Feeding

Signs of readiness for solid food

The following are some guidelines from the American Academy of Pediatrics. Your child is likely ready to try solids when he:

• Can hold head up and sit upright in highchair
• Shows significant weight gain (doubled birth weight) and weighs at least 13 pounds
• Can close mouth around a spoon
• Can move food from front to back of mouth

Age: 6 to 8 months

What to feed

• Breast milk or formula, PLUS
• Pureed or strained fruits (banana, pears, applesauce, peaches, avocado)
• Pureed or strained vegetables (well-cooked carrots, squash, sweet potato)
• Pureed meat (chicken, pork, beef)
• Pureed tofu
• Small amounts of unsweetened yogurt (no cow’s milk until age 1)
• Pureed legumes (black beans, chickpeas, edamame, fava beans, black-eyed peas, lentils, kidney beans)
• Iron-fortified cereal (oats, barley)

How much per day

• 1 teaspoon fruit, gradually increased to 2 or 3 tablespoons in four feedings
• 1 teaspoon vegetables, gradually increased to 2 or 3 tablespoons in four feedings
• 3 to 9 tablespoons cereal in 2 or 3 feedings

Feeding tips

• Some doctors recommend that you introduce new foods one at a time. Wait two or three days, if possible, before offering another new food. (Wait three days if your baby or family has a history of allergies.) It’s also a good idea to write down the foods your baby samples. If she has an adverse reaction, a food log will make it easier to pinpoint the cause.
• The order in which you introduce new foods doesn’t usually matter. Your child’s doctor can advise you.

Age: 8 to 10 months

Signs of readiness for solid and finger foods

• Same as 6 to 8 months, PLUS
• Picks up objects with thumb and forefinger (pincer grasp)
• Can transfer items from one hand to the other
• Puts everything in his mouth
• Moves jaw in a chewing motion

What to feed

• Breast milk or formula, PLUS
• Small amounts of soft pasteurized cheese, cottage cheese, and unsweetened yogurt
• Mashed vegetables (cooked carrots, squash, potatoes, sweet potatoes)
• Mashed fruits (bananas, peaches, pears, avocados)
• Finger foods (O-shaped cereal, small bits of scrambled eggs, well-cooked pieces of potato, well-cooked spiral pasta, teething crackers, small pieces of bagel)
• Protein (small bits of meat, poultry, boneless fish, tofu, and well-cooked beans, like lentils, split peas, pintos, or black beans)
• Iron-fortified cereal (barley, wheat, oats, mixed cereals)

How much per day

• 1/4 to 1/3 cup dairy (or 1/2 ounce cheese)
• 1/4 to 1/2 cup iron-fortified cereal
• 3/4 to 1 cup fruit
• 3/4 to 1 cup vegetables
• 3 to 4 tablespoons protein-rich food

Feeding tip

• Some doctors recommend that you introduce new foods one at a time. Wait two or three days, if possible, before offering another new food. (Wait three days if your baby or family has a history of allergies.) It’s also a good idea to write down the foods your baby samples. If he has an adverse reaction, a food log will make it easier to pinpoint the cause.

Age: 10 to 12 months

Signs of readiness for other solid foods

• Same as 8 to 10 months, PLUS
• Swallows food more easily
• Has more teeth
• No longer pushes food out of mouth with tongue
• Tries to use a spoon

What to feed

• Breast milk or formula PLUS
• Soft pasteurized cheese, yogurt, cottage cheese (no cow’s milk until age 1)
• Fruit mashed or cut into cubes or strips
• Bite-size, soft-cooked vegetables (peas, carrots)
• Combo foods (macaroni and cheese, casseroles)
• Protein (small bits of meat, poultry, boneless fish, tofu, and well-cooked beans)
• Finger foods (O-shaped cereal, small bits of scrambled eggs, well-cooked pieces of potato, well-cooked spiral pasta, teething crackers, small pieces of bagel)
• Iron-fortified cereals (barley, wheat, oats, mixed cereals)

How much per day

• 1/3 cup dairy (or 1/2 ounce cheese)
• 1/4 to 1/2 cup iron-fortified cereal
• 3/4 to 1 cup fruit
• 3/4 to 1 cup vegetables
• 1/8 to 1/4 cup combo foods
• 3 to 4 tablespoons protein-rich food

Feeding tip

• Some doctors recommend that you introduce new foods one at a time. Wait two or three days, if possible, before offering another new food. (Wait three days if your baby or family has a history of allergies.) It’s also a good idea to write down the foods your baby samples. If she has an adverse reaction, a food log will make it easier to pinpoint the cause.

