When can babies have food other than formula
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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When Can My Baby Start Eating Solid Foods? (for Parents)
A friend just started giving her 3-month-old applesauce and rice cereal. My son is just 2 weeks younger than hers, and I am wondering if I should be introducing solids soon too. When should I start?
– Taylor
Doctors recommend waiting until a baby is about 6 months old to start solid foods. Starting before 4 months is not recommended.
At about 6 months, babies need the added nutrition — such as iron and zinc — that solid foods provide. It’s also the right time to introduce your infant to new tastes and textures.
Some babies may be ready for solids sooner than 6 months, but don't start until your baby is at least 4 months old.
How do you know it’s the right time to start solid foods? Here are some signs that babies are ready:
- They have good head and neck control and sit up in a high chair.
- They're interested in foods. For example, they may watch others eat, reach for food, and open their mouths when food approaches.
- They don’t push food out of their mouths, which is a natural tongue reflex that disappears when they’re between 4–6 months old.
- They weigh twice their birth weight, or close to it.
Talk to your doctor about the right time to start solid foods.
How Should I Start Solids?
When the time is right, you can 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 or other food to a baby's bottle because it can lead to too much weight gain. Let your baby practice eating from a spoon and learn to stop when full.
When your baby gets the hang of eating the first food, introduce others, such as puréed meat, fruits, vegetables, beans, lentils, or yogurt. Try one food at a time and wait a few days before trying something else new to make sure your baby doesn't have an allergic reaction.
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 are 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.
When starting your baby on solids, avoid:
- 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 drinks 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
Also, do not give fruit juices to infants younger than 12 months old.
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.
Reviewed by: Mary L. Gavin, MD
Date reviewed: February 2021
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 your baby or have had to switch to mixed 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
- do not introduce new products in the event of acute illnesses, as well as 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:
I feeding 6 hours | Breast milk or VHI* | 200 ml |
II feeding 10 hours | Dairy-free porridge** Supplementation with breast milk or VHI* | 150 g 50 ml |
III feeding 14 hours | Vegetable puree Meat puree Vegetable oil Supplemental breast milk or VHI* | 150 g 5 - 30 g 1 tsp 30 ml |
IV feeding 18 hours | Fruit puree Breast milk or VHI* | 60 g 140 ml |
V feeding 22 hours | Breast milk or VHI* | 200 ml |
* - infant formula
** - diluted with breast milk or VHI
Option 2.
* - infant formula Option 3. : ** - diluted with breast milk Up to 7 months, increase the volume of porridge and vegetable puree to 150 g and introduce fruit puree. The materials were prepared by the staff of the Healthy and Sick Child Nutrition Laboratory of the National Research Center for Children's Health of the Ministry of Health of Russia and are based on the recommendations given in the National Program for Optimizing the Feeding of Children in the First Year of Life in the Russian Federation, approved at the XV Congress of Pediatricians of Russia (02.2009d.) 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. 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. 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. 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. 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. 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. 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. 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.(In Russ.).] Available: http://www.pediatr-russia.ru/information/dokumenty/other-docs/nacprog1year_2019.pdf Link active as of 20.04.2020 2. Duryea T.K. Introducing solid foods and vitamin and mineral supplementation during infancy. In: Post T, ed. UpToDate . Waltham, Mass.: UpToDate; 2020. 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
** - diluted with breast milk or VMS
I feeding
6 hours Breast milk II feeding
10 hours Dairy-free porridge**
Breast milk supplement 100 g III feeding
14 hours Vegetable puree
Meat puree Vegetable oil
Breast milk supplement 100 g
5 - 30 g
1 tsp IV feeding
18 hours Breast milk V feeding
22 hours Breast milk
Union of Pediatricians of Russia
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!
“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!
) 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.
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.
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.
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.
outcome.