General Nutrition Guidelines

Helpful nutritional guidelines from the United States Department of Agriculture can be found at ChooseMyPlate.gov.  Also the American Academy of Pediatrics has recently updated much of the nutrition information on their parental site HealthyChildren.org in the nutrition sections within the Ages and Stages tab.

Index:

Ages 0-6 months
(click on link to go to section with more detailed information)

1. Breastfeeding

2. Bottle Feeding

3. How do I know if my baby is getting adequate nutrition?

Breastfeeding

Breastfeeding is the most desirable way to feed infants in the first six months of life. Breast milk provides all the nutrients needed for growth and development for the first six months of life.

Feeding Schedule

Feed baby on demand.  Your baby should be fed at least every two to three hours on demand, with attempts to feed eight to twelve times a day.

At the beginning of each feeding the fore milk (watery) will come first, followed by the hind milk which is richer in fat and most desirable for baby.  At each feeding, it is important to feed baby long enough to get this hind milk which is richer in fat.  Generally, about fifteen to twenty minutes is an average feeding time to ensure adequate nutrition..  If your baby still acts hungry after feeding well on the first breast, offer the other breast.  Very long feedings may indicate that the baby is not latched on well or ingesting enough milk to become full or satisfied.

If you are having trouble breastfeeding, your pediatrician will be able to refer you to a lactation consultant who will be able to help you.

 

Is my Baby Getting Enough?

Don't limit the length of your baby's feedings to a predetermined number of minutes on each breast. Allow your baby to finish the first breast before switching to the other breast. This gives baby an opportunity to fill up on the high-fat hind milk. If you switch your baby to the second side too soon, he/she will fill up on the watery foremilk, which will make him/her feel full but may not provide enough calories to grow. As a general guideline usually 15-20 minutes per breast is average feeding time to ensure adequate nourishment.

Weight gain and number of diapers per day are indicators of your baby's intake. Generally speaking, your baby is getting enough if there are 6-8 wet diapers per day and a weight gain of 1-2 pounds per month.

Your pediatrician will be able to tell you if your baby is getting adequate nutrition.

 

Skin to Skin Contact

Offer lots of skin to skin contact. Your newborn benefits from the physical closeness of breastfeeding. This emotional bond is as vital as the nutritional benefit s/he receives from you. Breastfeeding promotes a growing attachment between the two of you that will play an important role in your baby's development for years to come.

 

Mother's Nutrition

Mother's nutrition is important for adequate milk production and tolerance for baby. It is important that you are well hydrated. Not drinking enough fluids or becoming dehydrated can diminish your milk supply. Pay attention to your body's thirst cues. Feeling thirsty is an important sign that you need to drink extra fluid. It is also important to get adequate calcium. It is recommended you include three 8 ounce glasses of milk per day or its equivalent to ensure adequate calcium intake. A popular widespread belief related to breastfeeding is that nursing mothers must refrain from eating spicy foods, chocolate, beans, onions, broccoli and a host of other foods that could upset their infant's digestion and cause their baby to be fussy. While many believe this to be untrue, some babies react to these foods in the mother's diet, so caution is advised when consuming these foods when breastfeeding. Certain dietary restrictions are recommended, however, if you, the baby's father, or another of your children suffers from food allergies, asthma, or other type of allergic disease. Check with your pediatrician about what is right for you.
 

Vitamin Supplementation

Breast fed babies are typically prescribed Tri-vi-sol vitamins to ensure adequate vitamins A, D, and C.

 

Bottle Feeding

Is my Baby Getting Enough?

General guidelines is 2 to 3 ounces formula per pound per day for a total of 20-24 ounces per day for an 8 pound baby .

Full term babies will generally take 4 ounces formula approximately every 3-4 hours.  Be careful not to overfeed your baby. Babies can usually regulate the amount they need on their own. Often babies cry because they are tired, not because they are hungry.

Do not add honey or karo syrup to the bottle as these carry a risk of botulism.

Do not use a baby bottle to feed cereal or other solid foods to your baby.

 

Formula Preparation - Helpful Hints

When preparing powder formula, use warm tap water. Do not use boiling water to prepare formula - boiling can increase lead levels and also poses a burn hazard.

Usual preparation for powder formula is 2 ounces water and 1 scoop of powder.

Not all formulas come as ready to feed formulas. Be aware that some formulas come as a concentrated form and you need to add water to them before you feed them to baby. Check labels carefully for preparation instructions.

Do not use the microwave to warm formula.

Do not change formula without checking with your pediatrician

Do not add honey or karo syrup to the bottle as these carry a risk of botulism.

Do not use a baby bottle to feed cereal or other solid foods to your baby.

 

Is My Baby Getting Enough?

Weight gain and number of diapers per day are indicators of your baby's intake.

