If your baby could talk, he'd tell you when he is hungry, when he is full and why he refuses to eat anything green.
Unfortunately, that won't happen for at least a year — and it will probably take even longer than that before he's making his wishes known verbally. In the meantime, you'll have to figure out a few things on your own, most notably how much milk or formula baby needs, when to switch to solid food and what to introduce and when. To help, we talked to two experts who offer advice for the four general stages of baby's first year of life.
0 to 4 Months
Without question the best food for baby from birth is breast milk, says Dr. Rebecca Unger, a pediatrician in the Nutrition Evaluation Clinic at Chicago's Children's Memorial Hospital. In fact, the American Academy of Pediatrics recommends that babies be breastfed for at least the first year of life. Realistically, though, it's not always possible to follow AAP's guideline, Unger acknowledges. If giving your baby breast milk isn't possible, the next best thing is formula, she says. The good news is that a host of formula products exist, including several new products that offer extra essential fatty acids, which are especially helpful for premature babies. For babies with food intolerances or allergies, soy or hypoallergenic formulas also exist.
Fortunately most babies can tolerate cow's milk formula — the most commonly used base for formula — says Unger, who recommends opting for the powder variety for babies who are approaching 4 months. The reason: At 4 to 6 months old, babies can begin to benefit from fluoride, which is found in most tap water.
See the next page to learn more about feeding a newborn.
Feeding a Newborn
Whether they're fed formula or breast milk, newborns need to eat every two to four hours, says Unger, who notes that even though formula tends to digest slower than breast milk, formula-fed babies should still fall within the two- to four-hour range. Breastfed babies may want to eat frequently — sometimes every hour — in the early weeks of life. That's tough news for exhausted parents who are aching to sleep through the night, acknowledges Dr. Tom Collins, a private practice pediatrician based in Concord, Mass., and founder of askdrtom.com.
Since there's no hard and fast rule as to when baby can go the entire night without eating, Collins takes his cue from baby: If baby is gaining weight appropriately in the first weeks of life, Collins might give the go-ahead for allowing baby to sleep as long as he wants at night. "If baby comes in at a week or two and is losing weight or has just gained a couple of ounces, I'm more direct about how frequently to feed the baby." Most experts don't recommend forcing baby to sleep through the night — in others words, not feeding him should he wake up — until baby is at least 4 months of age.
Babies' habits will vary widely by baby, but roughly 25 percent of babies will sleep through the night by 2 months, 50 percent will do so by 4 months and 75 percent will sleep through the night by 6 months, says Collins. "It just depends on when baby is ready. A baby can be 18 pounds and still waking up," he adds.
Helpful hint: Once baby has sipped from a bottle, it's not a good idea to reuse the milk or formula in the bottle, even if baby hasn't eaten much. The reason: baby's sucking introduces bacteria into the milk.
During the first four months of life, Unger and Collins recommend an entirely liquid diet — of either breast milk or formula. That means you shouldn't heed well-meaning friends' advice and slip baby cereal in his bottle in the hopes that he'll sleep longer. Baby isn't ready for cereal and, besides, there's no evidence that cereal actually helps keep baby's stomach full longer. "We want to go at baby's pace," says Collins. "He'll be ready for cereal when he can open his mouth, accept a spoon and be part of the meal," he says.
One exception to the milk-only rule: Breastfed babies can benefit from a vitamin supplement. "There is some new information that suggests that babies who are purely breastfed should also be on a vitamin D supplement," says Unger. "It's based on the fact that with the increased use of sunscreen babies are not getting as much vitamin D naturally." Your pediatrician can suggest an over-the-counter vitamin supplement.
While what to feed baby may be a no-brainer, how much to feed baby is not such a simple matter. Generally, newborns likely will polish off 1 to 3 ounces per feeding, and will graduate to 2 to 4 ounces as they get a little older, says Unger. By 4 months baby may suck down 6 to 8 ounces per feeding, says Collins. Keep in mind, however, that every baby is different and while you want to be careful not to underfeed baby, overfeeding baby shouldn't be a concern, unless baby is throwing up, says Unger. "Weight gain in the first four months of life is not related to obesity later on," she says. Therefore, it's probably safest to put a little more in baby's bottle than you think he will drink. That way, when he's ready to graduate to bigger feedings he'll have plenty to eat. Still, be alert for signs that baby has had enough: if he turns his head away or stops drinking, he may be trying to tell you something.
The bottom line in deciding how much to feed baby and how often he needs to eat: steer clear of rigid guidelines and instead look to your baby for clues. "I think parenting books are wonderful and great to keep you informed about what is happening to other babies, but they don't apply to one baby," says Collins. So read the books. Then put them away and let baby be your guide.
Helpful hint: Don't get into the habit of letting baby fall asleep with a bottle in his mouth — milk pools in the mouth and promotes tooth decay. Even if your little one is still toothless, you'll be starting a habit that is hard to break later.
By 4 months you're probably more than ready for something new. The good news is that baby is too: It's time to start solid food. Or, more accurately, mushy food — whether it's from a box, jar or your own blender, at this age baby is only ready for smoothly puréed meals.
Of course, as with any guidelines about feeding baby, keep in mind that the timing for solid food varies by baby, too. "By 3 or 4 months baby will probably be ready to take a spoon," says Collins. Even so, for the first few feedings — and maybe longer — don't be surprised if much of the food ends up on rather than in baby. Baby should get the hang of this new skill pretty quickly, however, says Collins. If baby pushes every bite out with his tongue or turns his head away every time, he's probably not ready. "If he doesn't get the gist, I say put the spoon away and try again in two weeks," says Collins.
