Starting Solids with Luke McCabe from Milk To Meals

Starting Solids with Boob to Food

Hooray, it's time to start solids! You probably have a lot of questions about this next stage of life (just as you’ve mastered one thing, it's time to move onto the next with babies hey!).

Starting solids doesn’t have to be overwhelming, but there is a lot of information out there, and a lot of the information is conflicting. The reality is, all babies are different, all family units are different and also taking into consideration different backgrounds, cultures and values - well, there's just no ‘one size fits all’. My biggest tip to you, is to trust your instincts. Always come back to that. You know your baby best, and whilst there is so much great information and guides like ours at Boob to Food that are designed to help you ‘cut through the noise’ when it comes to starting solids, it's also about finding what works for you!

So, in saying that, here is some information to get you started.

WHEN SHOULD MY BABY START SOLIDS?

The current recommendation is that infants are exclusively breastfed (or formula fed) until they’re 6 months old (this means no water, other beverages or food). After that, the recommendation is to start solids once signs of readiness are met. This recommendation is supported by the World Health Organization, the American Academy of Pediatrics, the Australian National Health and Medical Research Council and Health Canada.1,2,3,4

These recommendations are based on a large systematic cohort review, which reviewed 23 studies. They observed child or maternal health outcomes from exclusive breastfeeding for 6 or more months, versus exclusive breastfeeding for 3 or 4 months, with continued mixed breastfeeding (breastfeeding with the introduction of other foods or liquids) until at least 6 months.5 The authors concluded that infants who are exclusively breastfed for 6 months experience less morbidity from gastrointestinal infection than those who are partially breastfed as of 3 or 4 months. This suggests that exclusive breastfeeding for 6 months is advantageous over exclusive breastfeeding for only 3 or 4 months.

This is because breastmilk or formula is considered a complete source of nutrition, and contains all the nutrients that your baby requires until 6 months. After 6 months, your baby will require some additional nutrients to those found in breastmilk/formula—predominantly iron and zinc. 

Alarmingly, many parents and caregivers are still being advised to commence solids between 4 to 6 months, despite all the evidence supporting exclusive breastfeeding (or formula feeding) until 6 months.

Starting solids too early can also cause digestive issues for your baby, such as increased wind pain, abdominal discomfort, constipation, diarrhoea, eczema and sleeping issues.6

METHOD OF FEEDING:

Spoon-feeding vs Baby-led weaning vs Combination feeding: these terms may be new to you, but they’re all different methods of starting your baby on solids. All this terminology can be very confusing. What you initially may think about when starting solids is when to begin and what to feed your baby—not necessarily what method to use.

Each ‘method’ has pros and cons and, as we will discuss, as long as you follow each method safely and mindfully, it will make for a happy and calm food journey for you and your baby.

What is Baby Led Weaning?

Baby-led weaning (BLW) is a method of weaning where a baby is given finger foods and allowed to self feed, rather than starting on purees.

BLW has many advantages, such as:

• Your baby has full control of how much they eat. This teaches them how to self regulate their appetite, which is so important for future healthy eating habits.

• Sensory exploration. BLW allows your baby to explore food, different flavours, different textures, smells and sensations. This is important because pureed food is always a very similar texture and can be hard to distinguish individual flavours because purees often contain more than one food mixed together. In contrast, your baby is generally only eating one food at a time with finger foods and this variety can help them become a more adventurous eater

• Helps your baby to desensitise their gag reflex and teaches them how much and how far they can put food into their mouths

• Teaches your baby how to chew. To develop efficient and safe chewing skills, babies need to be exposed to and have repetitive practice chewing a wide variety of food sizes and textures.

• Helps your baby develop their pincer grip

• Can be easier for you as the caregiver, as you don’t need to prepare separate meals. Your baby will generally be able to eat what you eat. 

• There is no greater risk of BLW babies choking than spoon-fed babies.7,8

Potential disadvantages of BLW:

• It can be messy 

• Some food may get wasted 

• How much food your baby ingests may be less than those being spoon-fed

• Gagging may cause anxiety for the caretaker

What is Spoon Feeding?

Spoon-feeding refers to feeding your baby pureed food via a spoon. This can be a great way of feeding your baby if the thought of finger foods creates feelings of anxiety for you, or if you need to monitor or control your baby’s ingestion more closely e.g. if there is a medical reason or concern about slow weight gain.

