Weaning your
premature baby.
a simple guide
for parents
By Irish Premature Babies CHY19532
INDEX
This resource book is a guide only and not a substitute for tailored advice. Whilst every
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information and details on entitlements for families living in Ireland. It also has details
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Compiled by Allison Fegan Molloy, Founder & Chairperson.
Weaning Your Premature
Baby
What Is Weaning
Why Should I Wean My Baby
When Should I Start To Wean My
Premature Baby?
How Do I Know My Baby Is Ready To Wean?
Can Your Baby Hold Up Her Or His Head?
Is My Baby Ready To Spoon-Feed?
I Think My Baby Is Ready To Wean –
Where Do I Start?
My Baby Is Spitting Out Her Food –
Does That Mean She Doesn’t Like It?
What Foods Should I Offer My Baby?
What About Allergies?
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10
Next Steps
Moving On
Why Do I Need To Add Calories?
Do’s And Don’ts
Is My Nutrition Expert A Dietitian? Moving Away From Purees
Why Is It Important To Add Lumps?
Finger Foods
Do’s And Don’ts
How Much Should My Baby Be Eating?
How Much Food?
Family Meals
Helping My Baby To Drink
What Are Good Drinks To Give My Baby?
Making Your Own Baby Food
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Some Recipes To Try
Apple Puree
Salmon And Cod Chowder
Lentils and Vegetables
Chicken And Tomato With Pasta Shapes
Where Can I Get More Help?
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5
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Weaning Your Premature Baby
What is weaning?
foods as they get older. This helps them to have a balanced diet later on.
Weaning is when we start to give solid foods to babies. This doesn’t mean we jump
straight in with carrot sticks - it just means starting to add foods other than milk to
what your baby eats. Weaning is an important step for any baby (or parent). Adding
new foods to what your baby eats helps to add more nutrition to your baby’s diet as
well as helping your baby to develop the muscles he or she will need to speak and
to chew. As babies get older, breast and formula milk can no longer give your baby
everything that he or she needs. This is why it is so important to begin giving your
baby other nutritious foods.
There are lots of guidelines out there about weaning babies but most of them talk
about babies who were born full-term. Premature babies can be a little different when
it comes to weaning. However, most of the advice is the same. The main difference
between weaning a full-term baby and a premature baby is when to start.
Why should I wean my baby?
Weaning introduces your baby to new foods and starts them on the road to eating
family meals.
Weaning adds extra nutrition to your baby’s diet. When babies are small, breast or
formula milk will give them the nutrition that they need. As they get older they need
more nutrition and this comes from adding other foods.
Weaning helps your baby to start using their mouth and jaw muscles as well as their
tongue and lips. These movements help to develop the muscles your baby will use for
speech as they get older.
When should I start to wean my premature baby?
You may have heard your baby’s doctors and nurses speak about your baby’s
‘corrected age’ and ‘uncorrected’ age. Corrected age is your baby’s age from the date
your baby was due. Uncorrected age is your baby’s age from their actual birth date.
The advice for weaning premature babies is to wait until they are 5 to 8 months after
their actual birth date – their ‘uncorrected age’. Before 5 months, a premature baby’s
digestive system may not be able to handle foods other than breast or formula milk.
It is important to remember that you should always follow the advice of your doctor,
dietitian or nurse when it comes to feeding your baby. Premature babies have special
needs and not all babies will be ready for solid foods at the same time. This booklet is
aimed at premature babies who have no on-going problems with feeding or any other
health problems that might affect what they eat.
Adding lots of different tastes and textures helps your baby to eat a wider range of
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How do I know my baby is ready to wean?
Although some premature babies are ready to wean at five months, most premature
babies are a little older and closer to eight months before they start to wean. It is best
not to wait longer than nine months unless you have been advised by your doctor or
dietitian. After nine months babies may not be as open to trying new foods and it can
be a little more difficult to wean them.
Can your baby hold up her or his head?
Your baby should be able to hold up and support their head before you begin spoonfeeding. He or she should also be able to sit up with support.
Is my baby ready to spoon-feed?
Some signs to look out for are:
•
•
•
•
•
•
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Can your baby hold their head up in a stable position?
