Wednesday, March 9, 2011

Thoughts about weaning

Weaning talk seems to be everywhere these days. Or maybe that is just me, as the mother of a four-month-old (yikes!). And there is so much information that is, I must say, rather poor (yes, I mean you, health care providers that don't follow the evidence). It is not helped by things like the article published in the British Medical Journal in January, which everyone seemed to interpret as saying that people should introduce solids at four months. (The NHS has a great explanation of what the article really did say here. Long story short: the authors suggest the government do a full review of the scientific literature to ensure that the recommendation of weaning at 6 months is based on up-to-date information. A full review is likely (in my opinion and others') to confirm the government’s current recommendations, but it is known that there are a small number of recent studies that show some possible benefits to earlier weaning. Oh, and some of the authors have, in the past, been paid by infant food companies, so there is a possible conflict of interest there.)

Before I go any further, I should define what I mean by weaning. Weaning can mean cessation of breastfeeding, but the way I am using it today is in the other sense of the word: introduction of complementary foods. For some people, the two go hand-in-hand, which, I guess, is why the one word has two meanings, although we are not planning on stopping breastfeeding anytime soon. I would prefer not to use such an ambiguous word, but introduction of complementary foods is a faff to write out all the time, so weaning it is! 

Anyway, I thought I would round up all my thoughts on the matter here. I did a research project a few years ago with regards to food and nutrition among children under 5 years of age. I read about all sorts of things, but one thing I learned about was baby-led weaning.  In this, you skip the whole step of feeding baby purees and instead give soft finger foods that baby can feed himself, such as banana, avocado, or cooked vegetables (more information in book formpaper, or blog). I really liked the idea of this, as it seemed to fit in with my general outlook on parenting (such as breastfeeding on demand, being sensitive to his needs, etc). 

One thing I noticed while reading the literature is that I could find information on possible benefits of both baby-led and traditional weaning, but I didn’t really read anything about negative consequences of either system. On balance, though, baby-led seems to be a good fit for our family, for various reasons, which I have outlined below for your reading pleasure!

1. Developmentally ready—inside and out. It is so important, when introducing solid foods, that your baby is ready to eat and digest them. Obviously, there is no magic switch that gets the gut ready for foods, and we can’t peek in to check if it is developed. However, the outer developmental signs give us an idea of internal development; basically, the skills baby needs to eat develop simultaneously to the intestinal tract. This is thought to occur at around six months old, which is why the WHO, UK Dept of Health, American Academy of Pediatrics, and others recommend waiting till 6 months to introduce solids.

Now, I was going to do a big list of what are and are not signs of readiness for food, with lots of detail. But then I found this page on the excellent website Kellymom, and the work was done for me! I’ll just give a quick list, then, and send you over to Kellymom if you want more details.

Many people think that a baby should be given solid foods when they stop sleeping through the night, as they probably aren’t getting enough milk. This isn’t a very good indication, though, as babies can wake up at night for a whole variety of reasons, including growth spurts for which breastmilk (or formula) should be sufficient. Dr Sears suggests that babies wake up more often before hitting developmental milestones, as they are dreaming about grabbing that toy or sitting up, and maybe even trying to do it in their sleep! I’m not sure how anyone might know this is going on, but it is a sweet thing to think about.

Another common reason for introducing solids is because baby is “interested” in food, watching what the parents eat or grabbing at it. I don’t really go along with this one, because Gus has seemed interested since about 3 months old, and has even swiped at my plate several times (spicy pasta probably not a good idea for baby!). The thing is, he shows a similar amount of interest in my polka-dotted pajama shirt, trying to grab and eat it too. So I don’t think he understands yet that food is for eating, just that it looks like an interesting toy and he wants to play with the things that we are playing with.

Signs that are generally thought to indicate readiness for food include being able to sit up unsupporteddisappearance of the tongue-thrust (when baby pushes things out of his mouth with his tongue), ability to chew rather than suck everything, and development of the pincer grasp (picking things up with thumb and forefinger rather than palm).  Obviously, babies develop at different paces, and parents are generally the experts on their own children. But, for the majority of babies, these things will all come together at about 6 months of age. 

