Rules for the first feeding of bottle-fed babies

Artificial feeding is the complete replacement of breast milk in a child’s diet with artificial milk formulas. They contain the maximum amount of vitamins and microelements necessary for the normal development of a little person. Despite the fact that formulas of this kind practically copy breast milk, they do not succeed 100%. They influence the baby's nutrition in the future. Therefore, it is very important for a young mother to know exactly when (in how many months) the first complementary feeding is made during artificial feeding and what products it should consist of.

If your baby has an enviable appetite and doesn’t get enough of the formula, it’s time to offer him “adult” foods.

Content:

1. Complementary feeding during artificial feeding 2. Why does a baby need complementary feeding 3. When can complementary feeding be introduced during artificial feeding 4. When should you hold off on complementary feeding 5. Basic rules for introducing complementary feeding 6. Scheme for introducing complementary feeding 7. How to choose foods for complementary feeding 8. Introduction of complementary feeding premature babies on artificial feeding 9. Answers to frequently asked questions from mothers

Tips for moms

• You can introduce unknown dishes to the menu only if your child is in good health.
• Food should be warm.
• Give new foods after the main feeding; This way the baby will better accept unknown delicacies.
• Feeding occurs in a sitting position; use a small spoon.
• The first complementary food is in the form of one of the types of vegetables or fruits; If you have an allergy, you can quickly determine its source.
• Postpone new foods during periods of active tooth growth, elevated temperatures, and after vaccinations.
• Does your baby refuse to eat? Offer him something different. Find a dish that suits your taste, within the acceptable limits, of course. Later, you can try again to feed the capricious one what he refused at first.
• Follow the regime. Feeding should occur at the same time.
• It is not recommended to introduce complementary foods during artificial feeding during periods of stress for the child - moving, appearance of a nanny, etc.
• Don't force food in. Unnecessary frustration and bad mood will not lead to anything good.
• Get your child used to eating next to the dining table so he can watch the adults eat. Small children quickly grasp everything, then it will be easier for you to teach him to eat with a spoon.

Remember that a new diet for many kids is stressful. Therefore, try to approach this issue delicately. If you have any doubts, consult your doctor. If your child responds easily to unknown tastes, is active and grows, then you are doing everything right.

Why does a baby need complementary foods?

Breast-fed and bottle-fed babies are usually equally full of energy, active and inquisitive. Introducing complementary foods allows you to begin to gradually accustom the baby’s gastrointestinal tract to new food, as well as give the growing body the vitamins and microelements it needs at a specific stage of physical development. Also, with its help, you can gradually adapt the baby to the diet of adult family members and then painlessly transfer him to the common table. There are no exact norms and rules for introducing complementary foods. It is necessary to focus on the child’s needs and follow the pediatrician’s recommendations.

Rules

Introducing other foods into the diet requires parents to strictly adhere to the pediatrician's recommendations , and if the child is on IV, they will have to be even more careful with the rules, adhering to the administration schedule according to the table prescribed by the doctor.

IMPORTANT! You should consult a specialist about what time you start giving your babies this or that product.

When to introduce?

The famous pediatrician E. O. Komarovsky suggested adhering to simple rules that will help make the transition to new food correct, understand when it is necessary to introduce complementary foods to a child and how to avoid negative reactions from the baby’s body.

These rules include:

• When the child has not yet reached 4 months, you should not give him new food. The baby should be provided with an adapted formula.
• At the age of 4 months, parents feed babies who are not gaining weight very well or have low hemoglobin levels.
• If the baby has no health problems and is developing normally, the start of the transition to a new food is postponed until it reaches 6 months.
• If a child has an allergy to introduced foods, it is necessary to start feeding the children a little later.

How to do this correctly?

To ensure that the transition to a new menu does not cause adverse consequences for the baby, you must strictly follow the rules.

1. Parents should introduce a new product carefully and gradually.
2. If there is anything alarming, you will have to wait a while with food.
3. When painful manifestations appear, new food is not introduced until they disappear.
4. It is strictly forbidden to give your baby complementary foods during illness or before and after vaccination (about 4 days).

Schedule and order of inclusion of products

When can complementary foods be introduced during artificial feeding?

