Category Archives: Stage 3 Adventuring Into Solids

• Probably not.
• There’s no evidence that starting solids helps baby sleep any better than he did before. So, do not give solid foods to your baby earlier than 6 months with the hope that he will sleep longer. This practise is not advisable because starting solids too early will have some negative impacts on baby’s digestive systems and affect nutrients absorption. The recommendation is to start solids when baby is about 6 months old.

• Not true.
• It’s what’s going on inside that counts. Babies are ready for solid foods when their digestive systems are developed enough to cope. This is usually when baby is around 6 months old. However, every baby is different, so if you think your baby is ready, speak to your doctor about it.

• Not true.
• Breast milk gives the baby everything there is in other milks, and more. Babies should be started on solid foods after 6 months so that they learn how to eat and begin to replenish their iron stores and other nutrients that are not supplied in sufficient amounts by breast milk. Cow’s milk or infant formula will not be necessary as long as the mother continues breastfeeding the baby.

• Not true.
• New research recommends that foods considered highly allergenic, such as peanuts, tree nuts, milk, egg, wheat, soy, fish and shellfish, should be introduced to baby one at a time, after baby reaches his 6 months mark. This is with the exception of whole cow’s milk, which should be avoided until after baby turns 1. Delaying the introduction of these foods might actually increase the risk of a food allergy. However, more caution is needed if you have a family history of allergies. Always speak to baby’s doctor about it to ensure you can safely feed these foods for your baby.

• Not true.
• Research shows that new foods may need to be offered more than 10 times before baby will actually eat it. Whether baby has a true dislike of a certain kind of food can only be determined much later. In the early stages of introducing solids to baby, he will pull all kinds of funny faces as he tries to understand the textures and tastes of these new foods. These funny faces, and even a refusal to open one’s mouth for a feeding, do not necessarily indicate a dislike for a type of food. The idea is to keep trying and not give up.

• Not true.
• Baby juice is not special, nor is it magical. A better option would be to purchase 100% freshly squeezed juice, or to squeeze your own. Make sure store-bought juices do not contain other ingredients such as added sugar and food additives. Don’t give your baby more than 100ml or ½ cup of fruit juice a day. Too much fruit juice will affect your baby’s appetite during mealtimes, and also lead to excessive calorie intake, tooth cavities, diarrhoea and some digestive problems.

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.

Breastfed babies are hardly ever constipated, although they may not have a bowel motion for several days or up to a week. Even then, their poo will usually be soft.

Many babies go red in the face and strain when doing a normal poo. This is not a sign of constipation unless the poo is also hard, dry and crumbly, or like pellets, and the bowel movement seems to cause him pain and discomfort.

If your breastfed baby is constipated, it’s possible he isn’t getting enough breast milk, and you might need to feed him more often.

It may also be that the solids he’s eating are not right for him. Introduce the correct solid food for the age of your baby. Be aware that excessive use of legumes (peas, lentils and so on) and high fibre cereals are not appropriate for young babies.

What to do

• Breastfeed baby more often
• Do not increase your baby’s fibre intake by giving him more wholegrain cereals and fruit, vegetables and water as this approach may NOT be suitable for an infant with constipation. Follow the usual advice regarding introduction of solids for infants less than a year old.
• A gentle tummy massage or a warm bath may help your baby’s muscles to relax, so that he can poo as normal.

Most babies have occasional loose stools. Breastfed babies have looser stools than formula-fed babies.

Diarrhoea is when your baby frequently passes unformed watery stools. If this happens, contact baby’s doctor for advice, especially if baby has passed 6 or more such stools in the past 24 hours, or if he has vomited three times or more in the past 24 hours.

When your baby is suffering from diarrhoea/vomiting, the need for fluids is three times greater than usual.

What to do

• Frequent breastfeeding is required to prevent dehydration and provide nutrients required for recovery from infections.
• Oral rehydration fluids may be needed to replace the electrolytes lost during diarrhoea or vomiting. But speak to baby’s doctor before giving this to your baby.
• Even though your baby’s appetite may be reduced during illness, continue to feed him to ensure he gets the right amount of nutrients, and to enhance recovery.
• If your baby is not vomiting, continue to feed your child, but you may have to give your baby smaller amounts than usual. Encourage your baby to eat soft, varied, appetising and favourite foods that will not further upset the stomach.
• After illness, give food to your baby more often than usual as he needs greater nutrient intake to make up for losses during illness.
• Extra food is needed until the child has regained any weight lost, and is growing well again.

