|GUIDELINES FOR SUCCESS
ENHANCING INFANT READINESS FOR
Infants need only breast milk
or formula for their first 4 to 6 months. The most common
question that parents ask their pediatricians and
extended family members is "When should I start my
baby on cereals, fruits, and vegetables". Many
infants are ready for this step at 4 months. Others need
to wait until they are 6 months. A baby who has been ill
or has experienced difficulty eating may need to wait
much longer. It all depends on the child. Babies give us
cues that let us know when they are ready. This helps
their parents identify the best time to introduce this
new step in feeding. Babies who are ready learn quickly
and are happier eaters than babies who need to wait a
bit. Babies are their own experts in eating. They know
when to move on to the next step. When your baby gives
you the weight, physical, and sensory cues listed here,
you can offer the first supplemental foods. Use ideas
from this guideline to make learning to eat from a spoon
as easy as possible for you and your baby. Observe your
baby's mealtime communication, mouth, and learning cues
during the first week to decide whether you'll continue
to offer supplemental foods or whether you will wait for
another week or two.
The baby who is growing rapidly and always seems
hungry may need extra calories from supplemental foods to
support growth and satisfy hunger. Supplemental foods are
foods fed in addition to the baby's regular diet of
breast milk or formula.
- Weighs 13 lbs. and has doubled the birth weight.
Physical cues tell us that the child is developing
good control of the head and trunk which support mouth
skills for eating.
- Holds the head up and supports weight on the
forearms when lying on the tummy.
- Pushes up on the arms with straight elbows when
lying on the tummy.
- Holds the head up while sitting on a lap. Adjusts
the head and maintains head control when tipped
slightly backward or forward.
- Back is straight in supported sitting on the lap.
Sits with less assistance and reaches out for a
[If your child has problems controlling the muscles of
the body because of a physical disability, head and trunk
support during eating will be provided by your body or a
special chair. You don't have to wait to introduce spoon
foods until these physical cues are present.]
The child is seeking important information about
texture, and is developing an acceptance of objects in
the front of the mouth. This prepares for the feeling of
the spoon and new food.
- Puts hands in the mouth easily and frequently.
Discovers variations in hand mouthing patterns,
sometimes sucking a fist, sometimes a thumb, and
sometimes several fingers and a thumb.
- Reaches for toys and brings them to the mouth.
Likes the feeling of different types of toys in
[If your child has physical problems bringing the
hands to the mouth, you may help. Look for the child's
response when fingers or toys are brought to the mouth.]
Mealtime Communication Cues
The child knows if he or she wants to eat and how much
food is needed. Children who use these communication cues
can guide the person feeding them.
- Uses non-verbal communication cues to say
"yes" and "no" clearly during
non-feeding activities such as diaper changes,
bath time, or play.
- Says "yes" to the food. Uses non-verbal
mealtime communication cues:
- Leans the body toward the spoon and food.
- Reaches for the spoon or the feeder's
- Looks at the food and smiles.
- Opens the mouth and begins to suckle.
- Makes happy sounds.
- Says "no" to the food. Uses non-verbal
mealtime communication cues:
- Turns the head and body away from the
spoon and food.
- Looks down or plays with food on the
- Pushes the spoon or the feeder's hand
- Looks distressed or unhappy.
- Closes the mouth tightly as the spoon
When the child has developed the type of tongue
pattern necessary for moving food to the back of the
mouth and swallowing eating is much easier.
- Opens the mouth easily when the spoon approaches
or touches the lips.
- Keeps the tongue inside the mouth when the spoon
- Uses a rhythmical forward-backward suckle motion
of the tongue as the food enters the mouth.
- Food stays inside the mouth and is not constantly
- Draws in the bottom lip
Babies go through a
period of learning to eat solids just as they
need time to learn any new skill. You can enhance
your baby's abilities in each of the eating
readiness areas. The following suggestions will
help this learning period be easy and successful
for both of you.
Food Selection Guidelines
- Single-grain infant cereal is often the
first starting food fed after breast milk
or formula. Rice cereal is ideal because
it is likely to be well tolerated by your
baby and is iron-fortified. At the
beginning, mix the cereal with breast
milk or formula.
- Other single-ingredient solid foods and
fruit juices can be added in the order
your pediatrician or dietitian suggests
until your baby is eating a variety of
foods. These starting foods should have
texture, nutrients, and flavor suitable
- These starting foods should be added one
at a time at intervals of three to four
days. You can watch for signs (such as a
skin rash) that the food might not agree
with your baby.
- A good body position will make it easier
for your baby to relax and use good mouth
control. Support your baby in a secure
upright or slightly reclined position on
- Because it takes more physical control to
hold the head up while eating from the
spoon, you should begin with your baby's
body slightly reclined to make first
learning easier. Provide head support
with your body or a pillow if your baby
wants to lean back.
- When your baby keeps most of the food in
the mouth, you can use an adjustable
infant seat for more upright supported
sitting. If your baby can sit without
much support, you can use a high chair.
- Encourage and enjoy the times your baby
sucks the hands and discovers fingers in
- Choose toys for your baby that have been
safely designed for infants. These toys
should be easy to hold in tiny hands.
