Introducing Solid Foods to Your Premature Baby

Mother feeding her baby
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In the first year of life, most full-term babies will follow a fairly predictable pattern of development. The standard advice given to parents about introducing solid foods to infants is based on these typical developmental patterns and milestones.

However, preterm babies often do not reach developmental milestones at the same pace as full-term infants. Preterm babies also have special nutritional needs. When introducing solid foods to their preemie, parents need to use the infant's corrected age rather than their actual age.

“Corrected age” is used because normal development relates to when a baby was due to be born rather than their actual birth date. A preemie's corrected age is an important indicator of when they will be developmentally ready for solid foods.

Both the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend that all babies are exclusively breastfed for the first six months of life.

Around the age of six months (adjusted or corrected age), infants can start being introduced to complementary foods but should continue breastfeeding through the end of their first year (and longer, if desired).

Solid food should never be introduced before four months of age. Your baby should be displaying signs of readiness before trying their first bite.

Here's a chart that can help you assess when your baby might be ready to handle new foods and textures. Keep in mind that every baby is different. Wait until your baby is showing signs that they are developmentally ready for solids before you begin introducing new foods.

Introduction of New Food Developmental Ready?
Pureed foods and infant cereal, given with a spoon

—Can sit with support and has neuromuscular control of the head and neck.

—Can take food without choking or gagging.

—Can indicate a desire for food by opening the mouth and leaning forward.

—Can indicate feelings of fullness by leaning back and turning away.

—Strong extrusion reflex has faded, and infant demonstrates the ability to swallow non-liquid foods, to transfer food from the front of the tongue to the back, and to draw in the lower lip as the spoon is removed. (Does not push large amounts of food back out of the mouth while being fed.)

First finger foods and larger foods that won’t break into small pieces (teething biscuits)

—Can sit independently and maintain balance while using hands to reach and grasp objects.

—Grasps large pieces of food such as thick dry, infant toast, in a palmar grasp.

Sippy cups

Exhibits the ability to control the size of the sip and to manipulate liquid to the back of the mouth and swallow without choking or gagging.

Food with increased texture and flavor

Shows the ability to manipulate food in the mouth with definite chewing movements.

Begins side to side, lateral tongue movements.

Smaller, softer finger foods

Development of pincher grasp that allows the infant to pick up foods between thumb and finger.

Soft table foods

Has munching type of chewing.

Improved ability to manipulate tongue and food in the mouth.

Food Allergies

It's preferable that parents delay the introduction of solid food until six (adjusted) months to avoid food allergies. A good rule of thumb is to introduce new foods to your baby one food at a time.

Adding one new food every two days, for example, gives you time to watch for signs of an allergic reaction. Common signs of a food allergy in babies include:

  • Rashes or other skin signs like eczema
  • Runny nose and sneezing
  • Stool changes and other digestive issues

Some babies with food allergies will demonstrate behavioral changes. For example, they might seem fussy, be difficult to soothe, or won't fall or stay asleep well.

If your baby is exhibiting severe symptoms of an allergic reaction, such as difficulty breathing or vomiting that will not stop, seek immediate medical care.

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