Most fevers are harmless and caused by mild infection. Regardless, you should tell your baby’s doctor about any fever that is higher than 38 degrees Celsius.

When your baby has a fever, the need for fluids is three times greater than usual.

What to do

• Frequent breastfeeding is required to prevent dehydration and provide the nutrients required for recovery from infections.
• Even though your baby’s appetite may be reduced during illness, continue to feed him to ensure he gets the right amount of nutrients, and to enhance recovery.
• Offer baby food if he has the appetite.
• After illness, give food to your baby more often than usual as he needs greater nutrient intake to make up for losses during illness and allow for catch-up growth.
• Extra food is needed until the child has regained any weight lost, and is growing well again.

For further information on infant and child nutrition, please refer to

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.

It’s important to pay attention to your baby’s appetite in order to provide optimal nutrition for your baby, and also to avoid overfeeding.

• Signs that baby is hungry:
• Turning to you/getting excited when he sees food or when food is offered
• Fussiness
• Crying
• Putting his hand in his mouth
• Chewing movements

• Signs that your baby may be full:
• Closing mouth as spoon approaches
• Batting away or refusing the spoon
• Show signs of wanting to leave the table or chair
• Becomes distracted by his surroundings

When baby refuses food

• Baby may be full, tired, distracted or sick.
• Always remember that your baby will eat when hungry, and will not starve to death through stubborn food refusal.
• Pay attention to signs when he is full and trust that your baby knows how much food he needs.
• Never force feed your child as this can turn feeding time into a battle time and may even result in overfeeding.

When baby avoids new foods

• Don’t give up if your baby is rejecting new foods. Research shows that a new food needs to be offered up to 10 times, or more, before baby will actually eat it.
• Just getting your child to taste the food will eventually lead them to accepting most foods in the future.

Helping baby accept new foods more easily

• Start with very small portions and offer new food to your child three times during a meal.
• Don’t overreact if your baby refuses. Move on to something you know he likes.
• Try offering the new food at another meal.

When infants are learning to manage new textures, they may gag or cough back food that needs more chewing. This is a natural part of the learning process, and parents should not to panic if it happens. It’s likely that baby just needs more experience to cope easily with the new taste and texture.

However, if an infant gags or coughs frequently after meals, you may want to speak to his doctor about it.

As for spitting up/regurgitation, this seems universal among babies. The good news is that spitting up tends to lessen as babies reach their first birthday.

Reducing the chances of spitting up:

• Burp him regularly
• Avoid overfeeding
• Keep baby upright when you feed him
• Avoid playing with your baby immediately after eating

For further information on infant and child nutrition, please refer to

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.

Food allergy

• When allergic to a food, the body’s immune system reacts to it as though it is toxic, releasing chemicals into the body’s tissues. The effects on the body can be quite major, even with tiny amounts of food

Food intolerance

• This is a reaction to a substance in the food you’re eating. Unlike allergies, intolerance is not caused by your body’s system reacting to the food, and is generally less severe

Prevalence

• 1 out of 3 Malaysians is currently suffering from some form of allergy.
• One of the most common allergies is food allergy.
• 60% of allergies appear during the first year of life. Therefore it is important that prevention of allergies should focus on infants and young children.

Causes

• About 90% of the food allergies are caused by the following foods:
• Cow’s milk.
• Hen’s eggs.
• Tree nuts (eg. Almonds, cashews, macadamia, pecans, pine nuts, walnuts, hazelnuts and pistachios).
• Fish and shellfish.
• The remaining 10% are caused by a wide variety of foods.
• In Asia, the most common foods causing allergies are eggs and cow’s milk, followed by seafood (fish and shellfish).
• Peanut and tree nut allergy is comparatively much lower than those in western counties.
• Wheat allergy is also less common in Asian countries.
• The most common food intolerances are caused by:
• Dairy products (lactose).
• Citrus fruit.
• The good news is that food allergies are often outgrown during early childhood. It is estimated that 80% to 90% of egg, milk, wheat, and soy allergies go away by the time a child is 5 years old.

