Weaning – The Biggest Questions Ever Asked By Parents

The idea of introducing solid food to your baby can be both exciting and daunting in equal measure. It can raise all sorts of uncertainty, after all you want to help baby build a positive relationship with food that supports their health, development, growth and immunity through childhood and beyond. This post gives a few essentials to help you make your baby’s journey from milk feeds to family meals nourishing and enjoyable. I aim to answer the biggest questions on weaning that we hear in our clinic every day, and I will follow this up with a second blog focused on trouble shooting ‘fussy’ eating as your baby grows into a toddler and beyond.

Purees Or Baby Led Weaning? Which Approach Is Best?
Parent-led weaning typically sees baby fed purees with a spoon held by the adult in charge, progressing to more textured purees and then on to finger food. Baby-led weaning sees baby provided with food that they feed to themselves from the start, using mainly their hands and being encouraged to use a spoon by themselves. I find that, as with so many parenting dilemmas, people view these approaches to weaning in a very black and white way – either you do one or the other. The thing is, there are pros and cons to both, and they can be easily combined to find an approach that works for you, your family and your baby.

A baby-led weaning approach is fantastic for developing motor-skill development, the ability to chew and manipulate food in the mouth which aids muscle control, speech development and even clearing wax from the ears! It may also promote better intake regulation helping to reduce the risk of overeating in years to come, and can lessen the likelihood of ‘fussy’ eaters because they are exposed to individual textures and tastes early on. Whilst a parent-led approach makes it easier for parents to establish intake and ensure baby is getting enough of certain important nutrients including iron and zinc.

Why Wean At 6 months?
For the first 6 months breast or formula milk provides all the nutrients and calories baby requires for their rapid growth. From 6 months, the introduction of solid food starts to provide additional nutrition that supports baby’s development. For example, baby is born with stores of iron and zinc that are starting to deplete by 6 months, it is important to introduce food sources to support growth and immunity. Also around this time baby is also experiencing physical development that enables them to deal with solid food:

• A larger oral cavity creates more space for food in the mouth.
• Neuro-muscular coordination allows baby to more easily manipulate food, munch, chew, swallow or spit out.
• The cells that form the baby’s gut lining close up together when the baby is ready for weaning. These cells are quite porous in he first few months to allow optimal absorption of nutrition from milk. This closing up of the gut lining helps to prevent toxic residue in the food from being absorbed into the body, and instead allows these unwanted toxins to be passed out of the body through bowel movements.

You may have heard of the signs of readiness that begin to emerge from 4 months old. However instead of jumping the gun look at these signs collectively rather than in isolation; when they all start coming together baby is ready to start eating:

• Good head control and able to maintain a sitting position – important for keeping airways and oesophagus open.
• Hand-eye-mouth coordination – baby can look at something, grab it and bring it to their mouth.
• Shows an interest in food – baby watches you eating and reaches for your food or cutlery.
• Loss of the tongue thrust reflex – a protective mechanism whereby baby automatically pushes food out with his or her tongue. This reflex moves backwards and becomes a gag reflex, another protective mechanism to stop food going down that isn’t ready to be swallowed. (I encourage you to attend a children’s first aid course so that you can recognise the difference between gagging and choking and know how to respond. It can make all the difference in you being able to enjoy the weaning process).

How To Begin Weaning?
Before starting to wean there are a few considerations to think about from timing to mood to which foods to start with:

• Environment – Offer first foods in a calm and relaxed environment, at a time when baby is happily awake and when you can give them your full attention.
• Offer milk first – This is to ensure baby isn’t hungry, reducing the possibility of them becoming frustrated and upset.
• Introduce 1-2 new foods at a time – Enabling you to identify any reactions.
• Vegetables and fruits – Parents tend to be most comfortable starting with vegetables and fruit. Think carrots, sweet potato, parsnip, beetroot, courgette, broccoli, peas, avocado, pears, melon, mango.
• Avoid baby rice – it has little taste or nutritional value in comparison to vegetables and fruits. Think of using whole grains such as oats, quinoa and buckwheat instead.
• Iron and zinc – Vegetables and fruits contain low levels of iron, zinc and healthy fats so once your baby is comfortable with them don’t delay in introducing a wide variety of foods including beef, lamb, sardines, lentils, eggs, beans, wholemeal bread.
• Variety – Expose baby to a variety of textures (crunchy, soft, slippery), colours (eat a rainbow!) and flavours from the beginning. Don’t focus on sweet flavours! Think savoury, bitter and sour too. Sweet signals to the baby that it’s safe and energy-rich so baby will automatically enjoy those foods. But we want to help them develop a broad palate and without any preconceived ideas or encouragement babies will show enthusiasm for all different types of food.
• Think about shape – To encourage baby to feed themselves. Stick shapes are ideal for baby to pick up whilst thick soups and stews will more easily stay on a spoon! Model how to use a spoon, pre-load spoons for baby to pick up themselves, let them practice and help the odd one into their mouth.
• Allow baby to get messy – it is very much a learning and exploratory process at first. It is incredibly valuable for baby to be experiencing different tastes, textures, colours and smells.
• Hunger and fullness cues – Be aware of them. Baby’s have a natural ability to know whether they are hungry and what they need. Try to trust that instinct and allow them to regulate how much they consume. If they turn their head away, shut their mouth or push away the bowl or spoon, respect that. As much as it may not come easily when our parental instinct is to want to feed them!
• Eat together and as a family – be a role model, eat what you want baby to eat and make it an enjoyable and sociable occasion.
• Water – introduce a small drink of water (boiled and cooled) with meals to encourage the habit of drinking water from an early age.Take a few weeks to introduce different foods slowly, then get stuck into family meals! Within a few months you want baby to be eating 3 meals a day and 2-3 snacks to ensure a good level of nutrition and energy intake.

