Which order should the parents introduce new foods to a 5 month old who is now eating fortified cereal mixed with formula?

As you are likely aware, feeding times provide the nourishments infants need for the rapid growth that occurs between birth and one year old. But did you know that feeding also plays a cooperative role in critical development across all areas (including cognitive, motor, sensory, dentition, and social development)? While parents want to ensure that babies have the nutrients to thrive, it is natural to have questions about the specifics of feeding such as positioning the infant, transitioning to solids, and monitoring safe eating habits. The following guide to a baby’s first year of feeding can help your child get off to a running start in healthy nutrition.

For newborns, breast milk or a pediatrician-recommended formula provides all the nutrition needed.

What Changes Should I Expect from 1 Month Old to 3 Months Old?

Feedings change to adjust to a baby’s growth. As newborns get a little older, they drink more milk during each feeding. As a result, they do not need to feed as often and learn to sleep through the night.

A baby’s appetite also increases during any developmental growth spurt. It is perfectly fine to feed on demand and increase the frequency of feedings if necessary. Babies signify that they have had enough by slowing down during feedings or turning away from the bottle.

Newborns also undergo significant changes in social development during this time. As your baby becomes more alert, expect to hear more cooing and see more smiling. Interacting gently with your child provides security and lays the foundation for future social encounters.

Breastfeeding: How Much and How Often?

As babies grow a few months older, they will need to breastfeed less often in order to sleep longer at night. Although parents naturally express concern about whether their child is eating enough, it is likely that the baby is consuming enough milk if you can confirm the following:

• Baby remains alert, content, and active during the day
• Weight gain and growth remains steady
• Baby regularly feeds at least 6 to 8 times during daylight hours
• Infant wets and soils diapers consistently (indicates digestion)

If an infant does not seem content after feeding or appears irritable more often than normal, the child may not be eating enough. Contact a physician if you feel your baby is not eating enough or deriving nutrients properly from food.

Bowel movements:

Breastfed babies have fewer bowel movements starting at around 3 weeks old. By 2 months old, breastfed babies may not soil diapers after each feeding or every single day. However, you should contact a doctor if your baby has not had a bowel movement in three days.

Bottle-feeding: How Much and How Often?

Infant formula digests more slowly than human breastmilk. As a result, formula-fed babies may have fewer feedings than breastfed babies.

As newborns develop, they learn to eat more formula during feedings and can remain content for longer stretches between feedings. This enables babies to sleep longer at night. For example, a 2-month-old may be able to consume 4 or 5 ounces during every feeding. By 3 months old, you may need to add another ounce to each feeding.

Overfeeding:

It is much easier to overfeed a formula-fed baby since it is easier for babies to drink from a bottle than a breast. To avoid overfeeding, ensure the nipple hole is the right size (the formula should drip from the hole instead of pouring out).

When your baby turns away from the bottle (as he or she would turn away from a breast when finished), there is no need to make the baby finish off the remaining ounces in the bottle.

Finally, you should never prop a bottle. While this might seem easier at first, this practice can cause choking. It also increases the likelihood of ear infections, gum disease, and tooth decay.

What Should I Do About Spit Up?

Newborns sometimes spit up after eating or burping. Small amounts (around 1 oz. or 30 ml) is generally a non-issue if it occurs within one hour of feeding and your baby is fine afterwards.

You may be able to reduce the occurrence of spit ups with the following safe practices:

• Keep infant in semi-upright position during feeding and for one hour following the feeding
• Burp your newborn regularly
• Schedule feedings before your baby becomes extremely hungry
• Avoid overfeeding bottle-fed babies
• Avoid jostling the infant immediately after feedings

Contact your pediatrician if your baby spits up large volumes on a regular basis. If a newborn has a fever or does not wet diapers (a possible sign of dehydration), call a doctor immediately.

