Feeding Your Baby and Toddler (Birth to Age Two)

One of the best things you can do for your baby is start him or her off with healthy, nutrient-rich foods. At every age and stage, you can’t go wrong when you help your child learn to appreciate a healthy diet.

Breastfeeding

Breast milk contains a unique mix of fatty acids, lactose, amino acids, vitamins, minerals, enzymes, and other important factors that combine to make the perfect infant food. It has everything a baby needs for easy digestion, brain development, and protection from illness and infections. Breastfeeding is also healthy for mom, reducing risk of ovarian cancer, breast cancer, and osteoporosis.

For the first 6 months, breast milk is all your baby needs to meet his or her nutrition needs. If you wean your baby before 12 months of age, be sure to give an iron-fortified formula.

Breastfeeding should continue until your baby is 12 months old (and after as long as baby and mom would like to continue). Do not give your baby cow’s milk until they are at least 12 months old as it does not provide the right kind of nutrition for your baby.

Your breastfed baby also needs vitamin D supplementation when exclusively breastfeeding (or mostly breastfed). Babies can become vitamin D deficient, especially in the winter when sun exposure is low. Vitamin D is important for bone health. Your baby should be taking 400 IU of vitamin D daily. Feel free to talk to your baby's doctor about vitamin D.

How much should my breastfed baby eat?

  • Most breastfed babies eat more frequently than those who are formula fed. They tend to nurse every 1-3 hours. Plan to nurse your baby on demand, which is about 8-12 times per day in the beginning.
  • Watch for signs of hunger such as waking up, putting hands in and around the mouth, turning the head from side to side, smacking lips, sticking out tongue. These are all cues that your baby is hungry.
  • Crying is a late sign of hunger and fussy babies can be more frantic at mealtime so try to feed your baby when you see the early cues of hunger, before the crying begins.
  • Try to nurse your baby 10-20 minutes on each breast during each feeding. Do not let your baby stay latched longer than 20 minutes on each side.

Storing breast milk

Safe storage of breast milk can extend the life of your breast milk and help keep your baby safe. Milk can be stored safely at room temperature for several hours, and in the refrigerator for several days.  Carefully freezing breastmilk can allow you to preserve your milk for months.  Review milk storage guidelines and consider posting a copy somewhere convenient so you’ll have the information handy when you need it.

How to warm milk

  • From frozen: thaw in refrigerator overnight or run under cool running water
  • Refrigerated milk or thawed milk: run under warm running water or immerse in a pan of warm water. Mix/swirl the bottle and test the milk on your wrist to make sure it is not too hot.
  • Never microwave formula or breast milk.  Microwaves can have uneven heating, causing some areas of the bottle and milk to be so hot it could burn your baby. It could also cause the loss of the beneficial properties of breast milk.

Breastfeeding information and support

It may seem like breastfeeding is natural and it should "come naturally." However, it can take a lot of work, especially in the beginning. .   Here are some places to find support while breastfeeding:

Formula Feeding

Infant formula is also a safe, healthy way to feed your baby. In some health situations, your pediatrician may recommend it. Infant formula that you can buy in stores must meet well-defined standards established by the U.S. Food and Drug Administration, and have the nutrition your baby needs to be healthy. Formulas can be made with different ingredients, some are cow’s milk protein based, some are soy based, and some are “hydrolyzed” or broken down into smaller proteins. If you have questions about which formula to use, please discuss the options with your pediatrician. Note that your formula-fed baby most likely does not need any vitamin D or other vitamin supplementation as all vitamins are included in infant formula.

How much should my formula-fed or bottle-fed baby eat?