Can your baby sit up easily with some support?
Is your baby watching you eat and showing an interest in your food?
Is your baby putting things (e.g. toys) in their mouth? Can they bring their
hands to their mouth?
Are they making chewing or munching movements when they have something
in their mouths?
Is milk feeding – from the breast or the bottle - going well?
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I think my baby is ready to wean – where do I start?
From here, the guidelines for premature babies are similar to the guidelines for fullterm babies.
Start spoon feeding your baby when both of you are relaxed and comfortable.
Don’t wait until your baby is really hungry to start a spoon-feed. He or she will be too
angry and confused to begin. A good time to start a spoon-feed is about 30 minutes
before your baby is due a breast or bottle-feed.
Make sure your baby is in a good position to feed. They need to be well-supported in
an upright position. This can be in your arms to begin with and later they can move to
a highchair with a tray. It is important to keep your baby’s head in line with their body
when you are feeding them as this makes it easier for them to eat.
Start with one meal a day. This can be any time of the day but lunchtime is often the
easiest as they are often less hungry and tired than in the morning or evening. After
two weeks, you can move to two meals a day and gradually to three.
Start with a small amount of smooth, pureed food. This can be pureed fruits, vegetables
or meats or baby rice made with breast or formula milk. Keep the puree quite runny at the
start with no lumps. In the beginning, you are just helping your baby to get used to taking
food from a spoon. Don’t worry about how much they eat at the start – they will spit most
of it back at you to begin with! Be patient – and try not to get too upset about the hours
you spent pureeing vegetables only to have them left on your baby’s bib (or your clothes…).
Use a small, soft spoon. Only put a little puree on the spoon. Hold the spoon to your
baby’s lips and let them ‘suck’ the food from the spoon or tip it in very gently. Don’t
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load the spoon with food and then put it right into your baby’s mouth. This can be
very difficult for your baby to handle and they can get upset. The idea is to introduce
them to eating, not to stuff as much food into them as quickly as possible!
Most babies will only take 2-3 teaspoons at a first feed and then gradually get used to
more. Watch your baby: if they start to get upset or bothered, then stop the feed and
try again the next day. Remember, there is no race to get them eating. Take your time
and both of you will enjoy these first steps. If your baby is not progressing, do get help
from your doctor, dietitian or nurse.
As soon as your baby starts to reach out for the food, give them a spoon and let them
‘help’ with feeding. This helps them to learn the skill of feeding themselves.
As your baby gets older and better able to support themselves, you can start to use
a high chair with a tray or a seat that attaches to your table. It is very important that
your baby can easily reach and touch the food that is in front of them. We might not
like the mess but babies learn about food by touching it as well as eating it!
My baby is spitting out her food – does that mean she
doesn’t like it?
It is normal for babies to spit out a lot of what you offer them in the first few days. Often
they are just trying to learn how to move the new food around their mouths. It doesn’t
mean that they don’t like it – just that they are learning a new skill. It can take longer
for premature babies to get the hang of moving the food to the back of their mouths to
swallow it. However, if they don’t seem to be getting the hang of it after a few weeks, do
speak to your dietitian, nurse or doctor as they may need some extra help.
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What foods should I offer my baby?
What about allergies?
It is important that your baby still has breast or formula milk while you are weaning
them. This is where your baby will still be getting most of their nutrition. If you want
to add liquid to your baby’s food, it is best to use breast or formula milk instead of
water.
Food allergies are quite rare. You only need to think about allergies if there is a strong
history of severe allergy in your family. If you or your partner have a severe allergy,
do speak to your doctor, dietitian or nurse about any concerns you have. Premature
babies have no greater chance of having a food allergy than full term babies so there
is no need to introduce foods only 1 at a time and there is no need to have them
spaced out. Babies love mixtures of foods like stews and casseroles!
Do start with pureed fruits, vegetables and meats. These can be alone or in mixtures
– meat, chicken and fish are often much easier to make into a smooth puree when
mixed with other vegetables or fruit. There is no need to wait to start giving your baby
pureed meat, chicken or fish, they can digest these foods as easily as vegetables or
fruit.