Accustoming children to adult food should be timely. The fact is that the baby’s gastrointestinal tract at too early an age (for example, 2-3 months) is not able to process some foods. The mucous membrane of the digestive organs becomes irritated, and this can cause gastritis and other serious health problems.

At what months can you introduce your baby to new foods? For children in good health, WHO recommends starting complementary feeding at 6 months. But for some children, if there are certain medical indications, the doctor may advise doing this earlier. The recommendations do not provide a specific menu for each age that must be followed. Much depends on the sociocultural characteristics of different peoples and the individual rates of development of children. In most cases, the timing of the start of complementary feeding varies from 4.5 to 6 months. Experts identify the following signs of a child’s readiness to try something new, in addition to the usual artificial formula:

• the baby is no longer completely full of the mixture and asks to continue the meal; • his first teeth have already erupted, he tries to chew with them, takes and tries to taste food from adults’ plates; • if you bring a spoon to your baby, he will begin to examine its contents and want to try it; • the child sits confidently, can turn his head and control his body; • the tongue thrust reflex subsides, so the baby can drink water from a spoon without it flowing back out.

All of the listed signs do not have to be present at once. If several of them are observed, then it is quite possible to try introducing the first complementary foods.

Dangers of early complementary feeding

Complementary feeding of a healthy child by month during breastfeeding, described in the table, provides for introduction to new products no earlier than six months of age. These recommendations should not be neglected. If for parents the sight of a child smeared with food is a reason for tenderness, then such actions will not bring benefit to a child with a fragile body. Possible consequences of early complementary feeding include:

• intestinal dysfunction (vomiting, problems with stool, regurgitation);
• the habit of swallowing food in pieces due to immaturity of chewing skills;
• impaired immunity;
• excessive stress on the kidneys, liver and weakening of organs.

Another reaction to early complementary feeding can be food allergies. It may appear as harmless redness and rash. In some cases, more serious chronic forms develop - bronchial asthma, dermatitis.

The introduction of complementary foods should be taken seriously by parents, as a new stage in the development of the baby. Complementary feeding for infants by month will help you correctly create a list of products; the table shows the recommended portions of foods that are important to follow. It is much easier to prevent mistakes than to correct them later.

When to hold off on complementary feeding

It is better to wait with complementary foods if: • the child is sick; • less than three days have passed since vaccination; • the baby is teething, sleeps poorly and is capricious; • there have been some changes in the family’s lifestyle, for example moving to a new home, mother going to work, traveling to another city or country; • the baby exhibits manifestations of allergies and gastrointestinal tract disorders; • the weather outside is too hot.

Thus, complementary feeding should only be offered to a child when he is completely healthy, calm and in a good mood.

What should you not give?

During the transition to a new menu, experts note that some foods are undesirable for the first feeding of a newborn up to one year old .

Such foods include:

1. Concentrated juices .
   Despite the fact that the older generation recommends them to their grandchildren or granddaughters, you should not give the product too early. Juices do not have any serious benefits for the baby, but they can have a strong effect on the gastrointestinal mucosa, causing irritation and various digestive disorders. That is why it is advisable to give such juices to the baby when he reaches one year of age.
2. Fresh vegetables.
   The product promotes bloating.

   They are also more difficult to digest compared to the boiled version.

3. Sweets (including cookies) .
   Such food promotes fermentation in the intestines, causing the child to become restless and irritable. It can be given later, but not as the first complementary food.
4. Exotic fruits growing in tropical countries.
   This food may cause an allergic reaction in an infant.

   Therefore, such fruits should not be offered to a child under one year old.

5. Cow's or goat's milk .
   The product contains a powerful allergen that causes severe allergies in newborns.

Basic rules for introducing complementary foods

Anna Levadnaya, pediatrician, candidate of medical sciences, explains that the principles of introducing complementary foods with natural and artificial feeding are similar: it is recommended to focus on food interest, signs of the child’s readiness for the introduction of complementary foods. The only thing is that if you are exclusively breastfeeding, it is not recommended to supplement your baby with water, while bottle-fed babies can be offered water.

Otherwise, the principle is similar: both with breastfeeding and with artificial feeding, you need to offer the baby new food before feeding, and then supplement him with breast milk or formula.