  • Formula-fed babies tend to go slightly longer between feedings than breastfed babies, usually every 2-4 hours.
  • Plan to feed on demand, which may be more frequent in the beginning and space out as your baby gets older.
  • Watch for signs of hunger such as waking up, putting hands in and around the mouth, turning the head from side to side, smacking lips, sticking out tongue. These are all cues that your baby is hungry. Crying is a late sign of hunger and fussy babies can be more frantic at mealtime so try to feed your baby when you see the early cues of hunger and before the crying begins.
  • When bottle feeding, there is no need to force your baby to finish the bottle. Babies know when they are full. They will tell you buy turning their head away, dozing off, or pushing the nipple out of their mouth.
  • Treat feeding time as a special bonding time. Hold your baby and enjoy your time together. Never prop a bottle during a feeding as your baby could choke if he or she cannot push the bottle away.
  • After the first few days, your formula-fed baby will take 2-3 ounces per feeding. By the end of the first month, your baby may be up to 2-4 ounces per feeding.

Formula preparation

  • Follow the mixing instructions on the formula can for powder formulas unless otherwise instructed by your pediatrician.
  • If you plan to refrigerate prepared formula, always store it in bottles.
  • Never microwave formula or breastmilk. Microwaves can heat unevenly, causing some areas of the bottle and milk to be very hot. This could burn your baby.
  • According to the CDC, formula and food prepared with well water may have excess nitrate. If you use well water, have it tested for nitrate content. Even when mothers take in very high levels of nitrates, a breastfed baby is not at risk.

Feeding Your Baby (2 – 6 months)

Around 2 months of age, most babies will begin to stretch out their sleeping at night to 4-8 hours. As long as they are growing well and still having an adequate number of wet and poopy diapers, it is fine to let them sleep and not wake them up to feed. They will compensate for these longer stretches by taking more at other feeding times.

Feeding Your Baby (4 – 6 months)

Breast milk or formula is far more nutritious than any solid food you could give your baby. Wait until your baby shows signs that they are ready. Some babies are ready around 4 months.

When you do start solid foods, keep in mind that solids are not nutrition at this age. Solid foods at this age are for taste and the practicing the mechanics of a new texture.

  • Look for developmental signs of readiness including:
    • Baby has steady head and neck control in an upright position
    • Baby shows interest in food when you eat
    • Baby can transfer food from a spoon to their mouth
  • Babies that are breastfed should start with single grain cereals, such as rice or oatmeal. These cereals are fortified with iron, which can help prevent anemia. These can be found in the baby section at the store. They are not the same as the rice or oatmeal cereals that kids and adults eat.
    • When first introducing cereal, mix cereal with breast milk or formula into a thin consistency. Your baby is learning the mechanics of swallowing and moving solid food in his/her mouth. When your baby handles this well, you can make it thicker.
    • Offer your baby 1-2 tablespoons of cereal in a bowl once per day. As they enjoy it, you can increase to twice a day
    • Be patient! Your baby may refuse to eat the cereal at first. It is fine to wait a few days before trying again.
  • Once your baby can eat one food well, it is ok to introduce other foods
    • Introduce one new pureed fruit or vegetable to your baby every few days. This way, if your baby develops a rash, you will be better able to tell which food may have caused it.
    • Pureed beans and lentils are a good source of protein, as well as pureed meats.

Tips for Starting Solids

  • Use a baby spoon and bowl to feed your baby. Do not put the cereal in a bottle. Your baby should learn to eat his or her food, not drink it.
  • Only take out a small amount of the baby food at a time. You can leave it at room temperature or warm it slightly. You can then refrigerate the open jar and use it in the next two days.
  • You can make your own baby food if you would like. Steam vegetables or fruit and then blend them. You can make the texture thinner if needed by adding  a little bit of breast milk or formula.
  • Use caution with the microwave as it can heat food unevenly. Always mix food well and check the temperature before feeding your baby.
  • There is no need to add any extra salt or sugar to your baby’s food. This is discouraged.
  • Wait until your baby is 1 year of age before feeding him or her honey. There is a type of bacteria (clostridium botulinum) in honey that can be very dangerous and cause paralysis in babies.  

