Starting your baby on solid foods is exciting — and messy! Most babies start with a very small amount of age-appropriate solid food between 4 to 6 months old and will continue to rely on breast milk or iron-fortified formula for their nutrition. Then, at around 9 to 11 months old, you may start noticing a dramatic drop in how much breast milk or formula your baby drinks as more nutrition and calories come from solid foods.
Because of their changing dietary needs over this transition, it is important that infants get the nutrition they need to grow and develop. For some children, this means working with a healthcare provider to fill nutritional gaps with carefully chosen supplements.
Babies are born with a store of iron that lasts them for about 4 to 6 months. The American Academy of Pediatrics recommends that full-term infants who are exclusively or mostly breastfed be given an iron supplement starting at 4 months of age. Talk to your baby’s healthcare provider about how long to continue an iron supplement after your baby begins eating iron-containing solid foods. Formula generally is iron-fortified, so formula-fed babies rarely need an iron supplement.
Children born premature or with a low birth weight may have reduced iron stores. If so, your baby’s healthcare provider will probably recommend iron supplements until your baby is at least 6 to 12 months old. This may be needed even for some formula-fed babies.
As infants begin to eat more solid food, serving them iron-rich foods such as iron-fortified cereal, meat or beans at least twice per day will help them meet their iron needs.
To promote iron absorption from plant foods, combine iron-rich solid foods you serve to your child with vitamin C-rich foods in one meal. For example, pair a bean and rice puree or finger food meal with tomato sauce or a fruit puree.
Vitamin D is important for healthy bones. Because low levels of vitamin D are so common, the American Academy of Pediatrics says all breastfed infants (whether completely or partially breastfed) — and formula-fed infants who drink less than 32 ounces of formula per day — should take a supplement beginning within a few days of birth. When starting solids, you can mix vitamin D drops in purees as well as add them to formula or water.
The AAP does not recommend fluoride supplementation for babies under six months of age. Fluoride supplementation may be necessary after that time based on levels of fluoride in your local water supply. Fluoride supplements are only available by prescription, so discuss this with your baby’s healthcare provider.
Vitamin B12, which prevents anemia and supports healthy neurological function, is found in animal products such as meat, fish, eggs and dairy, and is not a concern for most children. However, a vegan mother who exclusively breastfeeds should be sure to consume adequate vitamin B12 through fortified foods and supplements in order to provide ample B12 to her baby via breast milk. And if you plan to introduce only plant-based foods into your child's diet, a B12 supplement may be necessary. Formula-fed vegan babies can get their vitamin B12 from a special fortified formula, most often soy-based. Vitamin B12 typically is included in most over-the-counter infant vitamin drops and many fortified ready-to-eat cereals and soy milk.
Before giving your infant any supplements, always consult with the baby’s doctor. Not all infants automatically need supplements when starting solids. Once your baby is tolerating solid foods, make sure to introduce a variety of foods from all food groups in order to develop his or her palate and meet nutritional needs.