With your first baby, food is a big issue. You’ll probably worry about what to feed, how much to offer and how to encourage your infant to accept a wholesome variety of foods. For the first few months, just relax. Breast milk is all your baby needs. In fact, it is now suspected that starting solid foods too early can be a factor in the development of food allergies.
There’s no definite age for the introduction of solids to an infant’s diet. Different babies need to start at different ages. Most babies are ready to begin eating some solid food when they are about four months old. A few need solid food earlier; others will wait longer. Almost all should have started eating some solid food by about six months. If introducing solids is left too late, some babies find it difficult to adapt to a different way of feeding and may even refuse spoon feeds.
You must judge when your baby is ready. When your baby still seems hungry after a good milk feed, starts to demand feeds more often, or maybe, after sleeping through the night for a while, your infant suddenly starts waking again to be fed, it’s time to give solid food a try. It’s a good idea to discuss this topic with your pediatrician during a regular visit when your baby is about three months old, so you’ll be prepared.
Once the moment has arrived, start with a little vegetable or fruit puree or rice cereal on the tip of a teaspoon or your finger. Just a small bit is enough at first. Offer it after one milk feed in the day, or in the middle of the feed if that works better for your baby. The food should be at room temperature — not too cold, not too warm.
Most babies need time to learn how to take food from a spoon. Be patient and prepared for some spitting and mess. Your baby may also cry between mouthfuls at first. Until now, food has come in one continuous stream. Spoon feeding has frustrating pauses. Don’t press the food on your baby. If your infant doesn’t really seem to want to try solids, give up. Leave it a day, or maybe a week, and then try again with a different food.
Give only those foods suggested by your pediatrician and introduce one new food at a time. Carefully watch your infant after the introduction of a new food, looking for any signs of allergy.
Once your baby is adapted to accepting food from a spoon, gradually increase the amount of solid food you give after a milk feed. Try to follow your baby’s appetite. Give the amount that seems to be wanted and no more. At the same time, move gradually from solid food at one feed in the day, to solid food at two, and then three feeding times. Always keep in mind to follow your baby’s appetite and to go at your baby’s pace.
Try to keep cereals for one feed only. Begin to add different foods and different tastes at other feeding times. Take it slowly. Two or three new foods each week are enough. You’ll be able to use lots of the foods you already cook for yourself. Just mash, sieve or puree a small amount and give it a try. Leave out salt, spices or fats. Using your own family’s food is the best way to know the quality of what you’re feeding and your baby will adapt to your family’s diet, making meal times easier. At this time it is still important to avoid wheat-based foods, milk other than breast or formula milk, eggs, citrus fruits, nuts, honey and fatty foods.
Once your baby has grown used to a variety of foods, you can begin to give the solids first and the milk feed second. This way, your baby will gradually take less and less from the breast or bottle. You can also offer water or diluted natural fruit juice, as a drink with meals. Your baby will gradually learn to cope with food that’s lumpier. As your infant gains greater muscle control, you can move on from purees, to food that’s been mashed with a fork or minced. Never offer babies small hard foods such as peanuts or candies because of the high risk of choking.
Even after an infant is eating good quantities of solid food, breastfeeding should continue. Ideally, infants should be breastfed for at least one year — longer if possible. A bedtime breast feed can make a good end to the day. Bottle feeding is a different issue. Comfort sucking on a bottle can become a habit that’s hard to break and will lead to tooth decay. Try to wean your baby off the bottle by the age of one.
Weaning is easiest once the child has adapted to a lidded cup. Offer the bottle as well as the cup at first, and gradually cut down. Or, if you think this puts your baby off the cup because there’s something “better” coming afterward, try cutting out the bottle feed at one meal in the day and use the cup instead. Go on from there.
Never forget that the nutrition requirements for infants are different than those of adults. Don’t add salt to your baby’s food. A small baby’s system can’t cope with more salt than is naturally found in foods. When you’re cooking for the family, leave out the salt so your baby can share the food. Cutting down on salt is generally good for everyone.
Sugar should never be added to your baby’s food or drinks. This can cause terrible dental problems later. If you use tins or packets of baby food, look for the ones without added sugar. Read the labels. Sugar is often hidden in prepared foods. Ingredients such as glucose, sucrose, dextrose, fructose or maltose are all sugars to be avoided.
More and more children are suffering from food intolerance or allergies. This is why it is very important to wait to feed your infant cow’s milk, wheat-based foods, eggs, citrus fruits and nuts until recommended by your pediatrician. If anyone in your immediate family suffers from allergies, your baby might too, so talk to your doctor about your family’s medical history. It could be important in some cases for mothers of susceptible children to avoid eating certain foods to keep potential allergens out of the breast milk.
Some people believe that goat’s milk or sheep’s milk are preferable to cow’s milk. But these may also cause allergic reactions. Goat’s milk is also low in folic acid, an important nutrient. Remember that raw milk must be pasteurized before it may be offered to your child. Boil the milk and then let it cool before feeding time.
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(Dr. M.S. Karimuddin is a well-known pediatrician based in Jeddah.)