Fruit and vegetables are high in vitamins but they are very low in energy (calories).
Your growing baby needs energy so it is great to add higher energy vegetables like
sweet potato and potato. You can also include pureed meat, chicken and fish. These
are perfectly safe to introduce from early on.
You can add calories to fruit purees by adding baby rice mixed with breast or formula
milk. Mashed ripe banana or avocado are great first foods for baby and are a little
higher in calories than other fruits.
Try to make your own baby food as often as you can. This way you can vary the tastes
and textures for your baby. You can make up baby food in batches and freeze it. If
you are using shop-bought foods, start with stage 1 meals.
There is no need to only add one food at a time. Babies love different flavours and
mixtures – just like adults.
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NEXT STEPS
MOVING ON
Do’s and Don’ts
After 1-2 weeks, when your baby is used to taking food from a spoon, you can start
to vary the foods, flavours and textures. This is a great way to help avoid fussy eating
later on! Remember, it can take up to 16 tries before a baby will accept a new food –
so don’t give up if they don’t like something straight away!
•
Never add solid foods to your baby’s bottle. Part of weaning is helping your
baby to learn feeding skills. If you add solids to their bottle then they are
just still sucking. Babies need to learn to move food around their mouth to
develop speech skills as well as eating ones!
Gradually add breakfast and then an evening meal (or and evening meal and then
breakfast). Once your baby is eating 3 meals a day (breakfast, lunch and dinner)
then you can start to add a dessert after their main meal. This can be some strewed
fruit mixed with custard, baby rice or fromage frais.
•
Give your baby home-cooked foods as much as possible. You can give them
more variety in taste and texture.
•
Do not give your baby honey before they are one year old as there is a small
risk of infection.
You can also start to add some more calories to your baby’s food by adding a little
oil, full-fat spread or butter to vegetable dishes. You can also add grated cheese to
vegetables dishes and fromage frais or Greek yoghurt makes a great addition to fruit
or vegetable purees.
•
Do not add salt or sugar to your baby’s food. Small babies cannot handle salt
and it can be harmful for their kidneys. Look for baby stock for stews and
soups or use herbs and spices (but not chilli!).
Why do I need to add calories?
•
Do add lots of flavours to baby’s food. Babies are more adventurous than you
might think. Add garlic, herbs, and spices but do avoid chilli until they are older.
•
Do go to see a qualified dietitian (a member of the INDI) if you want to give your baby
a vegetarian diet. Vegan diets are not recommended for babies and young children.
•
Do try to eat as a family as often as you can. Babies learn by watching
and it is great for them to see other people eating other foods. A baby will
often eat something from your plate that they have refused from their own!
Fruit and vegetable purees are very low in calories. They are a great first food for
babies but you do need to move on. As your baby moves away from milk and on
towards eating solid foods and family meals, they need to get their calories from their
food. This is why you need to add some butter, fromage frais, cheese or similar foods
to purees. Do also start adding meat, chicken and fish as well as beans and lentils.
These foods are all good sources of protein which your baby needs to grow and develop.
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Is my nutrition expert a dietitian?
When you are looking for nutrition advice for your baby, do make sure you see a
qualified dietitian. There are lots of different nutrition experts out there but only
dietitians have the specific training that you and your baby need. Anyone who is a
member of the Irish Nutrition and Dietetic Institute will be qualified to help you. Go to
www.indi.ie to find a dietitian near you.
problem with them coughing or gagging a little at the start. Just stay relaxed
yourself and calmly encourage the baby. Most babies are quite happy to keep
going even if your nerve is gone!
Don’t put off adding lumps. Many parents are very nervous at this stage but it is
so important for babies to progress with their food. If they do seem to be having
difficulty managing lumps, speak to your doctor, dietitian or nurse or just wait a
few days and try again.
Moving away from purees
Babies all progress at different rates, but you can usually start to add lumps 1-2
months after you start weaning.
It is important that all babies are offered food that is pureed but with soft lumps
by nine months at the latest. Try ripe mashed banana that is not completely
pureed. You can add cooked lentils or well-cooked minced meat to your baby’s
normal puree.
