Starting Solids with Your Breastfed Baby

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Jacque Ordner BSN, RN, IBCLC, RLC 

You finally feel like you’ve gotten this breastfeeding thing figured out and your baby’s pediatrician mentions starting solids.  Like most parents, your mind is instantly filled with tons of questions.  When do I start?  How do I know she’s ready?  Do I need to offer foods in a certain order?  Do I start with baby cereal or baby-led weaning?  Will my baby still want my milk once he starts solids?  What about allergies?  HELP!!!  

We’ve got you covered with our quick guide to starting solids with your breastfed baby! 

How do I know my baby is ready? 

Current research and recommendations tell us that human milk is the only nutrition needed for healthy, full-term babies up to six months of age.  Breast milk is amazing because it changes in composition to meet baby’s unique needs as they grow. It’s not surprising that many babies begin to show signs of readiness for solids at around six months as well.  

Signs of readiness include: 

o   Can sit unsupported 

o   Has good head control 

o   Has lost the tongue thrust reflex and can move food from the front of the mouth to the throat 

o   Opens mouth when offered foods 

o   Can use pincer grasp to bring food to the mouth (essential for self-feeding) 

o   Has doubled birthweight 

 Which method is best? 

The goal of introducing solids is to help baby explore new skills, flavors, and textures while also introducing new sources of nutrition.  While trends may try to dictate a singular approach, it can be beneficial and even easier to use a combined approach.  For example, if you’re not keen on rice cereal because of the potential for arsenic, cadmium, and lead, opt for another fortified grain cereal like barley, oat, or amaranth.  Looking to keep things as whole as possible?  Consider cooking and mashing foods and mixing with breastmilk rather than purchasing pre-packaged options. Soft foods make good options for encouraging self-feeding.  Soft or cooked fruits and vegetables, shredded meats, flaky fish, and beans make great finger foods for little eaters.  Avocado packs a big nutritional punch and is often fun for baby to self-feed. When surveying pureed and prepackaged options, look for simple ingredient lists that don’t include sweeteners, thickeners, artificial preservatives or artificial colors and flavors. It’s ok to incorporate both purees and finger food options as baby needs practice with using a spoon and building dexterity in their hands! 

What about allergies? 

The most up to date recommendation is to introduce common allergen containing foods after 6 months and before 12 months for healthy, term infants.  The most common allergen foods are eggs, dairy, peanuts, tree nuts, wheat, seafood, soy, and sesame.  Another safety measure is to introduce only one new food at a time so that if an allergy occurs, it can be easily associated with its cause. Experts recommend peanut allergy testing (prior to introducing peanut containing foods) for babies who have severe eczema and/or have an allergy to eggs.  Allergy experts often recommend keeping common allergen foods as a regular part of baby’s diet provided there was no allergic reaction after introduction. 

How do we get started? 

Offer breastmilk first!  Breastmilk is still baby’s primary source of nutrition until 12 months.  Nurse or offer a bottle of breastmilk before moving to solids.  If baby is interested, it’s ok to give solids immediately after.  However, some babies prefer to wait a bit before taking in solid food after a nursing session or a bottle.  Solids should not replace breastmilk intake, but rather compliment it. Start small!  Occasionally parents will feel overwhelmed at the thought of getting an entire serving of baby-friendly food into their just-turned-six-month-old.  Keep in mind that introducing solids is meant to be a gradual process, so it’s ok if baby is only interested in a bite or two at first. As baby gets the hang of their new skills, they’ll naturally increase their solids intake.  Children learn through modeling, so consider feeding baby solids during your normal mealtimes.  There is no evidence that starting with fruits will make baby less likely to take vegetables or vice versa.  There is no specific order in which foods must be introduced.  If baby is completely resistant to starting solids, despite displaying signs of readiness, table the idea (no pun intended) for a week or two.  As with other developmental skills, not all babies are ready at the same time. 

Expect changes. 

It’s not uncommon for babies to experience a change in diaper habits. Introducing solids means more formed stools that often have a stronger odor as well.  Some babies may stool less often as well.  Introducing solids slowly can help reduce the risk of irritating baby’s digestive system.  Don’t forget that foods can influence the color of baby’s stool as well.  For example, beets turn stools an obvious red while peas often add a tinge of green.  Some parents report that stains from baby’s stool after starting solids are harder to remove than stains during exclusive breastfeeding.  

Does my baby need extra liquids? 

The short answer is NO.  As long as your little one is getting an adequate intake of breastmilk, no additional fluids are needed.  Breastmilk changes in composition to become more watery in hotter environments…..how amazing! It is still OK to offer a small amount (no more than 8oz. per day) of water once your baby reaches six months old. Many parents use a small amount of water to introduce a sippy or straw cup at this age.  Skip juice as it is high is sugar content and low in other nutritional value. Experts advise no juice for babies under 12 months, and only up to 4oz. of 100% fruit juice thereafter. 

