Aap starting solids 4 months

Infant Food and Feeding

Based upon evidence, a number of desired behaviors were identified as critic​​al to helping families foster healthy active living for their infant. For each desired behavior you can explore the evidence, learn what parents told us about these behaviors, identify opportunities to promote healthy behaviors at the point of care, review how to start conversations and access messages and resources to support families. Also available to inform your counseling is the Onset and Patterns of Risk Behaviors during Infancy Timeline located above this section.

Breastfeeding

• ​Exclusive breastfeeding for approximately 6 months.
• Continue breastfeeding until the baby's first birthday or longer while mutually desired by mother and baby.

• • ​​Breastfed babies who are breastfed for at least 6 months are less likely to be overweight.
  • The duration of breastfeeding also is inversely related to the risk of obesity.
  • A reduction of 40% in the incidence of type 2 diabetes mellitus is reported, reflecting the long-term positive effect of breastfeeding on weight control and feeding self-regulation.
  • 80% of mothers expect to breastfeed yet only 14% are exclusively breastfeeding at 6 months.
  • Critical periods for breastfeeding cessation are transition home from hospital, 6-8 weeks, transition back to work, and between 6-8 months due to self-weaning and/or introduction of solids.​
• • Breastfeeding was harder than they expected. Many tried but did not maintain.​
  • Surprised to learn that breastfeeding can impact obesity and many felt this info could impact decisions around duration.​
• • Support new mothers in breastfeeding. Provide lactation services at your office or know about sources of lactation support in your community.
  • Provide ongoing encouragement for breastfeeding at well visits. Ask patients about challenges or concerns.
  • Let mothers know It is wonderful that they are breastfeeding their baby. And that breastfeeding is great for their baby and has health benefits for them too.
  • If mothers are returning to work assure them that with careful planning and a few resources they can make breastfeeding work.
  • Remind families that babies reap the benefits of breastfeeding for their entire first year!

• Newborn, early months:

  • It is so great that you are breastfeeding your baby. It can be very rewarding but challenging too. How is breastfeeding going for you? Do you have any concerns about breastfeeding your baby?
  • Can you tell me about a typical feeding experience? Tell me how yo​​​ur family and friends (spouse, grandparents, etc) are supporting you with feeding your baby?

  For 2 or 4 month visit:
  

  • It is wonderful that you are continuing to breastfeed your baby. Are you exclusively breastfeeding?
  • Are you returning to work? Many women continue to successfully breast feed after returning to work. Tell me about your feelings about this. Are there any questions I can answer to help you during this time of transition?
  • Are you having any challenges maintaining exclusive breastfeeding?

  For 6 and 9 month visit:
  

  • It is wonderful ​​that you are still breastfeeding. Is there anything can I do to support you in your breastfeeding?

• HALF Message(s): 
  Lots of parents are surprised to find out that babies who are breastfed for at least 6 months are less likely to be overweight or obese as they get older. Breastfeeding can be a lot of work, but it’s a great way to bond with your baby and help him stay healthy. 

  HALF Resources: 
  For realistic parent derived strategies for breastfeeding refer parents to the following section​​​​s on healthychildren. org/growinghealthy:

  Quick Tips: Keep Your Child Healthy widget​.
  Simply select Breastfeeding to generate the results.

  Food and Feeding Infants.

  Also take advantage of the HealthyGrowth​ app​ to create personalized patient education for your patient.​

​Bottle Feed​​i​ng

Practice appropriate bottle feeding practices:

• Avoid bottle propping
• Only breastmilk or formula in bottle unless otherwise directed by physician​

• • Inadequate feeding practices associated with bottle feeding of infant formula or use of bottle feeding as a methods to soothe infants can contribute to greater energy intake.
  • It is not uncommon for mothers add cereal to the bottle in the belief that doing so will help the infant sleep longer.
  • A substantial number of families introduce solids early especially if they perceive the infant as fussy.
  • Inattention to a child’s hunger and satiety cues has been associated with infant overfeeding.
• • Other family members and friends were influencers and provided “evidence” that cereal in the bottle helped baby sleep.
  • Parental exhaustion/desire for sleep is a big motivator  to add cereal to the bottle.

