Pediatrician advice on baby food

When, What, and How to Introduce Solid Foods | Nutrition

For more information about how to know if your baby is ready to starting eating foods, what first foods to offer, and what to expect, watch these videos from 1,000 Days.

The Dietary Guidelines for Americans and the American Academy of Pediatrics recommend children be introduced to foods other than breast milk or infant formula when they are about 6 months old. Introducing foods before 4 months old is not recommended. Every child is different. How do you know if your child is ready for foods other than breast milk or infant formula? You can look for these signs that your child is developmentally ready.

Your child:

Sits up alone or with support.
Is able to control head and neck.
Opens the mouth when food is offered.
Swallows food rather than pushes it back out onto the chin.
Brings objects to the mouth.
Tries to grasp small objects, such as toys or food.
Transfers food from the front to the back of the tongue to swallow.

What Foods Should I Introduce to My Child First?

The American Academy of Pediatrics says that for most children, you do not need to give foods in a certain order. Your child can begin eating solid foods at about 6 months old. By the time he or she is 7 or 8 months old, your child can eat a variety of foods from different food groups. These foods include infant cereals, meat or other proteins, fruits, vegetables, grains, yogurts and cheeses, and more.

If your child is eating infant cereals, it is important to offer a variety of fortifiedalert icon infant cereals such as oat, barley, and multi-grain instead of only rice cereal. Only providing infant rice cereal is not recommended by the Food and Drug Administration because there is a risk for children to be exposed to arsenic. Visit the U.S. Food & Drug Administrationexternal icon to learn more.

How Should I Introduce My Child to Foods?

Your child needs certain vitamins and minerals to grow healthy and strong.

Now that your child is starting to eat food, be sure to choose foods that give your child all the vitamins and minerals they need.

Click here to learn more about some of these vitamins & minerals.

Let your child try one single-ingredient food at a time at first. This helps you see if your child has any problems with that food, such as food allergies. Wait 3 to 5 days between each new food. Before you know it, your child will be on his or her way to eating and enjoying lots of new foods.

Introduce potentially allergenic foods when other foods are introduced.

Potentially allergenic foods include cow’s milk products, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, and sesame. Drinking cow’s milk or fortified soy beverages is not recommended until your child is older than 12 months, but other cow’s milk products, such as yogurt, can be introduced before 12 months. If your child has severe eczema and/or egg allergy, talk with your child’s doctor or nurse about when and how to safely introduce foods with peanuts.

How Should I Prepare Food for My Child to Eat?

At first, it’s easier for your child to eat foods that are mashed, pureed, or strained and very smooth in texture. It can take time for your child to adjust to new food textures. Your child might cough, gag, or spit up. As your baby’s oral skills develop, thicker and lumpier foods can be introduced.

Some foods are potential choking hazards, so it is important to feed your child foods that are the right texture for his or her development. To help prevent choking, prepare foods that can be easily dissolved with saliva and do not require chewing. Feed small portions and encourage your baby to eat slowly. Always watch your child while he or she is eating.

Here are some tips for preparing foods:

Mix cereals and mashed cooked grains with breast milk, formula, or water to make it smooth and easy for your baby to swallow.
Mash or puree vegetables, fruits and other foods until they are smooth.
Hard fruits and vegetables, like apples and carrots, usually need to be cooked so they can be easily mashed or pureed.
Cook food until it is soft enough to easily mash with a fork.
Remove all fat, skin, and bones from poultry, meat, and fish, before cooking.
Remove seeds and hard pits from fruit, and then cut the fruit into small pieces.
Cut soft food into small pieces or thin slices.
Cut cylindrical foods like hot dogs, sausage and string cheese into short thin strips instead of round pieces that could get stuck in the airway.
Cut small spherical foods like grapes, cherries, berries and tomatoes into small pieces.
Cook and finely grind or mash whole-grain kernels of wheat, barley, rice, and other grains.

