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Wednesday, September 13, 2006,2:09:00 PM
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, peanutbutter (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.

DO'S
Do use ice cube trays to freeze pur饤 foods. Each cube should be about one ounce. Once frozen, pop out the cubes, store in a sealed plastic bag, and use within two months.

Do discard unfinished meals. Bacteria forms quickly.

Do introduce new foods at the rate of one per week, so you can pinpoint any allergies.

Do make sure your child has accepted most vegetables and fruits before trying any meats.

Do steam or microwave vegetables and fruits to retain as much vitamins and minerals as possible, as opposed to boiling.

Do use as thinners: water left from steaming, breast milk, formula, cow's milk, yogurt, broth, or apple juice.

Do use as thickeners: wheat germ, whole-grain cereal , cottage cheese, farmer cheese, cooked egg yolks, yogurt, mashed white or sweet potato.

DON'TS

Don't feed nuts, raisins, popcorn, raw vegetables, unpeeled fruits, or peanut butter to children under the age of 2.

Don't give honey to children under the age of one year due to potential contraction of infant botulism.

Don't give beets, spinach, collards or turnip greens to babies under one year of age due to high concentrations of naturally-occurring nitrates which can reduce the baby's hemoglobin.

Don't add salt, sugar, or strong spices to homemade baby foods. If you are using part of the family meal for the infant, remove the infant's portion before seasoning food for the family.

Don't use cookies as a pacifier for a fussy baby.

Don't use canned vegetables as they are usually loaded with sodium and additives. Check labels, but usually frozen vegetables have little or no sodium.

Don't use a microwave to warm foods. Even well-stirred foods could have dangerous hot spots. If you do, use the defrost cycle, checking and stirring often. Always test the temperature by touching a spoonful to the outside of your upper lip. Be sure to wash the spoon before using.

Don't put diluted foods into a bottle with a larger hole in the nipple for night feedings. It's dangerous, bad for the teeth, and doesn't build good eating habits.

Don't give highly acidic fruits, such as oranges, tangerines and pineapples, to babies under one year as the acid is harsh on the immature digestive system.

Don't feed egg whites to babies under one year of age, due to potential allergic reaction. Cooked egg yolks are fine.

Don't force feed your child. To begin solids foods, start with one or two spoonfuls and let your baby guide you.

Don't limit your child's fat intake during the first two years. Fats are necessary to development.

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