Wednesday, May 14, 2014

The What, When, and How of Weaning.


Last month, Charlie’s pediatrician gave us the green light to start feeding him cereal, fruits, and vegetables. While some of you might think I’m thrilled to finally feed my son the truth is, I’m a bit mystified.

Most pediatricians, in this country at least, suggest introducing solids anywhere between 4 and 6 months.1 The World Health Organization (WHO) suggests breastfeeding exclusively for at least 4 months and optimally 6 months. And, once you start to introduce solids, milk should remain your child’s main source of nutrition until around 12 months. But to me, those suggestions seem pretty vague. I’m still confused about when I should start, what I should start with, and how much I should feed him?

When should I start?

For the past month I’ve been reading the book Baby-Lead Weaning2. The book suggests beginning weaning once your baby demonstrates they are ready to feed themselves.  They do this by grabbing and bringing food to their mouths, intensely staring at you while you eat, leaning in when food is presented to them, and ultimately sitting up unassisted (Typically around 6 months, but sometimes as early as 4 months). Some research reports that many babies have been given solid food before 4 months, and as early as 14.6 weeks. In these cases mothers often claim they have a “big”, “hungry” or “fussy” baby, or they need to fill their child so they will sleep longer1 – this is especially true for mothers of boys. However, there is no need to give solid foods to babies that early, and some research suggests this can be harmful.

The American Academy of Pediatrics (AAP) states that introducing complimentary foods is important to childhood development, but starting too early can increase the incidence of obesity.3They recommend introducing complimentary foods to your child around 6 months. Which happens to be around the same time they start to sit up unassisted, reach for foods, and develop the fine motor skills to be able to pick food up and bring it to their mouths.

What should I feed my baby?

Weaning is not only a question of when, but what? When I think of feeding babies I think of purred foods in a jar (Most likely the result of good marketing). While most “first foods” are sweeter, it is important to offer a wide range of taste experiences. Research suggests that offering your baby a variety of foods and textures is really important to development and the weaning process.

Preparing foods at home helps predict a greater intake of fresh fruits and vegetables at a later age, and home-prepared foods are often more nutrient dense - as they are likely prepared with less sugar, water, or fillers.4So, if you can prepare your own foods, great. If not, aim to provide homemade food most days of the week.

Offer one new food a week to determine your baby’s tolerance of that food. While most foods are OK start with cereals, fruits, and vegetables should be some of your baby’s first foods. And remember, stay away from honey, corn syrup and any added salt.4

Babies also need to learn to feed themselves. Offering large pieces of food they can easily grasp and gnaw on helps to develop your baby’s coordination. Large, finger sized foods, that don’t easily break off are ideal. Things like soft toasted bread and teething biscuits are a good way to start. After that, foods like carrots, apples without the skin, and large pasta shapes can be easily grasped and gnawed. It doesn’t matter if your baby eats the food or not; the point is to get your baby experimenting with different tastes and textures.2

What are the benefits of feeding now?

During weaning, your baby’s main source of nutrition continues to be breast milk or formula. However, as your baby grows so do their nutrient needs. For example, Babies have enough iron stores to suit their needs up until about 4 months of age4. But infants who are only receiving breast milk*after 6 months are at risk for developing an iron deficiency. This is why iron fortified cereals and formulas are often encouraged.

Another consideration is Mom’s nutrition. Breast milk continues to be the most bioavailable food for babies, but just because your supply is well established does not mean your work is done. The quality of your breast milk is directly determined by the quality of your diet. If you are at all concerned about your diet offering some complimentary foods may be important.4

It takes time for your baby to develop the skills to properly chew and swallow food. Foods with varied consistencies can help develop these skills. And, as discussed before, babies are often ready to develop these skills around 6 months.

Research from Harris 1993 found that there is a “window for acceptance” of new tastes between 4 and 6 months. His research suggests children who lack experience of solid foods, and especially lumpy foods, during this time may show problematic eating later in life.  Who knows? But either way, it’s a good reason to start.

How much should I feed my baby?

Remember to always ask yourself “Is my baby peeing, pooping and growing?” Although your baby’s weight gain trajectory slowly declines, all babies should continue to gain weight over time. Make sure that you are feeding your baby enough to continue along their current growth trends, but don’t force your baby to eat. If you child doesn’t seem interested in food that day, don’t sweat it. Remember, Milk should be your baby’s number one source of nutrition until around 12 months, and you can always try again tomorrow.

Your food environment

If you’re not eating well you’re baby will likely not eat well either. This might be a good time to take stock of your eating habits, and consider how you want mealtime to look in your home. It can take time to change eating habits so the sooner you get started the better.

The home food environment directly effects your child’s acceptance of new foods and food altogether. You don’t have to sit down to a family dinner every night with your baby, but you should make an effort to sit with your baby while they eat. If you’re up walking around, watching TV, or looking at your cell phone your baby will pick up on it. Keep in mind that after a long day, mealtime can be a nice time to be quiet and engage with your baby.   

You should also think about having a small snack of something your baby is eating as well. Munching on a few apple slices, carrots, or toast strips demonstrates good eating habits and will help your child observe and learn.

What’s my plan?

Since starting my research for this article I have tried giving our son oatmeal, twice. While he loved it, I’m still not 100% confident with his ability to sit up so, I think I’m going to hold off a few more weeks until he’s really ready. But this mini-feeding experiment has given me an opportunity to come up with a 10-step feeding plan:

  1. Take the time to prepare foods and freeze them now. Our farmers market just opened so it’s prime time to get our stock up.
  2. Think about the different textures you may want to introduce your baby to. I’ll likely give our baby a combination of spoon and finger foods at each meal.
  3. Create the right environment. Our son loves to watch me eat. I’m going to continue to have him sit with me during mealtimes when I can. Once he’s eating more regularly, I’ll sit with him while he eats. No TV, Cell phones, or chores allowed!
  4. Plan on introducing one new food a week. I’m probably going to alternate between fruits and vegetables each week to start.
  5. Be ready to experiment. I know I won’t have all the answers, and I’m going to be willing to try new things like mixing foods to increase his nutrient intake and to vary textures.
  6. Keep track of his pees and poops to make sure he’s not constipated or experiencing any intolerance.  
  7. Let it go. Remember milk is still #1. Just because he may not be eating what I’m giving him does not mean I’ve failed. 
  8. Don’t let others intimidate me. I’m going to make sure to do what I am most comfortable with and what I feel is best for my baby.
  9. Remember to continue to progress. Weaning is important for my baby’s development, and continuing to offer him new foods is important. I’m going to be conscious of not getting stuck in a food rut.
  10. Have Fun! I have discovered that in parenting it’s easy to over think everything! I’m just going to go for it while having fun watching my baby learn.






*Most infant formulas are fortified with iron, but don’t assume that yours is. Make sure to check the label. 

  1. Vereijken, C.M.J.L, Weenen, H., Hetherington, M.M. (2011). Feeding Infants and Young Children. From Guidelines to Practice- Conclusions and Future Directions. Appetite, 57, 839-843.
  2. Rapley, G., & Murkett, T. (2011) The Baby-Led Weaning Cookbook. New York, NY: The Experiment, LLC.
  3. American Academy of Pediatrics. Food Introduction: Evidence. Infant-Food and Feeding. Retrieved from http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx#none.
  4. Mahan, L.K., Escott-Stump, S. (1996) Krause’s Food Nutrition and Diet Therapy. Philadelphia, PA: W.B. Saunders Company.