When to start top feed for babies

Formula Feeding FAQs: Starting Solids and Milk (for Parents)

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

When Can My Baby Try Solid Foods?

Doctors recommend waiting until your baby is about 6 months old to start solid foods. Some babies may be ready for solids sooner than 6 months, but wait until your baby is at least 4 months old.

Babies who are ready to eat solids foods:

are interested in foods (for example, they may watch others eat, reach for food, and open their mouths when food is near)
hold up their heads well, and sit up with little or no help
don't push food of their mouth (which is a natural tongue reflex that disappears when babies are 4–6 months old)
usually weigh twice their birth weight, or close to it

Talk to your doctor about the right time to start solid foods.

How Do I Introduce Solid Foods?

When the time is right, start with a single-grain, iron-fortified baby cereal. Start with 1 or 2 tablespoons of cereal mixed with breast milk, formula, or water. Feed your baby with a small baby spoon. Don’t add cereal to a baby's bottle unless your doctor recommends it.

When your baby gets the hang of eating the first food, introduce other foods from all food groups, such as puréed meats, fruits, vegetables, grains, beans, and yogurt. Wait a few days between introducing new foods to make sure your baby doesn't have an allergic reaction.

You can include foods that are more likely to cause allergies — such as peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy — among the foods you introduce to your infant. Waiting to start these foods does not prevent food allergies.

Talk to your doctor before giving foods that contain peanuts if your baby has severe eczema or an egg allergy, as these conditions make an allergy to peanuts more likely. Eating peanut-containing foods early on may lower a child’s chances of developing a peanut allergy. But your doctor will need to decide if you can give peanuts to your baby, and the safest way to do it. Usually, this requires allergy tests.

Should We Avoid Some Foods?

Yes, don’t give your baby:

foods with added sugars or 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 instead of breast milk or formula before 12 months. It’s OK to offer pasteurized yogurt and cheese.
foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts

Always supervise your child when eating. Make sure your child is sitting up in high chair or other safe place.

When Can My Baby Have Cow's Milk?

Before their first birthday, babies still need the nutrients in breast milk or formula. But after that, they’re ready to switch to cow's milk.

Most kids under age 2 should drink whole milk. If a toddler is overweight or there is a family history of obesity, high cholesterol, or heart problems, your doctor might recommend switching to reduced fat (2%) milk.

If your child can’t drink cow’s milk, choose an unsweetened soy beverage fortified with calcium and vitamin D. Other milk alternatives, like almond, oat, rice, or coconut milk, have less protein and may not be fortified.

How Do We Switch to Cow’s Milk?

You can switch your baby from formula to whole milk by replace bottles of formula with bottles — or sippy cups — of milk. By 1 year old, your baby should be eating a variety of solid foods and drinking about 16 to 24 ounces (480–720 milliliters) of milk per day.

When Can I Start Giving My Baby Water and Other Drinks?

In their first 6 months, healthy babies drinking enough formula usually don't need extra water. Once your baby is eating solid foods, you can offer a small amount of water between feedings, up to 4–8 ounces a day.

Water that has fluoride helps prevent tooth decay. If your water does not have fluoride, talk to your doctor or dentist about fluoride drops.

Do not give juice to babies younger than 12 months. After your child’s first birthday, limit 100% fruit juice to no more than 4 ounces a day. Always serve juice in a cup, not in a bottle. Don’t give your child sugar-sweetened beverages, including soda, juice drinks, sports drinks, and flavored milks.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 2021

Feeding your baby: When to start with solid foods

Up to 6 months old

From the first hour of life, through to 6 months old, your baby can receive all of the nutrition she needs to grow and develop from your milk. She doesn’t need anything else – no water, tea, juice, porridge or any other foods or fluids during this period.

Myth: Babies need solid food sooner than 6 months old

When you breastfeed your baby frequently, starting foods earlier than 6 months is not necessary and can even be harmful.

Introducing foods or fluids other than breastmilk to your baby before she is 6 months old can increase her risk of illnesses, such as diarrhoea, which can make her thin and weak, and even be life-threatening. Your baby may also breastfeed less often, so your supply of milk, her most vital food, may decrease.

A mother’s milk is the safest and healthiest food for the first 6 months of life for all children everywhere. It is a constant, safe source of essential nutrition, wherever you and your baby live in the world.