In order for new products to benefit a formula-fed baby and not harm his health, you should follow a number of simple recommendations. 1. Complementary foods are usually given in the morning before the main formula feeding. This allows you to monitor your reaction to unfamiliar food throughout the day and take action if necessary. 2. It is necessary to carefully monitor the cleanliness of children's dishes, pots and blenders. The baby's gastrointestinal tract is very sensitive to infectious agents. 3. New food is introduced into the baby’s diet with a quarter teaspoon. If he tolerates the product well, then within a week the portion is increased to one or two spoons. Next, you should look at the wishes of the child and his well-being, and also take into account the recommendations of the pediatrician. 4. The first dishes should have a liquid consistency, then they are made into purees, and only closer to the year can soft pieces be given to chew. Pediatricians advise adding butter and vegetable oils as vegetables and cereals are introduced into the diet. 5. In order to protect the child’s body from pathogens that may be contained in unprocessed food, complementary foods should first be boiled, stewed or baked. The baby is offered slightly warm food: the optimal temperature is 36–37 degrees. 6. It is advisable to immediately try the products from a spoon. If the baby gets used to the bottle, this will slow down the development of the skill of chewing food and may subsequently affect diction. 7. A food diary can help reliably determine what the child has an allergic reaction to. It should record everything that the baby ate during the day, in what quantity and at what time. You can also record in your diary whether he liked the new dish or not. 8. Complementary feeding should be introduced only with mono-products. Only after making sure that vegetables, cereals, juices, fruits or protein products are well tolerated by the child can you offer their mixes. 9. The interval between introduced and new complementary foods should be at least a week. This period of time will allow the child’s body to adapt to an expanded diet and accept other dishes without unpleasant surprises. 10. If you are allergic to any product, you should immediately remove it from the menu and consult a pediatrician. It will be possible to return to this complementary feeding again no earlier than in a month. 11. It is advisable that with the introduction of complementary foods the baby receives a sufficient amount of fluid. This can be either ordinary water or compotes. 12. Do not offer your child foods that are considered highly allergenic as first complementary foods: full-fat cow's milk, citrus fruits, cereals with gluten, chicken eggs, etc. 13. You cannot force feed your child, even if you think he is hungry. A little person has the right to defend his opinion in choosing dishes. 14. The baby should be fed exclusively in a sitting or reclining position to avoid the risk of aspiration. Special children's chairs made of easy-to-clean material are very convenient for this.

From 7–8 months, mashed or pureed food, such as a banana, can be taken as complementary food during artificial feeding. If semi-solid food is not introduced into his diet in time, problems with eating solid food may arise in the future: after a year, the child will refuse it completely. From 8–9 months, the child should be offered so-called finger food: cut soft fruits and vegetables, such as boiled carrots, potatoes, into pieces and offer them to the baby. If you adhere to this scheme, by the age of one year the child will be ready to eat solid food from the common table, explains Levadnaya.

Expansion of complementary feeding by month

Pediatricians recommend expanding the food menu for some children as early as 3 months. This may be due to anemia, lack of vitamins in the body, or poor weight gain.

It is important to gradually increase portions of new foods, supplementing the baby with formula at first - the total volume of food received in one meal should be approximately 150 ml. Do not forget to alternate complementary foods and main feedings so as not to overload the baby’s gastrointestinal tract. For example:

1. Mixture;
2. Porridge + mixture;
3. Mixture;
4. Puree + juice + mixture;
5. Mixture.

Below are recommendations for preparing new dishes for your baby and a table for increasing portions according to age.

Nutrition at 3 months

Diversify your baby's menu with natural fruit juice. It is better if a green apple is used to prepare it. The pulp is removed from the juice, and the liquid is diluted in half with boiled water. The warm drink is given to the baby in the amount of just a few drops, and the portion increases slightly every day. Over time, it is permissible to introduce peach, pear and apricot juices into the menu.

Nutrition at 4 months

Fruit and vegetable purees are added to the juices in the menu in a self-determined order. Among fruits, preference should be given to apricots, peaches, green apples and pears, and banana (it is given only raw).

The best vegetables for complementary feeding are: zucchini, squash, broccoli, cauliflower, pumpkin, green peas, carrots and potatoes. The first puree should be one-component. When the baby gets used to the products offered separately, they can be mixed into one dish.