Learn more about potential choking hazards and how to prevent your child from choking.

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Feeding Your 4- to 7-Month-Old (for Parents)

Most babies this age are ready to try solid foods. Experts recommend starting solid foods when a baby is about 6 months old, depending on the baby's readiness and nutritional needs.

Be sure to check with your doctor before giving any solid foods.

Is My Baby Ready to Eat Solid Foods?

How can you tell if your baby is ready for solids? Here are a few hints:

Does your baby swallow food or push it out of their mouth? Babies have a natural tongue-thrust reflex that pushes food back out. Wait until this reflex disappears (typically when babies are 4–6 months old).
Can your baby support their own head? To eat solid food, an infant needs good head and neck control and should be able to sit up.
Is your baby interested in food? Babies who stare, reach and grab, and open their mouths for food are ready to try solid foods.

If your doctor gives the go-ahead but your baby seems frustrated or uninterested in solid foods, try waiting a few days before trying again. Breast milk and formula will still meet nutritional needs as your baby learns to eat solid foods. But after 6 months, babies need the added nutrition — like iron and zinc — that solid foods provide.

Do not add cereal or other food to your baby's bottle because it can lead to too much weight gain.

Watch for signs that your child is hungry or full. Respond to these cues and let your child stop when full. A child who is full may suck with less enthusiasm, stop, or turn away from the breast or the bottle. With solid foods, they may turn away, refuse to open their mouth, or spit the food out.

How Should I Start Feeding My Baby Solid Foods?

When your baby is ready and the doctor says it’s OK to try solid foods, pick a time of day when your baby is not tired or cranky. You want your baby to be a little hungry, but not so hungry that they’re upset. So you might want to give your baby a little breast milk or formula first.

Have your baby sit supported in your lap or in a high chair with a safety strap.

Most babies' first food is iron-fortified infant single-grain cereal mixed with breast milk or formula. Place the spoon near your baby's lips, and let the baby smell and taste it. Don't be surprised if this first spoonful is rejected. Wait a minute and try again. Most food offered to your baby at this age will end up on the baby's chin, bib, or high-chair tray. Again, this is just an introduction.

When your little one gets the hang of eating cereal off a spoon, it may be time to try single-ingredient puréed meat, vegetables, or fruit. The order in which you give them doesn't matter, but go slow. Offer foods that are high in iron and zinc — such as meat, poultry, eggs, and beans — especially if your baby is breastfeeding. Try one food at a time and wait several days before trying something else new. This will let you identify any foods that your baby may be allergic to.

Which Foods Should I Avoid?

Foods that are more likely to cause allergies can be among the foods you introduce to your baby. These include peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy. Waiting to start these foods does not prevent food allergies. Talk to your doctor if you’re concerned about food allergies, especially if any close family members have allergies, food allergies, or allergy-related conditions, like eczema or asthma.

Infants with severe eczema or egg allergies are more likely to have allergies to peanuts. Talk to your doctor about how and when to introduce these foods to your child.

Possible signs of food allergy or allergic reactions include:

rash
bloating or an increase in gassiness
diarrhea
vomiting

Get medical care right away if your baby has a more severe allergic reaction, like hives, drooling, wheezing, or trouble breathing.

If your child has any type of reaction to a food, don't offer that food again until you talk with your doctor.

Babies shouldn't have:

foods with added sugars and no-calorie sweeteners
high-sodium foods
honey, until after the first birthday. It can cause botulism in babies.
unpasteurized juice, milk, yogurt, or cheese
regular cow's milk or soy beverages before 12 months instead of breast milk or formula. It’s OK to offer pasteurized yogurt and cheese.
foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts

Tips for Feeding Your Baby Solid Foods

With the hectic pace of family life, most parents try commercially prepared baby foods at first. They come in small, convenient containers, and manufacturers must meet strict safety and nutrition guidelines.

