The World Health Organisation recommends that all babies should be exclusively breastfed for six months, with no water or solids, and then to carry on with breast milk, alongside complementary foods for up to two years of age and beyond.
Research has shown that breast milk is a nutritionally adequate food that provides a complete nutrition, all in the right amounts for your baby.
Your baby’s digestive system is far more able to cope with foods at six months when foreign proteins from the foods start to enter his body.
There is also a full complement of enzymes then, ready to digest that food.
There is also evidence to show that the more exclusively a baby breastfeeds, the less risk of diarrhea and other gastric illnesses.
One particular study compared babies over four months who had been fully breastfed or fully formula fed, compared with exclusive breastfeeding for six months.
It was found that the babies who had been exclusively breastfed for the longest time were far less likely to develop those gastric illnesses.
Waiting until your baby is six months old before introducing solids can reduce his risk of developing food-related allergies and intolerances, especially where there is a family history.
Another study has also shown a reduction in risk of pneumonia and recurrent ear infections when compared to babies who have been exclusively breastfed for six months as opposed to a shorter time.
Within society, we often hear from experts about obesity and how to tackle this ‘epidemic.’
Copious studies show that exclusive breastfeeding can reduce a baby’s risk of obesity in the future.
Exclusively breastfeeding your baby for six months before you start introducing solids can reduce your own risk of breast cancer, as well as reducing the risk of anemia, and it can also help with weight loss.
Your baby will be developmentally ready to start solids around the six month mark. Most guidelines encourage you to look for signs that your baby is ready for solids, around this time.
It’s important to know that the guidelines for starting solids have changed over the years.
It had been previously suggested that if your baby started waking at night, this was a sign that he was ready for solids.
In reality, this would mean that the baby could have been as young as three or four months!
We now understand that babies will wake at night for various reasons, and this isn’t a concrete sign that solids are required!
Babies often begin to wake up more at night when they do what is termed ‘reverse cycling.’
The reason this happens is usually because of distractibility in the day, where they may consequently take very short, distracted feeds, but then make up their supply of milk at night, (when it’s quiet and often dark) and start to feed more frequently then.
Babies may also wake at night due to teething or a developmental change, so these are not reliable signs that a baby is ready for solids.
So how will you know that your baby is ready to start solids?
One of those signs is that he will be able to sit up well without support.
He will also have a lot more muscle control, and he’ll also lose the extrusion reflex, where he sticks his tongue out.
That tends to disappear around about six months of age.
Before 2003 we used to give purees to babies around the four-month mark.
At that age, babies were often pushing the food out of their mouths because of this reflex. The reflex usually disappears around six months.
You may feel that if your baby can use his palm to scoop up food and try to put it into his mouth, that he’s ready for solids.
However, he needs to be able to use a pincer grasp, and that means being able to pick up food between his thumb and forefinger and bring it to his mouth.
It may be quite surprising to learn that if you give solids to your baby before six months of age, he may receive fewer calories than if he was having breast milk itself!
Breast milk is a high calorific food.
There is also less protection for your baby because of reduced antibodies (as he will be taking in less milk).
So when you spot the reliable signs that your baby is, in fact, ready for solids, then this is a good time to start.
However, remember that your breast milk is still able to provide three-quarters of your baby’s nutritional requirements between six and 12 months.
When you start to offer foods to your baby, they will need to provide extra zinc and iron to contribute to the nutrition, but your breast milk is still paramount.
Along with the zinc and iron, food is providing your baby the opportunity to experiment with tastes and textures.
It can be useful to feed him at the breast before offering food. When he has had some food, you can breastfeed again.
Feed your baby as often as needed at the breast.
So when your baby is ready to eat solids, you can sit him upright in your lap to offer those foods, or sit him in a high chair with something underneath to catch all of the mess!
It may be a good idea to offer very small amounts of food at first.
A quarter of a teaspoon once per day, gradually increasing that as your baby needs, and try to provide just one food at a time for a few days, in case your baby has an intolerance to that food.
So what kind of foods should be offered?
Ripe bananas, sliced and cut into smaller amounts or soft avocado is great. If you use apple, it’s always good to soften them up first of all in the microwave and cool them down so that they are easily manageable.
There’s always a risk that babies could choke on harder pieces of fruit or vegetables, so it’s essential to ensure safety, and never leave your baby unattended.
Vegetables are an excellent food – but remember to wash them and peel them and cook them until they’re tender so that it’s easier for your baby to eat them.
Mashed potatoes are also good as well as mashed sweet potato – or you can cut them into chunks.
It is also important that babies around six months old receive extra zinc and iron from food, so meats e.g., cooked chicken and beef that is very easy to eat, and shredded into tiny pieces can be given.
You can also offer fish, but it’s crucial to ensure that there are no bones, as this poses a choking risk.
Bread in the form of fingers of toast can be excellent for your baby, as babies do love finger foods. Also, consider crackers and breadsticks.
If you have a family history of food allergies, it would be important to introduce foods that can be potentially allergenic, one by one.
So offer cows milk, eggs, wheat, gluten, nuts, peanuts and peanut products, seeds, fish and shellfish one at a time, and at the recommended time.
If your baby is already diagnosed with a food allergy or intolerance, or you have hay fever, asthma, or eczema, it would be important to speak with your healthcare provider or a dietitian.
Finally, if your baby has been born prematurely or with low birth weight, he may not have had enough iron stores at birth to last the full six months before the introduction of solids.
In this situation, your baby can be supplemented with iron before six months if necessary, and breastfeeding can continue – you can then introduce solids at six months.
After the introduction of solids, breastfeeding can continue for a substantial amount of time.
There is no upper limit to how long you do that. It’s really for you and your baby to work this out together.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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