Starting Solids

A Guide for Parents and Child Care Providers  

Click here to view/print the "Appropriate Foods Chart"

Infants' nutritional needs are met completely through breast milk or iron-fortified infant formula for the first four to six months of life. However, there comes a time when they're ready to graduate to "solid" foods. NOTE: Remember that breast milk or formula should continue to be the main source of nutrition for the first year.

Naturally, parents, grandparents and other care providers have many questions about this important milestone: When are babies ready for solid foods? Which foods should be given? How much food is enough?

This brochure provides general guidelines for introducing infants to solid foods, as well as tips for keeping mealtime safe. Keep in mind that each baby is an individual and may be ready for different foods based on age, nutritional needs, development and other factors. Ask your pediatric nurse practitioner, pediatrician, registered dietitian or other health care provider for specific feeding advice.


Newborns 

Most infants consume only breast milk or iron-fortified infant formula for the first four months of life. These liquid food sources provide all the nutrients and energy needed for growth. Infants are also born with stored iron, which helps get them off to a healthy start. This stored iron is used up around four to six months of age and must be replaced with iron in the infant's diet.  

Developmentally, newborns and young infants are not ready for solid food. They do not have the mouth and tongue movements necessary for effective swallowing of solid food. Also, their stomach is not ready to digest food well. In addition, starting solid foods too early may cause the infant to develop food allergies. Contrary to popular belief, solid foods will not help infants to go longer between feedings, help them sleep through the night, or improve the nutrition of their diets.


 4 to 6 Months

Most health professionals advise starting solid foods sometime between four and six months of age, while continuing to breast or bottle feed. At this time, most babies can hold their heads steady while sitting, and have developed the ability to swallow when food is placed on the tongue.

The first solid food should be single-grain(usually rice) iron-fortified baby cereal. Rice cereal is easily digested and is not likely to cause a food allergy. To begin, in a small dish, mix one or two teaspoons of cereal with enough breast milk, formula or apple juice to make it look like thin gravy. Hint: Apple juice has been found to be the best mixer with cereal because the vitamin C in the juice enhances the absorption of the iron in the fortified cereal.  

Use a small spoon with a long handle and a rubber coating at the feeding tip to serve the cereal from the dish. Begin feeding slowly and talk and smile as you feed your baby. Place a small portion of cereal on the back of the baby's tongue. Never mix cereal in the baby's bottle and feed through a large-holed nipple. A baby needs to learn how foods taste and feel in their mouth. The first feedings should be after the baby has taken a little breast milk or formula, so that feeding solid foods will be associated with a pleasurable event. Avoid trying to introduce new foods after the baby is already full from drinking formula or breast milk. Hint: Try not to feed the infant when rushed or pressed for time.  

At first, the taste of solid food may come as an unpleasant surprise. Most babies will make a face and push the cereal right out again. Don't be discouraged. They are learning what to do with the food in their mouth. Soon the baby will become more accustomed to eating and will eventually open his or her mouth in anticipation. Scoop the cereal from the chin and re-feed.  

The amount and thickness of the cereal gradually can be increased once the baby becomes used to the consistency. Feedings will gradually increase to two to four tablespoons of cereal. After several weeks most babies eat cereal twice a day, totaling about 1/3 to 1/2 cup a day. Always make sure the baby is sitting up to eat and drink. Position the baby so that they can see the face of the person feeding them. Mealtimes provide important opportunities for babies and their caregivers to smile, laugh, talk and enjoy being together.  

Babies' appetites can vary from day to day. Babies let you know they are full by turning their heads away from the spoon or holding their lips closed. Never force them to eat more food after they have indicated fullness.  

Once the baby has mastered cereals, other new foods and juices can be tried toward the end of this stage of growth. Begin with one to two spoonfuls of a single strained or pureed vegetables, such as squash, carrots or sweet potatoes. These foods contain no wheat, milk, or egg to which some babies may be sensitive. Then, offer strained fruits. Gradually increase the amount of food to two to four tablespoons twice daily - or about 1/4 to 1/2 cup in total daily - depending on the baby's appetite. Introduce one new food or juice every 3-5 days to allow the child's system to adjust and to watch for any unusual reactions. By age six months, your baby should be eating two meals of cereal, fruit and vegetables per day, in addition to being breastfed or taking formula.  

During this stage, commercially prepared infant fruit juices - such as apple, pear, or other fortified fruit juices - also can be given alone, or mixed with infant cereal, in place of other liquids. About two ounces of juice can be given, and gradually increased to four to six ounces per day, to provide additional vitamin C. Juice should not be warmed because heat naturally destroys vitamin C. When possible, juice should be given in a cup rather than a bottle to prevent dental caries and tooth decay.  

It's not unusual for the baby's stool to change color upon eating new foods. However, a skin rash, diarrhea, vomiting, wheezing or stuffy nose may be signs of a food allergy or intolerance. Stop feeding the new food and tell your baby's health care provider about the reaction at the next visit. Hint: Keep a diary of new foods introduced and anyreactions.


