Spoon-feeding practices vary from one family to another. Boys may differ from girls and breast fed infants tend to start spoon-feeding later than those who are not breast fed. This leaflet offers some general guidance to help ensure that your baby gets the right food at the right time. Remember, babies have special nutritional needs and what is healthy for adults (e.g. high fibre, low fat) is not suitable for infants and small children.
When to start
The Department of Health and Children recommend that weaning starts at 6 months for those babies who have been exclusively breast fed, or sometime between 4-6 months if your baby has been formula fed. It is not recommended to start solids before 17 weeks (4 months) or to delay past 26 weeks. Before 4 months a baby's gut
is not fully mature and easily digested breast milk or formula is all that is needed. You may notice, particularly around three and six weeks, that your baby becomes restless and seems to want to feed more often. At this time, increase the number of breast feeds or the amount of formula offered at each feed rather than introducing solid foods.
How to proceed
It is best not to offer the first spoon-feed when the baby is very hungry. The small amount taken will not be enough to satisfy his/her hunger and he/she may become frustrated and upset. Breast feed or give some formula first and then offer food when the baby is more relaxed. Begin by giving a spoon-feed once a day, at a time when you too are relaxed and can enjoy the experience. At first, only a very small amount of food will be eaten. What is important is that the baby is beginning to learn to take food from a spoon. Introduce one food at a time so that the baby can get used to the different tastes and textures. If a particular food is refused, wait a few days and try again. If you suspect that your baby has reacted to a food by being unsettled or upset, avoid this food for a while and if the problem persists when you try the food again talk to your doctor, a nutritionist / dietitian or your public health nurse.
Month by month guide
Precisely which food you begin with is up to you. Whichever food you choose, initially it should be of a soft, runny consistency. Pureed fruits (banana, pear) or vegetables (carrot, green beans) are excellent choices as are gluten free cereals, e.g. baby rice. The range of foods used may be expanded gradually to include all fruits and vegetables, potatoes, eggs (begin with the yolk, cooked solid), meat or chicken, pulses (peas, beans, lentils, appropriately cooked) and gluten free cereals. Cereals may be mixed with water, expressed breast milk or formula.
All infants should be given a diet which is free of gluten, until six months. This is recommended because the introduction of gluten is associated with the onset of coeliac disease in predisposed babies. Infant foods are labelled to indicate those which do not contain gluten. Gluten is found in wheat, rye, barley and possibly oats, so check that other foods do not contain any of these. If there is a family history of coeliac disease, your doctor may advise you to avoid giving your baby gluten-containing foods for a more prolonged period.
As your baby becomes used to swallowing solid food, a thicker consistency may be offered. Do not give hard or lumpy food until baby has enough teeth to chew it! Continue to use fruits, vegetables, meats, pulses and cereals which need not now be gluten free. After six months, cows milk may be used, but only to mix feeds or as an ingredient in foods (e.g. on breakfast cereals, as a sauce or in milk based desserts such as custard). Bread, or scones are useful between meal snacks. Try yoghurt for dessert.
Baby will now be able to bite and chew and eat most family foods and snacks. Breast milk or formula should continue to be the main milk drink. Encourage your baby to develop a healthy and varied eating pattern by offering a wide range of foods ñ even those you may not choose yourself. Ensure that snacks are nourishing; for example, offer finger foods such as toast, chopped fruit, cooked carrot sticks or a slice of fruit loaf (brack). If meals are not eaten, try to include the food at another time. Make a sandwich with chopped meat or chicken or melt some cheese on wholemeal toast. By their first birthday, babies should be able to eat most family foods and join in family meals. It is still essential to supervise your baby during mealtimes, never leave him/her alone while drinking or eating.
How much food?
Two or three teaspoonfuls is enough to begin with but the quantity and number of feeds will need to increase gradually. Each baby will progress at his/her own rate. By responding to your baby you will know how much he/she needs. Although spoon-feeding can be a somewhat messy affair initially, little by little, as the baby masters the technique, the amount of food which is actually eaten increases. Eventually, some food should be given at least three times a day with a milk drink (breast or formula). As the food intake increases, the baby will drink less milk. Small snacks, for example, fruit or rusk, may be offered between meals. Small babies are not able to eat big meals but by eating frequently they can get all the energy they need for growth.