Food Allergies and Prevention

The science and opinion about food allergies and prevention have changed in recent years. New studies show that delayed introduction of peanuts increases the risk for developing peanut allergy. For most infants, it is now recommended that foods containing peanuts be introduced, along with other varieties of solid foods, between 4 and 11 months. If there is a strong family history of food allergies or your baby has severe eczema or an egg allergy, he or she should be tested for a peanut allergy first. Most other babies, even those with mild to moderate eczema, are encouraged to start foods containing peanuts.

One way to introduce foods containing peanuts is to add peanut powder to cereal. You can also mix peanut butter in pureed fruit (like applesauce) or infant cereal. Talk to your pediatrician if you notice signs of a food allergy such as vomiting, diarrhea, or rash after eating a new food. If your baby ever has facial swelling or trouble breathing after eating a food, call 9-1-1 immediately. And remember, whole peanuts are a choking hazard to children under 4 years of age.

Feeding Your Baby (8 – 12 months)

Around 8 months is a good time to introduce finger foods – small, soft, bite-size pieces of food. Let your baby touch, smell, and taste many different kinds of foods. Be patient, though, because your baby may take longer to eat now that they are becoming more independent.

  • You can start to add cheese, yogurt, and cottage cheese for protein and calcium. However, still no cow’s milk at this time. Tiny proteins in cow’s milk are difficult for your baby to digest. In yogurt or cheese, the milk proteins are de-natured by heat in such a way that your baby can digest them.
  • Even if your baby doesn’t have teeth, you can add ground meat or small pieces of deli meat. There is power behind those gums! However, avoid steak or meats that need molars for grinding.
  • Choking prevention is important, so make sure foods are cut into small pieces for safety.
  • Never leave your baby alone while they are eating. You should be close by to make sure they do not fall out of the high chair or choke on his or her food.
  • The following foods are difficult to chew without a full set of teeth. They can cause choking. Only offer them to your child if cut into very small pieces that he or she can chew and swallow well.
    • Apple chunks and slices
    • Grapes
    • Hot dogs
    • Sausage
    • Popcorn
    • Whole nuts
    • Raw vegetables

Feeding Your Toddler (1 – 2 years old)

At 1 year of age, babies can switch to whole cow's milk. It is important to use whole milk because children under 2 years of age need the extra fat for brain development. 1-year-old breastfed babies will benefit from continuing to nurse for as long as both mom and baby are happy with the arrangement. When it comes time to wean from nursing, your baby can also start to take whole milk. Your toddler should get 16-24 ounces of milk per day. This allows them to get enough calcium, vitamin D and fat. However, if your child gets too much milk and fills up on this, he may not get enough nutrients from other foods.

Your toddler should be joining you at the table for meals and be learning about mealtime as family time. Family meals have many benefits as they grow.

  • Your child should be getting foods from all food groups: veggies, fruits, proteins, grains, and dairy
  • Encourage your child to use a cup and not a bottle
  • Start to teach table manners, including using a fork/spoon
  • Be patient! Toddlers can be picky eaters, deciding to like one thing one day and not want to eat it the next. Offer small portions of all foods and keep mealtime interesting! Serve colorful foods with different flavors and textures. Even if they refuse a food today, continue to serve it and encourage them to try it, but don’t force them to eat it.
  • For family meals, everyone should be eating the same food. This encourages your child to try what is on his or her plate.
  • Offer your child three regular meals and 2 snacks per day
  • For tooth health, your child should drink 8 ounces of fluoridated water each day (city water has fluoride in it

Every baby is special. Don’t worry if your baby eats a little more or less than this guide suggests. In fact, this is perfectly normal. Suggested foods and portion sizes are only guidelines to help get you started.

Milk and Juice

If your child doesn't want to eat food but drinks a lot of milk and juice, he or she may be filling up on calories (energy) from these liquids.

Preschoolers should not drink more than 24 ounces of milk each day. After 2 years of age, give your child reduced-fat milk (skim or 1% milk fat).

