Order of food introduction

In the previous presentation we learned that healthy exclusively breastfed babies with normal weight and growth do not need additional food until 6 months of age, when they should start receiving complementary foods.

This recommendation as we saw could be advanced by the pediatrician especially in infants who receive artificial breastfeeding. It should be taken into account that foods cannot be introduced before four months of age, as this could cause choking and serious digestive disorders, since babies are not mature enough to digest and assimilate foods other than milk.

Although there are no rigid rules as to the order of introduction of foods in the baby's diet, and family customs and preferences are generally followed, there are certain particularities and specific recommendations to incorporate some foods because they provide important nutrients or because of their complexity to be digested or because of their possible toxic contents.

In this presentation we will study the main aspects to take into account for the introduction of complementary foods.

In what order are complementary foods introduced?

Cereals: The first group of foods that can complement breastfeeding are cereals since their basic component - starch - can be perfectly digested after the fourth month of life.

It is currently known that the time of introduction of gluten does not change the risk of developing celiac disease, so it is recommended that after four months of age, both cereals that do not contain gluten -rice and corn- and those that contain gluten -wheat, barley, rye and oats- should be introduced.

With the introduction of complementary foods, should the baby start to be offered water?

Yes, as soon as the baby begins to receive complementary foods, water should be offered -which in case it is not drinkable should be boiled-. Water should be offered several times a day at times away from milk feedings. If the child rejects it, you should wait for a prudential time and offer it again, so that he/she gradually acquires the habit.

Important: Do not add sugar, honey, sweeteners or natural or artificial flavorings to get the child to drink liquids.

Dairy products: During complementary feeding it would not be necessary or advisable to introduce other dairy products -cheese, ice cream, butter, etc.- since milk continues to be the baby's main nutritional source, so the mother should continue to offer the breast on demand -between four and five times a day- preferably before meals. While infants who take formulas should continue to receive between four and five daily feedings of approximately 240 milliliters.

Children who for some reason do not receive the necessary quantities of breast milk or infant milk formulas could, from six months of age, introduce natural yogurts made from milk adapted to meet their milk needs.

Meat: Small portions of approximately 15 or 20 grams can be introduced from six months of age, incorporated into cereal porridges, mashed vegetables and vegetables. It should be taken into account that from the sixth month onwards, iron requirements are high, therefore meats, due to their high iron content, should be among the first foods to be introduced. You should start with milder tasting meats, such as chicken, turkey, rabbit and veal. Viscera should not be offered.

Fruits: Ripe and seasonal fruits can be introduced without adding sugar, honey or sweeteners from the fourth month of life; it is recommended to offer them preferably crushed or in the form of thick porridge; it is not advisable to offer them in the form of juices or in a bottle. Fruits should be offered daily as dessert and in snacks. All fruits are suitable: apples, pears, bananas, oranges, guavas, strawberries, kiwis, peaches and so on.

Important: For a long time it was recommended to delay the introduction of some foods considered potentially allergenic, including some fruits (peaches, kiwis, etc.), some fish (blue fish), shellfish, legumes and eggs. However, the competent authorities currently state that there is no evidence that the introduction of potentially allergenic foods should be delayed in order to prevent allergies. Vegetables: Vegetables, preferably steamed or cooked in a small amount of water in an open container, drained and mashed, can be introduced from the age of four months. It is recommended to start introducing potatoes, chard, green beans, tomatoes, Brussels sprouts and zucchini; salt cannot be added to vegetable porridges, but it is advisable to add a teaspoon of olive oil. Spinach, chard, turnip greens and beets should not be introduced before the age of one year because of their high nitrate content. Fish: They should be introduced from the sixth month, in very small portions. Both white fish -hake, hake, megri