Ioanna Angouraki, Dietician and Nutritionist, writes about the transition from purees to solids
When and how?
A subject of infant nutrition that scares all parents is transitioning from purees to solids. I’ll try to answer a few basic questions in this article:
When should it take place?
How can I help my child transition to solids and eat normal food?
Is mixed feeding allowed?
When and why should we transition?
Besides the issue of nutrition that’s also fundamental, the change in food texture is necessary to improve the child’s feeding abilities, while offering food with different textures generally improves the acceptance of a wider variety of foods.
In short, it’s imperative to change the food we offer from completely pureed to something more demanding that will force the child to make chewing motions. If we keep giving our children pureed food forever, they won’t learn to chew.
Many parents, out of fear and to avoid choking, keep extending the commencement of the transition, hoping that as their child grows older, they will be more capable of managing that. That capability, though, only comes through effort.
Studies now show that the transition to solids should be completed by the 9th to 10th month because it will be much harder later. At the same time, children who have stayed for longer on pureed foods can end up being pickier with their food, which means they might stop eating foods they did know and eat pureed.
As a last note, though, I must highlight that if a child really has difficulty with feeding, it might not be able to transition to more demanding foods, and that’s not always related to the parent(s) postponing it. If you try to make the transition and keep failing, you should seek out the help of a professional.
How to transition to solids
Before I mention the evolution of texture, it’s important to mention that the smooth texture of puree that we’ve grown used to use for feeding babies, didn’t exist a century ago as there was no home equipment to achieve that result.
Keeping that in mind, it’s probably easier to understand that the completely smooth puree isn’t necessary to start feeding, as the child is neurologically ready (unless your child must eat that kind of food for medical reasons).
However, even if you do begin with a diluted, smooth puree, the first step is to make it thicker. By reducing the liquid element, you slowly create a thicker puree that will force the baby to start using their tongue to transport food inside the mouth and the lower jaw for more intense chewing motions.
Since you’ve reached a thick, though still smooth, puree, you can transition to mashed food, which will initially be mashed with a fork to form a puree made from small and soft pieces (that is, don’t try to mash raw apples). As time goes on, mash the food less and less.
Approaching this from a time perspective, seek small changes in texture every 1 to 2 weeks, so that by the 9th or 10th month, you’ll finally have reached solid food pieces.
In no case should you offer smooth puree containing large food pieces (for example, pea-sized), since that increases the choking hazard. Another common mistake I see is a liquid soup with food pieces, like meat soup or vegetable soup. Foods with mixed textures offered with a spoon are one of the most demanding, from the point of view of one’s abilities, and aren’t suggested for children younger than 12 months old.
Long and hard items like a silicone spoon or a baby toothbrush can help even more in consuming normal foods since the child learns to place their tongue correctly. Also helpful are easy-to-digest foods that melt in the mouth like the teething cookies found in grocery stores, though it’s not necessary for most children.
Pieces and puree: can they be combined?
No matter how strange it might sound to you since I know what’s being said out there, the answer is a huge yes! You can start giving solid food along with purees from the start, or you can go from purees to solids without the transitioning phase of mashed foods described above.
There’s no literature to suggest that children are being confused by purees and must take a break from feeding before getting started on pieces. What I can say, from my experience with cases I’ve taken on, is this: some children might need the transitioning phase, others do not.
The belief that the two methods can’t be combined is based on the logic that children who have started eating purees haven’t learned to chew and will choke if we offer solids right away. However, children can easily feel that there’s a large and solid piece of food in their mouth and will either spit it out or start chewing to mash it. As I mentioned above, the smooth puree that contains some food pieces (for example, the size of peas) is what increases the choking hazard, since small food pieces can be “lost” in the mouth and end up in the airways more easily.
As such, the only thing we should do is ensure that the pieces we do offer are soft enough (able to be mashed in our hand with very little pressure) and allow the child to do it themselves.
Problems with the transition
Here I’ll mention the two basic “problems” that parents observe during the transition, forcing them to regress.
The first is gagging.
Gagging is the gag reflex, which can be activated when being in contact with an object or food that’s somewhere in the middle of the tongue. Since children who have begun with purees haven’t “trained” this reflex, as they haven’t come in contact with solid food pieces, gagging appears when the transition begins. Despite its dramatic appearance, it’s innocent and it should not be confused with choking in any way. All children will do it, each to a different degree. So, if the child does not appear irritated by gagging and continues eating, you don’t need to regress to smoother purees or stop offering pieces.
The second is the amount of food they eat.
When offering more demanding foods, in a texture the child isn’t used to, and due to the gagging, it’s completely natural that the amount of food eaten will be reduced. Don’t let your worry about the amount of food being eaten make you regress! Milk will complement the caloric gaps and at the same time, you can continue helping your child get used to normal foods. Besides, when offering food pieces, each bite “counts” for more, as it’s a much more concentrated food type when compared to pureed foods diluted with a liquid.
I really hope that this article will help you achieve the transition with self-confidence!
Bibliography - Coulthard, H., Harris, G., & Emmett, P. (2009). Delayed introduction of lumpy foods to children during the complementary feeding period affects child's food acceptance and feeding at 7 years of age. Maternal & child nutrition, 5(1), 75–85. https://doi.org/10.1111/j.1740-8709.2008.00153.x - Harris, G., & Coulthard, H. (2016). Early Eating Behaviours and Food Acceptance Revisited: Breastfeeding and Introduction of Complementary Foods as Predictive of Food Acceptance. Current obesity reports, 5(1), 113–120. https://doi.org/10.1007/s13679-016-0202-2 - Tournier, C., Demonteil, L., Ksiazek, E., Marduel, A., Weenen, H., & Nicklaus, S. (2021). Factors Associated With Food Texture Acceptance in 4- to 36-Month-Old French Children: Findings From a Survey Study. Frontiers in nutrition, 7, 616484. https://doi.org/10.3389/fnut.2020.616484
My name is Ioanna Angouraki, I’m a dietician and a new mom. I completed my basic education in the department of Nutritional Sciences and Dietetics of the Alexander Technological Educational Institute of Thessaloniki, and then earned a postgraduate degree in Nutrition and Public Health from the Harokopio University of Athens. Since then, I’ve continuously improved my knowledge regarding baby and child nutrition through workshops, conferences, and seminars, and I’ve been working towards international certification as a breastfeeding consultant. I recently created Mommy & Me, a centre for the nutrition of the baby, the toddler, and the mother. I have a license to practice the profession of Dietician, I’m an active member of the Hellenic Association of Dieticians and Nutritionists, and of the European Academy of Allergy and Clinical Immunology.
Website: https://mommyandme.gr/
Instagram: @mommyandme_dietitian
Facebook: Ιωάννα Αγγουράκη Διαιτολόγος Διατροφολόγος MSc
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