By Meri Levy, MFT, CLE
Breast milk or infant formula are adequate to meet all your baby’s nutritional needs until at least four to six months of age. Sometime between four and six months, depending upon your baby’s development, you may want to start introducing solid food. This does not mean that the milk feeding is no longer important. Most of your baby’s nutritional requirements should be met by the milk feeding until he reaches at least nine months to one year.
A full term, healthy baby receiving an adequate supply of milk will start needing iron from other sources by six to nine months of age, and may begin to require calories in addition to breast milk during this timeframe as well. In addition, some babies not started on solids by nine months or later may reject solid foods when offered.
Most babies will develop an interest in food between four and six months. This is the best time to start introducing solids. This is a developmental milestone, and signals that he is ready to begin the next stage of his life, exploring the wonder that is food. By the end of the first year, your baby will be taking 3 meals a day and one or two snacks, sitting at the table, eating table food and drinking from a cup. What a concept!
Breastfed babies tend to digest solid foods better and earlier than bottle-fed babies, because breast milk contains enzymes that help digest fats, proteins and starch. In addition, breastfed babies are exposed to a wide variety of tastes, since the flavors of many foods you eat pass into her milk. So they may more readily accept a variety of food offerings.
When you are starting solids, most parents offer a cereal (such as rice or oatmeal) first, because it can be mixed with breast milk or formula, and therefore has a familiar flavor. The order in which you introduce foods, however, is a matter of choice. It is a good idea to introduce less allergenic foods first, to determine if your baby is highly sensitive, and to introduce one food at a time in the beginning, avoiding salt and other spices. If your baby does not like cereal, try something else. If the baby reaches for the potato on your plate, and he is tolerating foods well, it is fine to give him a little taste, and you can mash some up if he likes it.
Offer your baby the foods that he is interested in, as long as they are not a choking hazard or likely to be allergenic. Common allergens that you should avoid at first are nuts and nut pastes, beans, citrus fruits, strawberries, chocolate, corn, soy (unless your baby is on soy formula), eggs, and wheat. Egg yolks can be introduced at nine months, and egg whites at a year. For the other “no no” foods, use your judgment. If you have a family history of allergy or allergy-related conditions, such as hives, eczema, or asthma, you may want to hold off on these foods until a year, and chocolate and peanuts until age two, but if your baby has tolerated other foods well, introducing small amounts of wheat (after seven to ten months) and other likely allergens can happen earlier. If your baby reacts to something new, take it off his list for a couple of months and try it again with your doctor’s permission. Many food allergies in babies are outgrown fairly quickly.
Don’t worry too much about how much your baby eats, as long as he is tolerating his food well and getting adequate milk. Babies of this age will not overeat, and they will let you know when they want more. Past six months of age, soft foods do not need to be pureed — mashing with a fork is all that is necessary. Relax, feed the baby at your mealtimes, and as he becomes a more accomplished eater of solid foods, offer a greater variety of foods at a sitting.
The easiest way to provide your baby with iron after about five or six months is from meat. Infant cereal has iron, but it may be poorly absorbed, and can cause the baby to be constipated. Using a manual or electric food grinder at this time can be helpful, because it may be a while before your baby can chew meat.
There is no reason to introduce vegetables before fruit, unless you prefer it. Breast milk is far sweeter than fruit; so don’t worry that the baby will take vegetables better if they are introduced before fruit. Your baby will develop likes and dislikes regardless of the order in which you introduce new foods.
RELAX AND LET YOUR BABY BE THE BOSS
Many babies will, as they reach eight or nine months of age, become pickier about what and how they are fed. Your baby may want to feed himself. Offering small pieces of soft finger-foods is fine at this stage. Pull up the rug or put down a tarp and do deep breathing exercises, but respect his autonomy and worry about the mess later.
Feel free to respect your baby’s likes and dislikes, and remember that avoiding power struggles and stress regarding eating is the best way to ensure your baby will be a good eater (although temperament controls in this regard). There is no one food that is essential to your babies health (except the milk feeding). If there’s a food you prepare often that you would like him to enjoy, offer it occasionally, but don’t make it a big deal.
OFFERING SOLIDS OR THE BREAST FIRST
Many parent worry about offering the milk feeding or the solid foods first. To start out, if your baby is hungry, offer the breast or bottle first. This will make him more relaxed during his initial solid food adventures. Your baby doesn’t know that this stuff is food yet! After that, if breastfeeding or bottle-feeding and the introduction of solid foods both are going well, it is not necessary that they be provided in a specific order.
As long as the baby continues to take four to six milk feedings a day (three to four feedings by nine months, about 24-32oz of formula, if bottle feeding), there is no reason that a baby needs both breast or bottle and solids every time he eats. As the baby approaches one year, the milk feedings may drop off to two to four a day. You may also offer a cup of water during solid feedings, since many babies enjoy water at this stage. Don’t bother with sugary juices if your baby is happy with water: there’s plenty of time for those later! If your baby is breastfed, tap water (filtered if necessary) will provide your baby with some fluoride, which can help prevent cavities (juice does the opposite, of course).
Most of all, enjoy your baby’s discovery of food, and make mealtime as fun and relaxing as possible. Your job is to provide your baby with healthy food offerings, and his job is to eat what and how much he likes. It’s one of those small but important steps along his long path to independence.
Starting Solid Foods, c. 2000, Jack Newman, MD, FRCPC, www.keepkidshealthy.com.
Child of Mine: Feeding With Love and Good Sense, c. 2000, Ellyn Satter, Bull Publishing Company.