CORONAVIRUS: WHAT DO I NEED TO KNOW? READ BELOW
Parents are often looking for exact instructions on how to feed their infant. There are none. You should learn your child’s cues for being hungry and satisfied and feed accordingly. Your child’s growth chart should act as a reflection on how you are doing.
Infants 0-4 months of age should receive their complete nutrition in the form of infant formula or breast milk. Do NOT use low iron formulas. Iron is important for brain growth. If your child is constipated, discuss treatment with your doctor.
The best time to begin starting solid/strained foods and using a spoon, is when your baby can sit with some support and voluntarily move his head to engage in the feeding process. This usually occurs between 4-6 months of age. From a nutritional standpoint, breast milk or iron-fortified formulas meet all of your baby’s needs until this age. The American Academy of Pediatrics no longer recommends exclusively starting with cereal. If you choose to do so, cereal can be mixed with breast milk or formula. You can also skip cereal and start with fruits, veggies or protein. Start with a few tablespoons at first. Feed him until he looks away and is no longer interested. Initially solid feedings should be once daily. The time of day does not matter; feed your child at a time during the day when your household is calm. It is easier to learn new things in a calm environment. After a few weeks of once daily, feel free to move to 2 solid feedings a day, but not more. Most of the infant’s nutrition should still come from breast milk/formula at this 4-6 months.
Whether you start with fruits, veggies, cereals or protein is really a personal preference. 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”. In our experience that doesn’t make a difference, but some believe it is easier to digest orange veggies like squash, before some green veggies like spinach. The only “rules” about foods at this age are: wait 1-2 days between introducing new foods (so if your child has a reaction, you can tell what it is from), do not give more than 2 solid meals per day, and consider using a food that has iron in it (iron fortified cereal or meats) as iron is related to brain growth. A good rule of thumb during the first year of life, is 2-4 tablespoons (1-2 ounces ) of each kind of food per meal. If your child is still hungry after that amount, feed her more.
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 4-6 months is okay in small amounts, but should not replace formula/breast milk as the drink of choice. Orange and tomato juices can be started at 9 months of age.
Your baby’s esophagus tone is reflected in his body tone. You want your child to sit up well on his own, and be able to “right” himself into an upright position after leaning over, before you give him something to feed himself on his own. Crackers/infant teething biscuits can often be introduced at about 7-8 months of age. Do NOT walk away from an infant feeding solids at this point. If they get a big piece in their mouth, be prepared to “swipe” it out with your finger. You should review your handout on “what to do if your child chokes”. Finger foods are small, bite size pieces of soft foods. You may begin finger foods when your baby develops a pincer grasp (finger-thumb pickup), which usually happens around age 8-9 months. Start with dry cereals that are easy to dissolve in saliva (Cheerios are hard to beat). 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 and then swallow.
Most children have an interest in sitting at the table for meals, and have the ability to finger feed at age 9 months. This is a good time to introduce them to the family meal routine, and begin gradually increasing the amount of finger foods/table foods and decreasing the amount of mashed foods that require a spoon.
Honey should be avoided until age 1 year because of its link to infant botulism.
Earlier recommendations about delaying foods with nuts, including peanut butter, eggs and shellfish have been changed. In fact, we believe we may have been making food allergies worse by delaying introduction. Most children should be exposed to peanut butter, peanut powder or peanut containing foods by 6 months of age. For young children, you can mix peanut butter in pureed fruits to moisten and/or add a small amount of warm water to make smooth/thinner. If your child tolerates the nut products, introduce 1/2 tsp three times per week to avoid building up an intolerance or allergy. Do NOT use nuts themselves as they are a choking hazard. If your child has severe eczema, speak to us before trying. It's also a good idea to have Benadryl (diphyenhydramine) at home in case of hives or an allergic reaction. Always call our office if your child is experiencing what you believe is an allergic reaction, or call 911 if they are experiencing trouble breathing.
Avoid sweet foods and desserts in the first year of life, including chocolate.
Orange juice is no longer restricted because the rash orange juice sometimes causes around the mouth is from an oil in the orange peel, it is not a true food allergy.