Feeding signs

If you see your baby with her hands near her mouth when she’s still younger than 6 months, you may think she’s not getting enough to eat from your milk alone. Actually your baby is showing normal feeding signs, they are just more developed now that she’s older. It doesn’t mean your baby needs solid food early. Your baby is ready when she is 6 months old.

Myth: Boys need more than breastmilk

Both baby girls and boys need the same amount of food to be healthy and grow strong and smart. Your milk alone will meet the nutrition needs of both a son or a daughter in these first months of life.

6 months and older

When your baby reaches 6 months, his rapid growth and development require more energy and nutrients than your milk alone can provide. He needs to start eating solid foods in addition to breastmilk to keep up with his growing needs.

When to feed your baby solid foods

Feed your baby whenever you see him give feeding signs. After washing hands with soap, start by giving your baby just two to three spoonfuls of soft food, such as porridge, mashed fruits or vegetables, twice a day. Continue to breastfeed as often as before.

Non-breastfed babies

If you do not breastfeed your baby, the best time to introduce her to solid foods is also at 6 months of age. This is the age when all babies, breastfed or not, need to start getting solid foods to ensure they are getting all the nutrition their growing bodies need.

Living with HIV

If you are living with HIV, introduce your baby to his first solid foods at 6 months and continue to breastfeed him while taking your ARV medicines and following your treatment plan.

Don't wait too long to start solid food

Your baby’s body needs the extra energy and nutrients to help him to keep growing. Waiting too long may cause your baby to stop gaining weight at a healthy rate, and put him at risk of becoming thin and weak.

what products are possible, features of complementary foods

It is no secret that young and not very experienced mothers receive information on the nutrition of an infant, including recommendations on how to introduce the first complementary foods, mainly from two sources: grandmother's stories and from the Internet. Unfortunately, both of these respected sources of information may voluntarily or not voluntarily, but be very mistaken, since grandmothers grew up in a more prosperous time in terms of environmental conditions, and the Internet is littered with various articles that are rarely written by professionals, moreover, they rely either on explicit outdated guides on baby food, or frankly on unverified information.

In this article, I will try to combine the latest scientific data and recommendations on how to introduce the first complementary foods with many years of observations from the experience of a practical pediatrician and an allergist-immunologist.

At what age is it time to introduce the first complementary foods

According to the recommendations of the Research Institute of Nutrition of the Russian Academy of Medical Sciences, the first complementary foods can be introduced from 4.5 - 5 months, regardless of the type of feeding. This is "average". In practice, the choice of when to start introducing complementary foods still depends on the individual characteristics of the child. For example, for a child with widespread atopic dermatitis (diathesis), we will not introduce complementary foods until at least acute skin symptoms, such as cracks, weeping or secondary eczema, have steadily disappeared. Increased dryness and flaking of the skin, of course, require constant application of moisturizers to the skin, but in no case are they a contraindication to the start of the introduction of the first complementary foods.

Another important point when choosing the time to start introducing complementary foods is the dynamics of the child's weight gain. The more intensively the child gains in height and weight, the sooner he may need additional calories, since the energy value of breast milk or artificial formula alone will most likely not be enough for a child who grows faster than his peers by 4 - 5 months. We must not forget that natural products contain a fairly large range of minerals and vitamins, and a mother’s body, alas, cannot be an eternal and bottomless source of useful nutrients, somewhere something will gradually begin to be missed.

In addition, the nature of lactation in the mother has a great influence on the timing of the introduction of complementary foods. If a nursing mother begins to feel a lack of milk, I would prefer to first give her advice on stimulating lactation, and at the same time begin to introduce complementary foods. It will be better than introducing an artificial mixture. But I repeat that the earliest start date for the introduction of the first complementary foods is the age of 4 months, before the child's body is not yet ready, the risk of developing allergies is also high.

So, we agree with you that the first complementary foods can be introduced no earlier than 4 months of a child's life.

First complementary foods: Which foods to choose?

The first complementary foods, as a rule, should consist of vegetable or fruit purees, but in no case juices. Still, juices, even for children, are highly filtered, mainly contain a large amount of organic acids and “light” carbohydrates (that is, sugar, to make it clear to everyone). I will not waste time explaining why juices are harmful to an infant, but I will describe a clinical case from practice.

Parents with an 8-month-old girl came to the reception. Somewhere from 5 months she practically did not gain weight, although before that all indicators were normal. In the analyzes, apart from visible signs of iron deficiency, slightly reduced hemoglobin, no pathology was also detected. The main complaint: "does not eat anything." And when I began to find out what she still eats, it turned out that the child drinks half a liter of juice every day. But porridge or cottage cheese, or mashed potatoes cannot be forced together, they spit everything out. I don't like the taste. And so - for three months. The child, of course, became very nervous, yelling at night, demanding juice.

So draw your own conclusions and be careful.

For the first feeding, this is now recognized by everyone, the best dishes are vegetable purees from green varieties of vegetables: zucchini, cauliflower, broccoli. The first complementary foods are introduced, starting with half a teaspoon, in the morning for three days, then gradually increase the amount of the product to 40-50 grams per week. Supplemented with breast milk or formula.

For problems with stools, constipation, it’s good to start introducing prune puree, green apple, you can try pumpkin, even apricot puree, but in no case start with carrots. Beta-carotenoids, which are abundant in carrots, are generally poorly absorbed and can cause allergies in a child.

Second food. Porridge or meat?

Even 5 - 6 years ago, we taught students at the medical institute that from 5 - 5.5 months old, an infant should begin to give cereal porridge for complementary foods. This is rice, buckwheat, corn. The first week you can cook 5% porridge: 5 grams of ground cereal per 100 ml of water. Then the porridges are cooked already denser: 10 grams of cereal per 100 ml of water. But now, basically everyone uses instant (soluble) cereals, which are diluted with water according to the instructions on the package. In addition, ready-to-eat liquid cereals are on sale: for example, Bellakt, Frutonyanya, etc.

Why meat? You ask. According to modern recommendations (they really began to change quite often), but in this case I support: if a child has a pronounced decrease in hemoglobin in the blood below 100 g / l by the age of 5 months, it makes sense to start introducing fruit or vegetable purees as a second types of complementary foods - meat purees as a source of the most well-absorbed heme iron. You need to choose from varieties such as turkey, rabbit, lamb. Beef and veal can only be offered to children who did not have red cheeks and diathesis.

In the absence of problems with low hemoglobin, feel free to introduce porridge as the second meal of complementary foods, especially if the child is small and does not gain weight very well. In this case, we can recommend breeding cereals with the addition of breast milk or a mixture (Nan, Nutrilon, Celia, Nanny). With mixtures based on goat's milk, parents of children with a predisposition to allergies should be very careful. Goat milk formulas are not the best choice for babies who are allergic or intolerant to cow's milk protein, whatever the internet says. Believe me, there are serious scientific articles by foreign authors, which provided data on a very high frequency of cross-allergy between cow and goat milk proteins in children who were transferred to goat milk mixtures. And I saw it myself in my practice, when a child with dermatitis was transferred to a mixture of goat's milk, there was a clear improvement for a month or two, and then all over again and with a doubled degree of allergic skin damage.

Introduction to fermented milk products

This is the most difficult question. I am sure that most of our grandparents demand that their stupid parents start drinking milk and kefir as soon as possible. In a number of cases, children really start to absorb sour-milk products quite well after 6 months, but before this age I am very careful even with sour-milk Agusha, and even introducing milk or kefir before 6 months is a bad form, believe me, and can lead to very bad consequences for the child. I understand the Western European medical community, which has recently banned its pediatricians from recommending fermented milk products for complementary foods for children under 3 years of age, just imagine!

They (the Europeans) need to do something with their artificial milk mixtures. Even 20 years ago, we did not know other mixtures after the "two", that is, the second formula for children from 6 to 12 months. Then there were formulas for children from 1 to 2 years old, then from 2 to 3 years old, and now there are already mixtures for children up to 4 years old, and I think if this goes on, then until the age of sixteen there will be their own milk substitutes. Dismiss me, I don't think this approach is correct. But the fact is that our grandparents had much better genetics than the generation of our children, alas. In the context of the growth of medical capabilities, genetically determined diseases are also growing, and in this case, intolerance to cow's milk protein, and with every 10 years there are more and more such people among us. But if a child really suffers from an allergy to cow's milk protein or is severely deficient in enzymes, then he will carry this peculiarity through his whole life, and most likely he will not drink milk or kefir himself, and there is no need to force him if he himself won't want to!

But you are lucky with genetics, and no one in the family has ever had an allergy (which is hard to imagine nowadays), and most importantly, if your child has always had perfectly clean skin, then the first of the dairy products - cottage cheese, you will begin to offer your child with 7 months, kefir - from 10 months. Milk - after a year. It will be better this way.

