Feeding our children is as much an art as it is a science. There may be many different methods, books, or suggestions that you will encounter, but ultimately each child is an individual who may not go “by the book”. The following bullet points can serve as a foundation upon which to build your food introduction routine as they are derived from the body of scientific evidence we currently have.
These recommendations can serve as guidelines, not hard and fast rules, to support you and help you avoid common pitfalls.
- Honey, whole milk, and foods that are choking hazards are the only foods to be avoided prior to one year old. Honey can be poisonous. Whole milk in large quantities can lead to anemia. Foods that cannot be mashed easily with your fingers or that are round or cylindrical are unsafe even after one year of age.
- Food should be introduced between four and six months of age. However, babies do not need anything but breast milk or formula until they are six months old. Waiting until six months avoids unnecessary work and allows babies time to become more receptive to foods with less gagging and tongue thrusting. Some six-month-old babies can even skip purees and begin with soft finger foods if they can sit upright, hold their head up well, and bring pieces of food to their mouth.
- It is not necessary to wait three days between food introductions to detect a food allergy. Allergic reactions can occur unpredictably even after many exposures to a certain food. Also, most allergic reactions will manifest within a few hours of ingestion. In addition, allergy tests can usually confirm any suspicion of food allergy.
- Early exposure to foods may reduce the risk of food allergies. The old recommendation to delay egg, fish, and foods containing peanut protein until after 1 year of age is not based on good science. In babies with severe eczema, allergy testing may be recommended before attempting certain foods such as peanuts; however, in most children preemptive testing is not necessary. Ask your doctor if you would like further guidance on this.
- The order of food introduction is not critical. Traditionally in the USA, many parents start with rice cereal and then other grains. However, there is no medical reason to proceed in a certain order. For example, in some cultures babies eat meat as a first food. Many experts support this idea as meat provides nutritional elements that cereal cannot.
- Consider ignoring your baby’s food preferences. They are quite fickle and sometimes need to taste a food more than 40 times before suddenly liking it. Similarly, they will suddenly reject a favorite food for several months only to like it again later on. Repeated introductions of varied, nutritious foods will yield better nutrition and eventually a broader palate.
- Do not soothe with food or drink. Consider using something else such as a toy, lovey, or an interactive distraction. Teaching a child that food is for comfort could lead to long-term bad habits and unhealthy ideas about food.
- After one year old, monitor for liquids intruding on solid food intake. If your baby is having five wet diaper per day, they are adequately hydrated. If they are thirsty, offer sips of water between meals from a cup. Limit juices to less than five total ounces per day diluted to 50% with water, juices are best regarded as a desert-like food.
- Eat together. Doing so will foster making your baby even more a part of the family routine. Babies are more likely to eat foods they see their family members eating. These are the foods already deliberately chosen to optimize the health and enjoyment of the entire family long term. Let’s bring the babies on board as soon as they are ready. Also, the regular family eating intervals help to foster self-regulation and reduce overeating.
The goals of solid food introduction are:
- Overall, to transition a baby from formula or breast milk to a predominantly solid food diet.
- By nine months, to have your baby consuming foods from all of the food groups at three-four meals per day with the rest of the family.
- By one year of age, to have them eating varied and nutritious solid foods from the family table at regular intervals and drinking no more than 24 ounces of whole milk per day.
Because infants begin their life on breast milk, parents often think that milk is essential for their child’s diet even beyond the first year of life. While milk is absolutely important for the first few months of life, once babies can start eating solids, the value of milk (breast, formula, or cow’s) quickly diminishes. Milk’s main purpose is to serve as an easy source of nutrition for our babies until they are ready for solid foods that offer a far greater diversity of nutrition.
By one year of age, the bulk of a child’s nutrition should come from solid foods. Ideally, babies should eat a well-balanced diet from all of the food groups. A one year old should be taking no more than 20 ounces of milk per day (transitioning from formula, if applicable). As long as they are eating an adequate diet of animal-source foods (such as meat, poultry, fish, eggs, and milk), a minimum of only seven ounces per day is recommended. Most organizations do not even specify a recommended lower limit of milk intake. Although milk does offer vitamin D and calcium, you can get plenty of vitamin D from the sun and all the calcium you need from meat, certain vegetables, soy, nuts, beans and other solid foods.
While there are many baby foods available at the supermarket, feel free to offer bite size portions of soft foods that the rest of the family is eating. Foods such as pastas, baked potatoes, soft meats, and steamed vegetables are all safe, nutritious, and tasty for babies to consume as soon as they can chew well.
The more flavors and textures children encounter early on, the less picky they will be later! So go ahead and give them a bite of your dinner. They are probably eyeing you as you eat it and wondering where their portion is! As long as you can mash a food between your pointer finger and thumb, a baby’s gums, even with no teeth, are powerful and can handle it. The sooner they are eating real foods, the sooner you can cook one meal and make your life easier. Ultimately, if it is nutritious for you, it is nutritious for them.
So how should you incorporate the solid foods into your current feeding schedule? The truth is there is no singular best way, but here is one method. Pick one meal to begin with such as the feeding closest to breakfast time. Before giving formula or breast milk, start by allowing your baby to eat as much solid food as they will take. When they will no longer take any more solids, top them off with formula or breast milk until they are full. Once they seem to have the hang of one meal, add a second around lunchtime, and soon thereafter a third around dinnertime. Some babies will need an afternoon or morning snack, which you can make like a fourth small meal if necessary. It is that simple!