For many years there has been debate surrounding weaning, complementary feeding and the types of food that we should introduce to our babies (in particular, potentially allergenic foods such as wheat, peanuts, eggs, fish and gluten). Recently there has been new ESPGHAN guidelines (The European Society for Paediatric Gastroenterology Hepatology and Nutrition). Here, we aim to summarise the new evidence for you that has emerged to make healthy weaning as easy as A, B, C!
During the first few months of life, babies are using vitamin, mineral and nutrient stores they acquired from mum during the pregnancy. Rest assured- all that nutritious food you ate during pregnancy has not gone to waste! Unfortunately, these stores do not last forever and at around 4-6 months these stores become depleted and breastmilk or infant formula no longer provide all the nutrients your baby needs, the most important one being iron. This is when the ‘complementary feeding’ or the ‘weaning’ period begins… and don’t worry it is not to be feared. This is an exciting time for your bundle of joy (after 4 months no sleep we understand your lack of enthusiasm). Your baby will start experiencing new tastes, textures and flavours, which will benefit their growth and energy, but also assist with muscle and jaw development which are required for speech (stuff you can actually understand instead of goo gah ga ga).
Previous guidelines by WHO advised that babies should be exclusively breastfed until 6 months of age. They also advised to avoid allergenic foods such as gluten, egg, fish, peanuts and seeds. However, new evidence that has emerged since 2008 has shown that allergenic foods introduced between 4 and 6 months was actually associated with a reduced allergy risk. They have concluded that there is no need to delay allergenic foods after 4 months and the avoidance could actually lead to more allergies in future.
Summary of the new evidence and tips for weaning
Infants should be offered foods with a variety of flavours and textures including bitter tasting green vegetables
Continued breastfeeding is recommended alongside complementary feeding
Whole cow’s milk should not be used as the main drink before 12 months of age
Allergenic foods may be introduced when CF is commenced any time after 4 months. Infants at high risk of peanut allergy (those with severe eczema, egg allergy, or both) should have peanuts introduced between 4 and 11 months, following evaluation by an appropriately trained specialist
Gluten may be introduced between 4 and 12 months, but consumption of large quantities should be avoided during the first weeks after gluten introduction and later during infancy
All infants should receive iron-rich CF including meat products and/or iron-fortified foods
No sugar or salt should be added to CF and fruit juices or sugar-sweetened beverages should be avoided
Vegan diets should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet
Parents should be encouraged to respond to their infant’s hunger and satiety cues and to avoid feeding to comfort or as a reward
Niamh is our committed Specialist Paediatric Dietitian who has experience in both the NHS and private sectors. She understands the complex needs of each individual child and their family to provide patient centred care which is results-focused, evidence based and personable.