Selected vegetables and fruits are pre-boiled, stewed or baked. The puree is prepared using a blender; you can add a little mixture to it so that the taste seems “familiar” to the baby. You can dilute the vegetable dish to the required thickness with boiled water or broth left after cooking. Fruit puree can be brought to the required consistency using juice.

Instead of puree, it is possible to introduce gluten-free and dairy-free porridge. It is prepared in water; the grain should be finely ground. Choose buckwheat or rice porridge. It is better to offer it for breakfast, and shift vegetables and fruits to the afternoon.

At 5 months

A new product in the baby’s diet is vegetable oil. It is added to vegetable purees, or you can drop it into porridge if it tastes better for your baby. Olive oil is a controversial product, so discuss with your pediatrician the possibility of including it in the children's menu. Dishes may be a little thicker, but without lumps. Fruit juice can sometimes be replaced with compote. The latter should also not be made too concentrated; it is better to dilute it with water.

In six months

It's time to switch the baby to milk porridge. First, they are prepared with milk, half diluted with boiling water; subsequently, the pure product is used. If you are allergic to cow protein, you can use goat milk. In porridges and purees it is allowed to add butter and boiled yolk. If chicken eggs are not suitable, replace them with quail eggs. The yolk can be offered to the baby as a separate treat, crushed with a fork and mixed with the milk mixture.

It is permissible to diversify the diet with kefir and cottage cheese. Although the respected Dr. Komarovsky believes that these products are the best for first feeding, many pediatricians do not share his opinion. Check with your doctor. These products contain bacteria beneficial for microflora and a lot of calcium, but they create a heavy load on the baby’s kidneys.

When preparing kefir and yogurts yourself, purchase the starter exclusively from pharmacies. Do not add sugar or fructose to them. Pay attention in the table to the maximum allowable amount of these products in the diet of a growing baby.

Nutrition at 7 months

At this age, you can include pureed meat in your diet. To prepare it, purchase meat without fat, veins and bones. Rabbit, turkey or chicken fillets are best suited for complementary feeding. Veal is allowed to be used if the baby is not allergic to cow protein. The meat is boiled or steamed, after which it is chopped with a blender or meat grinder.

You can diversify the menu by preparing not only puree from meat, but also pates and soufflés.

Meat broth is not used in any way, even in diluted form to improve the consistency of the puree. To stimulate the development of chewing skills, you can offer your baby a bagel, baby cookies or crackers, slightly soaked in compote, juice or kefir.

8 months

Cereals containing gluten are added to the diet. Start preparing oatmeal, barley, pearl barley, corn, and millet porridge for your baby. It is better not to introduce semolina into the diet until one is a year old - it is too high in calories and the least healthy. The baby can be served soup with meatballs. Its vegetable filling should be familiar to the child.

9 months

Your child can try low-fat fish, such as hake, cod, and perch. The fillet should be steamed, boiled, stewed or baked. Inspect it carefully for the presence of seeds - the puree should be smooth and tender. It is filled with vitamins and microelements and is easier to digest than meat. A fish dish should replace a meat dish twice a week; there is no need to include it in the menu more often.

Nutrition at 10-12 months

During this period, the baby’s portions become larger, and he is hardly fed formula. Vegetable purees become multi-component, and multi-grain porridges are prepared. Fruit juices and purees are added to cottage cheese, kefir and yogurt for taste; sugar is still prohibited. The meat and fish menu is complemented by steam cutlets. Instead of porridge, you can sometimes offer noodles cooked in milk. Prepare a casserole with fruit from cottage cheese.

Try offering your little one a piece of bread with the soup. You don’t have to grind the vegetables with a blender, but simply grind them or even cut them into slices. Knead the yolk with a fork. A meal can consist of several dishes at once. If the baby is healthy and not susceptible to food allergies, then new foods can be introduced more often - once every 3 days. You can safely start weaning your baby off the bottle, since his menu is very varied - he gets full.

Remember that all schemes are variable - the above is only an approximate plan for introducing complementary foods for an artificial baby. You should adapt only to your child, who may fall in love with one product and refuse another for a long time. Consult your pediatrician and please your baby.

Permissible amount of complementary feeding according to the age of the artificial baby

Approximate weight gain with proper introduction of complementary foods

Complementary feeding scheme

We offer an approximate schedule for the introduction of complementary foods up to a year, which you can use as a guide, unless otherwise recommended by your doctor. Typically, bottle-fed babies with normal weight gain are offered products in approximately this order: • vegetable puree; • porridge; • fruit puree; • kefir; • butter and vegetable oil; • children's cookies and bread; • meat puree; • fish puree.

