First smiles and coos aren’t the only momentous milestones in a baby’s first year. So is the progression to solid food—and, as with anything, your baby develops at his or her own pace.
The following timetable and guidelines can keep your little one well-fed and healthy, says Chinonyerem Pace, MD, FAAP, (board certified pediatrician) at Children’s Memorial Hermann Pediatrics Atascocita.
0-4 Months:
The menu: Both breast milk and formula are rich in the nutrients your baby needs to develop.
It’s time: “Deciding to give breast milk or formula depends on what works best for you and your baby,” Dr. Pace says. “Either way, they will get the nutrition they need.”
Do’s and don’ts: If you breastfeed your newborn, it’s common to struggle. Should you have issues with your little one latching onto your breast, talk with your pediatrician or a lactation consultant. You’ll get the best pointers if the expert can see you feeding or attempting to feed your baby. “They may have advice on how to position the baby and other techniques that may aid with latching, such as the use of a nipple shield,” Dr. Pace says.
Sometimes if your breasts are overly engorged but not releasing milk, ducts can clog. That can lead to mastitis, an infection which can be treated with antibiotics safe for you and your baby.
That’s enough: Your infant will turn away from the bottle or breast when full.
4-6 Months:
The menu: You can start supplementing formula or breast milk with baby food you make yourself or buy at the store.
Begin with infant cereal purees, which provide iron that may be lacking from the infant’s diet. Iron is important for neurological development. "Choose a variety of infant cereals such as oats, barley, quinoa or multigrain,” Dr. Pace says.
Next, serve pureed meat, which also is rich in iron, the American Academy of Pediatrics advises.
It’s time: Once your baby shows good head and neck control in a seated position, he or she may be ready for pureed food. Until that age, infants don’t have the oral motor skills to move food from the spoon to their mouth, then to the back of their throats and safely swallow.
Do’s and don’ts: Purees should be a thinner consistency at first. This helps prevent any aspiration, when babies gag or choke. “That’s an emergency, and they’d need to be medically evaluated promptly.”
Always introduce a single food at a time and give it a few days, so if your little one has an allergic reaction, you’ll know the likely culprit.
Heavy metals can affect the developing brain and nervous system.
Choose cod, whitefish, salmon or pollock over shark, swordfish, orange roughy or albacore tuna, which may contain mercury. Limit or eliminate commercially made puffs and cereal with rice, including brown rice. “They can contain arsenic,” Dr. Pace says. Since metals may come from the earth, water or packaging, organic commercially made baby food is not necessarily safer.
You can puree soft foods in a blender to make your own baby food.
That’s enough: When your baby loses interest in eating, he or she is satiated.
6-8 Months:
The menu: You can graduate to thicker purees, soft mashed foods and combined variations of fruits and vegetables, Dr. Pace says. Formula or breast milk remain staples. So does a well-balanced diet.
It’s time: When your baby can sit independently, the child likely is ready to progress from thinner purees to thicker ones and soft, mashed food. “If they show interest in or grab at your food or breast, that’s a sign,” she says.
Do’s and don’ts: To avoid aversions to foods, offer refused foods at different meals before moving on. “It sometimes takes up to 15 times for a child to finally accept and like a food,” Dr. Pace says. “They also may be more willing to try a food if you’re having a meal together and they see you or your other children eating it.”
It’s not yet time for infants to feed themselves. They may not be able to hold a bottle by themselves, and they won’t yet be able to use spoons or forks.
That’s enough: Children have an intuitive sense of when they’ve had enough. You may worry they’re not adequately fed, but they probably are. Your pediatric appointments will show whether they’re growing at a healthy rate.
8-10 Months:
The menu: Your baby is ready for a well-balanced diet of grains, fruits, vegetables and proteins. You can introduce finger foods that are finely chopped and easily dissolvable. Formula or breast milk remain a staple at this age.
It’s time: Babies of this age have no problem holding their own bottle.
Do’s and don’ts: Avoid carrots, grapes or nuts. “Rounded, harder foods are choking hazards,” Dr. Pace says.
If you are unsure of the quality of your home’s water supply, you should consider having them assessed for lead and other metals if you haven’t already. “And if you’re concerned, you can offer your child purified or distilled water rather than tap water,” Dr. Pace says.
That’s enough: Your baby will let you know when he or she is full.
10-12 Months:
The menu: It’s time for solids, but they should be cut into small bites that little ones can pick up and eat without choking.
It’s time: Don’t expect them to use a spoon or fork. “They won’t have those motor skills yet,” Dr. Pace says.
Do’s and don’ts: Let them eat as much as they want.
No child should eat honey before 12 months. “Their gut isn’t mature enough to break down the spores that honey produces,” she says. “That puts them at risk of infant botulism,” a poison.
Also don’t serve fruit juices until they’re a year old. “They have little nutritional benefit and can lead to excess calories, diarrhea, malnutrition and dental cavities,” says Dr. Pace.
Juices also may contain heavy metals, according to the American Academy of Pediatrics. Serve pureed or sliced fruit instead.
Offer food first, then follow up with breast milk or formula. Do not give them cow, soy, oat, almond or other grocery store milks, all of which are not nutritious enough for their growing minds and bodies.
“Until they reach one year old, no child should drink cow’s milk because it can create an iron deficiency that hinders their development,” Dr. Pace says.
That’s enough: Don’t force a child to eat. They’ll let you know if they’re hungry between meals.
One Year:
The menu: By now your child can eat what you’re eating. Be a good role model.
It’s time: Usually after age one, your tot will be able to hold onto a spoon or fork. It’s also time to move from formula or breast milk to whole cow’s milk.
Do’s and don’ts: Bribing children with food is tempting, but that may lead to unhealthy eating patterns now and later in life.
Offer food first and only then follow up with milk.
That’s enough: “Children innately don’t overeat,” Dr. Pace says. “You might have problems getting them to eat enough.”
A balanced and varied diet should be sufficient, unless your pediatrician feels they’re not growing at a healthy rate.
