First foods: What, when and how

Nutritionist Cindy Williams tells us all we need to know about feeding baby when it comes time to moving onto solids.

You’ve navigated child birth, sleepless nights and cracked nipples. Your baby is beautiful and you’ve got the feeding routine sorted. Now as you head towards the six-month mark, the conversation turns to food: when to start, what to start with and how much? Everyone has an opinion and they are not all the same. We’ve sorted through the latest research to help you navigate this next important stage in your baby’s development.

When should I start giving my baby solids?

Breast milk is the number one source of nutrients and energy for babies. Babies should be exclusively breastfed, if you can, for around six months and ideally during the introduction of new foods.

Start your baby on solids at around six months. As with adults every baby is different and some may need solids a little earlier but definitely not before four months of age.

Starting solids too early (before four months) will stress your baby’s immature digestive system and kidneys, and increase the risk of developing eczema, asthma, type 1 diabetes, coeliac disease or food allergy.

If food replaces some of the milk at this early age, your baby may miss out on vital nutrients and energy for growth.

A full-term baby is born with enough iron and zinc stores to last around six months. Around the six-month mark it is very important that your baby start to eat some iron-rich foods. Breast milk contains just small amounts of iron. More than 90 per cent of a breastfed baby’s iron requirements must come from food once the initial iron stores are used up. Starting solids later than six months also increases your baby’s risk of developing a food allergy.

How do I know if my baby is ready for solids?

Your baby is ready for solids when he or she shows some of the following signs:

• Is about six months’ old
• Can hold his or her head up
• Can sit with assistance in a baby high chair or on your lap
• Shows interest in food and reaches for food
• Often puts hands in mouth
• Opens mouth when food approaches or when spoon touches lips

What should I start with?

Most mums start off with an iron-rich food such as iron-fortified baby rice cereal thinned with breast milk or infant formula. Next, add a puréed vegetable such as kumara or pumpkin, or fruit such as mashed banana or cooked, puréed apple or pear. The vitamin C in the fruit and vegetables enhances iron absorption by about four times. You could also start off with cooked, puréed meat, fish, chicken or legumes. These foods provide both iron and zinc. Introduce just one food at a time.

How much do I feed and how often?

Buy a soft baby teaspoon and start with one-half to two teaspoons of food after the usual breastfeed. Gradually increase the amount until your baby is having around one or two tablespoons of solids two or three times a day. The amount may vary each day depending on your baby’s appetite.

Babies naturally know when they have had enough. If your baby turns her head away when food approaches or spits out the food, it’s a clear message that she’s had enough. Don’t be tempted to make her finish the plate or force in an extra spoonful. You are responsible for the type of food but your baby is responsible for the amount he or she eats. Overriding this in-built mechanism could cause your child to overeat when older.

For the first year of life, breast milk or infant formula is a baby’s most important nutrient source. Until eight or nine months, solids are simply a ‘top up’ after the usual milk feed.

How do I introduce new foods?

Make sure your baby has had a milk feed and is relaxed. Start with just a small amount. Consider mixing the new food with a food they are already familiar with such as adding a little puréed apple to a new vegetable, legume or puréed meat.

If your baby refuses it, don’t force it and don’t worry. Try again in a few days. It may take around a dozen small tastes for a child to like a new food flavour. Don’t give up introducing new foods. Babies who learn to enjoy a wide variety of flavours and textures are most likely to continue eating this wide variety as they grow older.

Is there any particular food order to follow?

From around six months of age babies should be given small amounts of a wide variety of foods. There is no special order for the type of food although with the texture it is best to start with mashed or puréed food and progress to chopped and finger food.

There is no need to delay introduction of potentially allergenic foods such as fish, eggs, nuts (apart from whole nuts), wheat and dairy.

Are there things I shouldn’t feed my baby?

• Cows' milk, milkshakes. Wait until 12 months before giving your baby cows' milk as his or her main drink. Babies can have small amounts of cooked whole milk as part of food such as custard, yoghurt and cheese from around six or seven months.
   
• Whole nuts. These are a choking hazard. Wait until five years.
   
• Fruit juice, soft drink, cordial, flavoured water. These are high in sugar and play havoc with budding teeth. There is no nutritional reason for a baby to have these drinks. Stick to breast milk, formula or cooled, boiled water.
   
• Salt and salty foods such as corned beef, canned fish, povi masima, soy or fish sauce, stock, tomato paste. Your baby’s food may taste horribly bland to your adult taste buds but it is perfect for them. Never add salt for ‘flavour’. A baby’s kidneys cannot handle too much salt and they may become seriously ill. Adding salt or sugar will only make a baby develop a taste for sweet or salty foods and sets them up to prefer these types of foods when older.
   
• Honey. Honey contains a spore that can cause infant botulism. Wait until 12 months. Honey is similar to sugar — babies don’t need it.
   
• Tea, coffee, herbal tea, alcohol. Babies do not need caffeine or alcohol.
   
• Choking hazard foods. Whole nuts, crunchy raw vegetables such as carrot, hard fruit, raisins, grapes, large seeds, popcorn, thickly spread peanut butter, stringy bits of celery or silver beet.

Always supervise your baby when he or she is eating. For older babies, make sure they sit to eat — no crawling, walking or running while eating.

When should I introduce cows' milk?

After 12 months of age they can have whole cows' milk as their main drink.

Is it OK to give babies tea?

No. Tea contains caffeine which is a stimulant that can harm your baby. Tea also contains tannins which reduce iron absorption — a critically important mineral for baby’s brain development.