If you prepare your own baby foods at home, here are some things to keep in mind:

Follow the rules for food safety, including washing your hands well and often.
To preserve the nutrients in your baby's food, cook it in ways that keep the most vitamins and minerals. Try steaming or baking fruits and vegetables instead of boiling, which washes away the nutrients.
Freeze portions that you aren't going to use right away.
Whether you buy the baby food or make it yourself, texture and consistency are important. At first, babies should have finely puréed single-ingredient foods. (Just applesauce, for example, not apples and pears mixed together.)
After your baby is eating individual foods, it's OK to offer a puréed mix of two foods. As babies get older, they will learn to eat a greater variety of tastes and textures.
If you use prepared baby food in jars, spoon some of the food into a bowl to feed your baby. Do not feed your baby right from the jar — bacteria from the baby's mouth can contaminate the remaining food. If you refrigerate opened jars of baby food, it's best to throw away anything not eaten within a day or two.
Around 6 months of age is a good time for your baby to try a cup. You might need to try a few cups to find one that works for your child. Use water at first to avoid messy clean-ups. Do not give juice to infants younger than 12 months.

Over the next few months, introduce a variety of foods from all the food groups. If your baby doesn't seem to like something, don’t give up. It can take 8 to 10 tries or more before babies learn to like new foods.

Pediatrician for a child under one year old

Kiseleva Elena Sergeevna

Candidate of Medical Sciences, Scientific Advisor MAMAKO ^®

After returning home from the maternity hospital, the mother has a large number of questions: how to care for the baby, why is he crying, how to feed the baby, and is it possible to be sure that there is enough milk. The main specialist to whom moms and dads ask all the questions that worry them, especially if they have their first child, is the local pediatrician. We tell you what a pediatrician does, on what issues you need to consult with him, how often to go to the clinic with a child of the first year of life, and in what cases to call a doctor at home.

WHAT DOES A PEDIATRIST DO? is engaged in the prevention and treatment of a number of childhood infectious and other diseases. The pediatrician also conducts explanatory conversations with parents. regarding the maintenance of the health of the baby, monitors the physical development child and his emotional state.

If necessary, the pediatrician can refer child for a consultation with a specialist. In the first year, regular preventive examinations are carried out both in the children's clinic and at home.

FIRST PEDIATRIC APPOINTMENT

During the first month of life, the pediatrician visits the child at home.

After the patronage of a newborn, as a rule, at the age of 1 month, they are already waiting for an initial appointment at the polyclinic.

What the pediatrician does at the first appointment :

physical examination;
will measure the height and weight of the child, sometimes the circumference of the head and chest;
will control the main development parameters;
refer to specialist doctors: surgeon, neurologist, ENT, ophthalmologist;
will issue a referral for examinations, according to the dispensary observation plan: as a rule, this is a complex ultrasound examination (ultrasound) of organs abdominal cavity, kidney, hip joints and other studies, complete the scope of which you can discuss with the pediatrician.

Do not worry too much about the baby and the upcoming extensive examination. Ultrasounds are usually performed in combination. This does not take much time: the ultrasound doctor examines the baby for about ten minutes. Reception with other specialists will also not be some kind of critical stage, the baby will endure everything calmly.

EXAMINATION OF CHILDREN UNDER A YEAR BY PEDIATRIC

In the first year of life, a pediatrician examines a child every month, and at the same There is almost always research going on. List of studies provided for by the Procedure for conducting preventive medical examinations ¹

Examination of a child up to a year old

Scheduled examinations in terms of time and nature of observations, as well as mandatory doctors up to a year old for a premature baby, if he is healthy, gains weight well and develops, will be the same as and for a full-term baby. In the presence of any pathology, the child will definitely visit a narrow specialist.

