Frequently Asked Questions about weaning your baby onto solids

• When should I start weaning my baby onto solids?
• Can you provide any useful tips for weaning my baby?
• What foods should I give at the start of weaning?
• Is there anything I mustn’t give at first?
• When should I give these first foods and how much should I give?
• When can I start introducing other foods?
• What are 'finger foods' and when should I give them to my baby?
• How much milk should my baby be drinking?
• Should I give my baby drinks other than milk during weaning?
• When can I start giving my baby the same foods as the rest of the family?
• What do the experts say about the best way to wean healthy babies?

• The Department of Health recommends exclusive breastfeeding for the first six months
• The decision to begin weaning, including the introduction of a follow-on milk formula, before the age of 6 months should only be made on the advice of a health professional based on your baby’s specific growth and development needs.
• Weaning usually begins between 4 and 6 months of age, dependant on your baby’s needs. Introduction of solids is not recommended before the age of 4 months because your baby's digestive system is not able to cope properly with solids before this age. There is also no nutritional reason for giving any food other than breast milk or infant milk before 4 months.
• If you don't think your baby is ready for solids at 4 months there's no need to start weaning then, but it is important that you start by the age of 6 months. By 6 months, breast or infant milk will not be able to satisfy all your baby's nutritional needs, and it is important from a developmental point of view to start giving other foods.
• Signs to look out for that may indicate that your baby is ready to start weaning are-
  • still hungry after a good milk feed
  • demands more frequent feeds
  • wakes more often at night for extra feeds
  • watches with interest while you are eating
• Have a word with your health visitor or other health professional if you believe your baby may be ready - they will be able to give you lots of good advice.

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• Tips on starting weaning
  • Choose a time when it is quiet and your baby is contented 
  • Give your baby’s usual milk feed first before any solids
  • Sit baby on your lap or in a reclining chair
  • Spoon out a small amount of food into a bowl or cup for less wastage
  • Use a small, shallow baby feeding spoon
  • Use a bib (those first tastes will probably roll right out again!)
  • First tastes should be mild and smooth in texture
  • There’s no hurry - baby’s usual milk still supplies all the nourishment needed

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• Think of the first solids as just 'tastes' - there’s no hurry. During the first weeks of weaning, your baby will learn that food has a different texture and taste to milk, and that it does not come in a continuous flow but on a spoon.
• The first foods offered should be mild tasting and should be mixed with your baby's usual milk or cool, boiled water to a thin, smooth consistency which can be easily sucked off the spoon. These first weaning foods should also be gluten free. Gluten is a protein found in the cereals wheat, rye, oats and barley and some babies are sensitive to it.
• You may choose to prepare your own baby meals, or you may try some of the many manufactured babyfoods available. If you are making your own foods, remember not to add salt or sugar. You should not use honey to sweeten your baby's food either, at least not during the first year of life. It can contain spores which can make your baby seriously ill (infant botulism).
• Gluten free foods such as pureed rice or cornmeal, Baby Rice (e.g. HiPP Organic Baby Rice), pureed vegetables (carrot, parsnip, potato) or pureed fruit (banana, apple, pear), are recommended first weaning foods.

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• What not to give a baby less than 6 months old:
  • Avoid using sugar
  • Honey should not be given before babies are 12 months
  • Avoid wheat-based foods - these  contain gluten, which is not suitable before 6 months
  • No nuts or seeds, including peanut butter
  • Don’t add salt to any foods you give
  • Processed foods that aren’t made specially for babies (eg breakfast cereals or pasta sauces) can be high in salt, so are best avoided
  • Avoid eggs
  • Avoid fish and shellfish

What is gluten?
All the information on weaning tells you to give ‘gluten free’ foods at first. Don’t be alarmed about this. Gluten is just a protein found in the following cereals: wheat, oats, rye and barley - so avoid these cereals, or foods containing these cereals, until your baby is 6 months or more.

All ready-made baby foods give information on the pack about when they can be given and whether they contain gluten.

