Stages of baby feeding: The 3 baby food stages: What foods and when

The 3 baby food stages: What foods and when

Making the leap from breast milk or formula to solids and then eventually to table food is an exciting time. But it’s also a little confusing because there isn’t a one-size-fits-all rule when it comes to baby food stages. While one child may happily take to pureed carrots at 6 months, another may purse their lips at anything but a breast or bottle until 8 months. 

To simplify the whole process, here’s a general rule of thumb to keep in mind: Most foods are OK to give to babies in the first year, as long as they’re properly prepared. And if you’re concerned about food storage, read more from our experts on how long baby food lasts.

Here’s the quick lowdown on what to feed baby and when:

• Stage 1: Purees (4 to 6 months).
• Stage 2: Thicker consistency (6 to 9 months).
• Stage 3: Soft, chewable chunks (10 to 12 months).

“With the exception of raw or cooked honey, which shouldn’t be consumed until 12 months because of the risk of infantile botulism, babies can have any food that is texturally appropriate for their developmental feeding stage,” says Dr. Kristen Treegoob, a pediatrician at Children’s Hospital of Philadelphia. 

In other words, it’s perfectly fine to give both a 6- and 12-month-old peas, but for the 6-month-old, they need to be pureed. 

In the past, parents have been advised to start their baby with single-grain cereals, such as rice cereal, but the American Academy of Pediatrics (AAP) now says there’s “no medical evidence that introducing solid foods in any particular order has an advantage for your baby” — nutritionally or when it comes to long-term food preferences. (So, when your Aunt Joanne tells you that your baby will be a vegetable-hater for life if you start off with applesauce, she’s wrong.)

All of this said, there is a method to the messy madness that is the three stages of baby food. In order to make things less complicated — and more delicious — we tapped top experts and veteran parents to find out everything you need to know about feeding little ones at every stage (plus, we included a handy baby food stages chart). All you have to do now is serve the food and clean the high chair!

Stage 1 (4 to 6 months): What you need to know

The fun begins! Stage 1 baby food is typically for babies who are between the ages of 4 months and 6 months. But as with all things parenting-related, it’s important to keep in mind that each baby is different, and there’s no hard and fast rule for starting solids. 

“While the AAP recommends exclusively breastfeeding from birth to age 6 months, it’s important to remember that not every baby is exclusively breastfed,” says Dr. Zulma Laracuente, a pediatrician in Alexandria, Louisiana. “Also, some babies show signs of readiness to start food earlier than others. You know your baby best.”

Solids that fall under the Stage 1 category are thin and smooth in texture — not much thicker than breast milk or formula — and contain a single ingredient. If you’re making your baby’s food at home, make sure it’s blended to an almost-watery puree.

“Stage 1 baby foods should have no chunks whatsoever,” says Jenifer Thompson, registered dietician and advanced practice dietician at Johns Hopkins in Baltimore. “Formula or breast milk can be added to the purees to make them thinner.”

While there’s no specific food parents need to start with, many pediatricians recommend beginning with iron-rich foods, such as iron-fortified cereals or pureed meats.

“The reason we advise introducing solids at 6 months and starting with iron-containing foods is because iron stores that were built up during pregnancy are depleting, and iron is important for infants’ brain development,” says Dr. Melanie Custer, a pediatrician at Deaconess Clinic in Evansville, Indiana. 

Custer also says that babies should “absolutely not” decrease their breast milk or formula when they first start off with solids. 

“Infants still should receive 24 to 32 ounces of formula or breast milk each day,” she says. “Solids at this point are more of a snack, with baby eating about 3 to 4 tablespoons once or twice a day.”

How to tell your baby is ready for Stage 1

According to Treegoob, here are the signs your baby is prepared to start Stage 1 foods:

• They’re showing an interest in what family members are eating.  
• They’re learning to open their mouths for a spoon.
• They’ve outgrown the involuntary habit of pushing food and spoons out of their mouth with their tongue. 
• They have steady head control.
• They have the ability to move food from a spoon to their throat and swallow without choking.

Stage 2 (6 to 9 months): What you need to know 

Time to mix it up! While Stage 2 solids are still basically mush, food has a little more texture at this point, as well as a few soft chunks. 

“Stage 2 baby foods are thicker in consistency than Stage 1 purees, and many of the jars you find in stores have some small mashable bits in them,” says Treegoob. “These are great for infants who have done well with Stage 1 but who are not quite ready to chew. The typical age for Stage 2 is between 6 to 9 months.”

Treegoob also notes that the 7 to 9 month time frame is also when many babies begin modifying their breast milk or formula intake. 

“As long as an infant’s weight remains on track and they’re drinking enough to stay hydrated, there isn’t a reason to worry if baby is showing interest in smaller or less frequent bottle or breastfeeds,” she says. “Infants typically take in somewhere between 24 to 32 ounces a day when they’re between 6 to 9 months.”

Whether you’re making your little one’s food on your own or getting it pre-made at the store, you have a little more room to play once you hit Stage 2. 

“In addition to being thicker in consistency, Stage 2 foods usually have multiple ingredients, including some spices,” says Custer. “At this point, baby is usually taking in more food than they were in Stage 1, so it’s important to make sure they’re being introduced to a wide variety of foods from different food groups.” 

