Weaning: 40 expert answers to your questions

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It is one of the fundamental moments in the growth of a child: weaning, the beginning of complementary feeding that replaces or is added to the milk (mother or formula) that the little one has fed exclusively for months. It is an exciting time, but not without doubts and worries on the part of parents: when to start, which approach to choose, how to reduce the risk of allergies, how long to breastfeed, which water to prefer, when to introduce the egg or fish ... . these are just some of the many questions you have directly addressed to our experts, Ilaria Giulini Neri e Giacomo Cagnoli.




Both are medical specialists in pediatrics and neonatology, with a PhD in experimental and clinical nutrition, and work in the pediatric structure of the Melegnano Hospital. In particular, Giulini Neri is the company contact for breastfeeding while Cagnoli is responsible for the auxology and clinical nutrition outpatient clinic. Since 2022 both have collaborated with the NutrMyModernsParents Project of the ICANS (International Center for the Assessment of Nutritional Status) of the University of our city.


Before moving on to all their answers, divided into different themes, two fundamental indications proposed by dr. Cagnoli:

  1. Don't worry about the risk of allergies. If until a few years ago it was believed that certain allergenic foods (eggs, fish, strawberries ...) should be introduced as late as possible, today the studies available say that, on the contrary, the late introduction of foods does not reduce the risk. allergy (and in some cases it is even counterproductive). Therefore it is not necessary to follow particular and rigid schemes but the various foods can be introduced according to the preferences of the family and the child.
  2. Whatever choice you make, manage it with a smile. Weaning must be a moment of serenity, of sharing beautiful moments. Too much anxiety risks compromising it and creating problems such as non-acceptance of new foods.
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Start weaning: when to start?

  • When should weaning start? (Donatella) Is it better to start at four months or six months? What are the pros and cons in early, four-month onset? (Desiree)

According to the international recommendations of the World Health Organization (WHO), weaning must begin in the sixth month completed. Sure, in some cases the pediatrician may recommend starting earlier - but always after the fourth month - if for example there are growth problems or the baby is showing signs that they need a transition to solid nutrition. Apart from these particular cases, however, the indication is to give milk - be it maternal or artificial - to the baby up to the sixth month.



In this regard, we remind you that exclusive breastfeeding for six months should be the model to strive for because it offers significant benefits to the mother and the baby. (Giulini Neri)

Read also: Health balances, what they are and when to do them
  • Does the child give us directions? Clues that can help us understand if he is ready or is it better to wait a little longer? (red)

Absolutely yes: it is good to wait until the child is ready even from a neuromotor point of view, and therefore that he can sit up, swallow food, grasp food with his hands to bring it to his mouth. And that he shows an interest in the food itself. It is clear that the completed six months of which WHO speaks are a general indication: some babies may be ready a couple of weeks later, others a couple of weeks earlier. (Giulini Neri)

  • Is it better to start with fruit or salty and why? (Desiree)

Traditionally it has always been recommended to start weaning with fruit, which is considered more palatable and therefore more pleasing to the child because it is sweet. In reality, from a nutritional point of view, not much changes: we can offer both naturally sweeter or salty flavors (but without added sugar and salt), also following the preferences of the child. (Cagnoli)

  • What times must be followed in traditional weaning with baby food? It starts with lunch, but after how much time can I also offer the baby food for dinner and as a snack? (Elisa)

In traditional weaning it was said to wait at least two or three weeks to move on to the addition of dinner, but in reality you can start immediately with baby food at both meals. It also depends a lot on the child: some accept and immediately prefer that they change both meals, others prefer a more gradual change. (Giulini Neri)

  • My baby has to be 4 months old: I can add biscuit powder in milk (Giovanna)

In reality there is no need to add a sweet, powdered food (which, therefore, the child does not even notice that she is eating) to the milk. She can only make her love the sweet taste prematurely, which she will then continue to search for even when she is "grown-up". Her advice is to continue with milk only for up to 6 months, after which she can start giving her a biscuit to munch on. (Giulini Neri)

