Introducing Solids to a Breastfed Baby
Current World Health Organisation guidelines say to feed your baby nothing but breastmilk for the first six months of life, and to continue breastfeeding alongside table food until your baby is two years old or older. But there is so much conflicting information out there as to what food to introduce first, how much, and even how. Here's a summary of current information and advice. |
The 6 month rule
Current advice is to offer solids at or around 6 months (or later, if baby is not yet willing to take solids). At this age:
- baby's gut has "closed" and the risk of allergies is much lower than if solids are introduced earlier.
- baby's immune system has developed to the extent where the risk of food-borne illness is reduced.
- baby can sit up and hold head up, reducing the risk of choking.
- baby can chew (teeth not needed!), has lost the tongue-thrust reflex which automatically pushes food out of the mouth, and the gag reflex has moved far enough back in the mouth to allow baby to deal with food.
- baby has the necessary motor skills to self-feed.
Current advice is to offer solids at or around 6 months (or later, if baby is not yet willing to take solids). At this age:
- baby's gut has "closed" and the risk of allergies is much lower than if solids are introduced earlier.
- baby's immune system has developed to the extent where the risk of food-borne illness is reduced.
- baby can sit up and hold head up, reducing the risk of choking.
- baby can chew (teeth not needed!), has lost the tongue-thrust reflex which automatically pushes food out of the mouth, and the gag reflex has moved far enough back in the mouth to allow baby to deal with food.
- baby has the necessary motor skills to self-feed.
“Food before one is just for fun”
This is often said though is not strictly true. In the second six months of life, milk remains the main source of nutrition, but babies begin to need additional nutrients. In addition, from 6-8 months, solids are as much about learning and development as they are about nutrition. Babies need their normal amount of breastmilk, and any solids they eat (not much at this point) will be as well as, not instead of, breastmilk. Do not worry if your baby does not eat much at this point, and do not feel that you need to reduce the amount of breastmilk your baby takes to encourage them to eat more solids. Breastmilk is more calorific and nutritious than most typical early foods. The average breastfed baby is not ready for solids until after 6 months, and some are not interested until even later. As with all developmental milestones, there is a wide range of "normal," so don't worry if your baby doesn't want to eat much at first.
At 8+ months, most babies begin to take in a slightly larger amount of solids and this begins to displace some of the breastmilk they consume. Breastmilk however remains the main source of nutrients until around 12 months, and a significant source of nutrients through the second year of life. What this means in practice is breastfeed on cue as normal, and before all table meals until your baby turns one. This way baby will get as much breastmilk as they need.
Let your baby be the guide
As of 6 months, babies are able to feed themselves, and health authorities recommend that this be encouraged. Self-feeding helps them develop motor skills and appropriate oral development. Offering a range of healthy table foods will allow babies to eat what they need. Spoon-feeding (e.g. purees) without being responsive to baby’s cues can lead to over-feeding, and replacing necessary breastmilk. Whether spoon-feeding or encouraging self-feeding, baby should be in charge, just as they have been while breastfeeding until now (baby has been telling mum when they need to feed, and baby stops feeding when they have had enough). Babies should be encouraged to continue following their internal hunger cues, and this sets up good eating habits for life.
This is often said though is not strictly true. In the second six months of life, milk remains the main source of nutrition, but babies begin to need additional nutrients. In addition, from 6-8 months, solids are as much about learning and development as they are about nutrition. Babies need their normal amount of breastmilk, and any solids they eat (not much at this point) will be as well as, not instead of, breastmilk. Do not worry if your baby does not eat much at this point, and do not feel that you need to reduce the amount of breastmilk your baby takes to encourage them to eat more solids. Breastmilk is more calorific and nutritious than most typical early foods. The average breastfed baby is not ready for solids until after 6 months, and some are not interested until even later. As with all developmental milestones, there is a wide range of "normal," so don't worry if your baby doesn't want to eat much at first.
At 8+ months, most babies begin to take in a slightly larger amount of solids and this begins to displace some of the breastmilk they consume. Breastmilk however remains the main source of nutrients until around 12 months, and a significant source of nutrients through the second year of life. What this means in practice is breastfeed on cue as normal, and before all table meals until your baby turns one. This way baby will get as much breastmilk as they need.