How often should your baby eat?

Every baby is unique — but one thing that’s pretty consistent is that breastfed babies eat more frequently than bottle-fed ones. That’s because breast milk is easily digested and empties from the stomach a lot quicker than formula.

Breastfed babies

There’s no rest for the weary. You should begin nursing your baby within 1 hour of birth and provide about 8 to 12 feedings daily in the first few weeks of life .

At first, it’s important not to let your baby go more than 4 hours without feeding. You’ll likely need to wake them up if necessary, at least until breastfeeding is well established and they’re gaining weight appropriately.

As your baby grows and your milk supply amps up, your baby will be able to take in more milk in less time at one feeding. That’s when you might start to notice a more predictable pattern.

• 1 to 3 months: Your baby will feed 7 to 9 times per 24 hours.
• 3 months: Feedings take place 6 to 8 times in 24 hours.
• 6 months: Your baby will feed around 6 times a day.
• 12 months: Nursing may drop to about 4 times a day. The introduction of solids at about 6 months helps to fuel your baby’s additional nutritional needs.

Keep in mind that this pattern is just one example. Different babies have different paces and preferences, along with other factors that influence the frequency of feedings.

Bottle-fed babies

Like breastfed babies, bottle-fed newborns should eat on demand. On average, that’s about every 2 to 3 hours. A typical feeding schedule may look like this:

• Newborn: every 2 to 3 hours
• At 2 months: every 3 to 4 hours
• At 4 to 6 months: every 4 to 5 hours
• At 6+ months: every 4 to 5 hours

For both breastfed and bottle-fed babies

• Don’t give liquids other than formula or breast milk to babies under a year old. That includes juices and cow’s milk. They don’t provide the right (if any) nutrients and can be upsetting to your baby’s tummy. Water can be introduced around 6 months when you start offering a cup.
• Don’t add baby cereal to a bottle.
  • It can create a choking hazard.
  • A baby’s digestive system isn’t mature enough to handle cereal until about 4 to 6 months of age.
  • You could overfeed your baby.
• Don’t give your baby any form of honey until after their first birthday. Honey can be dangerous for a baby, occasionally causing what’s called infant botulism.
• Do adjust your expectations based on your baby and their unique needs. Premature babies are likely to follow feeding patterns according to their adjusted age. If your baby has challenges like reflux or failure to thrive, you may need to work with your doctor on the appropriate feeding schedule and amount they should be eating.

How to get on a feeding schedule

Schedules are the holy grail of every parent. Your child will naturally start to fall into a feeding pattern as their tummy grows and they can take in more breast milk or formula at one sitting. This may begin to happen between 2 and 4 months of age.

For now, though, focus on learning your baby’s hunger cues, such as:

• rooting around your chest, looking for a nipple.
• putting their fist in their mouth
• smacking or licking their lips
• fussing that can escalate quickly (don’t wait until your baby’s hangry to feed them)

Once your baby is a few months old, you may be able to introduce a sleep/feed schedule that works for you.

Let’s say, for example, your 4-month-old wakes every 5 hours for a feeding. That means if you feed at 9 p.m., your baby wakes around 2 a.m. But if you wake and feed the baby at 11 p.m., just before you go to bed, they may not rouse until 4 a.m., giving you a decent chunk of nighttime winks.

What if your baby is still hungry?

In general, if your baby seems hungry, feed them. Your baby will naturally eat more frequently during growth spurts, which typically occur around 3 weeks, 3 months, and 6 months of age.

Some babies will also “cluster feed,” meaning they’ll feed more frequently during certain periods and less at others. For example, your baby may cluster feed during the late afternoon and evening and then sleep longer at night (yay!). This is more common in breastfed babies than bottle fed babies.

Worried about overfeeding? While this isn’t really possible to do with an exclusively breastfed baby, you can overfeed a baby who’s taking a bottle — especially if they’re sucking on the bottle for comfort. Follow their hunger cues, but talk to your pediatrician if you’re worried your little one may be overeating.

Solid foods to avoid

You should avoid giving infants the following foods:

Honey: It can cause botulism, a serious illness, if introduced too early.

Cow’s milk: Stick with breast milk and formula as a primary beverage until your baby is one year old. It’s fine to use cow’s milk in cooking or baking, though.

Choking hazards. Avoid these choking hazards during your baby’s first year: nuts, seeds, raisins, hard candy, grapes, hard raw vegetables, popcorn, peanut butter, and hot dogs.

