At the beginning of life an infant needs milk only. With time, however, its needs grow. Therefore the parents should start introducing new foods to their child’s diet. How can I do it safely? When should I introduce meat to the diet? Let us explain.
Information on how to add new foods to a child’s diet have been gathered in the guidelines by the Polish Society of Pediatric Gastroenterology, Hepatology and Nutrition (full content can be found on the webpage of the Polish Paediatric Society: https://ptp.edu.pl/files/Standardy_Medyczne_2014_Zalecenia_ywienia_.pdf. The guidelines are consistent with the recommendations of ESPGHAN (The European Society for Paediatric Gastroenterology Hepatology and Nutrition) and EFSA (European Food Safety Authority). We may find there advice on when to start introducing new foods to a baby’s diet, what to start with, in what quantities should we give them and many other information. It is worth mentioning that the recommendations apply to healthy children born on time. When it comes to preemies or babies who were diagnosed with any illnesses, the diet should be developed individually by specialist doctors (for example, preemies require a slightly different supplementation regimen).
The authors of the document emphasise that proper nutrition introduced at an early stage of life has a significant impact on further development of a child. It may also minimise the probability of development of various diseases, including obesity, type 2 diabetes, osteoporosis, atherosclerosis or allergies in the future.
The report also suggests, what mistakes are made by the Polish parents when feeding their babies. First of all, many babies aged both six and twelve months of life were given too many meals – about seven or more during a day. They were also given too much juice. More than a half of children were not given vitamin D supplements. There were also some problems with proper preparation of baby formulas.
How should I start introducing new foods to my baby’s diet to avoid the mistakes?
When should I start introducing new foods to the baby’s diet?
Both national and international scientific societies and expert groups recommend feeding the baby only with breast milk for the first six months of life (at least four months). According to the recommendations, there is no need to give additionally water, teas or juices to the baby. However, we may give drugs or vitamins, if necessary.
Specialists do not define exactly, for how long should a woman continue breastfeeding. It was only agreed that after the baby is twelve months, breastfeeding should be continued as long as the baby and mother want it.
We should remember, however, than in some children, e.g. in the ones with the greater need for iron, the necessity to introduce supplementary products may arise a bit earlier, that is before the sixth month of age.
If a baby does not get its mother’s milk, it should be fed with products that replace breast milk that are called formulas. We may distinguish infant formulae and follow-on formulae. They are modelled on breast milk/ They are usually made of specially prepared cow’s milk proteins (sometimes also goat’s milk proteins, protein hydrolysates or soya protein isolates), taking account of the needs of a baby at individuals stages of development. We may start adding new foods to the diet of the infants that are fed with modified milk earlier than in the children on breast milk only.
According to the current specialist recommendations, adding new foods to a baby’s diet should be started after the age of 17 weeks of age, but no longer than in the 26th week of age, that is between 5th and 7th month of life of a baby. In infants that are fed with modified milk, me may add new foods even a month earlier. The process starts when the child is developmentally ready for solid foods, that is:
- when it can sit in half-sitting position with little support;
- its nervous system and muscles are mature enough to fully control neck and head movements;
- it can eat from a spoon;
- and also when the baby no longer presents the reflect of spitting out foreign bodies from the mouth, that is natural in early infancy (it prevents from the baby choking with solid foods when it is not ready to eat them).
Baby’s diet in the first year of life.
The need to start adding new foods to the baby’s diet results from the fact that its needs for nutrients, that no longer can be delivered in breast milk, grow. Milk-free meals should replace milk meals with time. According to the recommendations, by the end of the first year of life a child should get only two to three milk meals a day.
Correct and safe adding new foods to a child’s diet is based on a few main principles.
1 We do not introduce new products into the child’s diet at once. We introduce them one by one, at three-day intervals, for example. At the same time, we observe the child’s reaction to the new food.
2. It is better to give the food in the form a smooth, one-ingredient puree, with a spoon.
3. We start with small portions, when introducing new products. At first three to four spoons of new food are fine.
4. Adding new products to the baby’s diet starts from typical complementary foods (described below) and, according to specialists, the order they are introduced has no influence on the baby or on the way it reacts to new things in its diet, namely it is not important whether the baby is given vegetables or gruel first.
5. We should not postpone the foods that are thought to be potential allergens, that is cow’s milk, eggs, fish, seafood and nuts. There is no data that the risk of allergy is lower, when they are given at a later time. According to the recommendations, products of this type should be first introduced to a baby’s diet at home, not in a nursery or restaurant.
What products should I add to the baby’s diet first? These may include:
- vegetable puree,
- fruit puree,
- or rice pudding, respectively.
Although, as we have already mentioned, parents have discretion on what foods should be given to their child as first, it is worth to start adding new foods from vegetables. That is because their taste may be later more difficult to accept than the taste of sweet fruit or pudding. We should give vegetables first so that the child has an opportunity to get acquainted with them and accept them, and only later, when the baby knows their taste, we should start giving fruit.
As experts report, during the first year of a baby’s life, we should support it in developing its biting and chewing skills. We should start teaching the baby between the sixth and ninth month of life. It lasts until the baby is two years old. Therefore, it is so important to introduce solid foods of variable texture gradually from the sixth-seventh month of life. What should be the order of adding new foods, depending on the child’s age?
