Introducing solid foods: What you need to know

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Does your baby reach for food at the dinner table? Is he or she still
hungry after regular feedings? These may be signs that your baby is
ready to start eating some solid food. But don't retire those bottles or
nursing bras just yet — you could be rushing the process.

Before they're 3 to 4 months old, babies automatically push out their
tongues when anything enters their mouths. This reaction, called the
extrusion reflex, is essential for breast-feeding and bottle-feeding, and
it indicates that infants can swallow only liquids. Even after losing
the extrusion reflex, though, babies lack the coordination to move food
from the front of their mouths to the back for swallowing. They start
to develop that ability between 4 and 6 months of age. That's also when
they start sitting with support and holding up their heads.

Is your baby ready?

If your 4-month-old needs more frequent breast-feedings or gets hungry
between bottles of formula, it may be time to experiment with the first
solid food. Start with 1 teaspoon of a single-grain, iron-fortified
baby cereal — rice is recommended most often because it's least likely to
provoke allergy — mixed with 4 to 5 teaspoons of warm water, formula or
breast milk. Signs that your baby is ready to go forward with solid
food include:

· Watching the food on a spoon and opening
his or her mouth to receive it

· Closing his or her lips over the spoon

· Keeping most of the food in his or her
mouth and then swallowing it

Some babies take to their cereal with gusto right from the start.
Others are less enthusiastic. And still others should wait a month or more
for medical reasons. It may be a good idea to hold off for a while if:

· Food allergies run in your family

· Your baby was born prematurely

· Your baby wants nothing to do with cereal
the first time you offer it

Whether your baby is 4, 5 or 6 months old when he or she first eats
cereal, one thing you shouldn't do is introduce it by mixing it in a
bottle. Even if the cereal barely thickens the milk or formula, swallowing
it requires different reflexes from swallowing liquid. A baby who hasn't
had any practice swallowing solids may gag on clumps of cereal from a
bottle and risk inhaling (aspirating) some of it. A less frightening but
still undesirable effect is overfeeding — cereal adds unneeded calories
to formula or milk.

What to serve when

The switch from an all-milk diet to a mixed diet doesn't happen
overnight. These guidelines lay out the order in which you should introduce
new foods and provide general age ranges for starting different foods.
The age ranges overlap because babies make the transition to solids at
very different rates.

Solid food guidelines



4 to 8 months

6 to 9 months

9 to 12 months

What texture or consistency?

Semiliquid at first; gradually add less liquid for a semisolid
consistency

Soft foods and some finger foods that dissolve easily

Finger foods and most table foods

How much?

1 or 2 teaspoons at first; gradually increase as your baby gets older

3 to 4 tablespoons of semisolid foods; bite-sized pieces of soft foods

Small, bite-sized portions

How often?

One to two times a day

Two to three times a day

Three times a day

What specific foods?

Iron-fortified baby cereal (usually rice)

Mashed bananas

Applesauce

Cottage cheese

Graham crackers

Mashed potatoes

Ground meat or poultry

Apples, peeled and cut in eighths

Soft cheese

Well-cooked noodles

Spaghetti with meat sauce

Tender meats, such as tuna, chicken or turkey

The first time your baby encounters cereal, he or she may frown,
sputter or spit it out. This isn't because the cereal tastes bad, but because
your baby is unfamiliar with the new flavor, texture and consistency.
If he or she gets the hang of cereal over the course of a couple of
weeks, try out some strained fruits or vegetables. Introduce only one new
food a week so that you can quickly identify any food that disagrees
with your baby.

If you're wary of food additives and preservatives, you may want to
prepare all your baby's food yourself. Is such homemade baby food better
than the kind you buy? Not necessarily. Commercially prepared baby food
is nutritionally balanced and free of added salt and sugar. Also,
popping open a jar is more convenient than cooking and pureeing fruit,
vegetables and meat. On the other hand, foods you've prepared yourself are
likely to be less expensive, and you have complete control of what goes
into them.

At any rate, home-cooked or store-bought doesn't have to be an
either-or decision. Many parents start their babies on commercial foods and
gradually phase in more and more items from the family table. Or they
prepare their babies' food themselves when they're at home and use jars
only when traveling. By the time your baby is feeding him- or herself — at
around 10 to 12 months of age — you no longer need to worry about
special food preparation. With the exception of hard or slippery foods and
other items that easily cause choking, your baby can eat the same things
you eat, provided you cut solids such as meat into very small pieces.

