When do I offer solids around milk?
All babies are unique and have different trajectories of solids and milk meeting their needs between age 6-12 months. One baby might take to solids with great gusto and another baby might still have milk as their overwhelmingly main source of nutrition, and both these babies are normal! You are your baby’s expert, feel free to experiment and use cued care to help meet their needs.
I recommend breastfeeding mothers offer the breast frequently and flexibly for feeds and as a tool to ‘dial down’ their baby. In a similar way, I recommend that babies are bottle fed using ‘paced bottle feeding,’ whereby parents offer milk when they think their baby is asking and only until they signal they’re full. Babies fed by paced bottle feeding are also able to benefit from all the feel-good hormones associated with breastfeeding and in this way, bottle feeds can be used as a tool keep your dialled down.
Help, my baby isn’t taking anything in! Don’t be surprised if food ends up everywhere except in your baby’s mouth. Try and be patient: it can take some time to learn something new. Sometimes it can be frustrating when we have lovingly prepared a meal for our child and it all ends up on the floor. Some ideas include: - offering smaller amounts to reduce wastage - minimising preparation time by cooking ‘family meals’ that are baby friendly - giving your baby some of what you’re eating - batch cooking and storing/freezing leftovers As much as possible, we want to keep mealtimes relaxed and pleasant. (Click here to read about promoting a healthy attitude to food from an early age) If you have concerns about your baby’s oral intake or weight gain, or your baby is approaching 12 months of age and still has very little interest in solids, then please see your doctor.
What’s on the menu? Good news! Solids can be introduced in any order. Infants can and should be exposed to all food groups leading up to 12 months of age. This is where parents can get really creative with gourmet baby food or they can make life as easy as possible by introducing foods that they usually eat themselves. There are just a few things to consider about your baby’s diet. For example, babies aged 7-12 months have HUGE iron requirements of 11mg/day, that’s the equivalent of eating a 450g steak. Of course, that’s unachievable for a baby, so luckily there’s lots of easy ways you can add extra iron each one of your baby’s meals. Good sources of iron include: beef, liver, shellfish, poultry, fish, lentils, beans, spinach, tofu, dried apricots, nuts, pumpkin, sesame, or squash seeds and many more. Infant formula is also fortified with iron.
What about drinks?
Breastmilk or infant formula are all your baby needs in the first months of life. Once your baby is over 6 months of age, small amounts of cooled boiled tap water can be offered. Tap water is best, especially if it contains fluoride, which helps protect your baby’s teeth against decay. It’s not necessary to use bottled water. Cow’s milk should not be given as the main drink to infants under 12 months (milk added to food is fine). Cow’s milk intake should be limited to <500mL in toddlers as it is associated with iron deficiency.
The ins and outs Baby teeth matter! You should start brushing your baby’s teeth twice a day when the first tooth erupts. Use a very small amount of fluoride containing toothpaste (about the size of a small grain of rice). When your baby starts eating solids, their stools become more solid and can be different colours depending on what they’ve eaten. Their stools will also have a much stronger odour and you may be able to see undigested pieces of food. This is all normal! If your child becomes constipated or has very loose, watery stools or has blood in their stool, please see your doctor.
Supervision – eyes on the prize! Some foods that are hard, served whole or certain shapes can be choking hazards. You can help with this by cutting up food into smaller pieces, softening food by cooking or mashing foods before serving. Nut butter should be used instead of whole nuts. Remember a child always needs to be closely supervised by a responsible adult when eating. True choking is silent so make sure everyone in the household is trained on what to do when a child is choking and hope they never have to use the skill. (See this informative short video on how to save a choking baby).
REFERENCES: (1) NIH: Iron: Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/ (accessed 8/9/2020)
(2) NHS: How much salt do babies and children need? https://www.nhs.uk/common-health-questions/childrens-health/how-much-salt-do-babies-and-children-need (accessed 8/9/2020)
About the author
Dr Clementine David is an Australian trained paediatrics doctor, the CEO and Founder of held. and a mum of two young kids who love both broccoli and ice cream!
held. are proudly the first accredited Neuroprotective Developmental Care Practitioner in Asia providing holistic evidence-based care in: antenatal education, sleep, settling, breastfeeding support and newborn care. held. is based in Hong Kong and provides online consultations to families all around the world. Click here to read more about our services
Tags: starting solids, baby led weaning, puree, when to start solids, cued care, iron requirements, choking, paced bottle feeding