At what age is it best to introduce foods to an infant feed something other than breastmilk or baby formula quizlet?

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

When Can My Baby Try Solid Foods?

Doctors recommend waiting until your baby is about 6 months old to start solid foods. Some babies may be ready for solids sooner than 6 months, but wait until your baby is at least 4 months old.

Babies who are ready to eat solids foods:

• are interested in foods (for example, they may watch others eat, reach for food, and open their mouths when food is near)
• hold up their heads well, and sit up with little or no help
• don't push food of their mouth (which is a natural tongue reflex that disappears when babies are 4–6 months old)
• usually weigh twice their birth weight, or close to it

Talk to your doctor about the right time to start solid foods.

How Do I Introduce Solid Foods?

When the time is right, start with a single-grain, iron-fortified baby cereal. Start with 1 or 2 tablespoons of cereal mixed with breast milk, formula, or water. Feed your baby with a small baby spoon. Don’t add cereal to a baby's bottle unless your doctor recommends it.

When your baby gets the hang of eating the first food, introduce other foods from all food groups, such as puréed meats, fruits, vegetables, grains, beans, and yogurt. Wait a few days between introducing new foods to make sure your baby doesn't have an allergic reaction.

You can include foods that are more likely to cause allergies — such as peanuts, eggs, cow’s milk, seafood, nuts, wheat, and soy — among the foods you introduce to your infant. Waiting to start these foods does not prevent food allergies.

Talk to your doctor before giving foods that contain peanuts if your baby has severe eczema or an egg allergy, as these conditions make an allergy to peanuts more likely. Eating peanut-containing foods early on may lower a child’s chances of developing a peanut allergy. But your doctor will need to decide if you can give peanuts to your baby, and the safest way to do it. Usually, this requires allergy tests.

Should We Avoid Some Foods?

Yes, don’t give your baby:

• foods with added sugars or no-calorie sweeteners
• high-sodium foods
• honey until after the first birthday. It can cause botulism in babies.
• unpasteurized juice, milk, yogurt, or cheese
• regular cow's milk or soy beverages instead of breast milk or formula before 12 months. It’s OK to offer pasteurized yogurt and cheese.
• foods that may cause choking, such as hot dogs, raw carrots, grapes, popcorn, and nuts

Always supervise your child when eating. Make sure your child is sitting up in high chair or other safe place.

When Can My Baby Have Cow's Milk?

Before their first birthday, babies still need the nutrients in breast milk or formula. But after that, they’re ready to switch to cow's milk.

Most kids under age 2 should drink whole milk. If a toddler is overweight or there is a family history of obesity, high cholesterol, or heart problems, your doctor might recommend switching to reduced fat (2%) milk.

If your child can’t drink cow’s milk, choose an unsweetened soy beverage fortified with calcium and vitamin D. Other milk alternatives, like almond, oat, rice, or coconut milk, have less protein and may not be fortified.

How Do We Switch to Cow’s Milk?

You can switch your baby from formula to whole milk by replace bottles of formula with bottles — or sippy cups — of milk. By 1 year old, your baby should be eating a variety of solid foods and drinking about 16 to 24 ounces (480–720 milliliters) of milk per day.

When Can I Start Giving My Baby Water and Other Drinks?

In their first 6 months, healthy babies drinking enough formula usually don't need extra water. Once your baby is eating solid foods, you can offer a small amount of water between feedings, up to 4–8 ounces a day. 

Water that has fluoride helps prevent tooth decay. If your water does not have fluoride, talk to your doctor or dentist about fluoride drops.

Do not give juice to babies younger than 12 months. After your child’s first birthday, limit 100% fruit juice to no more than 4 ounces a day. Always serve juice in a cup, not in a bottle. Don’t give your child sugar-sweetened beverages, including soda, juice drinks, sports drinks, and flavored milks.

The purpose of this study is to see if it is safe to give nevirapine (NVP) to breast-feeding babies from birth to the age of 6 months and to determine what dose of NVP should be given.

Breast-feeding has been shown to be very important for the physical and mental health of infants. This is especially true during the first 6 months of life. However, an HIV-positive mother can pass the virus on to her baby by breast-feeding. Because of this risk, HIV-positive mothers are encouraged to formula-feed, not breast-feed, their babies. In developing countries, however, some women cannot afford to formula-feed. If they do formula-feed, these women risk exposing their HIV status. These women have great need for methods that can lower the chance that they will pass HIV on to their babies. This study will test NVP as a way of doing this.

