Weaning is the process in which children begin to eat solid foods and transition away from feedings from a bottle or a mother’s breast. This process typically begins when an infant is between four months and one year old and is an important developmental milestone.

There is no standard age at which a child should be weaned. Instead, parents or caregivers can use their best judgment to determine when to make this transition. Weaning can be done all at once, or gradually. Weaning a child before the age of two may make the transition to solid foods easier than if weaning is attempted later in a child’s life. Children who are age two or older are more likely to feel an attachment to the breast or bottle, and are more likely to be upset at the thought of giving it up.

Children may display several signs that they are ready to be weaned. For example, the extrusion reflex – which causes children to instinctively push objects out of their mouths – may disappear. Other signs that a child is ready for weaning include intense interest at the sight of regular foods and high levels of distractibility during breastfeeding.

Before feedings, children should be safely strapped into a highchair that has a stable base so that it will not tip over. Parents who introduce solid foods to their child’s diet can use either commercially prepared baby foods, or create their own foods. Parents are urged to consult with a pediatrician about which foods to introduce first.

Creating the right atmosphere can play a large role in the success of weaning. Potential distractions should be eliminated. Parents are urged to remain patient, as it usually takes longer for a child to finish a meal of solid foods than to finish a meal of breast milk or formula. Some children will adapt to eating solid food with enthusiasm, while others will be harder to win over. Over time, all children become comfortable with the texture and consistency of solid foods.

Weaning is the process of transitioning a child from a diet of breast milk or formula to solid foods. There is no standard age at which a child should be weaned. Instead, parents or caregivers can use their best judgment to determine when to make this transition. Factors such as the health and emotional readiness of the child help parents decide when the time is right to wean.

Organizations such as the American Academy of Pediatrics (AAP) recommend that parents feed their child a diet exclusively of breast milk for the first six months of life, and breastfeeding may be continued for at least one year or for as long as desired. For women who are unable to breastfeed or are uncomfortable with the practice, infants can also receive all of their nutritional requirements from fortified infant formula. After six months of age, solid foods may be added to the diet until the child is a year old. These may include enriched cereals, fruits, vegetables and meats. Following a child’s first birthday, parents are urged to begin the weaning process because breast milk does not provide all the nutrients children over the age of 1 need to grow and remain healthy.

Weaning can be done all at once, or gradually. For instance, some working mothers may choose to have their child consume solid foods during the day, followed by breast milk at night. Parents using formula can employ the same strategy. In addition, some children may be more receptive to weaning than others. Though some children are willing to breastfeed indefinitely, others may become irritable or indifferent to their mother’s breast, or may nurse for shorter periods of time.

Weaning a child before the age of two may make the transition to solid foods easier than if weaning is attempted later in a child’s life. Children who are two years or older are more likely to feel an attachment to the breast, and are more likely to be upset at the thought of giving it up.

Children who breastfeed may be easier to wean if they have consumed breast milk from a bottle prior to weaning. Although drinking from an artificial nipple can negatively affect a newborn’s ability to learn how to breastfeed because of the different sucking motions required, this does not affect children after the newborn period. To promote weaning, mothers who breastfeed can give their child expressed breast milk in a bottle beginning at four months to seven months of age. This can be done even if the mother is planning to continue breastfeeding. If parents intend to start weaning at an earlier age, bottle feedings should also be attempted earlier in a child’s life.

Some parents or caregivers may wonder how long it is acceptable to continue to breastfeed. There is no standard answer to this question. Many experts suggest that children continue to nurse through toddler and even preschool years.

Children may display several signs that they are ready to be weaned. For example, the extrusion (or “tongue-thrust”) reflex may disappear. This reflex causes children to instinctively push objects out of their mouths and to only be able to swallow liquids. As long as this instinct is intact, children are likely to gag when solid food is presented and probably are not ready for weaning.

Sometime between the ages of four months and six months, babies develop the type of coordination that allows them to move food from the front of their mouths to the back, where it can be swallowed. Around this time, they are also able to sit up and hold their heads up before a parent attempts a feeding with solid foods.

There are many different ways to wean a child successfully. In most cases, it is better to make a gradual transition to weaning in which a diet of solid foods is integrated with continued feedings of breast milk or formula. Not only does this help ease the transition for the child, but it also reduces the risk that a breastfeeding mother’s breasts will become engorged, a painful condition that can lead to a breast infection. By gradually reducing the number of feedings, the mother’s body is given the time needed to slow down milk production.

Many parents begin to wean their child by dropping one breastfeeding or formula-based feeding session per week and replacing it with solid foods. A midday feeding is often the best time to introduce solid foods because it tends to be the smallest feeding. In other cases, parents leave it up to the child to determine when they should breastfeed. In this example, the mother only breastfeeds when specifically asked to do so by the child.  

In succeeding weeks, additional sessions of breastfeeding or bottle feeding can be dropped until the child is consuming solid foods all the time. The last breastfeeding sessions to be dropped are often the morning and bedtime sessions, as these usually involve comfort and emotional attachment and may be the most difficult to quit for mother and child.

