When my daughter was a baby and it was time to start solid foods, I remember wondering, “Where is the manual?”. The family matriarchs were suggesting just a little cereal in the bottle, my pediatrician was telling me to wait until 6 months and my sweet daughter was opening her mouth like a little guppy waiting for her first meal. It was confusing then and it still feels like a moving target. Recent research continues to evolve on feeding babies and toddlers. Nutritionists, allergists and pediatricians all weigh in on recommendations and it can be overwhelming! Here are some basic guidelines and considerations to help you with feeding your baby.
1. The American Academy of Pediatrics (AAP) recommends breast milk only for your baby for the first 6 months and then continuing breastfeeding until at least one year of age. If you can adhere to this you are a superstar! Most of us tweak this optimal schedule a bit because it is just not realistic in every scenario.
2. Starting solids before 4 months in most babies is not necessary. There are developmental concerns and early feeding of solid foods has been linked to obesity.
3. For formula fed babies age 4-6 months and for breast-fed babies age 6 months or older, there are signs from babies that they are ready to eat solid foods.
- Your baby can hold up his head well.
- Your baby seems interested in eating, watching you while you eat and opening up her mouth.
- Your baby is at least 13 pounds and has doubled his/her birth weight.
4. First meal. Remember the term solid foods for your baby means pureed fruits and vegetables (made at home or bought as baby food) and single grain rice cereal (be sure it is made for babies and iron fortified). For most babies, you can start with a fruit or vegetable baby food or a single grain cereal mixed until runny with breast milk or formula or a baby food as the first food. Rice was the traditional favorite because it was thought to be the least allergenic but recommendations about decreasing risks of allergies have changed and any single grain iron fortified baby cereal is fine. Also, concerns over arsenic in rice cereal have led parents toward barley and oatmeal. I recommend organic cereal and baby food. Price point is not that much different and your baby will eat a fair amount of these in the first few months after starting solid food.
5. Fruit or vegetable first? It really does not matter. Some pediatricians recommend starting vegetable baby food before fruit baby food but babies have a natural preference for fruits. However, studies show which order babies try fruits and vegetables will not change their natural preference.
6. Many babies get frustrated if solid food is given when they are really hungry. It is almost as if they can’t get it in fast enough to satisfy themselves. Try breastfeeding or giving some formula first to take the edge off if your baby seems too hungry to relax and enjoy the solid food.
7. If you are breastfeeding your baby, you may want to give baby food with meat. By 4-6 months, babies may need the iron and zinc contained in meats.
8. General considerations:
- First meal may end up all over your baby instead of in your baby. Be patient and try again in a few days.
- Never force your baby to eat.
- Use a clean spoon to scoop out the baby food from the jar (not the spoon you are using to feed your baby). Baby food stays fresh in the fridge for about 2-3 days. Home made baby food spoils quicker because it is not bacteria free.
- Don’t stress about how much solid food your baby eats. Breast milk or formula is still the main source of nutrition at this point. When your baby loses interest (closes the mouth tightly, turns head away), it is time to stop feeding.
- Don’t put cereal in the bottle. Your baby could choke and often it causes too much weight gain.
- Studies show that cereal won’t make your baby sleep through the night.
- Wait 2-3 days before trying a new food to make sure your baby does not have a reaction like vomiting, diarrhea or rash.
9. Trying other foods. The schedule of which foods to try in the past aimed to decrease the risk of food allergies but unfortunately withholding certain foods may have had the opposite effect. Within a few months of starting solid foods, your baby can enjoy a combination of cereal, fruits, vegetables, meats, fish, eggs and yogurt. These should all be pureed with no solid components for the first few months of learning to eat to reduce the risk of choking. Note that home made spinach, beets, green beans, carrots and squash may contain large amounts of nitrates (which can cause anemia) and should be avoided. Store bought baby food is tested for nitrates so for these vegetables, this is a safer choice.
10. Starting finger foods. Once your baby can sit up independently and bring things to his/her mouth, you can give finger foods. To decrease the risk of choking, foods should be soft, cut up very small (size of a pea) and easy to swallow. Also, if you have not taken a CPR class, now is a good time to find one in your area. Good first food choices are: scrambled eggs, well cooked pasta, cooked, mashed potatoes, mashed peas, very finely chopped chicken and small pieces of banana.
- Fruits (besides bananas) and vegetables should be cooked until soft.
- Avoid salt and other seasonings.
- THE FOLLOWING FOODS ARE HIGH CHOKING RISK FOR BABIES AND YOUNG CHILDREN, DO NOT GIVE: hot dogs/meat sticks, chunks of cheese, popcorn, hard candy, scoops of peanut butter, nuts or anything hard.