Advantages of spoon-feeding:

• Clean and tidy 

• Less waste 

• Baby is more likely to have a larger intake of food 

• Purees are easy to prepare in bulk 

• Can make for a calmer mealtime if a caregiver is anxious about choking 

• It can be easier to monitor nutritional intake, particularly iron, because spoon-feeding is a more controlled mode of feeding. However, studies have found comparable nutrition intake with BLW approach.8,10

Potential disadvantages of spoon feeding:

• Increased risk of over-feeding and baby not learning appetite control, which can also lead to displacement of breastmilk or formula feeds too early

• Less likely to eat meals as a family and for baby to observe you eating, as they are dependent on you feeding them

• Babies may have more difficulty with textures of food later on, which can lead to increased gagging and increased risk of picky eating

• Less chance for food exploration and the sensory benefits of touching, seeing and playing with food
  
  

However, there are some ways you can minimise these spoon-feeding hurdles:

• Let your baby lead and set the pace. Try to allow them to dictate when they want their next mouthful and when they have had enough

• Avoid using language like ‘just one more mouthful’ or ‘have one more bite’, as this does not allow your baby to self-regulate when they are full

• As messy as it can be, exploring food is a part of learning! Allow your baby to use the spoon, and offer them some puree on their tray or plate that they can play with

• Ensure purees are very smooth in consistency. You can gradually thicken the puree to a soup consistency, but do not leave lumps or chunks in it. Babies will ‘slurp’ or suck the food off the spoon. If the puree is chunky, your baby is at a higher risk of gagging or aspirating, as they will slurp the food off the spoon, slurping back chunks, which can activate their gag reflex.

• If you do choose to spoon feed your baby, introduce some finger foods by 9 months at the latest. Your baby needs to become accustomed to different textures and learn how to chew. Longitudinal studies have shown that babies introduced to textured and lumpy foods after 9 months had higher incidences of feeding difficulties at 7 years of age.11

WHAT SHOULD I FEED MY BABY TO START WITH?

I want to preface this by saying there is no ‘best’ first-food - but there are ‘best first-FOODS’. What this means is don’t focus on the single meal, but focus on what you’re consistently offering them! Most babies don’t eat much the first few weeks anyway, and food is so much more than just nutrients! It's a whole learning experience for them - new flavours/textures/smells and sensations!

I do have one golden rule for first foods though, and it's to not start with a top allergen. We want to start with a food considered ‘low-allergenic’ just to make sure that they can tolerate any foods. Foods that are considered ‘top-allergens’ are: eggs, peanuts, tree nuts, soy, sesame, cows milk, fish, shellfish and wheat.

Contrary to what you might have been led to believe, babies don’t need to be offered bland and boring food like rice-cereal. In fact, it's best to introduce REALLY flavoursome foods from an early age. And you ABSOLUTELY can combine different foods right from the start - just don’t combine any top-allergens with another new food, so that you know what (if) your baby reacted to.

If there is a family history of any other allergen causing food, then I would also be mindful of this food when offering.

If your baby does have trouble digesting even foods considered low-allergenic, if they have eczema, asthma or a family history of food allergies then I would err on the side of caution and follow a slower more mindful approach to introducing new foods, as they could be at higher risk of developing allergies.

Your baby does have some nutrient requirements after 6 months of age that breastmilk or formula doesn’t quite meet the needs of anymore — predominately iron - for this reason I recommend trying to focus on nutrient-dense foods where you can. This means foods that provide a lot of nutrients in small amounts (and you can read more about their nutrient requirements on this blog post).

My favourite very ‘first foods’ that you might like to choose from are:

• Bone broth (on its own or mixed in with some vegetables or meat).

• Avocado (ripe slices or pureed with some bone broth or breastmilk/formula)

• Root vegetables e.g. sweet potato, pumpkin, parsnip, swede, beetroot (peeled and steamed in slices, or pureed with some bone broth)

• Coconut cream - straight from the can or pureed with avocado or with steamed vegetables

• Liver strips or pate or mixed through vegetable puree

• Pasture-raised, organic meat - slow cooked in strips or pureed with vegetables and bone broth. Slow-cooked meats like chicken thigh, lamb shoulder and beef cheeks are great to start with!

• Bone marrow - delicious mixed into puree or spread onto finger foods.

