You may have friends or family members telling you (with differences of opinion) when the best age is to start weaning your baby.
Over the last 40 years, with more and more research in this area, the recommendations about when to start weaning have changed, and the current advice might therefore be different to how our parents weaned us or even more so to how our grandparents weaned our parents.
What do the current guidelines recommend and why?
In the UK it is recommended that babies are weaned onto solid foods when they are around 6 months old (1, 2, & 3). Solid foods include purees, mashed and finger foods.
Previous guidelines advised that babies were weaned at 4-6 months. However, these were updated in 2003, as research shows beneficial effects of exclusive breastfeeding for the first 6 months of life.
The World Health Organisation recommends exclusively breastfeeding for 6 months to obtain maximal benefits for mothers and their babies (4).
Therefore, to promote and protect 6 months of exclusive breastfeeding, our UK guidelines changed to recommend weaning onto solids at around 6 months, ideally alongside continued breastfeeding.
I’ve heard I shouldn’t start weaning before 4 months
old, is this true?
Studies have shown that by 4 months old, babies’ gastrointestinal tracts and kidneys are mature enough to digest weaning foods. If you wean before then, these organs may not be mature enough to manage solid foods (5) and therefore it is recommended to wait until your baby is at least 4 months or 17 weeks old before you start weaning.
What exactly does ‘around 6 months’ mean?
The phase ‘around 6 months old’ may confuse some people, especially those of us who love an exact figure! ‘Around 6 months’ really means a week or two before or after your baby turns 6 months old.
As babies grow and develop at different rates, the exact timing you choose to wean your baby can be individualised, depending on their development.
When you choose to start weaning may also depend on if your baby is exclusively breastfed or if they are drinking formula.
As the ‘weaning around 6 months’ recommendation stems from promoting 6 months of exclusive breastfeeding, if your baby is already having formula and is developmentally ready, there may no added benefit of waiting until they are 6 months old to start weaning onto solids, provided they are older than 4 months.
From what age does my baby need extra nutrients?
As your baby reaches 6-month-old they will start needing extra energy, protein, vitamins and minerals for healthy growth and development. For exclusively breastfed babies, extra iron is of particular importance (3 & 5).
Healthy term babies are born with sufficient iron stores to meet their requirements for growth and development for the first 6 months of life. At 6 months these iron stores start depleting and therefore iron rich weaning foods are an important part of your baby’s diet.
Iron is of particular concern in exclusively breastfed babies who were born prematurely, had a low birth weight, didn’t have delayed cord clamping or if their mum had iron deficiency anaemia (4). If any of these relate to your baby, they may need extra iron before 6 months old and you can speak to your GP, Health Visitor, or a Paediatric Dietitian about this.
It is therefore not recommended to delay weaning beyond 6 months old as it can increase the risk of your baby developing nutritional deficiencies.
Are there any health factors to consider if I wean my baby before 6 months?
One of the benefits of exclusive breastfeeding up to 6 months is a reduced risk of gastrointestinal, and lower and upper respiratory infections, compared to babies who receive solid food or infant formula before 6 months. Previously this was known in developing countries, however the latest research shows that this is true for developed or high-income countries, like the UK, as well (4).
If you are exclusively breastfeeding, this may be worth bearing in mind, as exclusive breastfeeding until your baby is 6 months old may provide extra protection against infections.
Weight gain remains a ‘hot topic’ regarding the timing of weaning. Research studies show no conclusive association between poor weight gain or increased weight gain and the age at which weaning foods are introduced.
Most babies will naturally cut down on their milk intake as solid food increases, therefore maintaining a similar calorie intake. Poor or increased weight gain following weaning is more likely associated with the type of foods babies are fed and the family eating habits they learn, rather than their age when weaning first started (2 & 5).
Are there any exceptions when weaning before 6 months is recommended?
Yes, if your baby has eczema, specifically if it started soon after birth or is classified as moderate-severe, or if they already have a food allergy, they are classified as higher risk, and it is recommended that you consider weaning early, from 4 months old.
Recent studies have shown that for babies who already have a food allergy or eczema, introducing allergens, specifically egg and peanuts early, from 4 months, reduces your baby’s chance of developing an allergy to these later in life.
