There will always be a time for each child to commence feeding with solid food. For some children this will occur sooner and for others it will occur later. No-one should define to you a set and rigid time that a child should or should not be consuming solid food. I did see the point, made by one of my lecturers when I was a medical student, that if the child has teeth nature is probably giving you a strong hint. The last section of this chapter gives some guidelines on time frames.
For those who have already read later chapters in this book, you will be aware that I try to encourage the majority of children to be sleeping between 10 and 12 hours as an unbroken block of sleep at night by three months of age. The majority of children can achieve this target with guidance from Mum and Dad. Some children may start on solids very early in their lives as a part of achieving the above sleep target. This will depend on the amount of breast milk which the Mother is able to produce and the amount of growth which the child’s genetics are attempting to achieve.
Let’s start the discussion assuming that the child has achieved 10 to 12 hours sleep at night and is fully milk fed. At what stage do we start solids for this child? The answer is that we allow the child to determine the age for progressing to this next stage of feeding. We wait for a cue from the child that he or she is not receiving enough total nutrition. The cue which will be used is a change in the child’s night sleep pattern. Whereas the child has been sleeping for the whole night for many days or weeks, for no apparent reason there is a change. The baby is well, has had good days and we know or believe that he or she is not overtired. The baby begins to awaken during the night. Despite being in a good sleep pattern at night for some time the baby is ’seriously’ awake in the middle of the night and is very difficult to settle without a feed. Instead of ‘crying down’ from the episode of wakefulness the baby ‘cries up’, becoming louder and more demanding. You may recognise a ‘hungry’ cry. The answer to this problem is definitely not to re-start night time feeds on a regular basis. You may need to feed once or twice at night to convince yourself that hunger is the problem but then switch the focus to the starting of solid foods during the day.
A child starting on solids will need only a small volume initially for a couple of reasons. Firstly the child needs only a small addition to the breast or bottled milk that the mother is providing. Secondly the child’s system of digestion does not contain adequate volumes of the chemicals required to break down the new foods to the point that they can be absorbed. The bowel is able to produce the chemicals, called enzymes, if it is given a gentle hint that a new food is to be introduced. A small volume of the new food can be given at any one time. Over a number of days the gut will develop the enzymes of digestion required for that food and the child will be able to handle a bigger volume.
An example of this from adult life may help you understand this idea. Imagine that you have not eaten meat for a long time, say for some months. Suddenly you eat a big volume of meat which contains a fairly high content of fat. In quite a number of people this can be a very nauseating experience. Part of the reason is that the body is producing less of the enzymes required to digest the meat and fat. The point that I wish to make here is that sudden changes in the type of food that a child receives or increases in the volume given could be counter productive. There is no point in being overly enthusiastic and making the child sick. You will lose confidence and then there will be a delay in progressing to the next stage in the childs development.
The initial volumes of solid food are quite small. On the first occasion the child may only consume one half teaspoon of food. Please do not expect the child to cope with a new feeding implement and a new food taste on the first occasion with speed and enthusiasm. In fact the child will probably cross its eyes, make a funny face and ‘tongue’ the food forward onto the teaspoon from which it came. This may be accompanied by a facial expression of surprise. Occasionally a child will take to solids at the first time. Often however, the babies face gives a wonderful display of emotion as it tastes a new flavour and texture. It may take two or even three days before the ‘penny drops’ and the child’s expression becomes one of enthusiasm. The baby will then move the food to the back of the mouth and swallow with greater efficiency.
The child is now able to commence solids regularly. The volume which you give will depend upon the baby’s interest and the routine which you establish. Increase the volume at a slow regular rate. At the end of the first week the baby may be taking only one teaspoon and continue to increase at that rate. Routine is useful. Babies function best with a sensible, predictable routine. For example once the solids have started, let them be continued. The solids become a regular part of their nutrition. Do not give solids for a couple of days and then miss for a few days. Do not give the solids only on those days when the baby ‘looks’ as if he or she needs it.
TIMING (PRE OR POST BREAST FEEDING)
The question of when to give the solids while still breast or bottle feeding is a little complex. Initially the solid feeding is an addition to milk feeding. The breast feed is given first and the solids are a top up. At this stage the majority of the child’s calories come from milk.
No one argues that breast feeding should continue permanently. At some stage the combination of solids and non breast milk fluids will become a more important source of calories. A time will be reached when breast feeding is given second. The timing of this change over is not critical. Some mothers even give solids before the breast feeding from the very beginning and claim that it can be very successful and does not interfere with their breast feeding.
TIMING (MORNING , NOON OR NIGHT ?)
As will be obvious from reading elsewhere in this book one of the major reasons for starting solids is to assist in the achievement of a full night’s sleep for the child and thus the parents. As a parent I thought a full night’s sleep was a great idea. Don’t apologise to anyone for seeking a full nights sleep. If the parents are fresh and in good humour they are far more likely to provide good parenting.
I believe that it is logical to give solids at the evening meal. The child thus has a supply of nutrition in it’s stomach to settle for the night. Yet again this issue is not critical. Some mothers give the solids in the morning and argue that it is just as successful.