Have more questions?  Need more details?  Check out these resources for additional information: 

Healthy Children.Org 

La Leche League 

CDC 

Looking for help creating a personalized plan for starting solids?  Schedule a FREE consultation with one of our specially train International Board Certified Lactation Consultants (IBCLCs) 

Sources 

Starting Solids. (2020, August 7). La Leche League International. https://www.llli.org/breastfeeding-info/starting-solids/ 

When, What, and How to Introduce Solid Foods. (2020, December 11). Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/InfantandToddlerNutrition/foods-and-drinks/when-to-introduce-solid-foods.html 

Working Together: Breastfeeding and Solid Foods. (2012). HealthyChildren.Org. https://healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Working-Together-Breastfeeding-and-Solid-Foods.aspx 

Child Care and the Breastfed Baby

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Melissa Portunato MPH, IBCLC, RLC

It’s likely that at some point, your breastfed baby will be cared for by someone else other than yourself. Sometimes it’s temporary while other times it can be long term like when returning to work. Child care options can vary from private stay at home nannies/family members, private home licensed child care, or commercial child care facilities. 

The process to find the perfect match for you and your baby doesn’t have to be stressful. Your breastfeeding relationship can absolutely continue and thrive with this new milestone. No matter who you choose to care for your baby, your breastfeeding goals should be supported and respected. Read on for tips on finding a caregiver for your breastfed baby including how to connect with local resources and how to share valuable education with your child care provider. 

Support and Communication 
Let’s start here. It’s OK if your child care provider isn’t a “breastfeeding expert” but they should be open and teachable when it comes to feeding mother’s milk to babies in their care. They should be willing and ready to accommodate your requests or accept breastfeeding-friendly education. An “open door” policy is one of the ways caregivers can be supportive of the breastfeeding dyad. Allowing mothers to drop in at any time without notice to pump or nurse their baby on demand protects breastfeeding. If your child care facility pushes back on your breastfeeding requests, then it’s probably not a good fit.

Knowledgeable Staff 
A child care provider whether in a private or commercial setting should have basic training on breastfed infant behavior, proper bottle-feeding techniques, and breastmilk storage handling.  All babies, breastfed or not, should be fed using The Paced Bottle Feeding Technique. This feeding method allows the baby to control the flow of milk, preventing overfeeding. Normal milk consumption for babies 1-6-month-old is 1- 1 ½ ounces per hour. Milk leftover from feedings should be discarded within 2 hours of initial use and proper breastmilk milk handling should be carefully followed. Download the handout here to share with your child care team. Breastfed babies should not be fed on strict schedules but rather monitored for hunger cues. For younger babies less than 3 months old this includes moving head from side to side (rooting), bringing fingers to mouth, and for older babies, actively moving arms and legs while gazing at the caregiver. 

Facility Accommodations 
Breastfeeding friendly accommodations on-site should include a designated area to pump or nurse your baby, other than a restroom. A fridge to store breastmilk and a sink to wash pump parts. You will need to label bottles and/or milk storage containers with the name of your baby and date with permanent, reusable, or personalized silicone labels. 

Additional tips for success:

???? Check with your local / state breastfeeding coalition to find breastfeeding-friendly centers here.

???? Take a tour with your prospective child care provider first before making a decision. 

???? Choose a child care provider nearby. You can hop into pump/nurse or simply check on baby anytime. 

???? A low child-adult ratio allows the caregiver to pay more attention to feeding cues and can prevent overfeeding. 

???? Long-standing caregivers provide added security your baby is in the care of an experienced professional. 

???? Send breastmilk in 1-2 ounce increments to prevent milk from being wasted. 

Always remember you are your baby’s advocate. No matter your breastfeeding goals, you should feel comfortable to easily keep an open conversation with your child care provider. 

Do you still have other questions about child care and breastfeeding? Email us at IBCLC@spectrababyusa.com anytime or schedule a complimentary consultation. Our International Board Certified Lactation Consultants are happy to assist you along your breastfeeding journey. 

We’re in this together and we support you! 

Sources

  1. How to choose a breastfeeding-friendly childcare provider. (2020, February 19). La Leche League USA. https://lllusa.org/choosing-a-childcare-provider/
  2. Proper Storage and Preparation of Breast Milk. (2020, January 22). Center For Disease Control. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  3. Anne Smith, IBCLC. (n.d.). Caregiver’s Guide to the Breastfed Baby. Breastfeeding Basics. Retrieved January 11, 2021, https://www.breastfeedingbasics.com/articles/caregivers-guide-to-the-breastfed-baby

Night Weaning

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Jacque Ordner BSN, RN, IBCLC, RLC 