According to the AAP, babies should be eating about 4 ounces of solids — about one small jar of baby food — at each of their meals.

How to tell your baby is ready for Stage 2

Once your baby has consistently been eating Stage 1 foods, they’re likely ready for the next step. Here are other signs to look for, according to Thompson:

• Their oral skills are continuing to develop.
• They’re consistently taking food in and swallowing when you offer it (and not spitting it out).

Stage 3 (9 to 12 months): What you need to know 

Now, the true culinary adventure begins — Stage 3 foods! While some babies will still happily have mom and dad spoon-feed them mashed food at this age, many babies will have what you’re having at this point — and they’ll do it themselves, thank you very much.

“As soon as we thought he was ready — at about 9 months — we started giving my son softer, cut-up versions of whatever we were having for dinner,” says mom of two Jennifer Reilly, of New York City. “There was more cleanup, but I actually got to sit down and eat my meal!” 

Once babies hit the age range for Stage 3 foods, most have the oral and fine motor skills to self-feed. 

“Between 8 to 12 months, babies develop the pincer grasp ability and should be able to pick up small pieces of finger foods with their finger and thumb and bring it to their mouth,” says Thompson. 

Technically speaking, Stage 3 solids are thicker, more sophisticated versions of the baby food your little one has already been eating (think vegetable and beef pilaf or tender chicken and stars), but also, they’re not necessary for everyone.  

“Stage 3 food is starting to have chunks mixed in, in order to prepare baby for table foods,” says Custer. “But some babies wind up skipping this stage altogether and go straight to soft table foods.”

While it’s perfectly fine to continue with Stage 3 foods up to your child’s first birthday, Treegoob advises letting your baby try their hand at “real food.” “Well-cooked veggies, ripe fruits, shredded meat, scrambled eggs, soft cheese and cooked pasta are all great options for babies this age,” she notes. 

Between 9 months and 12 months is also when you’re likely to see a significant drop in how much breast milk or formula your baby is drinking. 

“As babies continue to eat table foods, I’ve seen their breast milk or formula intake drop to as low as 16 to 20 ounces per day,” Treegoob says. “That said, some infants continue to show a heavy preference for breast milk or formula despite months of solid introduction. If you feel like your baby may be drinking excessive amounts of breast milk or formula, and they have no interest in food, I would recommend speaking with your pediatrician. ”

How to tell your baby is ready for table food

Your child’s readiness to start table food will likely be more discernible than any other baby food stage. As long as they’re continuing to hone their oral skills, as well as their ability to pick food up and bring it to their mouth, you can count on them to let you know they’re ready for “big kid” food. 

“My daughter looked like she was ready for pasta, eggs and basically anything we were eating shortly after she started solids,” says mom of two Julie Cortez of Brooklyn, New York. “We waited until about 8 months, when we knew she knew how to properly eat, and sure enough, she ate her whole plate on the first go! We completely skipped the Stage 3 jars of food.”

Follow these safe feeding must-knows

Even though your baby’s eating skills will continue to progress as they gain more experience, it’s important baby is always sitting upright, strapped in a high chair and never left unattended while eating. Also, make sure table food is always soft and cut into small pieces to avoid choking hazards. When first starting out with solids, be sure to wait a few days before giving them something new. 

“This allows for observation for any adverse reaction or intolerance to the new food,” Thompson says. 

And finally, be sure to give your baby a wide range of healthy food in order to expose them to a variety of tastes and textures — and don’t be discouraged if they don’t take to a specific food at first. 

“If baby refuses a food or makes a strange face when eating, this may simply mean that it is a new food and unfamiliar to them,” Thompson says. “Try again. It may take 10 to 20 exposures of a new food before they accept it.” 

Here’s more on every baby food stage:

• Stage 1 baby food.
• Stage 2 baby food.
• Stage 3 baby food.

Baby formula feeding chart: How much formula by weight and age

Is your baby getting too much or too little formula? It’s an important question that worries many new parents, especially those with newborns. When deciding how much formula to give your baby, it’s important to watch their hunger cues as well as looking at guidelines based on age and weight. In general, before they’re eating solids, babies need 2.5 ounces of formula per pound of body weight each day.

These guidelines are for babies who are exclusively formula-fed for the first 4 to 6 months, and then fed a combination of formula and solids up to age 1. If your baby is getting a combination of breast milk and formula, talk to their doctor for separate advice.

Your pediatrician can tell you where your baby falls on the growth charts, make sure they’re growing steadily on their own growth curve, and help you ensure that they’re getting a healthy amount of formula. If you’re ever worried about your baby’s growth, behavior, or development, talk with their doctor.

How much formula for a newborn

For the first few days, offer your newborn 1 to 2 ounces of formula every 2 or 3 hours. (At first, newborns may only take a half ounce of formula at a time. )

After the first few days, give your newborn 2 to 3 ounces of formula every 3 to 4 hours.

