Solid Foods (Baby Foods)

• When and how to start solid foods (baby foods) in infants
• When and how to start finger foods and table foods
• How to prevent food allergies

Foods to Avoid for Babies

• Honey. Never give your child honey during the first year of life. Reason: rarely, it can cause infant botulism, a muscle weakness disease.
• Cow's milk (whole milk). Do not give during the first year of life. Reason: in some babies, it can cause a low iron level (anemia). Cow's milk formulas are fine.
• High-risk Foods for Choking. Do not give any foods your child might choke on. Some high-risk foods are grapes and hot dogs. These may block the airway and cause sudden death. Raw vegetables (like carrots) and peanuts should also be avoided until 4 years old. Reason: Young children can't chew them and they could be inhaled into the lungs. Also, avoid large pieces of any sticky food (such as peanut butter).
• Heavy metals in trace amounts are found in some baby foods. The tiny amounts eaten are harmless. They can’t be completely avoided. Reason: heavy metals are normally present in the soil and water (AAP).

Iron-Rich Foods

• We all need iron in our diet to prevent anemia. Certain foods are very good sources of iron. Red meats, fish, and poultry are best.
• Lunch meats are also a good choice. Children may eat ham or turkey slices if they won't eat other meats.
• Other good iron sources are iron-enriched cereals and beans of all types. Egg yolks and peanut butter are iron-rich. Other good foods are plum juice and dark leafy greens. After age 4, raisins and other dried fruits can be offered.

Vitamins: When They Are Needed

• Formula-fed babies get all the vitamins they need from formula.
• Breast-fed babies need extra vitamin D. Start 400 units per day at 2 weeks of age. Vitamin D drops can be found in most drug stores.
• After your child is 1 and eating a balanced diet, added vitamins are usually not needed.
• If your child is a picky eater, give him 1 chewable vitamin pill. Do this at least twice a week. Gummy vitamins are not as helpful. Reason: they have all the vitamins, but not the minerals.

Contact Doctor During Office Hours

• Age greater than 9 months and your child refuses most solid foods
• Your child is losing weight
• Feeding problem occurs often
• Feeding problem doesn't improve with this care advice
• You think your child needs to be seen for their feeding problem
• You have other questions or concerns

Self Care at Home

• Solid foods (baby foods), when to start
• Finger foods and table foods, when to start
• Food allergies, how to prevent

Care Advice

Solid Foods (Baby Foods) - When to Start

1. Baby Foods - When to Start:
   • Baby foods are strained or pureed foods.
   • They are called solid foods only because they are not liquids.
   • Breast milk or formula meet all of your baby's diet needs until 6 months or longer. Starting strained foods earlier just makes feeding harder.
   • The American Academy of Pediatrics (AAP) recommends feeding only breast milk for 6 months.
   • For formula-fed infants, the AAP recommends starting baby foods around 6 months.
   • Which baby foods you start first is not important. Just start one new food at a time.
   • Try to wait 3 days in between starting a new baby food. Reason: that way if your baby has diarrhea or a rash, you might know what caused it.
2. Spoon Feeding - When to Start:
   • Do not start spoon feeding until your baby has the following physical skills:
   • Can sit with some support in a high chair or feeding seat.
   • Can hold his head steady.
   • Has strong neck muscles and good head support.
   • Knows to open the mouth at the sight of food.
3. How to Spoon Feed:
   • Teaching your baby to take food off a spoon and swallow takes time.
   • Use a small baby spoon.
   • Put the spoon just inside the mouth. Wait for your baby to close his mouth around it.
   • Then slowly pull the spoon straight out while he sucks the food off the spoon. The upper lip and sucking will keep most of the food inside.
   • You can add a little milk to make it thinner and easier to suck.
   • Some babies need to drink a little milk first if acting really hungry.
   • Some children will grab at the spoon. Others try to hold it while you are trying to feed them. These children need to be distracted. Use finger foods or give them another spoon to play with.
   • By 15 to 18 months of age, most children can use a spoon on their own. They no longer need your help to eat. The spoon now belongs to them.
4. Avoid Gagging:
   • Gagging means you need to slow down. Give smoother foods or smaller amounts. It may mean that you need to delay starting solids.
   • Most babies need to be 6 months old before they can easily swallow purees.
   • Gagging is a good body reflex. It keeps food from getting into the airway. It also prevents choking.
5. How Much to Give:
   • Start with a small amount on the spoon. At first, your baby may just want a taste. Slowly work up to larger portions after your baby wants more.
   • During the first year, 2 to 4 tablespoons (1 to 2 ounces) is a normal amount for each kind of food.
   • If your child is still hungry after eating that amount, serve them more.
   • If your baby doesn't like a new food, stop. You can tell because they spit it out. They may also refuse to open their mouth after a taste. Don't offer that food again for a few weeks.
6. Start New Foods One at a Time:
   • The order of which baby foods you start first is not that important.
   • Try to wait 3 days in between before starting a new food. That way if your baby has diarrhea or a rash, you might know what caused it.
   • Most parents start with rice, barley or oatmeal cereal. A mixed cereal should be added to your baby's diet later. (Note: Add only after each cereal type in the mixed cereal has been tried by itself.)
   • Next, give strained or pureed vegetables and fruits to your baby.
   • After that, give strained or pureed protein-rich foods. Do this by 8 months at the latest. Other protein-rich foods include eggs, beans and peas. These solids can add to your infant's iron intake.
   • Between 8 and 12 months of age, start mashed table foods. They can have small chunks of food in them. They are also called stage 3 foods or junior foods.
7. Call Your Doctor If:
   • Your child won't eat baby foods
   • You think your baby has a food allergy
   • You think your child needs to be seen
   • You have other questions or concerns

