By Dr. Catherine Gant

Weaning is the gradual transition from a purely milk diet to a mixed diet at between four and six months of age.

WHY WAIT UNTIL FOUR MONTHS?

Before four months, the baby does not need solid food. The calories from milk are sufficient. Also, before four months, the baby cannot chew properly, and cannot coordinate sucking and swallowing, so solids may cause choking. Solid food is not digested properly and the decrease in fluid intake may cause constipation. By six months the baby will definitely need more nutrition (especially iron, fat and protein), than is available in milk. Some people consider starting solids before their baby is four months old, particularly if their child is very big or hungry but you should always ask the advice of your health visitor before doing this.

WHEN TO START SOLIDS

Do not rush. At four months old, your baby should be settled and sleeping a longer period at night; you may need to increase the amount of milk given to keep up with growth.

Signs that a baby needs to start solids are:

A decrease in time between feeds

Weight flattening off on the growth chart

Sleeping for shorter periods at night

despite an increase in the amount of milk offered. A lot of mothers do not introduce solids until the baby is five to six months old. If your baby is gaining weight and sleeping well then there is no need to rush into starting solids at four months.

HOW TO START SOLIDS

Take a teaspoon of baby rice (try and get one with no added sugar). Mix it up to the consistency of thin gruel with the baby's normal milk. Start feeding after a milk feed, in the middle of the day, so the baby is not hungry, and is happy and awake. Put a small amount of the rice onto your clean fingertip, and hold it next to the baby’s lips, so that it can be licked off. If keen, give a bit more. Remember this will be a very messy process and most will end up in the baby's hair and on the floor.

Once the baby has taken rice like this for a few days, put a small amount on a soft plastic spoon. Again, hold it next to the baby's lips so that they can suck/lick it off - do not push the spoon into the mouth when starting feeding. During this time continue milk as usual.

Once a few spoons are being taken, introduce another feed; a good time to do this is in the evening, as a full stomach helps the baby sleep longer at night. Once the baby is taking several teaspoons of rice twice a day you can mix in a small amount of well-pureed, cooked vegetables.

By six months the baby should be taking at least two solid feeds a day and may be cutting down on milk feeds. As solids increase you can introduce some extra fluid, preferably water, with the feeds to prevent constipation.

FOODS TO BE USED

A mixture of vegetables can be used - carrots, sweet potatoes, spinach, cauliflower etc - all cooked and pureed. If you introduce fruit too early the baby may not want the less sweet-tasting vegetables. A mixture of a grain (e.g. rice cereal) and a vegetable followed by a fruit puree makes a good main meal at around six months.

You can introduce meat by mixing in small amounts of salt-free gravy, but be careful not to introduce anything too lumpy or chewy until the baby is ready which is often at around nine months.

Do not give foods with added sugar or salt, and do not cook the vegetables with salt. Dairy products can be introduced after nine months, although families with food allergies may want to take advice from their health visitor.

Between nine and twelve months the baby should be taking a normal, though chopped up, adult diet. There is evidence that not introducing more lumpy food at nine months can affect the babies ability to learn to chew and swallow.

DOS AND DONTS

Don't put your baby on a low-fat diet. There have been a number of cases of babies becoming malnourished after being fed health foods. Babies need fat - it is essential for growth and brain development.

Do cook as much food as you can yourself, it is cheaper and fresher. Avoid all additives - colourings, flavourings, preservatives, added sugar and salt - your baby does not need these.

FURTHER INFORMATION

This can be found on the Health Development Agency’s infant feeding advice pages and also at The British Dietetic Association (click on links, then nutrition and food) and at the fun Food for Tots: Home Page.

Information on stopping breastfeeding is at La Leche - weaning.