Initially it’s best to feed your formula-fed newborn on demand, whenever they show signs that they’re hungry. Because your little one can’t tell you when they want a bottle, you’ll need to learn to read their hunger cues. Crying is often a late sign of hunger, so if you can, try to catch the earlier signs that it’s time for a feeding.

Here are some hunger cues to watch for:

• Smacking or licking their lips
• Rooting (moving their jaw, mouth, or head in search of food)
• Putting their hands to their mouth
• Opening their mouth
• Fussiness
• Sucking on things
• Becoming more alert
• Crying

As time passes, your newborn will begin to develop a fairly regular feeding schedule. You’ll become familiar with their cues and needs, and knowing when and how much to feed them will be much easier.

Formula feeding chart by weight

During the first 4 to 6 months, when your baby isn’t eating solid foods, here’s a simple rule of thumb: Offer 2. 5 ounces of formula per pound of body weight every 24 hours, with a maximum of about 32 ounces.

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These numbers aren’t rigid rules. They offer a rough estimate for what your baby may need. Some babies will grow well while taking less than the recommended amount, while others consistently need more. Your baby’s daily feedings will also vary according to their individual needs – in other words, they may want a bit more on some days and a bit less on others.

Formula feeding chart by age

Here are typical amounts per day based on age:

From 8 months old until their first birthday, you can expect your baby to have 7 to 8 ounces per bottle, 3 to 4 times a day.

As your baby gets older – and their tummy gets bigger – they’ll drink fewer bottles a day with more formula in each. It’s important not to overfeed your baby so they’ll stay at a healthy weight. Your baby shouldn’t have more than 32 ounces of formula in 24 hours.

When they reach their first birthday, they can stop drinking formula and transition to cow’s milk in a bottle, sippy cup, straw cup, or open cup. Limit your toddler to 16 to 24 ounces (2 to 2.5 cups) a day of whole milk, so they have room for other healthy foods.

Here are signs that your baby’s getting all the formula they need:

• Steady weight gain. They continue to gain weight after their first 10 days and follow a healthy growth curve during their first year. (Most babies lose up to 7 to 10 percent of their birth weight in the first few days and then regain it by the time they’re about 2 weeks old.)
• Happy baby. They seem relaxed and satisfied after a feeding.
• Wet diapers. They wet two to three diapers a day in the first few days after birth. Over the next few days, the amount should increase to at least five to six wet diapers a day.

Babies are usually good at eating the amount they need, but bottle-fed babies can drink too much at times. Here are the signs that they’re getting too much formula:

• Vomiting after a feeding may be a sign that your baby had too much. (Spitting up is normal, vomiting isn’t.)
• Tummy pain after a feeding can also be a sign of overfeeding. If your baby draws up their legs or their tummy seems tense, they may be in pain. (See other possible reasons for stomach pain in babies.)

If your baby seems to want to eat all the time, even after finishing a bottle, talk to your pediatrician. Using a pacifier may help soothe their need to suck.

Formula-feeding tips

• In general, babies eat when they’re hungry and stop when they’re full, so resist the temptation to encourage your baby to finish each bottle. Overfeeding during infancy can contribute to obesity later in life.
• Don’t respond to your baby’s every cry with a bottle. They may be crying because their diaper is wet, they’re cold or hot, they need to be burped, or they want to be close to you. (Learn more about why babies cry, and how to soothe them.)
• Your baby may be hungrier than usual during growth spurts. These typically occur 10 to 14 days after birth and around 3 weeks, 6 weeks, 3 months, and 6 months of age.

Read more:

• Formula Feeding Problem Solver
• How to safely store and use formula

WHO recommendations for the introduction of complementary foods

08.08.2019

Readiness of the child to complementary foods According to the WHO recommendation, existing for 2018, it is optimal to introduce complementary foods to an infant at 6-8 months. Until six months, the baby’s gastrointestinal tract is still not sufficiently formed, all the necessary enzymes are not produced for the assimilation of food other than mother’s milk or formula. And by 9-10 months, the child can already form stable stereotypes of eating only liquid food, and overcoming them will be painful and difficult for the baby.
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Thus, WHO defines the following signs of a child’s readiness for the introduction of complementary foods: the maturity of the digestive system; extinction of the solid food ejection reflex; the appearance of the first teeth, making it possible to chew; the readiness of the baby to be stable in an upright position; emotional readiness for new tastes and sensations.

Complementary feeding system WHO has developed recommendations for three complementary feeding options: cereals, vegetables, and meat.

Fruit complementary foods are not recommended for cereals and vegetables. This is due to the fact that up to 8-9 months the gastrointestinal tract of the baby is not ready for the absorption of raw fruits and fruit juices. It is vegetables and cereals that will populate the intestines with the necessary bacteria for the absorption of fruits.

Kefir, according to the WHO, is not considered complementary foods because it is not a solid food. The WHO complementary feeding scheme includes kefir only as an additional food from 8 months. The introduction of cow’s milk is recommended by WHO only from 12 months.
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Any complementary feeding scheme assumes that portions of complementary foods will systematically increase from half a teaspoon to 100-200 g. The first dishes for complementary foods are prepared exclusively with one-component. Each next component is introduced only after complete addiction to the previous one (6-7 days).

Product sequence

The following sequence of introduction of complementary foods is proposed.

