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Weaning Your Baby on to Solids

The Department of Health (DH) recommend that all
babies should be exclusively breast fed or given infant formula milk until around 6 months of age. Once they are able to stay sitting, hold their head steady, and co-ordinate eyes, hands and mouth, they can be introduced to solid foods.


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The introduction of solids into the baby’s diet is known as ‘weaning’.  The NHS website has lots of useful advice about weaning your baby onto solid foods.  This can be found at: www.nhs.uk/Planners/birthtofive/Pages/Healthydietweaninghub.aspx

 

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When should I wean my baby?

Babies are more likely to develop allergies if there is a family history of eczema, asthma or hay fever (known as atopic conditions) or allergic reactions to foods, pets etc.  The DH recommend that if your baby has a family history of atopy or allergy, you should breastfeed or consider feeding your baby a partially or extensively hydrolysed formula from birth for the first 6 months exclusively.

Current research however, is exploring the ideal time to introduce solids and there is some evidence to suggest that introducing solid foods while breastfeeding between the ages of 4-7 months may have a protective effect against developing food allergies and coeliac disease.  If you feel that your baby does need to be introduced to solid food before 6 months, it is important that you follow the recommendation that the earliest a baby should be weaned is 4 months (17 weeks) of age.

Delaying weaning beyond 6 months is not advisable for any baby as:

  • babies need additional energy, protein, vitamins and minerals such as iron
  • they will miss the window for accepting a wide range of tastes and textures (lumps and finger foods), resulting in food refusal/ faddy eating
  • it may increase the risk of allergy and other diseases.

What foods should I start with?

Irrespective of when you introduce solid foods, it is important to start with low allergenic foods (foods least likely to cause an allergic reaction).  Foods most likely to cause an allergic reaction (high allergenic foods) should not be introduced before 6 months.

The following is a suggested order of introduction of low allergenic foods, also see chart:

First foods

  • Root vegetables e.g. carrot, swede, sweet potato, parsnip, butternut squash (mashed or pureed depending on age / ability)
  • Fruits pureed e.g. apple, pear, banana, plum, peach, apricot, avocado
  • Spinach, broccoli, green beans, courgette, cauliflower
  • Potato, yam, green banana

After a few weeks,

(Introduce these one at a time to spot any reaction)

  • Rice e.g. baby rice, cooked flaked rice
  • Ground quinoa
  • Cornmeal, polenta (good for finger foods)
  • Breakfast cereals and pasta/ noodles based on rice, corn and quinoa
  • Red meats (lamb, beef), pork and poultry (pureed or finely shredded and chopped)
  • Lentils and pulses e.g. haricot beans, kidney beans, butter beans (mashed)
  • Any of the above in cooked tomato or fruit-based sauces

Try later as finger foods,

  • Fresh tomatoes
  • Other fruits including citrus, kiwi, berry fruits

How should I introduce foods that commonly cause allergies?

The DH recommends that high allergenic foods:

  • milk, eggs, wheat, gluten, soya
  • fish, shellfish
  • peanuts, tree nuts, seeds

can be introduced from 6 months of age. There is no evidence to support delaying introduction of these foods after 6 months. They should be introduced one at a time, with a gap of 3 days in between each new food, so that it is easier to identify any food that causes a reaction.

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. It may be helpful to keep a food and symptom diary to identify any foods that may have triggered a reaction.

Using jars/ packets of food is very convenient, but it is best to try out each ingredient individually first. The ingredients list can be found on the jars/ packets with the 14 most allergenic foods highlighted in bold. The Food Standards Agency has produced a helpful leaflet on allergy labelling http://www.food.gov.uk/multimedia/pdfs/publication/allergy-leaflet.pdf.

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 at the latest, your baby should have been introduced to all the major allergenic foods (where appropriate).

Babies at risk of food allergies

Your baby is at greater risk of developing food allergy if there is a history of food allergy or atopy in the family, or if they have developed eczema in the first 3-6 months of life. The most common foods that trigger eczema are cow’s milk, egg and peanut. If this is the case, parents should consult their GP, health visitor or allergy doctor before giving these foods.  Many children outgrow their allergies to milk or eggs, but peanut allergy is generally lifelong.  

Symptoms commonly caused by immediate (IgE mediated) reactions to food include: hives (urticaria), swelling (angioedema), itchiness (pruritis), eczema and breathing difficulties [rhinitis (runny or congested nose), wheeze, cough]. Delayed reactions to food (usually over 2 hours after ingestion), known as non-IgE mediated food allergy, are more difficult to diagnose. Symptoms are mainly gastrointestinal e.g. loose, offensive poo, mucus or blood in poo, constipation, vomiting, gastro-oesophageal reflux, sore bottom/ nappy rash, poor weight gain and eczema.

