A
complete feeding guide
The first year of life is an important time in your child's nutritional development. It is a period of rapid growth for your infant. During this time your baby will make the transition from milk feedings to a varied table food diet.
Breast versus formula feeding
There are many factors which need to be considered by a mother when she decides whether to breast or bottle feed. Whichever method you choose, we will support your decision. Breast feeding is recommended as the initial method of infant feeding. In addition to best meeting the nutritional needs of your baby, breast milk contains important factors which will make your baby less susceptible to infection. Formula also provides balanced nutrients that your baby needs for optimal growth and development, and is designed to imitate the nutritional constituents of breast milk as closely as possible.
Feeding schedule
Whether you breast or bottle feed, allow your baby to feed on a modified demand
schedule, at intervals of two to four hours from the end of one feeding to the
start of the next. Most breast fed babies usually feed every 2-3 hours
during the day. Bottle fed babies, however, usually go 3-4 hours between
daytime feedings. If your baby sleeps longer than four hours during the
day, we suggest that you wake and feed him or her. If your baby sleeps
longer than four hours at night, assuming your child has already established
good weight gain, consider yourself lucky (!) and do not wake the baby for a
feeding. It is occasionally acceptable for your baby to want to eat in
less than two hours.
When feeding your baby, choose a position which is most comfortable for you and your baby. However, keep in mind that he or she should be in a semi-upright position during feedings.
Breast feeding
Most babies average 10-15 minutes on a breast. Try to allow the baby to
empty one breast, which is usually accomplished in about 15 minutes, and then
offer the second breast for 10-15 minutes. Some babies may not want to
breastfeed long on the second breast. Alternate the starting breast at
each feeding. We do not recommend supplementing in the first two
weeks unless directed by a physician. After two weeks of age, if you wish
to supplement breast feeding, it is best to supplement once a day at a fixed
time. You may give a bottle of expressed breast milk or formula as a
supplement.
Formula feeding
Start by putting four ounces of formula in every bottle. Let the baby
take as much as he or she wants. As your child grows, gradually increase
the amount of formula in each bottle to stay ahead of his or her demand.
Always try to have at least one-half ounce of formula left in the bottle when
your baby is finished eating. This will prevent air swallowing and let you
know when the baby is ready to take a larger quantity. Propping bottles
is not recommended.
Switching to solids
Solid foods are not necessary for the first four to six months of life. Rarely, an infant may need to start solids earlier, but only if directed by a physician, since starting solids early may predispose a child to allergies later in life. Indications for starting solids early may include increased frequency of breast feeding or consistently taking more than 40 ounces of formula a day. Even if your baby seems hungry, solids should not replace breast or bottle feeding, but rather should act as a supplement during the first six months.
The following are some overall guidelines for introducing solids to your baby:
- When starting a new food, introduce it early in the day
(before 2 p.m.)
- Do not introduce more than one new food to your infant
at a time, and give the new food for a minimum of five days before
introducing a different food.
- When introducing any new food, start your baby on up to
one tablespoon at the first feeding. You may gradually increase the
amount.
- There may be a change in the child's bowel habits with
the introduction of any new food.
- The progression of new foods is from least to most
allergic and from pureed to solid consistencies.
- Until 9 months, do not feed your baby berries,
citrus fruits and drinks, egg whites, or foods from tree nuts (such as
peanut butter). These foods are highly allergic!
- Do not use honey or Karo syrup during the first
year. They may cause infant botulism, which causes your child's
muscles to lose strength and may impair breathing.
Cereal
(4 - 5 months)
When introducing cereal, mix it to a thin consistency with either breast milk
or formula. You may gradually thicken it to a more pasty texture.
Start with rice cereal because it is least likely to cause an allergic
reaction. You may then switch to barley or oatmeal.
Feed your baby twice a day, in the morning (between 6 a.m. and 10 a.m.) and in the evening (between 4 p.m. and 8 p.m.)
Never put cereal in a bottle unless you are specifically told to do so by a doctor.
Fruit (5 months)
Begin the introduction of fruit with banana, since it is least likely to cause
problems. You may then progress to applesauce, peaches, pears, and then
other fruit.
Feed your baby fruit twice a day, in the morning (between 6 a.m. and 10 a.m.) and at midday (between 11 a.m. and 3 p.m.).
Vegetables (5 - 5 1/2 months)
Start with yellow vegetables (carrots, squash, sweet potatoes), then progress
to green vegetables (peas, green beans).
Feed your baby vegetables twice a day, at midday (between 11 a.m. and 3 p.m.) and in the evening (between 4 p.m. and 8 p.m.).
Yogurt and soft cheeses (6 months)
Use live culture yogurt in plain or vanilla flavor. Do not use yogurt
with large pieces or fruit. Start with any soft cheese, like cottage
cheese, ricotta cheese, or cream cheese. Feed your baby yogurt or soft
cheeses once a day.
Do not give your baby any milk products other than formula prior to 6 months.
Meat (7 months)
Make sure that any meat you feed your baby is strained or ground. Feed
your baby meat once a day, at the midday meal (between 11 a.m. and 3 p.m.).