In the early days, do avoid food that is liquid with hard lumps (like cereals with
milk or purees with whole peas) as babies can find it difficult to handle a runny
texture and a hard one at the same time. Once babies are able to manage soft
lumps, they can move on to foods these types of foods.
Your baby may cough or gag a little when they first try the soft lumps. This is
normal as they are learning to manage the new food and coughing or heaving
is how they bring back the food to chew or spit it. Choking is when they cannot
get any air in or out. As long as they can clear the food and breathe, there is no
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Why is it important to add lumps?
Once babies can manage purees, they can safely move to soft lumps and eventually
to more textured foods. Adding lumps continues to help develop the muscles that
your baby will use to speak later on. It also helps your baby on their journey to eating
normal, family meals. If you wait too long to introduce lumps, it can be harder for
babies to move away from smooth purees.
Finger Foods
Babies love getting their hands on food! You will have seen how they love stuffing
everything into their mouths and their delight when they can actually eat it is
lovely to see. You will know when your baby is ready to try finger foods when they
are able to hold small toys and bring them to their mouths. They may just chew
and spit the foods at the start, but that’s ok as they are just learning a new skill.
Finger foods also help baby to develop their chewing and speaking muscles and
adding them at this stage helps to give babies more variety in what they eat and
can help avoid fussy eating later on.
Do’s and Don’ts
•
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•
Do start with foods that go to mush rather than break into hard lumps. So
slices of cheese, sticks of banana, cooked carrot and buttered toast
fingers and well-cooked pasta shapes are good to begin with. Be careful
with foods like apple sticks that can break off into hard lumps.
•
Never give your baby whole nuts. Children under five should never have
whole nuts or large pieces of nut as there is a risk of choking. Ground
nuts (like ground almond) and smooth nut butters (like peanut butter) are
fine to use.
How much should my baby be eating?
At the start, most babies will only take about 2-3 teaspoons of food. As they get
used to the spoon, they will start to take more. There are no set rules about how
much your baby should eat – just go at his or her own pace. As a rough guide,
they should be managing about 3-4 dessertspoons of puree after 3-4 weeks. The
best guide really is your baby. If they are happy to keep eating, then keep going.
When babies have had enough food, they usually lose interest and start to turn
their face away, push away the spoon or just spit it all back out. You will not miss
the signals! Babies progress at different rates, and premature babies can take
a little longer than other babies. If you are concerned speak to your dietitian or
nurse.
Never leave your baby alone when they are eating.
Make sure your baby is well supported in their seat so that they are
upright and in a good position to cough if they need to.
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How much food?
Helping My Baby to Drink
If you make your own baby food, freeze it in ice-cube trays (silicone trays are best for this). Try just
one ‘ice cube’ of food at the start and as your baby begins to finish this, add another and another.
Eventually you can move up to the silicone muffin trays which are a great size for most babies and
hold about 3-4 dessertspoons of food.
It is important to start giving your baby drinks from a cup with no lid soon after you
start to wean her or him. Let your baby get used to taking some spoon-feeds, and
once they seem comfortable with this, you can offer them a small amount of breast
or formula milk or cooled, boiled water in a cup with no lid. This may sound like a
recipe for a big mess – and it can be – but just offer a couple of teaspoons of liquid,
and hold the cup to their mouth. The idea here is to help your baby to form a ‘lip seal’.
Being able to seal their lips around a cup is an important part of their development
and most babies figure out how to do it quite quickly. You may notice that if you let
your baby play with a bowl or cup that she will often lift it to her mouth and make a lip
seal all on her own. You are not trying to give her a big drink, just to start getting her
used to drinking from a cup. Your baby will still be getting her main drinks from the
breast or bottle at this stage.
Family Meals
The whole aim of weaning is to get your baby eating family meals. Most full-term babies
should be eating family meals, well-cut up, by the time they are a year old. It can take
a little longer for a premature baby to get to this stage – but many do! As babies get
used to more textures and finger foods you can keep adding new foods. Try meals like
shepherds lie, Bolognese with pasta shapes, mashed potato with chicken casserole or
whatever your family is having as long as it is cut into pieces that your baby can manage.
