Successful transitioning from breastfeeding to solids

By Amy Shelton, RD, Clinical Dietitian, and Nancy Thompson, Pediatric Nurse Practitioner and Lactation Consultant

Breastfeeding provides advantages with regard to general health and growth and development. It significantly decreases the risk for a large number of acute and chronic illnesses. The American Academy of Pediatrics recommends breastfeeding for the first year of life, and thereafter as long as it is preferred by mother and child.

The term weaning describes the stage that starts when the child begins to take anything other than the breast. It is a natural stage in a child's development. This process differs for each child, depending on the age and readiness of the child. This transition time will be an important time of development, as well as a great time to work on more advanced feeding skills.

Most children will adjust the amount they eat with their nutritional needs; however, it is important to be aware of how well the child is growing during this change in their diet. Regular weight checks with your pediatrician or registered dietitian are necessary to make sure their growth stays on target.

Around 4-6 months of age it is appropriate to introduce solid foods, in the form of semi-liquid smooth foods. Rice cereal is a good food to introduce first, as it does not commonly cause allergic reactions and is also a good source of iron. Baby foods are the next step. Introduce new foods one at a time, approximately one food a week, so that an adverse reaction to a specific food can be recognized. Don't be surprised if the child does not take more than a few teaspoons at first. As their feeding skills improve, their volume will too. During the transition to solid foods breastfeeding should take place before offering solids. This will help ensure that the mother's milk supply is adequate and that the child gets the milk he or she needs while learning to eat other foods. However, as the process continues, this may not be necessary. Adding solid foods may also give dad or other caregivers the chance to participate in the feedings.

Between 6-9 months is a good time to start introducing liquids in a cup with a lid and drinking spout. Prior to this time, a bottle may be more appropriate for the child's feeding skills. Initially, choose one breastfeeding per day to replace with the cup or bottle. This feeding is usually the one that the child is least interested in, when your breasts are less full, or when it is most convenient for your schedule. After a few days or a week, replace another feeding with the cup/bottle. The early morning and before bedtime feedings are last to replace as they are usually the most difficult. Don't be discouraged if your child becomes ill or is teething and goes through a time period of regression. After the child is feeling better you can go back to weaning.

The weaning process should be a gradual one. This minimizes mothers experiencing engorgement, leaking, plugged ducts and the emotional stresses that come with the transition. Sometimes it may be necessary to pump breast milk to prevent engorgement. This is done for the mother's comfort and not to encourage more milk production. Mom may need contact a lactation consultant for assistance or with any questions that come up during breastfeeding or weaning.

The most important thing is to be able to recognize the child's cues. As they begin to take more solid food and drink from the cup/bottle eventually they lose interest in being breastfed and their nutritional needs are being met in other ways. Enjoy your child's changes as he or she continues to grow and develop.