Caring for your baby at home Outpatients and follow-up Frequently asked questions - Community support

Babies who are born too early or unwell often need extra time to start being able to feed by mouth. Pre-term and unwell babies are often initially fed by either Parenteral nutrition (nutrition delivered via long line straight into the vein) and/or milk feeds through a naso gastric or oro gastric tube (feeding tubes from nose or mouth to the stomach).

 

After all this early difficulty starting to take milk by mouth it can be hard to imagine your baby starting solids.  But it is important to get going at the right time so your baby will learn to accept and enjoy a full range of tastes and textures.

 

Research and experience tells us that babies who are born prematurely need to be introduced to solids by 5-7 months of age.  This is actual age not corrected for prematurity so if a baby is born at 32 weeks they would need to be starting having solids between 3 and 5 months from their due date.

 

The following pages on other sites offer useful advice on weaning babies:

> BLISS – Weaning your premature baby

 

> Department of Health – Weaning leaflet

 

Top tips and common problems

 

1. Transition from smooth puree to lumpy solids (after 1-2 months on smoother consistencies or by 9 months of actual age) – this can be a bit tricky for babies to get used to and it is not uncommon for them to gag and spit out lumps when they are first offered.  They need practice to get used to managing the lumps to help try the following:

• Move from smooth to thicker and lumpier consistencies gradually – this is much easier with home cooking rather than jar foods which change consistency in big jumps. For example you can gradually mash a banana less and less over time. If you are using jars and your baby is struggling, try mashing the lumps a little bit to make the lumps smaller and more manageable
  
  
• If your baby does gag or spit out the lumps don’t worry just offer a few more spoonfuls with an encouraging smile and see how they manage.  If they seem upset or to be really struggling make the food a bit less lumpy next time and gradually re-start to build up to a more lumpy texture. Avoid going back to completely smooth puree as children can get stuck on this stage if they are not helped to move on
  
  
• Use an encouraging voice and facial expression when feeding your baby – if you sound or look anxious your baby will pick up on this

2. Babies like to be involved and if they want, let your baby hold a spoon and have a go at dipping the spoon or their fingers in the food at some time in the meal

 

3. It is normal and important that meals times are a bit messy.  For normal feeding development babies need to get used to food on their faces and hands.  It is probably worth having big bibs and a wipeable mat or old sheet on the floor underneath the high chair to contain the mess

 

4. By 12 months of age babies should be having chopped or mashed family foods

 

5. Introduce a free flowing beaker to your baby from 6 months onwards, this will help them to develop a more mature drinking pattern which is very different to sucking from a bottle.  Avoid 'no spill’ beakers when babies are learning to drink free flowing liquids as 'no spill’ beakers work in the same way as bottles, with babies needing to suck to get the drink out

 

6. Your baby may have been discharged on a post discharge formula called Nutraprem 2 which is prescribed by your GP, they can remain on this until 6 -12 months or until adequate catch up growth has been achieved.  Your Health Visitor, GP or Dietitian will be able to advise you further on this

 

7. It is important not to fill your baby up on milk so as to encourage solid foods. During weaning most babies will naturally decrease the amount of milk they drink. Once your baby is having three solid meals a day an appropriate amount is around 600mls or 18oz a day

 

If you are concerned regarding your baby’s growth or their safety when eating and drinking please discuss with your GP who can refer you to a dietitian or speech and language therapist as needed.

 

 

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