Health Eating for Infants and Toddlers

Feeding babies and toddlers is one of parents’ most challenging and important roles. The early months and years are the best time to establish a lifetime of good nutrition and health for your child. 

What follows are general recommendations for feeding your child from birth through age 4 years. If your child’s doctor or dietitian has given you special instructions for feeding because of your child’s medical condition, you should follow their advice.

• Do not put anything in your baby’s bottle other than breastmilk or formula, unless instructed otherwise by your doctor.
• If formula feeding, read the instructions on the can label carefully and mix and store the formula as directed. 
• If feeding expressed or pumped breastmilk, be sure to follow safe expression and storage guidelines. 
• Once bottle feeding starts, discard any leftover formula or breastmilk within 1 hour.

• From birth to 6 months of age, breastfeeding or pumped breastmilk is the only nutrition a baby needs. If human milk is not available, iron-fortified infant formulas regulated by the U.S. Food and Drug Administration are safe and have all the nutrients babies need to grow. 
• If breastmilk is most or all of your baby’s nutrition, start 400 international units of vitamin D3 daily within the first week or two of life (breastmilk does not have vitamin D).
• Newborns need to eat 8–12 times per day, on demand. Hunger cues include turning head to bottle or breast, putting hands to mouth, clenching fists, or smacking/puckering lips.
• Let your baby decide how much formula or breastmilk they need at each feeding. Signs that baby is full include turning head away from bottle or breast, closing mouth, or relaxing fists.
• The amount eaten at each feeding increases as your baby grows.

• Breastmilk or formula feedings may decrease to 5–6 times per day starting at 4 months of age, and amounts eaten at each feeding continue to increase. It is best to wait until your baby is 6 months old to start solid foods. Only if your baby shows signs that they are developmentally ready (such as head control, sitting with support or on its own, grasping objects and bringing to mouth) should you consider offering pureed single-ingredient baby food between 4 and 6 months of age. If your baby keeps pushing food back out onto the chin instead of swallowing it, stop spoon feeding and try again in a couple of weeks. 
• Iron-fortified infant cereals or pureed meats are great first food choices for breastfed babies. Breastmilk does not contain iron, and the iron your baby was born with begins to diminish around this age. Ask your doctor if your breastfed baby should be on an iron supplement.
• Your baby may make funny faces and act like they do not like the taste of new foods, but this behavior is normal when adjusting to new flavors. It may take up to 10 exposures to a new food before your baby accepts it regularly.
• Introduce one new single-ingredient food (from any food group) every 3–5 days. While it is rare, if your baby has an adverse reaction this will allow you to know which food caused the reaction.
• Experts used to recommend waiting to introduce babies to the foods most likely to cause allergic reactions. We now know there is no need to wait to offer baby-safe (soft) dairy (yogurt, cheese, and cottage cheese), eggs, fish, shellfish, and peanut/tree nut products. Early introduction can actually help prevent allergy later in childhood. However, talk to your doctor if your baby has severe eczema or an egg allergy, as they may need to be tested for a peanut allergy.
• Do not give honey to any baby younger than 12 months of age. Honey may contain the bacteria that causes botulism and can lead to serious illness in infants.

• Breastmilk or formula remains baby’s main source of nutrition (4–6 feedings per day) in this age group. 
• Offer age appropriate oods in a highchair at least once per day and increase up to three times per day. 
• Once your baby has been exposed to many single-ingredient purees, you can feed your baby mixed foods.
• Avoid foods with added sugars and limit added salt.
• Progress textures (from thin puree, to mashed, then ground and soft foods) but avoid choking hazards until 4 years of age. Common choking hazards include:
  • Popcorn
  • Whole nuts
  • Whole grapes (should be halved or quartered)
  • Hot dogs (should be cut lengthwise once or twice then sliced)
  • Uncut stringy meats (should be cut into small slices/pieces)
• You may offer plain fluoridated drinking water in a sippy cup with meals. Limit to 2–4 ounces of water per day.

8–10 months: 

• Breastmilk or formula feedings may decrease to 3–5 times per day.
• Start offering finger foods (cereal O’s, toast, soft crackers, cheese, soft fruit, and cooked noodles, rice, and vegetables) if you have not already.
• Consider offering finger foods along with something to spoon-feed your baby at each meal so they get practice with both.
• Consider offering safe utensils for exploration (with no expectation for use). 

