• When does a baby need solid foods?
• Getting started
• Which foods?
• How much and how often?
• Finger and table foods
• Allergenic foods
• Additional advice

When does a baby need solid foods?

In general, most babies do not nutritionally need solid foods until 6 months old. Babies under 4 months of age usually are not developmentally ready to eat; a tongue-thrust reflex pushes any foreign substance, food included, right back out.

Signs of readiness include:

• Baby's weight has more than doubled since birth and is more than 13 pounds


• Baby seems hungry after 8-10 breast feedings or drinks more than 35 ounces of formula per day


• Baby can push self up with straight elbows


• Baby can sit with support and have control of head movements

Introduction of solid foods before four months is often influenced by social pressure - well-meaning relatives, how other infants are being fed, and the false belief that feeding solid food will help infants sleep through the night. The disadvantages of early introduction of solid food include increased tendency toward allergic reactions to food if they are introduced before four months and increased tendency toward obesity.
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Getting started

Introduce solids at a time of day when your baby is not too sleepy, fussy or hungry to be interested in something new. You might nurse him/her a bit or give him/her some of his/her bottle before putting him/her in a sitting position with his/her back supported in an infant seat or on your lap. (An infant might not sit well in a high chair until 7 or 8 months old). Place small tastes on the tip of a small spoon and place in the baby's mouth. Solids should be offered on a spoon and not given in a bottle since it is important for your baby to experience handling different textures or he/she might have trouble eating well later on.

The first few meals are a developmental learning process. Your baby's first tries at swallowing food may be awkward but will improve with practice. Initially your baby may only eat one or two teaspoonfuls of solid food for an entire feeding.
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Which foods?

Start with a single-ingredient, pureed, strained healthful food such as a single-grain cereal (avoid wheat) mixed with breast milk or formula, single fruit or single vegetable. An advantage of starting with cereal is that infant cereals are iron-fortified and by 6 months old, most babies have almost depleted the store of iron they were born with. Almost all fruits and vegetables, except bananas and avocados, must be cooked in the first few months.

Introduce each new food one at a time and wait three to five days before introducing the next new food. If your baby initially rejects a new taste, mixing it with a food your baby already knows may help your baby to adjust to accept a new taste. After each new food, watch for signs of a food allergy which might include a rash around the mouth or on the bottom, diarrhea, vomiting, general fussiness, nasal congestion or wheezing. Since all of these symptoms may also be due to causes other than food tolerance, simply withhold that food for several weeks and try it again when your baby is well.

You may choose to buy commercial baby food or prepare your own foods. Generally, start with single-ingredient pureed food as found in first-stage selections. Second-stage foods are appropriate after six months and third-stage foods can be given after eight or nine months. Your baby does not need meats or additional sources of protein before nine months and by that age is often ready for table foods.
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How much and how often?

During the first few weeks of introducing solids, start with one feeding a day and do not expect your baby to eat more than a few teaspoonfuls of food. Generally by 6 to 7 months of age, your baby will be ready for two solid feedings a day and advance to three solid feeds in a day by 8 to 9 months of age.

At each meal allow your baby to eat as much food as he/she wants. Your baby will tell you if he/she is still interested in eating more by smiling, reaching toward the spoon and opening his/her mouth. If he/she happily consumes everything you offer, continue feeding. When he/she has had enough, he/she will keep his/her mouth closed or turn his/her head. Never force your baby to eat more or finish a bowl.

In the first six months of life, formula or breast milk provides all the calories and nutrients an infant needs. As the quantity of solid foods increases in the second half of the first year, the quantity of breast milk and formula will gradually decrease. By eight or nine months most babies will drink 16-24 ounces of formula or breast milk per day.

Try to respect your child's cues that he/she is full or disinterested in more food as you respect his/her cues that he/she is hungry. Your baby knows best how much food he/she needs. Emotionally stable children do not voluntarily starve themselves. Starting in the second half of the first year and even more so after the first birthday, your child's rate of growth decelerates and many parents become unnecessarily concerned about how seemingly little their child consumes or erratic his/her appetite may be. Remember that eating disorders and obesity are two of the most important nutritional problems in our country. Not only will the quantity of food vary, but so will your child's food preferences. Do not become concerned if your child seems to dislike all vegetables or another category of foods for awhile. This is typical in the first few years and your child will soon change his/her mind if meals are an enjoyable time for your child.
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Finger and table foods

When a baby can sit well and pick up things and chew and swallow, he/she is ready for finger foods.

Often at 6 to 7 months you can start with finger foods that are large, hard and primarily "gummed." Such initial foods include teething biscuits, day-old bagels or day-old crusty breads such as heel-end of French bread, baguette or French roll.

When your baby is able to pick up pieces of food with his/her fingers and put it in his/her mouth, he/she is ready for a wider selection of finger and table foods. Even if your baby does not have teeth, he/she can mash foods with his/her gums.

