Weaning at 4 months - puree or baby led

[Cherry85]

Hi we are weaning at 4 months ON THE ADVICE OF HEALTH VISITOR due to reflux and colic.

Due to baby being younger do we need to stick to purees or can we still do baby led?

Purees I imagine because baby has to be able to hold their head up. And sit up unaided

Surely the same health visitor should have given you advice for this?

Out of curiosity, as both mine had bad reflux, is there a reason you haven’t been prescribed omeprazole by the GP?

This. Feed her with whatever the health visitor said.

If your HV has genuinely recommended this, she will also, of course, have given you advice on the best way forward.

At 4 months i’d say 100% puree and stick to fruits / veg only not meat. But yes. Your HV should have given advice. My eldest is 32 and I weaned him at 11wks! It seems crazy now (older two big age gap were closer to 6 months) but at the time it was 3 months and HV said it was fine as he was a very hungry baby. He is actually the better eater of all 3, no allergies etc. Obviously advice has changed and i’d follow that and of course specific advice based on your own babies health issues. Good luck.

I weaned my two at 4 months due to potential risk of allergies as they had CMPA / it seemed like a good idea to start earlier with no pressure. I very much started with homemade purees (it seems like a pain but you do loads in one go and you just freeze them in ice cubes - otherwise you're stuck with the pouches which are really only fruit) and then added baby led weaning in as a mix between 6 and 9 months. I found that whole foods are great in the 9-12 month age but in the early stages are a bit useless as they don't actually consume anything meaningful (friends who only did baby led weaning seemed to have babies that barely ate at 1 whereas my kids were scoffing down loads of food). Doing a mixture of both worked well for me as purees introduced different tastes / got them used to swallowing food and then baby led weaning taught them textures and meant i didn't have to feed them everything as they got older. Before 6 months i also stuck to fruits and vegs instead of including meat.

One of mine also had internal reflux - i would be surprised if early weaning made much difference to that. We had omeprazole and that did work.

Also, what people don't tell you about weaning is that its not a couple of weeks of introducing them to food and then they get it - its roughly a 6 month+ journey as they learn the various skillsets associated with more and more complex foods.

Purees only to begin with, veg, fruit, porridge at first, meat from 5 months. Finger foods need to wait until sitting up unsupported.

Purees. Baby-led weaning is 6 months plus.

Did your HV not tell you this?

I weaned at 5 months with the advice of medical professionals and they gave me all the relevant information and support. We also had multiple lengthy meetings to monitor as we progressed. The fact you're on MN asking such a key question is quite odd, surely this was the first thing they discussed with you?

I'm worried that you need to ask. Please see another health visitor or GP for second opinion.

Maybe because studies show it's no more effective than placebo in infants under 1 years old and has its own risks associated so starting solids is a far safer and effective method to treat reflux at 4 months old.

Purée then start baby led at 6m
try to do different flavours though. So a carrot purée or a broccoli one rather than several mixed together. This will get your baby use to individual flavours so solids will be less of a shock

People always say things like this. When my dd, now 30, was a baby, the NHS guidelines were not before 4 months and preferably 6. There were still individual HCPs who promoted early weaning (there probably still are!) -but it definitely wasn’t considered best practice at the time.

Thanks everyone. HV is coming back on 10th to weigh and start weaning process. All she had said last time was we would go early and start with baby rice- so yes expect she will give more info at next visit but I was just trying to get ahead making purees if needed as will be half term when we start.

@Iocanepowder he is on omeprazole but a very hungry boy and was back up to 3 bottles a night having been down to one.

All she had said last time was we would go early and start with baby rice

I wouldn't listen to anything she has to say about weaning if she's suggesting you use baby rice.

It has almost zero nutritional value, and i'm shocked anyone is recommending it, let alone a health visitor.

For most babies, I agree with you about baby rice, but weaning for reflux can be a bit different. It was discussed for DD2 (but ultimately decided against), and the goal wasn't really new tastes or nutrition yet – it was to get a bit of thickener down baby to help keep her milk down.

Fruit and veg purées don't really achieve this, whereas a porridge-type thing will keep absorbing liquid after baby has eaten it. A lot of the baby porridges have cows' milk added, which they didn't want her having at 4 months (even though she didn't have CMPA), and some have various other bits added as well. They favoured baby rice because it's just rice (possibly plus vitamins) and perfectly smooth for so young a baby. I asked about blending down porridge oats to make smooth porridge, which was approved, but I don't think anyone wanted to suggest something that would make extra work for a mum of a reflux baby!

Weaning at 4 months for reflux is very different to weaning at 6 months. Fruits and veg purees will make the reflux a lot worse.

Stick to baby porridge and oats.