• Vegetables at 6 months. nine0022
• Porridges on the water (oatmeal, buckwheat, corn) at 6.5 – 7 months.
• Fruit puree, yolk at 8 months.
• Milk porridge at 8-9 months.
• Meat puree at 9 months.
• Meat by-products at 9-10 months.
• Kefir, cottage cheese, yogurt at 9-10 months.
• Fish at 10 months.
• Juice at 10-12 months.
• Berry puree at 12 months. nine0022
• Meat broths at 12 months.

The introduction of vegetable oil (olive, sunflower) in puree and porridge is allowed from 6 months: a scheme with 1 drop with a gradual increase to a volume of 1 teaspoon. The introduction of butter begins at 7 months: the scheme is from 1 g to 10 g in porridge.

For formula-fed babies, the first feeding schedule is similar, with a few exceptions. For these babies, it is better to introduce complementary foods from 5 months, because the milk mixture does not give the small body all the “building material”. The introduction of complementary foods differs only in terms: vegetable purees and cereals are introduced a month earlier.
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First cereals

If the child’s weight is significantly less than normal, WHO recommends starting complementary foods with non-dairy cereals. For babies, cereals are prepared only with non-dairy, unsalted, semi-liquid, absolutely homogeneous in consistency. The first cereals are prepared from cereal flour (the sorted and washed cereals are carefully ground and crushed).

The following sequence of introduction of cereals is proposed: buckwheat, rice, corn, oatmeal, semolina. It is recommended to cook semolina porridge only once a week, because it contains practically no nutrients, but it is rich in gluten, which can cause problems in the intestines. Proportion for the preparation of the first porridge: 5 g of cereal flour per 100 ml of water. After slightly cooling the finished porridge, chop again. In the finished porridge, you can add 1-2 drops of vegetable oil or a little expressed breast milk.
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From 9 months, the baby’s nutrition system involves multicomponent cereals, from products already well known to the child. You can already add vegetables and fruits familiar to the baby to cereals. At 9 months, it is allowed to cook barley and millet porridge for babies. And by 10-11 months, cereals on the water will be a great addition to meat and fish meatballs and steam cutlets.

Vegetable food

The first purees are made from one vegetable.

The sequence of introducing vegetables into complementary foods for babies suggests the following order: zucchini, cauliflower, pumpkin, potatoes, carrots, green peas, beets. These vegetables are introduced within 6-9baby months. After 1 year, you can give your child cucumbers, eggplants, tomatoes, sweet peppers, white cabbage. After preparing the puree, make sure that the mass is completely homogeneous, there are no fibers and small particles, the consistency is semi-liquid. Don’t salt. Add 1-2 drops of vegetable oil or expressed milk.

If the child refuses vegetable complementary foods, cancel this product for 1-2 weeks. Try to temporarily replace it with another and return to it after a while.

Meat supplements

From 9 months old, the first meat purees are recommended for babies. The first courses are recommended to be prepared from lean meats: rabbit; quail; turkey; chicken.

Complementary foods for a 6-month-old baby are recommended to be introduced in the morning. This will allow you to track the child’s reaction to an unfamiliar product before a night’s sleep: is there a rash, intestinal disorders, anxiety in the baby, profuse regurgitation. It is better to give vegetables or porridge first, and then saturate with breast milk or formula. Gradually, porridge and a vegetable dish will replace one full meal. The dish must be warm and freshly cooked. Gradually, by the age of 1, your baby will develop taste preferences. You will know what dishes he eats with pleasure. In the meantime, try to fully expand the child’s diet with products necessary for growth and development. nine0069

Be healthy!!!

WHO Complementary Feeding Charts and Charts

This article is a summary of two approaches to introducing complementary foods and feeding infants under one year of age: the Russian Research Institute of Nutrition of the Russian Academy of Medical Sciences and the World Health Organization (WHO). Also, the analysis took into account the opinions of some respected pediatricians of our country (Y. Yakovlev and others). nine0073

This page has a link to a PDF file with a table (calendar) for introducing complementary foods for the first 6 weeks

Two main principles for introducing complementary foods

The main thing to keep in mind before rolling up your sleeves is introduced to prepare for the common table (that is, the baby must learn to eat on his own)

This is the most important of all the variety of reasons to start introducing complementary foods. Of course, there are exceptions in terms of health, but we are talking about a standard situation. nine0003

Since the first stage of introducing complementary foods is precisely preparation, no breastfeeding during this period (according to WHO up to 1 year) should be removed or replaced with complementary foods.

And the second conclusion must always be put at the forefront of eating behavior. No cartoons, running after a child with a spoon, and even more so violence and blackmail.

Yes, at the first stage you will stuff the spoon, it is not difficult. It will be much more difficult to retrain a 1.5-year-old child to eat on his own or, even worse, form a food interest from scratch if the child does not start eating properly or refuses to eat (this is an extreme case). nine0003

I will say with the doctor’s words “A hungry child eats, but a tired child sleeps.” This reflects the essence of a well-formed eating behavior: I want to eat – I eat. Of course, this is more typical for an older child, when all stages of complementary feeding have been completed. And the right tactics at the very beginning is the key to the successful implementation of this rule in the future.