10–12 months: 

• Offer your baby 3 meals and 1–2 snacks per day, along with 2–3 breastmilk or formula feedings. 
• Wean bottle or breastfeeding sessions one at a time. By your baby’s first birthday, most of their nutrition should come from table foods.
• Close to your baby’s first birthday, start offering whole cow’s milk in a sippy cup at meals or snacks.

• Offer 3 meals and 2–3 sit-down snacks served at about the same times every day. Children thrive on a predictable routine. 
• Offer a few minutes of quiet time before washing hands and sitting down for a meal. Limit distractions during meals such as television and pets.
• Offer water between scheduled meals and snacks. 
• Include a variety of food groups at each meal or snack (dairy, grains, fruits, vegetables, and meat or meat alternatives).
• Try to eat meals as a family as often as possible.
• If you offer juice, limit to 4 ounces per day. Water and milk are the only drinks your toddler needs.
• Encourage independence by cutting your toddler’s food into bite-sized pieces so they can feed themselves. By 18–24 months, toddlers become better at using a spoon and fork but may prefer to use their hands. It will be messy at first!
• Toddlers’ appetites vary greatly from meal to meal and day to day. Over a 5–7-day period your child will eat enough to stay healthy if you follow the above tips. If you have concerns about your toddler’s weight gain or eating, talk to your doctor.

• Start weaning your toddler from infant formula and onto whole cow’s milk in a cup around their first birthday. You can do this gradually by mixing a small amount of whole milk with formula, and gradually increasing the amount of milk while decreasing the amount of formula over time. 
• Toddlers should drink whole milk (not reduced-fat or low-fat milk) until their second birthday. Fat is important for brain development.
• Limit milk to 2–3 eight-ounce cups per day. Too much milk can lead to iron deficiency anemia and contribute to constipation. 
• It is normal to have a little tummy upset when starting whole milk. Talk to your doctor if it continues longer than a day or two or if you are concerned.
• If your toddler has a milk allergy or intolerance, remember that not all non-dairy milks are equal. Soy milk has a similar amount of protein as cow’s milk and is usually a good choice. Oat and pea milks that are close to the calories of whole milk (about 150 calories per 8 ounces) are another good choice. Almond and rice milks tend to be too low in calories for most toddlers.

• Sit down and eat with your child to model healthy eating.
• Do not allow grazing or drinks other than water between scheduled meals and snacks. This allows your child to learn what hunger and fullness feel like.
• Never force your child to eat. When toddlers feel pressured they may rebel, as they are learning how to exert independence. Your job is to offer a variety of healthful foods at regular times, while your toddler’s job is to decide whether and how much of each offered food they will eat.  
• Remember that it is normal for toddlers to be fearful of new things and experiences. Offer new or less preferred foods alongside familiar and preferred foods so they can experiment with the new food and fill up on the food they are most comfortable with. 
• Avoid using desserts as a reward for finishing or trying certain foods. This may increase your toddler’s taste for sweet foods and lead to categorizing foods as “good” and “bad."

The United States Department of Agriculture’s My Plate is a helpful tool or understanding food groups and planning your toddler’s meal and snacks.

*Note these servings sizes are only a starting point; your toddler may eat more or less, depending on the day.

US Department of Agriculture. Choose My Plate: Infants. https://www.myplate.gov/life-stages/infants

US Department of Agriculture. Choose My Plate: Toddlers. https://www.myplate.gov/life-stages/toddlers

Healthychildren.org from the American Academy of Pediatrics. Baby Nutrition. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/default.aspx

Healthychildren.org from the American Academy of Pediatrics. Toddler Nutrition. https://www.healthychildren.org/English/ages-stages/toddler/nutrition/Pages/default.aspx

Academy of Nutrition and Dietetics. Nutrition Care Manual ®. Full-Term Infants Nutrition. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=299. Accessed June 2, 2021. 

Academy of Nutrition and Dietetics. Nutrition Care Manual ®. Nutrition and Feeding Tips for Toddlers Ages 1-3. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=310. Accessed June 2, 2021. 

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020–2025. Chapter 2: Infants and Toddlers.

Author: Greta Breskin, MS, RD, CSP, LDN
Editor: Amanda D. Deacy, PhD
September 2021