Switching to Solid Foods

Recommendations and practices of feeding solid foods to infants vary greatly. The following guidelines are from the American Academy of Pediatrics.

 

When can my baby begin solid foods?

Can he hold his head up? Your baby should be able to sit in a high chair, feeding chair, or infant seat with good head control.

Does he open his mouth when food comes his way? Babies may be ready if they watch you eating, reach for your food, and seem eager to be fed.

Can he move food from a spoon to his throat? If you offer a spoon of rice cereal and he pushes it out of his mouth and it dribbles on his chin, he may not have the ability to move it to the back of his mouth to swallow. Try diluting it the first few times, then gradually thicken the texture. You may need to wait a week or two and try again.

Is he big enough? Generally, when an infant doubles their birth weight (typically around four months of age) and weighs about 13 pounds, they may be ready for solid foods.

 

NOTE: The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.

 

How do I feed my baby?

Start with half a spoonful or less and talk your baby through the process (“Mmm, see how good this is?”). Your baby may not know what to do at first. He may look confused, wrinkle his nose, roll the food around his mouth or reject it altogether.

One way to make eating solids the first time easier is to give your baby a little breast milk and/or formula first, then switch to very small half-spoonfuls of food, and finish with more breast milk and/or formula. This will prevent your baby from getting frustrated when he is very hungry.

Do not be surprised if most of the first few solid-food feedings wind up on your baby’s face, hands, and bib. Increase the amount of food gradually, with just a teaspoonful or two to start. This allows your baby time to learn how to swallow solids.

Do not make your baby eat if he cries or turns away when you feed him. Go back to nursing or bottle-feeding exclusively for a time before trying again. Remember that starting solid foods is a gradual process and at first your baby will still be getting most of his nutrition from breast milk and/or formula.

Never put baby cereal in a bottle because your baby could choke. It may also increase the amount of food your baby eats, causing him to gain too much weight. However, cereal in a bottle may be recommended if your baby has reflux.

Which foods should I give my baby first?

For most babies, it does not matter what the first solid foods are. By tradition, single-grain cereals are usually introduced first. However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby.

Babies are born with a preference for sweets, and the order of introducing foods does not change this. For this reason, it may be easier to start yellow vegetables before fruits. If you do it the other way around, there is no evidence that your baby will develop a dislike for vegetables.

Baby cereals are available premixed in individual containers or dry, to which you can add breast mill, formula, or water. Whatever type of cereal you use, make sure that it is made for babies and is iron-fortified.

When can my baby try other foods?

Once your baby leans to eat one food, gradually give him other foods. Give your baby one new food at a time, and wait at least 2 to 3 days before starting another. After each new food, watch for any allergic reactions such as diarrhea, rash, or vomiting. If any of these occur, stop using the new food and call the office.

Generally, meats and vegetables contain more nutrients per serving that fruits and cereals, it is alright to try eggs and fish after the first six months. There is no evidence that introducing these nutrient-dense foods after 6 months of age increases the likelihood of allergic reactions.

Within a few months of starting solid foods, your baby’s diet should include a variety of foods each day that may include the following:

  • Breast milk/formula
  • Cereal
  • Fruits
  • Vegetables
  • Meats
  • Eggs
  • Fish

NOTE: If you make your own baby food, be aware that home-prepared spinach, beets, green beans, squash and carrots are not good choices during early infancy. They may contain large amounts of nitrates. Nitrates are chemicals that can cause an unusual type of anemia (low blood count) in young babies. Commercially prepared vegetables are safer because manufacturers test for nitrates. Peas, corn, and sweet potatoes are better choices for home-prepared baby foods.

When can I give my baby finger foods?

Once your baby can sit up and bring his hands or other objects to his mouth, you can give him finger foods to help him learn to feed himself. To avoid choking, make sure anything you give your baby is soft, easy to swallow, and cut into small pieces. Some examples include:

  • Small pieces of banana
  • Wafer-type cookies or crackers
  • Scrambled eggs
  • Well cooked pasta
  • Well cooked chicken finely chopped
  • Well cooked and cut up yellow squash, peas and potatoes

At each of your baby’s daily means, he should be eating about 4 ounces, or the amount of one small jar of strained baby food. If he takes less, never force him to finish the full amount. Limit giving you baby foods that are made for adults. These foods often contain more salt and other preservatives.

If you want to give your baby fresh food, use a blender or food processor, or just mash softer foods with a fork. All fresh foods should be cooked with no added salt or seasoning. Though you can feed your baby raw bananas (mashed), most other fruits and vegetables should be cooked until they are soft. Refrigerate any food you do not use, and look for any signs of spoilage before giving it to your baby. Fresh foods are not bacteria-free, so they will spoil much more quickly than food from a can or jar.

NOTE: do not give your baby any foods that require chewing at this age. Do not give any food that can be choking hazards, including hot dogs (including meat sticks or “baby food hot dogs”); nuts and seeds; chunks of peanut butter; raw vegetables; fruit chunks, such as apple chunks; and hard, gooey, or sticky candy. Chocolate, peanuts, peanut butter, and shellfish should be avoided to minimize the chance of an allergic reaction.

Honey should never be given to a child less than 12 months of age. Doing so may cause your child to become quite sick with an illness called Botulism.

