What you feed your baby in the first few years of life can affect his brain and body, so parents naturally want to make sure they get it right. As a pediatrician, I've heard all sorts of questions. Here are some common ones, along with my advice for raising healthy, non-picky eaters, hopefully with fewer food allergies.
Q: When should I start?
A: Most babies are ready to start solids between 4 and 6 months of age. Research shows that starting solids before 4 months may increase the risk for obesity later on in some babies. Signs that your infant is ready include good head control, the ability to move the food from the front to the back of her mouth, and pulling off the breast or bottle and looking around for other interesting things to do or eat. If you offer food and she simply pushes it out with her tongue, wait a week, and try again.
Q: What should I start with?
A: There aren't any strict guidelines as to what order you should follow when starting solids. Years ago, cereal was recommended as a first food for infants because it is fortified with iron and zinc, which babies over 6 months of age need. Some feeding experts say that meat is a better source of these nutrients, and I agree. I like to feed babies avocado as their first food because it's a good source of healthy fat, which is important for brain development. Green veggies, which are packed with important nutrients, are another great starter food. The younger and more frequently you introduce green veggies, the greater chance your baby will learn to love them. Whatever you choose to start with, make sure it is a healthy, nutrient-rich choice and a consistency your baby can handle (usually liquid puree first and soft pieces later).
Q: When can I give my child water or juice?
A: I love getting an infant used to drinking plain water as soon as she starts solid foods. Start with a few sips. Learning to like plain water is a healthy habit for life. How many adults do you know who don't like the taste of plain water? It's often because they didn't get used to it at a young age. Babies don't need juice. Even watered-down juice gets your infants used to wanting sweet beverages. It's much healthier to give them the actual fruit, even pureed or smashed, which also contains valuable fiber.
Q: What about finger food?
A: By the time they are 8 or 9 months old, infants love to feed themselves small pieces of food. I like to start with healthy options that can be mashed up easily by soft gums. (Even without teeth, your baby can mash soft food with their gums.) Think steamed soft peas (you can buy fresh frozen organic and thaw them) or soft scrambled egg pieces. Other options are small pieces of soft table food such as steamed veggies, beans or lentils, whole grain bread, or chicken. All fruit, including strawberries and other berries, is delicious and nutrient-rich and can be presented in small pieces.
Q: Do I need to wait to introduce allergic foods?
A: Not anymore. A few years ago, a study was published showing that early introduction of peanut products to infants can decrease the chance that a child develops a peanut allergy in the future. Based on this data, experts say that as long as your baby has not shown any signs that he may be allergic to foods, such as skin rashes (eczema or hives) or more serious signs such as facial swelling or trouble breathing, you can feed your baby any food (other than honey) with a consistency and texture he can handle. This includes the big eight: milk (under age 1, offer yogurt and cheese because they are more easily digestible), eggs (white and yolk), peanuts (offer peanut puffs and butter instead of whole peanuts), tree nuts (offer nut butters instead of whole nuts), soy, wheat, fish and shellfish (such as shrimp).
Q: Any foods to avoid?
A: Never give an infant under 12 months honey because of the risk of infant botulism, a deadly disease. (Kids over age 1 and adults are not at risk because their stomachs are able to kill the disease spores.) And stay away from anything that could be a potential choking hazard, such as popcorn, whole nuts and whole grapes. Otherwise, offer your infant a variety of healthy options, and let her see that you are eating a well-balanced diet, too.
Q: How do I feed my baby?
A: Start by using a small baby spoon to place a little bit of puree with the consistency of soup in your baby's mouth. Then wait and see what happens. Let him be the guide; if he opens his mouth and turns toward the spoon, let him eat more. If he turns away and closes his mouth, respect his wish to be done. As he gets older and tries to grab at the spoon, use two — one spoon for him and one for you. It may be messy as he tries to self-feed, but that's okay. The more a baby smells, tastes and explores healthy food options, the more likely he will be to eat those foods when he gets older.
Parents are a child's best role model when it comes to enjoying healthy food now and as they grow up. The more healthy options you introduce at a young age, the more your child will get used to the taste of healthy, whole, nutrient-rich food.
Adapted from Tanya Altmann's book "Baby and Toddler Basics: Experts' Answers to Parents' Top 150 Questions." Altmann is a practicing pediatrician who founded Calabasas Pediatrics, an assistant clinical professor at Mattel Children's Hospital at UCLA and a mom of three. She is an American Academy of Pediatrics spokeswoman and the author of several books.