But if your family does not have a very close and joyful relationship with milk, then it is better to postpone even the introduction of kefir and yogurt into complementary foods for a child until the age of 18 months.

Fish day and first meal

Fish is a very healthy product, rich in vitamins and antioxidants, but it must also be introduced carefully. I advise you to start introducing the first fish food at about 7-8 months. It is better to start with species such as cod, hake, haddock. The rules are the same: the first three days on the "gram," then slowly add. If there are no problems in a week or two, you can try such delicacies as tuna or salmon, of course, canned children, if you can find it. It is better not to mess with trout and salmon in the first year of life, this fish is all stuffed with dyes and antibiotics.

No matter how hard I tried, the article about the first complementary foods turned out to be long. Thank you for reading to the end, I hope it will be useful. If you have questions about the introduction of complementary foods, you can write your appeals on our website in the question to a specialist section. A short answer can be obtained on the Internet, but in order to make a diagnosis and give a detailed consultation, of course, you need to come to a face-to-face appointment with a pediatrician and a pediatric allergist.

at what age to introduce when breastfeeding and artificial feeding, how to cook at home

When to introduce the first complementary foods

Today there are no hard and fast rules and deadlines for the introduction of complementary foods. Parents should first of all focus on the signs of the child's readiness for complementary foods. Here is what pediatrician, candidate of medical sciences Anna Levadnaya advises to pay attention to , the author of a blog about pediatrics and not only on Instagram.

The child holds his head confidently.

Can sit with support, meaning it can be placed in a high chair or placed on an adult's lap.
The baby shows an active interest in food: he is interested in food, watches what adults eat.
Breastfeeding or formula feeding is well organized and does not cause any problems.
The child can put his hand to his mouth, puts various objects in his mouth, such as toys. In this case, the baby chews or champs.

As a rule, all these signs appear in the period from 5.5 to 7.5 - 8 months, but most often around 6 months. All babies develop differently, and one baby may be ready to try his first puree or porridge as early as 5 months, and another at 6 or 7 months will refuse the new food you offer.

What complementary foods a child needs in the first months

And here again, there are no strict recommendations and rules. On the contrary, many experts agree that it doesn’t matter which dish you start complementary foods with, the most important thing is to provide the right nutritional interest. In this case, the child will eat all the foods that you offer him.

In Russia, it is customary to focus on the following complementary feeding scheme. The first to introduce cereals or vegetables, depending on the weight of the child. As a rule, vegetables are first, then cereals, then meat, then fruits, then cottage cheese. In some US states, for example, on the contrary, it is recommended to start complementary foods with meat. But the general message of the recommendations is to maximize the variety of tastes and textures in the first year of life. From vegetables in the first months, you can offer zucchini, cauliflower, broccoli, pumpkin, carrots, potatoes. Of the cereals, gluten-free are the first to be introduced: rice, buckwheat, corn. From fruits - apple, pear, banana, peach and others. From meat - it is better to start with a rabbit, turkey, chicken, veal.

— At the very beginning, complementary foods should be puree-like, says Anna Levadnaya. - It is better to give preference to monocomponent purees so that the baby learns to distinguish between different tastes. As you introduce vegetables and cereals, add butter and vegetable oils to them. If there are no problems with the introduction of complementary foods, it is recommended to use the maximum variety of food textures as early as possible. Starting from 7-8 months, the baby can and should be introduced to semi-solid foods. This is very important for the correct formation of food interest, and for the development of chewing skills, the correct functioning of the tongue, the development of speech, the “tweezer” grip, and the coordination of the work of hands, mouth and eyes. If you do not introduce semi-solid food in time, then there may be problems with the introduction of already solid food, and after a year the child will refuse it completely. Therefore, starting from 7-8 months, the baby can be offered mashed or pureed food, such as a banana. From 8-9months, give the so-called "finger" food: cut into pieces soft fruits and vegetables, such as boiled carrots, potatoes, and put in front of the baby. By one year, the child is ready to eat solid food from the common table.

How to feed your baby correctly

It used to be that complementary foods should be introduced very carefully and gradually, always in the morning, many parents still introduce each product over a week or two, very slowly increasing portions.

— These recommendations are relevant, perhaps, only for the very beginning of complementary feeding, the first two or three weeks, — notes Anna Levadnaya. - In general, in children without food allergies, the most rapid and varied expansion of the diet is recommended. That is, a new product can be safely introduced every 2-3 days. If you need to breed complementary foods, for example, baby cereals, then it is better to do this with breast milk or formula, and not with cow's. Whole milk is not recommended for children under one year of age.