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• Choose a time when your baby is quite contented - not starving, not teething, not snuffly - and a quiet time of day
• Sit baby on your lap or in a baby reclining chair - remember you’ll need to keep those little hands under control!
• Start by offering very small amounts of puree, perhaps only 1-2 teaspoons, on the tip of a clean, sterilised plastic spoon.
• If possible, try this first taste of solids before your baby's milk feed, but if your baby is very hungry, you may have more success if you offer the food part way through or after a milk feed. If your baby doesn't accept the food at first, don't lose patience but keep trying over several days.
• It is reassuring to know that breast milk or infant milk still provides all the nourishment your baby needs at this stage, so take your time and don't worry if your baby is reluctant to take these first foods to start with.
• Over the next few weeks, gradually introduce new tastes, and as each new taste is accepted, increase the amounts of puree you offer your baby. The thickness of the puree can also be increased gradually. Don't be tempted to force your baby to eat more than is wanted, let them go at their own pace. As your baby becomes well - accustomed to the idea of solid foods, start giving food at two meals a day, and then three.
• Eating food from a spoon is a technique that needs to be learnt, so don’t be surprised if that tiny taste of solid food comes rolling right back out again (don’t forget the bib).

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• As your baby begins to accept more of these first foods, try adding new tastes. It is important that you start thinking about introducing iron-containing foods to your baby's diet, particularly if you are breastfeeding. You can include purees of meat and poultry, lentils or split pulses to supply iron in the diet.
• Milk products such as full fat yogurts, fromage frais, and custard can also be introduced at this stage (unless your family has a history of allergies in which case these should not be included in the diet before 6 months of age). For the vast majority of infants, gluten can now be can be introduced from six months.
• Many of the foods you eat as a family may also be suitable for your baby, so simply puree or sieve them to the correct consistency. HiPP Organic Breakfasts, Savouries and Desserts suitable from 4 months can help you to introduce a wide range of tastes to your baby's diet.
• By about 7 months, your baby should be having a wide range of foods at three meals a day and the foods should have a thicker, lumpier texture. Eggs (well cooked) can now be introduced and are a quick and nutritious source of protein.
• At 7-8 months, if your baby seems ready, you should move on to mashed, minced or finely chopped foods to encourage chewing. Your baby may spit out the lumps at first, but persevere. The HiPP Organic range of foods suitable for infants from 7 months can help add variety and new textures to your baby's diet at this stage of weaning.

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• Finger foods are foods that encourage babies to feed themselves. They should be introduced very gradually from around 7-8 months, but ensure that the pieces are not too small as these could choke your baby.
• Good examples of finger foods include slices of ripe banana or pear, pieces of toast, pitta bread or chappati, breadsticks, chunks of cheese, pieces of peeled cucumber

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• Throughout weaning, continue to breastfeed your baby or give 500-600ml (1 pint) per day of infant milk (or follow-on milk from six months if you prefer). Give your baby a milk feed first thing in the morning and at bedtime, and other milk feeds during the day. The timing of these feeds will depend on what stage of weaning you have reached, but you should try to give milk feeds after meals and you should limit the amount of milk taken between meals.
• From 12 months onwards, if you are bottle feeding you can start to give whole cow's milk as your baby's main drink (but not semi-skimmed or skimmed milk).
• By this stage, your baby's food intake should be good so you can decrease the amount of milk given to about 350ml (12oz) per day. You should not let your child drink large volumes of milk after 1 year (i.e. more than 600ml per day) as it reduces the appetite for other foods.

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• At the start of weaning, you should continue to give your baby's usual milk feeds at mealtimes. The quantities of food eaten at this stage are small and your baby still relies on milk to meet his/her nutritional needs.
• Once your baby has got used to eating solid foods, the drinks you give at mealtimes can be milk, water or diluted fruit juice or baby drink. Make sure that any diluted fruit juice or baby drink is given in a feeding cup or beaker (not a bottle). Make sure that you don't leave your baby with these drinks for long periods (prolonged contact with the sugar in these drinks can cause dental decay). Restrict the use of sugar-containing drinks to mealtimes, offering only milk or water between meals.
• You should not give your baby fruit squashes, fizzy drinks, tea, coffee, undiluted fruit juices or drinks containing artificial sweeteners.

