Starting Solids
Most babies will start solids by six months when they are showing signs of readiness. Solids are given to supplement milk intake and shouldn’t reduce the amount of milk taken. Breastmilk or formula is still the most important source of protein and energy at this stage.
From nine months you can start to give solids first, then breast milk/formula. This allows for the natural transition from breast milk/formula to solids as the main source of nutrition intake by 12 months.
Starting a baby with CF on solids is the same as for any other baby, except for the addition of enzymes (if required).
Stage 1: Early introduction to food (4-6 months)
- Identify your baby’s readiness for solids: Interest in watching others eat, reaches for your food, mouthing objects.
- Is your baby physically ready for solids: Can they sit independently, hold their head upright, able to swallow food, coordinating hands, eyes and mouth?
- Make it play-based: Allow your baby to play with and discover foods. This stage is all about first-tastes, so focus more on enjoying this time of discovery with your baby rather than the end goal of eating (that’s what milk is still for).
- Exploratory: Allow your baby to explore textures and foods with their hands. Most won’t go in their mouth! And that’s okay. This can be a messy time, however hands on fun fuels development.
- Create a positive experience: This is the start of your child’s relationship with food and creates the foundations for a life with food.
- Milk is still number 1: Solids are just a supplement to your baby’s milk feeds; so always give milk first. Food in stage 1 is seen as the tool to introduce your baby to new textures, tastes and sensory experiences related to eating and food.
- Introducing allergenic foods: This should start at around 6 months of age. They should be introduced one at a time so you can monitor for any allergic reactions.
Be aware that your baby’s poo will change colour and texture as new foods are introduced. It is normal for babies to gag frequently as they learn how to eat solid foods. Some babies can gag on purpose when they don’t want to eat something, which can last into their toddler years. It is recommended to speak to a health care professional if your baby gags, coughs or splutters regularly when being fed.
Stage 2: More textures & tastes (7-9 months)
- Milk is still the most important – Food is still seen as exploratory and an addition to the nutrition provided by the regular milk feeds. Introducing thicker/lumpier foods and flavour combos as your child tolerates.
- Self-feeding vs assisted feeding – Finger foods give your child independence and more sensory experience. Offering your child their own spoon to hold also develops fine motor skills and a sense of independence. Messy play is multi-sensory and super important for your little one.
- New foods – Introduce new tastes and textures as much as possible and start to blend flavours. It’s good to begin to identify what foods your baby is very happy eating as these can be used as “safe foods” when introducing other new foods throughout this journey.
- Hunger and fullness cues – learn your child’s cues, especially fullness cues, such as crying, turning away, keeping mouth shut, shaking head, spitting out. It’s good to teach a sign for “all done” so you and your child can communicate with a hand signal. This assures your child that they have some say and can be understood.
Stage 3: 10+ months
- Starting to introduce balanced meals – Transition away from milk. Start to introduce firmer, crunchier foods as well as the softer foods already offered. Varied meals now become the main nourishment for your child by around 12mths+.
- By 10 months you can feed your baby three meals a day plus two to three snacks. Your baby can have high energy and protein rich foods and will still require about three to five milk feeds a day.
Enzymes
If your baby is pancreatic insufficient, they will require enzymes (Creon) with any food containing fat, carbohydrate or protein, just like they have with formula/breastmilk. The only foods that can be digested without enzymes are fruits and most vegetables, all other foods (meat, fish, egg, nut paste, dairy, tofu and avocado) will need enzymes.
It is best to give the enzymes at the start of the meal to ensure the fats are digested and absorbed effectively. Remember, enzymes are only effective for about 30 minutes.
To work out how many scoops of Creon to give your baby, the amount of fat in the food needs to be calculated. One scoop of Creon covers, on average, four grams of fat. There are some excellent apps for fat counting, such as ‘My Fitness Pal’. You can also talk to your dietitian about reading nutrition labels to measure the fat content in food products or meals. They will go over examples with you to ensure you are confident in matching the Creon to your baby’s food intake.
High Calorie Food
Some infants with CF may need extra help to gain weight and grow well. Choosing foods naturally high in protein and healthy fats will assist with your child’s growth and development. Read more about high energy diet for infants here.
Useful Resources
- Introducing Solids for Infants with CF (QLD Health)
- Baby’s First Foods Brochure (QLD Health)
- Starting Solids– Raising Children Network