Breastfeeding and diversification: how to do it, at what age?

Breast milk is the best food for infant growth and cognitive development. This is its biological standard. Breastfeeding also promotes the mother-child bond. The WHO recommends exclusive breastfeeding up to 6 months, then until the child is 2 years old, in addition to diversification. The introduction of solid foods is thus intended to introduce baby to the taste of food without the breast milk filter, to chew, to meet the baby’s needs for micronutrients such as iron or zinc. At what age can we offer purees to babies when breastfeeding? How to go about diversifying the diet of a breastfed baby? Advice from Carole Hervé, IBCLC lactation consultant.

At what age should food diversification begin in a breastfed baby?

In principle, WHO recommends starting diversification in a breastfed baby from the age of 6 months. But Carole Hervé is more nuanced: “what if we just looked at our babies? Wouldn’t the right time to start be when we see that our baby is starting to show curiosity by looking at our plate? The main determinant of the introduction of solid foods is not so much a definite age as stages of its development.” In effect, to accept a solid diet, the child must have: double their birth weight, be able to sit up with some help, have developed an interest in what those around them eat, have intentional hand and finger movements, and have lost the protrusion reflex (a protective action of the tongue that pushes the solids outwards to avoid choking), details the lactation consultant.

There are two approaches available to parents starting diversification. In any case, it is essential to keep in mind that milk should remain the baby’s main food until he is 12 months old. It is advisable to add a teaspoon of pure vegetable oil to the puree (rapeseed, olive, walnut) or a knob of butter or fresh cream.

The traditional mixed

consists of presenting the child with foods in the form of purees and very smooth compotes. Vegetables and fruits cooked in water or steam, without seasoning are introduced gradually. The quantities must be increased little by little, until proposing 120g. Then, ten days later, fruit compotes are offered for tea. If the baby doesn’t like it, we don’t force it. We will ask him again a few days later.

Child-led diversification (CMD)

Appearing in the early 2000s, this concept advocates the autonomy of the child. It was Gill Rapley, a British nurse with a passion for infant feeding, who began to describe it. It consists of offering solid foods whose size and texture are adapted to the capacities of 6-month-old babies. This involves providing them with a varied plate with healthy food, raw or cooked, in pieces (the size of the baby’s palm) or in sticks. No small, hard foods. The baby makes his own choices on his plate. He takes the food, puts it in his mouth and does what he wants with it.

How many feedings according to his age?

“The concept of breastfeeding on demand has no “expiration date”, so it is not necessary to seek to regulate the number of feedings at this age, any more than at another age. besides (apart from the desire to wean the baby).According to the WHO, at 6 months we observe 9 feedings/24h on average, 7 feedings at 9 months and 5 feedings at 12 months in addition to solids”says the lactation consultant.

In case of mixed breastfeeding, diversification follows the same logic : milk remains the priority during the child’s first year of life. From 4-5 months, baby can be offered a few teaspoons of smooth purée at lunch, gradually increasing the quantity to 120g, then 150 to 210ml of artificial milk.

From 6 months, the quantities can be increased to reach 150g to 200g of smooth puree. It is quite possible to have a breastfeed one day, a bottle of artificial milk or breast milk another day… It’s up to the mother to listen to herself!

Thanks to Carole Hervé, IBCLC lactation consultant, author of My tailor-made breastfeeding, ed. Albin Michel and Choose to breastfeed, ed. First