• Egg yolk (allergen) can mix into puree or offer an omelette.
  Introduce after tolerating foods considered ‘low-allergenic’ first.

• Fish (allergen) - soft baked fish is a beautiful finger food, or you can make a puree by adding some vegetables. Fish like sardines, mackerel and wild salmon are incredibly high in DHA, a fat required for your baby's growing brain.
  Introduce after tolerating foods considered ‘low-allergenic’ first.

• Nut butters (allergen) - one of the first allergens to introduce, you can add nut butters to any puree to increase fats and protein, or spread onto finger food of choice.
  Introduce after tolerating foods considered ‘low-allergenic’ first.

Once you have introduced some first foods, the idea is really that your baby starts eating what you eat (or a version there of) - there is SO much to say about the benefits of eating as a family, eating the same (or at least similar) meals, and modeling good eating habits to your baby. It will also reduce the cooking and preparation for you if you can all eat the same thing. This will generally also ensure your baby is eating a variety of foods and getting the nutrients they require. We do have a FREE starting solids guide if you would like to know which foods we recommend and when.

NUTRIENT DENSE RECIPE:

BEEF AND SWEET POTATO PUREE 

Meals a day: 1

Making time: 45 minutes

Serves: 2-4 baby servings

Freezer Friendly: Yes

Contains Meat

Ingredients:

100g sirloin beef, diced

1 medium sweet potato, peeled and chopped

1 cup Bone broth

1 tsp fresh thyme, finely chopped

Method:

1. In a medium saucepan, bring the beef, sweet potatoes, thyme and broth to a boil over medium heat. Reduce heat to low and simmer for 25–35 minutes or until beef is cooked through and sweet potatoes are tender. Let cool slightly.

2. Transfer all ingredients into a blender or food processor and puree until it is a smooth consistency. Add extra bone broth or water in small increments if needed, until you reach desired consistency. 

Notes:

• Store in an airtight container in the fridge for up to 3 days, or in the freezer for up to 6 months.

• You can also grate frozen raw liver into the puree (add in step 1) for extra iron boost. And/or enrich with a cooked egg yolk.

KOFTAS

Benefits:

Koftas are another perfect introduction to meat as they are easy to grasp and take small bites from. You can essentially use any type of mince–we have used lamb for this recipe but it would also work with chicken or beef mince. You can also increase the iron content of these by adding some liver to the mixture (see notes below for instructions on how). Accompanied by our Probiotic-rich dip, these koftas are a lovely meal the whole family will enjoy!

Meals a day: 1

Making time: 15 minutes

Serves: 4-6 baby serves

Freezer Friendly: yes

Contains meat

Ingredients: 

250g grass-fed or pasture-raised mince (we used lamb)

1/4 tsp cumin

1 tsp finely chopped parsley

1 tbsp avocado oil

Method:

1. In a bowl add the mince, cumin and parsley. Combine together with your hands and make log shapes, about as long and wide as your index finger.

2. Preheat the avocado oil in a cast iron frying pan over a medium-high heat.

3. Add the koftas and cook, turning occasionally, for 10 minutes or until cooked through.

4. Once cooked, cut into shapes the same width and length as your index finger. 

Notes:

To add liver to this meal, grate 1 chicken liver into the mince mixture (approximately half a cup) prior to combining the mixture.

 

PROBIOTIC-RICH DIP

Benefits:

What child doesn’t love a fun dipping sauce? Even better when the dipping sauce is not only nutritious, but also rich in probiotics!

Meals a day: 1

Making time: 5 minutes

Serves:1 baby serve

Freezer Friendly: yes

Ingredients: 

2 tsp cultured coconut yoghurt

1/2 tsp sauerkraut brine

Method:

1. Place the coconut yoghurt in a small bowl.

2. Using a clean spoon, take ½ tsp of the sauerkraut brine (the liquid around the sauerkraut) and add to the coconut yoghurt.

3. Stir through and serve.

HOW MUCH AND HOW OFTEN?

When first starting out, your baby will likely not eat very much - if anything at all! As a general rule, I would start by offering them 1-2 tsp of food, or 1-2 pieces of finger food, once a day and gradually build from there. There is no ‘right time’ to offer solids, work in with your family and when suits you. Keep their milk feed (breastmilk or formula) as priority until 12 months of age, and offer solids some time after a milk feed, where they are happy and not overtired! For most 6ish month olds, this will be around mid-morning.