4 Tips for Managing Mealtime

Create a routine. A baby needs focus to eat, so start a routine where you wash his hands, soothe him, and then sit him down to eat. And maintain the calmness. Turn off the TV and any loud music.

Understand that starting solids takes time. It will take time for your baby to feel comfortable with the new sensations that go along with eating—the feel of a spoon in his mouth and the tastes and textures of different foods.

Prepare for messes. Your baby will likely fling food everywhere, especially if you’re practicing baby-led weaning. This is common and doesn’t necessarily indicate a dislike.

Watch out for allergies. To make pinpointing allergies easier, give your child only one new food at a time and wait three or four days before trying another. Keep an eye out for signs of an allergic reaction or intolerance, like a rash, hives, wheezing, difficulty breathing, vomiting, excessive gas, diarrhea, or blood in her stools. Call your pediatrician if you notice any of these symptoms (they can take minutes or days to appear), and go to the ER if the reaction seems serious.

Gagging: What You Need to Know About Feeding Baby

Your baby may gag when learning to eat solid foods, especially with baby led-weaning. Here’s when gagging is good—and when you need to be concerned.

Baby-led weaning, or baby self-feeding, is more popular than ever when it comes to starting solids. But whether your new eater is feeding himself soft pieces of avocado, sweet potato, or other squish-able options or slurping purees off a spoon, you may see your baby gag and attempt to push food out of his mouth. Gagging may seem scary, but it’s a natural part of the learning process and to be expected. That said, too much gagging isn’t healthy.

When Gagging is Good

Gagging is nature’s way of protecting your baby’s airway and a normal response to new tastes, temperatures, or textures. Be thankful for that gag reflex; babies learn from it! A newborn will gag if something unfamiliar touches the back three-quarters of the tongue. As babies grow, the reflex shifts even farther back. But by ten months of age, something must touch the back third of the tongue to elicit the gag. As the reflex moves farther back, babies learn how to tolerate new mouth experiences and continue to explore toys, foods, and fingers with his mouth, learning every step of the way.

When to Worry

In infants who are breast or bottle feeding, frequent gagging may indicate a loss of control of liquid in the mouth. Signs that your baby is in distress or having trouble keeping the liquid away from his airway include frequent coughing, color change around his lips or eyes, or sudden changes in breathing patterns. Children who are being spoon-fed or are self-feeding and consistently gag multiple times per meal may be having difficulty coordinating mouth movements to safely managing solids, which can lead to serious complications. Discuss any of these signs and the frequency of occurrence with your pediatrician, who may refer your child for a feeding evaluation to determine why he’s having trouble.

Gagging vs. Choking

Gagging is not choking. Gagging is a reflexive attempt to push something away from the airway, while choking is caused by food or an object partially or completely blocking the airway. When babies gag, it is not foolproof protection against choking. A gag may warn you of a possible choking episode, but not in every case.

Choking has little to no sound. It’s unlikely you’ll hear choking, but you will see it. Your child may be open-mouthed, wide-eyed and drooling with bluish skin around his lips or eyes. Partial obstruction may include audible gasps for air or faint noises. Always stay observant when your child is eating. Babies can gag and then choke, or they can choke without gagging first.

Here are some common signs that your baby or toddler is having difficulty learning to eat age-appropriate foods and is at risk for choking:

• Frequent gagging followed by a look of discomfort, panic, fear, or irritability.
• Lack of interest in eating
• Wet, “gurgly” voice quality
• Consistent coughing during or after eating/drinking
• Multiple episodes of chronic low-grade fever
• Strong preferences to certain foods for more than three weeks
• Swallowing foods whole or with minimal chewing
• Weight loss or poor growth

What to Do if Baby Gags

Stay calm, and observe quietly. Just like when a toddler falls as he is learning to walk, we don’t want to over-react. Your baby will gag occasionally as he is learning to eat a variety of foods, especially in the first 12 months of life. If you don’t see signs of choking, just wait a few seconds, and see if baby can remain comfortable and continue eating. Older babies or toddlers can then be encouraged to take a drink of water with a narrow straw, not a sippy cup with a spout. A straw will deliver just enough water to help wash away the tickly feeling and any residual particles of food. A sippy spout, which requires a child to tilt back the cup and tip up his chin to drink, can cause pieces of food to wash into the airway. Keeping the chin level or tilted down just slightly, as with a straw, decreases the likelihood of choking. Babies who have not yet learned to drink from a straw can be offered a baby-sized open cup (held by the adult) for tiny sips of water while their chin is slightly tucked.

