Weaning Your Baby on to Solids

Whilst babies should be kept exclusively on breast milk or infant formula milk for six months, after this time milk (breast or formula) should be continued, but with the addition of solid foods.

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• When Should I Introduce My Baby to Foods Which Might Cause an Allergy?
• When to Introduce Foods
• Key Points

The introduction of solids into the baby’s diet is known as ‘weaning’.

Advice from the Department of Health is that it is best to wait until six months of age before babies are weaned on to solid foods, irrespective of whether they are breast-fed or receive formula until that time. However, the European Academy of Allergology & Clinical Immunology recommends that, in terms of allergy protection, weaning should take place from four to six months of age.

If you feel that your baby does need to be introduced to solid food before six months, it is important that you follow the recommendation that the earliest a baby should be weaned is 17 weeks of age.

Irrespective of when you introduce solid foods, it is important it should start with what are considered low allergenic foods. Foods most likely to cause an allergic reaction should not be introduced before six months. When you do, you should introduce the foods one at a time, so you can spot any reaction.

High risk families may think they need to be very cautious about the types of food they introduce at six months of age, or even to consider delaying weaning further. However, it is important that you do not delay weaning beyond the age of six months; at this age, babies need the additional nutrition from solid foods. Furthermore, delaying or avoiding foods after this time does not seem to offer any protection against allergy starting in response to those foods. There is some research suggesting it may increase the risk of allergy and other diseases.

If you delay the introduction of foods, you can cause problems with a child accepting those foods later on. This can become serious in terms of a baby’s growth and development. Also, as they grow, they need an increasing number of calories supplied by food rather than milk. These extra calories are found in carbohydrate and protein foods, and cannot be supplied in enough quantity by fruits and vegetables alone.

When first weaning, it is recommended that parents choose rice, potatoes, green and root vegetables, apples, pears, bananas and stone fruits as starter foods. If you are concerned about the risk of allergy when weaning, the best advice is to feed the infant one type of food at a time until you are happy that the infant is not reacting to the foods.

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When Should I Introduce My Baby to Foods Which Might Cause an Allergy?

There is some controversy as to whether it is better to wait to introduce allergenic foods to children, or to introduce them as soon as possible. We simply do not know, as research to date has been inconclusive.

For example, medical evidence and biological theory have pointed to the fact that consumption of peanuts in the early years of life may cause an allergic sensitisation to peanuts. In addition, no one wants to risk an allergic reaction in a young child which may be life threatening. However, many doctors have started to question this approach, and believe that, by repeatedly exposing the immune system to an allergen at an early age, the body will learn to tolerate it, and the child will not then go on to develop an allergy.

Evidence for this comes from other countries where children consume large amounts of peanuts at an early age and yet the rates of peanut allergy in these countries are much lower than those in the Western world, which avoid peanut consumption during infancy. Studies currently being undertaken are looking at this issue very closely and will hopefully make it clearer what the best advice for infant feeding is.

Currently, there is no evidence that avoiding potentially allergenic foods beyond six months of age is protective. However, many doctors feel that avoidance of peanuts, tree nuts and shellfish in high risk children during the first few years of life may be a useful strategy, as this is unlikely to cause harm. More research is underway to try and help doctors work out the best advice to give parents.

The UK Government has recently reviewed the scientific evidence surrounding introducing peanuts into a child’s diet. The revised advice states that, if parents choose to start giving their baby solid foods before six months of age, they should not introduce peanuts or other allergenic foods (such as other nuts, seeds, milk, eggs, wheat, fish or shellfish) before this time. When they do, these foods should be introduced one at a time, with a day or two in between introducing each new food, so that it is easier to identify anything that causes a reaction.

Also, where a child comes from a family with a strong history of allergies, or has already been diagnosed with eczema or food allergy, parents should consult their GP, health visitor or allergy doctor before giving their child peanuts, peanut butter or any peanut containing foods. This is because these children are at a higher risk of developing peanut allergy.

Once your baby has had several attempts at eating the individual foods, you can start mixing them to increase the variety and enjoyment of eating. This ‘one at a time’ policy is very reassuring and useful for you if your child is at risk of allergy; it does not mean you have to delay any introduction of foods, whilst being able to keep vigilant to any possible allergy symptoms. It is also important to keep a food diary as a record of foods taken and tolerated (or not tolerated).

Using jars of food is very convenient, but it is best to try out each ingredient individually, and a list of these can be found on the jars. As time goes on, your baby will hopefully just be eating what you eat and you won’t need to be preparing or buying special foods for them.

By the age of 12 months, your baby should have been introduced to all the major allergenic foods (where appropriate), with the exception of whole nuts which should not be introduced until the age of five because of the risk of choking.

See the table below for the appropriate age to introduce foods.

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When to Introduce Foods

The NHS website has lots of very useful advice about weaning your baby onto solid foods.  This can be found at www.nhs.uk/Planners/birthtofive/Pages/Healthydietweaninghub.aspx

Although symptoms vary from person to person, symptoms commonly caused by IgE mediated food allergies are immediate and include hives, swelling, itchiness, and breathing difficulties. The symptoms of non-IgE mediated food allergies take longer to appear and may not occur on first exposure to the allergen. For this reason it can be difficult to diagnose the particular allergy. Non-IgE allergy symptoms are predominantly gastrointestinal, causing diarrhoea, vomiting (even a few hours after eating), eczema, poor weight gain and gastro-oesophageal reflux.

If you suspect your baby does have a reaction to a food, don’t test this out for yourself by trying the food again, avoid that food and see your GP as soon as possible. Your baby can then be referred to an allergy clinic so that the reaction can be investigated.

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Last updated: March 2012