Sleep is a sensitive and often sensationalized topic among so-called parenting gurus, authors, and creators of online sleep courses.  However, let me reassure you that if your baby nurses or takes a bottle to drift off and wakes to feed through the night, they are not broken….THEY ARE NORMAL!  In fact, research tells us that babies who sleep through the night at less than one year of age are closer to the exception than the rule.  New parents are often asked, “Is he a good sleeper?” or “Is she sleeping through the night yet?” when babies are barely out of the newborn stage. This helps perpetuate the myth that there is something wrong if babies under one are not yet giving their parents 6-8 hours of uninterrupted sleep.  Well-meaning advice givers often tell parents that their babies will magically stop waking if night feedings are cut-off.  In reality, early night weaning can lead to decreased milk supply and put baby at risk of receiving inadequate intake. At somewhere around six months of age,  you may begin to notice that your little one naturally stretches out the time between feedings and perhaps even stretches the time spent sleeping at night. While I recommend waiting until baby is closer to age one to start actively night weaning, there are some tips that parents can employ to encourage healthy sleep for their babies.  Since sleep is developmental, I recommend following your baby’s cues while eliminating obstacles to good sleep.  Find out more in our blog post, Newborn and Infant Sleep – What is Normal? 

While night weaning can help encourage an older baby or toddler to sleep longer at night, it’s not a guarantee of reduced night waking. This is because sleep is primarily developmental, and children wake for other reasons besides just hunger.  We, as parents, can help shape our children’s environment and behaviors to encourage sleep, but it is important to keep in mind that waking at night is normal even through toddlerhood.  Keep in mind that your child will eventually sleep through the night all on their own! 

Keep reading for our top tips for night weaning. 

Increase Daytime Intake 
When considering night weaning, it’s important to ensure your child is still receiving adequate calories.  Older babies and toddlers will often naturally shift to longer periods of sleep when their daytime intake increases.  Simply offering more nursing sessions or a greater volume of breastmilk via cup or bottle can be enough to encourage less need for night-time feedings.  Increasing solids is another way to get in more daytime calories.  Toddlers often do well with a bedtime “snack” that is nutritionally dense.  Foods that provide fiber, fat, and protein are often most satiating. 

Dream Feed Just Before Bed 
If your little one generally nods off before you’re ready to hit the sack, consider offering a dream feed to “top them off” just before you go to bed.  Babies will often rouse just enough to nurse or bottle feed without becoming fully awake.  This can give you a longer stretch before baby wakes for the next feed. 

Enlist Help 
If possible, ask your partner or another trusted caregiver to assist through the night during this transition.  This is especially helpful for nursing mothers.  If a non-lactating caregiver is present to comfort and soothe during night waking, baby may be less likely demand a feeding.  The old motto holds true…..Out of sight, out of mind! 

Increase Cuddles and Communication 
It’s not uncommon for toddlers to be anxious about weaning of any sort.  Reassure them with extra cuddles and clear communication about the night weaning process. Toddlers are perceptive and the often understand far more than we adults give them credit for!  Talk about night weaning during waking hours and let your child know when the process will start.  It’s ok to tell your toddler “no” when they ask for a night-time feeding, but follow it up by also letting them know when they can nurse again. For example, “We can’t nurse now, but we can nurse again when the sun is up”. Or “I’m just going to rock you for now, but we’ll get milkies when it’s time for breakfast”. Knowing when they will be allowed to nurse again, can bring an immense amount of peace to a worried toddler. 

Set Limits 
The counting method is often very effective with toddlers!  Let your little one know that they can nurse until you reach a certain number (whatever you are comfortable with).  For example, “You can nurse until Mommy gets to 20”.  Count out loud, going slowly for the first several nursing sessions.  After a few nights, begin to count a little faster.  As your toddler adjusts, you can reduce the number until there is no nursing.  If this approach is taken slowly and gently, it is not uncommon for toddlers to become uninterested in nursing at night. 

Don’t Be Afraid to Stop 
If you begin the night weaning process only to find that your baby or toddler is greatly distressed by it, don’t be afraid to stop and start again later.  If your child is hysterical each night and shows no signs of adjusting to night weaning, try again in a month or two.  There is no one-size-fits-all prescriptive timeline for any sort of weaning and it is rarely a linear process!  

Patience, reassurance, and planning are the keys to night weaning success! 

Tried all the tips and still struggling with night weaning?  You’re not alone!  Our International Board Certified Lactation Consultants (IBCLCs) have years of experience helping families navigate night weaning and many other sleep concerns.  We’re available 7 days a week for FREE CONSULTATIONS.  No matter where you are in your breastfeeding journey, we’re here to support you! 

 

Sources: 

Burnham, M., Goodlin-Jones, B., Gaylor, E., & Anders, T. (2002, September). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study. Retrieved January 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201415/  

Galbally, M., Lewis, A. J., McEgan, K., Scalzo, K., & Islam, F. A. (2013). Breastfeeding and infant sleep patterns: an Australian population study. Journal of Paediatrics and Child Health, 49(2), E147–E152. https://doi.org/10.1111/jpc.12089 

Kent, J., Mitoulas, L., Cregan, M., Ramsay, D., Doherty, D., & Hartmann, P. (2006, March). Volume and           frequency of breastfeedings and fat content of breast milk throughout the day. Retrieved January 4,        2021, from https://www.ncbi.nlm.nih.gov/pubmed/16510619