Juice is not as nutritious as fresh whole fruit. It is not needed in your child’s diet at all. It adds excess sugar and calories to your toddler’s diet and frequent consumption can cause tooth decay and cavities. According to the American Academy of Pediatrics, unless clinically indicated, juice should never be introduced prior to 12 months of age.

  • Intake of fruit juice should be limited to 4 ounces per day.
  • Read labels carefully and make sure it is 100% fruit juice. Juice drinks, beverages, or cocktails may contain very little or no real fruit juice. These drinks can look like fruit juice but contain no more nutrition than soda pop.
  • Children should not drink juice from bottles or cups that allow them to consume juice easily throughout the day because having juice in their mouths all the time can cause tooth decay.
  • Children should not drink fruit juice at bedtime.
  • Drinking too much juice can lead to poor nutrition, diarrhea, gas, abdominal pain, bloating, and tooth decay.
  • All children should be encouraged to eat whole fruits.

To reduce the amount of juice your child takes in, try diluting it with water and add more water gradually each day until your child is drinking plain water to quench her thirst. This will help your child make the change little by little. Or, for a yummy alternative to juice, try a fruit smoothie made with whole fruit and yogurt in the blender.

Soda Pop

Your child should not drink soda pop or other sweetened drinks. Soda fills your child up with either empty calories or artificial sweeteners and often contains caffeine. It is not good for your teeth to have acidic, sugary liquid pass over them as you drink. Remember to model good nutrition habits and, if your family likes these drinks, save them for an occasional, special treat. Start healthy habits early and don't introduce your child to soda/pop until they are older. Water should be your child’s main thirst-quencher.

Picky Eaters

When it comes to knowing what to do about picky eating behaviors, know your responsibilities and your child’s responsibilities around food. You decide what to offer, and your child decides what to eat and how much from the choices offered. As long as your child has energy and is healthy and growing, they are probably getting enough food. If you are concerned about picky eating behaviors, talk with your child’s doctor.

Snacks

The earlier you start healthy snacking habits, the better. Think of snacks as mini meals and use them to get more grains, fruits, and vegetables into your child's diet. Try to include at least two food groups in every snack.

  • Keep healthy snacks ready and available to your child. Bring healthy snacks with you on outings instead of relying on fast food.
  • Cut soft, raw vegetables or fruit (like cucumber or banana) into chunks. Skewer them onto thin pretzel sticks. To prevent discoloration, dip fruits in orange juice after they're cut. Have your child help!
  • Although it can be challenging getting some children to eat them, vegetables are a child's best friends. When eaten raw, the nutritional value in vegetables can't be beat. Try broccoli or cauliflower (trees), thin carrot sticks, green pepper slices, cherry tomatoes, or tomato wedges, to name a few. Cut them into sticks or coins and then dip them in salsa, hummus, or yogurt dip. These are great alternatives to high-fat dips made with mayonnaise or sour cream. For younger babies, steam the vegetables to soften them.
  • Kids also go for blender smoothies, made with plain yogurt and whole fruit. In the summer, you can freeze these into "popsicles."
  • Using cookie cutters with fun shapes, cut slices of cheese, low-fat lunch meat, or whole-grain bread (make sure the first ingredient is “whole wheat” or another whole grain). Then put them together to make fun sandwiches. Eat the edges, too.
  • Favorite fruits are often grapes (be sure to cut them in half for kids under age 4), thin-sliced apple wedges, and banana slices. When choosing fruit, it's important to remember the many options available, including berries, pears, grapefruit and orange slices, cantaloupe chunks, and pineapple. And don't forget about more exotic fruits like kiwi, papaya, mango, and star fruit (carambola).

Additional Resources

 

Originally written and compiled by Kyla Boyse, RN

Revised by Alyssa Wojciechowski, MD, Kelly Orringer, MD and Sara Laule, MD

Updated March 2018