Let your baby be the guide
As of 6 months, babies are able to feed themselves, and health authorities recommend that this be encouraged. Self-feeding helps them develop motor skills and appropriate oral development. Offering a range of healthy table foods will allow babies to eat what they need. Spoon-feeding (e.g. purees) without being responsive to baby’s cues can lead to over-feeding, and replacing necessary breastmilk. Whether spoon-feeding or encouraging self-feeding, baby should be in charge, just as they have been while breastfeeding until now (baby has been telling mum when they need to feed, and baby stops feeding when they have had enough). Babies should be encouraged to continue following their internal hunger cues, and this sets up good eating habits for life.
No need for purees
Once baby’s system is ready to deal with solids, they are also ready to self-feed. Therefore there is no need to introduce baby cereal or pureed fruit and veg unless you want to. Rice cereal in particular is now considered a poor first food, as it is low in nutrients and is not well-digested in the early months; its use dates back to when solids were introduced before babies were ready, and therefore foods fed to a baby needed to be a) something which could be pushed into the mouth to bypass the tongue-thrust reflex, and b) unlikely to trigger allergies. At 6 months (or when a baby is truly ready for solids), neither of these issues is likely to be significant, and babies are able to eat a much wider variety of food. If allowing your baby to self-feed, you may well find that (counter to the usual progression of spoonfeeding) your baby initially does better with larger pieces of food that can be held in the fist and nibbled at. Spears of broccoli, or vegetables/meat in a stick-shape, are examples of things which can be offered – in essence, anything your baby can pick up themselves. As your baby’s manual dexterity develops, you will notice that they are gradually able to deal with smaller and smaller pieces of food.
Premature babies, once ready for solids, may enjoy self-feeding. However, as their rates of development may be different, sometimes they are ready for solids before they are physically able to self-feed. In this case you may want to make sure to offer spoons as well as finger foods.
Do remember – a predominantly spoon-feeding approach does not mean you can’t offer finger foods – and a predominantly self-feeding approach doesn’t mean you can’t offer spoons! Do what works best for you and your baby; the key is not to push food on a baby who doesn’t want it.
Once baby’s system is ready to deal with solids, they are also ready to self-feed. Therefore there is no need to introduce baby cereal or pureed fruit and veg unless you want to. Rice cereal in particular is now considered a poor first food, as it is low in nutrients and is not well-digested in the early months; its use dates back to when solids were introduced before babies were ready, and therefore foods fed to a baby needed to be a) something which could be pushed into the mouth to bypass the tongue-thrust reflex, and b) unlikely to trigger allergies. At 6 months (or when a baby is truly ready for solids), neither of these issues is likely to be significant, and babies are able to eat a much wider variety of food. If allowing your baby to self-feed, you may well find that (counter to the usual progression of spoonfeeding) your baby initially does better with larger pieces of food that can be held in the fist and nibbled at. Spears of broccoli, or vegetables/meat in a stick-shape, are examples of things which can be offered – in essence, anything your baby can pick up themselves. As your baby’s manual dexterity develops, you will notice that they are gradually able to deal with smaller and smaller pieces of food.
Premature babies, once ready for solids, may enjoy self-feeding. However, as their rates of development may be different, sometimes they are ready for solids before they are physically able to self-feed. In this case you may want to make sure to offer spoons as well as finger foods.
Do remember – a predominantly spoon-feeding approach does not mean you can’t offer finger foods – and a predominantly self-feeding approach doesn’t mean you can’t offer spoons! Do what works best for you and your baby; the key is not to push food on a baby who doesn’t want it.
Variety
Babies need to be offered a variety of foods to ensure a balanced diet. Family table foods are ideal (although the general principles of good nutrition apply). With the current trend of early-cord clamping after birth, baby’s iron stores often begin to run low during the second half of their first year; good first foods therefore include iron-rich foods such as red meat and chicken, eggs, lentils, and some fruit/veg. These foods also include zinc, another key nutrient needed by older babies. Pretty much any healthy, home-prepared food can be offered, though. As the gut has closed by now and the real risk of allergies has passed, experts say that in most cases there is no need to introduce one food at a time. Although caution may be advised if there are allergies in the family, current advice is that potentially allergenic food should be introduced during the second 6 months, and that delaying this may actually increase the risk of allergy. Food can be offered at every family meal. Remember, if baby has breastfed first, they will not eat more solid food than they need (sometimes they may not want any extra at all).
