Introducing Solid Foods to Your Premature Baby

Mother feeding her baby
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Most full-term babies will follow a fairly predictable pattern of development, and the standard advice given in regards to introducing solid foods to infants in the first year of life is based on this pattern of development and developmental milestones. However, preterm babies often do not reach developmental milestones at the same time or pace as full-term infants.

Preterm babies have special nutritional needs. When introducing solid foods to premature babies, it is important to use their corrected age rather than their actual age, as it will be more of an indicator of when they are developmentally ready.

“Corrected age” is used because normal development relates to when a baby was due to be born, rather than the birth date. 

The World Health Organization and the American Academy of Pediatrics recommend that babies be breastfed exclusively for the first six months. Around six months, they recommend that you begin introducing complementary foods, but continue breastfeeding through the end of the first year and longer if desired. Solid food should never be introduced before four months of age, and your baby should display signs of readiness before trying his or her first bite.

Introduce your baby to solid foods around six (corrected or adjusted) months of age.

The following is a chart that is very helpful in assessing when your baby may be ready to handle new foods and textures. It’s important to know that every baby is different and foods should only be introduced when your baby shows signs they are developmentally ready.

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 important to delay the introduction of solid food (preferably 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, and preferably one every two days or so while you watch for reactions and allergy signs such as sneezing, runny nose, a rash, or a change in stool. Your baby may also show signs of an allergy by a change in mood or behavior, such as an increase in fussiness or inability to sleep or soothe. that has some good information and a schedule for introducing solid foods to babies to avoid allergies. Keep in mind when you look at this article to use your baby’s adjusted age instead of using their actual age, as well as the chart listed above to see if your baby is ready to take on the challenge.

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