A lot of people have asked me recently about skipping purees and going straight into baby led weaning. There are pros and cons to every weaning approach. You need to find the approach that works for you but here are some of my thoughts if you are looking for guidance.
Baby Led Weaning
The theory is that if you wait until 6 months your baby can skip purees and start feeding themselves with finger foods. The baby takes part in family meal times and the baby decides how much she/he will eat. Your baby is in the driving seat but finger foods have their limitations.
This approach starts with spoon feeding of purees which progresses through four stages of textures. Using a spoon can be helpful when trying to achieve variety as some foods are not good finger foods. It’s very much a parent led agenda and the risk is the parent does not respect the child’s refusal and spoon feeding becomes intrusive.
I believe there is a good middle ground and both spoon feeding and finger foods have their place in the weaning process. Just as long as you, the parent, fulfil your feeding role then there is no risk that spoon feeding becomes a negative experience.
- Attentive feeding is at the heart of this approach. Respect your role in the feeding realtionship (see earlier post) and watch for signs that your baby wants more or has had enough.
- There is nothing wrong with spoon feeding if it is done properly. When you first start with weaning your child will most likely be unable to feed themselves sufficiently. Spoon feeding will provide taste exposure and nutrition until they can adequately eat by themselves. I have known some babies to start waking up at night again because baby led weaning did not fill them up.
- Let them play with food even whilst you are spoon feeding e.g. give them a soft cooked carrot stick to chew on. That way they get to feel the texture and engage with the food.
- Be wary of iron deficiency.The foods that are good sources of iron (chicken, meat, fish, beans/lentils) are often hard to give a 6 month old as finger foods so spoon feeding is handy for these.
- The stages of weaning are not time specific. Your child may progress very quickly through purees and textured foods to soft finger foods. Let your child be your guide to the right texture for them at that stage.
- Encourage family meals. Try to involve your baby in your meal times (have them sit at the table with you) and try to eat something when they eat. And instead of cooking separate meals, try to tailor your meals to your little one (no sugar and salt).
TOP TIP: Let your child’s development determine how you progress with weaning and what type of foods you offer.
When you have a child you have to start thinking about the best way to feed your child. And getting it right from the start will stand you in good stead for the future. Understanding your role as a parent in the feeding process will make meal times easier, relaxed and more fun. I recently came across Ellyn Satter’s work and she explains the feeding roles of the parent and child really well. Here’s a quick summary for you.
THE PARENT is responsible for
- What your child eats. You choose the meals you cook and serve and can ensure your child has a balanced and varied diet.
- When your child eats. Setting routine meal times is important to make sure your little one does not go hungry and their energy levels remain topped up. Having meals together with the family is great because then your little one can watch you eat..
- Where you child eats. Meals are best at a table and together with the family.
THE CHILD is responsible for
- How much they eat. You have to trust your child and that they know when they have had enough. Research indicates that children have very good satiation and hunger cues. Let them listen to their internal cues and stop when they have had enough
- Whether they eat. Remember when your parents’ asked you to eat up? I am sure it didn’t make you want to eat. There will be some days your child does not feel like eating. Respect this wish and your child will respond positively when they want to eat.
These roles apply to solid food as well as any milk feeds you give your child.
TOP TIP: You can make meals a positive experience if you provide balanced meals at the right time and place but respect your child’s right to choose how much they eat.
It’s official. Oscar does not enjoy broccoli. I found myself performing tricks like a circus monkey to sneak in an extra teaspoon. And then he just got more annoyed. Fair enough. I remember the same response to my mother’s cajoling when I was a child.
Try not to force your child, even if you have slaved over that meal. You wouldn’t want them to develop negative associations with solids, would you? Learning to like foods takes time.
Here are some signs that your little one has had enough;
- Keeps his mouth shut
- Turns head away
- holds food in his mouth and refuses to swallow
- Cries or screams
- Gags or retches
- Pushes away the spoon or food offered
TOP: No means no. Accept it and put the spoon down.
Oscar had his palate repair operation this Monday. It’s been an emotional and exhausting week but we are relieved to be the other side of the operation. We have been amazed by how quickly Oscar has bounced back. We had our first smile on day 2 and he has been smiling ever since. We are so proud of our little boy for getting through it all and a big thank you to all the doctors and nurses at Great Ormond Street Hospital. A truly amazing and humbling place.
Below are some of my learnings. I hope these can help you if you have a child with a cleft palate. Please feel free to share any thoughts you may have as every child is different and other parents can benefit from your experience.