Before feedings, children should be safely strapped into a highchair that has a stable base so that it will not tip over. Highchairs should not be placed next to a counter or other stationary object that the baby can push off against and tip the highchair over.

Parents who introduce solid foods to their child’s diet can use either commercially prepared baby foods, or create their own foods by making cereals or pureeing vegetables. Parents should dish out a certain amount of food onto a plate before serving it to their child. Feeding children directly from the jar risks contamination of the food due to bacteria and saliva on the spoon.

Solid foods should never be given in a bottle. Swallowing solid foods requires different reflexes than swallowing breast milk or formula, and there is a danger that a baby who is swallowing the liquid portion of the bottle’s contents will gag on clumps of solid food.

In addition, weaning may be easier if a child drinks breast milk or formula from a cup rather than from a bottle whenever possible between the ages of four months and seven months. This will eliminate the need to wean the child from the bottle later on. Most children should be weaned from bottles soon after they turn one year old, as the transition is easier at this age than it will be later. Replacing the bottle with another comforting object – such as a blanket or favorite toy – can help.

Parents are urged to consult with a pediatrician about which foods to introduce first. One good choice may be a single teaspoon of a single-grain, iron-fortified baby cereal such as rice, which is unlikely to provoke an allergic reaction. This should be mixed with four to five teaspoons of warm water, formula or breast milk. As a child becomes used to eating solid foods, less water can be added to the mixture.

Some children will adapt to eating cereal with enthusiasm, while others will be harder to win over. Some children will refuse to eat the cereal at all. In such cases, it may be a good idea to wait and try again in another month or so. It is natural for children to initially spit out foods or otherwise react negatively during the transition to eating solid foods. Over time, children become comfortable with the texture and consistency of these foods.

One or two teaspoons of rice cereal is a good choice of solid food for babies who are between four months and eight months old, followed by introduction of strained fruits and vegetables. Babies who are six months to nine months old may graduate to soft foods and finger foods that dissolve easily, including mashed bananas and potatoes, applesauce, cottage cheese, graham crackers and ground meat or poultry. Babies this age can typically eat between 3 and 4 tablespoons of these foods two to three times a day. They can also eat bite-sized pieces of foods such as graham crackers.

Utensils can be introduced to a child’s feeding regimen sometime between six months and nine months of age. Parents may want to begin this process by having a child hold a spoon while the parent feeds the child with a second spoon. Eventually, the child will grasp the purpose of the spoon and the parent can dip the spoon in food and attempt to have the child self-feed.

Between nine months and 12 months of age, children may be able to eat bite-sized portions of finger foods and table foods. These include apples that are peeled and cut into eighths, soft cheese, thoroughly-cooked noodles (including spaghetti with meat sauce) and tender meats (e.g., tuna, chicken, turkey).

Foods that may cause illness or intolerances (e.g., honey, certain home-canned vegetables, cow’s milk) should be avoided in children under the age of one.

Other foods to avoid are those that pose a choking hazard to young children. Foods that should be avoided until a child turns three years old include:

• Small, slippery foods (e.g., hard candy, whole grapes, hot dogs)
• Dry foods that are difficult to chew (e.g., popcorn, raw carrots, nuts)
• Sticky or tough foods (e.g., peanut butter, large pieces of meat)

Creating the right atmosphere can play a large role in the success of weaning. Potential distractions should be eliminated. Parents or caregivers are urged to remain patient, as it usually takes longer for a child to finish a meal of solid foods than to finish a meal of breast milk or formula. Children are likely to play with solid foods, which is normal and should not be discouraged.

Weaning is often a period of emotional adjustment for parents and children, particularly when a child has been breastfed. Children who struggle to make the emotional transition from breastfeeding to solid foods may benefit by participating in a fun activity during times when they would normally breastfeed. In addition, they may adjust better if weaning is attempted at a point when they have no significant outside stresses in their lives, such as starting at a new childcare facility.

Children who are adjusting to weaning sometimes begin to suck their thumb or to engage in a similar habit. Such habits are comforting to the child and should not be discouraged during this time of transition.

Mothers who breastfeed may also find weaning to be a time of transition, particularly in terms of emotion. Mothers are urged to think about the positive aspects of weaning a breastfed child – not only does it signal a major milestone in the baby’s maturation process, but it can also give the mother increased freedom and flexibility.

Preparing questions in advance can help patients and parents have more meaningful discussions with their physicians regarding their or their child’s development. The following questions related to weaning may be helpful:

1. How will I know when my child is ready to wean?
   
   
2. How can I make this transition easier for me and my child?
   
   
3. What are the pros and cons of quitting breastfeeding or bottle feeding “cold turkey”?
   
   
4. How long should I wait to wean if my child was born prematurely or if our family has a history of food allergies?
   
   
5. Which solid food should I use at the start of weaning?
   
   
6. What are the pros and cons of preparing my own solid foods for my child?
   
   
7. What should I do if my child refuses to eat solid foods?
   
   
8. If my child refuses to wean, how long should I wait before trying again?
   
   
9. How long should I continue to occasionally breastfeed or bottle feed my child?
   
   
10. What should I do if my breasts become sore during the transition from breastfeeding?