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Guide to Starting Solids

Starting your baby on solid foods is the beginning of lifelong eating habits that contribute to his or her overall health. For this reason we have some general guidelines that can help you start your baby out on the right track to a healthy life.


Breast milk or infant formula supplies all of your baby's nutritional needs for at least the first 4 to 6 months of life, so don't be in a rush to start solid baby foods. Starting solids too early can cause your baby to develop food allergies. Your baby's intestinal tract is not as fully developed during the first few months and introducing solids at this time can be too much to handle


Another reason for not giving solid foods earlier than 4 to 6 months is unintentional overfeeding, since younger babies can not offer you signals when they are full, such as turning away or showing disinterest.


A third reason for holding off on solids is your baby's inability to swallow solids correctly before 4 to 6 months of age and this can potentially cause choking. And contrary to the popular myth, starting solids early will not help your child to sleep through the night.


When offering a new type of food, always feed it for several days in a row before starting another new food. This makes it easier to detect food allergies, which can present with diarrhea, vomiting, coughing, hives or a rash. Do not offer mixed ingredient foods until you are sure that the baby isn't allergic to any of the individual ingredients. Also, don't add any seasonings to your baby's foods.


Other practices to avoid are putting your baby down for a nap or sleep with a bottle of formula or juice, as this allows sugar to pool in your baby's mouth and can lead to cavities. Don't feed your baby cow's milk, honey or egg whites until your baby is at least one year of age. Also, do not give carbonated or caffeinated drinks, candy or other foods that your baby may choke on.


Remember, these are general guidelines and the amount and types of food that your baby eats may vary from day to day.


Food Allergies


Preventing food allergies may be possible, especially if your child is at high risk of having a food allergy, including already having an allergy to aother food or formula, having other family members with food allergies, or having other 'allergic' type conditions or family members with these conditions, such as eczema, allergic rhinitis (hayfever) and/or asthma.


Most importantly, breastfeed and avoid supplementing with infant formula or offering solids for at least the first six months of your child's life. If you are not breastfeeding or need to supplement, then consider using a hypoallergenic infant formula such as Nutramigen or Alimentum (soy formulas and goat's milk may not be good alternatives, because many infants that are allergic to cow's milk may also be allergic to soy). If you are breastfeeding, then you should avoid peanuts and tree nuts in your own diet, and consider avoiding milk, fish and eggs too (discuss this with your doctor, as avoiding too many foods may cause poor nutrition).


If your child is at high risk of having food allergies, you should also delay offering solids until he is at least six months old (and continue breastfeeding), and begin with an iron fortified infant cereal. It is best to start with rice and oat cereals and introduce wheat cereals later. Next you can introduce vegetables, but avoid legumes (foods in the bean and pea family) at first, and then non-citrus fruits and fruit juices. Meat and protein foods can be added once your child is 8-9 months old.


Foods to avoid until your infant is at least a year old include cow's milk, citrus fruits and juices, and wheat and egg whites until he is two. Also, avoid giving peanuts (as smooth peanut butter), fish and shellfish until your child is at least three years old. Whole peanuts and tree nuts should be avoided until your child is four because of the choke hazard.


When you do introduce new foods, do so slowly and only give one new food every four to five days. This way, if your child does have a reaction or allergy, then you will know which food caused it and you will be able to avoid giving it again.



Four to Five Months


At this age, breast milk or formula is the only food that your baby needs and he should be taking 4-6 feedings each day (24-32 ounces), but you can start to familiarize your baby with the feel of a spoon and introduce solid foods. Cereal is the first solid you should give your baby and you can mix it with breast milk, formula or water and feed it to your baby with a spoon (not in a bottle). Start by feeding one tablespoon of an iron-fortified Rice cereal at one feeding and then slowly increase the amount to 3-4 tablespoons one or two times each day.



Six to Seven Months


While continuing to give 4-5 feedings of breast milk or formula (24-32 ounces) and 4 or more tablespoons of cereal each day, you can now start to give well-cooked, strained, or mashed vegetables or commercially prepared baby foods. Start with one tablespoon of a mild tasting vegetable, such as green beans, peas, squash or carrots and gradually increase to 4-5 tablespoons one or two times each day.


Start fruits about a month after starting vegetables and again, gradually increase to 4-5 tablespoons one or two times each day. You can use peeled, cooked, or canned fruits (but only those packed in light syrup or water) that have been blenderized or strained


You can also begin to offer 2-4 ounces of 100% fruit juices. Start by mixing one part juice with two parts of water and offer it in a cup.



Eight to Nine Months


While continuing to give 3-4 feedings of breast milk or formula (24-32 ounces) and 4 or more tablespoons of cereal, vegetables and fruit one or two times each day, you can now start to give more protein containing foods. These include well-cooked, strained or ground plain meats (chicken, beef, turkey, veal, lamb, boneless fish, or liver), mild cheese, peanut butter (this is controversial though), or egg yolks (no egg whites as there is a high chance of allergic reactions in infants less than 12 months old). If using commercially prepared jars of baby food, do not use vegetables with meat as they have little meat and less protein and iron than jars with plain meat.


Start with 1-2 tablespoons and increase to 3-4 tablespoons once each day. If your baby doesn't seem to like to eat plain meat, then you can mix it with a vegetable that they already like as you offer it.


You can also start to offer soft table foods and finger foods at this age. Give soft, bite-size pieces of food, such as soft fruit and vegetable pieces, pastas, graham or saltine crackers, and dry cheerios, but do not give these foods if the child is going to be unattended in case of choking.


You can also begin to offer 3-4 ounces of formula or 100% fruit juice in a cup at this time.



