Exclusive Breastfeeding beyond Six Months
June 6, 2009 by Angela White, J.D., breastfeeding counselor
Filed under breast milk, health of the baby, nutrition
In my Tips for When Your Baby Resists Solid Food, I made the remark that “there is no rush to get the baby to eat solids because breast milk provides complete nutrition through the first year.” I’ve since revised that statement to “there is no rush to get the baby to eat much solid food because breast milk provides the bulk of nutrition through the first year (and in fact some babies thrive on breast milk alone)” based on the following comment that that post received:
http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_00.1/en/index.html – see page 10 + 11
Breastmilk does not provide complete nutrition for the second six months of life. I am all for full term breastfeeding (I am still feeding my 18 month old), but I think it is fair to point out that the energy gap between what a baby needs and what breastmilk can provide gets wider from about 6 months.
There are other important nutrients which are also needed – iron stores from birth run out at around six months, so it’s important for babies to get some iron from other foods.
While I think that many doctors are ill informed and try to bully us into pushing solids before the baby is really ready, it’s important for parents to be informed of the facts, so they can make an informed decision.
Baby who resisted rice cereal (Photo by LizaWasHere)
As I replied in the comments section:
“In general I agree that it’s a good idea to start solids around 6 months of age and I certainly believe every mother should do her own research and consult a doctor for medical advice.
When a baby resists solid food and/or has a family history of allergies or shows signs of severe and numerous food allergies, some mothers choose to rely on breast milk for the baby’s sole (if not “complete”) source of nutrition. Kellymom.com says: “Some babies are exclusively breastfed for a year (and occasionally up to two years) with no problems at all. In addition, some doctors recommend that babies with a high risk for allergies be exclusively breastfed for a year.”
Kellymom also notes: “The current research indicates that a baby’s iron stores should last between six and twelve months, depending upon the baby.” Your comment implies that there is no iron in breast milk, although perhaps that is not what you intended. The good news on iron is that “up to 50% of the iron in human milk can be absorbed by the infant, as compared to 10% in cow’s milk, and 4% in iron-fortified formulas.” (LLL fact list). Some (many?) babies might need an additional source of iron (from solid food or vitamin supplements) at some point after 6 months, but not all babies will.
The points I hope to make are that parents need not worry quite as much as some seem to about getting solids into a baby, that breast milk continues to provide the bulk of nutrition, that it’s not always a good idea to push solid food when the baby resists or has allergies, and that there is anecdotal evidence (and perhaps more) that some babies thrive on breast milk alone for up to one year and even beyond.”
Your Thoughts?
Did anyone reading this delay (or stop feeding) solid foods after six months of age? What was your experience and reasoning?
I agree with you, Angela, that breast milk is pretty much the only nutrition needed for the first 12 months. Solids before 12 months are like dessert.
I even go a step further and say that babies don’t need solids until they can feed themselves solids.
If you think about it, there was a time before Gerber, and a time before high chairs and spoons. I think that when children are physiologically ready to digest solids they will be able pick them up and feed themselves. We allowed our kids to eat the same (healthy) foods that we ate. I practiced baby-led weaning with my second child. He started eating solids at 8 months of age when he started swiping them off my plate. There must be a biological component–able to feed self=able to digest food.
I just don’t like the idea of forcing a child to eat before they’re ready, or of feeding them processed, bottled foods.
And we always nurse before solids until baby is more than a year old.
I started offering my first child solids at around 6 1/2 months, but she was phenomenally uninterested. So I pulled back re-introduced them at around 8 months when she started showing real interest. I had particular concerns about her iron because she was a preterm infant. I would just like to add that if you are concerned you can ask your doctor for a blood test. In our case we offered an iron supplement, since my infant was something of a special case but she wasn’t interested in the food I offered.
I chose this route because I wanted to avoid starting food battles just as my baby was learning to eat. I think it’s good to be aware of what an infant’s nutritional requirements are. But parents are in a tough spot if a baby rejects solids and they’re told their child MUST eat them. I can’t imagine that force-feeding a 6-month-old establishes a good relationship with food, you know?
I also started offering my baby solids after 6 months and she wasn’t interested. I give them to her everyday but she barely ate 3 bites. This continued till 10 months, then she became very interested and would eat the whole portion. She never had any iron issues, my family was worried, they really wanted her to eat baby cereals, but it just felt like i was force feeding her. I asked her ped. about it and she did a little finger prick test for her iron levels and they were fine, she told me my baby would eat when she was ready and she was right.
oh and of course I forgot to add that I was breastfeeding exclusively!
We also practiced a baby-led weaning approach, and never did the traditional pureed baby food. My first was completely uninterested in solids until he was about 8 or 9 months old, so he only had breastmilk until then. My younger one was trying to grab food off my plate at 5 months, so she started much earlier. I’m a big believer in following a baby’s lead- I think they will let you know when they are ready.
