Mixed Feeding

Breast milk or formula is a complete food and drink except that some breast-fed babies may need a little extra iron by the time they are four months old. In theory your child could go on living on milk alone forever but in practice a milk-only diet would not work out very well.

Although the foodstuffs in milk are complete they are very diluted: milk contains far more water than anything else. As the baby gets heavier he needs more calories so he drinks more milk. Eventually he reaches a point where he is drinking all the milk that his stomach can hold at every feeding, yet four or five 7 to 8oz (200 to 225ml) stomachfuls per day do not give him quite as many calories as his body requires. Since he literally cannot hold any more milk on each occasion, the only way he could get more food would be to feed more frequently. If you had nothing but milk available for him, you would find that he begun to demand back the night feedings he had just abandoned and to demand the bottle or breast at more and more frequent intervals through the day. Fortunately you do have something else available: solid foods which are far more concentrated sources of calories than milk. Tiny quantities of a solid food give the baby the extra calories he needs without stretching his milk-distended tummy much further.

There are social reasons too for offering your baby solid foods. You are trying to bring up a human being and human beings eat "real" food. He needs to get used to a wide variety of tastes and textures; he needs to learn that good food can come from a plate as well as a breast or bottle. Until he has learned these things he cannot join you, happily, at your family meal-table.

Once a baby is ready for solid foods, do give them all from a spoon rather than adding any to his bottle. Feeding your baby a bottle which has a spoonful of cereal mixed into it is forced feeding - it means that he cannot get his accustomed quantity of milk (and that means water, too) without getting the added cereal as well. It deprives him of any chance of saying "no" to the cereal without saying "no" to the milk. If you are ever tempted to add anything to your baby's bottle remember that breast-feeding is nutritionally ideal and you can't spoon cereals into breasts . . . .  

When to Start

While there are no hard and fast rules that apply to all babies, no baby should start solid foods before he is four months old without special medical reasons. After this age, your baby's weight, hunger and feeding pattern will cue you when to start.

Your aim should be to spot the time when he is coming near to the limits of milk-only feeding so that you introduce him to the brand new experience of minute tastes of solid foods before he really needs their food value. If he is over four months and bottle-fed, you can estimate this time quite accurately enough if you consider the baby's milk consumption, the number of feedings he is having and his weight.

Milk consumption

If your baby is taking 7oz (200ml) at most feedings, you can assume that he is near the limits imposed by the capacity of the stomach. To get more food there would have to be more meals rather than larger ones. 

Number of feedings

If 7oz (200ml) is all he can take at a meal, then seven times the number of feedings he has each day will tell you how many ounces of milk he could take. If he has five feedings, then he could drink as much as 35oz (1 litre). If he only has four feedings, then he will not manage more than 28oz (800ml).    

Weight

Your baby's daily needs are likely to be around 3oz (85ml) of milk for every pound that he weighs. So consider whether the maximum number of ounces he could take in his chosen number of feedings adds up to somewhere near this figure. For example, a 10lb (4.5kg) baby is likely to need 30oz (850ml) of milk per day. Five feedings (maximum 35oz (1000ml)) is still plenty, but four feedings (maximum 28oz (800ml)) would be barely enough.

If the baby is breast-fed, so that you do not know exactly how much he drinks, you can use his weight combined with his demands for food to tell you when to introduce solids. If he weighs as much as 12lbs (5.5kg), he cannot be getting enough for his needs in less than five feedings each day. A baby's refusal to lengthen the interval between feedings and/or a sudden demand for an extra, sixth, feeding, will tell you that he needs something more than milk.

An average birthweight baby who has gained weight at the normal rate will probably pass 12lbs (5.5kg) in his fourth month. Since this is also about the age when he will be ready to go for longer intervals between feedings, this may be a sensible time to start solids. A very large baby may reach 12lbs (5.5kg), and therefore his stomach's limits on five feedings per day, earlier than this. Consult your doctor about whether milk on demand is still enough. A very small baby will not reach 12lbs (5.5kg) until he is much older, but he should probably start tastes of solid foods by his fifth month. If you leave the new experience until he is much older than this, he may find the new tastes and feeding methods hard to accept. If he is entirely breast-fed he might also begin to need more iron than he gets from the breast milk.    

