Feeding your Baby, Four Months to a Year

Mom feeding baby in highchair at the family table

How can you tell an infant is ready to start solid foods?

    • Your baby is at least 4-6 months old
    • He or she has doubled his or her birthweight
    • Your baby can sit supported in a high chair for several minutes without getting tired
    • He or she opens his/her mouth and seems interested in what you are eating when seated at the family table
    •  Your baby can use his or her tongue to transfer a small spoonful of thin baby cereal to the back of his or her mouth and swallow

 

How can you tell an infant is NOT ready to start solid foods?

    • Baby has trouble holding his or her head up steady while seated in a feeding or high chair
    • Baby shows no interest in your food while seated at the family table during meals or when offered on a spoon
    • Baby turns his or her head away when offered food, does not attempt to open his or her mouth to accept the food, or is unable to move the food from the spoon to the back of his or her mouth and swallow.

 

If your baby isn’t ready for solids try again in a week or two. If your baby is not interested in solids by 6 months, talk to your child’s pediatrician. Some babies are ready for solids as early as 4-5 months and others are 6 months or older.

In the first year, most of your baby’s nutrition still comes from breastmilk or formula so don’t worry about the amount of food he or she takes. Keep mealtimes social, casual, and peasant. He or she may eat a lot one day and hardly anything the next. That’s normal!

Infants’ growth and activity levels vary dramatically from day to day. Only your baby knows how much he or she needs to eat! That’s why how much to eat is always determined by your child and nobody else. (There are rare exceptions due to serious medical conditions.)

 

Division of Responsibility for feeding changes as your baby approaches 4 months of age.

 

Your Job as a Parent of a Newborn:

    • Pay close attention to sleep, activity, and hunger cues from your baby
    • Offer breastmilk or formula on demand
    • Provide a calm space where your baby can feed at his or her own tempo
    • Stop the feeding when your baby loses interest in eating more

Your Newborn’s Job:

    • Decide when to eat
    • Decide how much to eat

 

Your Job as a Parent of an Infant 4 to 12 months:

    • Continue to pay attention to sleep, activity, and hunger cues from your baby
    • Offer breastmilk or formula on demand
    • Offer solid food only when your baby shows signs of being ready (see below)
    • Stop the feeding when your baby loses interest in eating more
    • Sit at a table with your baby when solid foods are offered
    • Relax! Don’t worry about how much or how little solid food he or she eats

Your Infant’s Job:

    • Decide when to eat
    • Decide how much or whether to eat at all

 

The First Feeding

When you are ready to feed your baby his or her first solid meal, offer about ½ of your baby’s usual amount of breast or bottle feeding so he or she is still hungry but not fussy.

Mix fortified commercial infant cereal with enough breast milk or formula to make a thin paste in a small clean bowl.

Seat Baby in a feeding chair or highchair at the family table during a relaxed meal or snacktime.

Using a soft-tipped baby spoon, offer ½ a spoonful of cereal and watch your baby’s reaction. If he or she opens his or her mouth and tries to accept the spoon, and then swallows some of the cereal, offer another bit. Your baby may grimace, act surprised, or be happy when the cereal enters his or her mouth. It will be messy and much of the cereal will end up on your baby’s face or bib. Have your camera ready to capture the moment. Stay positive no matter what his or her reaction!

If your baby swallows the cereal offer another ½ spoonful. Continue to offer food, paying attention to your baby’s pace until he or she loses interest.

Your baby has lost interest in feeding when

    • Baby does not open his or her mouth for the next spoonful
    • Baby turns his or her head away when the spoon approaches
    • He or she spits out the food and doesn’t attempt to swallow
    • Baby is more interested in the spoon than the food
    • Baby cries, fusses, tries to block the spoon with hands, shakes head, or blows raspberries when food approaches

 

What Foods Should I Try First?

Start with iron and zinc-fortified baby cereal mixed with formula or breastmilk

Use a soft-tipped baby spoon about ½ full of thin cereal

After your baby has been accepting cereal for a week or two, you can offer single-ingredient fruit or vegetable purees one at a time

Wait 3 to 5 days between new foods to make sure your baby doesn’t have an adverse reaction to the new food

If you choose not to use commercial baby food, do not add sugar, salt, or seasonings to homemade baby foods!

Always pour a portion of the food being served into a bowl before spoon-feeding your baby.

If you feed your baby with a spoon and then dip that spoon back into the jar of baby food, any leftovers must be thrown away to prevent food poisoning!

Add more texture and variety when your child has mastered purees.

When your baby is able to tolerate more texture, add more food groups and more lumpy textures: table foods mashed with a fork, or second and third-stage commercial baby foods.