I breastfed my son till he was 2 and a half and breastfed him exclusively till he was 1 years old before I introduced any type of solid foods/baby cereals to him and he was always the healthiest baby his Dr had seen. His Iron levels were always normal and he was a chubby healthy baby. But like Azucar said up top… Back in the day, they didn’t have baby food. Kids that live in the jungles, they don’t have baby food either and are breastfed for all of their infant life because that’s what it’s there for and breast milk provides what your baby needs.
With my 1st son, I started rice cereal at about 4 1/2 months, because I thought that’s what I was supposed to do. I tried the same with my 2nd son, and it went terrible! I didn’t want to force it, like I had with my 1st. He’s now over 6 mos. old and I am still not doing any solid foods. Not for any other reason other than it just doesn’t “feel right”! I’ve learned that nothing replaces a mother’s instinct. I’m sure in the next couple of months or so, I’ll know when its right and start it back up then.
We didn’t start solids until after 7.5 months with my first daughter, even though we were strongly bullied by our pediatrician to start sooner. Even once she started we went very slow and it went well. She turned out to have some food allergies, so I am glad that we went very slow. She never once had low iron levels. We now have a 6th month old and this time around we have a new pediatrician that is open to us starting solids when we feel ready.
My middle daughter (now almost 5) was my first breastfed baby. She had undiagnosed cerebral palsy and was physically incapable of eating food until well over a year of age – even though she appeared to be a “normal” little girl. Her CP affects mostly just her mouth and facial muscles so it was very difficult for her to eat anything without choking. She finally was able to handle food at around 14 months of age but still got the bulk of her nutrition from breastfeeding. She wasn’t fully on solids until she was 2 and self-weaned at 37 months, when her baby sister was born.
She never had anemia or other issues related to not having solids. She did have failure to thrive, but this was due to her CP. She was unable to form a complete seal while nursing – imagine trying to drink from a straw with your mouth open. But once we figured that out (around 7 months) she was able to gain weight.
The worst part of this ordeal was all the doctor referrals to dietitians. Every dietitian we saw told us that my milk was “too thin” and she needed formula. (Never mind that she aspirated anything from a bottle or cup – formula would have killed her!)
In our case, delaying solids saved my daughter’s life. If I had another baby like her, I would seek a diagnosis much sooner, but otherwise would do the same thing I did with her – give her the nutrition she needs in the way she could handle it.
I didn’t breastfeed any of my babies – a decision I haven’t regretted in anyway at all, my partner didn’t seem to understand my reasons but now he does – health issues. Anyhoo I would never condone anyone’s opinion or decision, each to their own. however my sister in law refused flat out to ween her now 2.5 yr old – she breastfed her daughter until she was 18mth old – the downfall was the following – the daughter was undernourished and her new teeth literally decayed before her 2nd birthday and now she is left with stumbs. when they brought her to the doctor – he explained that when breastfeeding your diet must be tip top and if not then you should be supplementing with other sustenance, also this little girl from the age of 1mth was constantly at the doctors with colds etc – her immune system was not supported, now I am sure that most women who breastfeed are taking care of this issue but if you are not then you should evaluate your diet before considering breastfeeding exclusively, it’s not fair to your child. I’m fairly confident that most women know this. It’s nice to see so many women promoting breastfeeding.
Hi Alexandra,
I am glad to hear you have been happy with your decision. I do feel the need to respond to some of the claims you make. It’s great that your sister-in-law nursed for 18 months, particularly if the nursling was having illnesses and could particularly benefit from the immune protection that breastfeeding provides. Imagine how sick she might have been had she not had the antibodies provided in mother’s milk! The World Health Organization recommends breastfeeding until at least 2 years of age. A breastfeeding mother’s diet does not have to be perfect — even a malnourished mother makes milk that is better for babies than formula. Mothers who breastfeed exclusively (no solid foods) beyond six months of age would be wise to monitor their babies’ health in conjunction with a doctor. Dental caries are a difficult issue. Breastfeeding exclusively does not cause decay — it’s actually the addition of solid food or formula that causes a problem. Some children are born with dental defects that make them more prone to decay as well. The answer is not weaning.
To ensure that your baby is eating often enough, you should wake him up if it has been four hours since the last time he has been fed. Getting comfortable Feedings can take 40 minutes or longer, therefore you’ll want a cozy spot. You don’t want to be sitting somewhere where you will be bothered, as it can make the process very hard
Hi all,
My son is just over 6 months and i followed all guidlines and started him on solids once he turned 6 months. I have breastfed him and will continue to do so, i introduced a bottle at 8 weeks so that he would get use to a bottle as well as breast and he took fine to it, he then had expressed milk in a botle once a day. I then started giving him formula (cow and gate) at night as i found it really tiring doing the night feeds. He took fine to formula as well. Since he was introduced to a bottle he slept through the night and goes 12 hours. My milk supply was just enough to provide 4 feeds a day so I then decided to give him 1 bottle a day before he went to bed. He has since had 5 feeds a day, 4 of breast and 1 bottle formula before bed.
Since 8 weeks he has had excema (sorry about spelling) and has been given creams for this, as it runs in the family i was very keen to breastfeed as i feel his skin would have been much worse if i hadn’t.
