Baby-led weaning

When should I wean my baby?

Weaning is the process of adding food other than breast milk or infant formula to your baby's diet. Advice about when exactly to do this has varied over the centuries:

• The World Health Organization (WHO) currently recommends exclusive breast-feeding for six months, with foods introduced at 6 months of age (26 weeks), while the mother continues to breast-feed.

• In the UK, Department of Health guidelines recommend the introduction of solid food 'at around 6 months', but that as individual development of babies varies widely, the recommended 'range' of ages is not before 4 months (17 weeks) of age, and not later than 6 months.

In the recent past, babies were weaned at 4 months. Concerns developed that babies might develop food allergies (such as coeliac disease) due to early weaning, and the advice changed. Research in the EU, however, suggests that six months of exclusive breast-feeding may underfeed some babies, that sometime between 4 and 6 months is the right time to introduce solids, and that doing so does not increase allergies. Canada also offers guidance on allergy prevention, saying that there is no evidence that delaying the introduction of 'trigger' foods protects against future allergy.

Preterm infants are a little different, as their 'maturity' age is less than their birth age, so you should ask your doctor's advice about when to start to wean.

Patient picks for Feeding your baby

Pregnancy

A guide to comfortable breastfeeding in public

Breastfeeding is legal in public spaces across the whole of the UK. However, many mums still struggle to breastfeed comfortably outside the home.

by Victoria Raw

Pregnancy

Feeding premature babies

Premature babies have extra nutritional needs. It is very important that they get the best possible nutrition to support them as they continue to develop outside the womb. Breast milk is the ideal nutrition, but babies born early may not be able to breastfeed directly. This leaflet explores some of the ways in which you and the hospital staff can feed your premature (preterm) baby in the early weeks.

by Dr Toni Hazell

How do I know my baby is ready for weaning?

You know your baby better than anyone but there are a few signs which your baby can give which suggest he or she is hungry for more than breast milk or formula:

• Babies who can sit up are more likely to want an active part in eating.

• Babies who can coordinate eyes, hands and mouth in order to look at food, pick it up and put it in their mouths are more likely to be ready for weaning. Read our feature on Spinal Muscular Atrophy to see the muscular milestones your baby should go through.

• A baby who is ready to eat may lose the reflex that makes them push food out of their mouth with their tongue if you put it there. This means they probably can now swallow food. They may also put things into their mouth, although this can sometimes mean early teething rather than the wish to eat solids. Most babies produce their first tooth at around 6 months, but some babies start teething a month or two before this.

• Your baby may seem hungrier, although this doesn't always mean it's time to wean. Your baby's appetite will increase as he or she grows anyway, and can do so in sudden spurts. If your baby is less than 6 months old and seems hungrier then it is worth trying feeding more frequently for a few days if breast-feeding, or giving more milk if formula-feeding, to see if this is enough, before introducing solids. Solid foods don't make your hungrier baby any more likely to sleep through the night than extra or longer milk feeds.

What should I give my baby when I first start weaning?

How do I start?

Start very gradually, just at one of the daily feeds, perhaps offering two or three spoons of food, or two or three different items to hold. Don't force your baby to eat, and if they don't seem interested, give up and try again another day. Your baby will still be getting most of their nourishment from breast or formula milk. Babies will often reject new food many times before accepting, so keep trying. Think about a baby-led weaning approach (see below).

• If the food is hot, test it carefully before giving it to your baby. Microwaves can cause hot 'pockets' in the middle of food, so take particular care to stir if microwaving.

• Always stay with your baby when they are eating in case they start to choke.

• If using a spoon, wait for your baby to open their mouth before you offer food.

• Don't be afraid of mess - learning to eat is messy but if babies are allowed to explore their food they are probably more likely to develop varied tastes.

• Feeding your baby when the other family members are eating can make sense, as your baby will see what you are doing and may try to copy. However, you don't want to begin weaning when your baby is at their most tired or crotchety.

