starting solids
    starting solidsstarting solids

    Forget apple mush and those little jars and spoons – simply let your baby feed herself. A baby’s instincts will lead him to do the right thing when it’s the right time. Trusting those instincts is what baby-led weaning is all about.

    When you have a baby, you’ll  find there is one topic that everyone has a view on – starting solids. And they won’t hesitate to share those views with you. While there are some people we don’t mind getting advice from, it can be overwhelming to hear too many opinions. You probably won’t be able to stop unsolicited suggestions, but in deciding what works for you and your family it might be helpful to know what your options are, and what the latest research shows.

    WHEN TO START SOLIDS

    Recommendations from the World Health Organization and health authorities in most countries have been to breast-feed exclusively until six months and then start introducing solids. However, new research from immunologists around the world suggests that starting solids between four and six months may help to protect children against food allergies and coeliac disease. While most countries have not changed their recommendations yet, there seems to be mounting evidence that introducing foods such as egg, wheat and peanuts during this four to six-month window might actually be protective and prevent allergies.

    The best advice is to follow your baby’s own lead and watch her for individual signs of being ready to start solids. These include:

    • Doubled birth weight
    • Good head control
    • Loss of the tongue-thrust reflex. In the first four months of life this reflex protects babies from choking. When anything unusual is placed on the tongue, the baby will automatically push it out rather than back. This reflex starts to diminish between four and six months.
    • The ability to communicate fullness by turning away from the bottle or breast. Babies need a way to let you know they are full to prevent over-feeding.
    • Interest in food. Is your baby trying to grab food off your plate?
    • Waking more frequently at night. But bear in mind that babies often go through a growth spurt at three to four months, and this may mean that more milk (breast or bottle) might be needed.

    SOLIDS AND ALLERGY RISK

    Dr Brian Symon, a clinical senior lecturer at the University of Adelaide, says that a number of studies have shown that delaying solids may increase the risk of allergies.

    ‘The research is increasingly robust that the human gut has this window of opportunity which is there from at least four months of age, and if we’re to utilise that window of opportunity then the baby may have a significantly lower risk of developing allergies,’ he said. ‘Clearly there is a correlation between the later introduction of solids and the rise in allergies. The research shows it’s increasingly likely that by introducing a range of food choices earlier in life – as early as four months because that’s less contentious than introducing them earlier – will be protective.’

    HOW TO START SOLIDS

    When people think of starting a baby on solids, they tend to envisage the traditional spoon-feeding approach to weaning, usually starting with rice porridge or some other cereal. There is another way to introduce solids, however – not only by letting the baby set the pace for when she is ready, but by letting her take control of the whole feeding process. This approach is called baby-led solids, and allows babies to feed themselves from the start.

    While there is a lot of information and debate about when to start solids, until now there has been very little research about how the method of introducing solids affects babies’ food preferences and health. Recent research in the British Medical Journal by Ellen Townsend and Nicola J Pitchford1 compared a traditional spoon-fed group with those allowed to follow baby-led weaning.

    They found that compared with the spoon-fed group the baby-led group had a significantly increased liking for healthy carbohydrates as opposed to sweet foods. They also liked vegetables more. The authors concluded that ‘Weaning style impacts on food preferences and health in early childhood. Our results suggest that infants weaned through the baby-led approach learn to regulate their food intake in a manner which leads to a lower BMI and a preference for healthy food like carbohydrates. This has implications for combating the well-documented rise of obesity in contemporary societies.’

    WHAT ABOUT CHOKING?

    Development of a baby’s ability to manage food in his mouth and to digest it keeps pace with his development in other areas. A baby who is struggling to get the food into his mouth is probably not yet ready to eat it. Parents need to resist the temptation to help as it’s the baby’s developmental abilities which ensure that the transition to eating happens at the right pace and that the chance of choking is minimised.

    A baby must always be in an upright supported position when eating. This ensures that food he can’t yet swallow can fall out of his mouth. Never tip a baby backwards or let him eat lying down.

    TIPS FOR BABY-LED SOLIDS

    • Offer the baby a chance to participate when everyone else in the family is eating.
    • Make sure he is upright in a well-supported position, on your lap or in a high chair.
    • Offer foods that are about the same size as the baby’s fist and that have a ‘handle’, e.g. broccoli on the stalk, fingers of toast, wedges of pear, banana, cheese, etc.
    • Offer a wide variety of foods.
    • Don’t hurry your baby – let him set the pace and don’t be tempted to help.
    • The baby may not actually eat any food the first few times. Playing, squashing, sucking, and putting some food in his mouth and then spitting it out is absolutely normal.
    • Try food that the baby has rejected again later on. Sometimes babies need to taste something quite a few times before they start to like it.
    • Never leave a baby unattended while he is eating.
    • Don’t offer fast food with high sugar or salt content.
    • Start to offer water from a sippy cup, but again it may take a while before the baby starts to drink it.
    • Continue with breast-feeding and/or bottle-feeding as before. The baby will not eat enough in the beginning to satisfy his hunger.
    • Breast-milk will adapt to the weaning changes – its concentration of water increasing to deal with the extra digestion needs associated with eating solids. Bottle-fed babies may need extra water as their formula does not usually change with weaning. In both groups watch out for constipation.
    • Finally, expect a bit of mess and enjoy watching your baby discover food!

    Reference

    1. Townsend E, Pitchford NJ. Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case- controlled sample. BMJ Open 2012;2.

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