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Introducing solids is often referred to as “weaning” and feels like a milestone moment for many parents. I personally love weaning because I love food and feel excited to introduce a world of new flavours. Not everyone loves the process though, especially if you have previously had a difficult experience or aren’t a fan of mess.

Introducing solids can also be a daunting time for parents. There may be worries such as whether you are weaning “at the right time”, concerns about risks of an allergic reaction, or worries about choking.

When is the right time to introduce solids?

father-and-son

The advice always seems to be changing but generally has been more consistent in recent times that you should introduce foods at around 26 weeks (6 months). Each baby is different though and it may be appropriate to wean earlier than 6 months.

It’s considered acceptable to introduce foods from 17 weeks – 6 months, but you should not introduce foods before 17 weeks of age as the digestive system isn’t mature enough for food yet.

Breast milk or formula milk remains the most important nutrition before 6 months. 

Signs of readiness

The 3 accepted signs of developmental readiness are:

  • Being able to hold their head steady and stay in a sitting position 
  • Being able to coordinate their eyes, hands and mouth so that they can pick up the food and put it in their mouth 
  • Swallow the food in their mouth. Babies have a tongue thrust reflex that will push food back out of the mouth if the reflex is still present. This reflex usually disappears at 4-6 months.

The importance of signs of readiness after 17 weeks of age is to minimise the risk of choking. A baby that isn’t able to co-ordinate the picking up of food and bringing it to their mouths will not be able to self-feed. They may be able to be spoon-fed but would still need to be able to hold their head steady in a seated position.

Some babies such as those that were born prematurely may take a little longer to be able to stay in a seated position. You may be advised by a healthcare professional to start weaning before they can independently stay in a seated position. Staying in a seated position can be supported with the right baby chair, but they should never be leaning to the side or slumping over.

Both my sons had all the signs of readiness  when weaned at 5.5 months and 5 months. My youngest daughter who was weaned at 17 weeks due to severe reflux and slow weight gain, needed to be a seated in a chair that would help support her staying in a sitting position. 

If I put her in a regular highchair (such as some of the wider ones available in coffee shops), she would start leaning to the side and therefore they weren’t suitable. She could hold her head steady very well and would sit well when seated on an adult’s lap or in her Mama and Papa’s Baby Snug Seat which, according to the manufacturer, is suitable from 3 months or when they are able to hold their head up independently.  I used to do lots of tummy time which helps develop the core muscles.

There may be other signs too that may make you wonder if your baby will be ready for weaning, like your baby showing an interest in your food. It’s normal for babies to go through periods of seeming to want more milk and waking up more frequently at night, so these are not considered signs of readiness.

What about allergies?

peanuts

All three of my babies had reflux and were weaned before 6 months of age using the traditional method of introducing purees first and finger foods alongside from 6 months of age. The debate about the ideal time to wean is an interesting one, particularly for babies with eczema or considered to be at risk of developing allergies.

My first baby was under the care of a consultant who was involved in the LEAP study, which was a study looking into the best way to prevent peanut allergy.

Interestingly, it was found that peanut, sesame, and tree nut allergy was more common amongst UK children than Israeli children of a similar age. In Israel, they were noted to consume high quantities of sesame and peanuts from an early age, which was thought to explain this difference. The LEAP study results supported an early, rather than later, introduction of peanuts. The results of the EAT study that looked at 6 allergenic foods also supported earlier introduction of allergens for allergy prevention.

This is really interesting because the advice years ago used to be to delay introduction. The current UK recommendation is to introduce allergens from 6 months of age.

Infants that are considered to be at higher risk of developing a food allergy may be advised to introduce allergens from 4 months after skin prick testing, which is what I was advised for my children.

 

allergens

It’s important to note that my children were under the care and guidance of a Paediatric Allergist and received this specific advice due to their own personal medical and family history. 

It’s an interesting discussion point and worth bringing up with your doctor if you think that your child is at a greater risk of developing an allergy. The BASCI (British Society for Allergy & Clinical Immunology) patient leaflet is a useful read.

You should familiarise yourself with the signs of an allergic reaction which includes, but is not limited to:

  • sore, red and itchy eyes
  • swelling of lips and throat
  • nasal congestion
  • cough
  • wheezing /shortness of breath
  • diarrhoea / vomiting
  • itchiness
  • rash
  • Severe symptoms and signs affecting several body systems called anaphylaxis.

It’s often advised to leave a 3 day gap between introducing different allergenic foods so that it is easier to identify what may have caused an allergic reaction. The NHS Start4Life website has a nice summary of safe weaning which you can access here.

Methods of introducing solids

purees

I introduced food the traditional way by starting with purees and changing the consistency and texture over time, introducing finger foods at 6 months. I liked the plan suggested in the Ella’s Kitchen: First Foods book which worked well for us, so followed a similar plan for all my babies. This book, and the River Cottage Baby and Toddler Cookbook, were my go-to books for weaning recipes too. 

Baby-led weaning means no puree stage and going straight to introducing finger foods from 6 months.

There isn’t any strong evidence that one way is better than the other. I personally think, like most things in parenting, there are lots of different approaches when embarking on either method so no two parents necessarily introduce solids the same under either umbrella. I have known children that are fussy eaters that were introduced to solids the traditional way, and I have known children that are fussy eaters that were weaned the baby-led way. There are also lots of other different factors involved in fussy eating.

One of the commonly reported benefits of baby-led weaning is that you can’t overfeed a baby that is self-feeding. Whilst it’s true that you can’t overfeed a baby that is self-feeding, you also don’t need to overfeed a baby that is being initially spoon-fed.

