Infant and early nutrition

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Infant and early nutrition - part 3

Long-term approach

For the first few months of life, breast milk is all that a normal, healthy baby requires. Thus, if a mother is breast feeding, she should not rush to start solid foods. Today, most pediatricians advise waiting until a breastfed baby is 4 to 6 months old before introducing solid foods. Since breast milk does not contain much iron, some pediatricians recommend an iron-fortified cereal after 6 months or so.

Formula fed babies may need solid food at an earlier age than those who are breast fed. For both breast-and formula-fed babies, there are no fixed rules about introducing solid foods in any special order. Typically, a rice cereal is one of the first solid foods since it is easily tolerated and less likely to cause digestive problems than other foods.

Babies tend to prefer sweet-tasting foods. Thus, strained fruits, such as apple sauce or mashed bananas, are usually the next solid foods. These may be followed by carrots, peas, or squash. Oatmeal or other cereals also may be added.

Strained meats are the last foods to be added; eggs (especially egg whites) should not be given until the baby is at least 9 months old, especially if there is a family history of allergies or food sensitivity.

In addition to sweets, babies usually prefer bland-tasting, unsalted foods. It's a good idea to introduce solid foods one at a time, and if a baby obviously doesn't like a food, don't force the issue. Try it again in a few weeks.

By age 7 or 8 months, the average baby eats 2 or 3 tablespoons of solid foods — usually a combination of a cereal, a fruit, and a vegetable — 4 or 5 times a day, and may begin cutting back on the breast or bottle feedings without encouragement. Start offering the baby finger foods, such as bread sticks, O-shaped dry cereals, or a piece of peeled fruit, as soon as the baby's chewing reflexes and hand-mouth coordination are sufficiently developed, which is usually by 7 to 9 months. As soon as a baby can sit and has achieved reasonable hand-mouth coordination, encourage self-feeding. This promotes independence and is also important in developing eye-hand coordination. At this early age, don't scold a baby because of poor table manners; these can be dealt with later.

Depending upon circumstances, a baby can be weaned to a cup beginning at about 9 months, although he or she may still want a bottle, especially at bedtime, for many more months.

Toddlers should be encouraged to feed themselves as early as possible.

Advice about infant nutrition

Relax! Feeding should be a pleasant experience for both parent and the baby.
Avoid using food as a pacifier or to stop crying.
Don't worry about messiness and table manners. It's important for a baby to learn self-feeding. Spread newspapers or a plastic sheet on the floor and don't scold overspills.
As the baby's coordination improves (usually in the second year), encourage him or her to use a spoon. Don't worry if after a few tries, the youngster reverts to using his or her fingers. Be patient and eventually he or she will succeed.
Table manners and social graces are developed by imitation. Set a good role model and, with gentle reminders, chances are your child also will practice good manners.
Don't let a baby fall asleep with a bottle of milk or juice. This can cause tooth decay.
Let your baby set his or her pace (within limits, of course). Don't rush starting solid foods or weaning before your baby is ready.
Avoid giving a baby or toddler nuts or other hard foods that may cause choking. Cut meats and other solid foods into small, bite-size pieces.
Avoid making food an issue. If a baby obviously hates spinach or broccoli, offer alternatives and try again at a later date.

Don't overwhelm a toddler with large portions. It's better to put a small amount on the plate and offer a second helping.
Some children need snacks to avoid getting too hungry between meals. Make sure that snacks are nutritious; fresh fruits, vegetable sticks, dry cereals, or bread, are good choices. Time snacks so that they stave off hunger but do not kill the appetite for the next meal.
Avoid using foods, especially sweets, as a reward for good behavior or as a bribe ("You can have a piece of candy if you eat your broccoli.")
Go easy on salt, especially if you have a family history of high blood pressure.
Don't be alarmed by food jags. All toddlers go through stages when they may eat only 2 or 3 items and everything else is "yucky." Just be patient.
Typically, a baby or toddler prefers bland foods that are soft and moist over those that are spicy and dry. A young child does not produce as much saliva as an adult, and often finds dry foods hard to chew and swallow.
If a baby is putting on too much weight, encourage more exercise and avoid overfeeding. However, don't put a young child on a diet without consulting your pediatrician beforehand.

This article was last reviewed December 7 , 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.

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