Nutrition—Infant Food Introduction FAQ’s
When do I start cereal/pureed food?
- The best time to start your baby on solid/strained foods is when they can sit upright, with some support, and voluntarily move their head to engage in the feeding process. This usually occurs when they reach about 4-6 months of age. The American Academy of Pediatrics recommends exclusive breastfeeding or formula until 6 months. Our practice recognizes that some infants may not be able to get all their caloric needs from breast milk or formula and therefore, they may be ready for pureed food sooner. Breast milk or iron-fortified formulas are sufficient to meet all of your baby’s nutritional needs until then. Cereal should be mixed with breast milk or formula, but don’t expect your baby to eat much at first. Most infants will start with either rice cereal or oatmeal (preferred if your infant has infrequent or hard BMs). Start them off with just a few tablespoons and feed them until they look away and no longer appear interested. Initially feedings should occur once daily. The time of day does not matter, but try to feed your child at a time when your household is calm and your child is not over hungry. After 1-2 weeks with one daily feeding, feel free to move to 2 solid feedings a day. Most of the infant’s nutrition should still come from breast milk or formula at this stage.
What should I feed my infant?
- Current recommendations say any single grain, fruit, or vegetable, in whichever order you desire. Only introduce one new food every 3 days (so if your child has an allergic reaction or digestive issue, you can tell what it is from). It does NOT matter in which order you introduce foods. Some people say to start vegetables before fruits so your child doesn’t get a “sweet tooth”, however, there is no scientific evidence to support such claims. Once your child has tried all the different single fruits and vegetables, they can start “stage 2” baby foods which are more combined foods, thicker consistency, and larger volume. At this point, they can be given two to three solid feedings a day. Their formula or breast milk intakes will natural decrease at this time to a range of 20-30oz. per day.
What about juices?
- There is nothing nutritionally necessary in juice. Infants who like juice often become toddlers who only want to drink juice. Excessive juice intake has been linked to a higher likelihood of childhood obesity. Water at age 6 months is okay in small amounts and can be given by Sippy cup, but should not replace formula or breast milk as the drink of choice.
What about protein foods?
- All of the protein that your infant needs is in formula or breast milk. It is not necessary to give your infant pureed meats. You may want to start introducing meats and other protein sources (such as beans, peas, lentils, cottage cheese and yogurt) when your infant is around 8-9 months old.
When do I start introducing finger foods?
- The strength and condition of your baby’s esophagus is reflected in his or her body tone. If your child can sit up well on his own, and “right” himself into an upright position after leaning over, he is probably ready to feed himself. Dissolvable crackers such as “puffs or wagon wheels” can be introduced at about 8 months of age, but you should absolutely NOT walk away from an infant feeding themselves solids at this point. Review your handout on “what to do if your child chokes”. You can begin to introduce finger foods, or small, bite-sized pieces of soft foods, when your baby develops a pincer grasp (finger-thumb pickup), usually around age 8-9 months. Start with dry cereals that are easy to dissolve in saliva. Only put a few pieces on your child’s tray because they often have a tendency to “squirrel” food in their cheeks and you want them to learn to take a piece, chew and then swallow. Other suggestions for table foods include cooked vegetables, beans, soft, cut up meats, rice, eggs, pasta, breads, etc.
When do I move to 3 meals a day plus snacks?
- Most children have an interest in sitting at the table for meals, and have the ability to finger feed by 9 months. This is a good time to introduce them to the family meal routine, and to begin gradually increasing the amount of finger foods and table foods in their diet while decreasing the amount of mashed foods that require a spoon. Encourage Sippy cup (usually with water) use at meal time.
What foods should I avoid?
- Honey should be avoided during the infant’s first year because of its link to infant botulism. Avoid sweet foods and desserts in the first year of life. No sugary drinks should be introduced. Avoid any choking hazard foods (i.e. popcorn, nuts, hard circular pieces of food such as hot dogs, hard carrots, etc.)