Weaning is a critical time for infant’s in terms of brain development. Research on mice has indicated that weaning is involved in the regulation of brain development and function, through modulating responses to food and environmental, and instigating behavioural changes. This article will explore key considerations with relation to weaning and brain development, signs of weaning readiness, safety considerations, supplementation of vital nutrients and foods to avoid.
General considerations for Safe Weaning (6-12+ months)
Breastfeeding is a very personal choice, and can be extended as long as the parent wishes. The WHO recommends, if possible, babies should be breastfed exclusively for six months, and once solid foods begin to be introduced, that breastfeeding continues for at least the first two years of life, if possible. Regardless of whether an infant is breast of bottle fed, breast or first infant milk should continue to be baby’s main drink until 12 months.
Signs of Weaning Readiness
Infants who are ready to begin weaning will demonstrate:
Babies should always be supervised when eating to prevent choking, and served food when seated in an upright seated position (such as a high chair).
Psychological and Social Considerations for Weaning
If possible, mealtimes should be enjoyed with other family members to support them to develop positive eating habits and encourage them to try new foods in a supportive environment
Vitamin and Mineral Supplements
To ensure all babies and children are getting adequate levels of the vitamins A, C and D, the government recommends children aged six months to five years are given vitamin supplements containing these vitamins, unless they are receiving at least 500 ml of infant formula per day. Vitamin drops, including vitamins A, C and D are available free from some families through the Healthy Start scheme in the UK.
Emerging research is indicating that weaning infants are at higher risk of other nutrient deficiencies. For example, recent research in America demonstrated that weaning infants who were breastfed were at higher risk of iodine deficiency during weaning, compared with bottled fed (who have fortified milk). Iodine is an essential mineral for brain development, particularly in utero and during the first two years of life, as it is essential for cognitive and motor development. Moreover, further research suggested vegetables, which are a key source of fibre and polyphenols, as well as the nutrients iron and omega 3, are also lower in the diets of young children across Europe. These nutrients all play a key role in supporting the gut-brain axis, the bidirectional communication system between the gut and brain which is essential for the development and maintenance of a healthy brain. It therefore may be of merit for babies to receive a broader multivitamin and mineral supplement, including iodine, omega 3, and iron although more research is required to fully investigate and substantiate this area. Increasing consumption of vegetables and fruits is also essential, to increase fibre and polyphenol intake, as well as increasing intake of vitamins and minerals through diet.
Note: Always discuss with your GP / health visitor before commencing a new supplement regimen for your child
Foods to Avoid
It is imperative that babies and infants avoid consuming salt and sugar, as these have adverse effects on teeth and kidneys, as well as the developing gut in terms of balance of beneficial bacteria. Many processed and ready made baby food products contain high amounts of salt and sugar. Always read the label and avoid products which are contain these ingredients, as well as added additives, preservatives and E numbers. Public Health England reported in 2019 that some sweet snacks marketed as suitable for babies and toddlers contain as much sugar as confectionery. Additionally, fruit juices should be avoided due to high amounts of fruit sugar (called fructose) present, as well as additional added sugars in many instances.
Drinking cow’s milk should be avoided until 12 months. Additionally, unpasteurised dairy products should be avoided until 12 months due to risk of food borne illness
Consuming honey is also not recommended for babies and infants until 12 months due to concerns over bacteria which may cause a serious called infant botulism, in the very young.
Unpasteurised dairy products should be avoided. Water should be offered from an open or free flow cup, to ensure hydration.
Babies and infants should avoid caffeinated beverages and never be exposed to alcohol of any amount.
Foods to Consume with Caution
Eggs should be Red Lion approved and cooked thoroughly until the white and yolk are both solid. Foods containing raw or partially cooked eggs should be avoided.
Other Weaning Guidance
To reduce risk of choking, foods should be cut (for example, grapes and tomatoes cut in half)Whole and chopped nuts and seeds should not be offered to children younger than 5 years or age due to choking risks.
Stages of Weaning
Starting Weaning (aged 6 months)
Weaning should not begin until at least 6 months of age and it is best to start slowly, introducing vegetables and fruits first, and one at a time. It is important during this time that the infant continues to receive breast or formula milk (500ml-600ml daily), to ensure that they are nourished and hydrated.
Consequences of early weaning may include an increased risk of food allergies, particularly gluten (found in wheat and other grains, including barley and rye) and dairy and increased risk of infections. However, weaning should not be delayed past 6 months. In the case of premature babies, extra advise and support may be required in terms of when and how to wean safely, and a health visitor and paediatric dietitian’s advice should be sought. Some animal research has also suggested that early weaning may increase levels of stress hormones, increase anxiety and reduce levels of BDNF, which is essential for the growth, maturation and maintenance of brain cells.
Examples of Appropriate First Foods
Some good examples of vegetables to start with include steamed broccoli, cauliflower, sweet potato, butternut squash, carrots, aubergine (eggplant), courgette (zucchini). Cooked pear, apple, bananas (not overripe), strawberries, blackberries, blueberries, and raw, mashed avocado are all suitable examples of fruits that can be introduced during weaning. It is essential that all these foods are blended and broken down into a smooth and easy format, for your little one to be able to consume safely and easily. Infants can be spoon fed by carers, or to encourage some independence, given a baby spoon and allowed to feed themselves under supervision. Once the infant has had some experience of smoother textures, they can move on to more lumpier textures (from age 7 months), but this should be approached very gradually and with care. Finger sized portions of food, such as cooked vegetables and peeled fruits, can be offered under close supervision to prevent choking.
