Starting Solids and Beyond | BreastfeedingHerts

Starting Solids & Beyond

The below information aims to help you understand the transition from milk feeds to adding in solids, when it's appropriate to reduce or drop milk feeds, and options for managing expressing and/or weaning from the breast.

The information here is written for a generic audience, and all information may not be appropriate for you - please refer to your personalised plan and contact Heidi Hembry IBCLC if further clarification is needed.

There can be many challenges when navigating all of the different advice and practices of starting solids. The truth is that there is no one 'right' way of weaning, it's all about doing what feels Ok and manageable for you (with certain safety guidelines), so it's a good idea to sort out some fact from fiction first. A lot of our cultural expectations around weaning come from old, outdated and potentially dangerous practices. We used to talk about weaning babies at 3-4 months, whereas for the past couple of decades we encourage families to wait until their babies are 6 months. There are a lot of differences between a 4 and 6-month-old baby.

4-month-old babies have:

Underdeveloped digestive system, not yet capable of dealing with complex meals.
A gag reflex that is quite far forward on their tongue to prevent them from in-taking/inhaling food or other products.
Limited hand-to-mouth coordination, making self-feeding difficult
Inability to sit upright, making gagging and choking more likely.

Because of this, we had to begin pureeing food to get it over the protective gag reflex, giving simple bland vegetables/fruits/rice to avoid inflaming and irritating the gut, feeding just once a day with one food for a few days, to watch for signs of gut irritation, and use parent-led feeding for babies who were not yet capable of self-feeding.

6-month-old babies have:

A well-developed digestive system, capable of digesting a wide variety of carbohydrates, protein, fibre and fats.
A gag reflex that has moved further back on the tongue, enabling better and safer intake of solids.
Well-developed hand-to-mouth coordination to enable better self-selection and self-feeding.
Ability to sit upright with gentle support, reducing choking hazards.

When we wait until approximately 6 months, babies are developmentally ready for solids and can take a wide variety of foods straight away, they can self-feed, and they can manage textures better due to their desensitised gag reflex and ability to sit upright. Many parents prefer to start with one or two simple foods, and quickly gain confidence in offering a wider variety.

In general, a baby of 6 months can eat a modified version of what you eat, with a few guiding rules:

6 Month Guidelines

No/low salt and sugar - avoid pre-packaged processed food where possible as they are high in salt and sugar. Cook at home as much as possible choosing low salt stock if available, and low salt/sugar items where purchased.
No whole nuts or grapes - they present a choking hazard as they are not easily crushed in the mouth, or back of the throat should they make it that far. Nut butters and/or chopped nuts in foods are fine. Grapes should be cut in half before being offered as this makes them softer and more squashable in baby’s mouth.
Avoid honey until 1yr - honey can contain botulism and presents a risk for babies under 1yr.
Never leave baby alone to eat - a baby coughing and spluttering is a baby who is learning to deal with sizes and textures of food. Though choking is rare, it is silent, and you need to be there, face to face with your baby to know the difference between coughing and choking and take appropriate action. Much like a baby taking in too much milk too fast will often posset it up and then smile at you totally unbothered by the experience, the same can be true of a baby coughing up a bit of food they are struggling with. They will often smile and try again, and learn something in the process.
Everything else can be tried straight away, with caution if your baby has family with allergies. Some very acidic foods (like strawberries and kiwis) can leave a rash around your baby’s mouth that is an irritation rather than an allergy. Many parents start with simple foods increasing in variety as the days pass.

So… Puree or Baby Led?

The choice is yours, and the reality is that most families do a combination of both.

Both are messy - babies see solids as a source of fun, experimentation and messy play.

Cooking separate meals is expensive, time-consuming, hard work, and very annoying when baby ignores your specially prepared food and eats off your plate anyway. Have a look at what you are eating, and see if it can be adapted for your baby. Simple is best in the first couple of weeks or so as you and your baby grow in confidence.

Vegetable sticks can make great dipping tools for babies - a spoon that you can eat too!!

Cool cucumber, steamed carrot out of the fridge can make an excellent teether before a breastfeed, or solids.

Eating with your little one is developmental very important. Babies will often eat better if they are sharing food with you or other children. Eating off someone else's plate and eating the same food as others is a safety mechanism, ensuring food that the food they eat is safe. If no one else is eating red berries, they are unlikely to want to either.... but they will often feel the same if their food looks very different to your food.

