Infant nutrition

Proper nutrition is essential for your baby's health and development. The most important dietary item during your baby's first year of life is an adequate amount of breast milk or formula. Solid foods, which provide exposure to tastes and textures, should only be considered a supplemental part of your baby's diet during the first year.


Breast milk/formula
At first, breast milk or formula is the most important element in your baby's diet. The American Academy of Pediatrics recommends breastfeeding for infants until age 1. Breast milk improves a baby's health, development and ability to fight infections. Breastfeeding also meets psychological and social needs that may not be offered by other sources of nutrition.
If you opt for formula feeding, choose an iron-fortified formula unless your baby's doctor specifically suggests otherwise. If your baby can't tolerate a milk-based formula, the doctor may recommend a soy-based one. Always consult your baby's doctor before changing your baby's formula. As with breastfeeding, most doctors recommend formula feeding as the main source of nutrition until age 1.


Cow's milk
Cow's milk isn't suitable for infants younger than age 1 because it doesn't contain iron and isn't easily digested. If your baby is eating a balanced variety of solid foods, the doctor will usually give the OK at age 1 or older for introducing up to one quart of cow's milk a day. Remember to start with whole milk. The reduced-fat variety is not recommended for infants and children younger than age 2. Remember, breast milk or formula is the recommended main source of nutrition until age 1.

Iron supplements
Most babies are born with iron stores that last four to six months. By four months, the AAP generally recommends a supplemental source of iron, such as an iron-fortified formula, iron-fortified infant cereal or vitamin drops that contain iron. Discuss any iron or vitamin supplements with your baby's doctor before giving them to your baby.

Solid foods
Your baby's doctor may recommend gradually adding baby food to your child's diet at about age 6 months. Waiting until this age gives your baby's digestive system and swallowing ability time to mature. It also limits problems with possible food allergies and other food sensitivities. You can buy ready-made baby foods or puree solid food to an appropriate consistency at home. As you add foods to your baby's diet, remember that most of the calories should come from breast milk or formula during the first year -- solid foods should be considered a dietary supplement.
Your baby's doctor may recommend feeding your baby one type of solid food every day for three to seven days before introducing another type of food. Contact the doctor if your baby seems sensitive to a certain food. Eventually, you can begin to mix foods or serve them at the same time. Don't worry if your baby spits out much of the food at first or seems to like only one or two food items. It may take a while to develop swallowing skills and become accustomed to certain tastes. If your baby refuses many foods, try different combinations or consistencies.

Solid foods are often introduced in the following order:

4 to 6 months: Begin feeding your baby solids once a day when your doctor recommends it. Begin with precooked infant cereal mixed with breast milk or formula. Rice cereal is a popular choice because it doesn't cause digestion or allergy problems for most infants. When you feed your baby cereal, use a baby spoon. Do not use a bottle with an enlarged hole in the nipple.

5 to 6 months: Add single, precooked pureed fruits twice a day between breast or bottle feedings.

6 to 7 months: Add precooked pureed vegetables once a day. Although commercially prepared vegetables are safe before age 6 months, home-prepared vegetables such as beets, carrots, collard greens, turnips or spinach may have high nitrate levels that can cause a form of anemia (a condition marked by a decreased number of red blood cells or hemoglobin, a protein in red blood cells that contains iron) in infants younger than age 6 months.

7 to 8 months: Add precooked pureed meats or plain yogurt once a day.

8 to 9 months: Add a cooked (scrambled) egg yolk once a day.

9 to 12 months: If your child is ready, you may want to add finger foods. Make sure they're soft and finely chopped.
Unless your baby's doctor instructs you differently, let your baby decide how much to eat. Babies should not be force-fed or made to finish a bottle or serving of food. On the flip side, don't limit the amount your baby eats if he or she is hungry.


Allergies
Dairy products, egg whites, wheat, corn, citrus fruits, tomatoes and seafood may cause your baby to have an allergic reaction. Don't offer these foods until your baby has successfully eaten other solid foods for at least a few months.

Choking
To prevent choking, infants should always sit upright when eating solid foods. Don't offer cut or mashed table foods until your baby is older than age 1. To be safe, never give a child under age 4 the following foods:
nuts, sunflower seeds or popcorn
raisins, whole grapes, large apple chunks, or unripe pears or peaches
pieces of raw vegetables, such as carrots, celery or peas
chunks of meat or whole hot dogs
caramel, peanut butter, or other thick or sticky foods
hard candy

Preparation
Safe food preparation and storage are important parts of feeding your infant.
Temperature
You can give your baby room temperature, warm or cold baby foods or formula, but be consistent. Your baby will likely develop a preference. If you heat the food or formula, avoid using the microwave -- the quick and uneven heating can create hot spots that could burn your baby's mouth. Instead, heat the baby food or bottle in hot water. After heating, stir or mix the food or formula thoroughly and make sure the temperature is appropriate. You can check the formula temperature by splashing a few drops onto your wrist. For room temperature food or formula, leave it out of the fridge for about an hour before feeding.

Seasoning
Don't add salt or sugar to your baby's food. Typically, infants don't accept foods more easily when they're salted. And although babies often prefer sweeter foods, sugar doesn't add any vitamins or minerals. Also, once babies get used to sweet-tasting food, encouraging them to eat a balanced diet may become difficult.

Contamination
Improper storage and food handling can cause food poisoning, which may lead to serious or even fatal illnesses in infants. Because of the contamination risk, keep the following considerations in mind:

Don't give your baby unpasteurized fruit juices (especially apple). Look for juice stored at room temperature in cans, bottles or juice boxes, or buy the frozen concentrated variety. Perishable juices in the refrigerated section may be unpasteurized. If you purchase juice in cans, make sure the cans do not contain lead.

Avoid giving your child honey or corn syrup until at least age 1. Some cases of botulism (a type of poisoning) have been linked to these substances.

Thoroughly cook any foods of animal origin, including meat, poultry, seafood and eggs. Young infants should have fruits and vegetables cooked as well. Ask your baby's doctor when it's OK to give your baby raw, pureed fruit and vegetables.
Storage

Keep infant cereals in a clean, dry place. After you mix the cereal with breast milk or formula, feed your baby immediately. Throw away any leftovers.

Store unopened baby food jars in the cabinet. After they've been opened, you can replace the cover and keep them in the refrigerator for up to two days. Throw away any uneaten food if you feed your baby directly from the jar, however. Saliva from the spoon can cause the leftover food to quickly spoil in the refrigerator. It is best to transfer a portion of food from the jar to a dish before feeding your baby to avoid this type of contamination.

When covered, small containers of juice can be refrigerated for up to three days. Large containers can be refrigerated for up to seven days.

Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
Because good nutrition during pregnancy, infancy and childhood is so important to your child's health, the U.S. Department of Agriculture has established the Special Supplemental Nutrition Program for Women, Infants and Children, otherwise known as WIC. The program provides state funding to help provide supplemental food, health care referrals, and breastfeeding and nutritional education for low-income pregnant and postpartum women and infants and children up to age 5 who are at nutritional risk, often due to certain health problems, pregnancy risks or complications, or an inadequate diet. WIC helps provide foods high in nutrients such as protein, calcium, iron, and vitamins A and C. The program also helps families obtain infant formula and cereals.
WIC is available in every state, the District of Columbia, Indian tribal organizations, Puerto Rico, the Virgin Islands, American Samoa and Guam. The program may vary some from state to state. For details, consult your health care provider or contact your state WIC agency. Information can also be obtained from the U.S. Department of Agriculture.