Feeding Your Baby from 4 Months Old to 7 Months Old

Pediatricians refer to this exciting stage as the “transition period.” As babies leaves the newborn stage and reaches around 6 months old, they gradually start on solid foods. Since every child is different, experts leave this window open between 4 and 7 months old. Always check with your doctor to ensure readiness before feeding your baby any solid foods.

Is My Baby Ready to Eat Solid Foods?

If you need help on when to ask your doctor about starting on solids, watch for the following signals:

• Tongue-thrust reflex. This natural reflex helps prevent newborns from choking. When a baby is ready for solids, however, the reflex reduces drastically to enable children to swallow food (instead of only liquids).
• Unassisted head support. A child must have good head and neck control in order to eat solid foods without choking. Babies must also be able to sit up on their own.
• Demonstrated interest. Babies who follow food with their eyes or swipe at food during family meals are usually ready to start some solids of their own.

Even if babies’ tongue thrust has diminished and they can hold up their own heads without assistance, parents should not feel alarmed or dismayed if an infant seems uninterested in solids. Simply wait a few days and try again. At this age, breast milk and formula can still fulfill an infant’s primary dietary needs.

How Do I Begin Feeding My Baby Solid Foods?

Once your doctor has given permission, select a time of day that your baby is not overtly tired, cranky, or hungry. Some babies do well if the solid food introduction occurs toward the end of feeding (reduce the usual breast or bottle feeding by an ounce or two in order to introduce the solids).

Support the infant in your lap or upright infant seat. Babies who are at least 6 months old and hold themselves upright can sit in a highchair. Be sure to secure the safety strap.

Doctors typically recommend mixing iron-fortified, single-grain infant cereal mixed gently with breastmilk or infant formula. Using a baby spoon, place a small amount near the infant’s lips. Let them smell or taste the solids. It is normal if a baby rejects or seems uninterested in the solid. Just take time so that the baby grows accustomed to solids as food.

Cereal in bottles:

Do not put cereal into an infant bottle unless advised by a doctor (occasionally for weight gain). Putting cereal in a milk bottle can cause normal-weight infants to become overweight. The cereal can clog or damage nipples eventually. And most importantly, this method does not teach infants anything about the mechanics of eating solid foods.

Beyond cereal:

Once your baby becomes accustomed to eating infant cereal off a spoon, you may transition to pediatrician-recommended, single-ingredient pureed veggies.

What Solid Foods Should I Avoid Giving My Baby?

Foremost, you should talk to a doctor before starting solids. Children have a higher risk of food allergies if there is a family history of allergy conditions like a food group allergy, eczema, asthma, or lactose intolerance.

Studies have also shown that some peanut allergies are related to how early babies receive peanut products. Talk with your physician about the right time to introduce peanut foods to your child.

What are the signs of an allergic reaction?

Potential signs of a food allergy may include the following:

• Rash
• Bloating
• Unusual gassiness
• Fussiness or irritability
• Diarrhea
• Vomiting

If you notice hives or if your baby has trouble breathing after eating, get medical help right away.

Milk and Honey:

For clarification, you should not give cow’s milk to a baby younger than a year old – as it does not provide the nutrients that developing human infants need. In addition, do not give honey to any child under the age of one. Honey contains microscope spores that may cause botulism infants, plus it can also be a choking hazard.

What are Some Additional Tips for Introducing My Baby to Solid Foods?

Once a baby transitions from cereal to pureed veggies, many families elect to purchase commercial baby foods. If you go this route, avoid baby food that contain fillers or added sugar.

Parents who wish to puree their own foods can use the following general guidelines:

• Use a pediatrician-recommended food preparation manual
• Follow important food safety rules (like washing hands and prep areas thoroughly and often) to protect your baby from illnesses
• Bake or steam vegetables before processing (to retain as high nutritional value as possible)
• Freeze unused portions instead of canning them (which can cause the growth of microbes)
• Do not feed infants home-processed spinach, beets, green beans, squash, or carrots before 4 months old. The nitrates in the store-bought versions of these fresh veggies can cause anemia in some infants.