QUESTIONS YOU CAN ASK YOUR PEDIATRICIST

Feeding issues are a fairly common reason for visiting a pediatrician. Due to the fact that the gastrointestinal tract is still being formed, each baby reacts in its own way to the food that is offered to him, whether it is mother's breast milk, adapted milk formula or complementary foods. And, according to the experience of doctors and parents, no matter how much time is allotted for an appointment, most of it is devoted to the problems of breastfeeding and artificial feeding, the start of complementary foods and the transition to a common table.

ROUTINE IMMUNICATIONS FOR CHILDREN FROM BIRTH: PREPARATION RULES

The question of whether to vaccinate a child worries many mothers and fathers. Today it is obvious that there can be no two opinions on the question of whether to vaccinate a baby. Vaccination is the only way to protect your child from many dangerous infectious diseases. In our country, information about the necessary vaccinations, timing and the frequency of their conduct is contained in the National calendar of preventive vaccination ² . Seek advice from a doctor and a pediatrician will definitely answer all questions.

Remember that when properly preparing a child for vaccination, all the risks associated with complications can be avoided.

It is believed that breastfed babies may tolerate vaccination slightly easier than formula-fed babies. With breast milk, mother passes to your baby antibodies to certain infections. But again, this is all individual, and Each organism perceives the vaccine in its own way.

How to prepare a baby for vaccination

Can complementary foods be introduced immediately after vaccination? The immature body of a child critically perceives each new product and each new vaccination. Let it be small, but still stressful. Therefore, it is better to wait a few days, and then give the baby the next product according to the plan.

WHEN YOU NEED TO CONTACT A PEDIATRIST

An experienced mother who is raising more than her first child, as a rule, knows how to act and how to help her baby in many situations, including colds, colic, rashes, teething. But for the parents of the firstborn, each uneven breath of the child will be an emergency event, and somehow it is impossible to protect yourself from this. Preventive conversations with the pediatrician will help here.

When do you call a pediatrician at home? It is important to assess the general condition of the child, his activity and appetite. With fever, cough and runny nose, rash, any injury, refusal to eat, the appearance of digestive disorders, increased drowsiness requires specialist supervision. And it's better if the doctor comes to the house, to examine the baby and decide on his treatment.

Don't put off a visit to your local pediatrician. This is the closest doctor throughout the entire time until the baby grows up and moves to an adult clinic. Let all your visits be exclusively preventive. Let your baby grow strong and healthy!

* Breast milk is the best food for babies. WHO recommends exclusive breastfeeding for the first 6 months of a child's life and continued breastfeeding after complementary foods are introduced until the age of 2 years. Before introducing new products into the baby's diet, you should consult with a specialist. The material is for informational purposes and cannot replace the advice of a healthcare professional. For feeding children from birth. The product is certified.

Information sources

Order of the Ministry of Health of the Russian Federation N 514n dated August 10, 2017 “On the Procedure for Conducting
Preventive Medical Examinations of Minors”

Order of the Ministry of Health of the Russian Federation N 125n dated March 21, 2014 National calendar
preventive vaccinations. (as amended by the Orders of the Ministry of Health of the Russian Federation of 06/16/2016
N 370n, of 04/13/2017 N 175n, of 04/24/2019 N 243n, of 09/14/2020 N 967n, of
of 02/03/2021 N 47n)

#Tips for Mom #first check-up

Union of Pediatricians of Russia

Introduction of complementary foods

How to introduce complementary foods correctly is one of the most pressing issues that concern parents.

In the first months of life, the main food for the baby is breast milk or an adapted milk formula, however, as the child grows and develops, this becomes insufficient and it is necessary to think about the introduction of complementary foods.

Your baby is over 4 months old. He has noticeably grown up, become more active, is interested in objects that fall into his field of vision, carefully examines them and reaches for them. The child's emotional reactions have become much richer: he smiles happily at all people, makes various sounds. Perhaps you notice that the child looks into your plate with interest, closely monitors what and how you eat, does this mean that it is time to introduce complementary foods? And where is the best place to start? Let's figure it out!