Baby food hygiene tips

• Wash your hands before preparing and feeding baby.
• Always discard baby’s leftovers.
• Prepare enough for a few meals. Freeze unused puréed food in ice-cube trays or in small dollops on a tray lined with plastic wrap. Once frozen, tip into a freezer bag, seal and label. Use within three months.
• Reheat food to piping hot and allow to cool before feeding baby.
• Never reheat more than once.
• Never refreeze food once thawed.

First foods and allergies

There is no evidence that delaying the introduction of potentially allergenic foods such as nuts, egg, wheat, dairy and fish beyond six months will reduce the risk of a baby developing an allergy. In fact, allergy specialists think that the old advice to delay certain foods may have partly contributed to the dramatic increase in childhood allergy.

The most important way to reduce the risk of developing a food allergy is to continue breastfeeding while introducing small amounts of new foods to your baby. If you are at all concerned, see a dietitian specialising in food allergy for advice.

Key ways to reduce risk of food allergy

• Breastfeed for at least six months
• Continue to breastfeed while introducing solid food
• Start solids around six months

If your baby has a suspected or proven food allergy, eczema or asthma, see your allergy specialist for specific advice.

Baby-led weaning: What is it and should I try it?

Baby-led weaning is when the baby self-feeds with solid finger foods from the outset. They skip the spoon-fed, purée stage and start eating small pieces of what the rest of the family is eating — a stick of cooked broccoli, peeled soft pear, toast with avocado, a strip of meat etc. Proponents say that these babies end up eating a wide range of foods, can cope with a wide range of textures and are less likely to become obese because they self-regulate how much they eat.

On the negative side, baby-led weaning is very messy and there may be a greater risk of choking. In the early stages when they have no teeth, they may not consume enough food to meet their growth needs and they may not get enough nutrients, particularly the critically important iron and zinc.

The New Zealand Ministry of Health does not recommend baby-led weaning because as yet, there is not enough evidence to allay these concerns. Every baby is different. One may love grasping and munching on family foods while another may prefer to start with spoon-fed puréed or mashed food. No one knows your child better than you so go with what works best for you and your baby, perhaps a combination of spoon-feeding and baby-led weaning.

Bought baby food: Is it as good as homemade?

Bought baby food is really convenient and can be nutritionally as good as homemade baby food. Many bought baby foods contain exactly the same ingredients as what you’d use at home —vegetables or fruit and water — and they are useful to have on hand especially when you’re out and about or travelling.

Homemade baby food is likely to be cheaper than bought, and giving your baby variations on what you are eating should mean they’ll grow up enjoying the same foods and flavours as the rest of the family (minus any added salt and sugar). But it’s worth noting that baby food manufacturers put a lot of work and research into making sure their foods are nutritionally balanced and appropriate for infants, so there’s no need to feel like a ‘bad parent’ for using bought baby food.

Guidelines to buying/using bought baby food

• Choose a variety of textures, not just purées.
• Check for added sugar, often in the form of apple juice. This may encourage your baby to develop a sweet tooth.
• Check for thickeners such as maize starch or added water which bulk out a food without adding nutritional value.
• Use as a base sauce and add grated vegetables or cooked meat.
• Discard any unused food left in the jar. Don't save for later.

First food ideas

Around the six to eight-month mark is a critical window of opportunity when a baby is ready to experience a wide variety of tastes and textures. If a baby is not eating lumpy, solid food by around 10 months there is a greater chance of feeding problems later on. Introduce a wide range of foods quite quickly, especially iron-rich foods.

Purées

• Iron-fortified baby cereal thinned with breast milk or infant formula
• Cooked, puréed meat such as beef, lamb, pork, chicken, fish (choose low mercury types). Simmer chopped meat, chicken and vegetables in pot with water then purée
• Rice congee
• Cooked and puréed vegetables such as carrot, pumpkin, potato, kumara, parsnip, courgettes, peas, cauliflower, broccoli, cassava
• Puréed or mashed fruit such as banana, avocado, mango, cooked apple, pear (no skins or pips)
• Cooked and puréed legumes such as lentils, split peas and chickpeas. Simmer lentils in water with vegetables then purée
• Steamed, puréed boneless fish fillet with cooked vegetables
• Whole-milk yoghurt, milk pudding or custard. Add purée fruit or banana for sweetness – no sugar or honey

Thick, lumpy purée, soft mashed, minced, grated, soft finger foods

• Grated cheese, cottage cheese
• Cooked pasta, chopped up noodles, rice
• Porridge topped with unsweetened stewed apple or chopped banana
• Smooth peanut butter (check label for no-added-salt-or-sugar)
• Grated or cut fingers of carrot, courgette, pumpkin, steamed
• Roasted whole kumara: scoop out centre
• Grated roasted beef, lamb or chicken over mashed vegetables
• Pan-fried chicken or fish grated or flaked over mashed vegetables
• Cooked, mashed egg

Firmer finger foods, bite-sized pieces, chopped, lumpy mashed

• Fingers of cooked vegetables
• Mini meatballs
• Thin strips of cooked meat
• Breakfast cereal such as infant muesli or wheat biscuits — only once a day with breast milk or infant formula (never add cereals or any other food to an infant’s feeding bottle)
• Mini sandwiches
• French toast — cut in fingers
• Mini pancakes with sliced banana
• Peeled raw fruit such as orange (no pips), kiwifruit, pineapple
• Rinse and drain a can of chickpeas. Blend with cooked pumpkin or beetroot (remove skin). Serve with capsicum sticks or toast cut in fingers
• Mini corn fritters

Remember: Just because your baby is eating solid food there’s no reason to stop breastfeeding. If you are able, continue breastfeeding until baby is one year or beyond.