If you have any concerns (especially about textures and types of food), talk to your doctor before making baby food at home.

What About Sippy Cups?

Babies start using sippy cups (durable cups with two large handles and a drinking lid) at around 6 months old. Once you show babies how to hold these cups, they tend to catch on quickly. Always provide 100-percent fruit juice and limit the daily total to 4 fl oz (120 ml). Overdrinking juice can cause weight gain or painful diarrhea.

Feeding Your Baby from 8 Months Old to 12 Months Old

If the last few months were all about the transition period (transitioning a baby from liquid to solid foods), we can refer to the period from 8 to 12 months old as the stage of the table. That is, your baby has adapted to deriving nutrients from infant cereal and veggie purees in addition to the usual breast or formula milk. It is now time to start discovering table foods just like the other members of the family.

Understanding Eating Habits

The basic method for serving a wider variety of foods is to introduce a new food for a few days at a time. As a reminder, do NOT give babies this age honey (can cause botulism in babies and be a choking hazard) or cow’s milk (does not provide adequate nutrients for developing human infants). You can either purchase age-appropriate baby foods or mash/blend homemade foods with the doctor’s permission. Be sure that your baby sits with the rest of the family during meals for social development and learning through observation.

Finger Foods

At around 9 months old, many babes are ready for finger foods. This involves the dexterity and coordination to pinch food between the thumb and forefinger. Always use soft, dietician-recommended foods to prevent any safety hazards.

Leaving Breastmilk or the Bottle:

After a child turns one year old, it is okay to introduce cow’s milk (whole milk) in small amounts. Breastfed babies can continue to drink breastmilk after turning one.

• If a mother decides to stop breastfeeding before a child turns one, parents will need to provide iron-fortified infant formula instead.
• If a child is already over the age of one, it is okay to offer whole milk.
• Serving whole milk in a cup can also help your little one transition from dependence on the bottle.

Understanding Food Safety

Never leave a baby unattended while eating. You should also never serve foods that are choking hazards. These include whole grapes, raisins, hot dogs, raw veggies, hard fruit, white bread, popcorn, hard varieties of cheese, and hard candy.

Unsure about whether foods are baby-safe? Consider the following:

• Dry finger foods like cereals or crackers should be able to melt in the mouth upon contact.
• Any cooked vegetables or fruit should mash easily. Canned or jarred food should also be mashed (avoid commercial foods with added fillers, sugar, or excess salt)
• Choose the soft version of all foods (instead of hard cheese, buy cottage cheese, shredded cheese, or soft tofu)
• Foods should be able to be gummed (even without teeth). Examples include ripe banana and very soft pasta.

Understanding Your Baby’s Food Personality

Every child is different. While children who need sensory stimulation may need you to “play airplane” to eat, other child may simply require face-to-face table interaction with a lot of smiling and encouragement (and minimal external stimulation). If a child resists new food textures that your doctor has already recommended, consider mixing small portions into food that your child already enjoys.

How Much Should My Baby Eat?

Breastmilk or infant formula provide nutritional support for babies up until they turn one year old. However, you should find that babies drink less as derive more nutrients from the table foods they have learned to love.

Just like younger babies turn away from the bottle when full, babies ages 8 months to 12 months tell you they are full by turning away from the spoon, keeping their mouths shut after enough bites, or even spitting the food out. Instead of insisting the baby “finish the plate” now, schedule regular mealtimes so that you can monitor whether your child received adequate nutrients over the course of the day.

In addition, make enough time allowance for your baby to finger-hold the spoon (while you are controlling the actual feeding). This allows you to learn the child’s pace. Finger-holding spoon meals are also like “training wheels” that prepare babies for using their own spoons when they become toddlers.

The Warren Center has many resources available to you ranging from feeding therapy and specialized skills training. Contact us for additional information.