Solid Foods: Frequently Asked Questions
Expert answers to questions about feeding your baby solids.
By Bryan Vartabedian, MD
When it comes to feeding solids, just as soon as you've figured out what foods to start with, you're wondering "What's next on the menu?" and "What should my baby be eating?" Late infancy brings your child from pureed baby feed closer to the table. He'll advance from two feedings a day to three and begin to eat with the rest of the family. Although each new step comes pretty naturally, here are some questions that may arise along the way:
How much cereal should my 6-month-old be eating?
While there's nothing magical about cereal, it does provide a valuable source of iron during the second half of a baby's first year. How much cereal a baby needs depends on the child's intake of formula or breast milk. A 6-month-old needs about 10 milligrams of iron per day, which can be met with 27 ounces of regular infant formula (avoid low-iron varieties). The amount of breast milk is harder to quantify, because the number of daily feedings and the amount of iron that a woman's milk contains will vary. Since your child may not consistently take in adequate formula or breast milk, to round things out, give her at least 4 tablespoons a day of dry cereal mixed with formula. This provides about half of her daily iron requirement. Once your child is 7 or 8 months old, you can introduce meat, which will make cereal less important.
My baby doesn't seem to like meat. Does he really need it?
While babies don't necessarily need meat, it offers a terrific source of iron, especially since cereal intake often decreases late in the first year. In addition, the type of iron found in meat is absorbed more efficiently than the iron in cereals or fortified foods. So give your baby some more time to get used to meat before counting it out.
My baby eats a lot of squash and carrots, and I've noticed that her skin in a slight shade of yellow. Is this jaundice?
This is a condition called carotenemia, which results from the intake of a lot of carotene, a pigment abundant in the orange and yellow vegetables your baby appears to enjoy. The resulting slight skin discoloration is harmless, and it will fade with the addition of other foods to your baby's diet. One of the ways you can distinguish carotenemia from jaundice -- an excess of bilirubin (a liver by-product) in the blood -- is that in children with jaundice the whites of the eyes are also yellow. Carotenemia doesn't affect the eyes.
When is it okay to switch from stage 1 to stage 2 foods?
Some parents place a lot of stock in the label on the baby-food jar. But these stages are created by the baby-food manufacturers and are somewhat arbitrary. The main difference between stage 1 and stage 2 is that stage 2 foods are more diverse, mixing foods such as chicken and rice. The jar may also be bigger to satisfy the larger appetites of older infants. But the texture of stage 2 foods isn't any more advanced, or lumpier, than stage 1 foods -- they're both purees. So if your child is polishing off his stage 1 foods and eating a small variety of four to six baby-food fruits and vegetables, feel free to take the leap. Just be aware of the new fruits, veggies, or other foods introduced in stage 2, in case your baby has an allergic reaction. Chunkier baby food (stage 3) can be offered at around 7 or 8 months.
What foods are most likely to cause an allergic reaction?
Fortunately, the fruits and vegetables that babies start with infrequently cause true allergic reactions, which usually means just a rash or stomach problems. The most common allergies experienced by children are to milk (from exposure to cow's milk protein in formula or breast milk), wheat, eggs, fish, and peanuts. Bread and egg yolks should be withheld until your baby is 8 months old, egg whites and fish until age 2; shellfish should not be given until age 3. Peanut exposure, through nuts, oils, or peanut butter, should certainly be avoided during the first year of life. (Allergic reactions to peanuts are often serious, and the nuts themselves are a choking hazard until a child is 4.) If you have a family history of allergies, you may want to talk to your doctor about holding off on these foods for even longer.
My son was diagnosed with a food allergy at 4 weeks. He's 5 months old now and we'd like to start him on solids, but we're nervous about it. What should we do?
This is a very common concern among parents of children with milk protein sensitivity. The fear is that if he's allergic to milk protein, he'll also be at risk for a number of other allergies. As it turns out, most babies who react to milk in the first weeks of life do just as well advancing on solids as any other baby would. However, if your baby has had a severe milk protein allergy with symptoms that included blood in the stool, rash, or breathing difficulties, you should proceed with caution. He's at risk for reactions to other baby-food components, such as soy. Discuss this with your baby's physician.
My son is 7 months old and we haven't yet offered him solids. Is there any danger in waiting?
