HELP, MY BABY HAS BEEN CONSTIPATED SINCE STARTING WEANING!

Poo changes during weaning are very normal.  A baby’s digestive system is adapting from processing just milk, onto a wide range of different foods.  This is often met with changes to poo including;

• Changes to stool colour – poos may become darker in colour or affected by what your baby is eating e.g. greener stools with green vegetables

• Changes to smell – poos may become more distinctive or stronger in smell

• Changes to frequency – reduced frequency of bowel movements or constipation can be a common side effect of starting or progressing through weaning. Constipation may present as a reduction in how often your baby is passing stools across each week (e.g. under 3 x per week), and/or a change in consistency in their poo (e.g. harder, lumpy or dry stools and/or look like rabbit droppings). Your baby may also be straining more to pass their poo, or present with some mild pain or discomfort.

Some helpful ways to help your baby towards softer stools and manage constipation include;

• Including ‘‘P’ fruits such as peaches, pears, plums and prunes in their diet. These fruits are higher in a natural laxative called sorbitol which can support regular bowel movements

• Check on your baby’s fluid intake- ensure they are having regular wet nappies, and urine is a pale and clear or a light yellow colour

• Include a variety of fibre in their diet, including a type of fibre often referred to as soluble fibre. This can be found in foods such as; beans and pulses, seeds (e.g. flax, chia, hemp), oats, sweet potatoes, avocado and other vegetables such as courgettes and green beans

MY BABY HAS UNDIGESTED PIECES OF FOOD IN THEIR POO, IS THIS NORMAL?

Yes! It’s very common to see pieces of undigested foods, such as vegetable or fruit skins or pith, bean skins or husks, seeds or whole pieces of foods such as sweetcorn in your baby’s poo. This is usually nothing to worry about. These foods are often more difficult to digest and/or babies don’t generally have the skills (or teeth) required to chew or grind down some of these foods in the same way we can as adults.

WHICH MEAL SHOULD YOU START WITH AT THE BEGINNING OF WEANING?

As with many things during weaning, there isn’t just one right answer to this question. The key is to find a time of day which works best for you and your baby. Choosing a time when your baby is awake, alert and eager to engage (e.g. around their normal playtime) can be helpful.  It can also be helpful to space their meal between feeds.  For this reason, many parents find offering a meal mid-morning a great place to start.

WHEN SHOULD MY BABY BE ON THREE MEALS PER DAY?

Each baby is going to progress up to three meals per day at a different pace, depending on their own experiences with weaning.  Aim to move from one to two, then two to three meals per day steadily, allowing your baby time to get to grips with each mealtime and establish the change to their routine.  As a general rule, babies should aim to have three meals a day from between 7-9 months of age. 

WHEN SHOULD I BE INTRODUCING SNACKS TO MY BABY?

The NHS currently recommends that babies do not need snacks between their meals until around 12 months of age onwards. Between meals, it is encouraged that babies continue with their normal milk e.g. breastfeeds or formula feeds.  Introducing snacks early can risk a scenario where babies are displacing important nutrients from their milk feeds e.g. iron.

IS IT TRUE THAT ‘FOOD BEFORE ONE, IS JUST FOR FUN’?

Lots of parents have heard this phrase when it comes to weaning, and it’s often used to reassure parents about a baby’s progress with solids. Whilst starting solids definitely can be fun (and should be for baby!), it’s important to remember that weaning is a key window of opportunity for your baby to learn to eat, find the full SACN report. The process of weaning is fundamental for their;

• Skill development e.g. gross and fine motor skills, hand skills, oro-motor skills (e.g. chewing, biting, swallowing).

• Understanding of mealtimes – babies benefit from getting used to a routine of food and mealtimes within their day. Mealtimes are also a valuable place for babies to pick up skills such as language, cutlery skills, turn taking and socialisation.

• Nutritional needs – babies’ stores of key nutrients such as iron start to run low from around 6 months of age, alongside their requirements for nutrients going up. Starting solids is an essential way of ensuring your baby is replenishing these stores, and consuming enough of key nutrients such as iron and zinc.

DOES MY BABY NEED VITAMIN SUPPLEMENTS WHEN THEY START WEANING?

