A six-month-old baby is growing rapidly and interacting with the world. He is also ready to be weaned – that is, he is ready to have his milk intake gradually reduced and to get started on semi-solids.

Milk alone will not provide a rapidly growing six-month-old with all the nutrients he needs. It does not mean stopping his milk feeds, only reducing them, while introducing semi-solid foods. According to Ms Patsy Lim, Senior Staff Nurse, SingHealth Polyclinics – Outram, a member of the SingHealth group, starting semi-solids before six months is too early as a baby’s digestive system is not yet fully mature. It may put him at an increased risk of allergies or obesity.

She said six months is the best time to introduce semi-solids. “Signs that a baby is ready for this include ability to hold his head up, sit up with little or no support, and use his tongue to move food to the back of his mouth. He may also reach for and show interest in food,” said Ms Lim. In premature babies, weaning should be done based on the infant’s corrected age: A seven-monthold, born 10 weeks premature, has a corrected age of four and a half months.

Ms Lim is among a team of nurses who conduct free nutrition talks-cum-demonstrations for new mothers each month at various SingHealth polyclinics. These cover the types of food for babies and their preparations. Here are some tips from her talk.

1. To fuel growth

A baby’s food should contain carbohydrates, fats, protein, vitamins, and minerals including iron. “Always make feeding a happy time for your child. If you try a new food and your child won’t eat it, don’t force him. Try again two or three days later,” said Ms Lim.

2. Start slowly and proceed carefully

For a baby’s first food, start with a single grain cereal, preferably rice cereal as it is least likely to trigger an allergic reaction. The cereal can be mixed with milk, and as the child grows, the mix should get lumpier. “It’s not a good idea to offer smooth purees for a long time. The child will become lazy about chewing,” said Ms Lim.

  • Six months
    Food should have the consistency of pudding – smooth, soft, and fine in texture. The food can be mashed, sieved, pureed in a blender, or scraped with a spoon.
  • Seven to 10 months
    Textures should be introduced. Food ought to be soft and lumpy to encourage a baby to chew, thereby developing stronger jaw muscles which help in speech development.
  • 12 months
    Baby is now ready to graduate to joining in at family meals.

3. The extrusion reflex

Ms Lim alerted mothers and caregivers to what is called the extrusion reflex – when a baby pushes his tongue out upon being given food. “This does not reflect distaste for the food. The extrusion reflex is a natural reflex. A mother may misunderstand that her baby dislikes food,” Ms Lim said.

4. Mind the allergies

Introduce new foods early in the day so that there is ample time to observe the child in case he develops allergy symptoms such as rashes or swollen eyes and swollen lips, and needs to see a doctor. “If you start in the evening and symptoms develop in the middle of the night, you will have to rush your child to the A&E.” Also, if this occurs in the middle of the night, a caregiver may not even realise it is happening.

5. Prevent choking

“When a baby is not ready to open his mouth, don’t force food into his mouth. You don’t want the baby to choke. You also don’t want him to lose interest in eating,” said Ms Lim. With regard to bottle feeding, she warned against adding any food such as cereal to a bottle as it can cause choking. Infants must also not be left unattended after being given some food.

6. What to avoid

Ms Lim advised against giving a baby carrots daily for an extended period, as the carotene in the vegetable will give his skin a yellowish tinge. To prevent choking, avoid fibrous, veiny parts of vegetables and remove tendons from meats. Taste any fruit juice first to ensure it is naturally sweet instead of sour before giving it to a baby. Durians are a no-no, being too fibrous for babies.

Dos and Don’ts

  • Don’t add sugar, salt or spices to your baby’s food. Sugar increases calorie content without improving nutritional value. As food in its natural state already contains enough salt, adding salt may put a strain on a baby’s immature kidneys.
  • Introduce one new food at a time, and only offer ¼ to ½ a teaspoonful at a time. Use the tip of the spoon and let the baby suck the food.
  • Increase the amount and variety of food gradually; three flat dessert spoonfuls of cereal is enough for a six-month-old’s meal.
  • Allow your baby to handle a spoon and bowl. Don’t be fussy about neatness during a meal.
  • Fruit juice can be introduced at six months. Dilute it as it contains fructose (sugar) which can cause diarrhoea. Limit juice intake to 60ml a day.

Ref: Q15