Timing of Introduction to Complimentary Foods
Carene When to Introduce Solid Foods to Your Little One
If you ask me, the introduction to solid foods is one of the most exciting milestones in a baby’s first year. This fun, yet challenging transition marks a significant step in the baby’s growth and development, but it also raises a number of questions for parents about when and how to start. Understanding the best time to introduce solids can ensure that babies receive the nutrients they need while promoting healthy eating habits for life.
"Research indicates that the introduction of complimentary foods before 4 months of age (3 months) may reduce the rate of exclusive breastfeeding, this in turn may result in a negative impact on health outcomes such as a higher risk of obesity"
This crucial transition not only marks significant growth and development milestones but also opens up a delightful array of possibilities for your baby to love good food.
The Definition of Weaning
According to leading guiding bodies such as the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and American Academy of Pediatrics (AAP), the term “complementary feeding” or “weaning” can be defined as the feeding of any solid and or liquid foods other than breast milk or infant formula to an infant.
Evidence of Weaning Success
Although there is still a lot of debate and misinformation on the ground, the recent evidence is clear. According to the available evidence, the current guidelines recommend that complementary foods should not be introduced before 4 months, but they should not be delayed beyond 6 months of age.
The global recommendation as stipulated by the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF) is that complementary foods should be introduced around 6 months of age with continued breastfeeding up to 2 years and beyond (World-Health-Organisation Global Strategy for Infant and Young Child Feeding. Geneva: WHO; 2003).
This timing of introduction to solid foods corresponds with the changes in the baby’s nutritional requirements and the physiological maturation of renal, gastrointestinal, and neurological systems, as the baby develops. There are known risks to both the early and late introduction of solids. Research indicates that the introduction of complimentary foods before 4 months of age (3 months) may reduce the rate of exclusive breastfeeding, this in turn may result in a negative impact on health outcomes such as a higher risk of obesity.
"The infant’s ability to tolerate complimentary food will progress with age. Therefore, the earlier food is introduced, the lower the tolerability and the greater the intervention from the adult in terms of food manipulation"
On the other end, delaying the introduction beyond 6 months can impact the dietary diversity of the complimentary foods by 1 year of age. Clinical trials have demonstrated that infants with a dietary pattern which included a greater variety of food groups from 6 to 9 months of age had a lower risk of developing food allergies during childhood (Int. J. Environ. Res. Public Health 2020).
It’s not just about when to introduce solid foods, but how we introduce them, a principle central to the philosophy of “baby led weaning helping your baby to love good food.”
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Readiness Cues – When is Your Baby Ready to Start Weaning?
So, there you have it, point black and we can all move on, right? Wrong.
Determining which age is suitable to start your baby on solids may be unique to your baby and their stage of development. With the recommendation as our guide, we can assess our babies for readiness cues to introduce complimentary foods as baby develops at his/her own pace. Look for these signs to determine if your baby is ready for solid foods:
1. Head and Neck Control:
Babies need to be able to sit up with minimal support, while holding their heads up steady to allow safe swallowing of solid foods.
2. Loss of Tongue Thrust Reflex:
The tongue thrust reflex, which pushes food out of the mouth, typically diminishes around six months, allowing babies to begin moving a bolus of food with their tongues and swallowing foods.
3. Interest in Food:
Babies may show curiosity about what you’re eating, reach for food, trace food with their eyes or open their mouths when offered a spoon.
4. Ability to Chew:
While they won’t have teeth yet, babies should be able to move food to the back of their mouths and munch it with their gums.
The infant’s ability to tolerate complimentary food will progress with age. Therefore, the earlier food is introduced, the lower the tolerability and the greater the intervention from the adult in terms of food manipulation. Around 6 months of age is when most of the milestones related to safety of food tolerance are developed to the extent that most babies can sit with support and can “sweep a spoon” with their upper lip, rather than merely sucking semisolid food off the spoon.
Around the age of 8 months normally have sufficient tongue flexibility to allow them to chew and swallow greater variations of textures in larger quantities than before. From the age of 9 to 12 months they should have had a fair amount of practice with eating a variation of foods and textures to develop the skills required to feed themselves, drink from a standard cup with both hands and eat the foods included in the family diet with minor adjustments such as cutting foods into bite-sized portions.
It is also important to note that there is a critical window period for the introduction of textured foods. If these are not introduced by 10 months of age, the infant is likely to develop feeding difficulties later on (Journal of Pediatric Gastroenterology and Nutrition, 2020).
The authors of the book Weaning Sense described these phases well:
- Ready Stage – 4 to 6 months
- Steady Stage – 6 to 10 months
- Go! Stage – 10 months to toddler
Other Factors to Consider before Weaning
There are some important aspects related to the timing of complimentary feeding, other than the baby’s readiness signs. Important nutrients, such as iron, are one such aspect to keep into consideration when determining when to introduce solid foods.
Many of us are familiar with the fact that babies require an increased amount of iron at about six months of age, and the amounts in breast milk may not meet those requirements. It is worth reminding that the quality of iron in breast milk remains high and is fully absorbed compared to formula and foods. Therefore, we recommend starting with iron-rich sources of foods such as animal products from 6 months, and not necessarily force-feeding iron-fortified infant cereals from 4 months.
Instead of defaulting to iron-fortified cereals, you can take a “baby led weaning” approach, introducing safe forms of iron-rich foods that your baby can explore and enjoy as part of your family diet.
The other aspect to keep in mind is the introduction to allergenic foods as mentioned above. Infants who are identified as high risk for developing allergies may require individualized approaches to the timing of introduction to solid foods. Malnourished, premature, or ill infants should also be assessed individually and may be required to introduce complementary foods at an earlier or later stage to the norm.
My final thoughts
As you embark on this weaning journey, remember it’s not about a one-size-fits-all approach. It’s about helping your baby to develop a sense of love for good, wholesome foods, guiding them with patience and responsiveness.
Your baby’s unique weaning journey should be filled with exploration, learning, and joy. As you proceed, consult with healthcare providers when necessary, and always prioritize your baby’s individual needs and cues.
Thanks for reading, and as ever please feel free to reach out if you have any questions!
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