If your baby is at higher risk of developing a food allergy, it may be beneficial for you to start weaning early and introduce egg and peanuts (in an age appropriate form) before they are 6 months old (6).
Which developmental signs indicate my baby is ready to start weaning?
As babies develop differently, it is important to consider your baby’s individual development before you start weaning.
Here are the 3 most important developmental signs that your baby is ready to start weaning:
1. They have good head control and can stay in a sitting position, relatively unaided. If they need some extra support, like a cushion tucked in next to them to help keep them upright that’s ok.
Having good head control and sitting upright is very important as it helps reduce the risk of choking.
2. They have the co-ordination to look at an object, pick it up and bring it to their mouths by themselves. You will probably have noticed them doing this with toys.
3. When you give your baby food, they are able to swallow it rather than push it back out with their tongues. This is an absence of what we call the tongue thrust reflex that babies are born with (1, 3 & 7).
The absence of the tongue thrust reflex may be difficult to judge before you give your baby solid foods. Therefore, if you start weaning before they are 6 months old and your baby keeps pushing food out with their tongue instead of swallowing it, they may not be developmentally ready to start weaning. It may be worth waiting a few weeks before trying again.
As mentioned before, it is not advised to delay weaning beyond 6 months. If your baby is 6 months old (was not premature) and is not showing all the above mentioned developmental signs, I would still suggest slowly starting to wean. Focussing on smooth pureed textures initially and speaking to your Health Visitor, Dietitian or GP if you have any concerns.
When your baby is between 4-6 months old, they may also start doing the following:
– Chewing their fists.
– Wanting extra milk feeds or are seemingly hungry between feeds.
– Waking at night when they previously slept through.
These are all normal developmental behaviours and not necessarily signs that your baby is ready to start solid foods (1 & 7).
My baby is waking more at night, should I start
weaning early?
When your baby is 4-6 months old, their sleep patterns change and they are more likely to wake when they are in a light sleep. Many parents start weaning around this time hoping that solid food will help their babies sleep better. However, most weaning guidelines discourage the early introduction of food to try help your baby sleep better.
One recent study randomised 1303 infants into 2 groups. One group started weaning early and the other started at 6 months. They found that infants in the early weaning group slept on average 16.6 minutes longer and on average their night time waking reduced from 2.01 to 1.74 times per night. They also reported that there was a lower incidence of parents reporting very serious sleep problems among the babies who were weaned early (8).
Despite us often been told that weaning early will not cause our baby to sleep better, some research does support this idea. However, babies only slept on average 16.6 minutes longer per night, so unfortunately, it may not be life changing and probably not solely the best reason to start weaning early.
However, if you are considering weaning your baby at 4 or 5 months of age, they are developmentally ready and you are happy with the health factors discussed above, then it is safe to do so.
In summary
If you wait until your baby is around 6 months old, they may be more developmentally ready to wean and if they are exclusively breastfed, they will get the maximal benefits of 6 months of exclusive breastmilk.
However, if you’d like to start weaning before 6 months, remember the developmental signs to look out for to help determine when they are ready and don’t start before they are 4 months old.
Lastly, if your baby is at higher risk of developing an allergy (they have eczema or already have a food allergy), it is recommended to consider starting to weaning when they are 4 months old.
The above information regarding when to start weaning is for healthy term babies. If your baby was born before 37 weeks gestation different guidelines may apply.
References:
1. NHS website, Your baby’s first solid foods.
2. Scientific Advisory Committee on Nutrition (SACN), Feeding in the First Year of Life, 2018.
3. British Dietetic Association (BDA), Complementary feeding (weaning) factsheet.
4. WHO Guideline for complementary feeding of infants and young children 6-23 months of age, October
2023.
5. ESPGHAN, Complementary Feeding: A Position Paper by the European Society for Paediatric
Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition, 2017.
6. British Society of Allergy and Clinical Immunology (BSACI), Early introduction of food allergens.
7. Carruth BR, Skinner JD, Feeding behaviours and other Motor Development in Healthy Children (2-24 months), J Am Coll Nutrition, 2002, 21 (2) 88-96.
8. Association of Early Introduction of Solids With Infant Sleep. PMID: 29987321