Breastfeeding & Solids

Every baby has a different breastfeeding pattern at 6 months, and every family will approach solids in their own unique way, so there is no set way of giving solids vs breastmilk. However, the below is a flexible approach that you can adjust day to day, week to week, depending on how solid feeds are going.
Initially, baby will not realise that food can fill her up - it’s a time for exploring. Milk feeds/breastfeeding will be her main source of nutrition. Breastfeeding before offering solids can lead to a more relaxed, playful, experience.
As you notice your baby is enjoying solids more, she seems to be actively eating more, and you are noticing a change in her stools, then you can offer food first and breastfeeds after.
Individual breastfeeds can be dropped/missed if your baby seems happy enough with her solid foods, though she may want a cuddle and a drink ‘later’.
It’s a good plan to always offer water with a meal or snack.
On days when feeding is going well, breastfeeds can take a back seat. On days when feeding is more erratic, and/or baby is unwell, breastfeeds may become her preferred nutrition. There is no way of guessing how many mls of milk your baby has had, or if it is ‘enough’. You have followed her guidance so far, she will continue to let you know what she wants and how often!
The WHO recommends that breastfeeding should continue until 2 years and beyond. However, at 1 year, if you choose, it can be replaced with full-fat cow's milk or water if preferred. If you choose to stop breastfeeding before a year, then infant first formula (0-6 months) should be given alongside solid meals.

Encouraging More Solids

Eat with your baby as often as possible, sharing foods. Babies are social and love to copy. Additionally if you are eating it, they see it as safe and are more likely to try it. Some babies will reject food that looks different to what their parents or peers are eating.
Social eating with peers can also be a great way to encourage your little one to explore and eat more.
Some babies/parents prefer spoon feeding, some prefer baby-led. There is no right or wrong approach, just what works best for you. Most families use a combination of both approaches
Many families lean towards vegetable based first foods. These contain excellent nutritional components but are not calorie dense. Hunger will not be sated, and milk feeds will not reduce until higher calorie foods are being regularly ingested in appropriate volumes.
If your little one loves a certain food, then offer it often, along with new foods to try.
You can try adding nutrient dense “sauces” (eg home made bolognese, hummus, mashed avocado, cream cheese) to their favourite food
Be prepared to be flexible. If your little one wants to dip a roast courgette into strawberry yogurt, or an apple wedge in to pesto, go with it. Food is Food!
Portion wise think of a meal as being about the size of 2 or 3 fists. Some babies eat more, some less. Putting less on a plate can enable you to see more clearly what has been eaten. You can always add more
You will know your little one is eating more volume when you see changes in the breastmilk/formula stool. At first you may see whole pieces of veg, but then the stool will become more tan coloured and thicker, like a smooth and spreadable peanut butter, before becoming firmer, perhaps darker, eventually looking like a formed poo.

3 Spoon Approach

Until your little one has much improved fine motor skills, you may need to be the one loading up the spoon.
Some babies are reluctant to release a spoon once they’ve got it.
Filling up two spoons means they can get one to their mouth and then the other.
Filling up a third spoon means that your little one is likely to drop one of her spoons to take the newly filled one
It doesn’t matter if its always the same one she drops, the aim is just to keep a regular conveyor belt of spoons so that she has lots of opportunity to take in and increasing volume.
You don’t have to restrict this to spoons. Bread sticks, rice cakes, cucumber, lightly steamed carrots, wedges of apple/pear can all be used as edible ‘spoons’
You can encourage her to dip her spoon/edible stick into a sauce too - beware, it can get messy.
What you ‘load up’ with doesn’t have to be a home cooked sauce. It can be mashed banana, mashed avocado, hummus, cream cheese, yogurt…

