags, and where to get help.
- Last reviewed
- Sources cited
- 5 sources
- Author
- Dr Jubal John, FRACP
- Category
- medical guides
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Take-home
Start solids at 4–6 months, when your baby shows readiness signs — and not before 4 months. Keep breast or formula going alongside, solids are complementary in the first year. Variety, iron-rich foods early, and introduce the common allergy foods one at a time between 4 and 12 months. No honey or cow’s-milk-as-a-drink under 12 months.
A few principles
- Wait for the signs, not just the date: steady head & trunk control, reaching food to mouth, tongue-thrust faded.
- Iron first. Iron stores from birth are low by 6 months. Cereal, meat, chicken, fish, eggs, beans, lentils.
- Introduce common allergy foods (egg, peanut, dairy, wheat, fish, soy, sesame, tree nuts) between 4 and 12 months, one at a time. Once tolerated, keep that food in the diet at least once a week for the first year.
- Variety beats restriction. Different textures, flavours, colours.
- Use the corrected age for preterm babies.
Foods to avoid under 12 months
Not safe under 12 months
- Honey: botulism risk; never under 12 months (including cooked).
- Whole cow’s milk as a drink: too high in protein, iron-poor. Cow’s milk in food (yoghurt, cheese, on cereal) is fine.
- Choking-risk foods: whole nuts, popcorn, raw carrot sticks, whole grapes, tough meat, hard lollies.
- Added salt, added sugar, sweetened drinks.
- Raw or undercooked egg, fish, shellfish, meat.
When to ring for review
Watch closely — MCH Line 13 22 29 for advice
Worth a chat with us, your GP or MCH nurse
- Persistent food refusal over 1-2 weeks
- Strong gagging or coughing on every meal
- Slow weight gain or weight crossing centiles downward
- Mild eczema flare with a new food
- Reflux symptoms appearing or worsening
Same day (or 000 if severe)
- Allergic reaction within 30 minutes: hives spreading beyond the mouth, swelling around eyes/lips, wheeze, vomiting, paleness, floppiness
- Anaphylaxis (call 000), noisy or difficult breathing, swelling of tongue or throat, hoarseness, collapse, follow your anaphylaxis action plan
- Choking episode: same-day review even if it resolves
- Persistent vomiting, lethargy, or refusing all feeds
If anaphylaxis is suspected, call 000
- Call 000 immediately.
- Follow your ASCIA Action Plan for Anaphylaxis and give the prescribed adrenaline autoinjector if you have one.
- Lay your baby flat (not sitting up) while you wait for the ambulance.
- Even if symptoms improve, a second wave can occur 1-4 hours later.
Where to get help
The right next step
- ASCIA — Infant feeding for allergy prevention: the national allergy-prevention guidance.
- Raising Children Network — Introducing solids: age-by-age practical guides.
- RCH Kids Health Info — Nutrition for babies and toddlers: printable fact sheet.
- Paediatric dietitian: for texture progression, fussy eating, vegetarian/vegan planning, allergy planning.
- Maternal & Child Health (MCH) nurse: your local MCH centre, or ring 13 22 29.
Related reading
Worried about how solids are going?
Your GP or MCH nurse can help first, and refer for a paediatric review: growth check, allergy screen and feeding history can decide whether a dietitian or allergy clinic referral is needed.