By Dr. Karen Prentice
Tips for Feeding Babies:
1. When should babies start to eat solid foods?
If your baby is solely breastfed, the AAP or American Academy of Pediatrics recommends solely breastfeeding until 6 months of age and then introducing solids while continuing to breastfeed. This helps the “gut” health and immune system. If your baby is formula fed, solids can be started around 5 to 6 months when your baby shows signs of readiness.
2. What are signs that a baby is ready to start solids?
If your baby has good head control while sitting in an infant chair or high chair and can bring food to their mouth with their hands or a utensil, they are ready to try solids.
3. What foods should be introduced first?
Our practice prefers the “baby-led weaning” method based on a book Baby-Led Weaning by Gil Rapley and Tracey Murkitt published in 2008 and updated in 2019. The premise of the book is to feed your baby healthy fresh foods that your entire family is eating while avoiding baby foods and cereals. The other key point is to avoid feeding the baby and let them grab food from their tray or hand them a spoon of food and let them do the rest.
We have found this method to be an excellent way to avoid picky eating later in life because babies are fed everything that the family is eating. There is no need to give them one food every few days. Just provide them with all the soft food the family is eating and let them do the rest.
4. Why shouldn’t we give our baby rice cereal and baby food?
You may have seen on the news that baby rice cereal has been found to have arsenic in it. The FDA has set a minimal acceptable level of arsenic but is still working with the manufacturers of baby foods and cereals to keep this at a safe level. In addition, the baby foods and pouches have been found to have heavy metals. The heavy metals and arsenic can be dangerous to a baby’s development and health.
5. What foods should be avoided for babies under twelve months old?
Do not give your baby honey or cow’s milk until they are over twelve months old. The spores in honey can cause infant botulism which is deadly. Cow’s milk under a year can cause intestinal irritation and bleeding of the intestine. However, small amounts of cheese and yogurt are fine.
6. What other things should we avoid when feeding babies?
Avoid juices, sodas, and any sugary drinks. Also, avoid candies, fruit snacks, processed foods like goldfish, and fast foods. Finally, avoid foods that can cause choking like nuts, candies, hotdogs, raw vegetables, grapes or popcorn.
7. Should my baby continue on breastmilk and/or formula while eating solids?
Yes! Continue either breastmilk and/or formula the first 12 months of life while introducing more foods from the family table.
8. Are eggs and peanut butter ok to give babies?
Yes! Studies have found that if we introduce eggs, peanut butter, fish, and all types of foods as early as 6 months of age, babies are less likely to become allergic to them. Of course, if your child has an egg allergy talk to their provider about feeding choices and if they should be allergy-tested before starting foods.
9. Is water ok to give to my baby?
Yes, in small amounts. Your baby already gets plenty of fluids from the breastmilk or formula and we want to make sure they keep getting all the good nutrition and calories from it, but 1-2 ounces of water starting around 9-12 months of age is a great way to teach the use of a cup.
10. How can you tell if your baby is choking or gagging?
We advise all parents, grandparents, and caregivers to take a CPR and first aid course. You can call the local hospital or Google for courses near you.
During feeding time, if your baby is not making any sounds, appears panicked, and/or is turning blue please call 911 and perform the Heimlich maneuver.
However, if your baby is coughing or spits up food that they just jammed into their mouth then watch them, give them some water and realize they are just learning how to eat solids. It is best to only give small amounts of food at a time.
Tips for Feeding Older Children:
1. What if my child doesn’t have much of an appetite?
Please keep your routine well-check ups with your pediatrician to ensure proper growth and development of your child. If your child is just not eating that day do not worry. Just like we have days that we may be more or less hungry than others, children do too. Kids’ appetites can go up and down based on their growth phase, activity level, and mood.
One thing to avoid is feeding non-nutritive snacks to your children. Non-nutritive snacks have very little or no nutrition, are generally high in sugars and chemicals, and are processed –so basically “junk food.” Avoid goldfish, Cheez-itz, fruit snacks, sugar cereals, cookies, and candies. These are often given daily as “snacks,” make up a large part of children’s diet, and offer them zero nutritional benefit. Instead of the above snacks, try fruit, yogurt, dried fruit like raisins, hummus and soft pita, and if your child is over 3 years old and chews well, popcorn is a nice snack.