What Your Infant Can Drink 6+ Months

Before 6months, all drinks/meals should be breastfeeding, expressed milk or Infant first formula.
After 6 months, you can continue with your milk of choice (Infant first formula 0-6months is suitable until 1 year, no need for older baby milks), but baby can also be offered water in a cup.
Milk feeds remain an important part of your infants diet until 1 year, and should not be dropped altogether.
If your little one does not like water (it can take plenty of attempts over weeks before some will accept this strange and cold liquid!), then you can offer expressed or formula milk in a cup too. There is no reason that milk has to come from a bottle at this age.
Breastmilk and formula are 90% water so work well to keep baby hydrated, just like they have done for the first 6 months
It’s best to avoid juices if possible as they are very sweet. However 50% diluted juice (unsweetened fruit juice, not squash or cordial) can be an acceptable alternative to water if you are concerned that your little one isn’t taking any. You may prefer that 25% fruit juice 75% water is a better starting point if you are wanting to transition to water longer term.
By 1 year, although breastmilk remains both nutritious and immunologically beneficial, your little one can move on from expressed milk to full fat cows milk if you are wishing to reduce expressing.
Likewise, if you have been using formula, then at around 1 year you can switch this out for full fat cows milk. If your child is having a full and varied diet there is no benefit to infant follow on/toddler formulas - which are considered a type of Ultra Processed Food.

Complete or Partial Weaning From the Breast

Weaning can be quite a quick process for some, and slower for others. Some families will start the weaning journey and pause at eg one morning and one evening feed. You can speed up your journey if needed, and in many cases you can reverse it if baby is ill, or you feel overwhelmed by the thought of stopping.
Before 1 year, unless you plan to express for bottles, any significant reduction in breastmilk intake will need to be supplemented with an infant first formula. Follow on, hungry baby, toddler milks etc are a marketing ploy. Infant first milk (or specialised milk if your baby has allergies) is all baby needs as replacement milk until one year.
The volume your baby needs will depend on how old they are and how much solid volume and variety they are taking. A 9-month-old taking 3 meals a day, plus snacks and drinks may be very happy with a milk feed morning and night only. A baby of a similar age who is not yet taking regular meals and is offered or chooses a limited variety of foods will most likely need to maintain several milk feeds across 24hrs
Night feeds are not essential, but can remain a normal and healthy part of nutrition well beyond the first year.
Around 1 year, your breastmilk feeds do not need to be replaced with formula. Regular full-fat cow's milk is a suitable alternative for most families, though even this is unnecessary if baby is having a wide and varied diet with access to calcium via other foods.
Initially, if feeding is very frequent and ad hoc, putting some patterns into breastfeeding will help you to see how often baby feeds and where you might choose to cut down first.
Making some sleep association changes can be helpful. Though it remains a lovely thing to do if feeding to sleep is not part of your long-term plan, then introducing a sleep association toy/soother can make the transition to going to sleep from awake laying down easier.
Depending on the age of your baby, distraction with healthy snacks, games, and a short walk, can all work wonders to reduce the frequency of feeds.
If you have been feeding often then you may expect some engorgement as the frequency reduces. Aim not to express if possible as the fullness is what tells your body to reduce supply.
Extending the times between feeds also helps to reduce supply - you are telling your body your baby needs to feed less often and to slow down on production. Again, distraction can be a great tool here.
If your little one is well into toddlerhood, you can phase out feeding in certain situations eg out and about with “yes, when we get home” or at certain times with “yes, when the clock turns green/after lunch”.
Make your breasts less accessible by adapting your clothing choices. So long as you are not suffering from regular engorgement a properly fitting sports bra or close-fitting non-nursing bra can really help. As can wearing polo neck sweaters, long dresses, tucked-in T-shirts, high round neck T-shirts instead of V or scoop necks, layers… It’s not a fail-safe, but it can give you a few extra seconds to choose to do something different, rather than you and your baby breastfeeding before you’ve really thought about what’s going on.
Having a singular/defined feeding space can help reduce feed frequency. Eg a particular room/chair/only in bed etc
When you are just feeding 2 or 3 times a day, reducing the duration of feeds can help to diminish feeds further. Setting a timer, singing a verse of a nursery rhyme, and reading a short book are all good ideas. The less milk, the less rewarding it is for baby.
You can further support a reduction by using herbs and medications to reduce your supply quickly if needed.
Some families will opt for an abrupt stop when feeds are just a few a day. If you have the energy and willpower, you can just say no, and use distractions. However other families will enlist the support of other family members, either to look after the home and baby whilst mum goes away for a couple of days or to take your baby/toddler to do something else at the usual feed times - eg breakfast with grandma, bedtime with daddy - consistently over a few days, whilst mum makes herself scarce.
You may need to express for comfort at any point during stopping breastfeeding as engorgement is a common experience. However, you should aim to express as little volume as possible to just take the edge off, and express as infrequently as possible too. If you need to express a significant volume, aim to reduce this by 5-20ml every 2-3 days.
Choosing to reduce or stop breastfeeding is not a one-way street. You can pause on your journey at any point, or reverse and introduce more breastfeeds if baby is poorly or going through a phase of reducing solids. Many families will wean during the day and feed either side of work and overnight. Other families will wean overnight (age appropriate) and continue to feed throughout the day.