Foods to avoid initially
Milk continues to be a very important part of a baby's diet throughout infancy (up to 12 months) but ordinary cows milk does not provide the nutrients a baby needs. It should not be used as the main milk drink during infancy as it is a risk factor for the development of iron deficiency anaemia. Breast milk or formula should be used as the main milk drink until your baby is one year old. Use whole milk; low fat products are not suitable for babies or young children. Foods containing gluten should be avoided until after six months. In families where there is a history of allergy (e.g. asthma, eczema, hay fever), delaying the introduction of other foods such as eggs or nut products may be advised to try to ensure that the new baby will not develop an allergy. Food allergy is relatively uncommon and should always be medically diagnosed. Whole or chopped nuts are difficult to chew and, to avoid choking, should never be given to babies or young children up to five years. For additional information contact a paediatrician, paediatric nutritionist / dietician or public health nurse.
Home prepared and ready-to-use foods
Home prepared foods which are suitably pureed can be perfect first foods. To begin, you will probably have to prepare your babyís meals separately. Stew small portions of fruit or steam or boil vegetables and purÈe or mash them to a soft runny consistency. Add a little boiled water if necessary. Small portions of family food (for example, a plain stew made simply with meat or chicken and vegetables) can be used between four and six months, as baby's tastes expand. Remember not to thicken stews with wheat flour, which contains gluten. Sieved or purÈed potato or rice (both of which are gluten-free) can act as good thickeners. Babies are happy with bland tastes and do not need strong flavours. Salt or salt products should not be added to foods for infants as babiesí kidneys can not cope with large amounts of salt.
If you prepare baby's food yourself, you will want to be sure that the meals you prepare provide the nourishment your baby needs. Foods may be diluted at first to achieve the correct consistency but more substantial meals will be needed as your baby grows. Use a variety of foods and include different tastes, textures and colours.
Commercially prepared baby foods are widely available and offer a convenient alternative to home cooked meals. Their nutrient content is controlled by law and they are sterile before opening. It is important to offer variety so that babies do not become used to a particular taste or texture and can easily adapt to eating a wide range of foods.
Vegetarian and vegan babies
Very special care is needed if you wish your baby to eat a vegetarian diet. Vegan diets present an even greater and more complex challenge. Vegan weaning generally cannot be recommended, as it is difficult to provide what the baby needs. Both vegan and vegetarian diets can be low in energy, protein, iron and certain vitamins, all of which are essential for small babies. Ideally, a paediatric nutritionist / dietitian should be consulted to help with planning vegetarian meals.
Breast milk is ideal to begin with so breast feed for as long as possible if you have chosen not to use dairy products for your baby. For vegetarian babies who are not breast fed use an infant formula (or follow-on formula from six months). A soya based formula may be used, if wished, but adult soya milk, which can be bought in a carton in a supermarket is not suitable for babies as it does not contain certain nutrients which babies need.
Vegetarian babies can begin with the usual combination of fruits, vegetables and cereals, but will not be eating meat, meat products, chicken or fish. Eggs and dairy produce can be used as alternative sources of protein. Beans and grains are bulky and have less energy than meat, but, if combined correctly, are important parts of a vegetarian diet. Use cereals (gluten-free to six months) which are fortified with minerals and vitamins and green vegetables, beans and grains to increase iron intake. Iron from these non-meat foods is poorly absorbed but by giving vitamin C (e.g. orange juice) at the same meal absorption is increased.
Iron for babies
Recently in Ireland about one in ten two-year-olds were found to be anaemic (not enough iron in the blood). Iron deficiency is the most common nutritional deficiency in the world and can affect the growth and development of infants. Small children are at greater risk of becoming iron deficient than adults because they need extra iron for growth. Red meat (lamb, beef, pork) and chicken are excellent sources of a type of iron which is easy for your baby to absorb. Vegetables, eggs, cereals and pulses also contain some iron but the iron from these foods is less well absorbed. Vitamin C (e.g. orange juice), given at the same meal, helps iron absorption from these foods.
