Solid Advice: Weaning your Baby

The Dietitian’s Perspective on Weaning by Siobhan Julian, INDI

Weaning onto solid foods is a critical nutritional and physiological stage in an infant’s life. Congratulations on reaching this important milestone with your little one! Most parents have lots of questions about this important developmental stage. Consultant nutritionist Siobhan Julian has developed this guide with Glenisk to help answer some of these important questions.

The Research:

Research from Tarrant et al (2007) indicated that a significant proportion of Irish parents failed to comply with the current weaning recommendations for 6 month old infants. This research indicates that it is likely that the diets of many 6 month olds are high in refined sugars, saturated fats, trans fats, salt and energy. As a dietitian working in clinical practice, I make parents aware of the adverse consequences such as dental caries and kidney problems associated with regular consumption of foods high in sugar and salt. In addition, the high fat and high energy contents of the weaning diet are particularly worrying given that a quarter of Irish children are classified as overweight or obese. In an effort to manage this problem in my clinical practice I encourage snacks for children that are low in salt and fat such as yogurt, milk, and fruit.

When to Start:

For most babies, the ideal time to begin weaning is from 6 months (26 weeks). Traditionally parents have started the weaning process earlier and obviously parental discretion is important. But remember, the introduction of solids is not recommended for babies under 4 months (17 weeks) due to nutritional and developmental reasons. Babies at this age tend to have poor head control for swallowing, immature gut and kidney function and an increased risk of allergies. Crucially, a baby of this age does not need the extra nutrients from foods. Breast or formula feeds fed at the correct volume are almost always sufficient. Breastfed babies in particular are less likely to need solids before six months.

There are also arguments against delaying weaning much beyond 6 months: after 6 months, extra energy and nutrients are needed from foods such as fruit, vegetables, cereal, meat fish and yogurt. From a developmental perspective, oral sensory development is also stimulated further at the weaning time.

If weaning is delayed much beyond 6 months, it may be difficult to persuade the child to take solids and hence the babies and toddlers may lack variety of foods and their associated nutrients. A delay in weaning can also be associated with a delayed advancement to the healthy family diet and may be associated with toddler food refusal. However, don’t be alarmed if your little one takes some time to adjust to solids, or takes only very small amounts of solid food initially. It may take some weeks to get established. This is perfectly normal.

How to start?

Patience is important as this is a new experience for your baby; ensure you have plenty of time and choose a time when your baby is not too hungry. Give food first and then follow with breast milk or formula milk. Introduce the spoon to your baby’s mouth gradually so that he or she can suck the food from it. Regular small meals are advised. As the weaning process advances, children will need snacks between meals and these should include yogurt, fruit or bread. Sugary snacks such as sweet biscuits, chocolate or sweets are not advisable from both a healthy eating and healthy dental perspective.

What are the ideal first foods?

Parents should continue to breastfeed or formula feed as usual. As the volume and variety of foods are increased, the volume of breast feed or formula feed required will decrease.
The first foods should be easy to digest (baby rice, ground rice, root vegetables, yogurt). There is a school of thought that encourages baby led weaning where some babies over six months begin solids with finger food (cooked vegetable batons etc.) However, typically the texture of first foods needs to be smooth, with no lumps. After two weeks, you can change the consistency of the solid food to a slightly thicker, smooth puree with no lumps, gradually introducing foods that are minced, mashed and have soft lumps.

Sometimes, when babies taste certain flavours they instinctively make a face which seems to express distaste. Do continue to offer these healthy flavours and don’t assume that you must offer a sweeter alternative. Do not be put off by the baby’s facial expression as they may well be willing to continue to eat the food; they are simply becoming accustomed to new tastes and textures.

Meat can be introduced early in the weaning process, usually in pureed or mashed form and babies do not need teeth to eat meat. Always ensure meat is properly cooked and is offered in such a way to ensure it is not a choking hazard.

What foods should be avoided?

It is better to limit the amount of baby juices and sugary foods. These foods can damage babies’ teeth and promote a preference for sweeter foods in childhood and adult life. If juice is given, it should always be diluted with water.

A number of foods are not recommended for young children due to health or allergy risks. These include nuts and peanut butter (should not be introduced before 2 years of age; in the case of whole nuts, should not be given before 5 years of age as it may represent a choking hazard); honey (before age one); shellfish (before age two); raw strawberries, raspberries and blackberries (before age one) and eggs (before six months); and foods that contain gluten - wheat, barley or rye (before six months).

Children who havea high risk of allergies, i.e. family history of asthma, eczema, hay fever or food allergy should be introduced one at a time to high allergen foods so that any reaction may be attributed to a specific food. There is however no evidence that delaying the introduction of these foods reduces the risk of allergy, although some parents may choose to delay. The high allergen foods are milk, eggs, fish, shellfish, wheat soya, peanuts, tree nuts, sesame seed, lupins, celery and mustard.

Do not add sugar or salt to your baby's food.

If in doubt, contact your GP, public health nurse or dietician.

Is Yogurt a suitable food for weaning?

Yes! It is not advised to give cow’s milk as a regular drink to children under the age of one. Breast milk, infant formula and water are the only drinks that should be given under 6 months and should continue to be the main drinks under the first year of life. However, yogurt is eminently suitable from six months, especially those with a smooth texture, as yogurt tends to be easy to digest. From a nutrition perspective they are an excellent source of calcium while also supplying protein and some vitamin D without being too high in calories. They are an ideal snack food or an ending to a main meal, especially yogurts that have no added sugars like Glenisk’s new Organic Fromage Frais. As well as no added sugar, Glenisk baby yogurts contain no artificial additives, flavourings or colours and because they are organic, they are free from any artificial pesticides and synthetic chemicals.

On a practical level, yogurt is also a very handy food to encourage self-feeding as weaning progresses, particularly if the consistency is right.

Note that there is a new HSE Policy on Vitamin D Supplementation for Infants in Ireland.
It is recommended that all infants, from birth to 12 months, whether breastfed or formula fed, be given a daily supplement of 5ug (200 IU) vitamin D. This should be provided by a supplement containing Vitamin D exclusively. For more information, contact your local public health nurse, GP or Dietitian.

Siobhan’s Top Tips:

• Weaning should begin when your baby is aged between 4 and 6 months.
• Each infant should be managed individually and developmental signs of readiness for solid food and parental considerations should always be taken into account when deciding the ideal time to start weaning.
• Spoon-feeding should be introduced to your baby’s diet at six months if you have exclusively breastfed your baby, or sometime between 4-6 months if your baby has been fed formula milk.
• Always stay with your baby when he or she is eating.
• Cow’s milk is not suitable as a main drink for children under one year. However small quantities of cow’s milk can be added to moisten your baby’s spoon-feed. From 6 months, milk in the form of yogurt, fromage frais and cheese can be added to your baby’s diet.
• Never put rusks, cereals or other foods into the bottle.
• Do not add sugar or salt to food.
• Encourage your baby to drink from a beaker with two handles and no lid from 6 months. Best drinks for babies under one are breast milk, water or infant formula.
• Bottles should be discouraged after the age of one year.
• By one year of age your baby should be able to eat most of the foods eaten by the rest of the family.

Siobhan Julian
June 2010.