   

• • If parent reports fussiness, counsel parent about importance of responding with an array of strategies, not just feeding.
  • If parent reports sleeping problems, counsel about bedtime routines, healthy sleep practices, and realistic sleep expectations based upon baby's age.
  • Let parents know that it is important that it will get better.
  • Encourage parents to make feeding time responsive and pleasant for them and their baby.
• • ​It can be difficult when a parent and baby are not getting enough sleep. Can you tell me how this is going for you?
  • It can be difficult when a baby cries a lot. How is it going with your baby? Would you like to talk about some ways to soothe your baby that don’t involve feeding?
  • Can you tell me about what feeding time is like for you and your baby?
  • Tell me how your family and friends (spouse, grandparents, etc) are supporting you with feeding your baby.
  • How would you describe your baby? Is she content, fussy, sleepy, etc?

   

• HALF Message(s): 
  Some parents (and grandparents!) worry that young babies aren’t getting enough to eat. But there’s no need to worry — babies under age 6 months get everything they need from breast milk or formula.

  HALF Resources:
  For realistic parent derived strategies for bottle feeding refer parents to the following sections on healthychildren.org/growinghealthy

  Also take advantage of the HealthyGrowth​ app​ to create personalized patient education for your patient.

​​​Food Intr​oduction

• Introduce solid foods around 6 months of age
• Expose baby to a wide variety of healthy foods
• Also offer a variety of textures

• • A substantial number of families introduce complementary solid foods around 3-4 months, especially if the infant is perceived as fussy.
  • Formula fed infants are at more risk for early introduction of solids.
  • Introduction to solids prior to 4 months is associated with increased weight gain and adiposity, both in infancy and early childhood.
  • Research indicates that it is important to expose children to a wide variety of flavors and textures.
  • Many babies and toddlers need to be exposed to foods multiple times before accepting them.
  • Babies and toddlers are more likely to eat foods they see their peers and parents eating.
• • Other family members and friends were influencers and provided false evidence that introducing solids helped calm fussy babies.
  • Parental frustration and desire for happy babies were big motivators to introduce solids.
  • Parents cited the concern about wasting food.
  • Many parents assumed once their child rejected a food that it meant their child did not like that food.
  • Concept of offering a food 10-15 times before acceptance was confusing. 
• • If parent reports fussiness and/or sleeping problems, counsel about the importance of appropriate complimentary food introduction. Share potential calming and soothing strategies for infants, as well as coping strategies for parents.
  • Encourage parents to wait until around 6 months to introduce solids.
  • Remind parents that this is a very important time and the kinds of foods your baby eats now help him to enjoy healthy foods later.
  • Counsel about the importance of introducing a wide variety of foods, especially vegetables and fruits. As the infant grows, it is important to expose the baby to variety of textures.
  • Explain that sometimes it takes a baby 10-15 tries over time before they will actually accept a new food.
  • Explain that this 10-15 tries is over a period of months and to not get discouraged.
  • To address concerns about waste, discuss strategies that limit wasted food, such as not feeding directly from a jar but removing a small serving from a jar to a different container.
  • You can reassure parents that it is okay if the infant doesn’t like something the first time, and it is important to keep offering it.
• • Tell me how your family and friends (spouse, grandparents, etc) are supporting you with feeding your baby.
  • How would you describe your baby? Is she content, fussy, sleepy, etc?

  Well Visit 2 and 4:

  • Can you tell me a little about your plans to introduce your baby to solid foods? 

  6 month visit:

  • It is wonderful that your baby is ready to embark or beginning to eat solid food. It is an exciting milestone! Do you have any concerns or questions
  • Tell me a little bit about your experiences so far.
  • Can you tell me about your feeding experiences so far? Are you having fun? Do you have any concerns?
  • Can you describe what foods your baby likes and dislikes?
  • What do you do when your baby seems to dislike or not try a new food?
  • How do you introduce new foods to your baby?

• HALF Message(s): 
  Lots of parents are excited to start their babies on solid foods. Others are nervous.  Starting to eat solid foods (like baby cereal and baby food) is an important part of your baby’s development. Did you know that babies who start eating solid food too early are more likely to be overweight or obese in childhood and adulthood? This is one more important reason to wait until your baby is really ready before giving him solid foods.

  HALF Resources:

  • For realistic parent derived strategies for solid food introduction refer parents to the following sections on healthychildren. org/growinghealthy
  • Quick Tips: Keep Your Child Healthy widget. Simply select Starting Solid Foods to generate the results.
  • Food and Feeding Infants​.

  Also take advantage of the HealthyGrowth​ app​ ​to create personalized patient education for your patient.