Introducing a Bottle Cups - Later weeks/Months

Some babies can be reluctant to take a bottle when they have perfected breastfeeding, though most can be coaxed to take bottles within a short space of time.
If you have waited until 4 months plus, then bottles are not necessary and you can, if you choose, transition straight to a cup.
Whether you choose a bottle or cup, ensure the flow and ease of accessing the milk is OK for your baby - try them yourself!! You will be amazed at how difficult some of them are, and the difference that having them full or ⅔ empty can make. Avoid valved and no-spill cups if your baby is struggling to drink - they can require a complex set of skills that are not intuitive such as biting and sucking at the same time.. Free flow spouted cups, 360 cups, or open cups can be easier for most babies - supervised of course!
Though a slow-flow teat may be preferred for a young baby of a few weeks, most babies over 3 months will be ready for a faster teat, and quite possibly frustrated on a slow teat if they are expert and efficient Breastfeeders.
Your own expressed milk is always preferable to artificial milks, which can be hard on baby’s digestive system and alter their gut microbiome. However, some mums can struggle to express, dislike expressing or have a preference for formula.
If baby is reluctant to take formula, try first with your own milk - changing the feeding route (breast to teat/cup) the way baby is held for the feed, the smell of the milk, and the flow of the milk - can all be too much for some babies. Keeping as much the same as possible can make for a less stressful time. You can add in formula in increasing ratios once you know baby can feed well from the bottle/cup
If expressing, there is no need to sterilise expressing kit. Breastmilk is safe in the fridge for between 3-8 days. Kit can be kept in a clean Ziploc bag or Tupperware box in the fridge between expressings and washed with hot soapy water once a day. If you are expressing infrequently, you may simply choose to wash after each express.
Breastmilk is safe at room temperature for up to 6 hours, so a recently expressed bottle taken out of the fridge at 10pm can be safely fed to baby at room temperature at 4am
How much your baby will take by bottle depends on age, feeding pattern, hunger, thirst, enjoyment of the bottle feed and all sorts of other things. Beyond 10 days, anything from 60ml upwards to 150ml or more for a baby of a few weeks or months is normal.
A baby of around 9 months having 3 meals plus snacks with water as a drink may not take much from a cup or bottle at all during the day time. Other babies are milk monsters and will happily take 200ml+ from anything! Both are healthy if your baby continues to have effective milk feeds at other times, eats a wide variety of solids, appears happy and settled between feeds, well hydrated nappy output etc.
And information on storing breastmilk here: https://www.breastfeedingnetwork.org.uk/breastfeeding-help/expressing-storing/
Allowing baby to become familiar with the bottle is important (or refamiliarising a recent bottle refuser) Give an empty bottle to baby to play with, chew on etc.
Play games with your baby and the bottle. Make it into something that they want to get hold of. Bop it on noses, cheeks, foreheads - always with a smile and chat/sing-song.
Tease baby - reverse psychology can work wonders “do you want the bottle? No, it's mummy’s bottle, yum yum. Oh, you do want it….” Etc
Anytime baby takes the bottle in their mouth, smile and congratulate.
Repeat repeat repeat, but make it about playtime, not about feed time.
When baby is happy to take the bottle in their mouth, add a small amount (30-60ml) of milk. Don’t expect baby to take it all in one go (though they might) but again, congratulate and reward any swallowing with smiles.
Any time baby shows continued upset or angst, stop the game, and do something else, but keep the bottle near. Baby may show signs of renewed interest in a few minutes.
All babies are different. Some relish trying new things, some are more cautious. Some will try more when they are hungry, some will be more willing to experiment when they are full and settled after a feed. Some will hate being woken with a surprise, others will be happily feeding on a bottle before they fully wake up. You know your baby best.

https://breastfeeding.support/best-bottle-breastfed-baby/