by Scholten A

IMAGE Your beautiful baby is about 4 months old now, and you are beginning to think about the transition to solid foods. But you are not quite sure when and what you should feed your little darling. Worse, you have visions of mashed peas being hurled through the air, covering your hair, and hitting the floor and the walls.

Breast milk or fortified formula are the only foods your baby needs for the first 4-6 months. Breast milk or formula should remain the core of the baby's diet for the first year of life.

Your baby's development partly determines when they are ready to begin eating solid foods. Most babies are ready to begin solid foods at about 6 month of age. Starting solids sooner than 4 months could put the baby at risk.

Solid foods may be slowly introduced if your baby:

  • Is able to sit up with little support, and head/neck movement is more coordinated
  • Is interested in the foods you are eating
  • Does not push food out of their mouth with the tongue
  • Is able to pull forward when food is wanted and push away when full

Eating From a Spoon

Your baby should learn to eat semisolid and solid foods from a spoon and with fingers. Never give your baby semisolid or solid foods from a bottle or infant-feeder because the baby could choke or take in too much food at once. Eating from a spoon and with fingers is the first step toward independence and will help your baby develop chewing and swallowing skills.

Here are some tips that can help you and your baby make an easier transition:

  • Do not expect the experience to be neat. —It is quite likely that more food may end up on the bib than in your baby's mouth, at least at first. Relax and try to make this an enjoyable experience for both of you. Talk calmly and softy to your baby while feeding.
  • Use a very small spoon, one that is meant for babies. —A small spoon with a long handle is preferable. You can find them at most grocery and department stores.
  • Start with only a small amount of food and work up to more. —Begin with no more than 1-2 teaspoons of food at a time and gradually work your way up to 1-2 tablespoons, 2-3 times per day.
  • Make sure your baby is sitting up straight and leaning somewhat forward. —This position allows your baby to swallow more easily and minimizes the risk of choking.
  • Let your baby set the pace of eating. —Do not feed too slow or too fast. Introduce only one new food at a time, at the beginning of the meal. Introduce new foods when your baby is most hungry. Otherwise, they may not be interested.
  • Try, try again. —If your baby refuses a new food, do not force the issue. Be patient. Offer it again in a day or 2. If you are still met with resistance, try again in 2-3 weeks.
  • When do I stop feeding them —During a meal do not try and give more food after your baby seem satisfied. Allow them to feed themselves with their fingers or a spoon as soon as they are able to. These can both prevent overfeeding

What to Feed Your Baby

Offer single component foods, such as cereals, vegetables, fruits, and meat rather than combination foods. Also, wait a few days before introducing new foods. This will allow you to see any signs of a food allergy and to know which food caused them.

Talk to your child's doctor about when to offer highly allergenic foods, such as tree nuts and eggs. Offering them early may reduce the risk of a food allergy.

Meats

Introduce strained lean meats—one at a time. Offer a variety of pureed or finely chopped meats, including chicken, beef, and turkey.

Cereal

Iron-fortified infant cereals are easy to digest and help meet your baby's iron requirements. They are frequently the first foods that a baby eats. Cereal should be thin at first—one part cereal to four parts breast milk or infant formula. Your baby will be ready for thicker cereal as eating skills develop.

Do not use cow's milk to mix cereal because it lacks important nutritional elements, such as iron and vitamin C and may be difficult for babies to digest. Give only about one teaspoon of cereal twice per day, at first, and then gradually increase to 2-3 tablespoons twice per day. Other grain products such as rice, soft breads, cooked pasta, and teething biscuits can be added a little later.

Fruits and Vegetables

Introduce strained fruits and vegetables one at a time.

Signs of Food Allergy

Signs of food allergy may include:

  • Diarrhea
  • Stomach discomfort
  • Vomiting
  • Spitting up
  • Wheezing
  • Skin rash
  • Hives
  • Swelling of the lips, tongue, and mouth

Extreme and life-threatening allergic reactions are rare but include difficulty breathing, swelling in the throat, decreased blood pressure, and passing out.

Try Smooth Foods First

Your baby will be able to eat mashed or finely chopped foods when you see teeth appear and detect chewing motions. As teeth grow in, you can introduce finger foods, such as cooked vegetables and soft fruit without seeds or a peel.

Offer a Variety of Foods

Eating a variety of foods will help your baby have a well-balanced diet and develop good eating habits for the future. Also, be sure to offer your baby foods that vary in color and texture.

Avoid Foods That Could Cause Choking

Babies less than 3-4 years old should not eat small, hard foods, such as chips, pretzels, raw carrots, celery, raisins, popcorn, snack puffs, nuts, or seeds. Large pieces of food should also be avoided— whole grapes, hotdogs, sausages, and large or tough pieces of meat and poultry. Also try and avoid candy, cough drops, and chewing gum.

Do Not Add Sugar, Salt, or Other Seasoning

Babies do not need added sugar, salt, or seasonings. They need to develop a taste for the natural flavor of foods. Avoid adding seasonings to your baby's food. If you buy commercially-prepared baby food, read the label to make sure sugar, salt, and seasonings are not added.

Other Tips

  • After your baby is eating a well-balanced variety of solid foods (generally after the first year of life) you can consider using cow's milk. The pediatrician can help you with nutritional advice.
  • Offer juice in a cup rather than in a bottle. It helps reduce the risk of tooth decay.
  • If warming food in a microwave, use a microwave-safe dish and heat to lukewarm.
  • Always read and follow instructions on containers of baby food.
  • Do not feed your baby directly from the jar or you could risk contaminating the leftover food. Spoon small amounts of food into a feeding dish and feed your baby from it. If your baby wants more food, take more from the jar with a clean spoon.
  • Date, label, and refrigerate leftovers immediately after each feeding. Use all leftovers within 3 days.
  • Leftovers should not be reheated more than once.
  • Do not use raw honey or corn syrup. In babies, they can cause a serious food-borne illness called botulism.
  • Never leave your baby alone during mealtime.
  • If you feel that your baby is not eating enough, call their pediatrician.

RESOURCES

Eat Right—American Academy of Nutrition and Dietetics  http://www.eatright.org 

Healthy Children—American Academy of Pediatrics  http://www.healthychildren.org 

CANADIAN RESOURCES

About Kids Health—The Hospital for Sick Children  http://www.aboutkidshealth.ca 

Dietitians of Canada  http://www.dietitians.ca 

References

Dos and don'ts for baby's first foods. American Academy of Nutrition and Dietetics Eat Right website. Available at: http://www.eatright.org/resource/food/nutrition/eating-as-a-family/dos-and-donts-for-babys-first-foods. Updated October 5, 2016. Accessed October 16, 2017.

Food allergy. EBSCO DynaMed web site. Available at: http://www.ebscohost.com/dynamed. Updated September 28, 2015. Accessed December 2, 2015.

Heartsaver First Aid With CPR AED—Classroom. American Heart Association. Available at: http://www.heart.org/HEARTORG/CPRAndECC/WorkplaceTraining/HeartsaverCourses/Heartsaver-First-Aid-With-CPR-AED%5FUCM%5F303778%5FArticle.jsp#.Vl8KpE2FPIU. Updated September 2, 2014. Accessed October 16, 2017.

Switching to solid foods. American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-To-Solid-Foods.aspx. Updated November 21, 2015. Accessed October 16, 2017.

Working together: American Academy of Pediatrics Healthy Children website. Breastfeeding and solid foods. Available at: https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Working-Together-Breastfeeding-and-Solid-Foods.aspx. Updated November 21, 2015. Accessed October 16, 2017.

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