When should complementary foods be started?

According to the Program for optimizing the feeding of infants in the first year of life in the Russian Federation (2019), the recommended age for the introduction of complementary foods is in the range from 4 to 6 months.

The following points will help determine the readiness of the baby for the introduction of complementary foods:

1. Food interest - you can check its presence as follows: during your meal, give the baby an empty spoon or fork, and if he plays with it, licks it, then there is no food interest yet; but if the child is dissatisfied with the fact that the spoon is empty, food interest has probably appeared. “But how does a child understand that there should be food in a spoon?” Parents often ask. The answer is quite simple: take your baby to the table with you so that he can see how you eat!

2. The child can sit alone or with support. It is unacceptable to feed the child lying down, because he may choke.

3. Extinction of the “pushing out” reflex - when the baby pushes out of the mouth both the offered food and the pacifier, etc.

Why is it not recommended to introduce complementary foods before 4 and after 6 months of life?

Before 4 months of life, the baby is not yet ready to digest food other than breast milk or infant formula. By this age, a number of digestive enzymes mature, a sufficient level of local immunity is formed, which reduces the risk of developing allergic reactions, the child acquires the ability to swallow semi-liquid and thicker food, which is due to the extinction of the “spoon ejection reflex”. The introduction of complementary foods after 6 months can cause a pronounced deficiency of micronutrients (iron, zinc, etc.) and lead to a delay in the formation of chewing skills for thick foods. Too late the introduction of a variety of products increases the risk of allergic reactions. Remember that the timing of the introduction of complementary foods is set individually, taking into account the readiness of the child to accept new foods.

Complementary feeding guidelines:

1. introduce a new product in the first half of the day to track possible reactions to it;

2. cereals, vegetable / fruit / meat purees should be introduced, starting with monocomponent ones, gradually adding other products of this group;

3. start giving a new product with 1/2 teaspoon, gradually increasing the volume to the age norm within a week;

4. It is not recommended to introduce new products during acute infectious diseases or at some special moments (moving to another apartment, leaving the city, on vacation, illness of parents, etc.).

What is the best way to start complementary foods?

The first complementary food can be anything. Often parents worry that if the child first tries the fruit, then because of its sweet taste, he will refuse other foods. We hasten to reassure you: breast milk is also sweet, so babies may like sweet fruits / berries more, but this does not mean at all that he will refuse vegetables or cereal. Traditionally, they begin to introduce complementary foods in the form of mashed potatoes, but if the child shows interest in “pieces”, then, observing the safety rules, you can give them. Also, along with the introduction of complementary foods, you can offer the child water.

With the start of the introduction of complementary foods, the child is gradually transferred to a 5-time feeding regimen. If the baby shows that he is full and no longer wants to eat (for example, leaning back or turning away from food), then you should not continue to force him to feed, because this can lead to eating disorders in the future. Also, do not force the child to eat as much as possible before bedtime in the hope that he will not wake up for nightly feedings.

Traditionally, in our country, complementary foods begin with vegetables or cereals.

Vegetables: zucchini, broccoli, cauliflower, pumpkin, etc. If the child did not like the dish, for example, broccoli, do not give up on your plan and continue to offer this vegetable in small quantities daily, you can even not once, but 2-3 times, and after a while (7-14 days) the baby will get used to the new taste. This diversifies his diet, will help form the right taste habits in the child.

As for cereals, it is worth starting with dairy-free gluten-free ones - buckwheat, corn, rice. You can use commercial baby food porridge, which is enriched primarily with iron. In addition, such porridge is already ready to eat, you just need to dilute it with water, which will save you a lot of time.

It is also recommended to add oil to food, for example, vegetable puree to vegetable puree, and butter to porridge.