• Don't expect your baby to eat much at first. Your baby may take less than a teaspoonful for the first few days, and there may be days when he or she rejects everything.

What first foods should I offer?

There is no single correct food to use to wean your baby. Weaning begins when you first introduce something new to your baby, and this needs to start very gradually and simply.

• Vegetables, fruit and rice all make good first foods. Food for babies should be as simple as possible, and it's best to stick to one food at a time first.

• Pieces of soft fruits like melon can really appeal to teething babies as they are cool on the gums.

• Babies' foods should not have salt added, even though they may taste bland to you.

• Babies also don't need sugary foods (which can cause tooth decay even before their teeth have come through) or spicy foods, and they should not be given foods which are too hot.

You can cook foods for your baby, puréeing or mashing them yourself, using breast milk, formula or boiled water to soften and thin them, or use commercial baby foods.

What should I include and avoid in my baby's diet?

• Apart from giving your baby extra calories and protein, weaning is a good time to think about your baby's iron and vitamin C. Sources of iron include red meat, peas and beans and some fortified cereals. Vitamin C is present in fresh fruit and fresh (or frozen) vegetables.

• Wheat-based foods are not recommended for babies aged under 6 months. Whole nuts and other solid foods which could cause choking or block the windpipe are not recommended until your baby is much older.

• It is now thought that babies at increased risk of peanut allergy (if, for instance, there is a family history of allergies) might benefit from early introduction to peanut-containing foods such as peanut butter - more research is being done in this area.

• The Department of Health recommends that all under-5s be given vitamin drops containing vitamins A, C and D every day, although babies who are having more than 500 ml of infant formula a day don't need vitamin supplements because formula is already fortified with vitamins.

What is baby-led weaning?

Baby-led weaning gives your baby a large degree of control over his or her move on to solid foods. In baby-led weaning, you offer your baby a variety of pieces of food (such as pieces of pasta, meat or fruit) that they can hold, and you let them suck and chew on them to explore the taste. To begin with your baby may end up wearing far more food than he or she eats (!) but gradually they will also start to swallow it.

In the 'purest' form of baby-led weaning you spoon-feed very little - just enough to allow your baby to learn to spoon-feed themself and to try foods like yoghurt and porridge - and you let them choose the rest. The principles of 'pure' baby-led weaning are:

• Let your baby reject food when they want to - you can try it again another day.

• Let your baby decide how much they want to eat. Don't top them up with a spoon at the end of a meal when they are 'done'.

• Allow lots of time for the meal; it may take a while for your baby to eat what they are playing with.

• Start with softer foods so that chewing is easy - lightly cook vegetables like carrot so it is not too daunting.

• Non-finger-foods, like yoghurt, can be offered with a spoon so that your baby can learn to self-feed with a spoon. Do this early in the meal, rather than just as they decide they have had enough.

• Never give your baby food that they are likely to choke on, such as peanuts.

What are the advantages of baby-led weaning?

The advantages are thought to be that:

• It is fun for your baby, although quite a lot messier for you.

• Some babies refuse solids off a spoon, but will happily help themselves to finger food.

• Your baby learns by watching and imitating you. Allowing him or her to eat the same food at the same time as the rest of the family, and eat whilst you are eating, will give them more chance both to learn and to socialise.

• It gives your baby a chance to be involved in their progression through weaning.

• Through exploring, your baby will develop eating skills at a pace he or she can manage, moving from sucking food to learning skills like chewing, munching and licking, yet at the same time having control over how fast this happens.

• Baby-led weaning allows your baby to set their own pace, choosing which foods to concentrate on.

• It supports other areas of your baby's development, such as hand-eye coordination.

• It encourages independence.

• It can reduce stress around mealtimes for both your baby and you. You won't feel that your baby 'has to' finish a portion, and won't keep trying to persuade them when they have lost interest. Your baby won't get fed up because you keep trying to put things they don't want into their mouth. Babies who are not stressed at mealtimes are less likely to be fussy and upset, and more likely to be open to trying new things.

