Breast milk is a dynamic fluid and remains the ultimate source of nutrition for the baby till one year of age. Breast milk has the unique quality of adapting according to the baby’s needs thus providing the baby with lifesaving nutrients from time to time making it “liquid gold”. WHO recommends that an infant must be exclusively breastfed till a period of about 180 days followed by breastfeeding and complementary feeding until the age of 2 years.

Complementary feeding is defined as foods other than breastmilk or infant formula, which can be solids, liquids or semi liquids. These foods should be nutritious and should be given in appropriate amounts to ensure optimal growth and development of an infant.

Recently, we hosted an enlightening live session featuring Pratibha P., a certified Lactation Consultant and IYCF(UNICEF) counsellor. In this blog, we’ve compiled a summary of the invaluable insights she shared with our audience.

Why to Transition Breastmilk to Complementary Food?

Breast milk is able to provide all the energy required by the baby till 6 months of age. After 6 months of age, the baby’s energy requirement increases. In order to ensure proper growth and development, complementary foods need to be introduced at 6 months of age. Complementary foods are additional foods and liquids other than breastmilk. This complementary food when started at the appropriate age helps a child to be active and grow well.

The prominent energy gap that needs to be fulfilled is iron and Vitamin A. A full term baby is born with all the stores required for appropriate functioning of the body. Iron is one nutrient that is required for making new blood cells and aids in fighting infections.

Vitamin A is needed for maintaining healthy skin and eyes and to help fight infections. Solid foods are necessary to help fulfil these energy gaps and ensure complete and definitive development of the infant.

When to transition?

The time to transition is usually around 6 months/180 days of life. Interestingly, the baby also gives you signals that they are ready to start solid foods.

• Baby is able to sit with support in tripod position
• Able to swallow food
• Baby shows interest in foods parents are having
• Development of eye hand and mouth co-ordination, so that the baby is able to take the food and put it in their mouth.

The baby’s digestive tracts develop slowly and steadily. Introduction of solid foods very early may potentially harm the baby’s gut and increase the risk of morbidity. Some studies have also associated early introduction of solids to gastrointestinal infections and diarrhoeal disease. At the same time late introduction of solids also predisposes the baby to develop micronutrient deficiencies like iron and zinc, which may lead to cognitive and neurological deficits and feeding difficulties. Children may not get the necessary nutrients, potentially leading to malnutrition and deficiencies, like iron-deficiency anemia.

Therefore, introducing solids at the appropriate age is of utmost importance.

What foods to start with and How much to start with?

The best food to start with is the food that the family eats. The family pot can be modified in baby’s age appropriate, size, texture and quantity. This gives the baby a variety of nutrients and at the same time habituating the baby to all foods. However, the preparation of the foods is also important. The baby’s digestive system is still developing and cannot handle spices, salt, sugar, or honey. The consistency of food offered to babies should be such that we are able to mash it within our thumb and index finger.

There should be a balance between breast milk and solid foods being offered. It is important to keep in mind that breastmilk will still remain the primary source of nutrition. A gradual transition in the frequency of food offering has to be carefully done. Starting with one meal per day and then slowly progressing to two meals in next 4 weeks and three meals in the consecutive 4 weeks, this should help in a smooth transition. The next transition will be to 3 meals and 2 snacks in a day.

Allergenic Foods, Gagging, Choking Hazards

Certain foods may pose to be allergic to the baby as the baby’s gut microbiome is still not developed. Introducing these foods slowly and early while starting solids may also play a role in reducing these allergies later on in life. The best way to do this is offering the baby the same food the family is consuming.

While transitioning to solids another very important factor to be kept in mind is texture and size of the food being offered. If the food is too hard or the morsel is too big it may pose a choking hazard for the baby. If the baby chokes on the food it may also result in compromising the airway, as the airway and food pipe is still under development. In case this happens, a parent should always take help from the health care practitioner to resolve the situation as soon as possible.

This journey of transitioning to solids from breast milk can be very exciting and also overwhelming as well. But it is a wonderful period where you get to know the baby better and bond with the baby better. It will have its ups and downs. Don’t hesitate to take help from your family, partner, and in special cases from a certified IYCF counsellor like Pratibha P. It will definitely make the journey easier. Feel free to reach out to any infant and young child feeding counsellor if you need any guidance regarding this transition. You can also reach out to our toll free Lactation helpline on 1800-419-2199.

References

• Borowitz SM. First Bites-Why, When, and What Solid Foods to Feed Infants. Front Pediatr. 2021 Mar 26;9:654171. doi: 10.3389/fped.2021.654171.
• Inoue M, Binns CW. Introducing Solid Foods to Infants in the Asia Pacific Region. Nutrients. 2014; 6(1):276-288. https://doi.org/10.3390/nu6010276