Think about the different mouth
sensations that a toy can provide.
Consciously select toys that provide many
- Remember that your baby is constantly
learning from everything that goes in the
mouth. The mouth is the most sensitive
and intelligent part of the baby's body
for first learning. The baby learns about
important sensations such as shape,
texture, and firmness by putting fingers,
toes, blankets, pacifiers, and infant
toys in the mouth. This information
prepares the mouth and provides readiness
for the new feelings of a spoon and
- When you start new foods, begin with
small tastes that your baby can suck off
your finger, hands, or a pacifier. It's
much easier for the baby to get used to
new tastes first before learning to suck
and swallow a mouthful of the new food.
- Make slight changes in the thickness or
thinness of the cereal. Many babies learn
to eat more easily if the cereal is very
thin. Others do better when it is
thicker. Find just the right consistency
for your individual baby. Remember that
as your baby develops and eating becomes
easier, a different consistency may be
needed. You can also make infant fruits
and vegetables thinner by adding juice or
water, and can thicken them with rice
- Introduce the first taste of fruit by
mixing infant juice with a favorite
cereal. Apple juice mixed with cereal
prepares for the new taste of applesauce.
Pear juice with cereal makes the
transition to pears easier.
Mealtime Communication Guidelines
- Listen! Recognize and remember the
non-verbal ways your baby communicates
needs and desires.
- Your baby should always be the leader.
When your child says "no", or
"no more", the feeding should
stop. When the baby says "yes",
offer more food and enjoy your mutual
delight and exploration of the meal.
- When mixed "yes-no" messages
occur, make small changes to find out
what part of the meal your baby doesn't
like. You might reposition the baby for
greater physical comfort, offer a more
familiar food, change the temperature of
the food, or return to the bottle or
- Resist the temptation to get your baby to
take "just one more bite" or
finish the jar of baby food.
- Encourage a rhythmical in-out suckle
movement of the tongue. Gently stroke the
lips with the spoon to get the suckling
movements started before you put a small
amount of the food in the mouth. Don't
dump food on a quiet tongue. Let your
baby use movement to bring the food into
- As your baby becomes more experienced,
the mouth will open and the tongue will
be quieter as you present the spoon
slowly. When you put the spoon in, the
top lip will come down on the spoon to
help bring the food in.
- Allow enough time between spoonfuls so
that your baby can adjust the mouth and
signal for the next one.
- If your baby has trouble developing a
good suckling rhythm with the spoon, you
can use an orthodontic pacifier as a
first spoon. If the baby has been using
this type of pacifier, a strong suckle
pattern naturally follows when it is
placed in the mouth. Dipping the pacifier
in cereal may allow the baby to
generalize a suckling movement to food.
Gradually introduce the spoon again when
your baby is ready.
- Many babies will spontaneously put their
hands in the mouth and suck their fingers
along with the food. Even though it may
be messy, your baby has discovered a
wonderful way to learn to suck and
swallow the food more quickly.
- You can help your baby learn to eat
supplemental foods more easily and with
greater enjoyment when you are calm and
relaxed. Sit with the baby in a rocking
chair and play soft, relaxing music to
create a relaxed atmosphere for both of
you. Remember that your initial goal is
to help your baby learn and enjoy a new
skill. It doesn't matter how much or how
little food is actually eaten at this
- Give some formula or breast milk first so
that your baby is not extremely hungry
when you try the new food. Babies are
impatient when they are very hungry and
may not want anything new. Your child's
motivation and interest in new tastes and
foods will be much higher after the first
hunger is satisfied.
- Follow the suggestions given in the
physical, sensory, and mealtime
communication areas. These will enhance
your baby's readiness and make it easier
to learn the new skill of eating
- Encourage tasting and eating the food,
but don't force your baby to continue;
stop when the child tells you "no
more". Conclude the meal while
everyone is still feeling happy and
successful. Finishing on a positive note
will ensure that the next mealtime is
just as pleasurable and successful.
- Let your baby know you are delighted with
this new learning. Be supportive and
encouraging even if it is initially
- If your baby doesn't enjoy the new eating
experience or if you are constantly
recycling the same spoonful of food, put
the food away and try again next week.
Remember there is a wide variation in
eating readiness, and only your baby
knows when the time is right. Respect
your baby's innate knowledge, and remind
yourself that waiting for another week
(or month!) does not mean that either of
you has failed. You have both succeeded
in communicating readiness and respect to
each other. If you trust your baby's
physical and emotional signals of
readiness, you will find exactly the
right time for introducing supplemental
foods so that both you and your baby can
enjoy this new accomplishment.
- A baby or young child who experiences
problems with postural tone and movement
may experience added challenges in
learning to eat from a spoon. These
guidelines will give you many good ideas
in helping all children learn to eat soft
solid foods from a spoon. However, some
changes or modifications will be needed
if your child has a physical or sensory
Suzanne Evans Morris, Ph.D.
1124 Roberts Mountain Road
Faber, Virginia 22938
This paper is a
working draft and multiple copies may not be
without prior written permission of the author
© Suzanne Evans Morris, 1997 All Rights Reserved