Baby-Led Solids Pt. 1: When to Start

“FOOD BEFORE ONE IS JUST FOR FUN”

• What Do the Experts Say?
• Not Necessarily Signs of Readiness
• Baby’s Ready to Munch!

BLW RESOURCES

**Check out Pt. 2 (What is BLW) and Pt. 3 (Breastmilk, Safety, etc.) next.**

“Food Before One is Just for Fun”

“It is well recognized that the period from birth to two years of age is the ‘critical window’ for the promotion of good growth, health, and behavioral and cognitive development. Therefore, optimal infant and young child feeding is crucial during this period.

Optimal infant and young child feeding means that mothers are empowered to initiate breastfeeding within one hour of birth, breastfeed exclusively for the first six months and continue to breastfeed for two years or more, together with nutritionally adequate, safe, age appropriate, responsive complementary feeding starting at six months.” – UNICEF

What Do The Experts Say?

Healthy, full-term breastfed babies under the age of six months should not be given ANY solid or pureed food or other liquids, including water. Breast milk is all a baby needs to remain nutritionally sound before the age of one (“food before one is just for fun”).

Four in ten babies in the U.S. are given solid foods much too early (most by four months, and some as early as four weeks!), per a 2013 study in Pediatrics by the CDC of more than 1,300 mothers. It was found that almost 93% had given solid foods before their babies turned six months old; 40% had given solids before they turned four months old.

Why do so many parents still give solids (which include rice cereal and pureed baby food) too early? Given a choice between a dozen reasons, “90% of [those] moms said they thought their baby was old enough to start eating solids…71% said their baby seemed hungry a lot of the time…55% believed their doctor or another health care professional said their baby should start eating solids.”

Apparently, this isn’t an issue isolated in the States. A 2010 National Infant Feeding Survey reported that 35.3% of babies in Australia were given solid foods by four months, and 91.5% of six-month-olds had received solids in the previous 24 hours. Other studies found a median age of solid introduction to be 17.5 weeks old (!) in Perth and 4.3 months in Melbourne.

So what are the actual, most current global guidelines for solid food readiness?

“Once your baby can sit up and bring her hands or other objects to her mouth, you can give her finger foods to help her learn to feed herself… exclusive breastfeeding for about 6 months [is recommended], followed by continued breastfeeding as complementary foods are introduced” – AAP, 2013 (AAP used to recommend starting solids between 4-6 months, but changed its guidelines in 2012 to advise the current minimum of 6 months).

“Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or more.” – WHO

“…breastfeed exclusively for the first six months and continue to breastfeed for two years or more, together with nutritionally adequate, safe, age appropriate, responsive complementary feeding starting at six months.” – UNICEF

“…all babies, with rare exceptions, [should] be breastfed and/or receive expressed human milk exclusively for the first six months of life. Breastfeeding should continue with the addition of complementary foods throughout the second half of the first year.” – CDC

“Breastfeeding is the only food or drink your baby will need for the first 6 months…[afterward, o]ffer your baby a range of nutritious foods from your family meals. Let them discover different textures and experiment with feeding themselves. Give your baby foods they can eat using their hands.” – Government of Canada, Health Canada

“…the majority of normal full term infants are not developmentally ready for the transition from suckling to sucking or for managing semi-solids and solid foods in addition to liquids until between 6 and 8 months of age.” – Literature review by LINKAGES project

Now, six months is not a magic benchmark number.  Evidence rests with “food before one is just for fun,” which means that if a child is maintaining healthy, steady weight gain and is allowed to nurse regularly, there is no standard health reason why a child needs to consume solids by his first birthday.

Still, as kids oh-so-love to do, they can explore and play with offered solid foods.