From 6 months of age, the NHS recommends that babies are supplemented with Vitamins A, C, and D.  Babies who are exclusively breastfed can commence this from 6 months of age, however, solely formula-fed or combination-fed babies will only need to introduce this once their intake of formula drops under 500mls per day.  This is because of the amounts of these vitamins already added to the formula.

For babies following a more restricted diet e.g. vegan diet, or who have multiple food allergies it would be recommended to discuss specific vitamin or mineral supplementation with a Health Professional.

I’VE HEARD YOU SHOULD INTRODUCE ONE NEW FOOD EVERY THREE DAYS DURING WEANING, ESPECIALLY IF YOUR BABY HAS REFLUX OR A SENSITIVE STOMACH.  IS THIS TRUE?

This is a common piece of advice that does the rounds on weaning forums, blogs and sometimes even from some Health Professionals.  Whilst there may be very specific cases where a routine like this would be recommended, for most babies introducing one new food every three days can significantly limit their exposure and progress with foods during weaning. For example, one new food every three days would mean only introducing your baby to around 10 foods across one month.  Given the benefits of offering your baby a wide variety of foods, both for experience but also for health reasons such as developing a healthy gut microbiome, it generally isn’t necessary to take this approach during weaning.

Note: it may be important to introduce some foods more gradually during weaning e.g. allergenic foods.  You can find more information about this here.

MY BABY IS ONLY HAVING A FEW MOUTHFULS AT MEALTIMES, IS THIS ENOUGH?

During weaning, it can be very easy to focus on the amounts your little one is consuming – especially compared to peers of the same age.  In reality, the amounts or volumes your baby consumes are likely to change as they progress through weaning but also on a day-to-day basis too.  There are no recommended portion sizes for babies, as they are still very much learning to eat.  It is encouraged that parents focus on a responsive feeding approach. 

MY BABY SEEMS ONLY TO PREFER THE SWEETER FOODS, IS THIS NORMAL?

Yes!  But this is why getting in a wide variety of tastes and flavours during weaning is so important.  Babies have a natural preference for sweet foods, and prior to weaning have been very familiar with the sweet taste of breast or formula milk. To support acceptance in the long term of all the different flavours associated with the foods we eat e.g. bitter, sour, savoury, tangy, and umami,  babies need to have plenty of exposure to these foods between  6-12 months of age .

To support this;

• Incorporate a range of flavours and foods into your baby’s diet

• Don’t be afraid to use herbs and spices – these are safe to use from 6 months of age (just be mindful with chilli, and avoid added salt). The Tilda kids range incorporates different herbs and spices into each flavour, and is recommended to parents whose children are safely weaned onto solids!

• Adapt family foods wherever possible

• Be mindful of packaged foods that say they contain vegetables, but actually contain a high proportion of sweet foods such as fruit purees

• Avoid the temptation to add sweeter foods like fruit to a baby’s meal to ‘help them eat more’. Allow them time to learn and explore different flavours.

WHAT’S THE BEST FOOD TO START WITH AT THE BEGINNING OF WEANING?

There is no one perfect or ‘right’ food to start weaning with, however, there have been some benefits shown to a child’s long-term eating behaviours if bitter or plain foods, such as vegetables, are introduced early or first. 

WHEN SHOULD I INTRODUCE CUTLERY?

Cutlery can be introduced to your baby from the start of weaning e.g. soft weaning spoons and you may progress towards offering a fork and other utensils at around 10-12 months of age.

Like learning to eat, cutlery skills take time to grasp and most babies will preferentially eat with their hands and possibly a spoon initially and into the toddler years.  You can keep offering utensils, model how they are used and include simple techniques to support their learning e.g. gently using hand over hand to show them how to scoop with a spoon and use a single phrase e.g. ‘scoop.’

WHAT IS THE BEST CUP TO INTRODUCE MY BABY TO DURING WEANING?

Health professionals recommend that babies should be introduced to an open cup or free flow beaker (no valve) from 6 months of age.  The reason for this is to support your baby to learn to sip rather than suck – thus supporting optimal oro-motor development.

If you are using a lidded beaker, aim to move your child onto an open cup and/or weighted straw cup as soon as they are ready.

WHEN CAN I INTRODUCE MY BABY TO COW’S MILK?

