Nutrition Tip Sheets
Readiness signs for starting solids:
- Positioning: Baby should be able to sit with minimal assistance (usually around 6 months) before starting solid foods. Baby needs to have good head control to tolerate solid foods safely. For more information, click here.
- Eagerness: Baby is often reaching for other family members’ food, attentive to others eating
- Usually babies are starting to do these things around 6 months, which is also when baby’s immune and digestive system seem to be more ready to handle solid foods as well
Choosing a high chair
Key features of high chair:
- Baby does not lean to either side
- Want to have a foot rest that reaches their feet (or is modifiable)
- Tray of high chair shouldn’t be too high so that baby can’t reach their food
- Baby should not be eating in any kind of reclined position
- May want to consider:
- Ease of cleaning
- Good safety harness in chair
- Height of kitchen table
- Removable tray to allow for baby to eat directly at the table as they get older?
Choking vs. gagging
Gagging is a normal reflex for babies to bring food back up to the front of the mouth until they learn to move food to the side and chew. Check out this article to learn more about the importance and function of gagging.
Baby Led Weaning (BLW) vs. Traditional Purees (spoon-feeding)
Traditionally, infants have started eating whole foods with the presentation of purees, being fed by parents via a spoon. Commonly parents start with infant cereals (rice or oatmeal) mixed with formula or breast milk and can slowly increase the thickness and texture as baby gets more used to feeding this way. Parents then offer home-made or pre-made pureed foods on the spoon, slowly increasing the texture as the baby gets older.
Baby-led Weaning (BLW) is typically categorized as infants eating whole foods (as opposed to purees only). Since young children at this stage don’t have the developmental ability to pick up small pieces of food, they are presented in strips or larger pieces. BLW can also include offering pre-loaded spoons with purees or letting baby play and self-feed purees off their tray.
The American Academy of Pediatrics (AAP) recommends starting solids around 6 months of age, but does not have a specific medical recommendation for the method of solid food introduction. Most babies will benefit from a combination of the approaches discussed above. The AAP recommends encouraging babies to use spoons and fingers to feed themselves and start practicing with a cup around 6 months of age (see below).
For additional resources check out:
We recommend starting to introduce cup drinking around 6 months of age when your baby is starting their experience with solid foods. You can put either water or breast milk/formula in the cup. Since an infant’s main source of fluid and nutrition is still coming from breast milk/formula, we don’t want to offer more than 1-2 oz of plain water at a time. Introducing a cup early helps with developmental skills, makes the transition away from bottle easier around 12 months of age, and gets baby used to the taste of plain water which can be helpful as babies transition to toddler stage
For more guidance on how to introduce your baby to a cup, click here.
Food allergies are commonly a concern for parents as their infants start eating solid foods. A food allergy is the body’s reaction to a protein found in a particular food that usually happens shortly after the food is ingested.
Allergic reactions can range from very mild to severe. Symptoms that you may see:
- Skin Problems
- Hives (red spots that look like mosquito bites)
- Itchy skin rashes (eczema)
- Breathing problems
- Throat tightness
- Stomach symptoms
- Circulation symptoms
- Pale skin
- Loss of consciousness
- Skin Problems
If many body systems are affected, the reaction could be life-threatening – call 911 immediately.
Sometimes similar symptoms can occur but are not due to food allergy:
- Food poisoning: vomiting or diarrhea caused by bacteria in spoiled or undercooked food
- Drug effects: certain ingredients in food can make children shaky or restless, such as caffeine in soda or candy
- Skin irritation: often caused by acids found in foods such as citrus food/juice (orange juice) or tomato products
- Diarrhea: sometimes occurs in children from too much sugar, such as from fruit juices
The American Academy of Pediatrics (AAP) recommends breast milk or formula as the sole source of nutrition for the first 6 months. Most children can start trying dairy-containing foods (such as yogurt or cheese) around 6 months of age. Aim for the whole-fat versions as the fat is good for the child’s brain development. Whole cow’s milk can be introduced at age 1. Baby’s digestive system may not tolerate the cow’s milk protein in large quantities before 12 months old.
If your child is allergic to or does not tolerate the whole cow’s milk well, there are many milk alternatives that may be considered. Many of the alternatives have less protein and fewer calories and are commonly fortified with vitamin D and/or calcium. Click here for a general comparison of common unflavored milk alternatives.
Keep in mind that we want babies to consume approximately 16-24 oz of whole milk per day and should be drinking the milk from a cup or sippy cup. Drinking more than 24 oz of milk per day can lead to poor appetite for solid foods and can contribute to iron-deficiency anemia.
Vitamins and Supplements
Vitamin D is the only supplement routinely recommended by the American Academy of Pediatrics (AAP). Vitamin D is known for promoting strong bone growth, helping the body use and absorb calcium, but may also help prevent chronic disease as children age. It is recommended that all infants (unless drinking 32 oz or more of formula per day) receive a daily dose of 400 IU of vitamin D per day. Read more about vitamin D here.
While we don’t routinely recommend a daily multivitamin for all children, it may be helpful in some cases if parents are concerned about the child’s limited food intake. If you do give a daily multivitamin, make sure it contains at least 400 IU of vitamin D per serving. For general recommendations on nutritional supplements, vitamins, and probiotics, click here.
Some articles/tips for helping your picky eater:
Preventing Childhood Obesity
Children with obesity are at a higher risk for chronic diseases such as asthma, sleep apnea, bone/joint pain, type 2 diabetes in addition to depression, lower self esteem and social isolation. There is no easy or quick fix for childhood obesity, so prevention is key. Check out some of these articles about ways to prevent childhood obesity: