We have put together general dietary information for healthy infants that should provide answers to many common questions. Parents are advised to consult their pediatrician for specific dietary recommendations regarding every individual child.
Infants 4 to 6 Months
Basic Principles
1. Milk (breast milk or formula) is the main source of nutrition for the first nine months of life. Breast milk has all the vitamins babies need. Formula is vitamin-enriched. All babies need a source of iron after four months of age, either in formula or as added cereal in breast-fed babies.
2. Early introduction of solids causes excessive weight gain and does not make babies sleep through the night sooner. (Several recent studies have disproved what grandma says about cereal helping babies sleep.)
3. Rice cereal, fruits and vegetables provide oral stimulation for babies as well as good sources of iron and vitamins. Feeding times should be fun. If the baby does not enjoy feedings-do not force feed! Stop and wait a few weeks before trying again. Forcing a baby to eat may produce an aversion to eating and a feeding problem.
4. When introducing a new food, wait at least three days (ideally a week) before introducing another. In this way, if your baby develops a rash or diarrhea or vomiting you will know which foods to avoid.
5. Avoid honey until one year of age because of the risk of infant botulism.
6. Addition of solids and juices will change the baby's stools. Juices tend to have a laxative effect while applesauce, bananas and cereal tend to be constipating.
7. From the beginning, most babies are programmed to know how much they need. If they are growing normally (based on the growth curves) and they are getting a reasonable balance of foods (as appropriate for their age), you can rest assured that they are getting enough.
8. Juice is not routinely recommended unless the infant is constipated. Then 1-2 oz. per day of apple or prune juice may be given.
9. We do not currently recommend supplemental fluoride. This is because our pediatric dentists cite low rates of cavities and the potential for fluorosis (tooth staining) caused from excess fluoride.
Introducing Solid Foods
Ordinarily this is done after 4-6 months of age. Your baby will be drooling, sucking on his fists, and becoming very “oral.” He will begin “teething,” although teeth will generally not appear until 6 - 12 months of age. He will welcome oral stimulation, but may have very particular taste preferences.
• Rice Cereal (iron fortified): Start with 1-2 tablespoons of rice cereal mixed with a similar amount of breast milk, formula or apple juice and stir into a paste. Feed the baby with an infant spoon, while he is sitting in an infant seat. After cereal is tolerated it can be offered twice a day. Some babies don't like the taste of cereal alone but do like it mixed with fruit. Cereal is constipating to many babies. Feed your baby at family mealtimes, thereby beginning to include him in these important social events. The addition of solids at this age will not result in a significant reduction in formula intake. It does not matter whether you offer solids before milk or feed some milk, then solids, then some more milk.
• Vegetables (pureed or stage 1): 4-6 months. Generally, start with yellow vegetables such as squash, carrots, sweet potatoes: if these are tolerated add green vegetables such as beans, peas, broccoli, etc. As with fruits and cereals, start with approximately 2 tablespoons once or twice a day, one at a time, waiting three days before the addition of new foods. Yellow vegetables tend to be relatively constipating while green vegetables tend to have more of a laxative effect.
• Fruits (pureed. stage 1): Begin with applesauce, bananas, pears, peaches and apricots. Avoid citrus until after six months of age. These can be mixed with cereal in a similar amount and offered once or twice a day.
Avoid added sugar and salt.
Infants 6 to 12 Months
Basic Principles
1. Milk (breast milk, formula, whole milk-after 12 months) is the major source of nutrition for the first year and accounts for approximately 40-50% of the nutritional needs of infants in the second year.
2. Feeding should be fun for you and your baby. Include the baby in family mealtimes. Let your baby feed himself when he becomes skilled at reaching, picking things up and bringing things to his mouth. Usually by eight months babies can finger feed Cheerios, overcooked spaghetti (no sauce, please). At 6-7 months they can handle teething crackers.
3. Avoid foods that can cause choking. Certain foods are high risk for aspiration; the peel of hot dogs or grapes, popcorn, peanuts and sunflower seeds, to name a few. All parents should take a CPR course and learn the Heimlich maneuver.
4. If the child cannot catch his breath, then pick him up, hold the child prone, with face down, and give three sharp blows to the back with the heal of the hand. Check to see if there is anything in the mouth that can be easily removed by the finger, but do not insert one's finger blindly. Repeat until the baby is crying or throws up and clears his/her mouth.
6-9 Months
Baby meats. (Pureed). Either separately or mixed with vegetable dinners, 1-2 times a day. Table foods. Yogurt, cottage cheese, ice cream in small quantities, mashed potatoes, pureed squash or carrots. Finger foods. Teething biscuits, peeled apple slice.
8-9 Months
Cheerios, overcooked spaghetti, broccoli, string beans.
9-12 Months
Many infants this age have four or more teeth and can handle chunky or stage 3 junior foods and finger foods. Finger foods are usually a big hit.
1 Year Olds
A one year olds diet should now consist mainly of solid foods, such as fruits and vegetables. Whole milk can now be introduced as early as 11 months, still maintaining about 16-32 ounces per day. Give a single feeding by bottle or cup on the first day. If your child tolerates it well without getting diarrhea, abdominal cramps or rash, it is pretty safe to switch over on the next day.
We recommend starting to weaning off the bottle between 9-12 months. Really encourage the cup over the bottle at all times. It is best to avoid bottles in bed, and do not allow you child to walk around with a bottle. Instead, encourage a blanket or stuffed animal as a more appropriate “transitional object” for the child to use for security as he or she walks around during the second year of life
12-24 Months
This should be the beginning of sitting down to meals as a family and socializing with each other at mealtime. By this age toddlers can eat almost anything, with exception of food like whole grapes, nuts, raw carrots, and popcorn. Smooth peanut butter is not recommended before 18 months of age for allergy reasons. Encourage a balanced diet of meats, fruits, vegetables, and grains. Avoid mealtimes turning into battles! Make mealtime a pleasant experience for your child. If your child refuses fruit and vegetables you may give him a supplemental vitamin daily. (polyvisol with iron drops or chewables for those over 18 months)
2 Year Olds
By this point your child does not need whole milk anymore he can be transition to 2% or nonfat milk. Ideally your child should take no more than 16-24 ounces of milk per day. Starting to emphasize proper calcium intake is important for prevention of osteoporosis even at this age. Other sources of calcium include yogurt, cheese, calcium enriched orange juice, sunny delight, and calcium fortified food (waffles, graham crackers, etc) This is a time where the eating habits of a child will start developing and often maintain into adulthood. Set an example for your children by emphasizing good, healthy eating habits!