1. Food Allergy

• Symptoms of food allergy include:
• Skin reactions, such as redness, hives or dermatitis.
• Itchy mouth or eyes.
• Vomiting, stomach pain or diarrhoea.
• Nasal congestion.
• Swollen lips or tongue.
• Swollen face, including swelling of eyelids and face.
• Anaphylaxis, a severe and life threatening condition. Your child might have a persistent cough, wheezing, hoarse voice, shortness of breath and difficulty swallowing. The child might even pass out.
• Thesymptoms of delayed-onset food allergies appear more than four hours after a child comes into contact with the food and sometimes many days later.
• Symptoms of delayed-onset food allergies include vomiting, diarrhoea and stomach cramps.

2. Food Intolerance

• Symptoms of food intolerance include:
• Constipation
• Diarrhoea
• Stomach pain
• Skin redness and dermatitis
• It often has a delayed onset

Speak to your doctor about it if you suspect your child is having a food allergy and intolerance.

• If you have a family history of allergies, you may want to practice the “4-day-wait” rule:
• Introduce new foods, one food at a time, spaced 4 days apart.
• Keep a diary/ journal and record the type of new food introduced each time, and if any adverse reactions occur.
• When your baby is around 9 to 10 months old, you can start to loosen the “4-day-wait” rule. However, it’s still important to pay attention to the new foods you offer your baby, especially those that pose an allergy risk. As always, you should consult with your baby’s doctor if you have any concerns about a particular type of food.

Beware of allergenic foods

• You can introduce highly allergenic foods to your baby after 6 months, as there is no evidence that you should do so later than that. However, if you have family history of allergies, you need to be cautious about it.
• Look for potential allergenic ingredients in food while shopping for food products.

Useful Download(s)

• List of allergenic ingredients in food

For further information on infant and child nutrition, please refer to

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.

There are no “best” solid foods to feed your baby. Your baby can consume almost any type of food, as long as the amount and texture is suitable to be eaten and digested at his age. If you have any concerns about a particular type of food, consult your baby’s doctor for advice.

Give your baby a variety of food and gradually increase the quantity to ensure that all nutrient needs are met:

• Offer a variety of staple foods such as cereals (rice, wheat, barley, oats) and tubers (yam, potatoes, sweet potatoes), all great sources of energy and vitamins.
• Meat, poultry, fish or eggs should be given on a daily basis as they are the main sources of protein, iron and zinc (1). However, avoid giving egg white to babies aged below 1 year.
• If milk and foods from animal sources are not consumed in adequate amounts, offer baby both cereals and legumes (eg. mung beans, red beans or dhal) in the same meal
• Try different coloured fruits (eg. ciku, papaya, dragon fruit, banana, and mango) and dark green leafy vegetables (eg spinach and mustard greens such as bok choy, kangkung and sawi), daily.
• Limit freshly-squeezed juice, with no added sugar to ½ cup a day. Always go for whole fruit first– skin as well as flesh –as they are always better than juices because they contain fibre.

Avoid giving baby processed foods high in sugar, salt, artificial colouring, and preservatives.

Continue breastfeeding on demand in between meals as breast milk is still the main source of energy and nutrients for a baby aged 6 to 12 months.

If you have a family history of allergy, you may need to be careful when offering baby certain foods, like eggs, fish, peanuts, and milk. You may want to introduce only one new food at a time and wait for several days (4-day-wait rule) before you add another new food to make sure your baby does not have a negative reaction to each food type. This will be discussed in more detail in later section.

Don’t be upset if baby rejects certain foods for the first time. Just try them again at a later date. Research shows that babies need to sample new food more than 10 times before accepting it.

What foods to avoid

Avoid giving your baby drinks with low nutrient value such as tea, coffee, sweetened condensed milk, syrup, cordials and carbonated drinks.

Some unsuitable foods for babies under 12 months include:

• Egg white – contains allergenic components that may cause egg allergy
• Honey – there is a potential risk of bacterial infection from honey.
• Tea – contains tannins, a substance that can restrict vitamin uptake.
• Whole nuts – should be avoided due to being a choking hazard.
• Reduced fat milk – not suitable for children under two.