7 to 9 Months 

By about seven months, most babies are ready to increase the variety of fruits and vegetables as well as the texturesof foods in their diet. New foods, such as strained meat or poultry and junior foods also may be introduced. At this stage, bottle-fed babies should not be taking more than 30 ounces of formula per day with the addition of solid foods in their diet. Hint: Babies should eat with the family, when possible.  

If home prepared foods are used, they should be steamed, then mashed with a fork. Never add honey or corn syrup as these sweeteners may contain botulism spores, which can be harmful to infants.  

At this time, many babies are ready to begin finger foods. The baby should be able to sit up straight in a high chair, be able to grasp food with their hands or finger tips, and move the food from their hands to their mouths. Finger foods such as chopped pieces of ripe banana or dry unsweetened cereal, crackers, or teething biscuits are good choices. Avoid giving the baby foods that could be swallowed and cause choking, including raw carrots, large pieces of raw apple, whole hot dogs or hot dog coins, whole grapes, large cookies, peanuts and hard candy. Hint: Always stay with the baby while he or she is eating.


 10 to 12 + Months 

Between 10 and 12 months of age, babies may have four to six teeth. Chopped table food, well-cooked vegetables (without salt or sugar), cottage cheese or other soft or lumpy foods also may be introduced. Although they don't have a complete set of teeth, babies use their gums and tongue to mash the lumps.

By this age, most infants eat three or four small meals a day. Gradually they grow more independent and can be encouraged to hold a spoon when being fed or to hold a cup with both hands while drinking. While you are feeding your infant, talk to him or her by naming the food he or she is eating, objects in the area, the utensils used, or the color of the food. Remember, each feeding is a special time for you to communicate together.  

If your family has a history of food allergies, it may be helpful to delay the introduction of the specific foods that have caused allergic reactions in your family, as well as certain foods such as wheat, egg white or cow's milk. Ask your health care provider for specific dietary advice.  

By about one year of age, most babies eat small, tender table foods or toddler foods. Whole cow's milk can be introduced in the range of 16 to 20 ounces per day. Children need the fat in whole milk for proper growth and development. Therefore, low-fat milk should not be introduced until two years of age. In the second year, consider introducing foods with fiber, such as multi-grain cereals and breads. Avoid peanut butter until after the second year because of allergies and choking.


Starting Solids 

The following checklist can help you determine if a baby is ready to begin "solid" foods:

  • Baby can hold head steady when sitting
  • Baby is between four and six months of age
  • Baby sometimes opens mouth when food approaches
  • Baby is interested in food when others eat
  • Baby has the ability to swallow baby food placed on tongue

Feeding Timeline 

The following guidelines indicate when babies may be ready to graduate to various solid foods. Ask your pediatric nurse practitioner, pediatrician, dietitian or other health care professional for specific feeding advice 

Months May Begin…
4-6 Iron-fortified, single-grain baby cereal
Strained/pureed plain vegetables and fruit
100% fruit juices fortified with vitamin C
7-9 Strained meats/poultry
Mixtures of strained vegetables and fruits
Junior baby foods
10-12 Soft, finely chopped foods
12* Toddler foods
Family foods
Fiber foods

*The American Academy of Pediatrics recommends that breastmilk or formula be used up to one year of age. Whole milk is recommended for babies from 12 to 24 months.


Safety at the Plate 

When feeding children under four years of age or children with developmental disabilities, take extraordinary care with foods that require extensive chewing or could cause choking if swallowed whole. Foods such as raw carrots, whole grapes, nuts, chunks of peanut butter, hot dogs, chunks of meat or cheese, hard or sticky candy and popcorn can increase risk of choking.

Follow these simple guidelines when watching children:

  • Always supervise them while eating. Choking incidents often occur when older siblings offer babies foods they're not yet developmentally ready to handle.
  • Encourage children to take small bites and chew their foods completely. Young children have a tendency to bite off more than they can chew at any one time.
  • Insist children sit down during mealtime or snacks. Never let them lie down while eating.
  • Don't let children run with anything in their mouths.
  • Cut foods into small pieces (<1/4") and place only a few pieces on the plate at a time.
  • Carefully select a high chair to use.

When An Infant Is Choking

American Red Cross First Aid

The Basics

  • Check the scene for safety
  • Check the victim for consciousness, breathing, pulse and bleeding
  • Dial 9-1-1 or local emergency number
  • Care for the conditions you find

If conscious, but choking…

Give 5 back blows…and 6 chest thrusts
Repeat blows and thrusts

If not breathing…

Give 1 slow breath about every 3 seconds

If air won't go in…

Give 5 back blows… and 5 chest thrusts
Look for and clear any object from mouth
Reattempt breaths
Repeat steps 1,2, and 3until breaths go in or help arrives

If not breathing and no pulse…

Give CPR- repeat sets of 5 compressions and 1 breath

 

 

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