How to Wean Your Baby Off Breastfeeding

There’s no universal approach to weaning, but a few golden rules can make the transition go smoothly. We’ve rounded up advice from lactation consultants and developmental experts for how to wean off breastfeeding.

There’s no ideal time to wean your child from your breast; it has more to do with your lifestyle. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for 6 months, then supplemental breastfeeding until Baby turns one. But only about one-third of moms actually do this—going back to work, physical challenges, or simply wanting their bodies back prompts many women to wean sooner.

So when you decide to cut down on breastfeeding, how should you handle the transition? We spoke with lactation consultants and developmental experts for weaning tips.

How to Wean: 0-6 Months

Whatever the reason, whenever you wean—and whoever gets the process started—only one thing’s for certain: you’re bound to run into some surprises. “Just like every other aspect of motherhood, weaning very rarely happens the way we think it’s going to. That said, here are some tips for how to wean off breastfeeding before your little one turns 6 months old.

Rely on bottles.

Bottles are the bottom line when you’re weaning a baby under 6 months old; for every nursing session you drop, you’ll substitute a bottle feeding. Sounds simple, but convincing your baby to accept that tasty bottle may not be so easy, especially if he’s more than 3 months old. So you may encounter more resistance at this point.

Prevent engorgement.

In the first few months, your breasts will be very full. If you’re not careful, you can end up with engorgement.  Your breasts will be uncomfortably hard and heavy, maybe even red and hot to the touch. This can lead to plugged ducts, which can lead to mastitis, so it’s important to treat symptoms early.

If you do end up with uncomfortably full breasts, ice them for about five minutes whenever they feel painful. If this doesn’t do the trick, you can pump for relief, but be sure to limit it to three minutes or so, just enough to feel some comfort.

Go slowly.

When it comes to helping your little one kick the milk habit, the rule of thumb is to go slowly. This will protect your breasts from engorgement and ease your baby’s anxiety. You can never go too slowly, but be sure to drop only one feeding every three or four days so that it takes about two weeks for the entire process. Drop the least preferred feedings first, which likely means the morning and bedtime feedings will be the last to go.

How to Wean: 6-12 Months

Babies often seem to lose interest in nursing between 8 and 10 months. So if you’re thinking of weaning, it might happen more easily during this window.

Of course, while some older babies are determined to break nursing ties, many tots want that physical connection more than ever. Separation anxiety tends to show up at about 9 months. If you notice that your baby’s really clingy, wait to wean until he’s weathered this anxiety a little bit. Here are some more tips.

Consider skipping the bottle.

If your baby is older than nine months, it’s best to wean straight to a sippy cup and solid food to avoid putting your child through another transition from bottle to cup just a few months later (since all children should be off the bottle by their first birthday). It’s a good idea to introduce your child to the cup about one month before you start the weaning process, so she has time to get comfortable holding and drinking from it.

Pick a plastic spill-proof cup with a spout, which most closely mimics a nipple. At first, you should just offer water in the sippy cup during meals of solid foods. Then as your child gets more comfortable, start filling the cup with breast milk or formula so she gets used to the idea that all her beverages can come from a cup.

Amp up attention.

The intimacy that goes with breastfeeding is what moms and babies miss most when nursing ends, so be sure to lavish your little one with lots of extra attention during the weaning process. You’ll want to substitute nursing with something that feels emotionally equivalent, like snuggling together to read or even horseplay on the floor.  And don’t forget how helpful your partner can be. Having Daddy put the baby to sleep and wake her up in the morning can soften the blow of not nursing during these times.

Use distractions.

For older babies and toddlers, the key may be distraction. When your kids starts hankering for the breast, lure her into a block-building bonanza, an engrossing game of make-believe, or a finger-painting frenzy.

What About Partial Weaning?

All-or-nothing isn’t your only option. Many working moms prefer partial weaning, where a caregiver bottle feeds during the day and Mom nurses when she’s home. There are two strategies:

Nursing and formula-feeding: Combination moms nurse when they’re with the baby but have their caregiver feed formula. This may mean nursing right before you leave for work and as soon as you’re home to prevent engorgement. On weekends, if your milk is low, you may want to supplement with formula.

Nursing and pumping: Other moms pump at work so their caregiver can put breast milk in the bottle. You pump as often as your child would nurse, maybe about three 15-minute sessions in a day.