  HALF Message(s): ​​
  Introducing your baby to new foods can be both fun and frustrating.  Some parents worry about wasting food and money if their babies don’t like a lot of foods at first.  Good news: a new eater only needs 1-2 tablespoons of each food and will gradually increase to 3-4 tablespoons as she gets older.  By getting your baby used to lots of different foods, you’ll help him build a healthy diet for life.

​​Healthy Snacking

• After 9 months, offer 2-3 healthy and nutritious snacks per day
• Maintain fruit and vegetable consumption after finger foods are introduced

• • Almost all older infants snack regularly, but the quality of the snacks is variable.
  • The most common snack foods are often finger foods such as cereal, cookies, crackers, and French fries.
  • Eating at regular intervals helps to foster self-regulation and reduces overeating.
  • At 9 months, there is a considerable drop in fruit and veggie consumption, and an increase in non-nutritive finger and snack foods.​
• • Many parents (especially grandparents) seem to associate snack time with “treat” time.
  • Parents generally were positive about introduction of finger foods but many opted for prepackaged foods that were portable and not choking hazards.
• • Counsel on appropriate feeding recommendations and the importance of regular healthy and nutritious meals and snacks.
  • When discussing routines, mention the importance of planning for regular and healthy snacks.
  • Explain that snacks are an opportunity to provide critical nutrients babies need.
  • Counsel that snack and meal times should be supervised and ideally occur seated at a table, not in transit (i.e. stroller or car seat).
  • By 9 months, counsel on the importance of maintaining fruits and veggies as part of the baby's diet.
  • Discuss strategies to use healthy finger foods as snack foods, rather than just prepackaged snack items.
  • Snacks are an important part of the baby's nutrition. Suggest that parents offer a fruit and/or veggie for at least one snack every day.
  • Discuss potential choking hazards and strategies to offer healthy foods in bite size portions.
• • What kinds of foods do you offer your child for snacks?
  • What kinds of foods does your child want for snacks?
  • What part do snacks play in your eating plan for your child?
  • How do you feel about snacks as treats or rewards?
  • How often does he have snacks? What other kinds of foods do you offer?
  • How does your child respond to being offered fruits? Vegetables?
  • What do you do if your child refuses to eat fruits and/or vegetables?
  • What kind of snacks does your child get in child care? What about when they are staying with grandparents or with other family members?

• HALF Message(s): 
  Have fun with finger foods. Let your baby try feeding herself. Offer healthy snacks 2-3 times per day. 

  HALF Resources:

  • For realistic parent derived strategies on healthy snacking and finger foods refer parents to the following sections on ​healthychildren.org/growinghealthy​
  • Quick Tips: Keep Your Child Healthy widget. Simply select Healthy Snack and Routines and Schedules to generate the results.
  • Food and Feeding Infants​.

  Also take advantage of the HealthyGrowth​ app​ to create personalized patient education for your patient.

Foster Self-feeding

• ​Babies are encouraged to use spoons and fingers to feed themselves
• Babies are encouraged to drink from a cup starting at 6 months of age
• Parents recognize hunger and satiety cues​

• • Babies have an innate ability to self-regulate their food.
  • Responsive feeding helps foster self-regulation.
• • Parents identified time and cleanliness as the two big barriers to self-feeding.
  • Wasting food is another concern.
• • Discuss responsive feeding, hunger and satiety cues with parents.
  • Encourage parents to foster babies self-feeding by using fingers, spoons, and cups. Explain that using their hands and trying to use a spoon are important parts of how a baby learns to self-feed and regulate how much they eat.
  • Acknowledge that self-feeding can sometimes be messy and take a bit longer. Strategize with parents about setting certain meals and snacks aside for their child to hone these skills, and remind parents when they opt to feed their child to be aware of fullness cues.  
• • How is your baby doing with a spoon?
  • Can you describe how you go about encouraging your baby to feed herself?
  • What is it like at mealtimes when your baby feeds herself? How do you feel about it, and how does your baby feel about it?
  • What would be helpful to you and your baby to encourage self feeding?

• HALF Message(s):
  Let your baby try​​ feeding herself as soon as she’s ready — usually around 8 or 9 months old.

