Dr Andy Raffles
Weaning: Before 6 Months of Age
Opinion regarding the best time to start a baby on solid foods has changed dramatically over the last 50 years, across the world there are many different philosophies. The UK’s Scientific Advisory Committee on Nutrition (SACN) currently recommends exclusive breastfeeding for 6 months from birth to give optimal nutrition for your baby although bottle feeding with a proprietary formula feed is an entirely satisfactory alternative.
By 6 months of age your baby’s digestive system will have matured sufficiently to begin eating solids. It is recommended to continue breastfeeding your baby, or alternatively give formula milk, until 12 months and sometimes beyond. Formula feeds should always be used in preference to cow’s milk.
Within these guidelines it is important for each individual baby to be cared for according to her unique needs. It is recognised that in the UK and across much of Europe and the USA, parents introduce foods earlier than 6 months for many valid personal, social and economic reasons. If you are unable to, or choose not to follow the SACN recommendations, it is important to be supported by your Health Visitor or other advisers to ensure you provide the best nutrition for your baby.
Weaning before 6 months
There is no evidence to suggest that giving a baby solid food before 6 months has any health advantage. In fact, giving your baby solid foods before the chewing and swallowing mechanisms are mature, and before the intestines and kidneys are sufficiently mature to digest and cope with a diverse diet, can increase the risk of infections and development of allergic illnesses such as eczema and asthma; may bring on colicky symptoms, worsen existing colic or lead to constipation or diarrhoea.
If your baby is not growing as expected for their age (failure to thrive), it is not appropriate to give solids before 6 months. A thorough medical examination is important and your doctor will give recommendations according to your baby's needs.
Some parents introduce their baby to solid foods before 6 months in the hope of longer sleep at night, but this is generally not recommended . Baby’s body may not be ready for it and they may sense parental frustration. Too early weaning may lead to overeating and set up a situation, leading to unnecessary weight gain. Finally this may result in food and feeding related anxiety and the possibility of an unhappy relationship with food. There are other ways to help your baby sleep.
Introducing your baby to solids from 6 months
Solids supplement, but do not replace milk feeds. By 6 months the recommended milk intake is 5 breastfeeds or 5 bottles of 250 ml (7-8 fl oz), giving a total milk intake of around 1125 ml (32 fl oz), plus small amounts of solid food.
Respond gently to your baby’s signals. Offer food when alert and content and let your baby set the pace and gradually get used to eating.
Offer something smooth with a gentle flavour, cooled to room temperature. Hold your baby on your lap and give the food with your finger. Later, you can introduce a soft plastic spoon. It is recommended at initial weaning, to sterilise all the spoons and bowls used.
Begin with baby rice mixed with your baby's usual milk. Try giving one spoonful a day, at lunchtime, after an initial drink; if baby has difficulty digesting, they should feel settled by bed-time.
If your baby seems happy after 4-7 days of having one spoonful a day, introduce another, and build up gradually. Try to end the day with a milk feed.
Take advice from a Health Visitor or one of the many specialist baby books with weaning and feeding, as you broaden the range of foods you give to your baby. Guidelines are based on what's known about baby's digestive systems, but they are only guidelines. Your baby will have their own reactions and own likes and dislikes. Always wash fruit and vegetables before giving.
Initially all the food your baby has, needs to be soft. You can gradually increase texture as your baby gets used to eating and when teething, or has teeth, they may enjoy chewing on solid pieces, e.g. cucumber, apple.
Although most babies seem to have a preference for sweet food they are not so partial to it as toddlers seem to be. Give vegetables as much as possible, with fruit purees as an option.
Foods to avoid or delay introduction
Current advice ideally is to delay introducing dairy as milk – rather than processed dairy products – e.g. baby milks, yogurt and hard cheeses. Avoid also significant amounts of gluten-based products and egg whites until 12 months, and nuts and nut containing products until the age 3. Adding salt or sugar to baby foods is also unnecessary and may possibly result in excess weight gain and high blood pressure in later life.
It is also better for your baby not to be exposed to excessively sugary foods, fruit juices, colas and cordials, crisps, biscuits etc.