By: Cristina Moreno, Bilingual Outreach Specialist, Penfield Children’s Center
Introducing your baby to his first solid foods is a very exciting milestone, but it can also raise a lot of questions about what is healthy, appropriate, and safe to offer children under 12 months. Natalie Alcaraz, Health Project Coordinator and Registered Dietitian for the City of Milwaukee Health Department WIC Program, sat down with us to help address some common, and some not so common, questions parents and caregivers may have regarding diets and nutrition for young children.
When should I start introducing solids? What are cues my child is ready?
NA: The American Academy of Pediatrics and the WIC program recommend introducing complementary foods to babies at 6 months of age in addition to breast milk or formula. Breast milk or formula have everything a baby needs until he reaches 6 months, at which point a baby’s need for iron increases and he would benefit from the additional nutrition in solids, so there is no rush to introduce him to foods any earlier. Signs of readiness include:
- Sitting up without support.
- The development of a “pincer grasp,” or the ability to pick up pieces of food
- Baby seems interested and eager to try food
- Baby accepts food and is not using his tongue to push food out, which is a sign that he is either full or not ready.
What is a good ratio of milk to baby food when starting out?
NA: This varies from infant to infant depending on calorie needs, but typically 1-2 tablespoons of cereal or other baby food twice per day in addition to milk is enough to get started. He can then work his way up to 3-4 tablespoons from a variety of food groups 3-5 times per day once he gets closer to 8 months. As his food intake increases, his formula or breast milk consumption should gradually decrease to about 16 ounces per day once he reaches 12 months.
Baby cereal is a commonly recommended first food; why is that? Are there any pros or cons to different types of cereal?
NA: Baby cereal is commonly recommended because it is fortified with zinc and iron, which are important minerals for babies over 6 months for their growth and development, but most pureed single ingredient foods would be okay. While it is traditional in the U.S., many other cultures start with some type of grain or starch as well; some common ones are bean or meat broths in many Hispanic countries and rice broths in some Asian countries. As far as the different types of cereals, some parents may be hesitant to offer wheat cereal over fear of an allergy, but by 6 months, most babies are well equipped to handle common allergy-containing foods such as wheat. Holding off on introducing allergen foods for too long may actually increase the probability that a child will develop allergies.
I have heard conflicting information about adding baby cereal to bottles; what is your opinion?
NA: You may have heard that adding cereal to baby bottles can help babies sleep longer because they are full, but in reality, it is unnecessary and can be dangerous. A baby who drinks cereal from a bottle may be sleeping longer because he is receiving excessive calories. These additional calories in the baby’s diet can lead to a child being overweight or obese later in life. It is also dangerous in the short term because it increases the risk of choking, especially if you cut the nipple to accommodate the thickened liquid. Drinking foods instead of practicing chewing them and using a spoon also get in the way of the child developing the skills needed to eat.
Are there any foods that should be avoided before they turn 1 year?
NA: Anything containing honey should definitely be avoided because it can potentially contain botulism, which is a deadly toxin. Cow’s milk should also be avoided. Other than that, it is important to offer foods that are texturally appropriate for young children. Whole grapes, hot dog slices, large pieces of melon, whole nuts and popcorn can all be choking hazards. We also do not recommend juice for young children. Any nutrients they can get from juice, they can get from other sources, but if a parent really wants to give juice we recommend a maximum of 2-4 ounces daily.
Prepackaged baby food is really popular, but are there any things I should be concerned about, like preservatives?
NA: Prepackaged foods have some good and not so good aspects. They can be convenient for feeding on-the-go and usually do not need to be refrigerated. Prepackaged foods should only contain what is on the label, and many single ingredient baby foods do not contain preservatives. However that can change once your child transitions to combo foods and toddler meals, which can be comparable to a prepacked meal for adults, so it is always a good idea to read nutrition labels so you know what your child is eating. An unexpected drawback of the pouches that are so popular now is that they are often given for a child to suck straight out of them, which again limits a baby’s sensory learning through food because he does not have to chew or pick foods up with his fingers. These pouches, along with jarred baby foods, can also reintroduce bacteria if eaten out of directly, so it is important they are not kept as leftovers for the next feeding.
Do you have any advice if a caregiver were to want to try making his/her own baby food?
NA: I would tell parents and guardians that I think it is a great idea! By doing this, they know exactly what is in the food they are giving to their baby and know it is safe. It is actually cheaper and easier than you might think. To start, you can puree simple, one ingredient foods that can be served right away or even frozen in ice cube trays that you can defrost one portion at a time. Eventually, you can offer less seasoned versions of the same food you eat at home. When making your own baby food, it is important to consider food safety guidelines to prevent food borne illness, such as proper hand washing, appropriate cooking, and not reserving food or letting it sit out.
You mentioned offering less seasoned foods; what about herbs and spices?
NA: They should be used with caution or avoided altogether for a few reasons. WIC and the American Academy of Pediatrics feels that foods for infants do not need additional flavor enhancers such as salt, sugar, herbs or spices. Very small amounts of herbs or spices are okay to use, and are good ways to add some flavor without adding salt or sugar. Using herbs and spices can also help a child get used to cultural flavors that your family may use regularly. However using herbs can also negatively impact a child’s health. Some people may offer herbs due to their believed medicinal properties, especially in the form of tea. But giving a child tea can potentially be toxic or unhealthy, especially if using honey or sugar to sweeten them, and can lead to other problems such as over-hydration and electrolyte imbalances due to a high intake of fluids. The Poison Control Center has more information about the potential dangers of herbs.
What was your child’s favorite first foods?