How often your baby should be served solids depends on him. Follow his lead, and ensure that he gets a well-balanced diet of solid foods.

At first, introduce solid foods to baby once daily. You can even start by offering just a spoonful of food, once in every couple of days, especially if your baby seems reluctant to try eating. At these feedings, your child may only take in a spoonful or two of rice cereal, mashed banana, or pureed sweet potato. But he’ll soon start eating more.

You can increase the feeding frequency of complementary foods according to age

Source: MDGCA(7)

Useful Download(s)

• Recommended food intake for 6-24 months
• Sample meal plans for baby 6-8 months and 9-11 months

(Bear in mind that this is just a guide. The actual amount varies based on the individual baby. Always pay attention to baby’s hunger levels, appetite and signs that he is full. Babies are very good at regulating their own food intake.)

Change baby’s food texture and preparation methods gradually as he gets older. Ideally, baby’s meals should always be freshly prepared

6-8 months: Blended/pureed, mashed and soft foods

9-11 months: Chopped foods + nutritious finger foods such as soft/small slices of fruits (eg. banana, papaya)

12 months onward: family/table foods

Avoid adding salt, sugar and sauces (eg soy sauce) when preparing food for your baby.

In addition, always make sure that you practice good food safety and hygiene while preparing baby foods to prevent baby from food poisoning.

Here are also some tips to prevent baby from choking:

• Avoid giving chunks of hard food larger than 0.5cm (1/2 of your thumb nail) and supervise children during mealtimes to avoid choking
• Vegetables like carrots, celery and green beans should be shredded or cooked until soft
• Cut fruits like grapes into pea-sized pieces before serving
• Cut meats and cheeses into very small pieces or shred them
• Remove all bones from fish properly
• Avoid giving the following to baby

• Small, hard foods such as candies and whole nuts
• Soft and sticky foods such as jelly or peanut butter.

For further information on infant and child nutrition, please refer to

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.

Your baby is ready for his first taste of solids after he has reached 6 months old. Research has shown that from this age,  milk alone will not meet his nutritional needs for certain vitamins and minerals, for example, iron.

Furthermore, most babies are, from 6 months of age, developmentally ready for foods other than milk.

• Signs that baby is ready for solid food:
• Can control his tongue and neck movements better
• Start to make up-and-down ‘munching’ movements
• Can sit up with minimal support
• Likes to put things into his mouth
• Shows interest in what you’re eating

Useful Download(s)

• Shopping list to start solid foods

It doesn’t matter what baby’s first solid foods are.

Traditionally, single grain cereals are introduced first but there is no evidence that introducing solid foods in any particular order has an advantage for your baby.

Some may recommend starting vegetables before fruits, but there is no evidence that your baby will develop a dislike for vegetables if he tries fruits first.

• You can start off with giving your baby a variety of energy rich foods such as
• Cereals: porridge rice, bread and others
• Tubers: potatoes, sweet potatoes, yam or others
• Other examples of first foods include
• Mashed or soft-cooked fruit and vegetables, like carrot, apple or pear, all cooled before feeding time.
• Soft local fruits like melon, ripe bananas, ciku, dragon fruit and papaya or avocado, also mashed.

Start with a few teaspoons of solids and gradually increase the amount.

If, at first, your baby is not too keen to try new food, try adding breast milk to his foods to help him get used to the taste.

If you have a family history of allergies, you may want to introduce only one new food at a time and wait for several days (4-day-wait rule) before you add another new food to make sure your baby does not have a negative reaction to each food type.

Remember to continue breastfeeding your baby on demand until up to 2 years of age, as breast milk is still your baby’s main source of energy.

Solid foods are still just practice sessions for the future and are insufficient to meet baby’s nutritional needs.

Breast milk remains his major source of energy and nutrients as he starts to try a variety of new foods.

It’s important to make sure baby continues getting enough breast milk to meet his nutritional needs for healthy growth.

Ideally, breastfeeding should continue until baby is 2 years old.

For further information on infant and child nutrition, please refer to

1. MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
2. NUTRITION SOCIETY OF MALAYSIA (2011) Baby’s First Bites. Petaling Jaya: Mother’s Smart Choice.