Protein foods such as meat, fish, chickpeas, beans and lentils can also be introduced from 6 months. These can be introduced to begin with in pureed curries, stews and soups. It is important that any meat and fish do not contain bones, and any beans and pulses are cooked thoroughly. Everything should be broken down into easy-to-manage mouthfuls and infants should be closely supervised to prevent choking.
Water should also be offered from an open or free flow cup, to ensure hydration.
Introduction of Foods that are Potential Allergens
Other foods that can be introduced from six months include:
The infant should be carefully observed for any sign of an allergic reaction. However, these foods need to be introduced individually and with extra caution. This is because these foods can trigger allergic reactions in some individuals, and so they need to be introduced in small amounts and individually, with the infant monitored to observe if there is any reaction to a particular allergen.
Gaining Experience with Eating (7-9 months)
Babies between 7-9 months will be gaining experience with new foods and getting used to lumpier textures, as well smooth ones. They should be moving towards having three meals per day (perhaps even scaled down versions of family meals) and consuming a wide array of foods including: meat, fish, vegetables, fruits, wholegrains and dairy products. If there are food allergies or special diets being followed, there needs to be extra care taken to ensure that babies are not becoming deficient in key nutrients such as protein, iron, B12 and omega 3. Babies should not be offered snacks between meals, but rather offered milk opportunities (breast or bottle), as needed.
Any nuts / seeds should continue to be offered in smooth forms (nut butters /tahini paste) to prevent choking.
Confident and Experienced Eaters (10-12 months)
Babies should be becoming confident and experienced eaters between 10-12 months, consuming 3 meals per day. For lunch and tea, a main meal based around protein (i.e chicken, turkey, salmon, lentils, chickpeas, beans) with a wide array of vegetables (i.e cabbage, broccoli and cauliflower) can be offered, as well as a pudding option (i.e fruit or natural yoghurt with smooth nut butter). Babies should be confidently moving towards chunkier and lumpier textures by this stage. Babies will also be helping themselves to water as and when they are wanting to drink it.
Beyond Weaning (12 months +)
Infants should be continuing to have 3 meals per day, but may also require 1-2 healthy snacks throughout the day. Examples could include slices of avocado, sticks of celery with homemade hummus (blended chickpeas + olive oil with no added salt), apple or pear and nut butter, natural yoghurt with tahini and berries. Infants can now have full fat cow’s milk to drink, also.
Common Weaning FAQs
What is baby led weaning?
Baby led weaning encourages the infant to self feed from the beginning. The research is still not conclusive as to what benefits exist long term to baby led weaning, but some preliminary research has indicated that infants who have followed the baby led weaning method may have greater satiety-responsiveness and reduced risk of obesity. This area requires more large scale research to explore further. From the perspective of personalised nutrition, it may also be posited that different styles of weaning will suit different infants, depending on their individual needs and abilities, so this is important to keep in mind.
What do I do if my baby rejects a food?
It can take times for babies to get used to new flavours and textures. Gently introducing the food over time, and findings different ways of integrating it (perhaps on its own, or in a puree with other foods, or in a curry, stew, or pasta bake with other flavours and ingredients) are all ways of consistently allowing the new food to become common place.
Can I wean my baby on a vegetarian / vegan diet?
Research has indicated that infants who are weaned onto a vegetarian / vegan diet are at higher risk of nutrient deficiencies. Therefore, families following these dietary practices needs to be aware of these risks when weaning, and ensure that they consult their GP / health visitor and a qualified nutrition practitioner to ensure that the weaning experience is well managed to reduce risk of nutrient deficiencies. Key nutrient deficiencies to consider are protein, iron, B12 and omega 3. Your healthcare provider may also refer you to a paediatric dietitian for further advice.
How do I know if my baby has a food allergy or intolerance?
Babies can present with food allergies and intolerances in a variety of ways, ranging from anaphaxis, a serious reaction which can involve swelling of the windpipe and threaten life and requires urgent medical attention, to failure to thrive, which should involve seeking a health care professional advice., to rashes, hives, eczema and other more milder reactions. If you are concerned your baby is having an anaphylactic reaction call 999 or the emergency service number in your country immediately. If you are concerned that your baby is failing to thrive, in that they are losing weight and are lethargic, pale and not developing in a healthful way, contact your GP and health visitor immediately to request an appointment. This could be a symptom of coeliac disease, which is an autoimmune disease where adverse reactions are triggered following ingestion of foods containing gluten (such as bread, cereals etc). If diagnosed, gluten must be completely removed and a gluten free diet followed for life. With regards to milder reactions such as eczema, rashes and hives, you should contact your GP and health visitor to investigate further, as this could be a sign of intolerance to dairy, gluten or other foods.
How do I know if my baby has had enough to eat?
Babies may signal this through continually refusing more food, closing their mouth or shaking their head from side to side. If you have concerns they are not consuming enough food and water, or they are showing sign of increased weight loss, contact your GP / health visitor for a check up to discuss further.
Additional References
British Nutrition Foundation, 2016: https://www.nhs.uk/ipgmedia/National/British%20Nutrition%20Foundation/assets/Weaningyourbaby.pdf
NHS Start4Life Weaning: https://www.nhs.uk/start4life/weaning/what-to-feed-your-baby/12-months/#anchor-tabs