Common Food Allergens
The biggest fear for parents these days is that their child will be allergic to a food or a several foods. The following 8 foods are recognised to be responsible for 90% of food allergies. Introduce them one at a time with two clear days in between so that you can identify any foods that cause a reaction: Eggs, Fish, Gluten, Milk Products, Peanuts, Shellfish, Soya and Tree Nuts. Look out for reaction signs and symptoms:

• Gut – abdominal pain, bloating, vomiting, diarrhoea, reflux
• Skin – itching, swelling, rash, hives, flushing
• Respiratory – runny/snotty nose, sneezing, coughing, wheezing, recurrent infections
• Behavioural – inexplicable crying, colic, picky eating

Other foods to be aware of until they are at least one year old:

• Salt – Too much can damage baby’s kidneys. Do not use shop bought stock cubes or gravy and add salt to your food after removing baby’s portion.
• Sugar – Provides no nutritional value and depletes vitamins and minerals, keep it to a minimum and be aware of how much is in the foods that you buy, including the not so obvious (e.g. yoghurts, pasta sauces, soups, bread).
• Honey – Not before 12 months due to its potential to contain bacteria that is harmful for babies.
• Cows milk – May be used to cook with in small amounts from 6 months but do not introduce it as a milk feed replacement until at least 12 months.
• Low fat foods – provide your baby with full-fat options, rather than low-fat foods. They need fat!
• Large fish (e.g. tuna, shark, swordfish and marlin) – Avoid as they contain levels of mercury that may be harmful.
• Eggs – Make sure they are cooked thoroughly with egg white and yolk both solid.

A Balanced Plate For Your Baby
Whilst you have control, before toddler-hood and ‘fussy’ eating potentially comes into play, make babies meals as nutritious and varied as you can. Concentrate on 3 key food groups at each meal:

Carbohydrate – Vegetables, fruits and whole grains provide much needed vitamins and minerals, as well as fibre that feeds beneficial gut bacteria. Focus on lots of colourful vegetables, some fruit and a few grains (e.g. oats, brown rice, quinoa). As adults, your meal may contain more grains but baby hasn’t got the teeth to grind them or the pancreatic enzymes to digest them fully until 10-12 months so keep amounts small for now. Where you do use grains, ideally soak them for a few hours first before using them in your purees to help break them be more digestible.

Protein – Provides building blocks for baby’s growth and development. Think meat, fish, whole dairy, eggs, beans, lentils, ground nuts and seeds. Parents are often wary of introducing meat because it is more difficult for baby to chew; however, it is a valuable source of easily absorbed iron, zinc, B12 and many other nutrients. This is where meals such as chicken soup, slow cooked beef stew and a slightly blitzed turkey curry really come into their own as they provide easily munched and digestable forms of protein in comparison to a lump of steak.

Fat – Healthy fat, especially DHA a form of omega-3, is a component of every cell in our body and is crucial for baby’s brain development. Include oily fish twice a week, as well as avocado, olive oil, eggs, butter, homemade chicken stock and ground nuts and seeds. Try My First Super Food by Science Kitchen for a lovely ground seed mix to add to purees, smoothies, soups, yoghurt, homemade pancakes or flapjack.

As a parent it is easy to get hung up on exactly what baby has eaten that day. Remember to look at the amount and type of food baby consumes over the course of a few days rather than just one day or meal. They may eat lots of protein one day, only fat the next and not much at all sometimes. This should naturally balance out over the course of a few days.

Do I Need To Supplement My Baby’s Diet with Vitamins and Minerals?
The NHS guidelines recommend supplementing baby’s diet with vitamins A, C and D, all of which are important for immunity. Try Biocare Baby A, C, D Plus Drops for a good quality formula that also contains zinc.

Vegetarian and vegan – Risk of nutrient deficiencies increases with any restricted diet, including vegetarian and vegan diets. Special attention needs to be given to intake of calcium, zinc, iron, vitamin D and vitamin B12. I would encourage a consultation with a nutritional practitioner to ensure baby is getting all the nutrients they need.

This post has provided you with lots of information about when your child is ready for solid food, how and what to introduce. Look out for my follow up blog post where I’ll cover tips for encouraging a healthy diet and dealing with ‘fussy’ eating as baby grows into a toddler and beyond.

Lucy Malone is one of our team of Nutritional Therapists who specialise in baby and early years nutrition. Lucy also provides weaning and practical advice for babies, toddlers and fussy feeders. She has a specialist interest in feeding support and nutrition for children with developmental and neurological challenges. To book a face to face or Skype consultation with Lucy, please call NatureDoc reception on 020 3397 1824 or email [email protected]