So, we remove all the garbage from the head (including those imposed by pediatricians working according to Soviet manuals) and move on to the tactics of the first complementary foods. nine0003

When to start introducing complementary foods

When to introduce complementary foods? I have already written about this in part in a general article. Here I will be guided by the WHO methodology stated above. It’s written in black and white.

“The start of introducing complementary foods should be considered the age of 6 months, and not the beginning, but the end of 6 months or 26 weeks

It is important to know the main indicators of readiness for complementary foods other than age.

Not the beginning of 6 months, but the child reaching the age of 6 completed months. Therefore, if your pediatrician once again prescribes complementary foods for you from 4 months without serious medical reasons, you can smile and keep a printout from this manual in your pocket. Non-critical weight loss does not apply here. This is a very complex topic, it should be discussed separately. At least 125 grams per week, babies should gain on GW, and not 700-800-800 . .. per month as in their Soviet-era tables. nine0003

Dear mothers, breathe out. You have a whole month from 6 to 7 to start introducing complementary foods. It is absolutely not necessary to do this at the 21-22nd week (page 220 of the WHO recommendations, chapter 8).

It is better not to delay 8 months later, as this will already concern the development of certain chewing skills, the development of taste perception, and not just the inability of milk to provide all the needs of a rapidly growing organism in micro and macro elements.

In addition to 7 months, in general, the development of the nervous system allows the child to master the following skills:

• biting and chewing
• cleansing the spoon with the lips
• lateral movements of the tongue
• moving food towards the teeth

All this indicates the ability of a child by the age of 7 months to taste food only in pieces, and not in pure form. You need to start with microdoses.

For some reason, nutritional consultants, at least those who met me, do not focus on this for a period of weeks. It seems to me that this is very in vain, since such a backlash will allow mom to calmly determine the degree of readiness of the baby to introduce complementary foods. And this is also very important for the formation of proper eating behavior. nine0003

Feeding food too early can have a negative effect on the formation of the correct nutritional interest . The unpreparedness of the child, in turn, can lead to nervousness of the mother, as the child will refuse complementary foods, or the gastrointestinal tract will fail, then persuasion, dancing with tambourines, and so on. All this alone will not solve the problem. This is already a consequence.

It is important to determine how ready your child is for complementary foods . Not ready – move the start to 6.5 – 6.7 months. It’s not critical. nine0003

2 clear signs of readiness for the introduction of complementary foods

• Readiness of the gastrointestinal tract
• Readiness of the nervous system (food interest)

An example of the manifestation of food interest. The child did not just take a spoon – but “stretches” for food.

Serving size of the first solid food

Your pediatrician will very likely tell you to increase the serving size to 200 grams. At the preparatory stage, this is completely optional! You remember, not a single breastfeeding (mixture) is replaced. This statement also takes its roots from pediatric tables, where a child at 6 months should consume 1 liter of food per day. We divide this into 5 doses – we get 200 milliliters

But we are talking about breast milk (formula). You breastfeed your baby on demand (if formula, then by grams, but also without changing the schedule before complementary foods). Accordingly, this recommendation has no weight until you start replacing one feeding with complementary foods, and this is definitely not the first stage. Unless, of course, you decide to quit breastfeeding early. I am talking about those mothers who plan to breastfeed for at least a year (not even up to 2, as WHO consultants now recommend, although the manual is not so strict and according to the mutual desire of mother and baby). nine0003

Myth – Start with canned puree

This myth is actively instilled by the same pediatricians (not all, we have met), scaring mothers with pesticides in purchased zucchini.

WHO guidelines clearly state :

“Ideally, infants should eat the same diet as the whole family” not french fries and burgers. Therefore, if the mother prepares a common table, all seasonings are introduced after the portion of the baby is postponed. Next, a portion of the baby is brought to the desired consistency. nine0003

From WHO recommendations:

“Carers should select appropriate foods and prepare them in such a way as to maximize their nutritional value”

steam” is preferable to boiling. Therefore, if you have the time and desire, and even more so if you have access to subsistence farming, a blender and a double boiler are in your hands.

Most importantly, read the basic cooking tips if you cook yourself. And if you decide to stop at canned food, analyze the product lines in your stores, choose the best quality without starch, flour and other surprisingly unnecessary components, and buy according to the complementary food scheme. nine0003

However, the same WHO recommendations say that if you choose industrial cans, you still need to give food from the common table, “to accustom the child to a greater variety of taste sensations and textures.” Again, food in pieces should be introduced from 7 months, and in one-component vegetable puree, food will be in the form of puree without pieces. Therefore, you still have to cook at least vegetables for microdoses.

Basic rules for the first phase of introducing complementary foods for the first six weeks

Complementary foods of a new product are introduced in the morning , usually for breakfast

Gradually! Serving size increases from 1/2 tsp. up to 150 – 200 gr. maximum within 7 days. Some modern pediatricians recommend extending this period at the first stage to 10-14 days. There are no strict requirements, so watch the child’s well-being after introducing new food, his mood and appetite in general.

