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Guidelines for
Introducing Solids
Birth to 4 months:
The World Health Organization and the American Academy of
Pediatrics, both recommend as the gold standard, exclusive
breast‑feeding to age 6 months. If not breast, an infant formula
that contains iron [not low iron] should be used. Baby's stomach
doesn't have the enzymes to digest anything but lactose [the sugar
in milk]. The iron in breast milk, or iron fortified formulas is
needed for brain growth. Extra water is not needed.
Solids may be introduced between 4 to 6 months.
At this time, baby is developmentally ready, by losing the
tongue‑pushing reflex [4 months], and by sitting up unsupported [six
months].
* Start Solids: Cereal in a bowl with breast milk or formula. In
T&T, we love to add cereal to the bottle, and make milk tea. This
habit should be discouraged, as it prevents the baby from learning
to advance to an adult type diet and one may overfeed, and encourage
obesity. Start with rice, as this causes fewer allergies.
* Fruit: Fresh such as banana/mango/watermelon or applesauce etc.
Fresh fruit is always better, but jar foods may be used also. We are
blessed with an abundance of fresh fruit in our twin islands!
* Juice: Fresh squeezed to cup or bottle e.g. watermelon, carrot,
grape or apple. Some experts advise starting citrus a little later,
because of higher incidence of allergies.
* Extra water may be given
* Introduce one new food at a time, every 2 to 3 days, in case of
allergic reactions.
6 ‑ 9 Months
* Finger foods‑bread/crackers
* Porridge e.g. cream of wheat, oats
* Calaloo/mashed potato/eddoes/dasheen/yam
* Split pea‑dhal consistency
* High chair useful, as baby is now sitting up, baby should have 3
meals a day.
No extra salt or sugar needed
7 – 9 Months
Aim is to be eating out of the family pot by age 9 months. Offer
strips of chicken or beef or fish or more legumes [if vegetarian].
At this age, your baby should be having three meals a day. The
volume of milk consumed will decrease: you may start offering the
cup for drinks, including milk. Baby’s rate of growth will be
slower.
1 year
Milk is no longer the main food source. Your baby should be off the
bottle [latest 15mths] and consuming other solid foods. By this age
not more than 2 cups of milk per day [as cereal or drink] is the
recommended intake. You may change to cow's milk. Before l year of
age, cow's milk has insufficient iron, and causes hidden bleeding
from baby's gut. Offer milk in cup or with a straw.
If your baby is still consuming large volumes of milk at this age,
there is a risk of problems of anaemia, poor growth and dental
caries [bottles in the mouth, especially at night promote caries].
Late weaning is difficult to interrupt, since habits are difficult
to change. It is therefore best to discontinue the bottle by one
year to fifteen months and introduce a varied solid diet.
Dr. Rosemarie Thomas, Paediatrician |
