Patient education: Starting solid foods with babies (The Basics)

When should I start feeding my baby solid foods? — 

Most doctors and nurses recommend babies start solid foods at about 4 to 6 months old. Until then, breast milk (or formula) is the best nutrition for your baby. Giving solid foods will not make a baby sleep longer.

When is my baby ready for solid foods? — 

Once they are old enough, a baby is usually ready to start eating solid foods when they:

●Can sit up with help

●Have good control of their head and neck

●Put toys or hands in their mouth

●Show an interest in food by leaning forward and opening their mouth when it's time to eat

Which food should I start with? — 

Start with a food that has only 1 ingredient and is mashed up well. Baby cereal or meats are good choices because they have the iron your baby needs.

You can mix baby cereal with breast milk, formula, or water. Make the mixture thin at first, and use a spoon to feed it to your baby. Doctors and nurses do not usually recommend putting baby cereal in a baby's bottle.

When you start feeding your baby solid foods, give them 1 new food every few days. Offer a small amount of the same food 1 or 2 times each day for a few days. That way, you can make sure your baby does not have an allergy to that food. After a few days, you can try another food. As your baby grows, you can add more food at each feeding and feed them more times each day.

What should my baby drink? — 

Babies should drink mostly breast milk or formula. By about 4 to 6 months, they can also have small amounts of water. You can give your baby 2 to 4 ounces (1/4 to 1/2 cup, or 60 to 120 mL) of water each day between meals. Do not give them juice until they are at least 1 year old.

What should I know about food allergy? — 

Many people wonder if their baby will have a food allergy. Food allergy is not common, even for babies who have a sibling or parent with a food allergy. The baby might be a little more likely to have the same or another food allergy. But usually, they have no food allergy at all.

Doctors used to think it was better to delay certain foods if a baby was at high risk for allergy. Now, they think it is better not to wait until the baby is older. In fact, giving the food at the normal time might make it less likely they will have a food allergy. This is true even if your baby does not have a sibling or parent with a food allergy. But there is still no way to know for sure if they will have an allergy. Their doctor can help you decide when and how to offer these foods.

It's important to know the signs of an allergic reaction. Your baby might have an allergy to a food if they eat it and then have 1 or more of the following symptoms:

●Hives – These are raised or puffy areas of skin that are itchy (picture 1).

●Flushing

●Vomiting or diarrhea

●Swelling, especially of the face, eyelids, lips, or tongue

●Trouble breathing, noisy breathing (wheezing), or coughing

●Looking sick, or not acting normally

These symptoms often start quickly, usually minutes to 1 hour after having the food. Call the doctor or nurse if your child has any of these symptoms.

Can I use baby food from a jar? — 

Yes. But it's important to know how to use and store it:

●Do not feed your baby directly from the jar.

●After opening a jar of baby food, keep it in the refrigerator. It usually lasts in the refrigerator for 2 to 3 days after it's opened.

●If a jar has been opened for more than 3 days, throw it out.

Can I make my own baby food? — 

Yes, but there are some things you should know:

●Do not add salt or sugar to it. Babies do not need extra salt or sugar in their food.

●First foods should have more liquid in them. As your baby gets older, the food can be thicker.

Which foods should I give my baby next? — 

After you give your baby different foods with only 1 ingredient, move on to foods with 2 or more ingredients. For example, you might try yogurt mixed with mashed fruit. Over time, you can give them foods that are thicker and have small chunks in them. That way, they can get used to different foods and learn to chew pieces of food.

By about 8 to 12 months, your baby should be getting more used to solid foods and their texture. At this age:

●Your baby should still drink breast milk or formula. But you can continue adding more solid foods to provide other nutrients.

●Offer vegetables and fruits at least once a day. If your baby refuses a vegetable or fruit, try offering it again another time. It often takes many tries before a baby learns to like a new food. Some doctors suggest giving vegetables more often than fruits so your baby learns to enjoy foods that are not sweet.

●Your baby should be getting more coordinated and able to feed themselves. You can give them soft "finger foods" in small pieces. Examples include soft vegetables, fruits, cheese, well-cooked meats, beans, and cooked pasta. You can also give foods that dissolve easily, like baby crackers or dry cereal.

●Your baby should be getting used to lots of different flavors, and able to eat many of the same foods the rest of your household eats. You will need to cut or mash some foods into bite-sized pieces.

●Your baby should be able to drink from a regular cup using both hands.

●Avoid sweets and foods with sugar, like ice cream and other desserts.

After your baby is 1 year old:

●You can continue breastfeeding if you choose. As your child grows, they will continue to need more nutrients from other foods, too.

●You can start giving your child whole cow's milk. If you want to use a different type of milk instead, such as soy, talk to your child's doctor or nurse. They can make sure your child gets the right nutrients.

●If your baby is used to drinking from a bottle, switch them to a cup. This can take some time and practice.

●You can give your baby small amounts of fruit juice. Do not give more than 4 ounces (120 mL) a day. Drinking more than that can lead to diarrhea, cavities, and other problems. Give 100 percent juice, rather than "fruit drinks," which often have added sugar.

What foods should babies not eat or drink? — 

Babies younger than 1 year old should not have:

●Cow's milk – Doctors recommend babies only drink breast milk or infant formula (and sometimes water) before 1 year. But if needed, you might be able to switch your baby to cow's milk after they are 8 or 9 months old. If you do this, give them plenty of solid foods that are high in iron, like meats and iron-fortified baby cereals.

●Homemade formula – Do not give your baby homemade formula, even if the ingredients seem healthy. That's because these usually do not have enough of certain important nutrients. This can be dangerous for babies.

●Honey

●Juice – Even 100 percent juice has a lot of sugar. Even though the sugar is naturally in the fruit, it is not healthy for babies.

●Drinks with added sugar, like soda, tea, or sweetened fruit drinks

Doctors also recommend children younger than 4 years old not eat certain foods that commonly cause choking. These foods include:

●Hot dogs

●Peanuts and other nuts or seeds

●Whole grapes, cherries, or cherry tomatoes

●Raw carrots

●Popcorn

●Hard candies

●Marshmallows

Does my child need vitamins? — 

Doctors recommend all babies who breastfeed get daily vitamin D drops starting when they are a few days old. Vitamin D helps bones grow strong. Babies who drink formula might also need vitamin D drops, depending on how much formula they drink each day.

Some babies need other vitamins each day, depending on what they eat and other factors. Ask the doctor or nurse if your baby should take vitamins and which ones they need.

What else should I know? — 

Always stay with your baby while they are eating in case they start to choke. To help your baby have a healthy relationship with food, you can:

●Learn how to tell when your baby is hungry or full. It is normal for babies and toddlers to eat different amounts at different meals. Do not force them to eat.

●Include your baby in meals with the family or other household members. They can sit in an infant high chair or in your lap. Never leave them alone while they eat.

●Let your baby touch and play with their foods. This helps them get used to different textures and tastes. Give them their own spoon to hold while eating.

More on this topic

Patient education: Weaning from breastfeeding (The Basics)
Patient education: Food allergy (The Basics)
Patient education: Vitamin D for babies and children (The Basics)
Patient education: Vitamin supplements (The Basics)

Patient education: Starting solid foods with babies (Beyond the Basics)
Patient education: Weaning from breastfeeding (Beyond the Basics)
Patient education: Food allergy symptoms and diagnosis (Beyond the Basics)