Parents often cannot wait to start giving their infant solids. Trying new foods with your child is very exciting, but where to start? More accurately, the first question should be when to start.
Whether your child is breast or formula-fed, the earliest you can try solids is at four months of age. When we start solids, we give them with a spoon, so your baby needs to be able to sit up with support and hold her head up on her own. Putting baby food in a bottle is not recommended, and cereal in a bottle is only recommended in certain instances.
Infant cereal is often the first food pediatricians suggest. Again, this will be fed with a spoon, not from a bottle. Instructions are on the package, but here are the basics:
• Start by mixing a little cereal with some breastmilk or formula and offering your baby a few spoonsful. Be patient! Your baby has never eaten this way before, so it may take 1-2 weeks of a few spoonsful every day before she will accept the spoon and swallow the cereal.
• Cereal is especially good for breastfed babies because it contains iron. Formula is fortified with iron, but iron absorption from breastmilk is poor and around six months of age, breastfed babies’ iron levels will start to decline. Infant cereal helps meet this nutritional gap.
• Once your baby is doing well with taking cereal, you will likely want to move on to other foods. NOTE: Your baby does not need any foods other than formula or breastmilk for the first six months.
Start with one food at a time and give the same thing for at least three days before trying a different food. This is in case your baby has some type of negative reaction. If you gave a few new foods and something happened, you would not know what caused the reaction.
STAGE 1 FOODS:
SINGLE INGREDIENT PUREES
These can be bought in the baby aisle or you can make them. The important thing is that they are single ingredient purees. For example, if you want to give a puree of cooked squash, it would just be squash, no other ingredients, not even seasoning! It used to be that new parents were advised to start with vegetables, thinking that if you start with fruit, your baby will become accustomed to food that tastes sweet and will reject vegetables. However, many first vegetables, such as sweet potato and peas, also have a sweet taste.
STAGE 2 FOODS:
SMALL FINGER FOODS
As you advance your baby’s diet, she will eventually be able to eat different textures together and will have fun feeding herself small finger foods, such as Cheerios or puffs. This typically takes place around 9 months.
By this point, you will likely start giving your baby some table foods and you may be wondering what the recommendations are regarding foods that are often associated with allergic reactions, such as peanuts.
Experts have found that avoiding allergenic foods for too long is often associated with developing an allergy and that early introduction of these foods is linked with allergy prevention. Where pediatricians had been recommending waiting to introduce some of these foods until one year of age or later, that is no longer the case. Of course, no foods that pose a choking hazard should be given to infants or even toddlers, such as nuts, grapes, chunks of cheese, pieces of hot dog, etc. So, you may give something with peanut in it, such as a peanut powder, but not the nut itself. The only food that should not be given before one year of age is honey, and that is not because of an allergy concern, but because of the risk of Botulism.
Food pouches have become popular recently for their convenience, but they are not the best way to routinely feed your child. Children need to learn how to eat different textures of food, so sucking food from a pouch is not ideal. Some parents believe they are the best way to give their child fruits and vegetables missing from their diet, but your best strategy is to continue offering your child a variety of fruits and veggies. Although they will often initially reject them, with persistence, most children will embrace a varied diet.
Naturally, every baby’s needs and readiness for solids is different. Speak with your pediatrician at the four-month well-check for recommendations tailored to your baby.
Dr. Jennie Hurwitz Tabakin is a board-certified pediatrician at Sentara Pediatric Physicians in Virginia Beach. She believes in creating a caring and sensitive relationship with her patients and their parents in order to communicate more easily with them about their health. Some of her clinical interests include health literacy and health communication.