Introduce new foods one at a time and watch for adverse reactions. A reasonable schedule for introducing foods in one new food every 2 to 4 days. Give combination foods after tolerance to the individual components has been established.
Introduce foods in a general progression that promotes achievement of nutrient needs. Evidence about the order of introduction of foods is limited.
Readiness for and accptance of different food textures appears to depend on child's developmental stage and prior experience with particular textures. In most infants, developmental skills needed to begin complementary foods are present between 4 and 6 months of age
Exposure to a variety of textures appears to promote accptance. Gradually expose infants to solid textures during the sensitive period for learning to chew (from be time complementary foods are introduced though 10 months of age) to reduce lihelihood of rejection of certain textures, refusal to chew, or vomiting.
Delay intorduction of cow's milk until after 1 year of age and provide only whole milk. If milk is limited to 2 cups per day, use an additional tablespoon of oil in food preparation or added to prepared foods to provide needed amounts of linoleic and alpha-linolenic acids. Soybean oil will provide adequate amounts of both essential fatty acids. If soybean oil cannot be used, a mixture of 50% canola and 50% safflower or cone oils will provide needed amounts.
In infants with a strong family hidtory of food allergy, delay introduction of the major food allergens (e.g., egg, cow's milk, wheat, and soy) until well after 1 year of age and introduction of foods associated with "lifelong" sensitization (e.g., peanuts, tree nuts, fish, and shallfish) even longer.
There is no evidence that the precautions for infants wujh a stong family history of food allergy are of any benefit to infans eho are not at risk for allergy.
Avoid wheat, rye, barley, and oats in infants with a family history of celiac disease. Oats do not contain gluten but may be contaminated with wheat gluten during processing.
Delay introduction of gluten-containing and gluten-free cereals before 4 months in infants with a strong family history of type 1 diabetes (parents and first-degree relatoves) to decrease the risk of developing islet immunity.
Encourage parents to develop a healthy feeding relationship with their infants/chile. Promote a role for parents in setting the eating environment and providing appropriate healthy foods. Encourage parents to respond appropriately to infants cues of hunger and satiety and to allow children to decide whether to eat and how much.
Encourage parents to demonstrate feeding skills rather than relying on verbal prompts alone.
Encourage fiber-rich foods.
Encourage an appropriate level of activity in order to allow a level of food intake that meets nutrient needs but does not promote excessive weight gain.
Promote physical activity by encouraging parents to limit excessive use of infant restraints, balance sedentary pastimes with active ones, and make a conscious effort to include movement and physical activity in play.
DRIs for physical activity in oler childen is 60 minutes of accumulated activity most if not all days.
Discourage television viewing by children under the age of 2 , in accordance with the AAP position, because of proteintial negative effects on development and physical activity. Limit TV viewing in children over the age of 2 to fewer then 2 hours per day.
Encourage parents to provide a good examole in their own food choices and physical activity patterns.