What about my baby’s liquid nutritional needs?

Milk – All infants must be kept on breast milk or commercially prepared infant formula until 12 months of age. This is necessary to provide the proper amount of vitamins, nutrients and fat for proper growth and early brain development. With your doctor’s approval, whole milk is introduced at 1 year of age; and 2% milk no sooner than 2 years of age.

Juices – Juices can be introduced when the infant can drink from a cup. Sucking juice from a bottle for prolonged periods of time or propping a bottle in an infant’s mouth while sleeping puts your infant at risk for developing “nursing bottle cavities”. Infant 100% fruit juices or adult 100% fruit juices (diluted 50/50 with water) are acceptable. Give no more than 4 oz. of undiluted juice mixed with 4 oz. of water (8 oz. total volume) per day.

Water – When solid foods are introduced, additional water is frequently needed, particularly during the hot summer weather. Infants should be offered water as part of a feeding to allow them the opportunity to fulfill their fluid needs without an increased intake of calories.

Can I use my microwave oven to warm foods?

Microwave heating is very uneven. A jar that feels cool can contain pockets of food at scalding temperatures. Food must be stirred thoroughly after heating to even out the temperature. Never heat a jar with the lid fully closed. It may explode! Never place any type of metal or foil container in the microwave. Never microwave breast milk. Be sure to check the temperature of the food heated in the microwave oven to make sure it is not too hot before it is given to your infant.

What changes can I expect after my baby starts solid?

When your baby starts eating solid foods, his stools will become more solid and variable in color. Because of the added sugars and fats, they will have a much stronger odor too. Peas and other green vegetables may turn the stool a deep-green color; beets may make it red. (Beets sometimes make the urine red as well.) If your baby’s meals are not strained, his stools may contain undigested pieces of food, especially hulls of peas and corn, and the skin of tomatoes or other vegetables. All of this is normal.

Your baby’s digestive system is still immature and needs time before it can fully process these new foods. If the stools are extremely loose, watery, or full of mucus; however, it may mean the digestive tract is irritated. In this case, reduce the amount of solids and introduce them more slowly. If the stools continue to be loose, watery, or full of mucus, call the office.

Good eating habits start early.

It is important for your baby to get used to the process of eating – sitting up, taking food from a spoon, resting between bites, and stopping when full. These early experiences will help your child learn good eating habits throughout life.

Encourage family means from the first feeding. When you can, the whole family should eat together. Research suggests that having dinner together as a family on a regular basis has positive effects on the development of children.

Remember to offer a good variety of healthy foods that are rich in the nutrients your child needs. Watch your child for cues that he has had enough to eat. Do not overfeed! If you have any questions please call your doctor.

 

Helpful Timeline:

  • Approximately 5 months old: start with baby cereal. Mix 1 tablespoon (15ml) of iron-fortified baby cereal with 4-5 tablespoons (60-75 ml) of breast milk or formula. Most parents start with rice cereal, barley, or oatmeal. Even if the cereal barely thickens the liquid, you must feed it with a spoon, not a bottle. Help your baby sit upright and offer the cereal with the small spoon once or twice a day. Once your baby gets the hang of swallowing runny cereal, mix it with less liquid so it starts to get thicker. Some babies get the hang of it in a few days, others in a week or two. Continue with the cereals until you are confident that your baby has mastered the skill.
  • Approximately 5-6 months old: add pureed foods. Once your baby masters cereal, we gradually start to introduce other foods. Traditionally we start with vegetables, then move to fruits, and finally meats. Initially, they must be very finely pureed, to a consistency similar to the thickened cereal. Once your baby gets better at eating, we can gradually thicken up the purees. We recommend offering single-ingredient foods at first, and waiting three days between each new food. That way if your baby has a reaction to a particular food, such as diarrhea, rash, or vomiting – we will know exactly which food it was.
  • Approximately 8-9 months old: offer finely chopped finger foods. By now, most babies can handle some finger foods. Many parents like to start with puffs or mum-mum crackers, which will dissolve in their mouths once they eat them. You can also offer small portions of finely chopped finger foods, such as soft fruits, well cooked pasta, graham crackers, and ground meat. Around this age, it is also typically safe to introduce dairy products such as cheese and yogurt.
  • Age 9-12 months old: more table foods. As your baby approaches his or her first birthday, mashed or chopped versions of whatever the rest of the family is eating will become your baby’s main fare. We also start to recommend trying some of the more allergenic foods around this time, such as eggs, fish, and small amounts of peanut butter. It is a good idea to have some liquid Diphenhydramine (Benadryl) available when trying these foods so you can administer an age-appropriate dose in case of an allergic reaction, of course in addition to calling your pediatrician as well. If there is a family history of food allergy, please consult with your pediatrician prior to trying any of these more allergy-prone foods. In addition, this is a great age to get comfortable with sippy cups, as we move away from bottles, and start them drinking water on a daily basis.
  • Age 12 months and older: eating like a toddler. Your child should now be eating most table foods and be mostly done with baby foods. Bottles should be stopped around this age, and formula can be switched to whole milk for most children. Continue to be aware of foods that are at a high risk of choking and avoid them, such as nuts, whole grapes, uncut hot dogs, hard candy, etc.