The hows, whens, and whys of infant nutrition.
Before my first child, Nicolas, was born, the prospect of feeding him inspired some of my most blissful daydreams. What could be easier, more natural, more satisfying, than nourishing a child with milk from my own breasts? Plenty, as it turned out. Nick had trouble latching on, but he refused the bottle - leaving me with a nasty case of sore nipples.
In time, we both improved our skills. And I learned another lesson: The only predictable thing about feeding an infant is its unpredictability. Still, all children follow roughly the same path as they develop from suckling newborns into chomping toddlers. Below, you'll find a road map. (Time frames and food quantities are approximate; it's best to follow your baby's lead.) When the going gets bumpy, remember: Despite the spitting up and spaghetti spills, every child eventually learns to eat on his or her own.
Age 4 to 6 Months: Starting Solids
Several developmental milestones indicate when your baby is ready to eat solid foods. He loses the "extrusion reflex," which used to make him spit out anything but liquids. He can sit up with support, hold his neck steady, and move his head from side to side. When you see those signs, don't delay: By the time he's 6 months old, your infant's natural iron stores are beginning to run out, and he needs more than he can get from milk alone.
Start with rice cereal, the grain least likely to cause allergies. Blend a teaspoon of cereal with several tablespoons of breast milk or formula, and feed it to your baby with a small, soft-tipped spoon. He'll eat only a bite or two at first. Gradually work up to thicker cereal, with feedings two to three times a day. Wait until he's 6 months old to introduce cereal containing barley, wheat, or oats. And do continue nursing or bottle-feeding -- cereal should supplement milk at this stage, not replace it.
Each time you let your baby sample a new food, wait at least three days before introducing another one. If your child has an allergic reaction, this makes it easier to determine what's causing it, says Bryan Vartabedian, M.D., a pediatric gastroenterologist in Houston. Diarrhea, rashes, repeated vomiting, and persistent fussiness are all possible signs of allergies.
Age 6 to 8 Months: Adding Fruits and Vegetables
At around 6 months, your baby should start to eat fruits and vegetables. Because infants have a natural preference for sweet foods, many pediatricians suggest introducing veggies first--otherwise, your baby might grow too attached to, say, bananas and refuse to give peas a chance.
Since yellow and orange vegetables are sweeter than green ones, carrots, yams, and butternut squash tend to go over best. But if your baby spits out her first mouthful of spinach, just keep trying: Repeated exposure can convert even the stubbornest vegephobe. Start with strained or pureed vegetables and then move on to mashed. Servings should gradually increase from a few teaspoons to about two tablespoons, twice a day.
After your child has sampled a variety of vegetables, bring on the fruit. (Start small and work up to a couple of tablespoons, twice daily.) Avoid sweetened treats like cobblers and puddings - the extra fat and sugar add empty calories and can sour your baby on plain fruit.
Juice is fine now and then, but it's no substitute for the fruit itself: Although it may be fortified with vitamin C, it lacks fiber and other nutrients, and its concentrated sugars can spoil your baby's appetite for breast milk or formula - still the most essential element of her diet. The AAP suggests serving no more than four ounces of juice per day, diluted half and half with water if you're offering it frequently. Citrus juice is too acidic for most babies, and some also find apple and pear juices indigestible. A recent study indicates that white grape juice is least likely to cause diarrhea and cramping.
Age 7 to 10 Months: Lumpy Foods
Up until now, your baby has been happy eating mush. But around month seven, she may begin picking parts of your dinner off your plate -- a sure sign that she's ready for the next phase. Pay attention to her cues: "If kids haven't been exposed to lumpy textures by their first birthday, they may develop an oral aversion," says Dr. Vartabedian. "They'll gag when offered food with an unfamiliar texture."
Good choices for first lumps include toast strips, well-cooked pasta, bits of soft fruit, and cooked chopped vegetables. But be careful: Many foods, such as nuts, raisins, grapes, and hot dogs, present a choking hazard for kids under 5 years.
Through the eighth month, breast milk or formula should form a large part of your baby's diet (three to five breast-feedings or 24 to 32 ounces of formula a day). At this stage, however, she needs additional sources of protein and iron. Meat can provide both--but she may not like it on first tasting. Try mixing a little pureed meat with her favorite vegetable, and gradually build up to two tablespoons a day. Or use a similar quantity of pureed beans: They're packed with nutrition.
Age 10 to 12 Months: I Can Do It Myself
As your baby grows out of a milk-based diet, his attitude changes too. More and more, he'll insist on feeding himself. To make it easier, serve thick-textured foods -- mashed potatoes, casseroles -- that stick to a spoon. The range of finger foods can expand to include finely chopped meat, chicken, or fish.
At 1 year, your child can drink breast milk, whole milk, or enriched soy milk from a cup. (Low-fat milk should not be given before age 2.) By this time, his daily diet will be nearly as varied as your own: six servings of grains, two to three servings of fruits, two to three servings of vegetables, two servings of protein foods, and three cups of milk.
1 grain serving = 1/2 slice bread, 1/4 cup cereal, 2 crackers
1 fruit/vegetable serving = 1/4 cup
1 protein serving = 1/4 cup or 1 oz.
Now that your child has mastered the basic food groups, you can begin teaching him the finer points of healthy nutrition. Setting a good example yourself works better than pushing him to swallow every bite of strained vegetables. Eat right, eat together, and work on making mealtime a relaxed, enjoyable occasion for the entire family.