Since introducing solids i have only giving pureed fruit / veg however he is not liking savoury and will only have sweet veg at the moment. I have also found he has a dairy intolerance and everything that has either milk or cheese brings him up in a rash. I was advised by the healthvisitor to start him immediately on finger foods….he has only just started having a few teaspoons a day twice a day and to rush straight into finger foods i was a bit shocked, they tell you to delay weaning until 6 months and then say should you wait this long you should speed the process up!????
If he has something he doesn’t like or a tiny lump he gags and is nearly sick so surely he is not ready…….As recommended though i tried him this morning on half a banana and a small piece of bread with non dairy butter (he wasn’t having any of it and i felt like i was forcing him to have it)…..i am happy to go slowly and give him what he wants and stick to purees at the moment but i feel very presurised by family/friends and the health visitor.
Since seeing them i have realised that his excema only started since he was introduced to formula milk and this could be causing it…..i have now stopped giving a bottle and fully breastfeeding, we are seeing the doctor later to disucss dairy free diets for him but i just hope they don’t make us feel more pressurised that we already do.
I am really happy to hear that there are others who breastfeed long term and delay weaning until they are ready. Breastfeeding is hard enough as you are made to feel uncomfortable in many places…doing something very natural!
Will keep you posted
xxx
My son is exclusively breastfed, he is 8 months old and was diagnosed with FPIES (food protein induced enterocolitis syndrome). He has severe GI reactions to dairy, soy, bananas, apples, sweet potatoes and a possible wheat. His pediatric allergist recommended breastfeeding as long as I could, he wants me to start pears or peaches, but I might wait another couple months. He is a very healthy little guy and thrives on breastmilk. If he had formula, he would go into shock, there is only one formula I could give to him but there is no need, so for now I am doing things the way I feel God intended them to be. I may exclusively breastfeed for longer than a year, why not? His blood came back great!
My daughter, now 14 mo old, was exclusively breastfed until she was 10 mo old, she showed no interest in solids until then except sucking the juice out of some bites of fruits when I would eat them, like grapes and melon. Then at 10 months we started few spoonfuls of fresh fruits (easy to digest) and at 12 months started little bit of oatmeal, steamed mashed veggies, avocado, etc. I have a dairy intolerance so we wont do it for a long time. Even now at 14 months I would say she is still 75% breastfed, and shows no interest in slowing, which is fine with me, except it leaves me kind of drained alot of the time. She is 22lbs, perfect skin and can say or attempt already about 50 different words, so developmentally she is just fine despite the lack of solids (which the dr. hounds me about!). I know that the breastmilk has been so good for her!
My daughter is now 7.5 months old. We started her on homemade baby food shortly after her 6 month birthday because that is what I thought I was supposed to do. We gave her rice cereal, then added some avocado a week later, then some millet cereal a week after that. She was interested in eating, but we started noticing that she was having a very hard time pooping and would go 5 or more days between bowel movements (this from a child that would usually poop at least 2 times a day, sometimes 4!). And she was noticeably uncomfortable from not being able to go to the bathroom, plus she would have a lot of gas, which was also unusual for her. So even though we started out slow (only one feeding a day of solids), we backed down even more. We went to every other day, then every third, then every 5th. Now we have just stopped completely with the solid foods. It took about 2 weeks for her system to get back to normal, but now she is my usual chubby, healthy, happy, active baby who poops every day!
I feel that if her body is showing me that it is not ready for solids, then why push it! And I have since found articles and research that backs up that idea. So she is once again exclusively breastfed and I plan to do that until she is about a year old.
I breastfed my daughter exclusively for 11 months and she was very healthy. Actually her weight was off the charts! I chose not to start solids b/c of mine and my husbands history of allergies. I did research this out before I made the decision, and I read that some baby’s digestive systems are not even mature enough to break down the food to get alot of nutrition from it. I understand that every baby is different, but my daughter was fine and very healthy. Her doctor couldn’t believe that she was not eating solids:) I think every mother should do the research and make their decision from their own convictions and not what family or society is telling them.
My daughter is 8 months old and on three meals of solids a day. However I am having second thoughts because I feel that the solids have replaced alot of the breastmilk she drinks. My supply has dropped since starting solids and I really want her to get as much benefit from the breastmilk as possibly. Additionally, her weight gain has doubled. She has been in the 5th to 10th percentile gaining about a pound a month, but since starting solids ended up gaining 2 pounds in one month. Which is fine if that is what her body needs to do, but I worry that I’m just feeding her too much now! On the other hand if I reduce her solids I worry it will affect her growth and development. My plan is to skip breakfast and lunch (breastfeed more) and give her a dinner with protein and veggies in it every night. (I make homemade meat and veggie purees for her)
Any thoughts? I would love to hear someone else’s take on it as I get really anxious about it. I’ve worked hard at breastfeeding (low supply, latch problems, thyroid issues, etc.) and want her to have the most benefit possible.