Before the operation
Oscar’s operation was booked for when he was 7 months old. I was pleased with this as we had ample time to get him used to solids before the operation (we started weaning at 5 months) and would have plenty of time after the operation to progress weaning before he turned 1 year old (the key milestone for getting babies off the bottle and onto family meals).
- Get to know your child’s eating habits and what they like eating. This will be important when encouraging them to eat after the operation e.g. enticing them with their favourite food.
- Get your little one well established on solids as the liquids like milk may not be accepted soon afterwards.
- Introduce the free flow cup. This may provide another option if your baby refuses his bottle
- Prepare for the nil by mouth period. We knew Oscar would only be going into to surgery after 8.30 in the morning. A few mornings beforehand I started delaying his 7.00 milk feed so he would not be completely distressed on the morning of the operation. Distracting him with a few new toys also helped!
After the operation
It’s an emotional and tiring time but there are things you can do to help.
- Try to get your baby eating asap after the operation (only if advised by your cleft team). The surgeon informed us that those babies that get eating soon after the operation bounce back quicker.
- Solids were accepted before liquids. Oscar did not enjoy liquids at all. Apparently this is because liquids are harder to swallow with a sore mouth. Instead we made up some baby porridge with formula so it was runny but could be eaten off a spoon. We also managed to squeeze some puree into his mouth from the ready made baby food pouches.
- Hydration is important. If they are not drinking, try to sneak liquids into them another way. Add formula or breast milk to purees or prepare baby rice/porridge/cereal with formula or breast milk. We also syringed small amounts of milk into his mouth every now and then.
- Play with textures. I tried several textures with Oscar before he accepted one. Just keep some milk to hand and mix it in with the porridge until it is just right for your baby.
- You know your child. Banana porridge was Oscar’s favourite and we had that for all meals for 3 days. He also loves his bouncing chair so we brought this with us to the hospital. He refused to eat anywhere else for the first week. It was a challenge for us as we had to hold it when I fed him so he did not bounce onto the spoon but he was happy so worth it!
- Try to give milk off the spoon if they won’t accept a bottle.
- Try feeding little and often. Oscar could not manage much at a time so we fed him whenever he was up for it.
- Don’t push your baby. I was desperate to get food into Oscar but had to remind myself that he had just had a big operation. Its important for them to eat but you don’t want them to get more upset than necessary. Take a break and try another time
TOP TIP: Don’t worry about how much they are having or giving them balanced meals after the operations. Just feed them their favourite meals and go for the ‘little and often’ approach.
Oscar definitely shows a preference for sweet foods like fruits. This is natural. Research has shown that babies are born with an inherent liking for sweet foods. Newborns that were given sugar water (prior to bottle feeding or breastfeeding) showed an expression of ‘satisfaction’ accompanied by eager licking of their upper lip and loud sucks. Those given just distilled water remained sleepy and disinterested (Steiner, 1977). It is thought that survival of the fittest ensured this preference for sweet foods as they are higher in calories, providing energy and so aided survival.
I do understand how parents bargain desserts against main meals. I found myself inclined to do it too and Oscar is only 6 months old! Keep perservering with the less sweet foods. These will take more attempts before they are accepted but worth it in the long term. It may take as many as 21 attempts before your child accepts a food.
TOP TIP: Don’t give up trying vegetables. Mix them with a fruit or sweeter vegetables like sweet potato to make them more appealing but still keep trying them by themselves.
Steiner JE “Facial Expression of the Neonate Infant Indicating the Hedonics of Food-Related Chemical Stimuli” in Taste and Development, ed. JM Weiffenbach, Bethesda, MD;US Department of Health, Education, and Welfare, 1977 pp. 174-175
We went to a hotel last weekend and I was dreading it. It was nice to get away but how would I feed Oscar away from our kitchen? Should I take a small break from weaning? PANIC!
This is where ready made purees play a role. I think that ready-prepared baby foods are often demonised and you are a ‘bad mother’ if you ever consider using a jar! But I am a realist. Homemade weaning foods play a key role in forming future eating habits but they are not always easily portable. Ready made purees can help you continue weaning when you don’t have access to a kitchen. I especially liked the squeezable sachets as I only needed to carry a spoon and a bib.
Here are a couple of things to consider;
- Check the ingredients list. Avoid those that contain added salt or sugar.
- Choose the right stage of ready made food for your little one (they are classed by stage). If they are having textured at home, try to get one that is textured.
- Use your pram as a high chair if they need support. It can get so messy having them sit on your knee, if they can’t sit in a restaurant high chair.
- Carry spare bibs. I found some disposable bibs I could throw away or use a plastic one you can easily wash in your hotel room.