What are good drinks to give my baby?
Do try not to use too many packaged foods and processed meats (like ham and bacon)
as these can have a lot of salt. It is best to continue to cook your baby’s food without salt.
Do keep giving your baby a good variety of foods so that they get the full range of
nutrients.
Breast or formula milks should be the main drink for your baby until they are at least
one year old. If your baby is having problems with eating or staying at a healthy
weight, do speak to your doctor, dietitian or nurse about staying on breast or formula
milk after one year. Many women enjoy breastfeeding beyond one year, and as long
as both baby and mother are enjoying breastfeeding, then this is encouraged.
As a rough guide, your baby’s meals should be:
1/3 protein foods like meat, chicken, fish, eggs or beans
1/3 starchy foods like potatoes, pasta, rice or bread
1/3 vegetables
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Cooled, boiled water is a suitable drink for babies but it should not replace the breast
or bottle milk that your baby needs.
Baby juices can have a lot of sugar and be quite acidic so they are not recommended.
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If you do decide to give your baby fruit juice, make sure it is well diluted with water
(5 parts water to 1 part juice) and only give it with meals, not in-between. Water and
breast or formula milk are the best drinks for babies.
Making your own baby food
Making your own baby food is one of the loveliest things you can do for yourself and
your baby. And it is a lot easier than you might think! Even if you have no idea about
cooking, you can still make baby food. The recipes below are really very simple and
straightforward so they are worth a try. They are also a lot cheaper than bought baby
food so you can save some money as well. Even if you just manage to do it once a
week, you will get great satisfaction out of feeding your baby something homemade.
Making your own baby food means that:
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•
You can give your baby a much wider range of tastes. You can play around
with herbs, spices and different fruits, vegetables, meats and fish. This will
help your baby to get used to different flavours from a young age and may
help to prevent fussy eating as children get older.
•
You can change the texture of your baby food more gradually for babies.
Many of the bought baby foods have big jumps in textures that can be a little
harder for babies to manage.
•
You can have more control over what goes into your baby’s food and you can
have some fun trying new recipes to see what you and your baby like.
•
Just remember, that you are not a terrible parent if you buy ready-made baby
food – having a small baby is very time consuming and the lack of sleep can
mean even simple tasks are twice as difficult. Premature babies often have a
lot of extra issues, so if you are not up to cooking meals from scratch, don’t
let this be another source of stress for you and your baby.
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Some recipes to try
Apple Puree
Fruit and vegetable purees are all made in the same way, so once you have made this
one, you can make any other variety! You do need a hand blender or food processor
and silicone ice cube trays make life a lot easier when you are trying to get the puree
back out of the tray. If you have space in your freezer, you can also cook large batches
of purees at one time. This will save you having to cook more than once or twice a
week.
You need:
Basic Fruit puree:
Basic Vegetable Puree:
•
•
4 eating apples (or pears)
2 tablespoons of water
Peel the apples and core them. Make sure you remove all of the pips and any tough
fibres. Slice the apples roughly and put into a saucepan. Add the water and turn on to
a medium heat. Stir the apples in the water to coat them. This will help to stop them
turning brown. You don’t need to add any sugar. Put the lid on and cook for about 20
minutes, until the apple is soft. You will need to stir them occasionally so that they
don’t stick to the pot. Once they have cooked, let them cool and use a hand blender,
liquidiser or food processor to puree them. Pop them into ice cube trays (silicone trays
are the easiest type to get the purees back out of!), cover with cling film and freeze.
You can mix fruit purees with custard or baby rice for extra calories.
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2 carrots (or 1 turnip or 1 sweet potato or 1 butter nut squash or 4 white turnips….)
Enough water to barely cover the carrots
Top & tail the carrots and peel them. Slice them and place them in a small saucepan. Add just
enough water to barely cover the carrots. Bring to the boil, turn down the heat and cook for 20
minutes, until the carrots are tender. Drain off the water and puree as for the apple puree.
