When to Start?
The NHS (1), the World Health Organisation (2) and the CDC (3), all recommend introducing your breastfed babe to solid foods around 6 months old. This is so that your baby’s digestive system is mature enough to digest solid food. It is also around this time that your baby’s iron stores start to dwindle and their daily requirements are unlikely to be met through breast milk alone (4). Before introducing your babe to solid foods, you should be sure that they can:
Stay steady sitting unsupported in an upright position.
Co-ordinate their hands, eyes and mouth so that they can look at their food, pick it up and put it in their mouth.
Swallow food (rather than simply spitting it back out) (1).
It is important to note that: frequent night waking; chewing fists and wanting extra milk feeds are not signs that your baby is ready to start solids - they are normal baby behaviours! Due to anecdotal advice that I received from friends and family, I believed that once my boy started solids, his sleep would be magically transformed. Needless to say, my son was a voracious eater from day one, but it had precisely zero impact upon his sleep.
Unlike my personal experience however, a 2018 study found that the introduction of solid foods did have a positive impact upon increasing sleep totals at night; reducing the frequency of night waking and reducing the impact of ‘serious sleep problems.’ (5) The authors of the study focused on maternal wellbeing too and those mothers who introduced solids to their infants early self-reported an improvement in their quality of life. The differences in the two groups in the study peaked at around 6 months old and the early introduction groups slept on average around 16 minutes longer each night. The limitations of the study lie in the fact that sleep totals were self-reported by parents meaning that they may not be accurate. Despite these results, it is important to recognize that the authors of this study recommend that mothers continue to follow official guidelines regarding the introduction of solids into their baby’s diet (5).
Baby Led Weaning or Not?
Coined in 2003 by Health Visitor Gill Rapely, this unstructured approach to weaning is based upon babies being offered foods which they feed themselves unaided. Research suggests that it may contribute to healthier eating habits, as it helps babies to learn self regulation at a young age (6). However, other research suggests that baby led weaning makes babies more likely to be underweight and iron deficient because they do not typically consume iron-rich foods through this method (7). Personally, our family used a mixture of both baby led weaning and parent feeding in an attempt to try to ensure that my son was getting all of the nutrients that he needed. Having said that, I believe that it may be possible for your baby to get all the nutrients that they need through baby led weaning, if their diet is sufficiently nutrient dense and varied. Because the weaning process is often a slow one - and babies and toddlers can be notoriously tricky eaters, I recommend age-appropriate vitamins or supplements to fill any nutritional gaps in your baby’s diet.
What Foods Should I Start With?
Focus on exposing your baby to a wide range of differ textures and flavours rather than simply trying to fill their bellies as quickly as possible. As aforementioned, from a purely nutritional perspective, it is most important that your baby’s iron needs are met - particularly as iron deficiency is know to affect baby sleep (8). For this reason, vitamin enriched cereals are a common favourite food. Be sure to steer clear of any with added sugar or sweeteners if you choose them. Fresh fruit and vegetables are popular choices too. Pre-prepared store bought foods save time, but if you want to make your own, remember not to add salt or sugar to anything that you prepare for your babe.
It is safe to cook with cow’s milk & alternatives from 6 months (The ’Allergens’ for more information). My son’s first ever food was a carrot and breast milk purée. He loved it and we progressed through a rainbow of purées and finger foods in those early months. Oat porridge soon became a firm favourite for him too, often with a dollop of nut butter stirred through.
Introducing Allergens
There are lots of allergies in our families and so I was apprehensive about introducing common allergens to my boy. I was reassured to know that exclusively breastfed babies are at a lower risk of developing allergies if they are exclusively breastfed for six months (11). Nonetheless, the risk of allergies can be scary, particularly if they run in your family. The following foods should be introduced one at a time, in small amounts initially, so that you can recognise any allergic reactions:
Cow’s milk or goat’s milk
Eggs
Nuts
Seeds (serve them crushed or ground)
Soya
Fish
Shellfish
Evidence shows that delaying introducing certain allergens beyond 12 months increases the likelihood of developing allergens in the future (10).
Food Before One - Just for Fun?
Kind of, but not exactly…breast milk, formula or a combination of the two should be a child’s main drink for the first year of their life. You should continue feeding your baby on demand for as long as you like. Be aware though that your babe’s stomach is still small, so offer solids before nursing them at meal times. Try not to wait until your little one is starving before offering them food, or they may be too upset to eat. Unlike formula (which takes 3-4 hours to digest), breast milk is digested in as little as 90 minutes, so you may nurse your child closer to meal times than mothers who are using formula (9). A helpful guideline to follow is that your baby’s diet should be at least 25% solids and 75% breast milk by around one year old and at least 75% solids and 25% breast milk by around two years old. Start slowly when it comes to weaning, allowing your child to explore different textures, tastes and temperatures in a safe and fun way. Avoid pressuring them to eat too much too soon, so that mealtimes do not become highly pressured. Listen to their cues when they indicate that they are finished and do not label any foods as 'good' or 'bad'.
For my son, breastfeeding was about comfort much more than it was about satiating his hunger and so I did not restrict his nursing until he was over two years old. He ate well until he was around one and then he became much more picky about when or how he wanted to eat (not so much about the types of foods) as a way of asserting his independence! He is almost three years old now and my milk supply is much smaller than it was a year or two ago. I do not restrict his nursing because I am worried about him eating, but I have recently put boundaries in place for my own sanity(!).
What About Drinks?
Offer your little one sips of water from a free-flow cup when they eat to protect their emerging teeth. Cow’s milk or non-dairy alternatives are only recommended as a drink after 12 months of age. Juices are not recommended before around five years old, so if you do introduce them before that, dilute them heavily (1).
Portion Sizes
When it comes to portion sizes, a baby led approach allows the baby to decide for themselves how much they would like to eat, but how much should you prepare? A good rule of thumb to follow is to think of your child’s palm as a portion of any of the food groups. Try to gradually include carbohydrates, protein and fruit or vegetables at each meal. Let’s not forget that although formula is not recommended beyond 12 months old, breast milk is recommended for as long as is mutually desired by mother and child (2). In fact, it continues to provide your 12-23 month old with the following nutrients as they grow:
448 ml of breastmilk provides:
29% of energy requirements
43% of protein requirements
36% of calcium requirements
75% of vitamin A requirements
76% of folate requirements
94% of vitamin B12 requirements
60% of vitamin C requirements (11)
Babies and toddlers are notoriously picky eaters as they begin to navigate the world of solids. In order to ensure that your little one is getting enough essential vitamins and minerals as they grow, you may want to give them an age-appropriate supplement to support their diet. Vitamins A, C, D & E are readily available in child-friendly drops or chewable gummies. You may want to consider giving your child a suitable calcium, magnesium and omega 3 supplement if you think they are not getting enough through a limited diet.
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