The Road to Table Food
Feeding your child during his or her first year of life can be challenging and stressful, especially if you are a first-time parent. But keeping an open mind and an eye on your child are the best ways to make the road to table food an easy path.
Breast milk, formula are primary
Breast milk is the best source of nutrition for infants during their first year, according to the American Academy of Pediatrics (AAP). Formula is the next-best choice, if breast-feeding isn't possible. Solid foods are introduced at 5 to 6 months, but they shouldn't replace breast milk or formula during that time.
Although many nursing mothers worry that starting solids will make their babies less interested in breast milk, the AAP says that if breast-feeding is well established and feedings are frequent, there shouldn't be a problem. Don't be surprised, however, if the frequency of breast-feeding diminishes slightly as solid foods help fill up baby between feedings.
Even if babies begin nursing less frequently, the combination of solids and breast milk is optimal. During the second half of the first year, babies need 750 to 900 calories each day. At least 400 or 500 of those calories, or about 24 ounces, should come from breast milk or formula.
How to start solids
Before starting solids, your child's tongue-thrust reflex should be gone; otherwise, the child will be more likely to push food out of his or her mouth. An infant also needs good head control to hold his or her head in position for eating.
Some pediatricians recommend starting solids as early as 4 months. A baby is less likely to develop food allergies, however, if his gastrointestinal system is given more time to develop.
When you feel it is the appropriate age to start, begin by choosing a comfortable place for the baby to sit. If he or she can sit up, place him in a high chair, which will help him remain upright and reduce the risk of choking.
A good first food is iron-fortified rice cereal, because babies need iron at this age, and rice cereal poses the least risk for allergic reactions. (Iron also is found in breast milk and iron-fortified formula.) Cereal can easily be mixed with breast milk, formula, or water. Mix the cereal to a very thin consistency, or about one tablespoon of cereal to four or five tablespoons of liquid, and adjust the thickness as your baby grows accustomed to swallowing. You don't need to heat the cereal. Keep in mind that babies need more liquid when they start solid foods. The liquid can come from water or extra breast-feedings or formula.
Resist the urge to add fruit juice to cereal. "There is no reason that an infant should be given juice," advises Robert Baker, M.D., Ph.D., a pediatric gastroenterologist in Buffalo, N.Y. "Because many juices are very sweet, babies will prefer juice over breast milk or formula, thus filling up on 'empty' calories."
Fruit juices—or large amounts of fruit, in general—can also make a baby's stool acidic and irritating to the skin, which can cause a painful diaper rash. Drinking juice from a bottle will significantly increase risk for tooth decay.
After rice cereal
Once your baby accepts cereal, you can gradually start introducing him to other foods. You can follow the rice cereal with other types of cereal. Then move on to strained vegetables, fruit, and, finally, ground-up meats.
Starting with vegetables rather than fruit may help your baby become accustomed to the taste. When you start with fruit, your child may get used to the sweet taste and then reject vegetables because they are blander.
Introducing new foods slowly will help you identify a problem if your child develops a reaction, such as vomiting, diarrhea, or rash, to a particular food. "Traditionally, pediatricians have advised parents to start one food at a time, introducing a new food no sooner than every two days," says Dr. Baker.
If your family has a history of severe food allergies, you should keep the label or carton from each new food source and mark it with the date and amount fed to the child. A reaction to food can be the result of not only the food itself, but from the packaging, processing method, or an extra ingredient. If you have documentation and a label, you will be in a better position to explain things to your doctor, and identifying the problem will be easier.
If your child turns his nose up at a certain food or has a mild reaction, such as a stomachache or loose stool, don't force it, but be sure to try it again a few days or weeks later. It's important not to give up completely, because you want to eventually have a good variety of foods on your baby's menu.
Fun with finger foods
Once babies are sitting up, they can be given small finger foods to help them learn how to feed themselves. Food pieces should be soft and easy to swallow. Bananas; well-cooked, mashed vegetables such as green beans, peas and potatoes; and small pieces of wafer-type cookies and crackers are good examples of acceptable foods.
By about 7 or 8 months, most babies will be eating up to three meals a day and consuming about four ounces at each feeding. Soon after, your baby may also be ready to try foods that have a thicker texture, including ground poultry and meat, and other combination meals. Finger foods can also become more varied, including Cheerios, diced cheese, turkey, or pasta, but they must be offered in pieces no larger than the size of a pea.
Use common sense when sharing "table foods" with your baby. Avoid foods with refined sugar, fried foods, and, in particular, foods they can choke on, such as raw vegetables, raisins, grapes, hot dogs, and nuts. Fast food, honey, and chocolate should be avoided completely until your child is at least a year old.
How much food?
Knowing how much your baby should be eating depends on several factors, including weight gain, readiness, and attention span. Because babies are growing so rapidly, their needs can change week by week and day by day. Take your baby for regular "well baby" check-ups so you and your pediatricians can keep an eye on development.
"Every baby is different," explains Dr. Baker, "but appropriate weight gain is a good indication that a baby is getting adequate calories. Most babies are better at fine-tuning their caloric intake than we are at calculating what it should be."
Watching for clues from your baby will be the best way to know when and how much he wants to eat. "It is true that a baby will 'self-regulate' himself on food intake if parents are able and willing to pick up on cues," says Dr. Baker. If he continues to open up and take in what you have to offer in the way of fruits, vegetables, or cereals, keep it coming. (This doesn't apply to desserts. Babies, just like adults, like sweet foods. It's up to you to limit them.) If he pushes the spoon away, shakes his head, or keeps his jaws clamped shut, it's likely he doesn't want or need anymore at the time.
Keeping your baby interested in eating will also be challenging as he learns to crawl and explore. Many times, babies are just too "busy" to eat.
Remember, as your child grows, he or she will follow your example. If you eat a nutritious diet, your growing child will, too.