Thursday, February 21, 2013

Complementary Feeding: Breastfeeding to Solid Foods

Today, I'm happy to have guest blogger, and fellow Pittsburgher, Deena Blumenfeld RYT, RPYT, LCCE. Deena is mom to Owen (7) and Elaine (3). She is an advocate for normal, physiologic childbirth and a mentor to expectant and new parents. See below for links to her website and for more information about Deena's important work here in the Pittsburgh area

When my son (now 7) was about 6 months we decided it was time for solid foods. He was exclusively breastfed and we were excited to introduce food to our boob-maniac! We did what most parents do. We grabbed a box of rice cereal (organic!), and mixed it with breastmilk and spoon fed him. He took to it right away and was an enthusiastic, if messy, eater from that first feeding.

However, that rice cereal had an unplanned side effect – constipation! No one told me that rice was constipating. My poor little guy had his first digestive problems ever. That’s when I learned about the “P” fruits.  If it starts with “P” it makes poop – peaches, pears, plums, prunes, etc. He was much happier after that.

When my daughter was born, almost 4 years later, I was a bit better educated. With her, we followed the AAP’s (American Academy of Pediatrics) and the WHO’s (World Health Organization) guidelines a bit better.

The AAP recommends exclusive breastfeeding for about 6 months, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant, a recommendation concurred to by the WHO and the Institute of Medicine.

AAP is cognizant that for some infants, because of family and medical history, individual developmental status, and/or social and cultural dynamics, complementary feeding, including gluten containing grains, begins earlier than 6 months of age. Because breastfeeding is immunoprotective, when such complementary foods are introduced, it is advised that this be done while the infant is feeding only breastmilk. Mothers should be encouraged to continue breastfeeding through the first year and beyond as more and varied complementary foods are introduced.

Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk. The target age range for complementary feeding is generally taken to be 6 to 24 months of age, even though breastfeeding may continue beyond two years.

Guideline: Practice exclusive breastfeeding from birth to 6 months of age, and introduce complementary foods at 6 months of age (180 days) while continuing to breastfeed.

When looking back at my own baby book from 30+ years ago, I saw that my mother had put rice cereal in my bottle at 2 months of age! Yikes! Live and learn I suppose.

So, with my darling daughter, when she reached the ripe old age of 6 months we started her on solids. Her first food was not rice cereal. She had homemade sweet potatoes, and loved them. She loved them all over her face, hair, high chair tray…

As a parent, how do we actually begin that weaning process to solid foods, even as we continue to breastfeed (or formula feed)?

Signs of readiness:

  • She can sit up (with support) and can hold her head and neck up well.
  • Her birth weight has doubled.
  • She’s interested in what you’re eating and may even try to grab food from your plate.
  • She can keep food in her mouth rather than letting it dribble out.
  • She shows signs of being hungry for more than she’s getting by clamoring for more when her bottle is empty or wanting to nurse more often.
  • 6 months per AAP and WHO
  • Check with your pediatrician before beginning solid foods to account of any of baby’s specific needs or allergies.

How to:
  • Substitute one breastfeeding for a solid feeding. 
  • Start with a fruit or veggie. Rice cereal is constipating and has little nutritive value past the added iron. 
  • When baby is hungry, offer the food. 
  • If baby turns her head away, it means she’s not hungry or finished eating. Don’t force her! 
  • Introduce one new food every 4 days. This will help you figure out if your little one has an allergic reaction to anything. 
  • Understand that with a new for it can take 12-14 tries before baby will eat it. Keep trying! 
  • Start with one meal a day, working your way up to 2-3 by 9 months and by 12 months, 3 meals and 2 snacks.

Finger foods:

  • Baby needs to have the pincer grasp (index finger and thumb to pinch and pick up). This is usually at around 8 months of age.
  • Foods should be soft, cut up small and easy to pick up.

Explore with flavors! My kiddos are well-rounded eaters because we never said “That’s too grown up for them.” They eat Indian, Ethiopian, Italian, Sushi, even octopus! Don’t be afraid of spices and seasonings (though keep the salt content low). A diverse palate at a younger age will make a big difference in “pickiness” later on. Also, don’t stress about baby eating the same thing over and over, or having a few days where they only want one food. We look at nutrition over the course of a week, not a day.

And keep breastfeeding! Baby’s main nutrition comes from you, not from the food you prepare. Although baby gets some nutrition from the solid foods, they still need you. Baby needs the closeness of mama (or daddy, grandma, etc.) during feedings. I love that the WHO calls it “Complementary Feeding.” I think that’s the perfect term for feeding baby solid foods from 6-12 months.

Food should be fun, not a chore. Go in with a fun attitude (and a washcloth and a change of clothes for both of you!). You and baby will have an enjoyable experience exploring solid foods.

Deena Blumenfeld RYT, RPYT, LCCE is the owner and principal educator at Shining Light Prenatal Education in the Lawrenceville section of Pittsburgh; Lamaze Certified Childbirth Educator; Lamaze Trainer for the Lamaze Educator Seminar; 200-hr Registered Yoga teacher through Yoga Alliance; Registered Prenatal Yoga Teacher through Yoga Alliance; Certified Khalsa Way™ Prenatal Yoga Teacher.

You can contact her through her website, through Shining Light Prenatal Education or email her at

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