It is actually perfectly possible to wait until full development before introducing solids using either baby-led or traditional weaning. However, for me, I think it will be easier to know for sure using baby-led weaning. It would be so easy (and tempting—I’m excited about his first solids!) to shove a spoon in Gus’s mouth when he isn’t quite ready. But if he isn’t ready for foods yet and we are doing baby-led, he just won’t try and eat it. He might mash and throw the foods, but he won’t try to put them into his mouth. Thus the baby-led part of this method. I really believe that babies do know when they can do things (instinct or whatever), they just need to be given the right opportunities and appropriate modelling and encouragement.

There are also lots of health benefits of exclusively breastfeeding a baby until 6 months of age. Kellymom can help us out with that one as well. A quick word about iron: many people worry about this, but if baby was born healthy and full-term and mom had a healthy pregnancy (and especially if you were able to delay clamping the umbilical cord), an exclusively breastfed baby should have plenty of iron for at least six months. There is less iron in breastmilk than in some other foods, but the bioavailability is high, meaning more of the iron is absorbed by baby’s intestines.

2. Going at Gus’s pace. I mentioned this a bit above, that with baby-led weaning, the child decides which foods and how much to eat. This helps them learn to regulate their appetite, as they will stop eating when they are full, rather than when mom stops putting the spoon in their mouth. Some people think this can help prevent obesity, because babies learn to listen to their bodies’ cues about satiation. And since breastfed babies already decide the when and how much, it makes sense to me to continue developing this skill.

I recently heard the phrase food is for fun until they are one. The WHO agrees that most of baby’s calories and nutrition should be met by breastmilk until she is 12 months old, and that even for children 12-23 months old, breastmilk can make up 35-40% of a child's caloric intake (here, p 12). This is why they use the term complementary foods. Solid foods shouldn’t be replacing milk feeds right away; they should be supplementing them. As baby grows, more calories come from solids. With baby-led weaning, baby will increase the amount of food actually ingested as needed (which may change day-to-day). Ellyn Satter recommends a division of responsibility in feeding in which it is the parents’ job to offer a variety nutritious foods at appropriate times, but it is the baby who decides how much and which specific foods to eat. Taking the focus off of shoving food in baby’s mouth in order to get enough calories instead gives baby the space to learn about tastes and textures of different foods at her own pace in a low-pressure environment. To me, baby-led weaning is the more natural way to achieve this goal.

3. Learn the social aspect of meals. Eating is about so much more than just getting the calories in. Mealtimes should be fun, relaxed times to spend with family and friends. All experts that I have read suggest that babies and children should eat with the family, and eat family foods, as often as possible and practical. Again, this can be done using either method of weaning, but it seems easier to do it with baby-led. I don’t think I could eat my food and spoon-feed a baby at the same time! I have lovely visions of Jon and I sitting at the table with our meal, Gus in his high chair, and all of us eating and talking together. Okay, Gus will probably do more throwing and playing than eating and talking, but it will be a family affair.

4. Save time and money. Or in other words, I am lazy. The idea of spending hours filling my freezer with purees does not excite me. Washing up all the accoutrements that do along with making those purees excites me even less. I know how our house works, and we will leave the pureeing utensils to sit dirty for days, because they are a pain to clean, will run out of food for Gus, and will have to open up a jar, which we will have paid an arm and a leg for, just to have him eat 2 bites. Excitement levels diminishing even more (I think I am actually digging a hole here for my lack of excitement to reach the appropriate depth.) Much better for my lazy self to peel a banana or steam a veggie or two in the microwave. Or just grab a bit of the dinner I am cooking for Jon and me and hand that over to Gus. Ahh, the bliss of the easy option!

5. Infant food companies. This reason gets me up on my political high horse a bit, but it is still important.  Infant food companies have in the past and continue today to engage in immoral and unethical practices with regards to promoting their products, particularly infant formula. Yes, some people do need to use breastmilk replacements for a variety of reasons, so it is good that they are available. But that doesn’t mean that they should be advertised using lies that undermine women’s confidence in their ability to breastfeed or to people who cannot ensure a safe, adequate supply of formula (i.e. people who would have to spend a majority of their income on formula or do not have access to clean water and sanitation). I am reading The Politics of Breastfeeding by Gabrielle Palmer at the moment, which has both horrified me with some of the advertising practices she describes and gotten me really passionate about the issue.

