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Top Tips for Weaning by Gina Ford

Extracts from Top Tips for Weaning

Top Tips for Weaning The 10pm feed

Many babies continue to need a feed at 10pm to get them through the night until solids are well established. If your baby is following the Contented Little Baby (CLB) routines during the day and sleeping through from 7pm to 7am with only a small feed at 10/10.30pm, then introducing solids and weaning him off this late feed should be fairly simple.

As the amount of solids he takes at teatime increases, the amount of milk he wants at the late feed should decrease. If he does not cut back automatically, as long as he is sleeping through to 7am, you can gradually reduce the amount he is taking. For breast-fed babies, reduce the feed by a few minutes, and for formula-fed babies you should reduce the amount offered by 30ml (1oz). Provided he sleeps through, you can continue to reduce this feed by this amount every three nights.

Once you reach a stage where your baby has slept through for several nights on a very short breast-feed (five minutes) or a formula-feed of a couple of ounces, you should be able to cut the feed out altogether without worrying about him waking up hungry before 7am.

With babies who are taking a full feed, it may take at least three to four weeks to eliminate it. There is no benefit in reducing it too quickly and having your baby waking up earlier.

If your baby is not cutting down on his 10pm feed once solids are introduced, it may be that he is not getting the right quantities of solids for his age and weight, or too small a feed at 6.30pm. Keep a diary of all food and milk consumed over a period of four days to help pinpoint why he is not dropping that last feed.

If your baby is taking a full feed at 10pm - with the knock-on effect of only taking a small milk feed at breakfast time, demanding a big milk feed at 10/11am, refusing lunchtime solids and then needing a further big milk feed at 2.30pm - it can be tempting to cut out the 10pm feed altogether, but this often results in a baby waking up hungry in the night, throwing the whole day out. It is better to drastically cut down the milk he has at 11am and 2.30pm. This will encourage him to eat more solids after the 11am milk feed, and make him more likely to want solids in the evening.

Once he is increasing the amounts of solids at mealtimes, you can gradually start to reduce the amount of milk he is taking at 10pm, using the method described above, without worrying about the risk of him waking early, genuinely hungry.

First stage tips

•During this stage, babies should taste cereal, plus a variety of fruit and vegetables.

•If weaning at six months, food still needs to be puréed but, between six and seven months, not so smoothly. This will prepare your baby for mashed food during the second stage.

•A baby may be ready to start having breakfast, once he shows signs of hunger long before his 11am feed. Organic oatmeal cereal with a small amount of puréed fruit seems to be a favourite with most babies.

•You should still give your baby most of his 7am milk feed first, even after breakfast has been introduced.

•If your baby reaches seven months and shows no signs of wanting breakfast, it would be wise to reduce his 6/7am milk feed very slightly and offer a small amount of solids.

•Your baby still needs a minimum of 600ml (20oz) of milk a day. Throughout the first stage, give milk feeds at breakfast, lunch, mid-afternoon and evening, supplementing with vegetable purée at lunch and baby rice and fruit purée in the evening.

Follow-on milk

It can be quite confusing to look at all the different formulas on shop shelves, especially as new ones appear all the time. The manufacturers of ‘follow-on’ formulas state that they are suitable from six months and that they contain a combination of nutrients suitable for babies of this age. Babies do start to need a slightly different nutrient mix from about six months, which neither breast milk nor a ‘starter’ infant formula can supply. Probably the biggest change is in iron requirements. Iron is an essential mineral for all of us, especially for its role in oxygen transport around the body. Babies are born with a good store of iron, but much of it is used up during their first six months as they get very little from their diet of breast milk or starter formulas. Thus babies require a better source of iron from about six months, and this is one of the reasons it’s recommended that they start solids at this time. By introducing a range of different foods during the weaning process (following the guidelines of just one new food at a time and using suitable textures, of course) you will gradually give your little one more and more foods containing a range of nutrients, some of which will be rich in iron. Particularly good sources of iron that can be suitable for babies are iron-fortified baby rice, minced beef or lamb, oil-rich fish such as sardines, egg (be sure it’s fully cooked), lentils, and green leafy vegetables such as spinach or broccoli. Do note that iron is more easily absorbed from meat than other food types. However, if iron-rich plant-based foods such as green vegetables or lentils are eaten along with a food rich in vitamin C, this will help the body to absorb the iron. Good sources of vitamin C include oranges (and their juice), berries, kiwi fruit and melon, as well as raw peppers and tomatoes. See The Contented Child’s Food Bible for more information on ensuring a good iron intake for your child.