  HALF Resources:

  • For realistic parent derived strategies on self-feeding refer parents to the following sec​tions on healthychildren.org/growinghealthy
  • Food and Feeding Infants​

Healthy Drinks

• Babies should drink breastmilk or formula for the first year of life
• Try to avoid introducing juice until child is a toddler. If juice is introduced, wait until 6-9 months and limit consumption to 4-6 ounces
• Avoid introduction of sugar-sweetened beverage

• • Almost 80% of babies 6-9 months drink juice regularly.
  • Children who consume such fruit juices have higher energy intakes.
• • ​​In general, parents thought 100% juice was a healthy choice.
  • Parents thought that the oral health angle was impactful when discussing risks of sugared beverages.
  • Some parents mentioned elimination issues as a reason to or not use juice drink.
  • Other family members and eating out were two factors parents identified as contributing to the introduction of juice or other sugar sweetened beverages
    .    
• • Remind parents that breastmilk, formula and water are the best beverage choices at this time. Suggest that water is a great choice for practicing drinking from a cup and encourage families to foster use of cups over bottles and sippy cups. ​
  • If they want to introduce juice, help parents understand what a 4-6 ounce serving looks like, and that this is the amount for one day. 
• • Does your child drink juice? How much do you offer?
  • How do you feel about your child drinking sugar sweetened beverages like soda, sports drinks, and juice?
  • What beverages does your family drink at meals and between meals? What about when eating out?
  • When you eat out, what beverages does your child drink?
  • What beverages does your child drink at child care? With other friends and family members?

• HALF Message(s): 
  Breast milk and formula are the best choices for your baby. When it’s time for him to start using a cup (around 6 to 9 months), give him breast milk, formula, or water. 

  HALF Resources:

  • For realistic parent derived strategies on healthy drinking refer parents to the following sections on healthychildren.org/growinghealthy
  • Quick Tips: Keep Your Child Healthy widget. Simply select Bottle Feeding and Healthy Snacks to generate the results.
  • Food and Feeding Infants

  ​Also take a​dvantage of the HealthyGrowth​ app​ to create personalized patient education for your patient.

Last Updated

07/06/2021

Source

American Academy of Pediatrics

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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Complementary foods at 4 months | Useful tips from the Tyoma brand

It is well known that the ideal time to introduce complementary foods is between 4 and 6 months of age. The presence of a child's teeth or the ability to sit are not signs of a child's readiness for complementary foods. It is important that the baby does not have a reflex of pushing the spoon with his tongue, and he can swallow food thicker than breast milk or formula well.

The pediatrician will help determine the exact start date for complementary foods, and in most cases this is the golden mean of 5-5.5 months. But there are situations when complementary foods need to be started from 4 months, including even a child who is exclusively breastfed.

In what cases are complementary foods introduced from 4 months?

• The child is not gaining weight well or is lagging behind in physical development.
• The child has functional digestive disorders (regurgitation, constipation).
• The mother has little breast milk or it is poorly absorbed.
• The child has a reduced appetite or is not digesting formula well.
• The child has signs of iron deficiency (anemia).
• The child has a pronounced food interest: he watches with interest the food of adults, reaches for food.
• The child stopped eating formula and began to demand food more often.

How to start complementary foods at 4 months?

The first product of complementary foods, regardless of the age and type of feeding of the baby (breast or artificial), should be energy-intensive foods: either porridge or vegetable puree. Porridge can be chosen first if the child has loose or unstable stools, and also if the child is underweight. After 4-5 days from the beginning of the introduction of porridge, butter can be gradually added to it (up to 5 g per serving of porridge in 150 g)

Mashed vegetables can be the first meal of the day if a child is prone to constipation, when it is better to choose zucchini, which can have a mild laxative effect on the child's stool. Starting from the 4-5th day of the introduction of vegetable puree, vegetable oil can be gradually added to it (up to 5 g per serving of vegetables in 150 g).

What foods can be introduced into the diet of a child at 4 months?

Kashi

Of the first cereals, it is better to give preference to buckwheat or rice. They must be dairy-free and can be diluted with water or breast milk, or the mixture that the baby eats. Later, you can introduce corn and oatmeal.

Vegetables

The first vegetable puree can be zucchini, broccoli, or cauliflower.

Fruit

The third type of complementary food can be fruit puree from apples or pears. Later, you can introduce mashed banana or apricot. At first, fruit puree can not be given to the child separately, but it is better to mix it with cereal or vegetables so that the child does not begin to prefer the sweet taste of fruits. When the amount of fruit puree reaches 50 g or more, it can also be given separately, for example, after the child has eaten porridge or for an afternoon snack.

Juices

Juices should not be the first feeding, in addition, they can not be introduced into the baby's first year of life at all, given their sweet taste and low nutritional value.

Can you make your own first meal?

You can prepare the first complementary foods yourself, but it is safer to use hypoallergenic monocomponent cereals or commercially produced purees prepared to high quality standards for baby food. In addition, it is important to consider that industrially produced baby cereals are often fortified with vitamins and minerals, which makes them especially useful for the first feeding.

