When to Wean and Why

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Probably the biggest concerns moms have is when to introduce solid foods to their little ones. The introduction of solid foods is a hot topic among pediatricians and in those dietitians with special interest in infant feeding. In this post we bring you the latest recommendations from the health care professionals.

What is weaning?

Weaning refers to the introduction of solid and liquid foods other than breast milk (or formula if unable to breastfeed) to a young child. The term ‘complementary feeding' is preferred though as this implies that foods complement breast feeding instead of replace it entirely.

Why is breast milk not enough for my baby anymore?

As your baby grows, the ability of breast milk to meet their nutritional needs becomes limited, and so solid foods are introduced to meet this nutritional gap. Breast milk becomes insufficient in energy, protein, iron, zinc, and vitamins A and D at about 6 months of age.

 
The transition from a milk-based diet to family foods is also important for the neurological and motor skill development of the child as different milestones are reached. For example, by 6 months most infants can sit with support and can ‘sweep a spoon’ with their upper lip. By 8 months the tongue becomes flexible for chewing and swallowing of lumpier foods in larger amounts. Between 9 and 12 months most children have the manual skills for feeding themselves, can drink from a sipee cup, and eat most family foods with little adaptation, such as bite size pieces or finer foods. Also important is the development of the gut and kidneys. At 17 weeks the kidney and gut function is mature enough to handle the nutrients from complementary foods. 




When must I introduce solids?

The Good Life Dietitians strongly support the World Health Organization (WHO) recommendation that all infants are exclusively breastfed until 6 months of age, and partially breastfeed thereafter. This implies that the infant receives only breast milk and no other liquids or solids, except for drops or syrups consisting of vitamins, mineral supplements, or medicine.


However, the latest information on infant feeding has become more specific. Though 6 months is a desirable goal, the introduction of complementary foods should not be before 17 weeks but should not be after 26 weeks of age. Experts suggest that this is particularly useful in the ever-increasing waging war on allergy prevention.

If breast milk does not meet my baby’s nutritional needs, do I stop breastfeeding after introducing solids?

Definitely not! Continued breastfeeding even after the baby’s first taste of solid foods is very important. Even though breast milk alone may not meet your child’s nutritional needs, it is still an important source of nutrients and minerals essential for healthy growth of a young child. Continue to breastfeed on demand, and add breast milk to modify consistencies of complementary foods.

First you say 6 months, then 17 to 26 weeks. No wonder mom’s are confused!

The lack of consensus on when to introduce solids is exactly what has caused such confusion amongst mothers of young children and even amongst health care professionals, with different countries having different recommendations. 

The difference of opinions as to when to introduce solids seems to depend on what population is being referred to. In third world, developing countries such Africa, where there are factors like poor economic background, unsafe and contaminated water, poor hygiene methods, lack of refrigeration, among others, it is recommended that breastfeeding is exclusive until 6 months. This reduces the risk for infections leading to diarrhea, malnutrition, and even death. Also important is that breastfeeding provides a contraceptive effect, promoting larger time intervals between births, particularly favourable in poorer families or cultures where women have no say in contraceptive use.

In developed, first world countries however these factors are of little concern, and so a slightly earlier introduction of solid foods (17 weeks to 26 weeks) is suggested.  South Africa is unique in this regard as our population is represented by both these instances. Because of the lower socioeconomic category make up a larger proportion of our population, the Department of Health recommends exclusive breastfeeding until 6 months. Breastfeeding should continue until 2 years of age.

References

Agostoni C et al. Complementary feeding: a commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr. 2008: 46 (1); 99-110.

Dewey K G. What is the optimal age for introduction of complementary foods? Nestle Nutr Workshop Ser Pediatr Program. 2006: 48; 161-175.