Breast-feeding is of such critical importance to the general health of the infant, as well as the mother-infant relationship, that special efforts should be made to retain this practice even during the HIV pandemic. Breast-feeding is associated with lower rates of infant gastrointestinal infections and protects against high infant mortality from respiratory and gastrointestinal diseases. These protective effects are greatest in the first 6 months of life. However, HIV is transmitted through breast-feeding. HIV-infected women whose circumstances permit them a choice between breast- and formula-feeding have been encouraged to formula-feed. But in developing countries there are HIV-infected women who cannot afford to formula-feed or who, knowing the risks, choose to breast-feed. In these societies, HIV-infected women who deviate from the cultural norm of breast-feeding risk exposing their HIV status and becoming prey to negative social implications. For this group of women, defining strategies that can reduce their risk of transmitting HIV to their infants is essential. Based on data from previous studies, this study proposes to test the hypothesis that NVP will reduce breast-feeding transmission of HIV.

Pregnant HIV-positive women take an oral dose of NVP at the onset of labor. A second dose of NVP will be given 48 hours after the first dose if the woman remains in labor. Infants who initiate breast-feeding are randomized to 1 of the 3 study arms below and receive their first dose of NVP within 48 hours of birth.

Arm 1 receives NVP once a week, Arm 2 receives NVP twice a week, and Arm 3 receives NVP daily. There is no placebo control group. The first 18 infants enrolled in each arm will contribute pre- and post- NVP dose blood samples for pharmacokinetics. The remaining infants will contribute data on safety and pre-dose NVP levels only. Infants return to the clinic weekly for visual assessment of NVP toxicity. Women are counseled to stop breast-feeding their infants by the end of 6 months. Infants receive their last dose of NVP at either 24 weeks of age or 1 week after breast-feeding cessation, whichever occurs first, and have follow-up visits until the infant is 32 weeks old.

Inclusion Criteria

Mothers may be eligible for this study if they:

• Receive prenatal care at King Edward VIII Hospital, Durban, or St. Mary's Hospital, Marianhill, South Africa; or polyclinics in Chitungwiza District, Zimbabwe.
• Are pregnant for at least 30 weeks before giving birth.
• Are at least 18 years of age.
• Are HIV-positive by 2 ELISA tests.
• Have no serious current or previous problems in pregnancy (e.g., seizures).
• Have a fixed home and/or work address.
• Plan to deliver the baby at a hospital or clinic where the study is based.
• Plan to breast-feed their babies.
• Infants may be eligible for this study if they:
• Are born to women participating in this study.
• Weigh at least 2.5 kg at birth.
• Begin breast-feeding by 48 hours.

Exclusion Criteria

Mothers will not be eligible for this study if they:

• Have AIDS or any other serious illness.
• Are using illegal drugs or have been using alcohol for a long time.
• Are sensitive to NVP.
• Have taken any nonnucleoside reverse transcriptase inhibitors in the past.
• Are using rifampin, rifabutin, ketoconazole, macrolides, or cimetidine.
• Infants will not be eligible for this study if they:
• Have jaundice (yellowing of the skin and whites of eyes) that requires a blood transfusion.
• Have any serious or life-threatening condition(s).

National Institute of Allergy and Infectious Diseases (NIAID)

Publications of Results:

Lee EJ, Kantor R, Zijenah L, Sheldon W, Emel L, Mateta P, Johnston E, Wells J, Shetty AK, Coovadia H, Maldonado Y, Jones SA, Mofenson LM, Contag CH, Bassett M, Katzenstein DA; HIVNET 023 Study Team. Breast-milk shedding of drug-resistant HIV-1 subtype C in women exposed to single-dose nevirapine. J Infect Dis. 2005 Oct 1;192(7):1260-4. Epub 2005 Aug 23.

Shetty AK, Coovadia HM, Mirochnick MM, Maldonado Y, Mofenson LM, Eshleman SH, Fleming T, Emel L, George K, Katzenstein DA, Wells J, Maponga CC, Mwatha A, Jones SA, Abdool Karim SS, Bassett MT; HIVNET 023 Study Team. Safety and trough concentrations of nevirapine prophylaxis given daily, twice weekly, or weekly in breast-feeding infants from birth to 6 months. J Acquir Immune Defic Syndr. 2003 Dec 15;34(5):482-90.

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):

Additional relevant MeSH terms: