Breastfeeding

How to manage breastfeeding when starting solids

It is World Breastfeeding Week and as a Children’s Dietitian I often get asked how to manage breastfeeding alongside the introduction of complementary foods (often referred to as weaning). Rest assured; it is not as complicated as it might seem.

Ready or not?
Before you think of introducing solids to your baby, let’s have a look if baby (and you) are ready for the exciting journey into the wonderful world of food…
UNICEF and the WHO recommend exclusive breastfeeding for 6 months before introducing complementary foods alongside the continuation of breastfeeding till the age of 2 years or beyond if mother/parent and baby wish to do so.  Breastmilk will provide all the nutrients your baby needs for the first 6 months of life, and will continue to contribute significantly whilst your baby gets to grips with solids and progresses towards regular meals. 
There are key developmental signs (remember each baby will be individual as to when they reach these too) that indicate that your baby is ready to start weaning:

1. Your baby can hold their head stead and upright, and is able to sit with minimal support
2. Your baby has eye – hand – mouth coordination, meaning, if your baby sees a toy or some food it will reach out with their hands, pick it up and move it towards their mouth
3. A diminished tongue thrust reflex - this is a natural reflex babies have, as this diminishes baby is likely to find it easier to swallow food than spit it back out!

Other signs that often are mistaken for weaning readiness signs that are however rather signs of normal baby development are; chewing hands or fists, showing an interest in you eating (although curiosity and interest in food is great for when you get going!), breastfeeding more frequently or waking more often at night again.
And last, but not least, are you ready? Many parents feel a mix of emotions from excitement to anxiety. Consider preparing for weaning by accessing evidence-based advice from professionals, exploring some recipes or first foods and taking a first aid course if you are concerned about factors like choking.

But how do I time breastfeeding and food?
The easiest way to approach the start of the weaning journey is to continue feeding responsively (following your baby’s cues) and start by offering some solids once during the day, at a time that suits you and baby.  For many this is a mid-morning or lunchtime, and this too allows time after meals to ensure your baby is settled and observe for any signs of food allergy.  You want to have baby alert, settled and not too hungry.  It is a misbelief that solid foods are to replace milk feeds straight away. It is called complementary food for a reason and realistically speaking, the first couple of months of the weaning journey are a lot about playful exploration of food rather than eating a substantial amount of a meal.  Focus on offering variety, rather than the volumes of foods your baby is accepting initially. Allow your little one to learn and skill build around feeding and eating!  Furthermore, breastmilk remains ta key and predominant source of nutrients throughout the first year of life.
Over time, when more food is consumed, your baby is likely to reduce or drop milk feeds naturally without you needing to do much about it.  This is often supported as you establish a regular routine of meals throughout the day, with most babies reaching three meals a day between 7-9 months of age.  For many breastfeeding mothers, breastfeeds then often fall in-between meals e.g., first thing in the morning, mid-morning, midafternoon, during the evening.  Babies will however, continue to have periods where they breastfeed more or less.  This may be due to growth changes, weather changes e.g. feeding more in warm weather,  or for comfort.   From the age of one, toddlers should be well established with three main meals and may also start to include 2-3 snacks per day too.
 
How to continue breastfeeding once baby turns one and I go back to work?
The next milestone many families wonder about in this context is how to continue your breastfeeding journey once your baby turns one and is well established on three main meals and 2-3 snacks. Often after one year, mothers return to work as well. None of these need to mean the end of your breastfeeding journey. Many families naturally fall into a rhythm of breastfeeding before nursery drop off/work, on return from nursery/work and for going to bed. Some babies might initially make up for the change of situation by requesting (more) night feeds again. While they shouldn’t need the nutrients to get through the night at this age if they are eating well, breastfeeding provides a lot of comfort throughout any period of change.

Blog by: Lisa Singh (IBCLC & 4th year Dietetic Student & Lucy Upton, The Children's Dietitian