Dr Andy Raffles
What's Weaning? When & How?
Updated: Feb 11, 2020
If ever there was a topic inclined to raise strong feelings amongst parents, grandparents, healthcare workers and presumably babies themselves, then this is one of the main ones!
Having read this quote from a parent many years ago, I am of the view that there is no one way which is best to wean your baby: I am so tired of hearing health professionals, midwives and health visitors pontificate as to what is best for babies. Every baby is different, and every situation is different. I started weaning my two children as soon as they showed an interest in reaching out for solid food. Both wanted solids at 4.5 months old and started on baby rice. Perhaps we should stop listening to blanket guidelines (which cannot possibly be completely correct, since they are changed every five minutes) and listen to our babies instead!
What is undeniable is that you and your baby are unique, and what is right for you and your baby may not be the same for others, or even you and another baby. You know your baby best, so follow their lead, and play your hunches – you will not cause harm and may even make weaning less of a problem.
Why and when to wean? From somewhere around four to six months, milk feeding (breast milk or formula) alone is not sufficient to meet your child’s energy needs for their rapid rates of growth and development. As you can see already, weaning is a very variable event, with a difference of anything up to three months between babies as to when weaning may start. This equates to up to 50% of the baby’s entire life since birth – so take it slowly, there is no need to rush or to start comparing with other babies born at the same time as yours. Weaning advice has also changed over the last ten-or-so years. A study in the US, found there was an increased risk of anaemia compared with those introduced to solids at four to six months. Swedish research also found that the incidence of early onset coeliac disease increased after a recommendation to delay introduction of gluten until age six months, but fell back after the recommendation reverted to four months.
Your baby’s gut will slowly be able to digest more complex foods, such as starch from around four and a half months, a process which may take a considerable period to complete, and hence weaning is a gradual process.
Chewing is also a slow to develop skill, and primitive reflexes such as tongue thrusting need to disappear before any foods placed in the mouth will be accepted. Crucially, this process does not start until three months, and although usually completed by six months (particularly if your baby has a tendency to reflux), they may become very sensitive to anything put into the mouth, be it a spoon or lumpy solids. This is a feeding aversion response and can considerably delay in weaning.
What is undoubtedly the case is that weaning is highly individual, and has many influences -personal preference, cultural and environmental. For example, in parts of the world where water purity is poor, and water and food-borne infection levels are high, then late weaning is preferable, reducing the risk of exposure to water and food-borne diseases.
So, having established that 'when' is a very variable time – and having looked at some of the factors influencing 'when', how will you know that your baby is ready to start?
If your baby is showing signs of interest in food, such as reaching to grab your food, putting his or her hands in their mouth, then this can indicate readiness – but do not rush! A baby should be able to sit unsupported, with good head control – meaning they don’t flop from side to side and don’t need help to sit up, they may even lean forward to greet an approaching finger or spoon laden with soft food. Occasionally the need to wean becomes more obvious due to a slowing in rate of weight gain, or a change in feeding pattern, e.g. more night wakening, indicating the calorie intake is not quite meeting their need. You will need to wait for the tongue-thrusting reflex to stop (at around three to four months) and voluntary chewing to start.
How will I know he/she is not ready? They just will not be that interested, or may clamp their mouth closed, or simply tongue-thrust. Some babies will take the food, albeit reluctantly, but then not swallow!
If this happens to you, retire gracefully, do not make meal times a battlefield, and revisit in a few days or weeks.
Above all, enjoy your baby and these important steps in their development – the time flies by, and before long they are helping themselves from the larder or fridge!