If you suspect that your baby does have a reaction to a food, consult your GP or health visitor. If it is an immediate reaction, don’t test it out for yourself by trying the food again, avoid that food and see your GP as soon as possible.

More about peanuts

The Government revised its advice about peanuts in 2009 based on a review of the evidence which showed there was no clear evidence that eating or not eating peanuts (or foods containing peanuts) during pregnancy, breastfeeding or early childhood had any effect on the chances of a child developing a peanut allergy. 

http://food.gov.uk/science/allergy-intolerance/peanutspregnancy

The revised recommendations state that if you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy and while breastfeeding, you can do so unless you are allergic to them or your health professional advises you not to.  Parents should avoid giving their baby peanuts and foods containing peanuts before the age of 6 months. Foods containing peanuts include peanut butter, peanut (groundnut) oil and some snacks. Whole peanuts or nuts should not be given to children under 5 years of age because they could choke on them. 

Summary table of introduction of appropriate foods and textures.

 

First weaning
(not before 17 weeks)

From 6 months
(26 weeks)

7 to 9 months

9 to 12 months

Serve food as:

 

 

 

Smooth purees

Well-mashed foods

Mashed foods with some lumps and soft finger
foods

Mashed, chopped and minced family meals and
finger foods

Introduce:

 

 

 

Smooth cereals, eg. baby rice, flaked rice, ground quinoa, cornmeal

Gluten containing foods (wheat, barley, rye) –bread
and cereals, oats, pasta, cous cous

Bread, chapatti, cereals, pasta, rice, polenta,
noodles, cous cous

Bread, chapatti, cereals, pasta, rice, polenta,
noodles, cous cous

Soft cooked pureed/ mashed fruit - bananas, pears, apple, stone fruit, avocado, tomato pureed / sauce, citrus flavour

Soft cooked/ mashed fruit
bananas, pears, apple, stone fruit, avocado, tomato pureed / sauce, citrus flavours

Raw soft fruit and finger foods e.g. banana, melon, mango, avocado, kiwi, berry fruits. stewed fruit, fresh tomato or citrus fruits,

Raw soft fruit and finger foods e.g. banana, melon, mango, avocado, kiwi, berry fruits
Stewed fruit, fresh tomato, citrus fruits

Soft cooked root and green vegetables. potatoes, yam, green banana

Mashed root and green vegetables, potatoes, yam, green banana

Raw soft vegetables e.g cucumber, courgette and soft cooked vegetables, potatoes, yam, green banana

Raw soft vegetables e.g cucumber, courgette and lightly cooked vegetables, potatoes, yam, green banana

 

Pureed pulses/ lentils
Meat and poultry (pureed)

Mashed lentils/ pulses Finely chopped/ pureed meat & poultry
Dairy foods - yoghurt , cheese, custard
Peanut butter, nut spreads, hummus

Mashed lentils/ pulses

Finely chopped/ minced meat & poultry
Dairy foods - yoghurt , cheese, custard
Peanut butter, nut spreads, hummus

Mashed lentils/ pulses Chopped/ minced meat & poultry
Dairy foods - yoghurt , cheese, custard
Peanut butter, nut spreads, hummus

 

Well cooked scrambled egg
Fish

Well cooked egg
Fish and shellfish

Well cooked egg
Fish and shellfish

Avoid:

 

 

 

All high allergenic foods - milk, egg, wheat,
soya, gluten, fish, shell fish, treenuts, peanuts, celery, mustard seed, sesame
seed, lupin, sulphites 

 

 

 

 

Key points

  • If your baby is at high risk of food allergy:
  • Breast feed exclusively for the first 6 months of life, and then introduce solids
  • If you are considering stopping breastfeeding BEFORE 6 months, consider replacing breast milk with a partially or extensively hydrolysed infant formula
  • If you choose to stop breastfeeding AT 6 months, replace breast milk with standard cows’ milk infant formula
  • Introduce solids at 6 months (no earlier than 17 weeks of age) and start with low allergenic solids
  • Don’t delay introducing foods after 6 months, even if you are a high risk atopic family
  • Then introduce high allergenic foods one at a time (not before 6 months of age)
  • Continue to breast feed if possible throughout the weaning process, but especially while introducing new foods
  • If parents of children at risk of allergy should ask their GP, health visitor or allergy specialist before introducing foods containing peanuts.

 

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Last updated: May 2014                      Next review date: October 2015
Version 5
 

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