When to start trying solids

Babies develop at different rates - they are very individual and readiness to begin solids varies between babies. Try not to compare your baby with friends' babies in deciding when to start. (If necessary, avoid the mums who are competing to see whose baby can eat three solid meals a day the soonest!) This leaflet explains when and how to begin giving your breastfed baby foods other than breast milk.

Breast milk for your baby’s first six months

Breast milk is the only food and drinks your baby needs for at least his first six months. It has all the essential nutrients in just the right amounts and is a better food than anything else you could give him. There is no set day to try solids, just like there is no set day that your baby will get up and start walking! Try the Banana Challenge.

Don’t be tempted to start solids "because the baby now needs more iron". Studies have shown that the baby’s iron reserves from birth, along with the well absorbed iron in breast milk, usually keep iron levels normal well into the baby's second six months1.

As a general guide, babies are ready to start trying some solid foods at around six months, although some may prefer to leave it until later. Your baby will show you when he is ready to try so look out for the following signs.

Signs that your baby is ready to try solids

• Baby is around six months old.
• He can sit up unassisted.
• He has lost the tongue thrust reflex, which pushes things out of his mouth.
• He shows interest in food, perhaps shouting and struggling to reach your food.
• He is able to pick up food and put it in his mouth.
• He wants to chew and may have teeth.
• He is still hungry after a feed and demands feeds more often. (But increase breastfeeding for a few days first, as this might be a growth spurt and your baby may settle back to less frequent feeds again after your milk supply is increased).
• Try the ‘Banana Challenge’. If your baby is able to sit up with their head steady, reach out, grab a finger sized piece of peeled ripe banana, and eat some of it all by themselves, they are ready!

Early solids can lead to allergies and other problems

Beginning solids too early can cause problems for your baby. Some foods may cause allergic reactions if they are started before six months because your baby's digestive system isn't developed enough to digest the food properly. If your baby fills up on solid foods he will take less breast milk - missing out on the balance of nutrients and essential antibodies. Research has shown that breastfed babies who start solids before six months are more likely to suffer a gastrointestinal infection than babies who are exclusively breastfed until 6 months2.

You may be tempted to give your baby solids to help him to "sleep through the night". Two studies found there was no difference in sleep patterns of babies given solids before bed and babies who were not given solids 3,4. In fact it is thought that babies who take ‘low calorie’ food during the day, i.e. pureed carrot or pear that fill up their stomachs without giving high calories, usually makes a baby to wake more at night to take on board the extra calories!

Waiting for your baby to be ready has these advantages:

• Feeding is less messy. Your baby won’t push food out of his mouth at you if you wait until his tongue thrust reflex has disappeared. He will also be able to co-ordinate swallowing mouthfuls of food.
• Your baby is less likely to suffer from food allergies.
• Preparing food is easier. Baby food can be mashed rather than pureed. Your baby may prefer to hold small pieces of food and feed himself.
• Your baby will progress from smooth to family foods more quickly.

Baby led weaning

Some babies are happy to lead the weaning process. At around six months, if food is within his reach or he sits on your lap at lunchtime, your baby may well help himself. If he can pick it up, get it into his mouth and chew, he can have it! For more information on baby led weaning go to:

http://www.borstvoeding.com/voedselintroductie/blw/engels.html

Start by offering your baby a small amount of your chosen food (see below) after a breastfeed. If he is very hungry, he may get too frustrated to try something new, so take the edge off his appetite by breastfeeding him first. If he refuses the food (turning his head away, spitting the food out, or pushing the spoon away) don't try and coax him. Let him feed himself particularly with ‘finger foods’. Let him decide when he has had enough. To begin with, your baby will be finding out about different tastes and textures. He may want to play with the food. Almost all his calories will still come from breast milk.

As your baby shows more interest in solid foods you can increase the amounts - he will show you how much food he would like. Continue to breastfeed too as breast milk is still an essential part of your baby's diet. There is no need to prepare separate meals for him. Offer suitable foods, mashed if necessary or bit sized chunks from your family's meal. Don't add salt to the meal during cooking - add it after you have taken out Baby's portion. You can also begin offering drinks of water from a training cup at meal times. (But mineral water is generally not suitable because of the high sodium content.)

First foods to try:

• For your baby's first tastes of solid food, stick to healthy, fresh, low allergen foods such as:
• Apple or pear (pieces or stewed and pureed)
• Vegetables such as carrots, parsnip or potato (pieces or steamed and pureed)
• Banana, avocado, or sweet potato.
• Mango or other soft fruit in season (but not citrus fruits or any berries) (pieces or pureed)

When your baby is over six months old, first foods need not be mushy and your baby may prefer finger foods such as toast soldiers, banana pieces or peas. (Be sure to stay nearby while your baby feeds himself in case of choking.) There is no need to add salt to food (added salt could damage your baby's kidneys). Don't sweeten food by adding sugar. It isn’t necessary and could encourage a sweet tooth.

Foods to avoid:

Certain foods may trigger an allergic reaction in some babies, especially if they are started before six months of age. If you have a history of food allergies, asthma, eczema or hayfever in your family, you may prefer to avoid introducing these foods for even longer, perhaps not until your baby is 12 months old. Some babies who are prone to allergies will refuse all solids until they are 8 or 9 months old or even older. Don’t worry, just make sure suitable solid food is available regularly, so that he can take it when he wants it.

Wait until your baby is at least six months old before trying these:

• Foods that contain gluten, especially wheat-based foods - bread, pasta, breakfast cereals, biscuits · Dairy products - cheese, yoghurt, fromage frais, cream, whey, milk
• Eggs, especially egg whites - offer hard-boiled egg yolk only the first few times your baby has egg.
• Citrus fruits (including orange juice) and berries, make sure that berries or grapes are cut in half so as not to present a possible choking problem.
• Honey - all babies should avoid honey until they are 12 months old
• Fish and shellfish - all babies should avoid shellfish until they are 12 months old
• Peanuts and other nuts and seeds - recommendations for children with a family history of allergy vary from waiting until 12 months to 7 years. Whole nuts are also a choking hazard.

For the latest information on foods to avoid ask your health visitor or visit the government Foods Standards Agency website www.food.gov.uk or check out Start4Life www.nhs.uk/start4life

Weaning from the breast

Weaning onto solids doesn't mean the end of breastfeeding. Breast milk should remain a large part of your baby's diet until he is at least 12 months old and breastfeeding is recommended for up to 2 years or more by the Department of Health and the World Health Organisation with the addition of suitable complimentary foods.

Breastfed toddlers have fewer illnesses than toddlers who are no longer breastfed. Your child will continue to get immunities through your breast milk. When he is ill, breastfeeding will be comforting for him and your milk may be the only thing he can keep down. Some of the benefits of breastfeeding (e.g. better dental heath6) are linked with continuing breastfeeding past the age of one.

References:

1. Pisacane, A. et al. Iron status in breastfed infants. J Pediatr 1995; 127
2. 429-31 2. Kramer, M.S. et al. Promotion of Breastfeeding Intervention Trial (PROBIT).A Randomized Trial in the Republic of Belarus. JAMA 2001; 285: 413- 420
3. MacKnin, M. et al. Infant sleep and bedtime cereal. Am J Dis Child 1989; 143:1066-68
4. Keane, V. et al. Do solids help baby sleep through the night? Am J Dis Child 1988; 142:404-05
5. Gulick, E. et al. The effects of breastfeeding on toddler health. Pediatric Nurs 1986; 12:51-54
6. Labbok, M. & Hendershot, G. Does breastfeeding protect against malocclusion? Am J Prev Med 1987; 3:227-32