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Introducing Complementary Foods

25 June 2024

Until now, your infant suckled or has been fed on pumped milk or maybe infant formula. At about six months’ age you can start offering them supplementary foods, depending on their willingness. That way they get to know new textures, flavors and temperatures, which is very important for their development.
The recommendation is to continue to breastfeed until the age of two years and possibly longer, as long as it suits you and your infant, while introducing and establishing supplementary foods, through attentive feeding.

When can you start exposing infants to supplementary foods

When they start showing signs of being ready, such as interest in food, the ability to sit unassisted, hold their head up and more. Gradually try to offer them diverse food types of all the food groups. Avoid cow’s milk as a drink and honey until one year’s age.

You should know

  • It is better to heat food by cooking, steaming or baking and avoid using a microwave oven.
  • It is important to cut round foods such as grapes and cherry tomatoes lengthwise, including for older children with well developed chewing ability. It is recommended to avoid ultra-processed food such as sausages. Please note that sausages also pose a danger of asphyxia in their original form.
  • Nuts and seeds may only be served once ground into a smooth texture.

At about six months’ age, parents can start introducing their infants supplementary foods and new flavors. Until then, breastfeeding is recommended. Infants that do not suckle or only partly so can be fed infant formulas. It is advised to continue to combine breastfeeding with supplementary foods until two years’ age, and even longer, as long as it suits you and your infant.

Supplementary foods that may be provided at sixth months’ age will not replace a whole meal. As a start, infants will still get most of their energy and nutrients from breastfeeding or infant formula, but because milk or infant formula alone do not provide enough iron and zinc at this stage, we should base meals on supplementary foods too, using the paced feeding approach. From six months’ age, depending on your infant’s willingness, it is a good time to start exposing them to new flavors, textures and eating experiences. It is a advised and important to feed infants during family meals. It is a unifying experience with personal example and a learning opportunity for infants, until eventually they dine with us at the table.

This is how you can know that your infant is ready to be introduced to supplementary foods

  • They can sit with support
  • They hold their head up firmly
  • They show signs of curiosity and willingness to eat when food is brought close to their mouth
  • They bring their hands and objects close to their mouth
  • They show an ability to pass food from side to side in their mouth and to swallow
  • Their tongue protruding reflex disappears

Important

Important

For most infants, these skills develop around the age of fix months, so it is recommended is to start exposing them to supplementary foods at that age. Exposure to supplementary food before the age of 4 months is not advised.

How to introduce supplementary foods

We used to call them "solid foods", but today we call them "supplementary foods". Why? Because the foods we start offering to infants from six months’ age will supplement their nutrition alongside breastfeeding or infant formula. So how do we serve them to our infants for the first time? And what should you know before we begin?

  • 1
    Familiarization and experimentation

    The main purpose of exposure to food is familiarization with new flavors, textures and foods. We do not necessarily try to establish full meals. At this stage it is important to create a positive eating experience for your infant, the emphasis being on diversification and quality of food rather than the quantity they eat.

  • 2
    Patience

    The stage of exposure to new foods may take time. There is no need to hurry. Even if you have to serve your infant the same food or texture several times, it makes sense and is the right thing to do. Remember, we adults do not readily take up new flavors either, and some tastes are acquired. It requires further exposure and patience.

  • 3
    Food texture

    Today there are diverse approaches on the texture and form of food that may be offered to infants. When choosing to try out a certain approach, whether involving food ground into a smooth texture or soft or hard food that can be held in the hand, it is very important to take into account the infant’s willingness and the manner of feeding with which you will feel safe and relaxed.
    In general, the recommendation is to advance with the texture of food offered to infants according to their age and ability. If at 6 months’ age they are given pureed food, from 7 months it is recommended to switch to a coarser food texture, such as: soft fruits and vegetables mashed with a fork, grated hard fruits and vegetables, well-cooked orange lentils and the like. From 9 months’ age, if the infant is willing enough, you may offer soft or hard food in small pieces that may be picked up using the fingertips and which they can put into their mouth unassisted.

    Important information on the subject: safe feeding for preventing asphyxia, is waiting for you here

Feeding infants

Meals are a great family time. Sitting together with your baby by the table is an excellent opportunity for them to get to know and feel different food types. During meals, try to avoid distractions such as games, screens and television. It is recommended to let infants eat independently, feel the food, try to hold it and put it in their mouth. Getting dirty is fine too. Let them get to know textures, flavors and temperatures. Creating a relaxed, pleasant atmosphere during a meal will help them develop positive feelings towards sitting at the table, nourishing food and the time devoted to dining.

To maintain a positive attitude around the table, it is recommended to adopt paced feeding rules, based on mutual respect and listening to the infant’s needs – whether they are still hungry or have had enough, whether the food is tasty and what they prefer.

It is worth avoiding continuing to offer infants food when they signal that they are not interested, even if you think they have not eaten enough. Respect their wishes to finish their meal. This course of action is important for maintaining infants’ ability to sense hunger and satiety and is also very important for maintaining a positive eating experience.