Also with the introduction of complementary foods, offer your child water, either bottled for children or boiled. It is recommended to offer water from a cup so that the child learns to drink, and not from a drinking bowl, a bottle with a tube or a pacifier.

Photo: pexels.com, MART PRODUCTION

Monitor your child's well-being, in case of any changes that worry you, consult a doctor.

Complementary foods with natural and artificial feeding

Mothers often wonder if there are any differences in the introduction of complementary foods with natural and artificial feeding. In both cases, the recommendations are the same: it is recommended to focus on food interest, signs of the child's readiness for the introduction of complementary foods. Usually, as we have already noted, the baby receives only breast milk or an adapted milk formula up to 6 months. With exclusive breastfeeding, it is not recommended to supplement the baby with water, especially in the first month, when lactation is established. Bottle-fed babies can be offered water.

For both breastfeeding and artificial feeding, it is recommended to offer the baby a new food before feeding, and then supplement it with breast milk or formula.

— It is desirable to keep breast milk or formula in the diet of a child up to a year, — says Anna Levadnaya. - After a year, it is better to leave the bottle completely, gradually reducing the amount of the mixture. After a year, preferably closer to one and a half, cow's milk can be offered if the child is not allergic to its protein. Breastfeeding can be continued as long as it brings pleasure to mother and child.

How to prepare the first complementary foods

Give canned puree and baby cereals or cook it yourself? This question worries many mothers.

“In fact, there is no universal advice here,” says Anna Levadnaya. - Do what is comfortable and best for you. But when choosing food, remember that you must be confident in the products you buy. If you are not sure, buy canned purees, industrial baby cereals. The main advantage of any industrial baby food is that the products from which it is made are tested for the content of pesticides, heavy metals, nitrates and other harmful substances (labeled up to 3 years). If you're cooking yourself, cook with either seasonal fruits and vegetables or frozen ones. It is best to do it for a couple - this is how most vitamins and minerals are preserved. The advantage of homemade products is that we can provide the child with a different consistency, which is very important. But in any case, choose what is more convenient for you, more comfortable, including financially. The main principle is to provide the baby with a varied diet. Alternate between different foods.

Photo: pexels.com, Enrique Hoyos

If you decide to cook yourself, follow our tips on how to prepare puree and porridge for the first meal.

Vegetable puree

Zucchini, broccoli, cauliflower, carrots, pumpkin are suitable for the first feeding. The vegetable should be fresh, without dark spots. We clean it from the peel, boil or steam it. Then we pass through a blender. The vegetable should be quite soft to get the most uniform consistency (if necessary, you can add a little boiled water). If it did not work out, then additionally the mass can be rubbed through a fine sieve.

Fruit puree

To prepare fruit puree for your baby, such as apple or pear puree, the fruit must first be baked in the oven, then peeled and passed through a blender or sieve to obtain the most homogeneous consistency. Choose fresh, ripe, seasonal fruits.

Porridges

Soak groats (for the first feeding, remember, this is rice, buckwheat, corn) for 4-5 hours in warm water. Then dry, for example, in a preheated oven. Next, grind the porridge in a coffee grinder into the consistency of flour and cook in water until cooked, this is about 5 minutes. For one tablespoon you need about 50-70 ml of water.

The main mistakes of parents

In fact, there is nothing complicated in the management of complementary foods. Use the guidelines, common sense, and have fun introducing your little one to new foods. With Anna Levadna, we have compiled a list of mistakes that parents often make when introducing complementary foods. Try to avoid them.

In a hurry

It often happens that a child refuses the first complementary foods. Most often, this suggests that the baby is simply not ready for it yet. And the parents, by hook or by crook, are trying to feed him mashed potatoes or porridge. Under no circumstances should you force-feed your baby. It is worth postponing the introduction of complementary foods for one to two weeks.

Give mashed food from a bottle

This should not be done because the child must learn to eat liquid and solid food separately.

Salt or sugar is added

These components are not recommended to be introduced into complementary foods for a child under one year old, sugar is better up to three years.

Only the bottle is used for too long

For example, in addition to formula, if the child is on IV, they give water, compote and other drinks from the bottle. The danger is that long-term use of the bottle can reduce the child's desire to eat complementary foods and malocclusion, as well as lead to speech delay and swallowing problems.