Read also: 4 month weaning?
  • My son is 4 and a half months old and is exclusively breastfed. The pediatrician told me that now is the time to start weaning because he has to start being more autonomous! She says that 8/10 feedings a day is too much (we are breastfeeding on demand) and it should be at most four a day, but my baby is growing very well. (Silvia)

Your mom instinct has rightly led you to question an incorrect indication. Breastfeeding on demand (therefore with a number of feedings decided by the baby) is the feeding model to which we should strive. Let us remember that the World Health Organization and Unicef ​​recommend exclusive breastfeeding on demand up to 6 months of life. Moreover, it is an old conception that the child would be less autonomous. The data from the medical literature tell us something else. (Giulini Neri)

Read also: Breastfeeding: 22 answers to the most common doubts of mothers In summary: when to start, what to give
Weaning tends to begin at six months (even if the baby takes formula milk). It is however possible to start even earlier, from four months, if the child shows a particular interest in food or grows little.

From six months on, there are no strict rules on the introduction of food. You can introduce whatever you want (strawberries, fish, egg, even mango or avocado) as long as it is safe and healthy.

Quantity and quality of food during weaning

  • What are the quantities of food to offer to the baby during weaning? (red)

There is no one-size-fits-all answer, as quantities can vary from child to child. There are two fundamental indications: do not overdo it with proteins, because an excess of protein in the first months of life leads to an increased risk of being overweight and obese in the future, e choose extra virgin olive oil as the main condiment (and fat resource).

However, we propose a general scheme of the quantities of the various foods, per meal:

  • Vegetable: 100 grams
  • Extra virgin olive oil: 10 ml
  • Cereals: 40 grams
  • Protein: depends on the protein source. It is important not to mix the various protein sources with each meal, but to propose only one at a time (no to homogenized meat with the addition of Parmesan, so to speak). Here are the main sources, with their quantities: vegetable buckets 30 grams; fish 50 grams; meat 30 grams; egg 1; cheese fresh 20 grams; parmesan, parmesan or similar 10 grams.
  • fruit 150 grams (Cagnoli)
  • Is it better to give baby food or to cook fresh meat and fish? (Clear)

The choice has to do more with criteria of comfort and ease of use than with real opportunity. If there is little time to cook, the baby food can be used with peace of mind (at the beginning half a jar at a time in order not to exceed the protein quotas). Having the time (and desire) to cook, however, is perfectly fine.

In this way, by the way, it allows the child to taste a greater variety of flavors, given that every single piece of meat or fish has a unique flavor, while that of the baby food is precisely more homogeneous. Obviously, freshly prepared foods must be chopped and blended for the child to enjoy. (Cagnoli)

  • Can a 5-month-old baby be given carrots instead of fruit as a snack? And how many months can avocado be given? (Adriana)

Carrot yes, why not?
For the avocado: there are no problems giving it from six months of age, as with any other food. (Giulini Neri)

  • In the sixth month my daughter never eats all the cream. Can I give her milk immediately afterwards or so do I ask her to never complete the meal? How much should you drink a day after eating? (Sabrina)

If the child does not finish all the baby food, I recommend waiting to supplement with milk: in this way she will get used to distinguishing well the solid meal from the milky one, which have very different nutritional functions.

As far as the quantity of water is concerned, it is necessary to take into account that children are able to regulate themselves: it is always necessary to offer a little water with each meal and it will not be difficult to understand how much they want to drink; the rest will be supplemented by the milk she takes during the day. (Giulini Neri and Cagnoli)

  • How much meat and fish at 8 months? (Ornella)

Since meat and fish are mainly protein foods, the quantity to be proposed during weaning should be rather controlled; if we talk about fresh foods, for the first we recommend between 30 and 40 grams per serving, for the second about 50 grams. If, for convenience, you prefer to use the baby food, the portion will be about half the size of the jar. (Giulini Neri and Cagnoli)

  • What can I have for dinner for my 9-month-old son who is intolerant to cow's milk proteins? He doesn't like fish. At lunch he already takes proteins (Gioacchino)

At each meal it is useful to provide a protein source, which is mainly found in meat, fish, legumes, eggs and cheeses. In relation to the known allergy to cow's milk proteins, you can offer your child alternatively one of the other foods, in order to make the diet as varied as possible. (Giulini Neri and Cagnoli)

5 PHOTOS

Weaning, what are the first baby food in the rest of the world?

