Baby’s First Foods
Peanut-free cafeterias, Epipens, gluten-free bakeries. Parents today are facing an increasingly treacherous world when it comes to introducing their babies to solid foods. What is the best way to start complementary foods? What can parents do to protect their children from a serious food allergy?
This is a hot area of research, and recommendations are evolving as we understand more about food allergies and their origins. Currently, there are a few key guidelines that can guide parents as to the safest feeding practices. These are based on the evidence we have today, and will likely be modified as we learn more about this emerging issue.
Guidelines to feeding your baby
1. Complementary foods should be introduced between 4-6 months. For nursing babies, the World Health Organization recommends exclusive breastfeeding for 6 months, due to concerns about the safety and nutritional value of food and water in many regions of the world. In the United States, there is no evidence that introducing foods after 4 months is harmful.
2. Signs that your baby is ready to eat solids include being very interested in what you are eating, becoming harder to satisfy with milk alone, and being able to hold up her head and chest without support.
3. Start with very small volumes once a day, given by spoon. Your baby may only take a taste initially, then a few spoonfuls. As he gets accustomed to eating, he will eat larger amounts, and you can increase to 2 and then 3 meals a day. This increase usually occurs over a few weeks.
4. First foods should be pureed until very smooth and thin. Baby cereals, fruits and vegetables are all fine first foods. There is no exact order you need to follow, but babies usually take to sweeter foods faster. Jarred foods are fine, as are homemade foods, which should include no added spice/sugar or salt. Homemade foods can be frozen in covered ice cube trays and then stored in freezer bags.
5. Foods should be introduced one at a time, usually one every 3 days.
6. After 6 months, foods become thicker, then with small soft pieces. A seven month old may be eating blended lentil soup with carrots, an 8 month old can eat a piece of soft scrambled egg, and a 9 month old can eat a soft, cooked noodle or piece of toast with peanut butter.
7. The ONLY food that a baby cannot eat is honey. This should NEVER be given before 12 months, due to the risk of botulism. All other foods, including peanut butter, whole eggs, fish and soy, can be given after 4 months. Delaying their introduction does not decrease the risk of allergy.
8. There is some evidence that introducing highly allergenic foods early may DECREASE the chance of your child having an allergy to that food. Early introduction of wheat may also DECREASE your child’s chance of having gluten intolerance. When first introducing nuts, soy, eggs or seafood, start with a tiny amount, and do it while you are at home, not on vacation! First allergic reactions are almost always mild, and usually present with a skin rash or hives. The chance of having a severe reaction after first exposure is very low. If tolerated, you can increase the volume slowly in subsequent servings.
9. Let your baby decide when they are done. There is no prescribed amount of food babies should be given. When they are opening their mouth wide and looking for that next bite, they are still hungry. When they are looking all around and not paying attention, resist the urge to keep shoveling it in. They are done!
10. Keep up good eating habits as your baby becomes a toddler. Toddlers become more interested in running around than sitting and eating. Try to avoid giving them too much of the foods they will always eat, such as chicken nuggets or pizza. If they eat these too often, they will lose their appreciation of more natural foods.
Introducing solids to your baby is an exciting experience for both of you. By following the guidelines above, you will do all you can to protect your baby from allergy and start a habit of lifelong, healthy eating. Have fun, and stay tuned!
Dr. Samantha Ahdoot