How to start the introduction of a new product?

Complementary foods are introduced before breastfeeding or formula. The introduction of a new product should be gradual. But how is it?

• On day 1, give your baby 1 tsp. complementary foods before breastfeeding or formula
• On day 2 - 3 tsp. (15 g)
• On day 3 - 6 tsp. (30 g)
• Day 4 - 50 g
• Day 5 - 70 g
• Day 7 - 100 g
• For 8-10 days - bring to 150 g.

Please note that if complementary foods are introduced from 4 months, then the introduction of 1 new product may take longer than the introduction of complementary foods from 5 or 6 months, namely up to 10 days or more, depending on the reaction of the baby.

Important!

If on the 8-10th day of the introduction of a new product, the baby still cannot eat 100-150 ml of porridge or puree at once, then this amount can be divided into 2 or even 3 doses, for example, give 50 ml of porridge in the morning, 50 ml in the afternoon and 50 ml in the evening. Why do this? So that the child gradually gets used not only to the new product, but also to its quantity. In the future, you need to try to gradually increase the one-time amount of the product to the age volume.

Questions and answers

Will the amount of breast milk decrease if we start introducing complementary foods from 4 months?

Of course, with the introduction of complementary foods, breast milk will be produced less, but only by the amount of complementary foods introduced. As long as you breastfeed your baby on demand and attach him to the breast every time after giving complementary foods, as well as maintaining nightly breastfeeds, you will maintain long-term successful breastfeeding.

Dear parents, remember that the introduction of complementary foods is a creative process that requires an individual approach and attention to the needs of the child. The proposed complementary feeding schemes in terms of time and quantity of introduced products are advisory in nature and do not imply their forced introduction.

Diet for a 4-6 month old baby

Your baby is already 4 months old. He has noticeably grown up, become more active, is interested in objects that fall into his field of vision, carefully examines and reaches for them. The emotional reactions of the child have become much richer: he joyfully smiles at all the people whom he often sees more and more often, makes various sounds.

You are still breastfeeding or have had to switch to formula or formula feeding. The child is actively growing, and only with breast milk or infant formula, he can no longer always get all the necessary nutrients. And that means it's time to think about complementary foods.

The optimal time to start its introduction is between 4 and 6 months, regardless of whether the baby is receiving breast milk or formula. This is the time when children respond best to new foods. Up to 4 months, the child is not yet ready to perceive and digest any other food. And with the late introduction of complementary foods - after 6 months, children already have significant deficiencies of individual nutrients and, first of all, micronutrients (minerals, vitamins, long-chain polyunsaturated fatty acids, etc. ). In addition, toddlers at this age often refuse new foods, they have delayed development of chewing skills for thick foods, and inadequate eating habits are formed. It is important to know that, no matter how strange it may seem at first glance, with a delayed appointment of complementary foods, allergic reactions more often occur on them.

When is it advisable to introduce complementary foods as early as 4 months, and when can you wait until 5.5 or even 6 months? To resolve this issue, be sure to consult a pediatrician.

As a rule, at an earlier age (4 - 4.5 months), complementary foods are introduced to children at risk of developing iron deficiency anemia, as well as children with insufficient weight gain and with functional digestive disorders.

The optimal time to start complementary foods for a healthy baby is between 5 and 5.5 months of age.

The World Health Organization recommends that breastfed babies should be introduced to complementary foods from 6 months of age. From the point of view of domestic pediatricians, which is based on extensive practical experience and scientific research, this is possible only in cases where the child was born on time, without malnutrition (since in these cases the mineral reserves are very small), he is healthy, grows well and develops. In addition, the mother should also be healthy, eat well and use either specialized enriched foods for pregnant and lactating women, or vitamin and mineral complexes in courses. Such restrictions are associated with the depletion of iron stores even in a completely healthy child by 5-5.5 months of age and a significant increase in the risk of anemia in the absence of complementary foods rich or fortified with iron. There are other deficits as well.

The first complementary food can be vegetable puree or porridge, fruit puree is better to give the baby later - after tasty sweet fruits, children usually eat vegetable puree and cereals worse, often refuse them altogether.

Where is the best place to start? In cases where the child has a tendency to constipation or he puts on weight too quickly, preference should be given to vegetables. With a high probability of developing anemia, unstable stools and small weight gains - from baby cereals enriched with micronutrients. And if you started introducing complementary foods with cereals, then the second product will be vegetables and vice versa.