Be sure to dish out servings of baby food rather than feed your baby
straight from a jar. Bacteria and saliva from the spoon act quickly to
spoil the food remaining in the jar.

Mealtime tips

Once your baby moves beyond breast-feeding or bottle-feeding, you'll
find that mealtimes quickly become an adventure — for both you and your
baby. Here are some suggestions to help ease your baby's transition to
solid foods.

Eliminate distractions during mealtimes as much as possible. At the
same time, expect that feeding your baby solid foods will take more time
than breast-feeding or bottle-feeding. Your baby will stop between bites
and spend a lot of time feeling and playing with food. When the play is
taking more time than the feeding, your baby may be letting you know he
or she is full.

Let your baby use his or her fingers and hands. Babies learn about food
by exploring it with their hands as well as their mouths. Although it's
messy, this exploration is the first step toward self-feeding. When
your baby gets interested in the tactile experience of eating, add a
little rice cereal to strained fruits and vegetables to make them less
watery and easier to grasp. You may also offer suitable finger foods, such
as diced apples.

Gradually introduce the spoon and cup at 6 to 9 months. Don't worry if
you're not successful — children learn to use utensils at different
ages. Here are some tips for starting out:

· Let your child hold one spoon while you
feed him or her with another one. Once your child figures out how to hold
a spoon, dip it in food and let him or her try self-feeding.

· Use a drinking cup with a lid, spout and
easy-to-grasp handles — sometimes called a sipper or sippy cup — and put
only a couple of ounces of fluid in it. Your baby's first taste of
fruit juice should, ideally, come from a cup. According to the American
Academy of Pediatrics (AAP), juice should be limited to 4 to 6 ounces a
day and drunk only from a cup, not a bottle. The AAP also recommends
leaving juice off your baby's menu until he or she is 6 months old.

· Even if your baby uses a cup at mealtimes,
you may choose to continue breast-feeding or using a bottle for
supplemental feedings. Feeding your baby breast milk or formula from a cup at
mealtime may pave the way for weaning later.

Use a highchair as soon as your baby can sit easily without support. To
safely use a highchair:

· Select a chair with a broad, stable base
that won't tip easily.

· Use the safety straps every time you put
your baby in the chair.

· Keep other children from pulling, climbing
or hanging on to the highchair.

· Place the highchair a safe distance from
the counter, table or any other stationary object your baby could push
against forcefully enough to tip himself or herself over.

Give your baby enough time to finish each meal. Most babies are full
after 20 minutes of mealtime, including several minutes of exploring
their food and socializing with the person feeding them. When your baby has
had enough to eat, he or she will refuse the spoon with mouth closed or
face turned away. Follow his or her lead, and never try to force in a
few more bites.

Safety tips

Some foods, because they cause choking or are otherwise potentially
harmful, should stay off limits for all children under 3. The worst
offenders for choking include:

· Small, slippery foods such as hard candy,
whole grapes and hot dogs

· Dry foods that are hard to chew, such as
popcorn, raw carrots and nuts

· Sticky or tough foods, such as peanut
butter or large pieces of meat

Foods that may cause illness in a baby include:

· Honey. Either straight or as an ingredient
in a processed product, honey may contain spores that can grow in the
intestinal tract and cause botulism poisoning in babies less than 12
months old.

· Certain home-prepared vegetables.
Home-canned spinach, beets, turnips, or collard greens may contain an unsafe
level of acidic compounds from soil (nitrates) for babies. Nitrates in
food can cause a disorder of the red blood cells in babies less than 6
months old.

· Cow's milk. Babies fed cow's milk before
they're 12 months old are more likely to have allergic reactions to it.
They also risk developing iron deficiency anemia.

Keep it fun

If you find it hard to tolerate messiness and disorder, your baby's
first adventures with solid food can be distressing. Try not to worry. In
time, your baby's fruit-smeared tray, gooey hands and sticky face won't
bother you at all. As babies learn to feed themselves and share family
meals, they also start developing attitudes about eating. If you can
avoid food-related power struggles and remain relaxed and affectionate at
mealtime, your baby will have the foundation for a lifetime of healthy
eating.


By Mayo Clinic staff

PR00029

July 01, 2004

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