Weaning is when your baby is introduced to solid foods alongside their usual milk feeds.
When should I start weaning?
Babies usually start weaning around 6 months of age. Solid foods provide extra energy and it is usual to introduce solids when babies are about six months of age. In some cases, your dietitian may encourage it after four months. Babies should not be weaned before four months of age as their gut will not be mature enough.
The following are good signs of when your baby is ready to start eating food:
- can sit up with some or no support
- able hold their head in a steady position
- can coordinate their eyes, hands and mouth so they can look at their food, pick it up and put it in their mouth
Each baby has different experiences and weaning needs. If your baby has kidneys that are not working well, they may find it difficult to start eating solid food. Kidney disease can affect the type of foods that are suitable or how interested your baby is in taking solids.
Changing the amount or types of certain weaning foods can be part of the treatment to keep your child’s blood levels safe and protect their kidneys. Your baby’s dietitian will give specific advice about this if it is needed.
Tips for starting weaning
Start with smooth pureed food.
Your baby may not swallow the food at first. New experiences of taste and a variety of flavours and textures are just as important as quantity. Don’t worry if your baby does not eat much at first, just work on their acceptance of different tastes.
Let your baby be independent, get messy and really enjoy the feeding experience, regardless of how much actually reaches their stomach.
Encourage progress with lumpy textures if you can. It is important that your baby develops chewing skills at this stage as this will help them to develop tongue and jaw movement and clear speech. All babies gag on lumps from time to time but this is not a sign that your baby is trying to be sick. Try again, perhaps just giving the lumpier texture for a few mouthfuls. Try the same approach with finger foods.
Cooking fresh food
Try to cook as much food from scratch as you can. Ultra processed or ready prepared food can contain salt, as well as, potassium and phosphate additives, which are not recommended for children with a kidney condition.
Most baby jars and pouches do not usually contain salt or additives. Check the label and avoid those with long lists of ingredients that you don't recognise.
If you need to avoid any specific foods, your dietitian will tell you and will help find you alternatives.
A small number of babies need extra salt. The doctor will prescribe them a salt supplement.
General weaning advice
- Include your baby at family mealtimes
- Eat with others and include other children where possible e.g. siblings, friends
- Keep mealtimes relaxed and fun and limit to no more than 30 minutes
- Always stay with your child when they are eating
- Avoid adding salt to homecooked foods and use low salt versions of ready prepared foods that you buy such as reduced salt baked beans and low salt stock cubes
- Avoid honey for children under 1 year of age, as it can make them unwell
- Encourage older babies to feed themselves while you watch them
- Contact your dietitian or doctor if you think your child has a food allergy.
Possible problems that you may observe when weaning a baby with chronic kidney disease:
- less interest in eating
- sickness or gagging
- may not eat enough to gain weight and grow
Your baby may have had early experiences that can impact on weaning. For example:
- if they repeatedly vomit
- take medicines that do not taste pleasant
- stressful family meal times
It can be tricky weaning a baby with a kidney condition and it may take longer to establish a regular eating pattern. Some babies do not eat very much until they receive a new kidney (transplant). This can be worrying for parents but is very common for babies with kidney disease. Your baby’s dietitian will make sure that their milk feed contains everything they need.
When a baby gets a new kidney, it can improve their appetite and desire for food. They will gradually start to eat a wider variety of foods again and get into a regular pattern of eating.
Gagging and vomiting
A gag reflex protects your baby from swallowing or choking on things. Everyone starts with a strong gag reflex, and this lessens as they get older and practice eating. A gag can often result in a vomit if your baby has recently had milk.
Some babies and children have a very sensitive gag reflex that lasts much longer than others. Reducing a gag reflex takes time. It is crucial that you keep giving your child opportunities to practice eating.
There are other reasons that baby’s vomit, such as if they have very high urea levels. Your kidney team will monitor and try to resolve any other causes.
What can I do to help?
One of the most important parts of weaning is that your baby enjoys the process of mealtimes. Licking, smelling or playing with the food is a great first step, and will set them up for when they are ready to eat. They will have already learnt that eating is fun family time.
- Give your child lots of opportunities to touch, smell, lick and taste different foods
- Give some control over to your baby. Give the spoon to your baby and be prepared for a mess! This could help reduce gagging.
- Offer food first and schedule milk feeds after mealtimes
- Use teethers and chew toys to help desensitize the mouth. Brushing teeth can also help
- Constipation can sometimes make vomiting worse. Talk to your doctor if this is a problem
- Keep your baby upright for a short time after feeding or eating
Progressing through textures
Weaning often starts with purees, moving on to more lumpy textures over time. More recently, baby led weaning has become popular. This type of weaning involves giving your baby only finger foods and letting them feed themselves rather than giving them purees.
There is no right or wrong way. But, if your baby has a strong gag reflex, starting out with smooth puree foods might be better tolerated.
Tips
- Make batches of pureed food. You can freeze food into ice cube trays, pop them out of the trays and store them in labelled freezer bags which can then be defrosted when you want to use them
- Boiling, steaming and roasting are all suitable ways to cook vegetables. Your dietitian may suggest a different way to cook vegetables if your baby’s potassium is high
- Good foods to start with include baby rice, cauliflower, carrot, broccoli, pumpkin, butternut squash, swede
- If your child is on a fluid restriction, try removing the excess liquid from the recipes or use a minimal amount
- There are lots of great weaning recipe books and free NHS resources. Suggested websites are at the bottom of the page
Monitoring growth
Your dietitian will check that your child is getting enough milk and solids to meet their needs.
The kidney team will weigh your child and measure your child’s height. They will plot these on a growth chart to keep track.
Poor weight gain and growth
If your baby or child’s weight gain is slow, your dietitian may adjust their milk to make it higher in energy. They may also suggest ways to increase the energy in the weaning food.
Increasing calories in weaning foods
- Add margarine, unsalted butter or olive oil to cooking
- Add olive oil to pasta
- Add cream to cooking and desserts
- Add crème fraiche, cream cheese and cream to cooking
- Use full fat products e.g. yoghurts, rice pudding, custard, mayonnaise, milk, margarines
- Add smooth nut butter or cream cheese to toast, crackers or bread
- Try hummus or avocado as a dip with breadsticks
More information
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