While the word "danger" may be a bit strong, it isn't a good idea to keep your child away from solids much longer, because you risk the development of what's known as oral aversion -- a hypersensitivity to solids usually characterized by choking or gagging. It can occur when a child is fearful of certain food textures or tastes because he's never encountered them before. Oral aversion can also occur when swallowing is painful. Babies with recurrent heartburn, or reflux, often learn to avoid solids because of their fear of pain. While I normally don't push parents to start their children on solid food until they feel comfortable, the potential for aversion illustrates the importance of getting things underway by 6 months of age.
When should my child begin eating three solid meals a day?
When you start your infant on solid food, you'll typically offer baby food twice a day. As soon as your child is used to solids -- at around 7 months -- you can transition him to three meals a day, just like the rest of the family.
How much formula should an 8-month-old be taking? My son takes three 6-ounce bottles a day, in addition to three hearty meals of baby and table food. But I'm concerned that this isn't enough.
Most babies between the ages of 6 and 9 months will take anywhere from 25 to 35 ounces of formula a day. This varies depending on how often a bottle (or breast) is offered, what other liquids are being given, and how interested the baby is in solids, among other things. At 1 year of age, formula intake should drop to about 20 to 28 ounces a day. In your case, 18 ounces a day in addition to healthy solid feedings is a little less than what the average 8-month-old consumes. This shouldn't necessarily be a cause of concern, since plenty of healthy, thriving babies get by on this amount of formula. And growth -- monitored by your pediatrician at well-baby visits -- should be the bottom line when judging whether your baby is eating enough. However, be sure that your child isn't filling up on juice or other beverages instead of milk. Breast milk or formula is the preferred beverage during the first year.
How do I know when my baby is ready for table food?
Once your child is 8 months old, if she seems curious about what's on your plate or bored with her same old baby foods, you can try offering some unseasoned mashed potatoes or squash. Some babies will actually begin to refuse their silky-textured baby food as a sign that they're ready for something more advanced. If giving your fickle feeder table food arouses a new attitude, you may be on to something.
How early can I begin giving zwieback toast or teething biscuits to my child?
While most teething biscuits are designed to soften and melt upon chewing, larger pieces can break off and present a choking hazard to young children. Because of this remote but possible risk, teething biscuits should not be introduced until your baby is 10 to 12 months old, and then only under close supervision. And if your child seems more interested in breaking the biscuit into pieces with his teeth than sucking on it, biscuits may not be a good idea, even if he's at the right age. Instead, offer unsalted crackers that have a melt-away consistency and present much less of a choking risk.
I understand that children aren't supposed to drink regular milk until age 1. Can I give my baby cooked table foods prepared with whole milk?
You're right that your baby's digestive system is unable to process the proteins in regular cow's milk until she's a year old. But table foods that a child eats toward the end of the first year can contain whole milk, because the amount in these foods is not enough to cause harm.
What about yogurt?
Yogurt contains cow's milk protein, but the quantities are fairly limited and thus not usually a concern. You can give your baby yogurt after 8 months of age, but limit it to 2 to 4 ounces a day. Stick with plain, unsweetened yogurt and add your own minced fruit to keep things interesting. Yogurt can be a good addition to a baby's diet, as it appears to offer health benefits: Studies have shown that its active cultures may help prevent and treat diarrhea in infants and protect against eczema. However, yogurt should not be given to babies who have a documented milk allergy.
My 9-month-old has started crying in the middle of the night. We offer her a bottle and it seems to help. Does this mean she isn't getting enough to eat during the day?
Most 9-month-olds are able to get enough to eat during the day and don't need to be fed at night. Yet babies at this age will experience nighttime awakenings, perhaps as the result of a dream. Some parents interpret these episodes as a sign of hunger, and the eager acceptance of a bottle reinforces that notion. After several nights of this, though, a baby will come to understand that her wailing leads not only to a midnight social break but also to a warm bottle. Instead of giving your child milk, be sure she has some familiar objects in her crib to reassure her she's in a safe place. Don't reinforce her awakenings with food unless you're prepared to make middle-of-the-night snacks a permanent habit.