So do you need to use a follow-on formula to supply extra nutrients such as iron to your baby? If he takes to solids well and, after a few months, is enjoying a range of different foods, try to ensure that he is offered a few iron-rich foods each day; this should meet his needs. Then there is no need to discontinue the formula he enjoys to change to a follow-on one. If your baby is not so keen on solids, though, or is slow to gain weight, there would be no harm in changing to a follow-on formula, as long as your baby is happy with it. They are nutritionally complete, which means that they do supply all the vitamins, minerals and protein your baby requires from formula at this stage. In this case, I’d also suggest discussing your baby’s diet with your GP or health visitor, just to be on the safe side.

Refusing solids

Babies aged six months or older often refuse solids because they drink too much milk, especially if they are still feeding in the middle of the night. Milk is still the most important food for babies under six months, but the introduction of solids can be affected if feeds aren’t structured.

•If your baby is six months old, taking five milk feeds a day and refusing solids, I would suggest you ask your health visitor about gradually reducing one of the milk feeds to encourage his interest in solids. If he has to be woken at 7am, I would advise cutting back gradually on the 10pm feed; if he is waking earlier than 7am, I suggest that you cut back on the 11am feed instead to encourage him to take solids then. Once he is happy taking solids at 11am, introduce some at the 6pm feed. As his appetite increases so will the amount of solids he takes, which will have the knock-on effect of him drinking less at the 10pm feed.

•By the end of six months a baby’s milk intake should be around 600ml (20oz) a day, divided between three drinks a day and small amounts used in food. If your baby still refuses solids at this age, despite cutting down on his milk intake, it is important that you discuss the problem with your GP or health visitor.

Refusing milk

•The amount of milk a six-month-old baby drinks will gradually begin to reduce as his intake of solid food increases. However, up to the age of nine months a baby still needs a minimum of 540-600ml (18-20oz) a day of breast or formula milk. This daily amount gradually reduces to a minimum of 350ml (12oz) at one year of age. If your baby is losing interest or refusing some of his milk feeds and taking less than the recommended amounts, careful attention should be given to the timings of solids and the type of food given.

•Up to the age of six months a baby should still be taking a full feed morning and evening. A full feed consists of 210-240ml (7-8oz) or a feed from both breasts. Babies under six months who are given solids in the middle of their milk feed will be more likely to refuse the remainder of their formula or the second breast.

•A baby under five months of age still needs a full milk feed at 11am, even if he is being weaned early. Introducing breakfast too soon, or offering too much solid food first thing in the morning, can cause a baby to cut down too quickly or refuse the 11am feed.

•The 11am feed should be reduced gradually between the ages of five and six months (if weaning early under medical advice). Introducing the tier system of feeding (milk, solids, milk) before five months can also be the reason a baby refuses his milk at this feed.

•Giving lunchtime solids at 2pm and evening solids at 5pm is the reason many babies under six months cut down too quickly or refuse their 6pm feed. Until he reaches six months, it is better to give a baby his lunchtime solids at 11am and his evening solids after he has had a full milk feed at 6pm.

•Giving hard-to-digest foods, such as banana or avocado, at the wrong time of day can cause a baby to cut back on the next milk feed. Until a baby reaches six months, it is better to serve these types of food after the 6pm feed rather than during the day.

•Babies over six months of age who begin to refuse milk are often being allowed too many snacks in between meals or too much juice. Try replacing juice with water and cutting out snacks in between meals.

•Between 9 and 12 months some babies begin refusing the bedtime milk feed, which is a sign that they are ready to drop their third milk feed. If this happens, it is important to reduce the amount given at the afternoon feed before eventually dropping it altogether.

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