Guide to Weaning
The UK government recommends that solids are not introduced before four months of age. However we know from the government’s own Infant Feeding Survey that 51% of infants were reported to have received solid foods before 4 months of age. This figure is consistent with the average age of introduction of solids in the Millennium Cohort Study (a study in the UK of 15,980 infants) which was 3.8 months.
One reason put forward for not introducing solids before six months is concern about an increased risk of gastrointestinal infections. However, the Millennium cohort has recently reported (Quigley, 2008) that the age of introduction of solids had no effect on risk of hospitalization for diarrhoea or lower respiratory tract infection.
In 2003, the World Health Organisation (WHO) published advice in partnership with the children’s charity UNICEF recommending exclusive breastfeeding for six months and that weaning or complementary feeding should be delayed until six months of age. The UK’s Department of Health adopted this recommendation and so have some EU States but the majority have not.
Nearly ten years on, the evidence behind the recommendation has been reviewed in some detail and many scientists recommend that since each baby is unique, a single recommendation to wean at six months may not be appropriate.
This recent change in viewpoint caters to your ‘average’ baby. However, there will be babies above and below this average line who have special circumstances, which need specific nutritional care; including weaning early.
- Most fruits and citrus fruits, fruit juice, especially orange, apple, blackberry, pineapple, raspberry, and strawberry.
- Tomatoes and tomato sauce
- Spicy Foods (even brand prepared baby food)
There are a set of signs that your baby will be demonstrating to you, which indicate that they are ready to cope with solid foods.
- can hold their head up
- sit with less help
- often put their hands in their mouth
- easily open their mouth when the spoon touches their lip or as food approaches
- can keep food in their mouth and then swallow it, instead of spitting the food out
- show signs of chewing movements
- increased saliva production
- sucking and mouthing toys or their hands
- putting everything into the mouth and also teeth making an appearance.
These signs usually arrive when your baby is around 16-18 weeks old. Furthermore, it is documented that between the ages of 3-5 months, there is a window of acceptance for a baby to accept new tastes and smells.
Using solids to help keep your baby’s milk feed down is fast becoming an acceptable ‘tool’ to help manage reflux. You know your baby best and unless your paediatric doctors consider other circumstances that would go against early weaning, then the decision is yours to make.
Puree the foods very smooth. Go very slowly, perhaps start with half a teaspoon to 2 teaspoonfuls per meal in the beginning and keep a note of the quantities your baby is consuming. If your baby turns the solid food away, leave it a few days and then try again. It may take several attempts with certain foods.
Hydration – If your baby is very young, perhaps 4 months old, then there are some considerations to take into account. Hydration is very important because as soon as you being to thicken up food, the levels of liquid are changed with the introduction of bulk. Ensure you are offering cooled boiled water a few times a day for a baby who is weaning early. This will help them to process the solid food, and hopefully avoid constipation
Gradually introduce avocado, broccoli, parsnip, swede, pumpkin, leek, butternut squash as smooth pastes. Think about taste – a parsnip for example is a strong-tasting veggie, so consider this when you introduce it. These vegetables are less likely to cause problems with reflux.
Avoid putting more than three veggies together in the early days, as the tastes can be quite confusing when mixed together. Try to introduce new tastes one at a time, every 3-4 days.
Bulky foods need to be watered down with formula or breast milk to a very thin texture. When building up your combinations, think about taste, smell and texture. If you would eat a combination, then the chances your baby will!
Rice or cereals can also be added to babies milk too and this may be suggested by your GP. Be aware of possible effects – In many cases when this is suggested, the reflux babies are younger than their non-reflux peers and the possibilities of a reaction may be greater. Essentially all the rice is doing is weighing down the milk a little to help it stay down. Note: also if you are using a normal teat and adding thickeners to a feed, you will need to upgrade to a larger teat. We used 6 month size teat with our daughter at only 5 weeks old, just to get the thickened milk flowing!
If you think about fruit in terms of your own eating – putting an apple on top of milky food usually causes us some indigestion. Imagine what it might do to a baby with reflux who has bubbling stomach acid – think about this when working out a meal plan for your baby with reflux. Banana’s are great for thickening a meal, but can also be acidic and hard to digest. The following fruits are less likely to cause a flare up, but should be used with caution: Banana, blueberry, peach, mango.
Avoid: citrus, strawberry, raspberry, blackberry, apple, orange, tomato.
There are no rules about weaning, just lots of great advice – remember you are the best judge! If in doubt about introducing solid foods at 4, 5 or 6 months, always discuss with your health professional.