Finger Foods and Table Foods - When to Start

1. Finger Foods - When to Start:
   • Finger foods are small, bite-size pieces of soft foods.
   • They can be started when your child develops a pincer grip. That means your child can pick objects up between the thumb and first finger. A pincer grip most often starts between 9 and 10 months.
   • Most babies love to feed themselves. Most babies will not be able to feed themselves with a spoon until 15 months. Finger foods keep your baby actively involved in the feeding process.
   • Favorite finger foods are dry cereals (Cheerios, Rice Krispies, etc.). Others are small pieces of soft cheese or scrambled eggs. Canned fruit (peaches or pears) or bananas are also good if cut into small pieces. Other choices are crackers, cookies, and breads. Be sure to include peanut-flavored Cheerios or puffs.
2. Snacks - When to Start:
   • Once your baby goes to 3 main meals a day, offer a small snack. This will help tide them over between meals.
   • Most babies begin this pattern between 6 and 9 months of age.
   • The midmorning and midafternoon snack should be a healthy non-milk food.
   • Fruits and dry cereals are good choices.
   • If your child is not hungry at mealtime, cut back on snacks or stop them.
3. Table Foods - When to Start:
   • Your child should be eating the same meals you eat by about 1 year.
   • This assumes that your diet is a well-balanced one. Avoid added salt.
   • Carefully chop up any foods that would be hard for your baby to chew.
   • Mash up some foods with a fork.
   • Avoid foods that he could choke on. Examples are raw carrots, candy, peanuts, and popcorn. These foods should not be given.
4. Call Your Doctor If:
   • Your child won't eat baby foods
   • You think your baby has a food allergy
   • You think your child needs to be seen
   • You have other questions or concerns

Food Allergies - How to Prevent

1. Preventing Food Allergies by An Early Start of High-risk Foods:
   • The advice for preventing food allergies has changed in recent years (AAP).
   • Current advice: start high-risk foods after 6 months of age. Begin with normal solid foods like cereals for a few weeks. Add new foods one at a time. Try to wait 3 days before starting another.
   • Eggs can be mashed up. Peanuts can be given as peanut-containing puffs. If peanut butter is used, it must be mixed into baby foods in small amounts. Continue with eggs and peanut-containing puffs at least weekly.
   • If your child has severe eczema, talk with your child’s doctor first before starting high-risk foods.
   • Early introduction of these foods reduces the risk of food allergies.
2. Avoiding High-risk Foods does not Prevent Allergic Disease:
   • Most allergic diseases such as food allergies, eczema, and asthma cannot be prevented by diet.
   • Probably helpful: Breast milk only for 6 months or longer
   • Not helpful: Diet limits on any foods for pregnant or breastfeeding women
   • Not helpful: Soy formulas instead of cow's milk formula
   • Not helpful: Delaying the start of solids past 6 months
   • Not helpful: Delaying the start of high-risk foods (such as peanut butter or eggs)
   • Resource: AAP Section on Allergy and Immunology Report.
3. Call Your Doctor If:
   • You have other questions or concerns