By 9 months your baby may be ready for coarser foods such as crackers, zwieback toast, cheerios, puffed rice cereal as well as cooked or mashed foods (potatoes, carrots, peas, sweet potatoes) or small chunks of well-cooked vegetables or soft fresh fruits such as slices of banana, ripe pears, melons and peaches (consider canned fruits when fresh fruits are not in season). Other table foods include rice, pasta, toast, tofu, beans, lentils, ground meats and tender pieces of chicken.

As you introduce the more allergenic foods (please see below), consider pancakes, waffles, French toast, eggs, yogurt, cottage cheese (or other soft or melted cheese) and fish.

Some infants prefer finger and table foods once introduced and will be entirely on table foods by 9 to 12 months. Other babies show no interest in table foods and will stay on baby foods until after the first birthday. Generally by 15 to 18 months most babies are no longer eating baby foods.

As you offer finger foods to your baby, you need to be especially aware of the potential for choking. Foods that should never be given to a baby or young child include hard candies, nuts, popcorn, chips, celery, large pieces of raw carrot or raw apple, melon balls, whole grapes, large pieces of meat and round slices of hot dog (cut into bites).

Once your baby is able to pick up foods and put them in his/her mouth, encourage your baby to feed him/herself initially with fingers and eventually with a spoon and child's fork. Establish the routine of providing water, juice, formula and eventually milk only in a cup at mealtime and with snacks after 9 months of age. He/she will probably not able to manage a cup by him/herself until closer to 12 months and after.
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Allergenic foods

When introducing foods in the first few months, you can choose in order almost any cereal, fruit or vegetable you desire with few exceptions. Some foods are highly allergenic and should not be introduced until your child is somewhat older to minimize the development of food allergies later on. Such foods are listed below and it is best to wait until at least 9 months before trying them. If you have a family history of allergies, it is advisable to avoid these foods until 12 months.

• Citrus fruits such as orange juice, grapefruit juice, lemonade


• Strawberries, raspberries, pineapple


• Tomato or tomato sauce


• Milk or milk products such as cottage cheese, yogurt, ice cream


• Whole eggs or egg whites


• Chocolate


• Nuts, such as peanut butter


• Wheat


• Fish, especially shellfish

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Additional advice

1. Unless your baby will finish the whole jar, do not feed directly from the jar. Discard any food left in bowl after the meal.


2. After opening a jar of food or juice, refrigerate the unused portion. Started jars will keep for up to two to three days.


3. When preparing your own foods, do not add salt, sugar or honey. Initially, foods will need to be pureed and strained and can be frozen in an ice cube tray so you can thaw out a portion at a time for future meals. Eventually your baby will be able to share meals with you by grinding cooked potatoes, rice, pasta, vegetables and even meats in a baby food grinder or food processor. Spices such as garlic, curry and pepper are fine and may actually encourage many "picky" eaters to eat. In some parts of the country, beets, turnips, carrots and collard greens such as spinach are not safe for babies since they contain large amounts of nitrates which can cause anemia in babies. You may consider buying commercial food for these particular vegetables as manufacturers use crops with low levels of nitrates.


4. Do not give honey or foods made from honey to a baby under 1 year old. Honey can contain the organism that causes botulism, and a baby's immune system is not able to fend off this severe bacterium.


5. Your baby's bowel patterns and the appearance of stool will likely change with the introduction of solid foods. Some foods are only partially digested and appear in the stool almost recognizable. This is not a problem and will resolve as the digestive system matures. Some foods such as rice cereal, bananas and applesauce tend to be more constipating. To balance this effect, you might offer some of the fruits that begin with the letter "P", such as prunes, pears, peaches, plums, apricots, or additional water or juices.


6. After 6 months you may wish to introduce a cup with water or juice. By 9 months your baby should be using a cup at mealtime and snack times, and by 12 months having only two to three bottles of formula or milk per day in addition to the cup. A baby can be weaned entirely from the bottle to a cup after 12 months without compromising nutrition or fluid intake. There is no longer a strong need for sucking. The hardest bottles to eliminate are those associated with sleep time, first thing in the morning, or those given for the convenience of the parent or caretaker.


7. Juices, just as with any new food, can be introduced anytime after 4 to 6 months. Juices are essential as a nutritional supplement to your baby's diet. Juices should be offered in a cup, not a bottle, and can be diluted with water. Too much juice may be harmful if it replaces formula or milk or solid foods. Water is healthy for your baby and can be offered at any age in a bottle or cup.


8. Your baby should remain on breast milk or formula until 1 year of age. Although your baby may be exposed to dairy products or milk in foods (for example, mashed potatoes) between 9 to 12 months, whole milk can entirely replace breast milk or formula after the first birthday. Low fat milk (2 pecent) can be used after age 2 years.

For additional information, please visit

Keepkidshealthy.com or

Kidshealth.org

Please remember that this advice is for educational purposes and should only be used as a guide.
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