To ensure that your baby gets enough, it is best to include foods which contain easily absorbable iron. You may begin to give small amounts of pureed meat or chicken from four to six months. Try making a lamb stew or use lean, finely minced beef in Shepherdís Pie as an easy-to-eat main meal. Iron requirements remain high during the second six months of life and the pre-school years, so all infants and young children should be encouraged to eat some meat on a regular basis (at least three to four times a week) to prevent the development of anaemia.
Snacks for babies
Snack foods, chosen wisely, can provide useful nourishment for your baby between meals.
Remember, up to six months all foods should be gluten free. Try fruit (banana, nectarine), vegetables (lightly cooked carrot, celery or broccoli) or gluten free rusks. Toast or scones may be used after six months or you could make a small sandwich with chicken or cheese.
Even when babies can hold small pieces of food, they should never be left unattended while eating.
More than milk to drink?
Breast milk, formula or cooled boiled water are the best drinks for babies. Fruit is very good for your baby but fruit juice drinks, even without added sugar, contain sugar and if used, should be well diluted (see note on tooth care). The more frequently teeth are exposed to sugar the greater the risk of tooth decay. Tea and coffee are unsuitable for babies. They do not provide the same nourishment as milk and can interfere with the absorption of nutrients such as iron. By the end of the first year much of the babyís nourishment will be supplied by solid foods but toddlers and young children continue to need about one pint of milk daily. More than this may decrease their appetite for other essential foods.
You may like to try using a drinking cup with a spout during the second six months. A cup is useful for giving small drinks between meals and using a cup encourages baby to develop another new skill. Bottle use should be discouraged after 12 months.
Taking care of baby's teeth
A baby begins to get teeth during the second six months of life. Tooth cleaning should begin as soon as the teeth are visible. Brush the teeth gently with a soft brush or a clean cloth after meals without toothpaste up to 18 months. Take your baby to the dentist from about one year to make sure the teeth are developing properly.
When toothpaste is introduced use a low fluoride version. As babies and small children are unable to spit out toothpaste it should be used sparingly, e.g. a small pea sized amount. Children should always be supervised when cleaning their teeth.
If the teeth are exposed frequently to sugary foods or drinks the risk of tooth decay increases. Never leave a baby with a bottle for a long period and do not give the baby a bottle to take to bed. Cool boiled water is best as a between-meal drink. If juices are used, they should be limited to meal times and preferably given from a cup.
While it is important to minimise the frequency and duration of exposure of the teeth to sugar it is neither practical nor necessary to avoid sugar completely.
Small babies are particularly vulnerable to infection, so great care must be taken to ensure that all foods are fresh, clean, hygienically prepared and stored correctly. Never leave leftover food lying around. If you wish to offer it again later the same day, cover it and store it in the fridge. Generally, what is not eaten on the same day should be discarded. Meals, which are prepared in advance for freezing, or for use later in the day, should be stored with care. Freeze small portions in containers or plastic bags and defrost in the fridge. Reheat all pre-cooked food thoroughly and allow to cool before serving.
Utensils used to feed small babies should also be scrupulously clean. Use plastic plates and spoons, which can be sterilised after each meal.
Practical points to remember
- Never leave baby alone while drinking or eating.
- Check with a parent or guardian before offering any food to a baby or young child.
- Breast milk or formula should be the main milk drink to 12 months.
- Cows milk should not be used as the main milk drink for the first year. It may be used to mix foods or as a food ingredient after six months.
- Solid foods should not be introduced before four months.
- Feed solid food from a spoon; do not add food to a bottle feed. Chewing is important for speech development and the muscles used for chewing are also used in speaking.
- Use gluten-free cereals to six months.
- Red meat is the best source of iron and may be introduced between four and six months.
- Sugar may be used in moderation, e.g. to sweeten stewed fruit.
- Salt should not be added to babyís food.
- Do not use ëlow fatí, high salt or high fibre products for babies.
- Hot or spicy foods are not suitable first foods.
- Never give chopped or whole nuts to small babies or young children.
- Keep all utensils used for feeding babies scrupulously clean.