Feeding Guide for the First Year

Don't give solid foods unless your child's healthcare provider advises you to do so. Solid foods shouldn't be started before age 4 to 6 months because:

• Breastmilk or formula gives your baby all the nutrients that are needed for growth.

• Your baby isn't physically developed enough to eat solid food from a spoon.

• Feeding your baby solid food too early may lead to overfeeding and being overweight.

Your baby may show signs that they are ready to start solids. These include good head and neck control, disappearance of the tongue-thrust reflex, showing interest in the food you eat, being able to sit in a chair with minimal support, and trying to bring objects to their mouth. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about the first 6 months of life. In addition, they recommend that all infants take in enough vitamin D through supplements or formula to prevent complications from deficiency of this vitamin. In November 2008, the AAP updated its recommendations for daily intake of vitamin D for healthy infants, children, and teens. It's now recommended that the minimum intake of vitamin D for these groups should be 400 IU per day, starting soon after birth. Your baby's healthcare provider can advise you on the correct type and amount of vitamin D supplement for your baby.

These are some things to think about when feeding your baby:

• When starting solid foods, give your baby one new food at a time—not mixtures (like cereal and fruit or meat dinners). Give the new food for 3 to 5 days before adding another new food. This way, you can tell what foods your baby may be allergic to or can't tolerate.

• Start with small amounts of new solid foods. Try 1 teaspoon at first and slowly increase to 1 tablespoon.

• You can choose which food to start first, such as iron-fortified infant cereal, fruits, or vegetables.

• Don't use salt or sugar when making homemade infant foods. Canned foods may contain large amounts of salt and sugar and shouldn't be used for baby food. Always wash and peel fruits and vegetables and remove seeds or pits. Take special care with fruits and vegetables that come into contact with the ground. They may contain botulism spores that cause food poisoning.

• Infant cereals with iron should be given to your infant until your infant is age 18 months.

• Cow's milk shouldn't be added to the diet until your baby is 1 year old. Cow's milk doesn't provide the proper nutrients for your baby. In addition, infants' digestive tracts are not developed enough to fully digest cow's milk as completely or easily as breastmilk or formula.

• The AAP recommends not giving fruit juices to infants younger than 1 year old.

• Feed all food with a spoon. Your baby needs to learn to eat from a spoon. Don't use an infant feeder. Only breastmilk, formula, or water should go into the bottle.

• Don't give your child honey in any form, including in foods, during their first year. It can cause infant botulism.

• Don't put your baby in bed with a bottle propped in their mouth. Propping a bottle has been linked to an increased risk of ear infections. Once your baby starts getting teeth, propping the bottle can also cause tooth decay. There's also a risk of choking.

• Transition your baby off the bottle by their first birthday.

• Don't make your child "clean the plate." Forcing your child to eat all the food on their plate even when they're not hungry isn't a good habit. It teaches your child to eat just because the food is there, not because they're hungry. Expect a smaller and pickier appetite as the baby's growth rate slows around age 1.

• Babies and young children shouldn't eat hot dogs, nuts, seeds, round candies, popcorn, hard, raw fruits and vegetables, grapes, or thick amounts of peanut butter (a thin layer of peanut butter spread on bread is okay). These foods aren't safe and may cause your child to choke. Many healthcare providers suggest these foods be saved until after your child is age 3 or 4. Always watch a young child while they're eating. Insist that the child sit down to eat or drink.

• Healthy babies usually require little or no extra water, except in very hot weather. When solid food is first fed to your baby, extra water is often needed.

• Don't limit your baby's food choices to the ones you like. Offering a wide variety of foods early will pave the way for good eating habits later.

• Don't restrict fat and cholesterol in the diets of very young children, unless advised by your child's healthcare provider. Children need calories, fat, and cholesterol for the development of their brains and nervous systems, and for general growth.

• Unlike previously thought, you don't need to wait to introduce eggs, dairy, soy, peanut products, or fish due to the risk of food allergies. If your baby has severe eczema or a known egg allergy, testing for peanut allergy may be advised. Talk with your child's healthcare provider if you have questions about safely introducing any of these foods.