Breastmilk alone is best for the first six months – here's what to do next

July 13, 2018 by Clare Collins And Jenna Hollis, The Conversation
Breastfeeding provides babies with the nutrients they need in their first months of life. Credit:

The Trump administration angered health experts around the world this week with its attempt to weaken a UN resolution encouraging breastfeeding.

Thankfully the US bid to promote the use of formula was unsuccessful and has prompted discussions about the importance of exclusively (if possible) for the baby's first six months of life, before solids are introduced.

It can be difficult to find reliable information online on timing and how to introduce foods – and how to balance that with breastfeeding. Here's what the recommendations say, and the science behind them.

Current infant feeding recommendations

Australian guidelines recommend exclusive breastfeeding for the first six months of a baby's life. But our 2017 study of new mothers found many were unsure what exclusive breastfeeding meant.

The World Health Organisation defines exclusive breastfeeding as feeding only breastmilk and no other food or drinks, not even water. The definition does allow inclusion of oral rehydration solutions, or drops or syrups for vitamins, minerals, and medicines given by a doctor.

Preterm or underweight babies may need extra nutritious fluids, which are administered in consultation between the parents and treating doctors.

Some mothers may not be able to breastfeed. Others may choose to move on from breastfeeding. If a baby isn't breastfed, or is partially breastfed, commercial infant formula should be the only other food given until six months.

Breast (or infant formula) feeding is recommended alongside solids until the baby is 12 months and, for breastfeeding, for as long as the mother and infant want to keep going.

Introducing solid foods

Parents can start introducing solids from around six months of age. At this age, the baby's iron stores obtained from his or her mother will have started to deplete. Pureed meat or legumes and iron-fortified rice cereal, are good sources of iron and are perfect first foods.

Next, parents can introduce a variety of vegetables, fruit, and other foods from the five food groups:

New foods should be added one at a time. Gradually increase the texture from pureed initially at six months, then to lumpy, and to family food textures at 12 months of age.

Take care to still avoid hard foods that don't break up easily to prevent choking, such as nuts and small, hard pieces of vegetables and fruit.

Cow's milk products can be introduced, including full-fat yoghurt and cheese, but cow's milk shouldn't be given as the main drink until after 12 months.

Five food groups: vegetables, fruit, grains, dairy, and meat/meat alternatives. Credit:

Boiled then cooled tap water can be given from six months and tap water should continue to be boiled first until 12 months.

By 12 months, babies can be offered a variety of nutritious foods that are enjoyed by the rest of the family, except for choking hazards such as nuts.

Why does timing matter?

Breastfeeding has many benefits for the mother and baby. It protects babies against infection, obesity, and chronic diseases such as type 2 diabetes later in life.

Breastmilk has all the energy and nutrients babies need in the first months of life. Even when exclusive breastfeeding doesn't work out as planned, every extra day a baby receives any breastmilk is beneficial. Breastmilk contains antibodies and helps to mature the infant's gut.

At six months, babies also need solid foods to help meet their energy needs for growth and development, and specific nutrient requirements. Iron deficiency anaemia is common in infants, mainly due to a low intake of iron-rich foods after six months of age.

By six months, babies usually show signs they're ready for food. These include sitting up, controlling their head, eyeing your food when you eat, and reaching out for food.

In our 2016 study of mothers and their children, we found babies introduced to solid foods at six months were less likely to experience feeding difficulties than babies who were given solids between four and six months of age.

Top tips for nutrition in the first year

1) Seek advice on breastfeeding when you need it. Talk to a lactation consultant, breastfeeding counsellor, or community health nurse. They help parents and caregivers work out the best approach to infant feeding and support mothers to reach their breastfeeding goals.

2) If at first you don't succeed, try, try again. Don't worry if your baby refuses new foods, that's normal. Babies need to be offered new foods many, many times before they learn to like them.

Fussiness can cause meal-time struggles for parents, but repeated tasting in a positive environment and role modelling can help learn to accept unfamiliar but , such as vegetables.

It's also important to respond to your baby's cues to know how much food to give them. Forcing them to "clean the plate" can erode their ability to follow their appetite and hunger cues.

3) Focus on developing healthy eating habits as a family. Mothers and fathers who have healthy eating habits are more likely to have children with .

Food flavours may be passed through breastmilk. This means if women who are breastfeeding eat a variety of healthy foods they could be helping their baby accept new flavours when they transition to solid foods and in later life.

Explore further: Giving your baby solid food early won't help them sleep better

Related Stories

Giving your baby solid food early won't help them sleep better

July 10, 2018
New research claims that giving babies solid foods at just three months old will help them sleep. Though this may sound appealing to exhausted new parents, unfortunately there is a large gulf between the headlines and the ...

Study finds that babies introduced to solids early slept longer and woke less frequently

July 9, 2018
A study by King's College London and St George's University of London has found that babies introduced to solid foods early, slept longer, woke less frequently at night and suffered fewer serious sleep problems, than those ...

Research finds babies that feed themselves have no increased risk of choking

December 7, 2017
New research from Swansea University shows that letting babies feed themselves solid foods from as young as six months does not increase the risk of them choking compared to spoon-feeding them.

Here comes the aeroplane—free videos guide first steps in feeding infants

March 10, 2016
What and when to feed a baby can be stressful for parents and carers, with lots of confusing and conflicting information about. Help is at hand from LEAPS (Learning, Eating, Active, Play, Sleep), a free program led by QUT ...

When is the right time to start infants on solid foods?

January 4, 2018
The first study of a nationally-representative group of U.S. infants reports that more than half of babies are currently introduced to complementary foods, that is, foods or drinks other than breast milk or formula, sooner ...

Four in 10 babies given solid foods too early, study finds

March 25, 2013
(HealthDay)—Child development experts advise parents not to introduce solid foods, such as baby cereal, into an infant's diet until the infant is at least 4 to 6 months old. However, new research suggests that about 40 ...

Recommended for you

Exposure to farmyard bugs reduces immune overreaction found in childhood asthma

September 24, 2018
Treating new born mice with farmyard microbes reduces wheezing and inflammation in the airways, by 'taming' their immune systems.

Stepfathers' 'Cinderella effect' challenged by new study

September 24, 2018
Long-held assumptions that stepfathers are far more likely to be responsible for child deaths than genetic parents have been challenged by researchers at the University of East Anglia (UEA).

Fatty acids can slow down an overheated immune system

September 21, 2018
Sometimes, the immune system mistakenly attacks the body's healthy tissue by responding to infections that do not exist. This causes chronic inflammation and leads to diseases including lupus (SLE), and this is what happens ...

Study shows surprise low-level ozone impact on asthma patients

September 21, 2018
A new study led by UNC School of Medicine researchers indicates that ozone has a greater impact on asthma patients than previously thought. The study, published in the Journal of Allergy and Clinical Immunology, recruited ...

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...

Fish-rich diets may boost babies' brain development

September 20, 2018
Women could enhance the development of their unborn child's eyesight and brain function by regularly eating fatty fish during pregnancy. This is the suggestion from a small-scale study led by Kirsi Laitinen of the University ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.