Ten to Twelve Months


Your baby's diet will begin to resemble that of the rest of the families, with 3 meals and 2 snacks each day and will include 3-4 feedings of breast milk or formula, iron fortified cereal (1/4 – 1/2 cup at breakfast), vegetables and fruits (1/2 cup/jar at lunch and dinner), protein foods (2-4 tablespoons each day), 100% fruit juice (2-6 ounces in a cup each day), and some finger foods.


It is important to offer a variety of foods to encourage good eating habits later.



Weaning


There is no set age at which you should wean your baby. The current recommendations of the American Academy of Pediatrics is to continue to breast feed until your child is at least age one. It is also an age when most children can successfully drink from a cup and is therefore a good time to wean. You can gradually wean your child from breast feeding by stopping one feeding every four or five days and then gradually reducing the amount of nursing when you are down to one feeding each day.


If you wean before the age of one, then you should introduce an infant formula and not cow's milk.



Twelve Months and Beyond


You may now give your baby homogenized whole cow's milk. Do not use 2%, low fat, or skim milk until your child is 2-3 years old.


If using soy milk after your child is a year old, keep in mind that it is low fat. A toddler soy formula may be a better alternative, or try to make up for the reduced fat intake from milk in other areas of your child's diet.


Your child should now want to feed himself with his fingers and a spoon or fork and should be able to drink out of a cup. The next few months will be time to stop using a bottle. As with weaning from breastfeeding, you can wean from a bottle by stopping one bottle feeding every four or five days and then gradually reducing the amount in the bottle when you are down to one each day.


Remember that your baby's appetite may decrease and become pickier over the next few years as his growth rate slows.


Until your child is at least 4 years old, you should avoid foods that can cause choking, including chewing gum, nuts, raisins, popcorn, chunks of peanut butter, hard candy, or hard, round foods (such as chunks of raw carrots, celery, grapes, or hot dogs).


Large amounts of sweet desserts, soft drinks, fruit-flavored drinks, sugarcoated cereals, chips or candy, should be avoided, as they have little nutritional value.


Also avoid overfeeding. Do not encourage your child to eat after he is full, as this can lead to a habit of overeating.


Following these guidelines will help you give your baby the good nutrition he or she needs to grow up to his or her full potential and a healthy life.

In our goal-oriented society, we often acknowledge only success and winning. This attitude can be discouraging and frustrating to children who are learning and experimenting with new activities. It’s more important for children to participate and enjoy themselves.



TV use should be monitored



Try not to use TV as a “baby-sitter” on a regular basis.  Be selective in choosing television shows for children. Some shows can be educational as well as entertaining.



School should be fun!



Starting school is a big event for children. “Playing school” can be a positive way to give them a glimpse of school life.



Try to enroll them in a pre-school, Head Start, or similar community program which provides an opportunity to be with other kids and make new friends. Children can also learn academic basics as well as how to make decisions and cope with problems.



Provide appropriate guidance and instructive discipline



Children need the opportunity to explore and develop new skills and independence. At the same time, children need to learn that certain behaviors are unacceptable and that they are responsible for the consequences of their actions.



As members of a family, children need to learn the rules of the family unit. Offer guidance and discipline that is fair and consistent. They will take these social skills and rules of conduct to school and eventually to the workplace.



Suggestions on Guidance and Discipline


   Be firm, but kind and realistic with your expectations. Children’s development depends on your love and encouragement.

   Set a good example. You cannot expect self-control and self-discipline from a child if you do not practice this behavior.


Criticize the behavior, not the child.  It is best to say, “That was a bad thing you did,” rather than “You are a bad boy or girl.”



Avoid nagging, threats and bribery. Children will learn to ignore nagging, and threats and bribes are seldom effective.



Give children the reasons “why” you are disciplining them and what the potential consequences of their actions might be.



Talk about your feelings.  We all lose our temper from time to time. If you do “blow your top,” it is important to talk about what happened and why you are angry.  Apologize if you were wrong!



Remember, the goal is not to control the child, but for him or her to learn self-control.



Provide a safe and secure home.



It’s okay for children to feel afraid sometimes.  Everyone is afraid of something at some point in their life. Fear and anxiety grow out of experiences that we do not understand.



If your children have fears that will not go away and affect his or her behavior, the first step is to find out what is frightening them. Be loving, patient and reassuring, not critical. Remember:  the fear may be very real to the child.



Signs of Fear



Nervous mannerisms, shyness, withdrawal and aggressive behavior may be signs of childhood fears. A change in  normal eating and sleeping patterns may also signal an unhealthy fear. Children who “play sick” or feel anxious regularly may have some problems that need attention.


Fear of school can occur following a stressful event such as moving to a new neighborhood, changing schools, or after a bad incident at school.



Children may not want to go to school after a period of being at home because of an illness.



When to seek help



Parents and family members are usually the first to notice if a child has problems with emotions or behavior. Your observations with those of teachers and other caregivers may lead you to seek help for your child. If you suspect a problem or have questions, consult your pediatrician or contact a mental health professional.



Warning Signs



The following signs may indicate the need for professional assistance or evaluation:


   Decline in school performance

   Poor grades despite strong efforts

   Regular worry or anxiety

   Repeated refusal to go to school or take part in normal children’s activities

   Hyperactivity or fidgeting

   Persistent nightmares

   Persistent disobedience or aggression

   Frequent temper tantrums

   Depression, sadness or irritability


Where to seek help


Information and referrals regarding the types of services that are available for children may be obtained from:


   Mental health organizations, hotlines and libraries

   Other professionals such as the child’s pediatrician or school counselor

   Other families in the community

   Family network organizations

   Community-based psychiatric care

   Crisis outreach teams

   Education or special education services

   Family resource centers and support groups

   Health services

   Protection and advocacy groups and organizations

   Self-help and support groups