- Always carry a change of clothes for you and your baby
- Be wary of distractions. Oscar was so distracted at breakfast in the hotel, he refused to eat. I found it easier to feed him in our hotel room beforehand.
- Weaning on the go gets easier. As babies progress through the stages, they can start to eat your food (minus salt and sugar!). Just mash some of the boiled vegetables with your fork or cut a piece of toast into soldiers.
- The occasional meal out can still be homemade. Just get a plastic container that you can put your homemade puree in
- Food safety is important. You may want to consider a cooler bag for your purees so they remain cool when you are out and about.
TOP TIP: Don’t worry about using some ready made purees. They are great for travelling or that one day you are short on time and don’t have anything at home.
Unfortunately Oscar was born with a cleft palate. It’s quite common in the UK and 1 in 700 babies are born with a cleft palate. Feeding has been slightly more difficult as he is unable to suck (he can’t get a vacuum to suck) and so we have use a special squeezy bottle to give him milk. We effectively ‘squeeze’ the milk into his mouth and he drinks it. Sometimes the milk goes up his nose and he does get a lot of wind but he is doing very well and thriving.
Weaning presents it’s own challenges but being a dietitian has given me confidence to overcome these. Here are a few things I have learnt along the way;
- Weaning is really messy. Food does go up his nose and he sneezes alot. Never wear a white t-shirt when serving carrots!
- Give drink breaks. Between mouthfuls of food give some sips of milk (formula or breastmilk) or water to help your baby clear out his mouth/nose.
- Play with the texture. Stage 1 purees were too runny for Oscar. They kept going up his nose. I found that by adding baby cereal, rice or porridge to fruit/vegetable purees to make them thicker helped a lot. Every baby is different so you may need to play with the texture to get it just right for your little one.
- Be careful with citrus fruits. Oscar has not had any of these yet but I have heard these can be harder to tolerate due to the acidity
- Get advice from your cleft team. We were advised to start weaning at 4 months so Oscar would be used to solids by the time of his operation. Please follow guidance from your cleft team.
- Alot of the normal weaning advice still applies. Like all babies, your baby still needs to experience a range of textures and flavours by the age of 1 year. this is to ensure that good eating habits develop for life. Don’t be put off by the cleft palate!
TOP TIP: Weaning is pretty much the same with a cleft palate baby. You may need to make a few minor tweaks but it is still a fun adventure and Oscar is really enjoying his food.
Today I tried 2 spoons of baby rice again. He is still unsure. He looks like he has just sucked a sour lemon!
Pear for afternoon tea today. His first taste of something that isn’t milk. Despite it being sweet, he is still not convinced. He still sticks his tongue out but every now and then he gets the hang of it.
TOP TIP: when Oscar was unsure, I broke up the solids experience with a few sucks on his bottle. He then relaxed and was happy to try another mouthful.
Sweet potatoes are a total success!!! He not only mastered the tongue action today (well, it still comes out first on his tongue before he swallows it) but he also asked for more. I couldn’t believe it. He has gone from two tentative mouthfuls of pear this morning to more than five of sweet potato.
TOP TIP: Coloured vegetables like sweet potato leave coloured marks! Weaning is meant to be messy but be prepared. We needed to change clothes afterwards. Oh and giving your child sweet potato just before you take him to meet family friends for the first time is not a great idea. And I was wearing white…nice!
It’s amazing how quickly your baby masters swallowing. Today Oscar wolfed down his cube of sweet potato (fast becoming a firm favourite) and I had to quickly defrost a cube of pear. I could not keep up!
TOP TIP: be ready with the next spoonful. Remember that a liquid diet can be consumed quickly so your little one easily becomes impatient with solids!
How quickly you progress depends on when you decide to start weaning. If your baby is 4 months you will go at a slower rate than if your baby is six months. Allow your baby to guide you.
As a rough guide, start with a spoonful once a day for the first week so your baby can get used to it. As he accepts solids you can start to introduce a second spoonful and add less liquid (making the puree less runny). Then introduce solids at a second feed. When your little one is ready, introduce solids at a third feed.
Below is a rough schedule to aim for;
||Cereal/Porridge/Rice with milk
This first stage of weaning is about your baby learning a new skill and trying new tastes. Breast milk/formula remains the main source of nutrition so don’t cut out any milk feeds until solids are more established. When your baby is taking a few mouthfuls of solids you can start with the solids first and then top up with milk.
TOP TIP: You can play with the texture. The carrot puree I made was too watery so I added some baby rice to thicken it all up. You can add breastmilk or formula if you want to make the purée runnier. As your baby advances, make the purée thicker.
