While starting your child on solid food isn’t always “love at first bite” it also does not have to be complicated or stressful.
Here are some overriding principles to keep in mind when feeding your baby:
1) It’s not just about the food. It’s about teaching your child to eat when hungry and to stop when full.
2) Eating a meal with family is social as well as nutritious. Keep eating pleasant and relaxed and never force feed or trick your child into eating.
3) Babies start out with pureed foods in a spoon between 4-6 months and progress to finger foods when physically capable, usually between 7-9 months. Teeth are not required; hand to mouth coordination is required.
Start with food on a spoon at 4-6 months. Before this age, babies don’t really digest solids. Also it’s hard to feed a baby who still slumps when propped in a sitting position. In addition, the normal “tongue thrust” reflex is less pronounced after 4 months of age. Putting cereal into a bottle doesn’t count as “eating” and is not necessary.
Timing is important when offering solid food for the first time. Babies learn to expect a breast or a bottle when hungry. So make sure your baby is happy and awake but NOT hungry the first time you feed her solid food because at first, she is learning a skill, not eating for nutrition. You should wait about an hour after a milk feeding when she is playful and ready to try something new. Keep a camera nearby because babies make great faces when eating food for the first time. Start a new food in the morning so that you have the entire day to make sure it agrees with your baby. Watch for rash or stomach upset. Once you know the food agrees with your baby, that food can be fed at night if you prefer.
Traditional first food in the USA is single grain rice cereal because it is easy to digest and most kids are not allergic to it. This is the one food I suggest keeping store bought rather than home made because this cereal is fortified with iron which is important for your baby’s growth. Mix the cereal with breast milk or formula so it smells familiar to your baby and because it adds calories (vs. mixing with water). Don’t worry about measuring. This is not an exact science. Just mix up a small amount to the consistency that you would likely eat oatmeal. Then put a small amount in a spoon and Go For It.
Some babies take one feeding to “figure it out.” They learn quickly to swallow without gagging and open their mouths when they see the spoon coming. Other babies need more time. They may tongue thrust the food back out, cough when trying to swallow, cry, or seem clueless when the spoon comes back to them. Don’t worry and go back to the above ground rules. Quit and try again another day. Some babies take several weeks to catch on to the idea of eating solids.
It is ok to try another single-ingredient food such as fruit or vegetable or another kind of cereal such as oatmeal if you think your baby does not like rice cereal. The overriding principal is to try one new food at a time so that if your baby has a reaction to the food, you know what to blame.
Stage 1 vs. Stage 2 baby food: The only difference is the size of jars. The consistency of the food is the same. Some stage 2 foods combine ingredients. Combinations are fine as long as you know your baby already tolerates each individual ingredient ( i.e. “peas and carrots” are fine if they’ve already had each one). Avoid the “dessert” jar foods. Your baby does not need fillers such as cornstarch or concentrated sweets. You could also make your own baby food by making a puree with cooked vegetables or soft fruits. Again, avoid introducing many new ingredients at once and avoid added salt and sugar.
Not all kids like all foods. Don’t worry if they hate carrots or green beans or apples. Many other choices are available. At the same time, don’t forget to offer a previously rejected food multiple times because taste buds change.
Be forewarned: poop changes with solid foods. Usually it gets more firm or has more odor. Food is not always fully digested at this age and thus shows up in the poop. Wait until you see a sweet potato poop!
By six months, babies replace one milk feeding with a solid food meal. Some babies are up to three meals a day by 6 months but should be receiving more calories from breast milk or formula than from solids. Also at six months you can offer a cup with water at meals. Juice is not necessary to give if your child eats fruit.
Sample menu by 6-7 months: breakfast: cereal mixed with formula/breast milk and fruit, lunch: fruit and vegetable, dinner: cereal and vegetable. Cereal has the highest calories and best nutritional content and should be offered at least twice daily. Jar baby food meats can be omitted: most kids don’t like them and cereal and breast milk/formula have plenty of protein. You can wait with meat until offering finger foods.
Finger foods can be given when your baby can sit alone and manipulate a toy without falling over, usually between 7-9 months. Even with no teeth your baby is able to gum a variety of finger foods. Examples include “Toasted Oats” (Cheerios), which are low in sugar and dissolve in your mouth eventually without any chewing, ½ cheerio-sized cooked vegetable, soft fruit, ground meat or pieces of baked chicken, beans, tofu, egg yolk, soft cheese, small pieces of pasta. Start by putting a finger food on the tray while you are spoon feeding and see what your child does. They often do better feeding themselves finger foods rather than having someone else “dump the lump” into their mouths.
Children should always eat sitting down and not while crawling or walking in order to AVOID CHOKING. Feed them while other family members are also eating. Babies imitate at this age and learn how to eat by watching others.
Finger food sample meals: Breakfast: cereal, pieces of fruit. Lunch: pasta or rice, lentils or beans, cooked vegetables in pieces, pieces of cheese. Dinner: soft meat such as chicken or ground beef, cooked veggies and/or fruit, bits of potato, or cereal. By nine months, kids can eat most of the adult meal at the table, just avoid these choking hazards: raw vegetables, chewy meats, nuts, hot dogs. You can use breast feedings or formula bottles as snacks between meals or with some meals. By this age, it is normal for babies to average 16-24oz of formula daily or 3-4 breast feedings daily.
Avoid fried foods and highly processed foods. Do not buy “toddler meals” which are small versions of adult TV dinners and very high in salt and “fillers.” Lastly, do not give honey before one year of age because honey can cause botulism in infants.
A word about food allergies: Even the allergists lack a definitive answer of what makes a child allergic to a food. A general rule of thumb is that if there is a known food allergy in a family, avoid THAT food as long as you can. If no food allergies run in the family, focus more on avoiding choking hazards (see above) than on potentially allergenic foods. Please refer to our blog post on food allergies for more information.
Julie Kardos, MD and Naline Lai, MD
©2009 Two Peds in a Pod®