If the first complementary food is introduced at 6 months, it must be baby porridge enriched with iron and other minerals and vitamins, the intake of which with breast milk is no longer enough.

Another important complementary food product is mashed meat. It contains iron, which is easily absorbed. And adding meat to vegetables improves the absorption of iron from them. It is advisable to introduce meat puree to a child at the age of 6 months. Only the daily use of children's enriched porridge and meat puree can satisfy the needs of babies in iron, zinc and other micronutrients.

But it is better to introduce juices later, when the child already receives the main complementary foods - vegetables, cereals, meat and fruits. After all, complementary foods are needed so that the baby receives all the substances necessary for growth and development, and there are very few in their juices, including vitamins and minerals.

Juices should not be given between feedings, but after the child has eaten porridge or vegetables with meat puree, as well as for an afternoon snack. The habit of drinking juice between meals leads to frequent snacking in the future, a love of sweets is instilled, children have more tooth decay and an increased risk of obesity.

With the start of the introduction of complementary foods, the child is gradually transferred to a 5-time feeding regimen.

Rules for the introduction of complementary foods:

• preference should be given to baby products of industrial production, they are made from environmentally friendly raw materials, have a guaranteed composition and degree of grinding
• Complementary foods should be offered to the baby by spoon at the start of feeding, before breastfeeding (formula feeding)
• the volume of the product increases gradually, starting with ½ - 1 spoon, and in 7 - 10 days we bring it to the age norm, subsequent products within the same group (cereals from other cereals or new vegetables)
• can be entered faster, in 5 - 7 days
• start introduction with monocomponent products
• it is undesirable to give a new product in the afternoon, it is important to follow how the child reacts to it
• new products are not introduced in the event of acute illnesses, and before and immediately after prophylactic vaccination (should be abstained for several days)

When introducing a new type of complementary food, first try one product, gradually increasing its amount, and then gradually "dilute" this product with a new one. For example, vegetable complementary foods can be started with a teaspoon of zucchini puree. During the week, give the baby only this product, gradually increasing its volume. After a week, add a teaspoon of mashed broccoli or cauliflower to the zucchini puree and continue to increase the total volume every day. Vegetable puree from three types of vegetables will be optimal. The portion should correspond to the age norm. Over time, you can replace the introduced vegetables with others faster.

After the introduction of one vegetable (bringing its volume to the required amount), you can proceed to the intake of porridge, and diversify the vegetable diet later.

If the child did not like the dish, for example, broccoli, do not give up and continue to offer this vegetable in a small amount - 1-2 spoons daily, you can not even once, but 2-3 times before meals, and after 7 - 10, and sometimes 15 days, the baby will get used to the new taste. This diversifies the diet, will help to form the right taste habits in the baby.

Spoon-feeding should be done with patience and care. Forced feeding is unacceptable!

In the diet of healthy children, porridge is usually introduced after vegetables (with the exception of healthy breastfed children, when complementary foods are introduced from 6 months). It is better to start with dairy-free gluten-free cereals - buckwheat, corn, rice. At the same time, it is important to use porridge for baby food of industrial production, which contains a complex of vitamins and minerals. In addition, it is already ready for use, you just need to dilute it with breast milk or the mixture that the baby receives.

Children suffering from food allergies are introduced complementary foods at 5-5.5 months. The rules for the introduction of products are the same as for healthy children, in all cases it is introduced slowly and begins with hypoallergenic products. Be sure to take into account individual tolerance. The difference is only in the correction of the diet, taking into account the identified allergens. From meat products, preference should first be given to mashed turkey and rabbit.

Diets for different age periods

Explain how you can make a diet, it is better to use a few examples that will help you navigate in compiling a menu specifically for your child.

From 5 months, the volume of one feeding is on average 200 ml.

Option 1.

If your baby started receiving complementary foods from 4-5 months, then at 6 months his diet should look like this:

* - infant formula
** - diluted with breast milk or VHI

Option 2.

I feeding
6 hours Breast milk or VHI* 200 ml II feeding
10 hours Dairy-free porridge**
Fruit puree 150 g
20 g III feeding
14 hours Vegetable puree
Meat puree Vegetable oil
Fruit juice 150 g
5 - 30 g
1 tsp
60 ml IV feeding
18 hours Fruit puree
Breast milk or VHI* 40 g
140 ml V feeding
22 hours Breast milk or VHI* 200 ml

* - infant formula
** - diluted with breast milk or VHI