Feeding Your Baby - Supported Sitter

These instructions are for caregivers of Children's Hospital of Philadelphia (CHOP) infant patients that can sit with support to learn about feeding and nutrition.

Important information about starting baby food:

• Most full-term babies are "supported sitters" at 4 to 6 months old. This means they can sit up with a little help. When they are lying down on their tummy, they can push up with straight arms. They are also able to turn their head and look around.

• When your child has the skills and strength to sit with support, they may be ready to start baby foods in addition to breastfeeding or formula feeding. Breast milk or formula should still be your baby's main source of nutrition. Supported sitters will drink between 6 to 8 ounces at a time or 27 to 45 ounces per day.

• Ask your healthcare provider if it is OK to start baby food.

• Remember, when a child is ready depends on their development. Babies that are born premature may need to wait longer before starting baby foods.

Instructions for feeding your "supported sitter":

• Feed your baby in a highchair.

• Food should never be added to a bottle.

• Give all food from a spoon. The first few times your baby gets food, they may push both the spoon and the food out of their mouth. This is normal. Your baby will soon learn to take the food into their mouth and swallow it.

• You may want to try formula or breast milk from the spoon first. Then switch to a half-spoonful of food.

• Prevent choking by offering foods that easily dissolve and do not require chewing. Feed your baby small portions. Always watch your baby while they are eating.

• Do not force your baby to eat. Serving sizes for babies are estimates. Feed your baby only when  they are hungry.

Watch for signs from your baby that will tell you if they are hungry or full:

If your baby is drinking from a bottle:

• Signs of being hungry

  • Opens mouth, moves head side to side

  • Sticks out tongue

  • Placing hands, fingers or fists to their mouths

  • Crying

  • Flailing arms and legs

• Signs of being full

  • Stops or slows down sucking

  • Moves head away

  • Falls asleep (although some babies need help staying awake if they have not eaten enough yet)

  • Starts to play or becomes distracted with feeding

If your baby is eating solids

• Signs of being hungry

  • Opens mouth and moves towards spoon

  • Tries to grab at food or spoon

  • Points or nods to food

• Signs of being full

  • Turns away from spoon

  • Spits out food

  • Pushes food away

  • Ignores food

  • Holds mouth shut

Instructions for introducing new foods:

• The American Academy of Pediatrics (AAP) says that for most children, foods do not need to be  given in a certain order. When you give food for the first time, do not give any other new foods for 3-5 days. If you have a family history of food allergies, or think that your baby is likely to have food allergies, speak with your healthcare provider about how to introduce foods.

• Watch for signs that your baby is having a reaction to the food. Signs to watch for are rashes, vomiting, and diarrhea. If these things happen, call your healthcare provider. It may mean that your child has a food allergy. If there are no signs of a reaction for about 3 days, you may try another new food.

• Babies who get mostly breast milk should start with meats or iron-fortified cereals. Breastfed babies need iron. Formula fed babies get iron in their formula so they can start with any baby food.

• Avoid baby food "dinners" with multiple ingredients, such as meat with vegetables.

• If you puree meat at home, cook the meat until it is done then add gravy, breast milk or formula to make it thin and smooth. The meat should not have chunks in it.

• Offer single grain cereals first. Examples are rice, oatmeal and barley baby cereals. If your baby has no signs of a reaction after eating these cereals, you can try mixed grain cereals.

• The first few times you give your baby cereal, it should be very thin and look like milk. Follow the directions on the cereal box for making the cereal.

• If your baby is 6 months old or older and has had other solid foods without concern for food allergies, you may give your baby foods with peanut butter. If you choose to give your child peanut or other nut butter, use just a thin layer because it is a choking hazard.

Sample meal pattern for supported sitter:

Morning

• Breast milk or formula (typically 6 to 8 ounces)

Breakfast

• Serve cereal with a bowl and spoon.

• Never add cereal to the bottle.

• Option 1:

  • About 1-4 tablespoons of baby cereal made with breast milk or formula.

  • AND

  • About 2 tablespoons of Stage 1 baby food fruit or thin homemade fruit puree

• Option 2:

  • About 1-4 tablespoons of Stage 1 baby food meat or homemade  meat puree

  • AND

  • About 2 tablespoons of Stage 1 baby food fruit or thin homemade fruit puree

Mid-morning snack

• Breast milk or formula (typically 6 to 8 ounces)

Lunch

• About 2 tablespoons of Stage 1 baby food vegetables or thin homemade vegetable puree

• Afternoon snack

• About 2 tablespoons of Stage 1 baby food fruit or thin homemade fruit puree

• AND

• Breast milk or formula

Dinner

• Option 1:

  • About 1-4 tablespoons of baby cereal made with breast milk or formula

  • AND

  • About 2 tablespoons of Stage 1 vegetable baby food or thin homemade vegetable puree

  • AND

  • Breast milk or formula to drink

• Option 2:

  • About 1-4 tablespoons of Stage 1 baby food meat

  • AND

  • About 2 tablespoons of Stage 1 vegetable baby food or thin homemade vegetable puree

  • AND

  • Breast milk or formula to drink

Evening

• Breast milk or formula (typically 6 to 8 ounces)

Reviewed on November 1, 2021, by Angela Luciani, RD