Okay, but why such emphasis on waiting? Here’s some eye-opening material on that:

• “6 Reasons to Delay Introducing Solid Food” – Dr. Sears
• “Heed Natural Timing before Infant Introduction to Solid Foods” – Sherry Rothwell
• “Is my baby ready for solid foods?” – Kellymom
• Risks of inappropriate early solid protein intake
• “Solids? Wait a Bit” – Diane Wiessinger, MS, IBCLC
• “The Case of the Virgin Gut” – Anne Calandro, RNC, IBCLC
• “The Normal Bacterial Flora of Humans” – Kenneth Todar, PhD
• “The Virgin Gut: a note for parents” – The Alpha Parent
• “When should baby start solids?“- Kellymom

Consider this:

“[F]rom birth until somewhere between four and six months of age babies possess what is often referred to as an ‘open gut.’ This means that the spaces between the cells of the small intestines will readily allow intact macromolecules, including whole proteins and pathogens, to pass directly into the bloodstream. This is great for your breastfed baby as it allows beneficial antibodies in breastmilk to pass more directly into baby’s bloodstream, but it also means that large proteins from other foods (which may predispose baby to allergies) and disease-causing pathogens can pass right through, too.” – Kellymom

“Recent studies have shown that hydrochloric acid – used to digest most protein – doesn’t even appear in the stomach until the end of the seventh month and doesn’t reach a peak until the eighteenth month. Coincidentally, 18 months is approximately when rennin – used to digest the protein in breast milk – has disappeared. Also, it seems that ptyalin, the digestive juice for carbohydrates, doesn’t appear until the end of the baby’s first year. (The earliest books on baby care always recommended that mothers pre-chew any solid food.)” – Dr. George Wootan

Not Necessarily Signs of Readiness

What are the common myths that are not independently signs of a baby’s readiness for solid or semi-solid foods?

• Baby doesn’t weigh much; Baby weighs a lot.

Scenario 1). “My baby is thin, he needs more to eat!” If baby isn’t gaining weight well, the mother most likely needs help with a breastfeeding problem — not help with supplementing. In fact, any solids consumed prematurely will replace breast milk rather than provide additional nutrition. Even stringbean babies can meet all of their nutritional requirements until around one year of age from breast milk alone.

Scenario 2). “My baby is a chub, he obviously requires more calories!” Again, not necessarily. Every adult human is biologically unique — some are tall and gangly, some are short and squat, some are petite all over, some are large all over, some are missing limbs or living with dysfunctional organs. And these adults were once smaller versions reflecting the same variety of biological uniqueness. Nutritional needs don’t vary so drastically among healthy, full-term babies.

Despite what some health care providers might imply, weight matters are usually nada but a number, which doesn’t dictate the overall health of a child in and of itself. It can be hard to resist ‘measuring’ progress (or lack thereof) in this way, but please… don’t. Is baby happy? Energetic? Meeting milestones? If your pediatrician agrees that everything looks good, you can release power from the scale.

A big appetite is easily satisfied with breast milk (babies know no difference between appetite and hunger, so comfort-nurse away!). A baby who desires to nurse around the clock is not necessarily an unsatisfied baby. This is a normal baby. This baby is NOT pleading for a top-off of Gerber rice cereal, or whatever. Assess the WHOLE PICTURE to determine whether your baby craves more calories than your breast milk can provide.

• Baby isn’t sleeping through the night.

Feeding solids won’t help, in fact it could make things worse. Mixing rice cereal in a bottle can irritate a baby’s digestive system, resulting in restlessness, poor sleep, painful gas, reflux and other problems (not to mention risk of arsenic contamination). It’s a baby-raising tradition of antiquity and no longer recommended. So just don’t go there.

• Baby just turned six months old, like, two minutes ago.

Or, baby is nearly six months old. Babies don’t live by calendars, though…

• Baby is grabbing for food.

“My baby is reaching for our food all the time, and she’s four months old. Obviously she’s hungry!”

Don’t babies grab for just about everything? By that token, should we feed our babies floor lint and bits of toilet tissue, too?

Try this: Put a wad of lint in front of your baby. Or a new toy. Does she reach for it? She’s naturally interested about the sensational world around her, not necessarily craving the nutrition from a dust bunny or the heel of your dinner toast.

• I see a TOOTH!

If a baby sprouts an early-bird tooth prior to six months, this is not a determinant itself for readiness.

Dr. Sears says: “Teeth seldom appear until six or seven months, giving further evidence that the young infant is designed to suck rather than to chew. In the pre-teething stage, between four and six months, babies tend to drool, and the drool that you are always wiping off baby’s face is rich in enzymes, which will help digest the solid foods that are soon to come.”