Egg yolk (7 months)
Use hard boiled or well done scrambled egg yolk only. Do not use egg
white until the baby is at least 9 months old.
Your baby may have egg yolk three to five times a week.
Sippy cup (7 months)
We recommend introducing your child to a non-spill proof sippy cup at 6-7
months. You may put water, formula, or
breast mild in the cup. You should give
your child juice from a cup only.
Giving you child juice in a bottle can lead to problems with dental
cavities. You should limit your child's intake of juice to no more than 8
ounces a day.
Most fruit juices consist mostly of sugar and are not nutritional. Too much juice will impair food intake. You may dilute the juice with water. Any juice is acceptable to try; however, do not use citrus juices until the baby is at least 10 months of age.
Whole milk (9-10 months)
We usually switch your child from bottle or breast and onto whole milk at 9 to
10 months of age. Occasionally, if your child has poor nutritional intake,
was premature, or has other medical problems such as a milk allergy, we may
extend formula feeding to 1 year of age.
To introduce milk, mix your baby's cereal with milk for two to three days. If your baby tolerates the milk without a problem, substitute one bottle or cup of milk for a bottle of formula (or one breast feeding). Gradually increase the number of bottles or cups of milk per day until the child is taking only milk instead of formula (or breast milk). Some mothers may with to breast feed until 1 year of age or longer. If you wish to continue breast feeding beyond 1 year, do not breast feed more than twice a day. More frequent breast feeding may impair your child's intake of other nutrients from solid food.
After a year of age, you should limit your child's intake of milk to 16 to 24 ounces of milk per day. Food at this age is more important for the growing toddler.
Other information for 9-12 months of age
Between 9 and 12 months, your child should move towards a more adult-like schedule of eating and table foods. He or she may eat regular table food as long as certain guidelines are followed:
- The consistency and size of the piece of food are most
important. Do not feed your child any foods that he or she may choke on;
examples include peanuts, chunky pretzels, whole grapes, large pieces of
raw fruit or vegetable, and popcorn. These foods should be avoided
until 3 years of age. Never give your your child sucking
candies or chewing gum.
- Meat, including hot dogs and hamburgers, should be cut
into small pieces.
- Vegetables should be well cooked. Do not give
your child thick hard raw vegetables, especially whole carrots.
- Fruit should be cut into small pieces.
- Do not feed your baby berries, citrus fruits and
drinks, egg whites, or food made from tree nuts (such as peanut butter)
until at least 10 months of age. These foods are highly allergic.
- Avoid soda.
- Do not use honey or Karo syrup during the first
year. They may cause a disease called infant botulism, which causes
your child's muscles to lose strength and may impair breathing.
- Foods high in cholesterol help build brain and nerve
tissue. Do not try to limit your child's intake of cholesterol under
2 years of age.
- Your child's appetite may start to wane around 12
months of age. Emerging food preferences and a decreased rate of
growth are usually responsible. This may persist until well over 2 years
of age.
- We do not recommend the dripless cup, since it mimics a
sucking mechanism and will not help your child to learn how to drink from
a cup. You may use a bottle up to 18 months of age, but the number
of bottle should be decreased and milk should be given in a sippy
cup. There should be no use of the bottle after 18 months of age
because prolonged use may influence the jaw line.
Fluoride
All children from age 6 months until 13 years (or until the back molars erupt)
that live in areas without fluoride in the water supply should be on a fluoride
supplement. This can be part of a total vitamin pill or given by
itself. To find out whether your water supply contains fluoride, contact
your water department or check the fluoride page on the
New Jersey Department of Health and Senior Services web site.
All towns in Bergen County, and almost all towns in Passaic County, have
minimal amounts of fluoride in their drinking water supply.
Nutrition
It is important for your child to eat a well balanced diet, with servings each
day of fruits, vegetables, carbohydrates, and proteins. Many children are
erratic and finicky eaters. As long as over the course of several days to
weeks your child eats a varied and nutritious diet, it is okay for his/her
intake to be "off" at times.
Cholesterol and saturated fats
Children under two years of age need a higher fat and cholesterol intake.
Their energy requirements are great and they require cholesterol for the
formation of their developing nervous system. Children under two should
be on whole milk.
Over two years of age, all children benefit from a diet low in cholesterol and saturated fats. Children should be on lowfat or skim milk and lowfat milk products. They should not eat more than 3 to 4 egg yolks per week. The entire family will benefit from eating more fish, poultry, and legumes, and less red meat. A diet low in cholesterol and saturated fats will help prevent heart disease.
Fiber
Roughage from raw fruits, vegetables, unprocessed wheat, bran, grains, and
beans are important in your child's diet. Adequate fiber in the diet
helps bowel regularity and also helps rid the body of cholesterol. A high
fiber diet lowers the future risk of bowel cancer and heart disease.
Sugar
Sugar is not nutritionally important. It also promotes dental
cavities. However, sugar has not been shown to cause behavioral changes
or hyperactivity. Sugary treats, if used should be given in moderation
and followed with appropriate tooth brushing.
Nutritional supplements
If you plan to use any nutritional supplements, special vitamins, teas, herbal
preparations, etc., please consult with your pediatrician first. Some
nutritional supplements may be harmful to your child.