If you need more than 7 days to adapt to a new food, simply extend the proposed complementary feeding schedule over a longer period, adjusting the amount of food introduced. nine0003

At the stage of introduction of complementary foods, the maximum is how much the child wants to eat (even 2-3 tablespoons), but not more than 150 – 200 grams

Remember! At the input stage, the maximum is how much the child wants to eat (even 2-3 tablespoons), but not more than 150 – 200 gr.

And here it should be noted that a child should consume 200 grams of porridge or vegetables at 9-12 months. according to the methodological recommendations of the Russian Academy of Medical Sciences (namely, the “Scientific Center for Children’s Health of the Russian Academy of Medical Sciences” of the State Institution “Research Institute of Nutrition of the Russian Academy of Medical Sciences, 2010)

In 6 months. Serving size – 150 gr. nine0003

At 7 months — 170 gr.

Therefore, your maximum is the one from which month you introduce complementary foods, and not 200 grams

New food is introduced only after complete assimilation of the old

In case some product was rejected, we remove it completely and introduce a new one also according to the scheme. We return to the rejected product no earlier than 14 days. It may take several approaches to try. This is absolutely normal. The child grows, there are more enzymes, tastes change. It is also possible to completely refuse to eat, for example, broccoli. Don’t worry, there are many more flavors. Remove the broccoli completely before moving to the common table. Then you will use the method of interest and curiosity to attract the attention of an already grown up baby, with rapture eating the same broccoli from your plate and smacking your lips. It will be much later. And now it doesn’t matter. nine0003

Digested products are gradually shifted to lunch, then to dinner.

The time of meals in the scheme is taken conditionally ! You can shift the total time by 1-2 hours to fit your sleep and wake schedule. It is desirable that the meal regimen be maintained at the time you have chosen. If breakfast is at 10:00, then it is always at 10:00 +/-10 min. From the very beginning, the regimen will help you form an understanding of the time of meals. And in the future, it will be easier for the child to control his appetite. That is, the appetite will come around for lunch, dinner, and not “when I want.” nine0003

Remember! Biting during the day is a bad habit and your path to the term “little one”.

Do not chase volumes at the first stage of introducing complementary foods! Literally from the WHO manual:

“The goal at the initial stage is to teach the child to eat from a spoon. Learn eating habits and enjoy new tastes”

“After a FEW WEEKS, the infant should take a small amount (not 200 grams!) of foods selected from a wide variety of foods, 1-2 times a day”

This means that there is no need to frantically increase the volume of new food to a full serving of 150-200 grams!! Provided that you continue to feed on demand, and breast milk remains a priority for up to a year (that is, the completion of all stages of the introduction of complementary foods and the transition to a regular common table). If you are formula feeding, you are also feeding normally at this stage. Not replacing any feeding with complementary food.

Traditionally weaning starts with cereals or vegetables

Verbatim from WHO recommendations:

“Positive examples include cereals other than wheat, such as home-cooked and mashed rice, soft, thick porridge made from traditional cereal products, and mashed vegetables and fruits”

Note that the WHO does not ban the introduction of fruits outright, as recommended by today’s complementary food consultants. It is enough to open any chat, where “fruit after meat” will flash here and there. This opinion exists in view of the fact that a child can get used to sweet apples and refuse to eat broccoli. It is not devoid of common sense. nine0003

Therefore, in order to minimize the possible risk of refusing vegetables, I will be guided by their recommendation in the scheme. Moreover, fruits are not the main meal, but serve for a variety of tastes and as a treat.

If you want to introduce fruits earlier, such as moderately sweet seasonal apples. Below is the serving size in grams also by month from RAMS. However, remember that apples and pears also need to be baked the first time, because. in their raw form, they carry a fairly large load on the digestive tract. Also, we introduce seasonal fruits, no mangoes, bananas or passion fruit, etc., and cooked correctly. nine0003

6 months — 60 g / 7 months — 70 gr.

All products are introduced without the addition of salt, sugar and spices. Note that in the WHO recommendations for the first complementary foods, both cereals and vegetables are good.

In Russian pediatric practice, there is such an experience: The child is “low weight” – start with cereals; problems with stool – with vegetables.

On the one hand, this statement is not without meaning, since the calorie content of cereals is indeed higher than breast milk and vegetables. However, we have already found out that there is no approved serving size at the first stage of the introduction of complementary foods

If the child eats his 150 grams of porridge, then yes. And if he eats 30-50 grams for 3-5 weeks and no more, these recommendations make no logical sense.

However, like the concept of “lightweight” is now so vague. A perfectly normal developing child of small-sized mothers and fathers will never enter the norms of pediatrician tables, which were written back in Soviet times for children on mixtures, and are completely outdated. But even there, and what can we say about the outback, these terrible 600-800-800 grams of the set are in front of mothers’ eyes. nine0003

By the way, our child is also the first 4 months. I was gaining about 550-600 grams per month along the lower border, and at 4 and 5 I fulfilled the double norm and only on breast milk. Our pediatrician, although she works in a private clinic and is in good standing in the reviews, also insisted on complementary foods from 4 months. I refused. And, on the contrary, she moved complementary foods by 6.5 months, when the baby began to actively show food interest.