• There is some evidence that baby-led weaning may have a beneficial effect on childhood obesity, helping them learn to regulate what they eat from an early age.

• It makes eating a form of learning, and allows babies to develop their natural curiosity around food, together with learning to take only what they need.

• Experts do agree that responsive feeding of babies both before and after weaning (see below) is a good thing. Baby-led weaning is a form of (very) responsive feeding.

• Evidence so far does not suggest it makes your baby less likely to gain the weight they need to, which had been a concern when the idea was first introduced.

There has been relatively little research comparing baby-led weaning to the 'old-fashioned' method of blending, puréeing and spoon-feeding what you feel your baby needs. This means that experts are not yet sure whether baby-led weaning should be clearly recommended as being better than the traditional approach. However, they do agree that common sense suggests it has many advantages, and the evidence does NOT indicate that baby-led weaning makes babies less likely to achieve healthy weights or more likely to choke.

What is responsive feeding?

Experts agree that responsive feeding is good for babies, and helps them develop healthy eating habits, and it is very clearly recommended by WHO. Responsive feeding simply means that you feed your baby when they seem to be hungry, responding to their needs. It is used to describe demand feeding in babies who are not yet weaned. Baby-led weaning is a type of responsive feeding.

What if my baby develops a food allergy?

There is a chance any baby may be allergic to certain foods, particularly cow's milk, eggs, wheat, gluten, nuts, peanuts, peanut products, seeds, fish and shellfish. These foods should be introduced one at a time, in small quantities, and not before 6 months. Waiting until your child is much older will not prevent them developing a food allergy. If you think your baby has developed an allergy to a food, discuss this with your doctor or health visitor.

If you have a family history of food allergies, eczema, asthma or hay fever, or your baby has eczema, your baby may be more likely to develop a food allergy.

What if my baby needs a special diet?

Some babies have medical conditions which mean that they cannot cope with certain food components and need a special diet from very early on. You will be given medical and dietician advice on feeding your baby if this applies to your baby.

Many mums choose to feed their babies in a way that is in tune with their moral and religious beliefs. This is not a problem, as long as the baby has a balanced diet containing all of the major food groups and a proper supply of vitamins and minerals.

What do I offer my baby from 6-9 months?

From 6-9 months, once your baby seems to have got used to some basic, simple food in pieces or as purée, you can start to add variety. Babies need to develop broad tastes in order to eat the things that they need.

• They can have soft cooked meat such as chicken, mashed fish, pasta, breads, lentils, rice and mashed hard-boiled eggs.

• They can have full-fat dairy products such as yoghurt or fromage frais.

• You should use foods with no added sugar or salt.

• Whole cow's milk can be used in cooking or mixed with food from six months (although drinks should still be of formula milk. First formula is absolutely fine - you don't need to use follow-on milk. Follow-on milk is fortified with some extra protein and minerals that older children need, but some doctors feel that follow-on milk should be avoided, as it is sweetened with corn syrup, and that the extra vitamins and minerals are obtained through solid foods and through drinking extra first formula).

• Cups can be used from around 6 months to offer sips of water with meals. Using an open cup or a cup with a free-flowing spout will help your baby learn to sip and is better for their teeth, although it will be more messy.

What do I offer my baby from 9-12 months?

From 9-12 months your baby will gradually be moving towards three meals a day, and their solid food will gradually be becoming a more and more important part of their nutrition, even if they are still breast-fed.

Your baby will gradually be able to chew more, and will be able to cope with 'looser;' textures like chopped or scrambled egg. You should be offering, over each week, fruit and vegetables, starchy food such as bread, rice, pasta, or potatoes, protein such as meat, fish, eggs or beans, and milk and dairy products.

Remember that your baby is very small, so their calorie requirements and needs are very much less than those of older children or adults. Don't be surprised if they don't eat very much.