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100 4.2­ Weaning onto Solid Foods – Complementary Feeding

Table 4.2.1 Summary of advice on weaning

Year Organization Recommendation
1994 UK Department of Health
2001 ’The majority of infants should not be given solid foods before
World Health Organization the age of 4 months and a mixed diet should be offered by the
2001 age of 6 months’ (Department of Health 1994)
UK Scientific Advisory
2004 Committee on Nutrition (SACN) 1. Exclusive breastfeeding until 6 months of age to reduce the
2008 incidence of gastroenteritis, which causes death in developing
2009 UK Department of Health countries
2. But each baby should be considered individually because
European Society for Paediatric exclusive breastfeeding to 6 months could lead to iron deficiency
Gastroenterology, Hepatology in susceptible infants, and growth faltering and other
and Nutrition (ESPGHAN) micronutrient deficiencies in others
European Food Safety
Authority (EFSA) ‘There is sufficient scientific evidence that exclusive breast
feeding for 6 months is nutritionally adequate’, however, ‘early
introduction of complementary foods is normal practice in the
UK’ and there should be flexibility in the advice but that any
complementary feeding should not be introduced before the end
of 4 months (17 weeks)

‘Although there is no evidence to suggest that giving a baby solid
food before 6 months has any health advantage, it is important to
manage infants individually so that any deficit in growth and
development is identified and managed appropriately’

‘Exclusive breast feeding for around 6 months is a desirable goal.
Weaning on to solids should begin by 6 months but not before 4
months’ (Agostoni et al. 2008)

‘The introduction of complementary foods into the diet of
healthy infants between 4 and 6 months is safe and does not pose
a risk for adverse health effects’
‘Exclusive breast-feeding is nutritionally adequate up to 6 months
for the majority of infants, while some infants may need
complementary foods before 6 months (but not before the age of
4 months) in addition to breast-feeding to support optimal
growth and development.’ ‘Breast milk may not provide sufficient
iron and zinc in some infants after the age of 4–6 months, and
these infants require complementary foods’
If complementary food is introduced after 4 months of life it does
not constitute a problem for the digestive system or the renal
function of the infant
Iron deficiency in fully breastfed 6-month-old infants is more
likely to occur in male infants and in infants with a birthweight of
2500–2999 g

Within Europe, national recommendations vary This is probably because they perceive that babies
from country to country, with most recommending growing more quickly are ready for more than just
beginning weaning between 4 and 6 months of age milk at an earlier age.
(EFSA 2009). The UK Department of Health
recommends term infants should be considered In practice, the developmental signs that
individually and should begin around 6 months or suggest that an infant is ready to accept solid
26 weeks, beginning by this age but not before 4 foods are:
months or 17 weeks. Mothers tend to choose to
wean male babies and larger infants earlier than ●● able to sit with support and with good head and
smaller and female babies (Wright et al. 2004). neck control

●● putting toys and other objects in the mouth