First Solid Foods are Extras

These early tastes of solid foods are intended more for education than for nutrition. You start offering them while your baby is still getting enough from his milk alone to cover the possibility of his needing a tiny bit extra and to get him used to them. They are extra, and they are not meant to change his diet or to replace any part of it. The beginning of mixed feeding is not the beginning of weaning. 

Keep the quantity of solids down and the quantity of milk up

Don't let advertising by babyfood manufacturers convince you that your baby should match increasing quantities of solid foods to decreasing quantities of milk. Instead, feed very small quantities of solid foods and the usual amount of milk, increasing the solids only if the baby wants more as well as the milk. 

Never force solid foods on the baby

Offer tastes and let him decide whether he wants them or not. 

Offer a wide variety of flavors

Find out, by experiment, what the baby likes and and what he does not. Even at this early stage he will have definite preferences which you should respect.

What Solid Foods Should the Baby Have? 

Most of the baby's diet will consist of milk for weeks yet. Even when he does begin to reduce his milk intake because he positively wants more solid foods, the milk that he goes on drinking will provide almost all the protein, minerals and vitamins he needs. His first solid foods are needed only for their calories - their fuel - and there are calories in every kind of food. So it does not matter which particular foods you choose to give him, provided that they are of a semi-liquid texture, that the baby likes the taste and that the food does not give him indigestion. He will get no more benefit from a "high protein" cereal than from an ordinary one. He does not need the extra protein, only the calories which are in both.  

Cereals

Cereals are the traditional first solid foods. They are marketed specially prepared for babies and they only need mixing with formula for a bottle-fed baby or with water or expressed breast milk for a breast-fed one.

Cereals have the advantage of being rich in iron which is important to breast-fed babies. They also have a bland milky taste which is sufficiently like the baby's accustomed food to make them acceptable. On the other hand most babies refuse cereals unless they are sweetened, and once you add sugar, even a tiny portion of cereal will add a lot of calories to the day's diet. So try unsweetened cereal, but if your baby refuses, keep quantities of sugar very small indeed. A single teaspoon of the dry cereal mixed with three teaspoons of milk and a quarter teaspoon of sugar will be plenty.

Strained Fruits

Many babies prefer strained fruits to cereals. While the taste of fruit is more surprising to him than the taste of cereal it is also more interesting and pleasurable. If being given fruit makes him enthusiastic about these early lessons in eating, give it to him. The more he enjoys solid foods now, the more easily he will accept them later on when they become important in his diet.

Strained Vegetables

These are another excellent first choice if your baby likes them. If he enjoys the taste as it is, fine. If he refuses, convention will probably help you resist the temptation to sweeten them! Carrots, which are naturally sweet, are often preferred to other vegetables.

Once your baby happily accepts one or two solid foods it is good for him to be offered a wide variety. You can buy special babyfoods for him or put tiny portions of your own cooking through a blender or food-grinder. If you want him to like your cooking, make sure he has some home-cooked foods from the beginning. If he gets very used to the bland sameness of commercially prepared babyfoods, he may later reject the stronger and more definite tastes of your foods. Fresh stewed apple, for example, is nothing like "apple dessert."  

Home-Prepared Foods

Since you do not have to worry, at this early stage, about feeding your baby a "balanced diet" of solid foods, you can simply put a tiny portion of any bland food which you have available through a food-grinder. A teaspoon of mashed potato mixed to a semi-fluid texture with milk or gravy would be excellent. So would carrots or other bland vegetables similarly treated. Any fruit except strawberries (which occasionally cause an allergic reaction), or very seedy ones like raspberries, will be good for him if they are stewed and pureed. They can be made less strong tasting by being mixed with milk or yogurt.  

Commercially Prepared Foods

Cans and jars are an extravagant way to feed a baby at this early stage. He will only need one or two teaspoons of food at a time, yet the jars hold three or more tablespoons. You cannot use the remainder up over several meals because the foods will not stay safe for more than 24 hours after opening, even in a refrigerator, and you do not want to offer the same food three times running.

Dehydrated foods can be used as gradually as you like. Buy several different kinds, both sweet and savory, so that your baby can explore variety. You can also ring the changes by occasionally mixing the food with fresh stock (not made from a salty cube) or water instead of milk.