Cow’s milk can be introduced to your baby, in their food, from 6 months of age.  This is unless your baby is known to be allergic to cow’s milk e.g. is diagnosed with a Cow’s Milk Protein Allergy.  

Cow’s milk should not be given as a drink to your baby until at least 12 months of age.  Choose whole (e.g. blue top in the UK) cow’s milk for babies and toddlers, as it’s important they consume enough fat to support growth.

If your baby cannot have cow’s milk, you can introduce a suitable fortified milk alternative e.g. soya or oat-based milk alternative within their food from 6 months of age also, but not as a drink.  Seek advice from a health professional about the best milk alternatives to use for your baby, as their nutritional composition is not comparable to cow’s milk.  It will be important to choose an option higher in energy (calories), unsweetened and fortified with important nutrients like calcium and iodine.

DOES WATER FOR MY BABY NEED TO BE BOILED AND COOLED?

If you are starting weaning prior to 6 months (26 weeks) of age, then yes,  it is recommended that you use cooled boiled water.  From 6 months of age, tap water can be safely given to your baby during weaning and beyond. 

HOW MUCH WATER SHOULD MY BABY BE DRINKING?

When you first introduce a cup, it’s likely your baby will be taking very little water as they get to grips with the skills needed to drink water.  It can be common to see babies cough, splutter and spit out water initially, which improves with time and experience.  When first introducing water, it can also be helpful to remember babies will still be getting all the fluids they need from breast or formula milk

As you progress through weaning, your baby will start managing more water and much like the amounts they eat, this is likely to be led by them.  Babies will be led by their thirst, balancing the fluids they get from milk, foods and water.  To support good hydration aim to offer your baby a drink of water with each meal, and in between meals as necessary e.g. after active play, during warm weather.  Keeping an eye on their nappies is a great way to be reassured they are having enough to drink – babies should have regular wet nappies and urine should be light in colour and not too smelly.

I’M NERVOUS ABOUT INTRODUCING COMMON FOOD ALLERGENS TO MY BABY, WHEN SHOULD THESE BE GIVEN?

It is now recommended that common food allergens including; cows milk, egg, peanut, fish, shellfish, tree nuts, wheat, sesame and soya are given to your baby proactively during weaning from 6 months of age.  It is not recommended that introduction to these is delayed, as early introduction has been shown to help prevent food allergy.

For the group of babies considered at higher risk to develop food allergy, even earlier introduction of specific food allergens such as egg and peanut may also be recommended prior to 6 months of age, with the guidance of a health professional.

You can read much more about this topic in our blog on introducing food allergens.

I’M ALLERGIC TO CERTAIN FOODS, IS MY BABY LIKELY TO BE ALLERGIC TO THESE TOO?

It’s natural to be concerned if you have a food allergy yourself that your baby will also be allergic to these foods.  From research we understand that children don’t necessarily directly inherit the same food allergies as their parents.  When it comes to looking at a baby’s risk of developing food allergy, health professionals are likely to consider a range of factors including;

• Family history of any atopic (allergic) condition, which including food allergies but also eczema, asthma and hayfever

• Whether a baby has eczema

• Whether a baby has a food allergy already e.g. Cow’s Milk Protein Allergy

You can find more information about introducing common food allergens to your baby here

MY BABY GETS A RASH AROUND THEIR FACE WITH SOME FOODS, DOES THIS MEAN THEY ARE ALLERGIC TO IT?

It can be common for babies to develop a red rash around their face, neck and even hands (where they have been handling food) when exposed to certain foods.  This is called a contact reaction or irritation.  It occurs when something within the food aggravates a baby’s delicate skin e.g. acidic foods, histamine rich foods.  Symptoms include localised redness and a rash where food has been on the skin, that does not spread and self resolves.  Common culprits can include acidic fruits or vegetables e.g. citrus, tomato, salty foods and histamine rich foods e.g. aubergine, spinach.  

If you are unsure about a rash your baby has had when eating a food, or the rash is accompanied by any other symptoms consistent with food allergy please seek the advice of your Health Professional.

This article was first published on Tilda, see the original here: https://www.tilda.com/blog/kids/common-questions-during-weaning-answered/