The earlier introduction of vegetable puree rather than fruit puree is explained by the fact that the former has a blander taste. Having fallen in love with sweet apples and bananas, a child may subsequently refuse to eat zucchini, pumpkin, etc. However, if the baby is underweight, the doctor may recommend porridge as the first complementary food for him. They are higher in calories and allow you to gain missing kilograms faster. Each type of complementary feeding is described in the table.

It is not advisable to add salt, sugar and spices to your child’s food. His taste buds are not yet accustomed to strong stimuli, so it is better for him to appreciate the natural taste of the food offered. The soup should be cooked only in vegetable broths, and the meat should be added to the already prepared dish. Meat broth may be too hard for your baby's kidneys.

Products that should be limited

Sweet fruit purees should be introduced into complementary foods after the child gets used to vegetable ones.

When transferring to a mixed diet, children's nutritionists draw the parents' attention to which foods are introduced first and which are left for a later date. In pediatrics, it is considered correct to administer approximately the following nutritional schedule:

• First come the hypoallergenic vegetables of green, yellow and white colors: zucchini - cauliflower - broccoli - green beans - potatoes - turnips - pumpkin.
• Then non-dairy, gluten-free porridges are offered: buckwheat, rice, corn.
• Fruits and berries that taste delicious are offered only after getting used to the vegetables. The first to be introduced are yellow and green apples, pears, and plums.
• Meat and fish purees enter the diet much later, eggs and dairy products are the latest.

How to choose foods for complementary feeding

The main recommendations when choosing specific products to start complementary feeding are as follows:

1. It is recommended to make up your baby’s diet from products that are grown in the region of residence. If the first complementary feeding period occurs in the winter, it is advisable to stock up on vegetables, fruits and berries from your garden in advance, putting them in the freezer for safekeeping. In cases where this is not possible, you can give preference to ready-made jarred purees. They undergo mandatory certification confirming quality. 2. It is advisable not to buy store-bought juices in large quantities for your child. Compotes will be much healthier for him. You can also offer decoctions of dried fruits. 3. If you decide to purchase ready-made food for your baby, then pay attention to the labeling and production date. The product must be appropriate for the child’s age and be fresh. The composition should not contain salt, sucrose, dextrose and other foreign additives.

In general, it is worth remembering that the first food offered to a child should be pureed, not too viscous products, consisting of one ingredient, soft consistency, without added sugar, salt and spices, says Andrey Mosov, head of the expert department of NP Roskontrol, hygiene doctor nutrition of children and adolescents. He insists that preference should be given to industrial prepared foods, since such products have passed tests and certification. There are no guarantees with pureed homemade vegetables.

Ready-made baby food

Many parents find ready-made baby food convenient and easy to use.

However, the amount of meat in some commercial products may be low, and it may be advisable to add some home-cooked meat to meet iron requirements.

It is not recommended to use commercial baby food as it may result in delayed chewing skills and poor acceptance of new flavors and food forms.

When can I give store-bought baby food? Commercial baby food products can be used in cases where you are away from home for a long time, while traveling. But they should not be the main ones in the diet of infants.

Homemade food offers more variety in taste and texture. Plus, it's cheaper than commercial baby formula.

Introduction of complementary feeding to formula-fed premature infants

The question of the correct introduction of complementary foods to a premature baby should be discussed individually at an appointment with a pediatrician. In order for the body to process a new product, organs and systems must be sufficiently mature and prepared. The quality of food digestion largely depends on the production of special enzymes, so you should not show initiative in creating your baby’s menu.

The schedule for introducing complementary foods will be determined by the presence or absence of anemia, rate of weight gain, tendency to allergies and some other nuances. It is usually recommended that formula-fed premature babies begin introducing meat and egg yolk earlier. It is advisable to cook porridge in vegetable broth or mixture, rather than in water, as then they will be more nutritious and healthy.

However, the progress of complementary feeding must be monitored by a pediatrician. The doctor monitors the child’s reaction to new foods, assesses the dynamics of growth and general physical development. The scheme may be changed if any deviations from the norm are identified during routine inspections.