Before serving food to an infant, it is very important to test its temperature to make sure it is not too hot or too cold. It is worth serving the food in a dish or bowl and during the meal hand them a teaspoon but let them eat with their fingers too. That way they practice chewing and try out eating independently.

The period of familiarization and experimentation with supplementary foods allows infants to get used to new mouth movements gradually, such as actions with the lounge, synchronizing swallowing and more. Eating with a pacifier, or a fruit feeder pacifier increases the risk of dental caries, impairs the hunger and satiety mechanism, reinforces the sucking action and prevents trying the transition to eating solid food.

Try not to force or manipulate them into eating more than they indicate they want. Maintaining infants’ natural hunger and hunger mechanism is very important for later in life and for preventing obesity in adulthood. You may offer infants a certain food again if they show no interest in it the first time.

It is recommended to start with a small quantity, gradually increasing it according to your infant’s wishes and signals. Infants who express a wish to continue eating can be given more. The quantity of food is determined by their hunger or satiety and may vary from one meal to the next during the day.

Before starting to prepare or serve food, it is always important to wash your hands with soap and water and work on clean surfaces in the kitchen and on the dining table. It is important to rinse well and peel uncooked fruits and vegetables.

Recommended foods for infants

  • Healthy, balanced nutrition: it is recommended to ensure balanced, diversified nutrition, based on fresh, raw, unprocessed and home prepared foods: legumes, cereals, fruits and vegetables (poultry, turkey, beef), fish, eggs and olive oil. In vegetarian and vegan families it is worth consulting a nutritionist specializing in child nutrition.
  • Iron: it is important to combine foods rich with iron into the menu such as meat, poultry, turkey, beef, fish and legumes. For improving iron absorption, it is important to add fresh fruits and vegetables rich with vitamin C into the same meal, such as tomatoes, peppers, citrus fruits and more.
  • Fish: the Ministry of Health recommends to the entire population, including children, to consume fish and diversify fish types in their menu. There is no need to restrict the quantity of fish but diversification is important. Make sure to remove small bones from fish flesh or grind them well.
  • Dairy products: dairy products are low in iron, so it is not a good idea to make them the key ingredient in infant nutrition. One can combine some unsweetened dairy products (such as cream cheese, yogurt, sour cream) into meals.
  • Plant substitutes: plant based milk substitutes such as soy milk, rice beverage, oat beverage, almond and sesame beverage are not suitable for use as a main food source in the menu.
  • Water: when infants start to eat supplementary foods, it is also the right time to start letting them drink water. Sweetened beverages are not recommended at all.

We recommend reading more on the "food rainbow": creating a balanced menu for the whole family

Foods that should be avoided

  • Until the age of one year, infants should not be given cow’s milk to drink

    You can offer foods containing cow’s milk such as cream cheese, but do not offer cow’s milk as a drink or a substitute to infant formula or breast milk.

  • Until the age of one year, infants must not be given honey

    Giving infants under one year’s age honey may cause botulism, an acute neurological disease. This disease is caused by a toxin produced by the clostridium botulinum bacterium. The symptoms of the disease include: blurred vision, difficulty speaking and difficulty breathing. After the first year of life, infants can be given honey but you do not have to introduce them to honey.

Foods we recommend to avoid

  • There is no need to buy food that is especially made for children and infants, even if it says "baby food" or "enriched with minerals and vitamins" on it. In many cases, it is processed, industrial and packed food that is more expensive, may contain large amounts of sugar, salt and saturated fat, and might create monotonous, unhealthy eating habits.
  • It is advised to avoid foods such as snacks for infants, sweetened cereals, fruit juices and smoothies, because they may impair your children’s acquisition of eating habits.
  • Foods containing soup powders or a large quantity of salt. It is recommended to eat as little high sodium food and salted snacks as possible. There is no need to add salt to foods that you give to infants, even if you are accustomed to salting these foods when you eat them yourself.

Note

Note

it is recommended to avoid heating baby food in a microwave oven. Microwave heating is uneven and may cause burns.

Foods that might cause asphyxia

  • Hard fruits and vegetables: these need to be cut into small pieces, pureed, grated or ground.
  • Round foods such as grapes and cherry tomatoes: these need to be split in half lengthwise and cut into small pieces.
  • Children under the age of 5: must not be given nuts, hazelnuts and seeds, popcorn, candy and gum. Candy and gum are not recommended for health reasons at any age.

For further information on safe feeding of infants and children to prevent asphyxia

Nutritional supplements for infants

  • Vitamin D: a dose of 400 IU (international units) a day from birth to one year’s age. The supplement is provided in drop form and should be given using a teaspoon.
  • Iron: the supplement is provided in drop form and should be given using a teaspoon.
    • From 4 months’ age* to half a year – a dose of 7.5 mg a day.
    • From six months to a year and a half, unless you have been guided otherwise – 15 mg a day.
    • Note: there are other directions for preterm infants.

*From the day on which the infant is 4 months old.

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