Adapted from the book First Foods, Copyright 2001 by Bryan Vartabedian, MD. Reprinted by arrangement with St. Martin's Press, LLC, New York, NY
By Bryan Vartabedian, MD
When it comes to feeding solids, just as soon as you've figured out what foods to start with, you're wondering "What's next on the menu?" and "What should my baby be eating?" Late infancy brings your child from pureed baby feed closer to the table. He'll advance from two feedings a day to three and begin to eat with the rest of the family. Although each new step comes pretty naturally, here are some questions that may arise along the way:
How much cereal should my 6-month-old be eating?
While there's nothing magical about cereal, it does provide a valuable source of iron during the second half of a baby's first year. How much cereal a baby needs depends on the child's intake of formula or breast milk. A 6-month-old needs about 10 milligrams of iron per day, which can be met with 27 ounces of regular infant formula (avoid low-iron varieties). The amount of breast milk is harder to quantify, because the number of daily feedings and the amount of iron that a woman's milk contains will vary. Since your child may not consistently take in adequate formula or breast milk, to round things out, give her at least 4 tablespoons a day of dry cereal mixed with formula. This provides about half of her daily iron requirement. Once your child is 7 or 8 months old, you can introduce meat, which will make cereal less important.
My baby doesn't seem to like meat. Does he really need it?
While babies don't necessarily need meat, it offers a terrific source of iron, especially since cereal intake often decreases late in the first year. In addition, the type of iron found in meat is absorbed more efficiently than the iron in cereals or fortified foods. So give your baby some more time to get used to meat before counting it out.
My baby eats a lot of squash and carrots, and I've noticed that her skin in a slight shade of yellow. Is this jaundice?
This is a condition called carotenemia, which results from the intake of a lot of carotene, a pigment abundant in the orange and yellow vegetables your baby appears to enjoy. The resulting slight skin discoloration is harmless, and it will fade with the addition of other foods to your baby's diet. One of the ways you can distinguish carotenemia from jaundice -- an excess of bilirubin (a liver by-product) in the blood -- is that in children with jaundice the whites of the eyes are also yellow. Carotenemia doesn't affect the eyes.
When is it okay to switch from stage 1 to stage 2 foods?
Some parents place a lot of stock in the label on the baby-food jar. But these stages are created by the baby-food manufacturers and are somewhat arbitrary. The main difference between stage 1 and stage 2 is that stage 2 foods are more diverse, mixing foods such as chicken and rice. The jar may also be bigger to satisfy the larger appetites of older infants. But the texture of stage 2 foods isn't any more advanced, or lumpier, than stage 1 foods -- they're both purees. So if your child is polishing off his stage 1 foods and eating a small variety of four to six baby-food fruits and vegetables, feel free to take the leap. Just be aware of the new fruits, veggies, or other foods introduced in stage 2, in case your baby has an allergic reaction. Chunkier baby food (stage 3) can be offered at around 7 or 8 months.
What foods are most likely to cause an allergic reaction?
Fortunately, the fruits and vegetables that babies start with infrequently cause true allergic reactions, which usually means just a rash or stomach problems. The most common allergies experienced by children are to milk (from exposure to cow's milk protein in formula or breast milk), wheat, eggs, fish, and peanuts. Bread and egg yolks should be withheld until your baby is 8 months old, egg whites and fish until age 2; shellfish should not be given until age 3. Peanut exposure, through nuts, oils, or peanut butter, should certainly be avoided during the first year of life. (Allergic reactions to peanuts are often serious, and the nuts themselves are a choking hazard until a child is 4.) If you have a family history of allergies, you may want to talk to your doctor about holding off on these foods for even longer.
My son was diagnosed with a food allergy at 4 weeks. He's 5 months old now and we'd like to start him on solids, but we're nervous about it. What should we do?
This is a very common concern among parents of children with milk protein sensitivity. The fear is that if he's allergic to milk protein, he'll also be at risk for a number of other allergies. As it turns out, most babies who react to milk in the first weeks of life do just as well advancing on solids as any other baby would. However, if your baby has had a severe milk protein allergy with symptoms that included blood in the stool, rash, or breathing difficulties, you should proceed with caution. He's at risk for reactions to other baby-food components, such as soy. Discuss this with your baby's physician.
My son is 7 months old and we haven't yet offered him solids. Is there any danger in waiting?