Each one of my babies clearly showed signs that they were full. You don’t need to give “just one more spoonful” or finish the bowl because there is still some food left. Responsive feeding is easy as long as you don’t ignore the cues.

baby-led-weaning

My babies would keep their mouth closed at the sight of an oncoming spoon when they were full or turn their face and I wouldn’t offer another spoonful if they showed signs that they were full. If you are worried about waste, I found it better to decant a small portion of food into a bowl first using a separate spoon. That way, the remaining food is kept free from contamination from mouth bugs that would be introduced when putting the feeding spoon back into the pot and can be kept in the fridge for the rest of it’s shelf life. 

Freezing food in small portions is especially useful for this so that you can defrost a small amount at a time when needed, especially during the early days when the amount of food consumed is tiny.

Reflecting on your own relationship with food

food-aversion

One of the most important things you can do before you even get out your recipe books is reflect on your own relationship with food. Do you or other family members have particular aversions to certain tastes or textures? Could this subconsciously result in limiting exposure to certain tastes and textures?

What are your own beliefs about food and portion size? I know that in my culture, food is often piled high on a plate. It is considered “good manners” in some cultures to finish your meal even if you are full.

It’s better to offer a small portion first and top up if still hungry than offer a huge plate of food and insist the plate is finished. This leaflet by the British Nutrition Foundation provides a useful guide on portion sizes for 1-4 year olds.

When I first met my husband, I had no idea that he had so many aversions to different types of food, tastes, and textures. I love exploring new foods and I always want to try the latest restaurant in town but my husband much prefers to stick to the foods he knows he likes.

My step-daughter was initially a fussy eater and everyone would tell me she was a “copy of her father when he was a child”. I did wonder whether the other children would also be fussy with food but thankfully they enjoyed eating a wide variety of tastes and textures and still do. My step-daughter now eats a much wider variety of food, so early history of fussy eating doesn’t necessarily mean it will continue.

If you don’t like a particular food and unlikely to prepare it often, it is worth considering making a batch and freezing it in small portions so that you can defrost and continue to offer to your little one regularly.

Starting solids is a messy journey. Someone who dislikes mess may be reluctant to offer foods deemed “too messy” or allow self-feeding with a spoon because of the mess it creates.

It’s important to explore our own feelings about food and weaning and whether that may impact the weaning journey, whichever method you choose. 

Weaning mess

Worries about choking

It’s natural to worry about the risk of choking. Some examples of ways you can reduce the risk of choking include:

 

  • Weaning when your baby shows signs of readiness
  • Feeding baby in an appropriate feeding chair
  • Always supervising your baby when feeding
  • Never leaving an older child alone with the baby – you will be surprised how often an older sibling may try to share their food with a baby sibling
  • Cutting up foods to an appropriate size and shape – round shaped foods are more likely to get stuck (e.g. grapes). See this post “Food Choking Hazards” for more examples
  • Soften hard foods by pre-boiling or steaming
  • Take the skin off foods
  • Remove pips / stones from fruit
  • Serve meat and fish without the bones
  • Don’t serve whole or coarsely chopped nuts.

Gagging is different to choking. Babies may gag time to time whilst learning to eat. It is a normal safety mechanism which results in bringing the food back to the mouth, either spitting it out or chewing it a bit more before attempting to re-swallow it.

Choking occurs when food blocks the airways. The usual response is to cough to clear the food, but sometimes if the food completely blocks the airway, they may be unable to cough and remain silent. This is an emergency and choking manoeuvres should be carried out.

choking-manoevre

You should familiarize yourself with these manoeuvres so that you know how to respond if the situation arises.

I have had to carry out these manoeuvres myself for two of my children. One choked on a slippery bit of food as an infant, and the other choked on a piece of food as a 4 year old when he decided that he wanted to get up and jump around whilst eating.

I always taught my children to sit down and eat but it can still happen in a moment of spontaneity. Thankfully, I was able to relieve the obstruction both times.

It is important to try to remain calm as children can pick up on anxiety and become more stressed. It is also easier to respond efficiently and effectively if you remain calm.

Here is a list of some resources which nicely explain how to manage infant choking:

Although it is a scary thought it is far better to be prepared than not! For more tips check out my post “10 Top Tips For Starting Solids”.

References for further reading (in addition to those linked in the text):

1) www.bsaci.org/professional-resources/resources/early-feeding-guidelines/

2) du Toit G, Sayre PH, Roberts G, Lawson K, Sever ML, Bahnson HT, Fisher HR, Feeney M, Radulovic S, Basting M, Plaut M, Lack G; Immune Tolerance Network Learning Early About Peanut Allergy study team. Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort. J Allergy Clin Immunol. 2018 Apr;141(4):1343-1353. doi: 10.1016/j.jaci.2017.09.034. Epub 2017 Oct 31. PMID: 29097103; PMCID: PMC5889963.

3) Du Toit G, Katz Y, Sasieni P, Mesher D, Maleki SJ, Fisher HR, Fox AT, Turcanu V, Amir T, Zadik-Mnuhin G, Cohen A, Livne I, Lack G. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol. 2008 Nov;122(5):984-91. doi: 10.1016/j.jaci.2008.08.039. PMID: 19000582.

4) www.nhs.uk/start4life/weaning/ready-or-not/

 

I’d love to hear your thoughts and if you found this post useful, please share!

MedicMum101
MedicMum101

Amal is a paediatrician and mum/step-mum to four wonderful children. She started MedicMum101 to share tips and experiences on all things motherhood. She enjoys writing about parenting, health, and wellness, as well as other life musings from time to time. When she is not working, writing, or running after the kids, you can often find her working on a new piece of art.

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