Stapleton Pediatrics Blog

Baby’s first foods – the when, the what and the how?

Baby’s first foods – the when, the what and the how?
 
For many families starting with “solids” – or anything other than breast and bottle can be daunting with an overwhelming amount of info/theories/strategies.  Here is a summary and some tips…
 
The When
     The American Academy of Pediatrics (AAP) recommends starting solids between 4 and 6 months of age, but it also advocates exclusive breastfeeding for the first 6 months.  This is done to encourage breastfeeding; I suggest to parents that each baby has their own timeline.  A timeline with these specific signs of readiness:
  1. Your baby has good head control and can sit with support (in a high chair for example)
  2. Your baby is grabbing things with their hands and bringing them to her mouth
  3. Your baby is showing interest, watching you eat and opening her mouth when she sees food, and may be still hungry after a bottle or breast. 
     Similarly, your baby will tell you if she is not ready– she will turn away, thrust out her tongue or it will just all dribble out.  No problem, try again in a week or two. 
 
The What
     There is no true recommendation on which foods to start first (despite what grandma says).  I usually recommend baby cereal because you can mix it with breast milk or formula (a taste not new to baby).  For breast-fed infants, cereals are iron fortified to make up for the decrease in breast-milk iron at this stage (iron is added to formula).  Another option is to start your baby on iron drops at this age if breast fed (Discuss this with your provider at your chils's well check). 
 
     After eating baby cereal, veggies and meats are an excellent choice as they are more calorically dense than fruits, but feel free just to try what is in season or in the house.  Avoid added salt or sugar, but spices are fine to try.    
 
     Food allergies are a common concern when determining baby’s first foods. The incidence of food allergies has been on the rise, but a recent study suggests introducing these allergenic foods to your baby early and often.  These allergenic foods include wheat, soy, egg, fish/shellfish, peanuts/tree nuts and cow’s milk.  Make sure to go one new food every 2-3 days and watch for food allergies (vomiting, rash, diarrhea).
 
     You may be saying, “Wait, Dr. Nicki but how do you introduce these?” Well remember I said I am a fan of the iron-fortified cereals? The multigrain ones have wheat. Beyond that you can add a spoonful of peanut butter or nut butter to cereals (it works great if you heat it up a bit first).  You can easily add some smashed up scrambled egg or egg yolk.  Fish is flaky and very easy to crush and add to any veggie puree.  Lastly, whole fat yogurt is available at the store. 
 
     As your baby is able to self finger feed, it becomes easier, small smashable pieces of most foods (besides honey and choking hazards) can be offered. 
 
     Don’t forget – breast milk or formula is still the main calories for your baby and amount taken from bottle/breast will not decrease until consuming three meals per day (closer 9-12 months). No water until 6 months, and no juice!
 
The How
     Okay – So you have a happy and a little hungry (maybe 1-2 hours post milk/formula) baby sitting up in her high chair/your lap/floor to prevent choking.  Prepare for a mess (baby feeding is not for the faint of heart) – bib, plastic floor mat, damp cloth.  I prefer to try these foods in the evening, right before bath time. Start with thinner and less dense mixtures until you and baby are getting the hang of it. 
 
     Your baby will make some great faces, good and bad, but go slow and your baby will tell you when she’s done.  Leaning or turning away, fussing, closing lips are all indicators that your baby is done.  Don’t forget to try foods again, as it may take 10-20 times for a baby to get used to a flavor – though I think my kid will never take to kiwi no matter how hard I try.  There are some great lists out there on Pinterest to make sure your baby is getting a variety... just search.    
 
Resources:
 
https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf
 
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx
 
www.fisher-price.com/en_US/parenting-articles/nutrition-and-feeding/when-to-give-a-baby-cereal
Posted: 3/7/2017 6:56:28 PM by Stapleton Peds | with 0 comments


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