‘Milk before food until 1 year old’

You may have heard this popular saying and it is in fact true. Breastmilk or formula is what your baby will obtain the majority of their nutrient needs from in the first year and, therefore, should be offered prior to food. 

When your baby first starts solids, their intake may be quite small, so the amount of breastmilk or formula should remain mostly the same. As your baby’s solid food intake increases, their breastmilk or formula consumption will gradually decrease, and you may notice your breastmilk supply gradually drop. 

This will be a very gradual and very natural exchange.

When offering your baby food, it can be a good idea to offer food not too close to their last milk feed, so that they’re neither too full, nor too hungry.

After 12 months, food can then be offered to your baby prior to their breastmilk/formula feed. This may slowly begin the natural process of weaning from milk feeds to solids. However, your baby will still reap the benefits of breastmilk as long as you and your baby wish to continue that journey.

WANT MORE INFORMATION:

Starting solids can be overwhelming, and sometimes it's nice to just have a resource to take all the guessing out of the picture! For this reason I created my book, Milk to Meals. A beautiful, hardcover book with almost 300 pages, packed with insights and tips on transitioning from milk, choosing a feeding method to suit your family, navigating the top allergenic foods, which nutrients to focus on to meet your baby’s nutritional needs and when to incorporate certain foods in their diet in the most mindful way (plus much more!). You can purchase the Milk to Meals book here.

We also have MANY free resources on our website, podcast and instagram and also offer starting solids consultations if it's all too confusing!

Good luck on your solids journey! Remember to have fun with it and enjoy the process!

Luka xxx

Boob to Food

@boobtofood | www.boobtofood.com | www.milktomeals.com 

References:

1. World Health Organisation. Infant and young child feeding. June 9, 2021, https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding, accessed 02/04/2023.

2. American Academy of Pediatrics, Policy Statement: Breastfeeding and the Use of Human Milk, Pediatrics, 2022, 150 (1): e2022057988. https://doi.org/10.1542/peds.2022-057988 2023.

3. National Health and Medical Research Council, Infant Feeding Guidelines. Canberra: National Health and Medical Research Council, 2012.

4. Health Canada, Infant nutrition, 2014, Government of Canada.

5. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews 2012, Issue 8. Art. No.: CD003517. DOI: 10.1002/14651858.CD003517.pub2.

6. Kramer MS, Chalmers B, Hodnett ED, Sevkovskaya Z, Dzikovich I, Shapiro S, et al. Promotion of breastfeeding intervention trial (PROBIT): A randomized trial in the Republic of Belarus. The Journal of the American Medical Association. 2001;285:413–420. doi: 10.1001/jama.285.4.413.

7. Daniels L, Heath AL, Williams SM, Cameron SL, Fleming EA, Taylor BJ, Wheeler BJ, Gibson RS, Taylor RW. Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr. 2015 Nov 12;15:179. doi: 10.1186/s12887-015-0491-8. PMID: 26563757; PMCID: PMC4643507.

8. Fangupo LJ, Heath AM, Williams SM, Erickson Williams LW, Morison BJ, Fleming EA, Taylor BJ, Wheeler BJ, Taylor RW. A Baby-Led Approach to Eating Solids and Risk of Choking. Pediatrics. 2016 Oct;138(4):e20160772. doi: 10.1542/peds.2016-0772. Epub 2016 Sep 19. PMID: 27647715.

9. Williams Erickson, L., Taylor, R. W., Haszard, J. J., Fleming, E. A., Daniels, L., Morison, B. J., Leong, C., Fangupo, L. J., Wheeler, B. J., Taylor, B. J., Te Morenga, L., McLean, R. M., & Heath, A.-L. M. Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial. Nutrients, 2018, 10(6), 740. https://doi.org/10.3390/nu10060740

10. Cichero, J. A. Y. Introducing solid foods using baby-led weaning vs. spoon-feeding: A focus on oral development, nutrient intake and quality of research to bring balance to the debate. Nutrition Bulletin, 2016, 41: 72–77. o Coulthard

Coulthard, H., Harris, G., & Emmett, P. Delayed introduction of lumpy foods to children during the complementary feeding period affects child’s food acceptance and feeding at 7 years of age. Maternal & Child Nutrition, 2009, 5(1), 75–85. https://doi.org/10.1111/j.1740-8709.2008.00153.x