When can I start complementary feeding to my 6-month-old premature (preterm) baby born at 35-36 weeks gestation?

When to Start Complementary Feeding for Your Premature Baby

You can start complementary feeding now at 6 months chronological age for your baby born at 35-36 weeks gestation. 1, 2

Timing Based on Chronological Age

Your baby is ready for solid foods at 6 months chronological age (the age since birth), not corrected age. 1, 2 The key developmental milestones to confirm readiness include:

• Good head control - your baby can hold their head steady 2
• Ability to sit with support - can sit in a high chair with assistance 2
• Interest in food - watches you eat and reaches for food 2

For babies born at 35-36 weeks (late preterm), standard feeding guidelines apply since this is close to term. 1

What Foods to Start With

Begin with iron-rich foods as the priority, since your baby's iron stores from birth are now depleted. 1, 2, 3

First Foods (Starting Now):

• Iron-rich vegetables: Broccoli, cauliflower, squash, carrot, white potato (smooth, thin purees) 2
• Meats: Finely ground beef, lamb, chicken, or fish 2, 4
• Iron-fortified infant cereals 1, 2

Progression Over Next Months:

• At 6 months: Add fruits while continuing vegetables 2
• At 8 months: Progress to soft-cooked, bite-and-dissolve textures 2
• At 12 months: Offer modified family foods that are table-chopped and soft-cooked 2

Introducing Allergenic Foods

Do not delay allergenic foods - introduce peanut, egg, dairy, and wheat at the same time as other complementary foods, starting now around 6 months. 1, 2

• Introduce one new food at a time and wait at least 4 days before introducing another to watch for reactions 2
• For standard-risk infants (no severe eczema or egg allergy), allergenic foods can be introduced at home without specialist evaluation 2

Continue Breastfeeding

Breast milk or formula should remain the primary nutrition source throughout the first year, even as you add solid foods. 1, 4

• Offer breast milk or formula first, then solids 1
• Breastfeeding frequency of 3-5 feedings per 24 hours is typical at this age 1
• Continue breastfeeding alongside complementary foods for as long as mutually desired 1, 2

Feeding Frequency and Amounts

Start small and gradually increase:

• Initial amounts: 1-2 teaspoons per feeding 2
• Frequency at 6-8 months: Offer complementary foods 2-3 times per day 1
• Frequency at 9-11 months: Increase to 3-4 times per day 1

Normal Responses vs. Warning Signs

Expected Normal Reactions:

• Initial refusal or hesitation (may need 8-10 exposures to accept a new food) 2
• Facial expressions showing surprise or confusion 2
• Small gagging episodes as they learn to manage food 2
• Changes in stool color, consistency, and frequency 2
• Small undigested food particles in stool 2

Seek Medical Attention If You See:

• Persistent vomiting 1-4 hours after eating a specific food 2
• Severe diarrhea with blood or mucus 2
• Skin rashes, hives, or facial swelling shortly after food introduction 2
• Respiratory symptoms like wheezing or difficulty breathing 2
• Lethargy or significant behavioral changes after eating 2

Critical Pitfalls to Avoid

• Do not delay beyond 6 months - delaying increases risk of iron deficiency anemia, inadequate nutrient intake, and feeding problems 2, 3
• Avoid added salt or sugar in complementary foods 1, 3
• Limit juice - avoid sugar-sweetened beverages entirely 1, 3
• No honey before 12 months due to botulism risk 1
• No whole cow's milk as main drink before 12 months 1, 3
• Ensure appropriate textures to prevent choking hazards 2, 4