When you begin to feed your baby something other than breastmilk or formula, also known as complementary foods, it is an exciting and fun time. Don’t get too bogged down by the exact details, such as how much or what “stage,” and try to have fun. Don’t be afraid of messes, and let your baby try a food at least 10 times before you “table” it for another month.
When do we start?
You can give your baby complementary foods any time between 4 and 6 months (adjusted for premature babies). Before that, you increase the risk of gastrointestinal infections (this includes rice cereal in the bottle – just don’t do it); and if you wait too far past 6 months, some babies can develop oral aversions. Some babies need a little more time in the beginning – make sure she can hold her head up well and that she doesn’t push the food out repeatedly with her tongue. But 4-6 months is a big window, and when you and your baby seem ready, get started with a pureed fruit or vegetable.
What do we give the baby?
Start with a single ingredient, pureed fruit or vegetable. This is a “Stage 1” food, which you can make, by mixing breastmilk, formula, or water with a food like avocado, sweet potato, or banana. Introduce a new ingredient every 3-5 days, so you have time to see if the baby has a sensitivity to an ingredient; some reactions are delayed, and you may just see diarrhea, a rash, or an eczema flare. After you see that the baby has no reaction, you can freely give her this ingredient, even mix it with other foods she has already had. You can give cereal, but it does not have to be a first food. Cereal has iron in it, and can help prevent anemia in the young child. If your child does have a reaction to a food, discuss it with someone in our office, and we can help you decide if you can reintroduce the food sometime in the future.
When do we feed our baby, and how often?
When you first start feeding your baby complementary foods, you will probably just start once a day. Any time of day is fine, but dinnertime is often fun, when everyone is together and experiencing their meal together. As your baby becomes more interested in eating, you will find it difficult to eat in front of him without him wanting “in on the action” and soon you will be feeding him every time you sit down to eat (breakfast, lunch, and dinner). Feed your baby food before you give him breastmilk or formula. This will ensure that you have a hungry, interested baby. Also, as the baby eats more food, he will eat less milk and naturally start the weaning process.
How much do we give?
This is a difficult one – at first you will start with a few tastes. If your baby seems to LOVE the food, you can give her as much as she wants – unless it’s the first time you give it to her. Give her a few tastes at first, to look for an allergic reaction. You will soon notice when your child is satiated, or done – she will start throwing her food off her high chair, or turning away. Try to teach your child the sign language for “all done.” This can be a great tool for a preverbal child. Also try to eat in a calm, quiet environment. Children often stop eating when they are distracted or overwhelmed.
When can we expand his palate to something beyond fruits and veggies?
You can start to give your baby more foods about 1-2 months into his eating adventure. And you can give him just about everything – simple 1 ingredient meat, bean, fish, cheese, peanut butter, egg, yogurt. Just no honey until 1 year old. Again, once your baby has had an ingredient without a reaction, you can mix it with other ingredients, so you can give him table food and your own recipes. Avoid heavily salted foods – our culture eats too much salt, and we pass it to our babies. We know what you are thinking – fish, eggs, peanut butter?? Yes, this is another recent change in recommendations – we have found that if you introduce some of these historically allergenic foods sooner, it doesn’t cause more allergies and it may even be protective against the development of food allergies.
What about texture, consistency, and “baby led weaning?”
There is no magic age to increase on the texture of foods, but generally start with smooth foods and you can start to introduce thicker foods as tolerated. Your baby may gag on new textures, but this is different from choking. Always sit with your baby while he is eating. If you are interested in baby led weaning, check out the website on the bottom of this page.
Can we give water or juice?
After 6 months, you can give your baby water to drink, in addition to his breastmilk or formula, but avoid juice. Juice just adds extra sugar and calories with little to no added nutritional value. If you do give juice, only give 100% juice – no fruit punch, soda, sports drinks or juice drinks, which often have excessive amounts of added sugar. Pay close attention to all ingredient labels.
Are there any needed vitamins/supplements?
Currently, the only recommended supplement for children is Vitamin D 400 IU/day until 1 year old (and beyond if they are not taking in sufficient amounts in their diet). Also check with your water company to find out if she will need a fluoride supplement. A multivitamin is not necessary for most healthy children. If you decide to give vitamins, avoid gummies – they get stuck in teeth!
When can we give…
pureed food – 4-6 months
table food – 6-8 months
water in a sip cup – 6 months
cow’s milk products like yogurt or cheese (not milk to drink) – 7-8 months
meat, eggs, beans, grains, fish, bread, peanut butter, cheese – 6-8 months
honey – 1 year
cow’s milk to drink – 1 year
Use this time to shape your child and family into healthy eaters! Babies can have such a positive influence on an entire family! Think of what they eat – fruits/veggies and minimally processed, low sodium, whole foods like plain beans/grains/meats/yogurt/cheese (unless we offer less healthy/overly processed choices- so get them off to a good start early on). Plus, they only eat when they are hungry (better than most adults!).
AAP recommendations: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-To-Solid-Foods.aspx
For details on quantity: http://m.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/feeding_guide_for_the_first_year_90,P02209/
Baby-led weaning: http://www.thebump.com/a/baby-led-weaning