As a parent, what your child eats rests mainly in your hands—beginning as soon as you bring your baby home from the hospital. And since nutrition is incredibly important for your child’s health and development, it’s good to know exactly what foods and feeding processes are recommended as your new baby grows to a preschooler. Dr. Alan Yedwab, pediatrician at Doctors Hospital, stresses the significance of being an informed parent when it comes to feeding your youngster.

0-4 MONTHS
"During the first four months of life, babies should be fed only breast milk or formula," Dr. Yedwab said. Unfortunately, many new mothers feel their newborns are ready for solid foods at less than four months. They may say, "Other mothers do it," or "Mom says it’s OK." Another myth is the belief that feeding a baby solid food, such as cereal, will help the infant sleep through the night. "This is not true," Dr. Yedwab warns.

In fact, the effects of feeding solid food this early do pose health risks (and possibly many sleepless nights!). A baby’s digestive system or immature kidneys may not be ready for solid foods at such a young age, and could cause upset stomach, food allergies, constipation or diarrhea. Straying too early from only breast milk or formula could also lead to an overweight baby. Additionally, one greater health hazard that could result from early solid food feedings is choking.

In contrast, the safest feeding methods during the first four to six months of life are breast-feeding or feeding your baby formula. While each method provides sufficient nutrient needs, breast-feeding is ideal, as it contains at least 100 ingredients not found in formula. The protein content is also particularly suited for a baby’s metabolism, and the fat content is easily absorbed and digested. Most importantly, the breast milk produced and fed to a baby during the first days after birth provides immunological protection from various bacteria and viruses.

The second best alternative to breastfeeding is feeding your baby instant formula. Commercial formulas, when properly prepared, are sterile and safe. Your baby will receive adequate amounts of vitamins and minerals, including essential fatty acids and lipids.

At the age of four months, begin checking for signs that your infant is ready for solid foods.

• First, notice if your baby can sit up with support and can control his or her head. This will allow your baby to communicate with you during feeding time, letting you know he or she is possibly not hungry anymore or not ready for the next spoonful.
• Next, see if your baby can control upper body movements, which is important in pulling forward when food is wanted or moving back when he or she is full.
• Also, become aware of your baby’s tongue. Does he or she keep pushing food out? This is the "extrusion reflex" that babies usually have until the age of three months. It is useful in sucking, but not so useful in eating solid foods.
• Finally, the best checkpoint in determining if your baby is ready for solid foods is to consult your pediatrician. Your doctor can give you the green light for starting solid foods, while also providing valuable information on the proper steps of how to do so.

4 MONTHS to 1 YEAR
As you prepare to introduce solid foods to your baby, an important precursor to remember is that breast milk or formula should remain the mainstay of your baby’s diet throughout the first year. Do not use raw or pasteurized cow’s milk during this time (not until after one year of age). This type of milk is difficult for a baby’s system to digest.

When the time comes to add to this core diet of breast milk or formula, pediatricians recommend keeping in mind a certain methodology when introducing solid foods. For instance, introduce only one food at a time. Begin feeding only a small amount—about one teaspoon twice a day, and increase this to about two or three tablespoons twice a day. Then, wait a week before introducing another food, allowing time to watch for any reactions your baby may have to the new food. Reactions to watch for include vomiting, diarrhea, wheezing or skin rash.

The best solid food to first introduce to your baby is dry infant cereal. "I usually suggest rice cereal as a start, since it is least likely to cause a reaction," Dr. Yedwab said. Oat or barley cereal is recommended next. These commercial cereals can be mixed with breast milk, formula or water, depending on the package you purchase and its instructions. All varieties, when prepared properly, will meet your baby’s iron requirements.

After one month on cereal, strained fruits and vegetables may be offered. Remember to introduce only one fruit or vegetable at a time, and watch for any sensitivity to the new food. Dr. Yedwab’s recommendation is to begin with fruits, then progress to the sweeter vegetables (carrots, sweet potatoes), before finally moving to the more plain vegetables, such as green beans.

Strained, lean meats may be offered once your baby accepts fruits and vegetables. Again, offer a single meat at a time, and only introduce cooked egg yolks after such meats have been accepted. (Egg whites should wait until your baby turns one year old, since they may cause a food reaction.)

At nine to twelve months, you may begin feeding finger foods to your baby, such as hard toast, melba toast, bananas and crackers.

1 to 2 YEARS
At one year, it is time to start weaning from the bottle. Begin to teach your child to drink more from a cup. Juice is suitable, and cow’s milk is now tolerable between these ages. However, Dr. Yedwab does not recommend feeding your baby low fat or skim milk. "These derivations of whole milk do not provide enough calories that are necessary to a small child’s growth and development," he warns. Also, the proportions of minerals and protein found in low or skim milk add strain on your baby’s kidneys, running a risk of dehydration.

During these ages, parents will also be glad to know that feeding their children can now follow the standards set out by the Department of Health and reflected in the Food Guide Pyramid. Feed your child mostly those foods that are within the "Bread, Cereal, Rice and Pasta Group," followed by "Vegetables;" then from foods that fall in the "Milk, Yogurt and Cheese" category. Portions of "Fruits" and "Meats" are next, with "Fats, Oils and Sweets" to be kept at minimal servings. As you follow the pyramid guidelines, keep in mind that the number of servings and the size of portions for your child may be less than the standard recommendation. Furthermore, healthy snacks—like crackers instead of potato chips—should be made available to your growing child, outside of regular meal times.

3 to 5 YEARS
Continue following the Food Guide Pyramid during these ages. Snacks will remain an important component of your child’s diet—but they must be healthy snacks. Candy, chocolate and chips, for instance, should be replaced with fruits or perhaps graham crackers.

It is during these years that common feeding problems may occur. Your child may refuse to try new foods. "Do not force your child to eat," Dr. Yedwab counsels. "As a solution, try to prepare the food in alternative ways."

If your child has a small appetite, make sure that what your child does eat is nutritious, and offer healthy snacks often.

Many children won’t eat vegetables during this time. Again, Dr. Yedwab suggests trying various methods of preparation, even with a dip as a snack, for example. Another solution may be to involve your child at the grocery store, allowing them to pick out the vegetables. This creates an interest before the vegetable is laid on their plate.

If your child wants the same food over and over, Dr. Yedwab feels there is no harm in allowing this—if the desired food is not high in sugar or empty calories. "This is usually a phase that will pass," he encourages.

Some children may become overweight. Begin to implement changes in your child’s diet, by switching to low fat milk and dairy products. Control the amount of fat in food and when preparing food. Try to make sure your child is eating only when he or she is hungry. Regular exercise should also be placed into your child’s daily activities.

It’s amazing to think how much your baby will grow in the first five years. As an informed parent, and with the right feedings, you can make sure your youngster is given the proper nutrition during such an important time of development.

Dr. Alan Yedwab is on the active staff at Doctors Hospital. Contact 1-888-TENET-4U (1-888-836-3848) toll-free, 24 hours a day, seven days a week, for physician referrals.