Why it is recommended to introduce complementary foods with cereals or vegetables

The recommendation to introduce complementary foods with cereals or vegetables, although it belongs to the principles of pediatric complementary foods, has a whole and very strong justification. On the course “Complementary foods with a mustache” a whole block is devoted to this. Namely, the physiological readiness of the gastrointestinal tract to assimilate certain macronutrients. These include proteins, fats and carbohydrates. It may seem that since the maturation of enzymes for proteins occurs earlier, then complementary foods could be introduced, for example, from meat, as it was around the beginning 90’s, when meat was recommended as a prevention of iron deficiency.

However, later it became clear that the ability of such babies to DIGEST complex meat protein is so small that it can hardly cover the daily requirement. Then it was due to the mother’s need to go to work from 4-6 months, maternity leave was so small, and, accordingly, the preservation of breastfeeding was called into question. And the child needed to be fed. So, back to protein, hydrochloric acid in young children is still produced in negligible amounts, bile to break down complex meat fat (and there are also fats in meat) is also produced negligible, but there is lactic acid. It is she who is needed to curdle milk protein, or mother’s milk. nine0003

What else do we cover in the course “Complementary foods wisely”

In the course, of course, we consider this topic in more detail, but in general, I hope you understand why we start introducing complementary foods with lighter foods. The main sign that meat food at this stage is not suitable for the baby is a change in the nature of the stool, it does not just thicken, but becomes fetid. Communicating with mothers for more than 5 years, I often hear: “And they told me that this is the norm.” No, the stench, as you understand, cannot be attributed to the norm even in an adult. It tells us that the environment in the intestine is shifting to the alkaline side, this is the result of putrefactive dyspepsia (when undigested protein particles remain in the intestine for a long time, which feeds pathogenic bacteria). And the next step in this process is constipation. nine0003

We analyze in detail the dangers of constipation in early childhood in the 3rd module of the Gastrointestinal Health school.

The main stages of introducing products, taking into account the physiology of the gastrointestinal tract, are shown in the table. After the first stage of introducing products, when the “Diet Expansion” stage comes, there will no longer be a need to comply with this rule. As foods other than breast milk or BMS are introduced, both stomach and pancreas enzymatic activity will begin to increase, but this takes time. Even an adult vegetarian, to start eating meat, needs about a month under the “cover” of enzymes, and here is a baby who did not give out this very meat. This is the basis of the main principle of complementary foods: GRADUAL. Now, while in the baby’s body everything is set up for digesting breast milk, even the activity of gastric lipase now matters, while in adults it does not play any role in the process of digesting fats. nine0003

When should an infant not be introduced to complementary foods?

• The child is unwell, teething
• A vaccination is due
• A stressful situation is coming for the child that you know about (a trip, a large number of people at home or going to visit, going to a clinic, etc.)

Better in these cases maintain the most familiar conditions for the child and minimize stress. Since we remember that the main food at the stage of introducing complementary foods is breast milk, it is more important to maintain interest in it. nine0003

Scheme and table of the first stage of introducing complementary foods to a child for 6 weeks – based on the recommendations of WHO and RAMS

• The most hypoallergenic vegetables are introduced first: zucchini – cauliflower – broccoli
• Gluten-free cereals: buckwheat, rice, corn
• Grams cost conditionally, in proportion to the days of entry and the maximum serving size (the first day is always 0.5 teaspoon)

First week

We introduce the most hypoallergenic vegetable – zucchini

Second week

Since porridge is traditionally served for breakfast, vegetables are gradually transferred to lunch. At the first stage of entering vegetables, see how it is more convenient for you. Or give two kinds of vegetables for breakfast. Or immediately share for breakfast – lunch. I would divide it up to better control the gastrointestinal reaction and allergies

Third week

Similar to the second week, for breakfast instead of cauliflower – broccoli, for lunch zucchini or cauliflower (alternate if both were digested, if not, the product that mastered)

Fourth week

We introduce cereals in the sequence buckwheat – rice – corn grits for breakfast. For lunch, we eat any vegetables already entered in the amount of your maximum (zucchini, cabbage or their mixes). After assimilation of cereals, we add vegetable oil to them. By the end of this period, the child is offered complementary foods 2 times a day in its maximum volume (150 grams per 1 serving)

Fifth week

Taking into account the fact that in the recommendations of the Russian Academy of Medical Sciences, cereals are always offered in the morning, we cook 2 types of cereals in the morning. Vegetables are left for lunch in the amount of your “full portion” (150 – 170 grams)

Sixth week

Further, by analogy, corn porridge is introduced for breakfast. And for breakfast, rice and buckwheat are left in turn. Also decreasing in volume as the corn porridge increases. Lunch no change – vegetables in the amount of your “full serving” (150 – 170 grams per serving)

Not sure? I also decided that everything is somehow complicated, and therefore I brought everything into one table. Below is a link to download it.

Complementary feeding table for the first 6 weeks

Here is an image with a table below, if you click on it, you can download a PDF file with a complementary feeding table for the first 6 weeks. It also contains grammar and more and more clearly Ska download PDF file – Scheme and table for introducing complementary foods to a child for the first 6 weeks – based on WHO recommendations.
This table can be your sample plan for introducing complementary foods . It also has free cells in which you can put dates and get complementary feeding calendar .