Of meat products, lean meats, such as mashed turkey or rabbit, are most preferred to start complementary foods. Meat puree contains iron, which is easily absorbed, and adding meat to vegetables improves the absorption of this micronutrient from them. Subsequently, the daily use of children's enriched porridge and mashed meat allows you to meet the needs of babies for iron, zinc and other micronutrients.

When introducing fruit purees (apple, pear, peach, prunes, etc.) into your baby's diet, you should pay special attention to the composition of the product - it is important that it does not contain added sugar.

Fish is a source of easily digestible protein and contains a large amount of polyunsaturated fatty acids, including the omega-3 class, as well as vitamins B2, B12, and minerals. Preference should be given to oceanic fish, preferably white (cod, hake, pollock, sea bass, etc.), salmon can be recommended from red, and pike perch from river.

Fermented milk products are prepared using a special starter culture that breaks down milk protein, so that the baby can get an indispensable set of amino acids in a well-available form. Some foods have added prebiotics, certain vitamins and minerals. Their regular use favorably affects the functioning of the intestines, increases appetite and the absorption of micronutrients.

Recommendations and timing of the introduction of complementary foods for children at risk of developing food allergies and suffering from food allergies are the same as for healthy children. Delayed introduction of highly allergenic foods has previously been recommended to prevent the development of allergic diseases in children at risk. There is now evidence that this practice may lead to an increase rather than a decrease in the incidence of food allergies. The most common highly allergenic foods include cow's milk, chicken eggs, soybeans, wheat, peanuts, tree nuts, shellfish and fish. If a child has a high risk of developing allergies or an existing allergic disease, it is recommended to consult a pediatrician, an allergist-immunologist before introducing highly allergenic products.

By the age of 8 months, when all the main food groups have already been introduced and your baby is improving his skills to eat on his own, special attention should be paid to the diversity of the composition of dishes and the change in food consistency - from puree to finely and coarsely ground. Soft foods cut into small pieces (fruits, vegetables, meat, etc.) are perfect for a little gourmet, which diversifies his diet and will contribute to the formation of chewing skills.

By 9-12 months, most babies have the dexterity to drink from a cup (holding with both hands) and to eat foods prepared for other family members. This behavior needs to be encouraged, but combined with regular feeding to meet energy and nutrient requirements.

It is advisable to use industrial products that are designed specifically for young children after a year.

What should not be given to the baby?

It is not recommended to add salt or sugar to food to enhance the taste.

Drinks that should be avoided include fruit juices, whole cow and goat milk (whole milk is not recommended for children under one year old, and even longer, due to a high risk of developing iron deficiency and increased kidney stress), sweet fruit drinks, compotes and carbonated drinks.

Also, some foods should be excluded from the diet of infants: solid round foods (for example, nuts, grapes, raw carrots, raisins, peas, etc.), due to the fact that the child can choke on them.

It is not recommended to eat products with added sugar, for example, confectionery (marshmallow, marshmallow, marmalade, jam, jam, cookies, waffles, etc.), etc.

You should not give your child the meat of large predatory fish (shark, bigeye tuna, king mackerel, swordfish): these types of fish accumulate more harmful substances than others.

It is forbidden to give honey to children under one year old due to the fact that it may contain spores of Clostridium botulinum bacteria, which in the still immature digestive system of babies are able to multiply, produce toxins directly inside the intestines and, thus, cause infant botulism, which can be fatal. outcome.

Do not give babies raw meat, fish, eggs, caviar, salted fish, soft pickled cheeses because of the risk of intestinal infections.

If you follow all these simple rules, your baby will grow up healthy and happy!

Diets for different ages

References:

1. Methodological recommendations. The program for optimizing the feeding of children in the first year of life in the Russian Federation. [Internet]. - M.: Union of Pediatricians of Russia, 2019. [Methodicheskie rekomendaczii. Programma optimizaczii vskarmlivaniya detej pervogo goda zhizni v Rossijskoj Federaczii. [Internet]. – Moscow: Soyuz pediatrov Rossii, 2019.