Promoting Healthy Growth and Development

It's important not only for you to give your baby nutritious foods and drinks but also for you and your baby to interact with each other during mealtimes. These things help your baby's mind and body grow. Breast milk (with supplements) and formula give babies all the calories and nutrients they need until they are 6 months old. After that, babies need other nutrients and energy from solid foods. You can wean gradually or abruptly in order to get your baby what he or she needs for growth. When you make choices about weaning, always think of your baby's emotional needs, age, and readiness as well as your own needs.

The weaning process

The American Academy of Pediatrics recommends that babies be breast-fed for at least a year and as long after a year as mother and child desire.¹

• If you are not breast-feeding and your baby is younger than 12 months of age, use iron-fortified formula. Do not offer your baby cow's milk.¹ The iron in cow's milk is not well-absorbed, and iron is necessary for healthy development. Also, some babies may be more likely to react to the protein in cow's milk.
• Most children need whole milk when they are 1 to 2 years of age. But your doctor may recommend 2% milk if your child is overweight or if there is a family history of obesity, high blood pressure, or heart disease.
• Switching from breast milk to formula may cause differences in how often your baby feeds and a change in the color and consistency of your baby's stools.

When you have decided that you and your child are ready to give up breast- or bottle-feeding, develop a plan for what you will do. Talk with other family members and get their help.

In general, you can start giving your baby solid foods at 4 to 6 months of age. Feed your baby at the table with the rest of the family. Follow your doctor's advice on when and what to feed your baby. ¹ Usually, the more solid foods a baby eats, the less breast milk or formula he or she needs, and the easier it is for your baby to switch from the breast or bottle. Be sure your child gets the recommended vitamin and minerals for children.

Weaning from breast- or bottle-feeding can be done gradually or abruptly. Watch for signs that your baby is ready to wean. To gradually stop breast- or bottle-feeding while you offer cup-feeding and/or solid foods, give up the least important feeding first, which is usually the midday one. Then stop the late afternoon and morning feedings. Stop the most important feeding (the one that provides the baby the greatest emotional comfort) last: this is usually the first or last feeding of the day. Whether you are weaning or not, the last feeding should gradually be moved up so that by 4 months it is no longer at bedtime and other soothing rituals can be established. Pay attention to whether your baby is sucking for comfort or hunger. If your baby uses a pacifier, think about replacing it with a blanket or a stuffed toy for comfort.

Tips for using a cup

Getting your baby to use a cup may not be easy. These tips may make it easier:

• Show your baby different types of cups and let him or her choose.
• Try to use cups with a spout, two handles, and a rounded, weighted bottom. If your baby accidentally bumps the cup, it will stay upright and less liquid will be spilled.
• If the cup does not have a lid and spout, put only about one sip of liquid at a time in the cup, in case your baby tips the cup over.
• Do not be upset if your baby just wants to play with the cup at first.

Gradual weaning

A gradual weaning slowly reduces the number of breast- or bottle-feedings. One feeding is eliminated every 5 to 7 days, giving the mother and baby time to adjust. Gradual weaning helps maintain emotional attachment, prevents breast engorgement for mothers who are breast-feeding, and allows the baby to learn other ways of eating. Gradual weaning is generally planned to suit both the mother's and child's needs.

Gradual weaning is best for both you and your baby. It is recommended for babies unless the mother has a medical condition that does not allow it.

Abrupt weaning

Abrupt weaning is a sudden end to breast- or bottle-feeding and can be hard for both the mother and the child. The breast-feeding mother may experience painful breast engorgement and has an increased risk for a breast infection (mastitis). Both the mother and the child may miss the emotional attachment and closeness of breast- or bottle-feeding.

Your child may respond to abrupt weaning by:

• Refusing to drink from a cup for a period of time. Prolonged refusal to drink from a cup can lead to dehydration and nutritional deficiencies.
• Sucking his or her thumb.

Times you may not want to wean

You may not want to wean your baby:

• When a child is learning new skills. Learning new skills, such as crawling or walking, can be stressful for your child, and the breast or bottle may provide comfort and security.
• When there is stress in the home. A new tooth, an illness, a new day care center, or the caregiver starting back to work can all be stressful. Weaning at this time, or during any difficult time, results in more stress and more difficulty weaning.
• During unusually warm weather. During weaning, babies sometimes refuse any liquid other than breast milk or formula for 24 to 48 hours. So weaning your baby when it's very hot outdoors can put your baby at risk for dehydration.

Weaning a toddler

Gradual or abrupt weaning may work for 1- to 2-year-olds.

• A toddler who breast- or bottle-feeds 3 or more times a day may do better with gradual weaning.
• A toddler who breast- or bottle-feeds 2 times a day or less may do well with abrupt weaning.

You may find the following suggestions helpful as you switch to other types of feeding:

• Tips for weaning a toddler from breast-feeding include distraction, postponing feedings, and not offering feedings.
• Tips for weaning a toddler from bottle-feeding may help you find ways to limit or replace drinking from a bottle.
• Abrupt weaning for toddlers may help you wean a child who nurses 2 times a day or less.

As your baby learns to feed himself or herself, keep in mind that your job is to provide a variety of nutritious foods but your baby will decide how much to eat. This is sometimes called the division of responsibility.