When do I start adding complementary foods? Each child’s development is different; in general, when children have grown to twice their birth weight (usually at about 4 months) and weigh about 5.9 kg or more, they may be ready for solid foods. The American Academy of Pediatrics (AAP) recommends breast milk as the single source of nutrition for 6 months; continue breastfeeding until at least 12 months after solids are added; and continue breastfeeding beyond 12 months if you and your child wish. When breastfeeding is no longer sufficient to meet the infant’s nutritional needs, complementary foods should be added to the child’s diet. WHO recommends that infants begin consuming complementary foods in addition to breastfeeding at 6 months of age, and all infants should begin consuming foods in addition to breast milk at 6 months of age. (If there are special reasons for adding complementary foods at 4-6 months, it is recommended to do so under the guidance of a pediatrician.) What complementary foods should be added first? For most infants, it does not matter what is added as the first solid food. There is no medical evidence that introducing solid foods in a specific order is beneficial for children. Some pediatricians recommend giving eggs and fish after 1 year of age, but there is no evidence that introducing these foods after 4-6 months of age will determine whether a child will be allergic to them. On December 2, 2013, the Canadian Academy of Pediatrics and the Canadian Society of Allergy and Clinical Immunology also issued a joint statement: Do not delay the introduction of any specific solid foods after a child is 6 months old, and delaying the introduction of peanuts, fish or eggs does not prevent or may even increase the risk of developing food allergies. If a child is breastfed, he may benefit from baby food made from meat because it contains more easily absorbed iron and zinc. Whichever cereal you add to your child, make sure it is fortified with iron. All foods should be free of added salt or seasoning. For the first few months of solid food, your child should eat the following foods daily: 1. breast milk and/or formula. 2. Meats. 3. grains. 4. Vegetables. 5. Fruits. 6. Eggs. 7, fish. (Recipe: fruits, vegetables, meat, eggs, milk, grains and fish) Spinach, beets, green beans, pumpkin and carrots are not good choices if they are homemade supplements because they may contain high levels of nitrates. Nitrates can cause unusual types of anemia (low blood counts) in small infants. However, the pre-made fruit and vegetable purees sold in supermarkets are safe because the manufacturers test for nitrate levels. Peas, corn and sweet potatoes are better choices for homemade baby food. Fish is a good source of protein and healthy omega-3 fatty acids. However, almost all fish can have mercury residues, both naturally occurring in the environment and from industrial contamination. Most people are not affected by these trace amounts of mercury. But for infants and small children, mercury can cause damage to the nervous system. For fish caught from local waters, watch for information from local authorities about fish safety. If information is not available, then eat up to 170 grams per week. These recommendations also apply to shellfish. How to add complementary foods? At 6 months of age, infants should be eating pureed foods, transitioning to finely chopped foods at 7-9 months, and crumbled and diced foods at 10-12 months. Start with 2-3 times a day at 6-8 months of age; gradually increase to 3-4 times a day during 9-11 months of age. Add only one new food at a time and watch for allergic reactions (e.g., diarrhea, rash, vomiting), and then add another after 2-3 days of eating. When you start feeding complementary foods, you can give him a little bit of breast milk and/or formula, then give him a small half spoon of complementary food, then breast milk and/or formula again. This will prevent your child from getting frustrated when he is very hungry. If your child does not want to eat complementary foods, do not force him to do so. Adding complementary foods is a gradual process that begins with your child still getting most of his nutrition from breast milk and/or formula. If your child does not want to eat complementary foods, continue to give him breast milk or formula and then try to give him complementary foods at another time. Do not put complementary foods in the bottle for your child to eat, as it may choke and may make your child eat too much, thus making him gain too much weight. To use a small spoon to feed, a small coffee spoon is just the right size, and a silicone baby spoon is a good choice to avoid injury to the baby. However, if your child has gastroesophageal reflux signs, your doctor may recommend feeding rice flour in a bottle. When should I start finger foods? Finger foods can be given once a child can sit up and put his hand or other object in his mouth to help him learn to eat on his own. Most children can learn to eat on their own at about 8 months of age. However, to avoid choking, make sure that the food you give your child is soft, easy to swallow, and cut into small pieces. For example, small pieces of banana, scrambled eggs, chopped chicken, chopped pumpkin, peas and potatoes. Bananas can be eaten directly raw, but most other fruits and vegetables should be cooked until they are tender. Note: Finger foods refer to foods that can be eaten directly by grasping them with your fingers, as opposed to foods that can be eaten with tools such as knives, forks and chopsticks. Instead, it refers to food that is shaped like a finger. You cannot give a child of this age any food that requires chewing! Do not give your child any food that could cause choking! Examples include: hot dogs, sausages, nuts and seeds (like squash), large pieces of meat or cheese, whole grapes, popcorn, peanut butter pieces, raw vegetables, large pieces of fruit, hard candy, and kraft candy. What will happen to my baby after adding complementary foods? After starting solid foods, your baby’s stools will become firmer and take on a different color, as well as having a stronger odor. Green vegetables such as peas may turn the stool dark green, and beets may turn the stool red (and sometimes the urine red). The stool may contain undigested food, especially the husks of peas or corn, and the skins of tomatoes or other vegetables. All of this is normal. If your child’s stool is very thin and contains mucus, it may be because he has digestive discomfort and you should consult your doctor to see if your child has a digestive disorder.