It’s exciting but needs some planning
- Choose a time when your baby is happy and alert (usually mid morning after a feed and a nap) and you are relaxed
- Help your little one sit up supported (car seat, bumba seat, a bouncer or a high chair if they are able)
- Make sure you sit facing your baby so they can see your face
- Start with a smile. Remember this is a new experience and your baby will look for reassurance from you.
- Eating food is a new skill that needs to be learnt. Babies naturally push their tongues forward when they drink milk so need to learn another tongue movement with solids.
- Don’t push them. Some babies need more time and one spoonful may be all they can manage at a time
- Once a day is enough for the first week
- Allow no more than 30 minutes per meal time
- Put the spoon in your baby’s mouth gently. You can use your baby’s top gum and lip to carefully remove the puree from the spoon
I decided to start with baby rice. Making it up to runny yoghurt texture was not straight forward even though I followed the instructions. It came out very runny so I added a little more rice to get the right consistency. I also discovered it needs some time to thicken.
Oscar’s first mouthful was not how I imagined. I started with a smile and I expected him to be equally as happy. He opened his mouth and I gave him a small spoonful of baby rice. He didn’t know what to do with it! He frowned and stuck his tonque out and the food came out with it. I tried another spoonful and he gave me a disapproving glance, spitting it out again. It made me laugh and he smiled back. I suppose it a new skill he has to master (like rolling over) and so will take time. We’ll try again tomorrow.
TOP TIP: Let your baby suck the spoon. This is a good transition step from drinking milk to swallowing solids
Less than you think!
The guidelines have been revised. Recent evidence indicates that potentially allergenic foods such as egg, fish, cow’s milk used in foods and cooking, cheese, yoghurt, wheat and other gluten containing cereals do not need to be delayed until a certain age. If there are some family allergies you may want to be more careful and check with your GP before starting weaning.
There are still a few things to avoid for all babies:
Honey before 1 year – due to the botulism risk
Whole nuts before 5 years – because of the choking risk
Sugar – children have a natural sweet tooth and this should not be encouraged. They also don’t need any extra sugar.
Salt – babies’ kidneys tolerate salt less well than ours. Don’t add any salt to their meals.
Cow’s milk as a main drink before 1 year – iron levels are lower in cow’s milk than in breastmilk or formula. You can offer cow’s milk as a drink aftre 1 year as then your baby should be getting most of the iron they need from the food they are eating.
See the link below for more information;
TOP TIP: Please avoid honey, sugar, salt and cow’s milk as a main drink until 1 year and whole nuts until your baby is 5 years old
Baby Rice, Baby Porridge or Baby Cereal
Baby rice is great to start with as it still tastes of breastmilk or formula (you make it up with breastmilk/formula) but allows your little one to experience spoon feeding. Few babies are allergic to rice. Other options are baby cereal or baby porridge. These tend to be gluten free for those starting weaning under 6 months. You could make your own but I found the ready made packets easy to use and in the future you can add them to fruits and vegetables to bulk them up (e.g banana porridge).
Make up the baby rice/cereal as per the manufacturers instructions but the puree texture should resemble runny yoghurt. This semi-liquid consistency helps your little one get to grips with eating.
TOP TIP: Aim for the consistency of runny yoghurt when making up that first puree
Weaning doesn’t have to be daunting or complicated
Before I started I thought I would refresh my memory and look through several of the weaning books I have. They are all more than 100 pages long!!! Which new parent has time to read on top of a busy day looking after a baby? I definitely don’t!
My aim with this blog is provide simple, bite size pieces of information that you can look at as you go along. All this information will be based on sound evidence and in line with current guidelines. It will also be practical as I will have personally tried it all out.
Please feel free to share any of your tips or learnings. Weaning doesn’t have to be daunting. It should be fun and simple. Enjoy it, because if you do, then your little one will too! Good luck!
Our Weaning Adventure
Weaning is an exciting but a daunting adventure that all parents must face when their baby reaches 6 months old. I am a dietitian with professional experience advising parents on how to wean and now I am doing it as a parent. And it’s definitely different being on the other side. I am really excited to share this journey with my little boy Oscar.
Weaning is very important for the future eating habits of your little one and how your baby is weaned really does matter. Research shows that babies weaned on home cooked foods eat more fruit and vegetables as toddlers than those weaned on prepared baby foods. I’m not the best cook but I am good enough, and determined to give it a go whilst having fun along the way!
I hope some of my learnings can help you. Please feel free to share your thoughts and experiences too.