While bowel movements vary, generally speaking, your baby is getting enough if there are 6-8 wet diapers per day and a weight gain of 1-2 pounds per month.

Your baby does not need to have a bowel movement every day. If your baby does not have a bowel movement after 3 days, you should consult your pediatrician.

Your pediatrician will be able to tell you if your baby is getting adequate nutrition through the breast or bottle.

 

6-12 months
(click on link to go to section with more detailed information)

  1. Introducing Solids
  2. What Should my Baby's First Solid Food Be?
  3. Preparing Baby Cereal
  4. Introducing New Foods
  5. Serving Sizes
  6. Fluoride supplementation
  7. Fruit Juice
  8. Choking Hazards

 

Introducing Solids

When can my baby start eating solid foods?

When your baby is able to sit independently, hold his/her head steady, open his/her mouth when food approaches and grab for things to put in his/her mouth, it's time to begin introducing solid foods, usually age 6 months or later.  At this time baby usually has the ability to swallow baby food placed on the tongue.  Before this age, instead of swallowing the food, babies push their tongues against the spoon or food.

 

What should my baby's first solid food be?

For most babies it does not matter what the first solid foods are.  Traditionally it was recommended that babies be started with simple, basic foods such as rice cereal.  However, that recommendation has recently been revised.  According to the American Academy of Pediatrics there is no medical evidence that introducing solid foods in any particular order has an advantage to your baby.  Discuss with your pediatrician recommendations for your baby's first solid food.

Avoid honey and Karo syrup due to the risk of botulism.

 

Preparing Baby Cereal

Baby cereal is available premixed or dry to which you can add breast milk or formula.  When preparing baby cereals, you should add breast milk or warm formula to the cereal, mixing about 1 tablespoon of cereal with every 4 to 5 tablespoons of breast milk.  Dry cereals to which you add breast milk or formula have an advantage as you can control how thick you make it.  Also, the dry cereals tend to be higher in iron, an important nutrient your baby needs at this age.

 

Introducing New Foods - When should I introduce a new food?

Introduce your baby to other solid foods gradually.  Good initial choices are other simple cereals, such as oatmeal, as well as vegetables and fruits.  Many pediatricians recommend offering vegetables before offering fruits, however there is no strong evidence that offering fruits before vegetables will cause a baby to develop a dislike of vegetables.

Start these new foods one at a time, and wait at least 5 days before starting a new food.  This approach will help you identify any food sensitivities or allergies that may develop as each new food is started.  Also, it will allow your infant to become used to the taste and texture of each new food.  Some pediatricians advise introducing wheat and mixed cereals last because young babies could have allergic reactions to them.  Contact your doctor if symptoms (for example, diarrhea, vomiting, rash) develop that seem to be related to particular foods.

Keep introducing healthy foods even if your toddler initially refuses them.  It takes numerous times of introducing a food for a toddler to become familiar with the food and accept it.

 

Serving Sizes - What is a serving size of solid foods?

In the beginning, feed your infant small serving sizes - even just 1 to 2 small spoonfuls to start.

Within about 2 to 3 months after starting solid foods, your infant should be consuming a daily diet that includes not only breast milk or formula, but also cereal, vegetables, fruits, and meats, divided among 3 meals.

When your infant is about 8 to 9 months old, give her finger foods or table foods that s/he can pick up and feed to herself.  Make sure s/he's not putting anything into her mouth that's large enough to cause choking.  Do not give small infants raisins, nuts, popcorn, or small or hard food pieces that can be easily aspirated.  It is important to develop good eating habits at a young age.

Do not overfeed young children.  They can usually regulate the amount of food they need on their own.  Children should not be forced to finish meals if they are not hungry as they will often vary intake from meal to meal.

 

Fluoride supplementation

If you live in an area where the water is not fluoridated, your pediatrician may prescribe fluoride drops or chewable tablets.  For more guidance on fluoride supplements, talk to your pediatrician.

 

Introducing Fruit Juice

Getting your infant used to the taste of plain water is a healthy habit that will last a lifetime.  Fruit juice is not a necessary part of a healthy diet; however, after six to eight months, you can offer your child small amounts of 100% fruit juice, as long as the juice serves as an addition to, not a replacement for, his/her usual intake of breast milk or formula.  Limit the intake of fruit juice to no more than 4-6 ounces per day.  Fruit juice should be given from a cup not a bottle.  Also, do not allow your child to drink fruit juice from a sippy cup for a prolonged period.  Remember, giving plain water is a much healthier option than fruit juice.  If a child drinks too much juice, sometimes it can't be digested properly, and can result in gas or diarrhea.  Some fruit juices, such as white grape juice, may be digested more easily than others.

 

Choking Hazards

The following foods create choking hazards and should be avoided: