'How should I wean my baby?' Ask five different people, get five different approaches. The changes in baby care over the last 50 years have been huge and leave parents confused, as the information they receive from different people can be completely contradictory. From the introduction of formula in the 1920s, the push for standardisation in the 50s, and then the modern reversal to baby-led approaches, baby feeding is one of the hardest hit aspects and produces some of the most polarised arguments which do nothing to help new parents.
Note that 'weaning' has a different meaning in the US and UK. In the UK it means 'to introduce solids alongside milk'. In the States, it means 'to replace milk feeds with solid food'. Here we're using the UK definition.
This Entry cannot be the authoritative answer to this problem, as there is no correct answer. All it can do is try to give an overview and leave the reader to go out, do more research, and form their own opinions.
What Does the Science Say?
Before 17 weeks of age, a baby's digestive system can't handle solid food. After this time it is starting to mature and grow, but won't be fully operational until past six months. That's what we do know. In addition to this, studies have been done to prove, disprove, and be inconclusive about a range of things, including when breast or formula milk stops being everything a baby needs (results range from six months to over a year, depending on who funded the study), when to introduce foods with a family history of allergies (some say you should hold off introducing them, and others seem to indicate that this can actually cause allergies), and a whole host of other things.
In the UK the current advice is to wait until around six months of age, when the baby can sit up by itself, when it can coordinate well enough that it can get food into its mouth, and when its tongue stops pushing food out of its mouth1. As for whether you use purees or start straight away with unpureed food, that decision is left to you, as long as you wait until the baby is showing the signs2.
But My Mum Says
Yup, she does. And probably your best friend says something else, and your uncle, and their opinions are valid. While their advice should be listened to, remember that advice from peers is just one part of a parent's decision. A generation ago it was customary to place babies to sleep on their tummies. These days it's made out to be the greatest of all evils, and babies must always sleep on their backs3. Ask your health visitor, your doctor, and your family, and also see what your baby wants to do. If your baby doesn't want you to put a spoon in their mouth, then maybe they aren't going to be a puree baby! Whatever you decide, make sure you are doing it because you think it is the best option for your baby, not because of peer pressure. Do as much research as you can, and be confident with what you are doing and why.
So What are the Options?
The aim of traditional weaning is to get the baby off milk and on to real food quite quickly. In order to do this, the food has to be made easier to eat, especially in the early days before a baby has learnt to chew. This will involve purees and spoons before moving onto real food, and will probably be what grandma expects! It is a parent-led approach, as parents will lead in deciding when babies start to eat solids and drop milk feeds (although the baby will still be able to refuse solids and demand milk, of course).
The second approach is more relaxed about when a baby drops the milk feeds, and instead concentrates on letting the child master eating skills, such as chewing and manipulating the foods in front of them, but not expecting them to swallow much to start with. This is known as baby-led weaning, and skips all purees and starts on real food straight away. It means that the parent gives the control to the baby, who will eat food and drop milk feeds when they are ready. This is a much more flexible approach which doesn't have an end goal in terms of time. Some babies may drop milk feeds quite quickly, but some may not do so for months - the key thing is to relax and let your baby decide for itself.
Which is Best?
Ah, now you're asking the hard questions. Studies come up with various results, but at the end of the day there is no correct answer, or everyone would be doing it the same way! The more modern research appears to show that there is no benefit to pureeing food, but research into baby eating habits is a slow process and we may not see a definitive answer for some time.
Both approaches have their plus points, and sometimes they will both claim to be best at the same thing! For example, parent-led feeding tends to create less mess in the early days, but by the time you get to a year old, baby-led children are often cleaner because they've had more practice at feeding themselves. Similarly, baby-led advocates will say that having the baby eat the same meals as you is much easier, as you only have to cook one meal. People who puree will say once you've cooked up a few batches of food it's much easier to defrost a portion and not have to worry about getting everyone sat down together (especially if parents are used to eating after baby has gone to bed).
Most people will be advocates of their chosen method, so finding balanced opinions on the internet can be hard. In addition, a lot of scientific research has been done with very small numbers of participants, or with money from people who could make a profit if the result goes one way. That's not to say that all research is bad, but make sure you take everything with a pinch of salt!
OK, What are the Most Important Things?
If we think ahead, what we want is adults who eat a wide range of foods to prevent malnutrition. So the most important thing is making sure that babies can experience a diverse range of tastes and textures, especially foods that are good for them. This might be a challenge if your diet isn't that varied, and a cookbook can be a really useful purchase! Obviously pureed foods don't have any variation in texture, so make sure that you introduce mushy and lumpy foods quickly to prevent your baby deciding life is far easier when the blender does all the chewing.
Another goal is learning to feed themselves. At some point all kids will need to learn to use a knife and fork, so, once they can successfully feed themselves with their fingers, let them figure out cutlery. They will copy you, so if you are able to eat at the same time this makes it easier.
Learning how to stop when you're full is something that a lot of us struggle with as adults, so allowing our children to develop that habit themselves can only be a good thing! Watch your baby closely and you will discover its 'I'm full up' cues; it might lose interest and play with its restraining straps, start playing with its food rather than eating it, or start banging its hands on the tray. If you are spoon feeding, try not to make the baby finish every last morsel you've prepared unless they want it. It's a bit more wasteful, but you are allowing the baby to develop that stop-when-I'm-full skill. Pureed food is a lot more dense than real food so it's easier to override a baby's hunger cues; it's a lot less effort and much quicker to swallow a pureed apple than it is to bite and chew it.
Finally, making sure that a baby receives all the nutrients it needs through the weaning process is a biggie, and the jury is still out on the best way to do this. Some people advocate purees, or a combination of purees and finger foods so that the parent can make sure the baby gets a varied diet. Others say that as milk is still the most efficient way for your baby to get its nutrients, it's OK to keep milk feeds as the main source of food until the baby starts to wean itself. Whichever way you choose, the national guidelines for the UK recommend vitamin supplements of A, C and D, just to make sure. Rickets in particular is a nasty condition, and is easily prevented with vitamin D.
What About Choking?
Waiting until six months of age is your best guard against choking. A baby who can sit up is able to use their gag reflex to shift food to the front of their mouth to prevent choking. It can be hard to watch, but gagging is normal and a part of learning4. Never lie your baby down or recline them while feeding, as gravity will cause food to shift backwards in their mouth. If you decide to use a spoon, don't push the spoon too far into your baby's mouth, which might override their gag reflex and cause a choke. Allow your baby to use their lips to get the food off the spoon.
What About Iron?
This debate has been the cause of lots of worried parents, but appears to have no scientific basis. The UK guidelines advise that there is no reason to introduce follow-on milk, as the extra nutrients aren't needed by the child. It is true that a baby's iron stores begin to run out around this time, but it is a gradual drop off, and as long as a varied diet is offered then iron will be a natural part of this. Remember that milk isn't a good source of iron anyway, so if you see an advert telling you how many cups of milk a child would have to drink to get their RDA don't be concerned, just make sure you are offering foods that are actually rich in iron alongside their breast or formula feeds.
Something to remember is that babies learn by themselves. They manage to figure out how to smile, how to roll over, how to walk and a hundred other things even if we don't make a concerted effort to teach them. So, when it comes to food, don't sweat it. They'll figure it out themselves.