- 6-8th month of life – at first we give: thick semolina, ground products (gruel and puree), then ground products with lumps;
- 9-11 month of life – start giving chopped or ground foods and soft products to the baby’s hand, so that it can put it into its mouth;
- after the 12th month of age – chopped and ground products, if necessary.
How many meals should a baby eat daily? According to the recommendations of the World Health Organization (WHO) the number of meals depends on the age of the baby and the way it is fed. The infants that are given breast milk, between the sixth and eighth month of life, should be given two or three supplementary meals, and since the ninth month of life up to two years of age – three or four supplementary meals and one or two nutritious meals. Babies fed with formulas and also children aged one and older should eat four to five meals a day, and also one or two snacks.
When should I add meat? When and how should I start adding individual products?
What are the recommendations for adding individual products?
- Gluten – according to experts, we should start introducing products that contain gluten (like semolina), after the baby is four months, and before it is seven months of age.
- Milk – as far as cow’s milk is concerned, it should not be the main drink until the baby turns 12 months of age. After that time, the baby should not drink more than 0.5 l of cow’s milk a day. Also “Junior” type of milk is not recommended for the babies under 12 months of age. Goat or sheep’s milk should not be used in children below the first year of life. However, experts warn that children who drink this type of milk are at risk of developing anaemia due to the lack of folic acid and/or vitamin B12.
- Fats (butter, margarine, oils) – there are no guidelines for their use in children under the age of one. In older kids, they are a good addition to vegetable meals. Note – while shopping, we should choose margarines with trans fat content lower than 1%.
- Eggs – we may introduce whole eggs at any time when adding new foods to a baby’s diet. We should only avoid giving raw eggs, as there is a risk of salmonella infection.
- Salt and sugar – we should try to avoid adding them to the baby’s diet for as long as possible. At best for the first two to three years of life.
- Honey – it should be avoided in children below the first year of life, as it may contain botulinum toxin, which is dangerous for babies.
- Water – if the baby is on breast milk, there is no need to give it water until it is 6 months old. It is good to get the older babies accustomed to drinking water instead of juices – it prevents obesity development in the future. However, we should avoid giving water from a well to a child, as it may be contaminated with nitrites and nitrates from fertilisers.
- Fruit juices – we should not give them to babies younger than 4 months in the case of babies fed with modified milk and younger than 7 months in the case of breastfed babies. We give only 100% juices (only such products may be called juices in Poland), unsweetened, smooth and pasteurised. Maximum daily amount is 150 ml. We should also avoid giving them between meals, so that the baby does not lose appetite.
- Meat – as we read in recommendations: “Due to the content of iron, zinc, arachidonic acid, complete proteins, vitamin B12 and carnitine, meat should by introduced early, as a supplementary meal.” It may be introduced at the very first stage of adding new foods to the baby’s diet, namely between the 4th and 7th month of age. What meat should I give to the baby? Experts recommend to give poultry (turkey, chicken, goose or duck meat), rabbit, beef or lamb, at first. The initial portion is about 10 g a day, given with vegetables. By the end of the first year of the baby’s life, the amount should by about 20 a day. Remember that is should be high-quality meat. Giving giblets to children under 3 years of age is not recommended.
- Fish – it should be present in the diet of both adults and children. However, we should give it to babies gradually – at first not more than once a week, in small amounts, and observe the baby’s reaction to it. Fat sea fish, like herring or salmon are recommended due to the content of unsaturated fatty acids. Predatory fish, like tuna or mackerel, are advised against.
Specialists emphasise that a certain rule should be introduced, when feeding the baby. It is up a to a parent to decide when and what does the baby eat. The baby decides how much it eats. If it wants to eat more, we may give it more food. If, on the other hand, it needs smaller portion, we should allow it to eat less. The experts who have prepared the report emphasise, that overfeeding is a common mistake that may influence the baby’s wellbeing in the future.
Meat in a child’s diet. Which one should I choose? How and when should I serve it?
According to the recommendations of the Polish Society of Pediatric Gastroenterology, Hepatology and Nutrition, meat should be one of the first products introduced into a baby’s diet. Not only high content of easily absorbed protein is important, but also the content of iron, zinc, arachidonic acid, vitamin B12 and carnitine, that support development of the baby. We should remember not to buy the meat from unverified sources, when we are not sure, if it was tested for the presence of bacteria or parasites.
We give leaner types of meat, including poultry, i.e. turkey and chicken meat, to children. According to the recommendations of Polish Society of Pediatric Gastroenterology, Hepatology and Nutrition, we may also give goose and duck meat, beef, lamb and rabbit meat to children. Currently there is no data that would suggest a specific order of adding new types of meat to the baby’s diet.
We should start giving small portions of meat – about 10 g a day. At first the meat should be cooked, mixed with vegetables. After the 7th month of life, it does not have to be in the form of puree (of course if the baby is able to eat larger pieces of food). Between the 4th and 12th months we gradually increase the amount of meat given to a bay – up to 20 g a day. After the baby is 12 months old, we may give it larger pieces of meat – but they still have to be cooked in water, broth or steamed, as the baby’s digestive system is not adapted to heavy foods – fried or very fat meals.