2. Should we force our children to eat?
No! If they do not feel like eating, simply store their lunch or dinner in the fridge and an hour later when they say they are hungry, serve them their well-rounded meal from earlier.
3. My child is a picky eater. Should I be worried?
It’s always best to talk with your child’s provider to ensure they are growing and developing well. Ask about vitamins for your child. For the “average” toddler going through a picky eating phase, do not worry, just provide them with 3 healthy well-rounded meals and 2 healthy snacks of fruits, vegetables, whole grains, and healthy proteins and let them do the rest. After 1 years old, water should be the only beverage aside from 1-2 cups of either whole milk or a milk alternative such as soy or almond milk.
4. What are some proven strategies to overcome picky eating?
There are no proven strategies. You just do your best and realize as a parent your job is to provide healthy food and beverages to your kids, don’t let them fill up on junk foods or junk liquids (juice), and let them do the rest. If the picky eating is severe, talk to your child’s provider about Feeding Therapy.
5. What are some ways to create a love for healthy foods?
Modeling is everything. If your child sees you enjoy a wide variety of vegetables, fruits, beans, grains, and healthy fish and protein and you provide it to them in a non-pressured environment things should work out. The key is to enjoy meal times, never pressure your kids to “clean their plate” or finish all their vegetables. Never bribe them by saying “if you eat this food, you can have dessert,” as it should all be available, meaning a plate should have a vegetable, fruit, grain, protein source and maybe some dark chocolate, or small amount of yogurt or pudding for “dessert.” By not labeling or calling this food good and this food bad, we get rid of judgement and labeling food and hopefully, kids will just enjoy the meal.
Another way to help kids enjoy food is to get them involved. Yes, it takes longer when they help, but allow them in the kitchen (supervised of course) to set the table, help with cooking, and assist with creating meals.
6. If there was one thing you wanted to share with our families, what would it be?
One of my favorite things is the family meal. It is so difficult when everyone is so busy, but it is so important to everyone’s health. Studies show children and teens who have regular family meals 3 or more times a week are less likely to be anxious, depressed, use drugs, and have a teen pregnancy. For my family, we may not have dinner until 730 or 745 when everyone is home from work and sports, but we sit down together. Even when my kids were toddlers, I would insist on them waiting until we were all home together.
Another important part of this is absolutely no electronics at the table and no TV! If you have toddlers, you can have little toys or colors at the table. As they get older, you can play games together as you eat. One of my favorites is “Best and Worst.” Ask “what was the best thing that happened today and what was the worst thing?” Now everyone goes around and gives their answer. Another great game is the “What” game. For example, “If you could be a superhero, what would you be?” or “If you could be any animal, what would you be?”
As the kids got older, we would play the movie quote game. You say a line from a movie and whoever guesses it correctly has to think of the next movie line.
7. What are your favorite resources for feeding babies, kids and teens healthy foods?
My favorite resource is the Pediatric Anti-inflammatory Food Pyramid created by Dr. Andrew Weil, director and founder of Integrative Medicine at University of Arizona. Other great resources include Nourish Your Tribe by Nicole Magryta, MBA, RDN and the Environmental Working Group ewg.org Dirty Dozen and Clean Fifteen the top twelve fruits and vegetables that have the most pesticides and the top fifteen that have the least.
Learn more at gdpeds.com with additional resources and articles on feeding babies, nutrition for the young athlete, hydration for the athlete, nutrition for the female athlete, and our favorite pediatric and adult food pyramids.
Dr. Karen Prentice a board-certified pediatrician in private practice at Great Destinations Pediatrics located in Peoria, Arizona. Her passion and focus are on wellness, nutrition, integrative medicine, and the prevention of illness. She and her partners, Dr. Kristin Shepherd and Dr. Robyn Alfeche love to educate and partner with parents to help kids learn healthy habits that last a lifetime. Currently she provides YouTube videos and writes educational material for her patients and practice. For more information check out their website gdpeds.com and Facebook at GDPeds. Dr. Karen is married, has 4 kids, 2 dogs, and 3 cats and in her free time enjoys hiking, biking, yoga, and running marathons with her husband.
Raising Arizona Kids partners with the Arizona Chapter of the American Academy of Pediatrics to bring evidence-based child-health information to our communities.