The taste of the baby’s food can be a factor in determining your success. For those of you who have tasted human breast milk, you will have found that it is quite sweet. The taste is about half way between cow’s milk and cordial. There is quite a significant and pleasant sweetness. I generally recommend to the parents that I am seeing to place a couple of drops of milk onto a finger tip to taste. This understanding of the level of sweetness assists in the later ‘designing’ of the level of sweetness of the babies solid foods. When ‘designing’ foods it can be helpful to mimic this degree of sweetness. For vegetables, if a potato is being used as the base, then some apple, pumpkin, or carrot can be added for sweetness. If using rice cereal, which by itself is quite bland, then a little apple puree or banana pulp may give it a little more interest.
Infants are not keen on lumps. Most babies will be on at least some solids before they have teeth. The food should be a fine puree particularly when first started. This can be achieved using a food processor, vitamiser, or forcing through a sieve. In addition to avoiding lumps, the child requires a mixture which is reasonably fluid. For first solids I generally recommend a consistency similar to thickened cream.
What solid food to give young children is an area of great discussion. Foods which are commonly used in our society include rice cereal, various fruits and vegetables, and some other cereal foods.
Common sense must prevail and many adult foods are not considered. Young infants certainly have a decreased ability to handle a salt load and what some physicians refer to as a solute load. What this means is never add salt and choose foods with a higher water content. For example vegetables are often 80-90% by weight water.
There are certainly many fine books and books on infant feeding which I will not try to equal.
The most specific I will be is to describe what we used for our own children. Even though my wife had a very generous milk supply, we started solids early as part of encouraging night sleep. We used vegetables to start. Boiled potato was vitamised with some other vegetable such as pumpkins, or maybe apple. Introduce one vegetable at a time to detect any intolerance. One advantage of mixed vegetables is that they can be frozen as ice cubes and in an emergency ‘tea’ can be produced from the freezer in a couple of minutes by using the microwave. After vegetables we used Weet-Bix made into a creamy paste with milk. This tended to be the breakfast meal, vegetables at the evening.
There are certainly many variations on this theme.
FOODS TO AVOID
Babies have a limited ability to handle salt. Do not add salt to infant food. For the majority of infants there is no need to add butter or margarine. Avoid foods which may have a strong flavour. Baby food tends to be fairly bland. Meats, fats and in fact most adult food will be introduced quite slowly and well after six months.
Once started on solids the volume will increase slowly but steadily. Remember that growth is hugely energy expensive. It takes a lot of food to build a body, even a small body. My personal experience is that boys will eat more than girls, but I have not seen any research to support that impression.
Do not be surprised if the baby, once started on the solids, comes to believe that they are a really good idea. The volumes which are taken are sometimes quite large. It is not uncommon for a healthy baby of six to nine months to be taking in addition to their breast or bottle milk a volume of food almost as large as an adult woman.
The other thing which goes with volume is speed. Once solids are a regular part of their nutrition many babies will want them delivered fast. The spoon can become a bit of a conveyor belt. If you are too slow you will hear all about it. I am told that feeding twins can be fun where it is almost impossible to keep up with the needs of two mouths.
Beware of increasing volumes too quickly. Some babies will believe that the food is a good idea and eat greedily to the point of being sick. That is counterproductive. You will set the upper limit. If the baby is finishing all that you offer, add a little more each day so that the volume gradually increases. For the majority of feeds the baby will lose interest at the appropriate point and simply stop opening the mouth in response to the spoon.
Once solid foods are a regular feature on the menu, you will also set the minimum volume. On some days they will not be so interested. Do not be discouraged and gently persist. Try to achieve at least half of their normal volumes.
WHEN TO START SOLID FOODS.
I have left this to last because it is quite controversial. All that I can say is that my private, unpublished research shows that the majority of babies are receiving solid food by four months. These results come from a survey of over two hundred city and country families which showed the following.
- 14% of babies had started solids at two months or younger.
- 47% of babies had started solids by three months.
- 73% of babies had started solids by four months of age.
When advising parents the specific answer depends upon a number of factors. The most important variable is the baby’s weight gain. If the child’s weight gain is low then start solids a little earlier.
If the weight gain is excellent, and the sleep pattern is evolving nicely then delay solids. In fact this later group are fairly easy in that they make the decision themselves. Their sleep gradually develops. Lets say they are being perfect, with eight hours straight sleep at eight weeks, ten hours at 10 weeks, and twelve hours at 12 weeks. Then out of the blue they begin to wake up at, say 2 am, genuinely hungry. This is the signal. Time to start solids please Mum.
This gives us three groups of babies.
- Solids started a little early, say eight to 12 weeks of age to support poor weight gain.
- Solids started a little early, say eight to 12 weeks to encourage longer night sleeps. (These children will often be gaining weight well, but are still unsettled. Given more food they gain weight at an even greater rate, and become more content and sleep longer.)
- Solids started late. Twelve weeks to six months. These babies did perfectly and then began to awaken hungry through the night.