Clinical Reference Systems: Pediatric Advisor 10.0
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AGE FOR STARTING SOLID FOODS

The best time to begin using a spoon to feed your child is when your baby can sit with some support and move his head to participate in the feeding process. This time is usually between 4 and 6 months of age. Breast milk and commercial formulas meet all of your baby's nutritional needs until 4 to 6 months of age. Introducing strained foods earlier just makes feeding more complicated. Research has shown that in most cases solid foods won't help your baby sleep through the night. The only exceptions are those few breast-fed babies who are not getting enough calories or gaining enough weight.

TYPES OF SOLID FOODS

1. Cereals

   Cereals are usually the first solid food added to your baby's diet. Generally these are introduced to formula-fed infants at 4 months of age and to breast-fed infants at 6 months of age.

   Cereals should be fed with a small spoon and never given with formula in the baby's bottle. This is because an infant should be taught to differentiate between what he eats and what he drinks.

   Start with rice cereal, which is less likely to cause allergies than other cereals. Barley and oatmeal may be tried 2 or 3 weeks later. A mixed cereal should be added to your baby's diet only after each kind of cereal in the mixed cereal has been separately introduced.

2. Vegetables and fruit

   Strained or pureed vegetables and fruits are the next solid foods introduced to your baby. The order in which you add vegetables and fruits to your baby's diet is not important. However, you should introduce only one new food at a time and no more than three new foods per week.

3. Meat and protein alternatives

   By 7 to 8 months of age your baby should be ready for strained or pureed meats and protein alternatives (such as beans, peas, lentils, cottage cheese, and yogurt).

4. Possibly allergenic foods

   Egg whites, wheat, peanut butter, fish, and orange juice may be more likely to cause allergies than other solid foods, but this is controversial. Avoid adding these foods to your baby's diet until 1 year of age, especially if your infant has other allergies.

   For more information, see Food Allergies.

SPOON FEEDING

Begin feeding your baby with a spoon at 4 to 6 months of age. Place food on the middle of the tongue. If you place it in front, your child will probably push it back at you. Some infants get off to a better start if you place the spoon between their lips and let them suck off the food.

Some children constantly bat at the spoon or try to hold it while you are trying to feed them. These children need to be distracted with finger foods or given another spoon to hold.

By the time they are 1 year old, most children want to try to feed themselves and can do so with finger foods. By 15 to 18 months of age, most children can feed themselves with a spoon and no longer need a parent's help to eat.

FINGER FOODS

Finger foods are small, bite-size pieces of soft foods. They can be introduced between 9 and 10 months of age or whenever your child develops a pincer grip.

Most babies love to feed themselves. Since most babies will not be able to feed themselves with a spoon until 15 months of age, finger foods keep them actively involved in the feeding process.

Good finger foods are dry cereals (Cheerios, Rice Krispies, etc.), slices of cheese, pieces of scrambled eggs, slices of canned fruit (peaches, pears, or pineapple), slices of soft fresh fruits (especially bananas), crackers, cookies, and breads.

SNACKS

Once your baby goes to three meals a day, or eats at 5-hour intervals, he may need small snacks to tide him over between meals. Most babies begin this pattern between 6 and 9 months of age. The midmorning and midafternoon snack should be a nutritious, nonmilk food. Fruits and dry cereals are recommended. If your child is not hungry at mealtime, cut back on the snacks or eliminate them.

TABLE FOODS

Your child should be eating the same meals you eat by approximately 1 year of age. This assumes that your diet is well balanced and that you carefully dice any foods that would be difficult for your baby to chew. Avoid foods that he could choke on such as raw carrots, candy, peanuts or other nuts, and popcorn. (For more information, see Choking. )

IRON-RICH FOODS

Throughout our lives we need iron in our diet to prevent anemia. Certain foods are especially good sources of iron. Red meats, fish, and poultry are best. Some young children will only eat lunch meats, and the low-fat ones are fine. Adequate iron is also found in iron-enriched cereals, beans of all types, egg yolks, peanut butter, raisins, prune juice, sweet potatoes, and spinach.

VITAMINS

Added vitamins are not necessary after your child is 1 year old and is eating a balanced diet. If he's a picky eater, give him one chewable vitamin pill a week.