ADVANCING THE DIET Starting your infant on solid foods should be an enjoyable experience.  In general, we recommend that you wait until 4-6 months of age and until your baby is drinking more than 32 ounces of formula a day for a week (if bottle feeding) to begin solids.  Contrary to popular belief, feeding solids will not make your baby sleep through the night any sooner.

The following is a list of foods, the sequence in which they should be introduced, and the general amounts that should be offered to your infant.  Please remember that every child is an individual and may require more or less in terms of quantity.  You will find that as your infant increases his solid intake, the formula intake or nursing will naturally decrease. 

Making your own:  You certainly may make your own baby food instead of buying it from the store.  Choose healthy foods, including fruits, vegetables and tender cuts of meat. Thoroughly rinse fruits and vegetables and remove any seeds and stem.  Boil the produce in a small amount of water until it is soft enough to mash. Use a food processor or blender to puree the foods. Homemade foods given before 6 months of age should be strained or sieved before feeding it to your baby. Do not add sugar, salt, strong seasonings, or honey.  You can freeze the food in ice cube trays and defrost it in the refrigerator or microwave oven when you are ready to use it.

So you are ready to begin: Start by offering your child one meal of solid food a day, given at a time when he is most likely to be in a good mood, open to new experiences and moderately but not ravenously hungry.  Usually after naptime works well; make sure it has been at least an hour since the last bottle feeding or nursing.

Baby food can be heated in the microwave but BE CAREFUL.  Since microwaves do not cook evenly, it’s easy to burn a baby with food that is too hot in some spots. If you use the microwave oven, heat only the portion of food you expect baby to eat. Place the food in a small, microwave safe container, cover it, and heat for only a few seconds. Stir the food well and test it with one of your fingers to make sure it isn’t too hot.  When baby has finished eating, discard any unused food.

How much to feed: There is no absolute set time at which additional meals are added to your child’s eating schedule.  Instead, observe his development for clues as to when he is ready for more food. As your child becomes more competent at and eager for eating solids (he anticipates the food by widening his mouth and eyes and keeps at least half of the spoonful of food in his mouth) you may add more meals throughout the day.  At first, your baby will eat only a few tablespoons at a sitting, gradually increasing over time. By the time your baby is 1 year old, he should be eating about 4 to 8 tablespoons of vegetables and fruits, 4 servings of breads and cereals (a serving is ¼ slice of bread or 2 tablespoons of rice, potatoes, or pasta), 2 servings of meat, poultry, or eggs. After his first birthday, if he’s weaned, he’ll begin drinking 16-24 ounces of whole milk per day.  Cereal—Begin with infant rice or oatmeal cereal, mixing one tablespoon of cereal with 4-5 tablespoons of formula or breast milk. It is not unusual for your baby to take only 1-2 teaspoons of cereal in the beginning.  As your baby begins to enjoy the cereal and swallows well, you may increase the amount and thicken the consistency of the cereal. Infants generally take between 2-4 tablespoons of cereal per feeding, but let your child’s appetite be your guide. Barley, mixed and high protein cereals may be introduced after 9 months of age. Using squeezable infant feeders or putting cereal in bottles is not recommended unless we instruct you to do so for medical reasons.

Vegetables --Once your infant’s interest in cereal is well established, usually 2-4 weeks after starting, you may start vegetables. By this point, your infant will probably be eating cereal twice a day. Begin with yellow vegetables (squash, carrots, sweet potatoes). Make sure you leave 4-5 days between every new food you introduce. Again offer your infant 2-4 tablespoons of vegetable in addition to cereal once or twice a day.  After you have introduced all the yellow vegetables, you may try the green vegetables (green beans, peas). Do not use mixed vegetables initially for if your child has a problem with them you will not know which food caused it.  It is best to avoid corn, cabbage, broccoli and other gassy foods until 9-12 months of age.

Fruits—Some fruits such as bananas and applesauce may be introduced with cereal if necessary to entice your baby to eat the cereal.  Generally, use the plain baby fruits without tapioca (pear, applesauce, banana, plum). Again, leave 4-5 days between introducing new foods. Avoid citrus fruits and juices (orange, grapefruit, or pineapple) until 9-12 months of age.

