Doctor in the House: Weaning baby

Most new parents are excited about the whole process of starting solid food for their babies and tend to get carried away — within a month of starting, they are feeding the baby two or three meals.

Most paediatricians will tell you that you should breastfeed your baby exclusively for the first six months and then start introducing solid food. But, by five to six months, most babies are ready to eat solid food as a complement to breastfeeding. By this time, babies typically stop pushing food out with their tongue and begin to develop their coordination to move solid food from the front of the mouth to the back.

When is your baby ready for weaning?

Your baby is ready to start weaning when the baby can hold his/her head steady and sit up with support. Your baby will be mouthing their hands and toys all the time and they will be leaning toward your food and will be interested in what you are eating.

How to start off?

When we start weaning, start with once a day and do it in the morning hours ideally, between two milk feeds. I prefer that babies are offered vegetables as the first food and that sugar or salt not be added to their food for the first year.

Start with a single vegetable or a couple of vegetables that cook well and can be mashed smoothly with a spoon or fork, initially you will have to smoothly mash it as otherwise the baby would gag on the food. Give this for two to three days before you move on to a new vegetable. You can add a small amount of unsalted butter or ghee and a pinch of other condiments like turmeric or asafoetida to add flavor to the food. Give as much as the baby will take and don’t be disappointed if she spits it out the first time. You can use potatoes, carrots, peas, pumpkin and other gourds.

After a few days, you can add soft mashed dal like moong dal, arhar or masoor dal and follow this by adding rice and feeding it as a soft khichdi. By one month, when your baby is eating a small bowl of khichdi, the second meal starts as a mashed fruit.

Give one fruit at a time for a few days, increasing the quantity to as much as the baby will tolerate. Once you have tried three to four fruits, you can give a mixed fruit puree.

Rice or suji porridge can be given and you can use cow’s milk to make the porridge. Don’t give cow’s milk alone as a feed till your baby is closer to one year. Yoghurt and paneer can be given if there is no history of cow’s milk allergy. You can use fruit or mashed raisins or dates to offer some sweetness to the porridge.

By eight to 10 months, your baby should be able to handle small portions of finely chopped finger foods like fruit, vegetables, idli, uttapam, and soft paratha. You can introduce dalia, oats, ragi and barley by this age.

Chicken, fish, eggs, and even meats can be introduced side by side as long as it’s well cooked. You can start off using stock to cook the rice and vegetables.

Babies often reject their first servings of pureed food as the taste and texture is new. If your baby refuses, please don’t force it, and just try again after a few days.

When you introduce potentially allergic foods

Potentially allergic foods can be introduced along with the rest of the diet:

— peanuts

— egg

— shellfish

— wheat

— fish

There is no evidence that introducing these later foods is of any benefit. Do it at home, in the morning hours and keep an antihistamine handy.

What to avoid

— Don’t give juice to the baby, rather give fruit. If you want to give it, especially in the summer months, do it closer to a year, not before. Too much juice can lead to dental caries and can also lead to runny stool.

Honey is not recommended for children under one year old, as it may contain certain spores that can cause a very serious illness called botulism.

Don’t offer large pieces of fruit, meat, or cheese that are choking hazards. Be with your child when they are learning to bite and swallow.

Encouraging baby to experiment

— As soon as your baby can sit well, it might be prudent to use a high chair where she can be strapped in.

Encourage your baby to explore and play with the food and feed herself. Offer your baby a spoon while you feed her with a spoon. This will help her to learn independent feeding soon. Don’t force feed when your baby turns away, avoid power struggle.

Around nine to 10 months of age, try offering water or even some formula or breast milk in a cup.

— Enjoy your baby’s sticky face, gooey hands and messy tray and floor, as this encourages a lifetime of healthy eating. Encourage them to feed from your plate once they are older and don’t fuss too much that it has a little salt or sugar.

(Dr Saroja Balan is consultant neonatologist and paediatrician at the Indraprastha Apollo Hospital, New Delhi. Her column appears every fortnight)

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