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Sara Honegger in the book A world of baby food explains how children are weaned in various countries. Generally the first taste is fruit: apple, pear, banana, but also mango or papaya ....

Autosvezzamento

  • What precautions should be followed in case of self-weaning? (red)

First of all, the "grown-up" foods must be made usable: smoothed, crushed or crushed. The other important indication is that it is healthy food. In this sense, the choice of self-weaning can represent an opportunity for the whole family to balance their diet, if there is something wrong. (Giulini Neri)

  • Can we give some basic principles of healthy eating? (red)
  1. Cooking must be simple and healthy: yes steam, no fried or complicated sauces.
  2. Plenty of room for variety: a growing child must taste as many foods as possible during the week, while the family's diet is often very monotonous.
  3. Pay attention to the portions: A small child should not be expected to eat the same amount as older siblings.
  4. Salt should not be added to food, which already naturally contain it.
  5. Neither should sugar be added to food, in order not to set the threshold of preference of children on sweet foods.
  6. No honey up to 12 months of life because it can contain dangerous spores.
  7. No cow's milk up to 12 months. Before the year, cow's milk can be prepared for home preparations (such as puree) but not as an alternative to breast milk or formulated. (Giulini Neri)
  • My baby is 15 months old and we have been self-weaning. I let her do it but at times she seems to eat little: how can you manage the quantity? (Glenda)

What it looks like to us is actually different from what it really takes for a child to grow up. If a child is well, is active, has a good growth it means that he regulates himself on the quantities. (Giulini Neri)

  • What could be the right breakfast for a 14-month-old self-weaned baby who refuses a bottle? (Jiannellia)

Refusing the bottle is a good thing: the habit of feeding bottles should be abandoned as soon as possible. He is a grown child and can have a breakfast like the grown-ups: milk in the cup, or a yogurt, with a source of carbohydrates (rusks, dry biscuits, breakfast cereals). (Cagnoli)

Choking hazard

  • Can you talk about bits of food, to take away the anxieties? (Veronica)

On the web there are many sources that explain how to cut unsafe foods: this is the first fundamental indication. The other is to trust them, but not let them eat alone ... (Giulini Neri)

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Choking on children: 21 tips for preparing food

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Every year in Del Paese about 50 children under the age of 4 lose their lives by suffocation. Food is responsible in 70% of cases. This is why Sipps, Società Del Paesena of ...

After weaning ...

  • What should a baby eat after one year of life? (Angela)

After the year, the feeding becomes more and more similar to that of the older child and the adult. There remains the indication of limit the protein quantity for at least two years. For the rest, he can eat anything, always in the context of ahealthy and varied diet.

As for the quantities, the child will probably dictate his rules: we should learn to trust his instincts, avoiding to insist too much if he does not want to eat. (Cagnoli)

  • My two-year-old is starting to eat less and above all he doesn't want meat, which he can't chew well. Is it a phase? (Michela)

Yes, it could be. Children often alternate periods when they are very hungry (and eat a lot) with periods when they eat less. This baby may be in a transition period where he chooses to eat a little less meat. In a few weeks he should be back to the average Mom was used to. But it could also be that he begins to structure his preferences and that he likes meat less.

Read also: Weaning, the 15 things to know

Vegetarian children

  • We are vegetarians: in the future could the child have problems if he were to taste meat, which he has never eaten before? (Adele)

No, the probability that he could be allergic is the same as he would have had by introducing the meat immediately at the beginning of weaning. Obviously, in the case of a vegetarian and vegan diet it is advisable that the family has followed a very balanced weaning, able to balance the vegetable protein sources well and attentive to any deficiencies to be supplemented (such as vitamin B12). (Giulini Neri)

Read also: Vegan diet for children: can it be done, and under what conditions?

If he refuses the baby food ...