While the word "danger" may be a bit strong, it isn't a good idea to keep your child away from solids much longer, because you risk the development of what's known as oral aversion -- a hypersensitivity to solids usually characterized by choking or gagging. It can occur when a child is fearful of certain food textures or tastes because he's never encountered them before. Oral aversion can also occur when swallowing is painful. Babies with recurrent heartburn, or reflux, often learn to avoid solids because of their fear of pain. While I normally don't push parents to start their children on solid food until they feel comfortable, the potential for aversion illustrates the importance of getting things underway by 6 months of age.
When should my child begin eating three solid meals a day?
When you start your infant on solid food, you'll typically offer baby food twice a day. As soon as your child is used to solids -- at around 7 months -- you can transition him to three meals a day, just like the rest of the family.
How much formula should an 8-month-old be taking? My son takes three 6-ounce bottles a day, in addition to three hearty meals of baby and table food. But I'm concerned that this isn't enough.
Most babies between the ages of 6 and 9 months will take anywhere from 25 to 35 ounces of formula a day. This varies depending on how often a bottle (or breast) is offered, what other liquids are being given, and how interested the baby is in solids, among other things. At 1 year of age, formula intake should drop to about 20 to 28 ounces a day. In your case, 18 ounces a day in addition to healthy solid feedings is a little less than what the average 8-month-old consumes. This shouldn't necessarily be a cause of concern, since plenty of healthy, thriving babies get by on this amount of formula. And growth -- monitored by your pediatrician at well-baby visits -- should be the bottom line when judging whether your baby is eating enough. However, be sure that your child isn't filling up on juice or other beverages instead of milk. Breast milk or formula is the preferred beverage during the first year.
How do I know when my baby is ready for table food?
Once your child is 8 months old, if she seems curious about what's on your plate or bored with her same old baby foods, you can try offering some unseasoned mashed potatoes or squash. Some babies will actually begin to refuse their silky-textured baby food as a sign that they're ready for something more advanced. If giving your fickle feeder table food arouses a new attitude, you may be on to something.
How early can I begin giving zwieback toast or teething biscuits to my child?
While most teething biscuits are designed to soften and melt upon chewing, larger pieces can break off and present a choking hazard to young children. Because of this remote but possible risk, teething biscuits should not be introduced until your baby is 10 to 12 months old, and then only under close supervision. And if your child seems more interested in breaking the biscuit into pieces with his teeth than sucking on it, biscuits may not be a good idea, even if he's at the right age. Instead, offer unsalted crackers that have a melt-away consistency and present much less of a choking risk.
I understand that children aren't supposed to drink regular milk until age 1. Can I give my baby cooked table foods prepared with whole milk?
You're right that your baby's digestive system is unable to process the proteins in regular cow's milk until she's a year old. But table foods that a child eats toward the end of the first year can contain whole milk, because the amount in these foods is not enough to cause harm.
What about yogurt?
Yogurt contains cow's milk protein, but the quantities are fairly limited and thus not usually a concern. You can give your baby yogurt after 8 months of age, but limit it to 2 to 4 ounces a day. Stick with plain, unsweetened yogurt and add your own minced fruit to keep things interesting. Yogurt can be a good addition to a baby's diet, as it appears to offer health benefits: Studies have shown that its active cultures may help prevent and treat diarrhea in infants and protect against eczema. However, yogurt should not be given to babies who have a documented milk allergy.
My 9-month-old has started crying in the middle of the night. We offer her a bottle and it seems to help. Does this mean she isn't getting enough to eat during the day?
Most 9-month-olds are able to get enough to eat during the day and don't need to be fed at night. Yet babies at this age will experience nighttime awakenings, perhaps as the result of a dream. Some parents interpret these episodes as a sign of hunger, and the eager acceptance of a bottle reinforces that notion. After several nights of this, though, a baby will come to understand that her wailing leads not only to a midnight social break but also to a warm bottle. Instead of giving your child milk, be sure she has some familiar objects in her crib to reassure her she's in a safe place. Don't reinforce her awakenings with food unless you're prepared to make middle-of-the-night snacks a permanent habit.
Adapted from the book First Foods, Copyright 2001 by Bryan Vartabedian, MD. Reprinted by arrangement with St. Martin's Press, LLC, New York, NY
posted by Chommar at 2:21 PM
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