Keep it safe
A few caveats apply:
- do not cook with salt, as this can be dangerous for a small baby's (spices are fine, though, so baby can enjoy tastes of family favourites very early on!)
- avoid obvious choking hazards (e.g. cut in half and remove stones from fruit such as olives or cherries; do not offer whole nuts).
- avoid fish with high levels of mercury (shark, marlin, swordfish).
- do not give honey until 12 months due to the risk of botulism.
Gagging or choking?
Gagging is not the same as choking; it can be scary for parents but is not dangerous for the child, and is the normal physiological way of preventing choking. It can be quite common in the early months of introducing solids when the gag reflex is still further forward in the mouth, and protects the baby as they learn to deal with solid food. The risk of choking is no greater with self-feeding than with spoon-feeding. Choking can still take place with spoon-feeding, as the baby is not in control; also, as a spoon-fed baby learns to suck rather than chew, they may have more difficulties dealing with lumpier food when it is introduced – and at this later stage, the gag reflex is further back in the mouth thereby potentially increasing the likelihood of choking if baby has not yet learned to deal with chewable food). Choking, although not common, is always a possibility so use common sense. While they are eating, never leave your baby unattended, make sure they are sitting upright, and do not offer obvious choking hazards. You may also like to make sure you know what to do in case of an actual choking incident.
Water
An exclusively breastfed baby needs no additional water. However, as solids begin to replace the amount of breastmilk your child takes, they may need sips of water to prevent constipation and mealtimes are a good opportunity to introduce a cup. Water consumption can be gradually increased along with the amount of solids eaten.
Babies need to be offered a variety of foods to ensure a balanced diet. Family table foods are ideal (although the general principles of good nutrition apply). With the current trend of early-cord clamping after birth, baby’s iron stores often begin to run low during the second half of their first year; good first foods therefore include iron-rich foods such as red meat and chicken, eggs, lentils, and some fruit/veg. These foods also include zinc, another key nutrient needed by older babies. Pretty much any healthy, home-prepared food can be offered, though. As the gut has closed by now and the real risk of allergies has passed, experts say that in most cases there is no need to introduce one food at a time. Although caution may be advised if there are allergies in the family, current advice is that potentially allergenic food should be introduced during the second 6 months, and that delaying this may actually increase the risk of allergy. Food can be offered at every family meal. Remember, if baby has breastfed first, they will not eat more solid food than they need (sometimes they may not want any extra at all).
Keep it safe
A few caveats apply:
- do not cook with salt, as this can be dangerous for a small baby's (spices are fine, though, so baby can enjoy tastes of family favourites very early on!)
- avoid obvious choking hazards (e.g. cut in half and remove stones from fruit such as olives or cherries; do not offer whole nuts).
- avoid fish with high levels of mercury (shark, marlin, swordfish).
- do not give honey until 12 months due to the risk of botulism.
Gagging or choking?
Gagging is not the same as choking; it can be scary for parents but is not dangerous for the child, and is the normal physiological way of preventing choking. It can be quite common in the early months of introducing solids when the gag reflex is still further forward in the mouth, and protects the baby as they learn to deal with solid food. The risk of choking is no greater with self-feeding than with spoon-feeding. Choking can still take place with spoon-feeding, as the baby is not in control; also, as a spoon-fed baby learns to suck rather than chew, they may have more difficulties dealing with lumpier food when it is introduced – and at this later stage, the gag reflex is further back in the mouth thereby potentially increasing the likelihood of choking if baby has not yet learned to deal with chewable food). Choking, although not common, is always a possibility so use common sense. While they are eating, never leave your baby unattended, make sure they are sitting upright, and do not offer obvious choking hazards. You may also like to make sure you know what to do in case of an actual choking incident.
Water
An exclusively breastfed baby needs no additional water. However, as solids begin to replace the amount of breastmilk your child takes, they may need sips of water to prevent constipation and mealtimes are a good opportunity to introduce a cup. Water consumption can be gradually increased along with the amount of solids eaten.
Remember
Continue to breastfeed!
Early foods are in addition to breastmilk, not instead
Breastfeed as normal, before offering extra food
Sips of water with extra food
Continue to breastfeed!
Early foods are in addition to breastmilk, not instead
Breastfeed as normal, before offering extra food
Sips of water with extra food