  • My little one was born in the 30th week and now at 11 months he is fine, but he has difficulty eating baby food (even if I do everything at home) and prefers milk: is this normal? (Daniela)

Yes, being born premature you may have some more difficulty accepting solid foods. There is no need to fret if it grows well, but you have to keep trying anyway, because you often give up a little quickly. It doesn't necessarily go well with the first, but neither does the third or fifth. Maybe it's okay for the fifteenth time something is proposed. And if he doesn't like baby food, he can try the way of self-weaning (always focusing on a healthy and balanced diet). (Giulini Neri)

Read also: Premature babies, what are the health consequences?
  • My eight month old refuses fruit and yogurt categorically and just wants my milk. How can I do? (Will be)

If we talk about a snack, it may be that he also associates breastfeeding with a value of another kind and we can let him do it, it is still a perfect snack. Regarding the refusal of fruit, we must consider that it is a lot, it is difficult for all of it to be refused. Since there are no restrictions dictated by allergy risks, you can try various offers: apple, pear, banana, strawberries, blueberries, mangoes and so on.

We don't like yogurt right away, because it has a particular flavor: maybe you can add a teaspoon of pureed fruit (without other sugars).

  • My two-year-old son no longer wants to eat pasta or whatever you eat at the table, he only eats baby food, or chips, chocolates and various snacks. What to do? (Danila)

Unfortunately, if we introduce these delicious (and unhealthy) foods then it is difficult to remove them ... we should really avoid offering them. There is a tendency to think "chips better than nothing", but that's not the case: nothing is better than an unhealthy meal. With calm and patience we must try to propose other foods, healthier and suitable for a small child.

As for the return to homogenized things, it can be a sign of a period of difficulty for the child, it is worth trying to understand what it could depend on. (Giulini Neri)

The child does not chew

  • My 16-month-old grandson eats everything but doesn't chew ... How can I teach him to chew? (White)

To chew is not taught: he will learn little by little, as he will be offered foods for which it is necessary to chew. It is probably a child who is used to eating foods that did not need to be chewed. (Cagnoli)

  • I have a 2 year old who doesn't want to start eating solid foods other than bread, pasta and cookies. For the rest, he only eats baby food. How to get him to leave them?

Again, with a lot of patience: proposing, proposing and continuing to propose ... (Cagnoli)

Breastfeeding and milk: which and how much?

  • What to do with breastfeeding during weaning? (red)

The ideal is to continue breastfeeding even during weaning. Indeed, in the event that self-weaning is chosen, in which the child is left the freedom to taste various foods without making the classic baby food, it is essential that breastfeeding continues, because in these cases milk is still the main food source. of the child, who just does a few small tastes. (Giulini Neri)

  • My son at almost 3 years old eats everything, but for the afternoon nap, the snack and in the evening he always asks for milk (he still takes follow-on milk). Is it okay or should I take it off? (Valentina)

If the milk in the afternoon is part of the snack it may be fine (and the follow-on milk is ok), but the milk before the nap and in the evening is not a correct food habit, however it would be good to limit it and gradually remove it. This is because it is a plus compared to meals, which should be five (breakfast, snack, lunch, snack, dinner), with the risk of an excess in proteins, calories and fats. (Cagnoli)

  • My 13-month-old girl drinks 240ml of milk with biscuits in the morning, then doesn't drink any more for the rest of the day (but has a snack with yogurt and fruit). Is that okay or should you drink more?

That's okay, even more so if you take other dairy products such as yogurt which amply covers the amount of vitamin D and calcium you need.

  • If the mother wishes it until she can exclusively breastfeed and after weaning? (Giusy)

Exclusive breastfeeding is indicated for up to six months. Regarding breastfeeding after weaning, WHO says that mothers and babies can continue for up to two years and beyond if they wish to continue this experience. (Giulini Neri)

Read also: How to stop breastfeeding, 10 anti-stress tips (and without medicines)
  • I am breastfeeding exclusively and in the fourth month, the pediatrician wants to insert gluten-free milk jelly with fruit instead of a feeding ... is that correct? (Federica)

No, it doesn't make any sense either from a nutritional point of view or as a food habit for later. (Giulini Neri)

  • Up to what age should follow-on milk be (could) be given? (Rita)