Signs that baby is ready for solid food: if he's hungry between feedings, if he can sit up and if he accepts a spoon (i.e., he doesn't push it out with his tongue). Once he's ready, start with iron-enriched baby cereal. Many parents start with a mix of breast milk or formula with one to two tablespoons of rice cereal, once a day at first and then more often as baby desires. By 6 months old baby should be eating three meals a day, in addition to milk or formula. As he ups his intake of solid foods his consumption of milk or formula may decrease, although solid food feedings should be offered in addition to milk or formula, not in place of it.
Once baby is comfortable with cereal, you can start to introduce other foods — either from the jar or those you make yourself with a blender. Collins suggests waiting to introduce fruits and vegetables until baby is 6 months old, although many doctors say you can start introducing them two weeks after you start feeding baby cereal. Whenever you decide to do it, Collins and Unger recommend introducing new foods one at a time, with four or five days between new offerings. This gives you a chance to see if a food produces an allergic reaction — causing an all-over body rash, blood in the stool, diarrhea or vomiting. If you do notice a problem, stop feeding baby the offending food and discuss it with your doctor.
Some parents swear by introducing veggies before fruits — so baby doesn't get hooked on the sweet-tasting fruit and shun veggies — but Unger says order doesn't matter. Just be sure to stick to fruit, vegetables and cereal at this age: Baby isn't quite ready for meat, crackers or teething biscuits yet.
Helpful hint: If you blend your own baby food, portion it in an ice cube tray and freeze — when you need a meal, just defrost a cube or two.
What to do when baby won't eat? "Let them go at their pace," says Collins. "However, I do tell parents that I want every baby to eat three times every day of their life. If they get dehydrated, we've got a problem." However, as long as baby is getting fluid, if he turns his nose up at solid food "give him a little space and he'll come back," says Collins. "Babies have an inborn drive to thrive and to grow and develop."
Helpful hint: Four to 6 months of age is a good time to introduce a cup. Try offering milk or formula in a "sippy" cup rather than a bottle. Of course, don't be surprised if it takes baby a while to get the hang of it. The idea is to slowly get him used to drinking from something other than breast or bottle: It will make weaning baby from either a lot easier.
If you never thought lumpy food was exciting you may begin looking at it in a whole new light right about now. By 6 months baby is likely ready to start tackling food with a little more texture and variety than he's been interested in so far. If you haven't already, you can introduce fruits and vegetables in addition to baby's cereal. During this period you'll probably switch to Stage 2 or Stage 3 baby food, which offers combinations of food — think apples and bananas or mixed green vegetables — and chunkier consistency. Toward the end of this period you might want to introduce meat and poultry, although Collins recommends waiting until baby is 9 months old for that.
Helpful hint: For the best luck in getting baby to eat, try feeding him an hour or so after he has had a bottle or breastfed, says Unger. If you try to feed him while he's hungry, his slow eating pace might frustrate him and you'll likely have a meltdown on your hands. Collins, on the other hand, recommends feeding solid food first and then topping it off with breastfeeding or formula.
By 8 or 9 months old your baby may want to try to feed himself, which means you'll want to offer up some finger foods — mashed up fruit, small pieces of carrot, large curd cottage cheese and small pieces of cheese. Be sure to avoid choking hazards, like grapes or carrots or hot dogs cut into medallions (the short way). Instead, cut them into small strips. How much your baby can handle depends on how many teeth he has, so let him be the judge.
Helpful hint: Try mixing yogurt with cereal and rolling it into balls so that so baby can pick them up and eat them. This will help get more iron-enriched cereal into baby's diet. If you can, buy full-fat yogurt (Yo-Baby is one product on the market) instead of regular or low-fat yogurt.
Although cow's milk isn't recommended until baby is 1 year old, Unger says it's OK for baby to eat small quantities of dairy, such as yogurt, cheese and cottage cheese after he is 6 months old. Now is a good time to introduce teething biscuits too, although you should only allow baby to chew on them when he's sitting upright and you're supervising him.
At this point, baby should be eating three full meals each day and most of his nutrition should come from solid food rather than liquids. Although you want to aim for a balanced diet, don't be surprised if your baby has other ideas. "Babies will tell you what they like and don't like over a period of time," says Collins. "Sometimes I see babies that have an orange hue to them because they like carrots and squash so much." If your baby spits out everything green, keep trying, but don't despair. "Don't make them eat what they don't like," says Collins.
Months 9 through 12 are much like months 6 through 9: You'll want to aim for three meals a day and continue to encourage the use of a cup and self-feeding. Unger suggests offering cereal twice a day, in addition to table food (cut small or puréed) and baby food. When baby is 1 year old, you can start to introduce whole cow's milk. Reduced-fat products like skim milk are not recommended until baby is 2 years old.
Although you've probably been keeping an eye on healthful eating until this point, now is a good time to really make an effort to instill healthy eating habits in baby. If you can avoid introducing sweets, you'll have a better chance of getting baby to avoid them later in life. Avoiding salt and highly processed foods is also a good idea, naturally.
What not to feed baby
What not to feed baby
There are a few items you'll want to avoid until baby is 1 year old, primarily because early introduction has been linked to food allergies. Foods to steer clear of until baby's first birthday: eggs, peanuts, shellfish and cow's milk. In fact, Unger doesn't recommend introducing eggs until 15 months and suggests shunning shellfish until baby is at least 2 years old. You'll also want to avoid giving baby honey for his first year of life since it may contain botulism, which adults can tolerate but young babies cannot.
Collins and Unger also both recommend avoiding juice in baby's first year of life. Baby is better off with water, milk or formula.
One last no-no: chocolate, says Collins. "Kids don't need chocolate in their life, even though you and I may think it's an essential food group," he jokes.
For more information about feeding a baby and other baby care tips, see the links on the next page.