Early Childhood Nutrition

Find out more about how you can give your child a head start in life with the best nutrition!

Birth to 6 months

• At this age, milk alone is enough for your baby’s nutritional needs. Breast milk is best wherever possible.
• Baby doesn’t need any additional water. Milk has enough water content to keep baby hydrated. Giving a young infant plain water may lead to “water intoxication” and cause the blood sodium level to drop. Low blood sodium level can be harmful to the brain, and can cause problems such as seizures (fits).
• Baby also doesn’t need any additional food like cereals or rice mixed into their milk. They may not be ready to handle thicker textures or semi-solid foods, and may choke.
• During routine well baby checks, the nurse/doctor will monitor your baby’s growth to ensure that baby is gaining weight well and growing healthily.

6 to 12 months – It’s time to wean!

At this stage, you will need to start introducing solid foods to meet the changing nutritional needs of your growing baby.

Why should solid foods be introduced at 6 months of age?

• Nutrients from milk alone are not enough for good growth. Late introduction may deplete your baby’s body stores of iron and other nutrients.
• Swallowing thicker textures helps your child develop the muscles for speech development.
• Social skills are developed during mealtimes.
• When children start to self-feed, they develop independence.

Most babies by 6 months are developmentally ready for solid foods. They are able to hold their heads up, can sit well when supported, can make chewing motions and move food to the back of the mouth to swallow.

Getting started

• Make sure your child is seated nearly upright in a chair with good head and body support.
• Start with foods that are rich in iron like iron-fortified rice cereals. Vegetables and fruits can also be given to provide Vitamin C, which enhances iron absorption.
• Ensure food texture is smooth, soft and fine.
• Do not add salt, sugar or honey, as babies do not have an acquired taste for seasoned food at this age and you should not encourage the development of a sweet tooth. Seasoning should be avoided before 2 years of age. 
• Avoid adding fats such as butter or oil unless medically indicated by your doctor or dietitian.
• Do not force feed your baby. If your baby does not seem keen to eat, wait and try again later or on another day. 
• Some babies take time to learn to eat new foods. It can take up to 15 or more exposures for a baby to try a new food. Persevere and be patient. Offer the new food again 2 to 3 times in the same week.
• Only 1 new food should be introduced at a time; wait 3 to 4 days and then introduce another new food, while looking out for any symptoms of intolerance or allergies.

Symptoms of food allergies

In general, symptoms may occur within several hours after eating the food. It is best to observe your baby’s reaction(s) closely, especially after introducing a new food.

Common symptoms

• Hives or rashes (may be around the mouth or over the body)
• Worsening or flaring of eczema
• Watery stools

More serious symptoms needing urgent medical attention

• Swollen eyes, tongue, face, mouth and lips
• Vomiting
• Difficulty in breathing
• Fainting

Some babies may have an allergic reaction 1 or 2 days later (e.g. eczema flare, wheezing, persistent vomiting, constipation, stomach pain).

Do keep a lookout and visit your doctor if your baby displays any of the above reactions.

Progressing on solids

• You can begin by feeding your child once a day, in between his milk feeds, when your child is most alert.
• After a week or two, you can increase the frequency to 2 times a day.
• As your child grows, he should start taking foods with increased texture and complexity e.g. thicker or coarser. This helps in developing oral motor function and sensory processing, which are essential skills for eating

What about milk feeds and other beverages?

• It is important to continue feeding milk to your baby.
• As your baby starts to eat more semi-solid foods, you can gradually reduce the number of milk feeds a day.
• As a general guide, once your baby is able to have a full meal, you can skip one milk feed. 
• Eventually, as your baby progresses on weaning, aim for milk intake of 500 to 750ml per day.
• You can start offering some water to your baby once you have started semi-solid foods in his diet.
• Use cooled boiled water. Avoid giving bottled mineral water to your baby as it may contain high levels of some minerals.
• Do not introduce sugar sweetened beverages such as fruit drinks or juices until at least 2 years of age. These drinks can contain large amounts of sugar, which may cause dental cavities and may lead to your baby developing a preference for sweet foods. They can also lead to early childhood obesity.

Safety Tips

• Your baby must always be supervised when eating.
• Always feed your baby sitting in the correct posture.
• Avoid giving foods that lead to choking easily such as:
  • Small and hard pieces of food (e.g. peanuts, nuts, seeds and grapes)
  • Food that is crunchy or hard (e.g. uncooked vegetables)
  • Fish and meat with bones
  • Fruits with seeds
  • Sticky food e.g. glutinous rice (pulut)
• When reheating foods, always bring to full boil, then cool. If reheating using a microwave oven, stir the food well and test the temperature on the back of your hand before feeding to avoid scalding your baby’s mouth..

Hygiene Tips

• Always wash your hands before handling your baby’s food.
• Separate raw and cooked foods.
• Cook meat thoroughly.
• Cover foods before keeping in the refrigerator.
• Discard food that is unfinished from your baby’s bowl.
• In general, a small thermal flask cannot store food at a safe temperature (60°C or above) for a long period. To reduce the risk of bacterial growth, food stored in a thermal flask should be eaten within 2 hours after it is cooked.
• If you are preparing a few meals at a time, set aside some portion of it and keep the remainder.
• Similarly, if you wish to give baby jar food, and your baby is unlikely to finish the whole jar, portion out the amount he can consume and store the remainder.

12 to 24 months

At 12 months of age, your toddler’s digestive system is ready to accept small portions of food similar to what adults eat. Ensure that meals are balanced amongst all four food groups (fruits, vegetables, grains, meat and alternatives) and prepared with minimal salt, sugar or seasoning. Instead, use ginger, garlic, spring onion or spices like turmeric as alternatives for seasoning. Include sufficient fibre (from fruits, vegetables and whole grains) and water to prevent constipation in your child.

What about milk and other beverages?

• Toddlers should continue to consume breast milk as an important source of nutrients through the first year and beyond.
• If your child has been drinking formula milk, he can switch to full cream milk such as chilled pasteurised, UHT (ultra-high temperature processing) or powdered full cream milk.
• Growing-up/Stage 3 formula milk is more energy-dense than full cream milk and may displace your child’s appetite for other foods.
• After 2 years of age, your toddler can be given low-fat milk if he is eating and growing well.
• Give your toddler a training cup or a straw to drink with. Replace the bottle with a training cup for one feed during the day, gradually increase the frequency. By 18 months of age, he should stop using the bottle entirely.
• Avoid giving sugared drinks, soft drinks or fruit juices.
• Avoid giving caffeinated drinks such as energy drinks, coffee or tea.

Do I need to give my child vitamins or supplements?

• Routine supplements are not required if your toddler is taking a healthy, balanced diet and growing well.
• If your child is a picky eater and it is challenging to achieve a balanced diet, you may seek a pharmacist’s or your doctor’s advice on the use of supplements such as multi-vitamins.

Reference: KK Women’s and Children’s Hospital, Health Promotion Board