If the child does not eat well

What should you do when, according to the complementary feeding chart for formula-fed children, you need to add new food for a long time, but the child stubbornly eats only formula? First of all, mom should not give in to panic. After all, the start of complementary feeding during artificial feeding can be postponed without harm to your beloved child for up to six months. Perhaps the baby’s digestive system has not matured, and he is not ready to accept a new product.

When the baby refuses food other than formula, the mother needs to be patient. It can be recommended to seat the child at a common table, thereby developing food interest. You need to offer food when the baby is hungry, for example, during a walk. To feed your child, it is advisable to buy a bright soft spoon and a bright plate. If your baby refuses industrial purees or cereals, then you can try preparing them yourself. Adding a small amount of the mixture to the porridge will make its taste more familiar.

Even when your baby’s relationship with unusual food doesn’t work out right away, you shouldn’t worry. Each child is individual. If he is not lagging behind in development, then you can safely postpone this for a while. The main thing is to follow the principle of gradual introduction of the product and not rush. It is not at all necessary that your schedule should coincide with the baby’s complementary feeding table by month with artificial feeding.

Answers to frequently asked questions from moms

• What foods should not be given to children under one year of age?

It is forbidden to give cow's milk to babies under one year of age, as it can cause allergic reactions and digestive disorders.
It can be perfectly replaced by adapted mixtures from modern manufacturers. In addition to milk, it is not recommended to include nuts, citrus fruits, exotic fruits and vegetables, red fish and honey in the menu of the first year of life. • What to do if a child absolutely does not want to eat complementary foods?
Wait a while and try offering food again, but do not insist on another refusal.
Perhaps the baby did not like the new dish because of the unfamiliar taste. Children are big conservatives and are often wary of change. Be patient and do not rush into introducing complementary foods. Show your child the appetite with which you yourself eat from your plate, and then he may have a desire. • What should you do if your baby has problems with bowel movements during complementary feeding?
If a child experiences stool retention for more than three days during the introduction of complementary foods, then we can talk about constipation.
In this case, you need to visit a pediatrician, and also immediately exclude strengthening foods from the menu and give you more fluids to drink. If bowel movements become too frequent (more than 5 times a day), this may be due to indigestion or an intestinal infection. Be sure to consult your doctor about this. • What to do if you develop an allergy to complementary foods?
It is advisable to take care of this issue even before introducing complementary foods by asking the pediatrician observing the child to prescribe an antihistamine that is optimal for his age.
You should also carefully fill out your food diary at first. With its help, it will be possible to identify a possible allergen and exclude it from the baby’s menu, preventing more severe health consequences. • How to understand that a child tolerates complementary feeding well?
The successful introduction of complementary foods is indicated by normal weight gain and height, regular bowel movements, and the absence of allergic skin rashes. If your baby is cheerful, active, has a good appetite and restful sleep, most likely this means that you are doing everything correctly and the selected diet is suitable for him.

However, in no case should you completely abandon artificial formula when introducing complementary foods, even when the baby eats complementary foods with appetite. His body is not yet ready for a complete change in the type of nutrition and may malfunction. This often manifests itself in the form of allergies, bowel disorders or growth retardation. Remember that your baby should enjoy new food. Only under this condition will he develop correct eating behavior.

Indications and contraindications

When is a child given a new food or how do you know from how many months food can be introduced? The introduction of complementary foods is recommended in the following cases :

1. A child who has reached 4 months but is not gaining weight well.
2. The baby has exceeded 5 months of age.
3. When a pacifier or other objects enters a child's mouth, he begins to chew.
4. Parents notice that the “pushing” reflex has faded, and the swallowing reflex has become good.
5. The baby started teething.
6. The child sits confidently and controls his head, expressing his emotional attitude towards food or satiety.
7. The baby does not have any digestive disorders or allergies to foods introduced during the first feeding in small portions.

It is prohibited to introduce complementary foods under the following conditions:

1. Decreased immunity with signs of colds in the baby.
2. Hot time of year.
3. The period when vaccination is carried out, as well as 3-5 days after vaccination.
4. A sudden change in the situation associated with moving, repairs or a trip to warm countries.

ATTENTION! Temporary contraindications when it is impossible to feed a child include undesirable reactions of the baby in the form of allergies, diarrhea, constipation or vomiting.