What does this have to do with weaning? Well, I know that if I use purees as the main part of Gus’s diet, I will be much more likely to rely on pre-packaged foods to feed him (see above re laziness), which all come from these same companies. I am sure that I will make some purchases of baby food anyway, but any way to limit the amount I give to these companies is good by me. I so far have not tried to join the complete boycott of Nestle, but I can do my little part. (There’s a good round-up of the reasons for the boycott, with lots of links, here)

6. He’s just so little! OK, this one (and the next one, really) don’t have to do with baby-led weaning per se, but they are too central to my whole thoughts about weaning to leave out. So many people start to give solids at four months, but I could just not handle that yet!  I am still getting used to Gus actually being here on this earth, much less be able to think about him growing up so fast that he can eat solid foods already.  I know I can’t keep him a baby forever, but if I can hold on to this bit for just a little longer and him still be healthy, I gladly will.

7. Proud of myself as a woman. To me, it is really empowering to see Gus growing and developing and know that it is all because of the food that I am creating for him with my own body. I don’t mean to imply that I am somehow “better” than non-exclusively-breastfeeding mothers, or that every breastfeeding mother should feel the way that I do.  But for me, in my own experience, it is a pretty awesome feeling. And to be able to go until 6 months of exclusive breastfeeding will be the icing on the cake for me. (Or really, the cake part of the cake, since I prefer it to the icing. But I digress.)

Anyway, that encompasses our weaning plans. Stay tuned for them to all come crashing down around us (hopefully not!).


  1. I was all excited about starting my son on cereal when he turned 4 months old. That excitement quickly vanished whenever I realized that I'm lazy and pumping to use breastmilk for the cereal and mixing the cereal and taking the time to feed him takes so much time. It's just so much easier to pull out the breast and feed. He gets his fill in about 7 minutes and is super happy. He's just not into cereal or baby food and he's 6 months old now. I still offer him baby food and he eats just a little bit, but I'm not worried about it because he'll eventually get it and he's getting all the nourishment he needs from me. That's just been my experience so far!

  2. Interesting. I'm also keen to delay weaning till as close to 6 months as possible. Partly laziness comes into it (there's plenty of washing up already, and I have enough trouble thinking what we're going to eat tonight without having to plan meals for H sooner than I need to!), but also because I know H can't sit up unaided and puts everything in her mouth. She may be 4 months, but it's not right for her yet. I was given an interesting NHS start 4 life leaflet at clinic today which I found really clear and useful. It doesn't particularly state one method over another, but there's a definite inclination towards what I'd understand as BLW. Anyway, I'm definitely in no rush!

  3. This is a great list with fantastic reasons - and the 'but it's easier' thing really does win out for me. As well as cheaper and , in my view, better for everyone!

    I actually wrote about that study too - and the rediculous headlines that accompanied it. How terribly misleading.

    Love your blog name, by the way, and have the song stuck in my head now...
    *and be led forth with peace, the mountains and the hills will clap their hands.... *

  4. @Maggie--Thanks for sharing your experience! You sound like you have such a calm attitude toward it all. I hope I can just roll with it like that when we start!

    @Claire--Yeah. one meal a day is plenty to try and plan! I should look at that leaflet; wonder if I have it around in one of the many piles of pamphlets I have picked up in the last 4 months...

    @Luschka--Thanks for stopping by! Good to hear that it is actually easier (if not easy--the mess!) for some and not just my rose-coloured view of it! I have bookmarked the first foods list you wrote--thanks for sharing.
    And sorry for getting the song stuck in your head ;) It took me about a month after I started the blog before I stopped singing it *every* time I opened up the page!

  5. Love this Amy. I'm sure you remember me ranting about this particular thing as nothing was more of a headache for me than introducing solids (cause of other people). Doc's first bite was at almost 7 months and he wasn't interested. Every once and a while I would put food in front of him (avacado, nanner, potates) but he was not even a little interested. I was perfectly happy with just breastfeeding him so no matter. He was about 8.5 months when he was finally interested. I'm very happy with the decision we made to let him decide when he was ready and I think it is part of the reason he has been such a healthy boy!

    Keep at it mom you are doing great! Thanks for sharing.

  6. Oh yea, and the laziness thing, right there with ya. :)

  7. @Dacia--Yes, I do remember that conversation. :) You have given me a great model for following Gus's needs rather than any predetermined timescale. And did Dominic ever decide he liked bananas?

  8. lol No he still doesn't like bananas. i always try to give him a little when I eat one. The funny thing is, if he gets a hold of one he loves chewing on the peel (yuck!!) but then when I open it up to give him a try he is disgusted. lol what a silly boy.