Finger Foods—Once your child is eating baby food well and able or sit up well without support, usually at 6 ½-7 months of age, place her in a highchair and allow her to try to feed herself Cheerios.  When she can accurately get them into her own mouth unaided she is ready for finger foods.  Choose soft foods that she can mash with her gums and cut them into irregular pieces the size of a pea to prevent choking.  The presence or absence of teeth does not matter as your baby can mash soft foods quite well with her gums.  If you can mash the food between your thumb and forefinger it is soft enough to feed to your baby.  You may start exposing your baby to foods from your own table now such as pasta, breads, well cooked meat, mashed potatoes, fresh soft fruit, cooked vegetables and main dishes.

Meats—Start meats when your child starts finger and table foods, at about 7-9 months of age. Use real meat from your own table, not baby food meat, making sure it is well cooked and properly stored according to safe food handling guidelines. As with other table foods make sure it is soft and diced small to prevent choking.  Offer preserved meats such as hotdogs, luncheon meats, bacon, ham and sausages to your child no more than twice a week as they are high in fat, salt and preservatives. Look for the words “nitrate” or “nitrite” on food labels to determine if the meat is preserved.

Juices—The need for and nutritional benefits of juice are widely overestimated, but you may offer some to your child once he is routinely eating meat. Usually 2-4 oz. of juice a day is sufficient. Many infants may not develop a taste for juice until after 9-12 months of age.

Eggs 9-12 months of age

Foods to Avoid: Avoid highly allergenic foods during the first 6-12 months of life such as shellfish, berries, and chocolate. Honey should not be given to your child until 1 year of age as it has been linked to the development of botulism. It is best to avoid peanuts and peanut butter, which can be highly allergenic, during the first 2-3 years of life.  You should never give nuts, seeds, raw carrots, uncut hotdogs, candy, uncut grapes, popcorn or any small hard food that can cause choking.  How much should she eat? Usually at about 7-8 months of age, your baby should be eating 3 times a day, taking 2-3 servings of fruit, 2-3 servings of vegetables, 1-2 servings of meat, and 1-3 servings of starches.  You will find that this is a time of many changes but the externally imposed structure of 3 meals a day will help establish your baby’s nap and play schedules.  Your infant should be eating primarily table food by one year of age. Keep your baby on formula or breast milk until 12 months of age at which time you may introduce whole milk. Never give your baby skim milk.

The “picky eater”: During this process your baby will start to become fiercely independent about feeding. Let him attempt to finger feed himself while you scoop food in his mouth; eventually he will become adept at avoiding even that. Accept the mess on the floor, it’s part of the process.  At 12-14 months, give your child toddler utensils to practice with, but still feed him some yourself as he will get frustrated long before he gets full.  Please remember it is a parent’s job to present their child with healthy, tasty food to eat, but it is not their job to make them eat it.  Do not engage in a battle of wills with your child over eating—you cannot win. Meals should instead be enjoyable, social and peaceful.  Do expose them to new foods and suggest that they try one bite (a “no thank you bite”). Studies show it may take 10-12 exposures to a new food for a child to acquire a taste for it. The presence of a food on the child’s plate implies to the child that the parents wish it to be eaten, so even if your child hasn’t so much as tasted a veggie in 6 months do continue to put some on his plate and briefly encourage one taste. Strike a balance between encouraging new foods and offering the picky toddler or preschooler their favorites.  Do make sure that each meal you present your child with has one food on it you know they will eat.  Young children cannot get all their nutritional and caloric needs in 3 meals a day and must be offered healthy snacks throughout the day.  Babies less then 12 months use nursing or bottle feeding as their primary snacks.  As they grow older the liquid will be replaced by more substantial food.  Pediatric nutritionists often refer to the appropriate approach to feeding infants, toddlers and preschoolers as offering “6 large snacks a day”, that is 3 small meals and 3 large snacks. The volume children eat will often vary greatly day to day based on activity levels and growth spurts.  You should allow your children to determine how much they eat based on their own needs and not coerce them into eating a set volume to please you.  Food, especially sweets and desserts, shouldn’t be used as reward or punishment as this trains children to eat for emotional rather than physiologic reasons.  Avoid salty snacks, sodas and caffeine whenever possible.