• Pediatrician gives the go-ahead at 3, 4, 5 months.

“The pediatrician said it doesn’t hurt to at least try giving solids as early as 4 or 5 months old.”

Yes, it certainly can! (Purees and rice cereal count as solids). Find a new pediatrician whose nose is capably removed from some dusty, long-disproved 1960s medical text.

• Family members want (whine?) to be able to feed the baby, too.

What harm could it do, right? Google “Infant Virgin Gut” before letting Grandma force-feed Little Johnny a spoonful of mashed taters. You’ll have plenty of regrets as a parent, but this is a pretty easy one to avoid.

• Baby is nursing too often.

No such thing. Babies tend to increase nursing when they’re teething, sick, when a big schedule change happens like moving or mom returns to work, mental or developmental or social leaps, lack of adequate sleep, earache, headache, and sometimes everything under the moon all at once. Yes, it could also indicate increased need for calories. But again, always look at the whole picture first.

• Baby isn’t nursing often enough.

Young babies don’t lose interest in breastfeeding because they’re dreaming of what they observed Mommy eating for lunch. Insufficient nursing can be tracked back to a breastfeeding problem or an underlying issue with the baby, and deserves the attention of some baby-boob detective work, not the aid of Gerber puree promotions.

• ‘Everyone’ else you know already shops in the baby food aisle.

Apparently every baby who shares your young baby’s birthday is filled with rice cereal top-offs, Juicy Juice in their sippy cups, and dutifully accepting Fruit Loops dispensed like pills at medication time, and of course whatever dinner leftovers the dog didn’t want. If you feel the insane pressure to give solids (that I think most moms feel at some point), please know you aren’t alone. Not ‘everyone’ is shushing their four-month-olds with Goldfish crackers.

• Fear of ‘texture issues,’ flavor pickiness.

You’ve likely already noticed how infants put anything and everything into their mouths. Soft things, hard things, slimy things, sandy things — they’re already immersed in a world of textures. Some things they want in their mouth (mommy’s hair) and some they just want to hold or look at (that expensive teething ring). This goes for ALL babies regardless how they’re fed.

The flavor of breast milk changes constantly so a breastfed baby is used to a variety of different flavors (a nursing rack’s got more flavors than Baskin Robbins, you know?). A breastfed baby is thus likely to recognize and appreciate many flavors with no coaxing necessary.

You may have heard frightening stories about kids with feeding issues who required food therapy, which is often blamed on starting solids at some too-late, too-wrong time. Many food therapists attest that although these conditions are real, they are rare, typically outgrown, and have nothing to do with the timeline of introducing solids; those kids were predisposed for feeding issues and would have experienced difficulty no matter what.

Baby’s Ready to Munch!

At some point around midway through your baby’s first year, consider whether all of these criteria have been met. This would mean it’s safe to try Baby-Led Weaning (BLW). According to the authors of Baby-Led Weaning, baby can:

• Sit up with little to no support

• Reach out and grab things effectively

• Take objects to his mouth quickly and accurately

• Make gnawing and chewing movements

• Use a ‘pincer grasp’ to pick up small objects such as food between thumb and forefinger. Using fingers to scrape food into the palm of the hand (‘palmar grasp’) doesn’t count.

Ask yourself: Does my baby reach for food on my plate, grab it and try to eat it? Is she engaged, interested, and eagerly willing to participate in mealtimes?

If some of these criteria aren’t met, have patience and wait a bit. Really, what’s the big rush to add more dirty dishes to the sink?

What if a baby under the age of six months seems interested in what you’re eating? Kellymom offers some ideas:

• Let her sit with the family at meal time

• Offer a cup of expressed breast milk

• Let her play with baby-safe eating utensils, bowls, and cups

• Offer breast milk popsicles, breast milk frozen cubes, or breast milk slushy to eat with a spoon

BLW Resources

Links:

• Baby-Led Weaning web site
• “Cultural Aspects of Starting Solids” – Michelle Brode
• “Finger Foods” – Kellymom
• Solid Foods and the Breastfed Baby – Kellymom
• “The Truth About Baby Food Jars” – The Alpha Parent
• “What to Feed the Baby when the Mother is Working Outside the Home” – Jack Newman, MD