Baby weaning: When, Why and How, with Dr Rachel Allen

 

When?

Babies are generally ready for weaning around six months, but babies do tend to work on their own timelines and all develop at different their own pace, so look out for signs that they’re ready:
- Can stay in a sitting position and hold their head steady
- Can co-ordinate eyes, hands and mouth, look at food, pick it up and put it in their mouth
- Can swallow food, rather than push it back out
 
Trust your instincts on when to start weaning, but generally you shouldn’t wait longer than six months (26 weeks) and not introduce food before four months (17 weeks). Don’t mistake chewing fists, waking in the night and wanting extra milk feeds as signs that they are ready.
 

Why?

Before four months your baby’s digestive system is not fully developed and breast/formula provides all the nutrients they need. Grandparents or older generations may differ and claim it’s fine to start weaning before this, but there is now sufficient evidence that earlier introduction is associated with greater risk of gastrointestinal, respiratory and ear infections.
 
Don’t wait any longer than six months, due to greater nutritional requirements e.g. iron.
 

What?

A great starting point is baby rice introduced in addition to your baby’s usual milk. Vegetables and fruit either mashed and soft cooked or puréed; and pieces small enough for your baby to pick up (i.e. size of your finger)
 
Be aware of our inbuilt preference for sweet foods and therefore offer vegetables before fruit. You can slowly build up over a few weeks and move on to mashed, less smooth, more lumpy food. Such as soft cooked meat, unsweetened full fat dairy products i.e. yogurt, fromage frais; finger foods such as strips of toast, pitta bread, meat or fish.
 

Baby Led Weaning

Baby Led Weaning can be quite the talking point. This method may help acceptance of a wider range of textures, and flavours. Research shows this can have a positive impact on speech development and management of own intake. However on the flip side, it is harder for parents to know how much food their little one is getting and whether a balance of nutrients. Not to mention lots of waste and mess! You don’t need to pick a method and stick to it.I would say a combination of both is a great compromise, offer purées and soft food spoon-fed, plus free access to lots of finger food that they can explore with and feed themselves.
 

What not to give

There are a number of recommendations around foods to be aware of before you start weaning:

Don’t give:

- Cow’s, goat’s and sheep’s milk as a drink until one-year-old, but can be used in foods from six months.

- Rice milk until five years

- Whole nuts until five years

- Whole grapes -cut in half length ways

- Honey until a year

- Shark, swordfish or marlin

- Salt (including in stock cubes) or sugar

- Juice/soft drinks

- High fibre foods

 
Choking

Choking is one of every parent’s biggest fears. Occasional gagging/regurgitation while eating is normal so don’t panic but try and be relaxed and prepare food adequately. Avoid hard chunks of foods such as raw apple or carrot and small hard foods such as nuts and popcorn, remove pips and tough skin and always cut up grapes length ways. Either cut up food tiny or leave in strips for them to hold and break bits off e.g. hard cheese
 
You can always consider attending a paediatric first aid course, it might make you feel reassured and more confident if the situation arises. Always remain present and vigilant when your little one is eating and look out for signs of choking and act accordingly.

How much?

You can start with a few teaspoons of purée to begin with, working up to more as your child grows to like food, slowly introducing more and finger foods as and when they are ready. Gradually increase the amount of solids, moving towards two then three small meals a day at your and your child’s own pace.
 
Cups
Water for babies over six months doesn’t need to be boiled and you don’t need to sterilize feeding equipment. Offer sips of water in a free flow cup without a value as this is better for their teeth and will help them learn to sip.
 
Supplements
The NHS recommends that all babies under five years of age are given a daily vitamin supplement of A, C, D, but not needed when babies are having more than 500ml of formula a day.
 
Where and how?
It can be a slightly daunting task for parents so to make it as comfortable for both of you choose somewhere relaxed and comfortable. Plan to try at a time convenient for you and their routine, ensuring they are hungry, but not too tired.
  
Allergies
Peanuts, nuts, seeds, egg, cows’ milk, soya, wheat/gluten, fish and shellfish, should be introduced in very small amounts, one at a time, after the age of six months. Watch carefully for any symptom of an allergic reaction, either immediately or up to 48 hours later, including
 - unusual rash
- wheezing
- hives (stinging nettle rash)
- swollen lips/eyes
- diarrhoea
 
Potential pitfalls
Grandparents have an unconditional love for their Grandchildren and are able to enjoy the joys of them without the daily challenges. Their love can mean they are more lenient and become a pitfall when you are trying to establish your baby’s diet. Drinks like juice and squash expose children to sugary sweet tastes so they are less likely to be happy drinking just water or less sweet foods.
 
Further information the NHS provide a great resource and guidance.
NHS Choices
 
Start4Life
Using planners to help you organise meals with snacks and finger foods for your baby is a great idea to get a nutritionally-balanced varied diet. If you are looking for portion sizes and recipe ideas First Steps Nutrition is a great portal.
 
If you would like to know more Rachel offers weaning workshops, covering all the things you need to know. For further information contact Rachel here:
rachel@rachelallennutrition.co.uk