    • Include foods your family likes.
    • Avoid processed foods and added sugar or salt.
    • Let your baby feed himself/herself when ready
    • Baby should sit well in a highchair without support (often around 7-8 months)
    • Can pick up small pieces of food and bring them to his or her mouth
    • Foods should be soft, easy to swallow, and cut into small pieces
    • Soft foods like small pieces of ripe banana or avocado can be served raw, but most fruits and vegetables should be cooked and cut up at this stage
    • Small pieces of foods that dissolve in the mouth like cheerios or teething biscuits work well
    • Letting Babies learn to feed themselves is messy but necessary, and helps them know when they have had enough food

*Wait until after a year of age to offer your baby honey. Honey can cause potentially deadly botulism in infants.

Preventing Choking

    • Always feed infants and children seated at a table.
    • Infants should always be strapped into a highchair or feeding chair to eat.
    • Toddlers too small to sit in a standard chair should be buckled into a highchair or secure booster seat. Never walking around with food!
    • Avoid giving young children hard, round pieces of food.

Children under 4 years of age should NOT be given

    • Whole or pieces of nuts, seeds, or peanuts
    • Whole small round fruits or vegetables (whole grapes, berries, carrots, etc.)
    • Popcorn
    • Hot dogs or large chunks of meat
    • Hard candy or chewing gum

Offer mealtime beverages in an open cup, not a bottle or sippy cup

While breastfeeding can continue for one to 3 years according to your preference, water and other beverages can be given in a small open shatter-proof cup

Babies who drink formula or are weaning from the breast are ready to transition to cow’s milk or soy/pea milk in a cup by 12 months

Throw away bottles at one year of age. Allowing children to sip beverages from bottles or sippy cups between meals and snacks can have devastating effects on children’s teeth (and your carpet).

Always serve foods and beverages other than breast milk or formula at the table.

Eating at the family table is important at all ages! It helps kids grow up to be healthy eaters and helps prevent obesity.

True or False?

Solid foods are introduced when your baby shows signs of being ready, never before 4 to 6 months of age.

True*

*Babies with  severe eczema and/or a history of food allergy should start solids as soon as they show signs of readiness to help prevent future food allergies. Consult your child’s doctor and work closely together to follow allergy prevention feeding practices. Allergy testing may be needed before starting allergenic foods

True or False?

Cereal should not be added to a bottle of formula or breast milk. It should be eaten with a spoon.

True*

* In rare cases, your doctor will recommend adding cereal to a bottle for infants with reflux. Discuss symptoms with your doctor before trying this.

True or false?

Babies continue to drink about the same amount of breast milk or formula even after solids are started.

True

Solid foods are just added to the diet.

Breast milk/formula remains the most important part of a baby’s diet.

True or False?

Babies should be seated at the family table in a feeding chair or highchair for all solid meals and snacks.

True

Babies learn how to eat and enjoy their food by watching you! Set a good example by always sitting at a table to eat meals and snacks. You can start seating your baby at the table with you as soon as he or she can sit comfortably in a feeding chair or in your lap.

Don’t forget to turn off your cell phone, tablet, and TV!

True or False?

It’s important that babies 6 to 11 months of age are eating enough fruit, vegetables, and cereal in addition to breast milk or formula.

False

Solid foods in the first year of life are about learning to enjoy eating and sitting at the family table, not about filling nutritional needs. Most nutrition comes from breast milk or formula.

True or False?

Babies should start drinking 100% fruit juice and water when they start solid foods.

False

While it is OK to offer a small open cup of water with meals, breast milk or formula provides all the liquid a baby needs. In very hot weather, extra water at meals can be offered at mealtimes. Avoid offering other beverages including fruit juice to infants.

True or False?

Infants should learn to drink liquids from a cup rather than a bottle by 12 months of age.

True

Toddlers are ready to substitute cow’s milk or pea/soy milk for formula at a year of age. Toddlers only need 16 ounces of milk per day as long as they are eating a variety of table foods.

Too much cow’s milk or dairy foods can cause constipation and anemia.

What about “baby-led weaning” and non-traditional feeding methods?

Any method that helps a baby safely learn to enjoy eating solids at the family table can work, but skipping the puree stage requires parents to really do their homework and pay close attention to their child’s feeding cues and safety. It is not suitable for all babies.

Suggested resource:

Always discuss your feeding plans with your baby’s doctor at the 4-month well visit

Life-threatening choking incidents while seated in a high chair eating age-appropriate foods are rare, however, a parent CPR course is always a good idea.

Don’t Forget Baby’s Teeth!

Wipe baby’s gums with a wet cloth after feeding solids and before bedtime

Once teeth appear, brush teeth and gums twice daily with a dab of fluoride toothpaste the size of a grain of rice on a soft toothbrush

Pediatric dentists like to see your baby in the second year of life>

Continue fluoride treatments at our office until they are seen by a dentist

Additional resources on infant feeding:

 

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