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• By the age of 9-12 months, babies should be able to eat many of the same meals as the rest of the family, minced or chopped to a manageable texture, and will enjoy feeding themselves. As well as three meals a day, offer fruit or another healthy snack twice a day between meals.
• Give plenty of starchy foods, for example bread, pasta, potatoes, rice, breakfast cereals, each day (3-4 servings), and fruit and vegetables (3-4 servings). Make sure your baby is getting enough protein and iron by including 2 servings of meat, poultry, fish, eggs, pulses or tofu each day.
• Some family foods will not be suitable for your baby. Give your baby full-fat dairy products i.e. cheese, yogurts – not low fat ones, but discourage high fat foods such as crisps, savoury snacks, pastry. You should try to limit the amount of high sugar and salty foods your baby eats. Whole nuts should not be given to any children under the age of 5 years because of the risk of choking.

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What do the experts say about the best way to wean healthy babies?

There's conflicting advice for parents

• When to wean, when not to wean?
• What foods to use, what foods to avoid?
• Will the food I give my child affect their later health and development?

These are all important issues which parents look to health professionals and others for advice, but don’t always hear a consistent message.

Aiming for consistency
In fact, because of the lack of published scientific evidence on complementary feeding and lack of consistent messages, there is considerable variation in weaning practices between different countries in Europe.  To try to overcome some of the confusion, a group of European child nutrition experts (ESPGHAN) has recently published a paper ¹ which has looked at all the current knowledge and feeding practices in healthy infants, with the aim of providing a list of conclusions and recommendations for health professionals and Governments to follow when communicating with parents so that more consistent advice is given.

Conclusions
So what conclusions did they come to and what recommendations have they given for the best weaning practices to follow?  A summary of these is given below, and are considered to benefit infants and young children not just in the short term but also in the medium to long term:

• Exclusive or full breastfeeding for about 6 months is a desirable goal
• Complementary feeding (introducing any solids or other liquids other than breast milk or formula) should not start in any infant before 17 weeks, and all infants should start by 26 weeks
• The same advice on weaning should be applied for breast-fed and formula-fed infants, even though their dietary needs may be different
• It is unclear whether earlier introduction of solids or other aspects of complementary feeding influence later obesity risk
• Avoiding or delaying the introduction of potentially allergenic foods e.g. fish, eggs, has not been shown to reduce allergies, in either infants considered to be at risk or those that are not (this conclusion has also been reached by the American Academy of Pediatrics in their recent review of dietary influences on the development of atopic disease²).  In fact, delayed exposure to high risk foods may be associated with an increased risk of allergy.
• Gluten should not be introduced earlier than 4 months, but gluten-containing foods should be introduced before 7 months of age.  Small amounts of gluten should be introduced slowly, preferably whilst a baby is still breast fed.  It is thought this could reduce the risk of developing coeliac disease, type 1 diabetes and wheat allergy
• Babies reach different feeding milestones at a range of ages and so appropriate foods should be given for each baby.  However, it is important to remember that there is a critical window for the introduction of lumpy foods, and if these are not introduced by around 10 months of age, it may increase the risk of feeding difficulties later on
• During complementary feeding, breast fed babies should receive at least 90% of their iron requirement from complementary foods and this iron should be sufficiently bioavailable.
• Cow’s milk is a poor iron source.  It should not be used as the main drink before 12 months, although small amounts can be added to weaning foods.
• Infants and children receiving a vegetarian diet should have a sufficient amount of milk (about 500ml), breast milk or formula, and dairy products in their diet
• Vegan diets are not appropriate for infants and young children.
• More research is needed to clarify the effects of different foods and/or nutrients on growth, development, and health during this period of rapid growth and development.

References

• Agostini C et al.  Complementary Feeding: A Commentary by the ESPGHAN Committee on Nutrition.  Journal of Pediatric Gastroenterology and Nutrition 2008; 46: 99-110.
• Greer FR et al.  American Academy of Pediatrics Committee on Nutrition. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas.  Pediatrics, 2008; 121(1): 183-91.

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