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Introduction of Solids (complementary feeding)
Complementary feeding is an exciting time for you and your baby, as you watch your little one progress from a diet of breastmilk/formula milk to eating family meals.
However, complementary feeding can also be challenging when your baby has CMPA.
The process
From birth to 6 months, breastmilk (or formula) will provide a complete source of energy and all the other nutrients your baby needs.
Although breastmilk or formula remains very important throughout early childhood, solid foods are required from 6 months to complement breast milk or formula as your baby’s requirements for nutrients are increasing. A child who is only taking breastmilk or formula after 6 months of age may struggle to meet their requirements for key nutrients such as iron.
A varied/balanced diet including iron-rich foods e.g. meat, eggs, pulses, energy-rich foods like starchy carbohydrates and higher fat food alongside fruits and vegetables will support the energy and nutrient needs of your baby.
For those following a vegan or vegetarian diet, fortified cereals can boost your child's intake of these nutrients. Remember, the more diverse the complementary feeding diet the better.
Did you know?
- Complementary feeding helps your baby experience new tastes and textures at a time when they are very receptive to learning about these.
- Complementary feeding helps your baby learn to move food around their mouth, chew and swallow safely.
- Complementary feeding can play a part in developing your baby’s social interactions as they become more involved in family meals.
- Learning to chew and swallow helps develop your baby’s speech muscles.
- Complementary feeding supports sensory based learning e.g. how food feels, smells and sounds (as well as tastes).
When to start
introducing solids
Babies with CMPA have a higher risk of nutrient deficits due to dietary exclusions so starting solid foods in an important step.
In babies with established CMPA, complementary feeding should start around 4-6 months of age (similar to non-allergic babies), but not before 4 months.
Remember, breastmilk and formula milk can provide all the key nutrients for babies up to 6 months of age. It is encouraged that parents looks for developmental signs that a baby is developmentally ready to commence solids.
These signs of readiness include:
- Baby will be able to move food from the front to the back of their mouth. Their tongue thrust reflex will have reduced and they will be able to swallow.
- Co-ordinate their eyes, mouth and hands (e.g. be able to pick food up and bring it towards their mouth.)
- Sitting upright with minimal support and holding their head steady
In babies with CMPA, there is no evidence that delaying the introduction of other potentially allergenic foods (e.g., wheat, soya, egg, fish, nuts) will prevent the development of other food allergies.
Complementary
feeding stages
STAGE 1
STARTING OFF
What texture?
- Continue with mashed food aiming to move onto more chopped up and minced foods
- Encourage finger foods
- Encourage your child to feed themselves
How Much?
- At least one small serving of an iron rich food at each mealtime such as; fortified breakfast cereals, meat, fish or pulses (including peas, beans and lentils)
- 3-4 small servings of starchy foods and 3-4 small servings of fruit and vegetables
- Look at what you are cooking for the family and see if it can be adapted for your child e.g. a milk-free spaghetti bolognaise or shepherds pie
STAGE 2
MOVING ON
What texture?
- Smooth purée, blended or mashed
- Cooked and soft foods can be made into a purée by passing them through a sieve or by a hand blender or liquidiser
- Finger foods - e.g. cooked, cooled and soft veggies
How Much?
- Begin with 1-2 teaspoons, gradually increasing the amount according to your baby’s appetite.
- Follow your baby’s lead with amounts to offer based on their appetite
- If offering finger foods from the start of complementary feeding, ensure your little one is well supported in their highchair and offer options that are soft and will mash easily in their gums e.g. well cooked vegetable fingers, ripe fruit
STAGE 3
FAMILY MEALS
What texture?
- Gradually move onto mashed and lumpier foods which encourage your child to chew
- Continue to introduce finger foods such as soft cooked vegeatable (e.g. boiled carrot/parsnip), soft toast and milk-free margarine, ricecakes, baby corn puffs or soft fruit (e.g. banana)
How Much?
- Servings can still be small
- Include meat, fish or pulses (including lentils, peas or beans) in at least 1 meal per day
- Try to offer 2-3 servings of starchy foods per day and 2 servings of vegetables and fruit
| Foods to start with around 6 months | Foods to progress to, from 6-7 months | |
| Texture | Smooth purees (smooth porridge or fruit puree) | Well mashed foods, softer lumpier foods and softer finger foods (e.g., pieces of cooked carrots or pasta) |
| Vegetables | Root vegetables e.g., carrot, swede, sweet potato, parsnip, butternut squash, potato, yam Spinach, broccoli, green beans, courgette, cauliflower. | The same as for 4-6 months just adapt the texture. |
| Fruits | Soft, cooked pureed/mashed fruits e.g., apple, pear, banana, plum, peach, apricot, avocado | Soft mashed or soft pieces of fruit e.g. apple, pear, banana, plum, peach, apricot, avocado |
| Carbohydrates | Smooth cereals, e.g., ground rice, flaked rice, ground quinoa, cornmeal | Rice e.g., baby rice, cooked flaked rice Ground quinoa Polenta (corn meal) Gluten containing foods (wheat, barley, rye) – bread and cereals, oats, pasta, couscous, chapatti Potatoes |
| Protein | Pureed pulses/lentils Smooth nut spreads Non-vegan/vegetarians Meat and poultry (pureed) Well-cooked pureed egg | Mashed lentils and pulses e.g., haricot beans, kidney beans, butter beans Nut spreads Non-vegan/vegetarians Red meats (lamb, beef), pork Poultry (pureed or finely shredded and chopped) Fish Well-cooked mashed boiled or scrambled egg |
Common misconceptions around complementary feeding:
- Chewing/ sucking their fists is a sign they are ready to wean.
- Increase in demand for breast or formula milk is a sign they are ready to wean.
- Waking in the night is a sign they are ready to wean.
- Remember it is what is happening inside that counts and a baby’s digestive system needs to be developed enough to manage foods.
- Larger babies need to wean early.
