FEEDING YOUR BABY: The First 6 Months
by Jo Ann Serota, RN, MSN, CPNP
With rare exception, the only source of nutrition for babies less than 4 months old should be breast milk or iron fortified formula. You may start baby juices at 2 months of age if your baby wants some variety. No more than 4 ounces of juice is suggested. Juices that are made for infants are more finely screened for solid content than juices for the general marketplace. Infant juices may, therefore, be easier to digest. Clear juices for adults may be given after 6 months of age. Breast milk or iron fortified formula should be continued until your baby is one year old. In general, an infant should take approximately 24-28 ounces of formula per day. The feedings are usually every 2 to 4 hours during the first 6 months of life.
Breast fed babies vary in the length of feedings and times. Usually, a breast fed baby feeds every 2 to 4 hours and for 20-30 minutes at each feeding.
Many parents wonder if they should schedule their new baby's feeding times, or simply feed on demand. On demand feeding works very well with most babies. It is very difficult for a mother to put off feeding her baby and listen to the continued crying when the baby becomes fussy, simply because enough time hasn't passed since the last feeding. Babies in the first month or two of life simply are not developed enough to be able to hold off on their needs. In reality, it is easier for both parent and baby to feed on demand initially, realizing that over time, both mother and baby will become more scheduled by 2-3 months of age.
BEGINNING SOLIDS
There is little nutritional value to starting solids too soon. An infant's colon lacks the specific enzymes needed to digest the carbohydrates in cereals, fruits and vegetables. There also may be an increased incidence of food allergy in infants started on solid foods before 4 months of age. By 4 months of age most babies are ready to begin rice cereal (least allergenic), fruits and vegetables. At this age, your baby can hold his/her head steady and the extrusion (tongue thrust) reflex disappears. That is, the ability to swallow food placed on the tongue has developed. By this time, most babies are interested in eating more than just breast milk or formula.
Most babies take readily for the introduction of solid foods. If your baby does not seem to be enjoying the meal, cries while being fed, spits out more than what goes in — wait a week or two and then begin again.
To begin, mix about 2-4 tablespoons of dry rice cereal with breast milk, formula or apple juice. Apple juice has been found to be the best mixer with cereal because the Vitamin C in the juice enhances the absorption of the iron in fortified cereal. Initially, make the cereal watery — it should drip off the spoon. Thicken it once the baby becomes used to the consistency. Hold your baby upright or place him/her in an infant seat with a large bib. The spoon should be small and rubber coated to protect the gums and lips. Begin feeding slowly, talking and smiling to the baby during the entire feed. This will make the feeding a pleasurable experience for both baby and mother. Try not to feed the infant when rushed or pressed for time. It is fine to allow someone at the daycare center or your baby sitter to feed the baby after you have given the appropriate instructions.
During the first week of feeding, give the cereal alone. Start infant strained fruits and vegetables during the second week. Begin with one new food for several days to be sure the baby tolerates the change. True allergy to fruits and vegetables is rare. Note that once solid foods have begun, the baby's bowel movement will change in smell, color, consistency and pattern of elimination. Babies may have a bowel movement with every feed or just once in 8 days. This is a normal phenomena. Don't become alarmed. Begin with green or yellow vegetables, or fruits. Babies have a natural sweet tooth, and some say that if fruits are started first, the baby may not become interested in tasting vegetables. Alternate between green and yellow vegetables. Don't worry if your baby develops an orange hue to his skin color after several days of yellow or orange colored vegetables. This is from carotene, the pigment that colors the vegetable, and is harmless. It may be wise to buy small jars (two ounces) of infant strained foods in the beginning stages of feeding solids. Start with a one ounce serving twice a day and increase the amount gradually to 2 ounces at a feeding.
The usual menu for infants between 4 and 6 months old (after the initial introduction period) is cereal and fruit in the morning, and cereal and vegetable at the end of the day. This should be taken as a suggestion only and not be considered written in stone, since every baby is her own person with her own likes and dislikes. Remember also, your baby's taste for foods will vary from day to day. Try to stay flexible, and vary the menu according to your baby's interests.
You will notice that the amount of breast or formula feedings taken may drop slightly with the introduction of solid foods. This is to be expected and should not cause worry. The baby may also change the times of nursing or bottle feeding depending on when given the solid foods. This, too, should be expected. It is just fine to be flexible with your baby's schedule.
Remember to alternate green and yellow vegetables and fruits. Try all types of foods even though you may not like them. Try to smile while feeding your baby foods you may not enjoy eating.
True food allergies are rare. Fleeting rashes are rarely harmful to your baby and probably of no real medical significance. Children who have real food allergies have severe abdominal pain, vomiting and explosive, bloody diarrhea. They fail to grow and thrive. Such reactions are extremely unlikely, and concern about food allergies should not hinder your interest in exploring new foods with your child. Feeding your baby should be an enjoyable and rewarding experience for both baby and parent.
At 6 months of age, you may increase your baby's diet to include meats and dairy products. More on this later at the 6 month visit.
If you have any questions about feeding your baby, please don’t hesitate to call us during regular office hours.