From 12 months you can safely switch to cow's milk. (Giulini Neri)

  • I have a 9 month old baby and I can't get him to take milk, he just takes my breasts (and only one of them) and I don't think he's getting enough. Can you recommend any ways to introduce milk? (Anna)

The amount of breast milk that you give to your baby has a value that goes beyond the mere nutritional significance and therefore should be encouraged. You can try adding yogurt to breakfast or a snack if you want to increase the calcium content. Instead, it is better to wait 12 months to insert the cow's milk. (Giulini Neri)

  • My daughter stopped taking my milk at 8 months, but she doesn't want any kind of milk. How can I replace it? (Lisa)

Milk itself is not strictly necessary as a food; the important thing is to replace it with analogues that have the same nutritional function. The advice therefore is to try with yogurt or fermented milks to be taken at breakfast or as a snack. (Giulini Neri)

  • Can breast milk be a breakfast even when weaning begins? When should it be replaced with something else? (Angela)

Certainly breast milk, for those who have the possibility, can be used during weaning and not only; the World Health Organization recommends continuing for up to two years or more. In the morning you can also try to integrate breakfast with a biscuit, if your little one wants it, to get him used to taking cereals as well. (Giulini Neri)

Reflux and allergies

  • My 5 month old is suffering from reflux. What should I avoid putting in the food? Do vegetables give acidity? (Silvia)

In principle no, there is nothing to avoid. The foods most at risk for reflux are those contraindicated even in adults such as citrus fruits and chocolate, but it is clear that they should not be in a baby food. The child suffering from reflux will likely benefit from the start of solid feeding, so the indication is always that of variety. (Cagnoli)

  • My 10 month old daughter is allergic to cow's milk proteins. I can't take her breasts off or introduce the pasta, she just wants velvety things. What do you recommend? (Cristina)

If the mother is able to do so, it is better to continue to favor breastfeeding, which is protective against allergies. However, there are alternatives, in case of allergy to cow's milk proteins, which are specific formulas (protein hydrolysates, generally however not very palatable) and plant-based drinks (soy, oat, rice milk).

For the refusal of pasta we return to the discourse of gradually proposing foods that are more similar to those of adults. As always, no panic and lots and lots of patience. (Cagnoli and Giulini Neri)


Food safety

  • Is it true that cooked ham (and sausages in general) should be avoided in the weaning phase and also afterwards? Katia

Rather than avoid I would say limit, because they are very salty foods: they should not be offered more than once a week even for the oldest child. For the little ones, it should be considered that they are dangerous foods from the point of view of suffocation and must be cut very finely. (Giulini Neri).

  • When can raw egg be introduced (Elisa)?

Raw egg is a food at risk of bacterial contamination (for example by salmonella). Even for adults it is not properly indicated, but in their case it is the conscious choice to take a certain risk. For the little ones I would say to delay their intake as much as possible and in any case not before the age of three (Cagnoli).

  • Mushrooms are to be avoided until what age? (Fairy)

They are not a fundamental food, if we can avoid giving them it is better. (Giulini Neri)

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Feeding 1-3 years old children, the NUTRITIONIST pediatricians 'answers to mothers' doubts

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Nutrition after weaning: here are the most common doubts of mothers with the answers of the nutrition pediatricians Giacomo Cagnoli and Ilaria Giulini Neri of the NutrMyModernsParents team of Icans, ...

Water and more, what to drink

  • When can you start giving chamomile and water to a child? (Clear)

Chamomile practically never: it is not needed and it must be considered that most of the formulations of chamomiles and herbal teas for children contain added sugar. As for water: if there is exclusive breastfeeding (breast or formula), water is usually not needed and the baby hydrates himself sufficiently with milk. After the introduction of other foods, water supplementation is also needed. We will propose it, because the child generally does not ask for it: do not worry too much if he does not take it, but remember to give it to him during the day.

Tap water is also fine in areas where we know there are no problems. If you don't trust it, bottled water is fine too. (Cagnoli)

The three fundamental words for weaning: trust in the baby, patience, variety

TAG:
  • self-weaning
  • baby food
  • weaning
  • breastfeeding
  • artificial milk
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