After you have completed these 6 weeks, the first stage of complementary feeding can be considered complete. You can either replace the remaining vegetables at the first stage, for example, if something from the first three does not work, or introduce gradually at the second stage already with meat and fruits. This will be even better since they are more allergenic. nine0003

A little breast milk (or formula) can be added to ready-made porridge and puree for taste, as I wrote earlier. ☝️ Do not cook! Don’t forget to add vegetable oil. By the end of the first stage, the volume of vegetable oil will be about 3 grams. More detailed information on the steps for entering products and quantities in the table below. It will also come in handy for 2-4 stages.

Next comes the second stage of the introduction of complementary foods. I will talk about its features in a separate article, also based on the recommendations of WHO and RAMS. nine0003

Complementary feeding scheme with cereals

Gluten-free and milk-free cereals are introduced first. This is important in order to minimize the risk of developing an allergy to gluten and cow’s milk protein. There is a detailed article about gluten and “what it is eaten with” on the website. Gluten-free is buckwheat, rice, corn (like cereals). At the first stage, these tastes are enough for the child.

To get a scheme for introducing complementary foods from cereals, you just need to swap all cereals with vegetables in the “scheme for introducing complementary foods from vegetables” (above in this material). That is, first we put buckwheat instead of zucchini, then rice instead of cauliflower – corn porridge instead of broccoli. Then come vegetables zucchini – cauliflower – broccoli. Grams remain unchanged. nine0003

Important points during the introduction of complementary foods

• Be sure to monitor the child’s condition and his reactions to the introduction of new products. A food diary can help you with this. So you can understand what and when you gave, if you see an allergy or problems with the stool, or a change in the general condition. When most of the products have already been introduced, you can refuse it.
• When weaning begins, start offering water if the baby is breastfed without supplementation. At this stage, there is no mandatory rule. How much he drinks, how much he drinks. Water is better to offer raw purified or baby water, not boiled. As Dr. Komarovsky says: “boiled water does not exist in nature.” nine0022

What to breastfeed or complementary foods first?

On page 229 of chapter 8 of the WHO recommendations it is clearly stated:

“Food should be offered after breastfeeding to avoid replacing breast milk with complementary foods”

At the same time, counselors say, on the contrary, “drink complementary foods with breast milk”. Again a mismatch.

It is logical that it would be more convenient for the baby to drink complementary foods that are not very tasty. Pediatrician Yakov Yakovlev writes about the same thing and believes that not everyone wants some kind of complementary foods after milk, and this issue needs to be approached individually. After 6 months the risk of reduced lactation is not great. nine0003

Breastfeeding remains the main source of nutrition for a baby up to a year. Unless, of course, you decide for some reason to complete it earlier. Then you switch not to complementary foods, but to a mixture and give it according to the schedule and in volumes already according to age.

It will be possible to replace feeding after all stages of introduction of products are completed, namely after a year. The child goes to the common table, and breast milk remains a pleasant bonus as long as it brings mutual pleasure to mother and child. In general, the WHO recommends that breastfeeding be stopped until 2 years of age. Russian science is not so categorical. nine0003

The main and most important rule for introducing complementary foods!

• Complementary foods are not forced! If you see, the child categorically does not eat what is offered, spits, hysteria (not just pushes out with his tongue, but does not even try to taste it), no matter how the grandmothers, the pediatrician, the husband and even the neighbor who has a child at 6 months old insist. already ate a baked apple, ☝️ leave this venture for at least a week – or even two. No violence, no shoving, worse than being held at the table. This is an indicator that the time has not yet come for your baby. nine0069
• Create your first food interest! Sit on your knees when you eat, show food, spoons, plates. Let everything touch. Just remove anything dangerous, sharp, hot or valuable and expensive from the access area. Babies learn so quickly that you won’t even notice how the baby himself or herself takes a spoon. Even if you do not remember anything written above, this point is the most important. Understanding that everything has its time will save your nerves. And for a baby, a calm and affectionate mother is more important than a belly stuffed according to outdated rules. nine0022

Conclusion

If your child eats with appetite, learns new tastes well, is ready to eat more, you will pass the first stage in 6 to 8 weeks. Or it may happen that the child does not want to eat first one, then the other. Then the preparatory stage of the introduction of complementary foods may be delayed and this is not critical.

The main thing is to keep calm and composure, look with the child for tastes that he will like in order to form the basis of dishes for the second stage, with which you will experiment further. The second stage begins with the introduction of meat and fruits (I indicated why above). And by the end of it, you will already get mixes: meat – vegetables, porridge – fruits. We will look at this in another article. nine0003

Love children! Feed confidently!

This material was created based on the recommendations of the WHO “Feeding and Nutrition of Infants and Young Children”

If you have read the article in full and watched all the videos on this page – this is a real reason to be proud of yourself! Below is my set of tutorials!

My name is Alena Ponedelko. I am a pediatric nutritionist with a preventive approach, a consultant on complementary foods, nutrition for babies and mothers.