Recently, the Trump administration angered health experts around the world with its attempt to weaken a UN resolution encouraging breastfeeding. The US bid to promote the use of formula was unsuccessful and has prompted discussions about the importance of exclusively breastfeeding (if possible) for the baby’s first six months of life, before other foods are introduced. In this edited version of their article in The Conversation, Clare Collins and Jenna Hollis look at current recommendations on introducing new foods to babies.
“Guidelines recommend exclusive breastfeeding for the first six months of a baby’s life. But our 2017 study of new mothers in Australia found many were unsure what exclusive breastfeeding meant. The World Health Organisation defines exclusive breastfeeding as feeding only breastmilk and no other foods or drinks, not even water. The definition does allow inclusion of oral rehydration solutions, or drops or syrups for vitamins, minerals, and medicines prescribed by a doctor. Preterm or underweight babies may need extra nutritious fluids, which are administered in consultation between parents and paediatricians.
Some mothers may not be able to breastfeed. Others may choose to move on from breastfeeding. If a baby isn’t breastfed, or is partially breastfed, commercial infant formula should be the only other food given until six months. Breast (or infant formula) feeding is recommended alongside other foods until the baby is 12 months and, for breastfeeding, for as long as the mother and her infant want to keep it going.
Introducing other foods Parents can start introducing other foods from around six months of age. At this age, the baby’s iron stores obtained from their mother will have started to deplete. Pureed meat or legumes and iron-fortified rice cereal, are good sources of iron and are recommended first foods. Next, parents can introduce a variety of vegetables, fruit, and other foods. New foods should be added one at a time. Gradually increase the texture from pureed initially at six months, then to lumpy, and to family food textures at 12 months of age. Take care to still avoid hard foods that don’t break up easily to prevent choking, such as nuts and small, hard pieces of vegetables and fruit.
Cow’s milk products can be introduced, including full-fat yoghurt and cheese, but cow’s milk shouldn’t be given as the main drink until after 12 months (this is because it contains too much protein and salts). Boiled then cooled tap water can be given from six months and tap water should continue to be boiled first and cooled before given to baby until 12 months.
By 12 months, babies can be offered a variety of nutritious foods that are enjoyed by the rest of the family, except for choking hazards such as nuts.
Why does timing matter? Breastfeeding has many benefits for the mother and baby. It protects babies against infection, obesity, and chronic diseases such as type 2 diabetes later in life. Breastmilk has all the energy and nutrients babies need in the first months of life. Even when exclusive breastfeeding doesn’t work out as planned, every extra day a baby receives any breastmilk is beneficial. Breastmilk contains antibodies and helps to mature the infant’s gut.
At six months, babies also need semi-solid foods to help meet their energy needs for growth and development, and specific nutrient requirements. Iron deficiency anaemia is common in infants, mainly due to a low intake of iron-rich foods after six months of age. By six months, babies usually show signs they’re ready for food. These include sitting up, controlling their head, eyeing your food when you eat, and reaching out for food. In the 2016 study of mothers and their children we published, we found babies introduced to semi-solid foods at six months were less likely to experience feeding difficulties than babies who were given them between four and six months of age.”
Nutrition tips for baby’s first year
- Seek advice on breastfeeding when you need it.
- If at first you don’t succeed, try, try again.
- Focus on developing healthy eating habits as a family.