Other purees to try:
•Turnip
• Sweet potato
• Apple and Carrot
•
•
•
Apple and turnip or sweet potato
Carrot and turnip
Butternut squash
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Salmon and Cod Chowder
This is one of the best ways to start your baby eating fish – and babies love this recipe. Fish is
so important for eye and brain development – especially oil-rich fish like salmon. This recipe
looks fiddly but is really very easy – and it makes a fabulous chunky soup for adults if you add
a vegetable stock cube (don’t add stock cubes for babies as they have too much salt).
This recipe includes cows milk so it is not suitable for babies who are younger than 6
months. You do also need to be very careful with fish bones. This is why you cook the
fish separately and then add to the vegetables near the end.
Meanwhile, carefully check the raw fish for bones – a tweezers is very useful to help
you pull out any tiny bones. Pop the fish in a saucepan and add the milk. Cook the
fish over a medium heat for 20 minutes. Be careful as the fish does like to sick to the
bottom of the pot, so don’t let the heat get too high.
Once the fish is cooked, drain off the milk, but don’t throw it away as you will be adding it to
the vegetables! Fork through the fish to see if there are any bones you might have missed,
then add it to the vegetables along with the milk you cooked the fish in. You can now blend
everything. In the early days, you will need to make this quite a fine blend, so you may need to
add more milk or water. Older babies love the rougher texture and will even like it just mashed.
You need:
•
•
•
•
•
•
•
•
•
•
1 tablespoon of olive oil
1 oz/30g of butter
1 onion, roughly chopped
1 fist-sized potato, peeled and sliced
1 carrot, peeled and sliced
2 sticks of celery, washed and sliced
1 leek (optional), sliced.
150mls milk
200g cod or other white fish (this can be fresh or frozen)
200g salmon (fresh or frozen)
Melt the butter and oil together over a medium heat. Add the vegetables and let them
sweat over a low heat for about 20 minutes. Then barely cover the vegetables with
water or baby vegetable stock (normal stock has too much salt for small babies to
handle). Bring to the boil and then simmer for 10 minutes.
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Lentils and Vegetables
Lentils are a great source of protein and iron. They are also rich in fibre, in case you
run into problems with constipation.
You need:
•
•
•
•
•
•
•
•
1 onion, chopped.
1 carrot, chopped
1 stick of celery, chopped
50g of red lentils
50g cheddar cheese, grated
1 small clove of garlic,
crushed or finely chopped
(optional)
1 teaspoon mixed herbs
1 tablespoon olive oil
Heat the olive oil in a saucepan. Add the chopped onion, carrot and celery and
stir them in the oil. Put the lid on a cook over a medium to low heat for about 5
minutes. Then stir in the lentils, garlic and herbs. Barely cover with water. Bring
it to the boil, then lower the heat and cook over a low heat for about 20 minutes.
When it is cooked, add the grated cheese and then blend. If you need a thinner
puree, you can add more water. You can also give this to older babies without
blending it as long as they can manage soft lumps and all of the vegetables are
well-cooked.
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Chicken and tomato with pasta shapes
This is a delicious tomato sauce and very easy to make. You may find you are eating it
yourself…
You need:
•
•
•
•
•
•
•
1 onion, chopped
1 carrot, chopped
1 clove of garlic, crushed or finely chopped
1 400g tin of chopped tomatoes
2 breasts of chicken, cut into chunks.
1 teaspoon of dried basil or mixed herbs or about 5 leaves of fresh basil
1 tablespoon olive oil
Heat the oil in the saucepan and add the onion, carrot and garlic. Put the lid on, turn
down the heat to medium-low and cook t for 10 minutes, stirring occasionally. Then
add the chopped chicken and stir it into the onion and carrots. Cook the chicken for
ten minutes until it is all white. The add the tin of tomatoes and the basil or mixed
herbs. Bring to the boil, then turn down the heat and simmer for 20 minutes until the
chicken is well cooked and the carrots are tender. Puree with a blender and serve
alone or with well-cooked pasta shapes for older babies.
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Irish Premature Babies working
together with parents for parents.
Where can I get more help?
Irish Premature Babies
www.irishprematurebabies.com
Bliss
UK charity with advice and information on premature babies
www.bliss.org.uk
The Irish Multiple Birth Association
Looks after the needs of parents with multiples in Ireland.
www.imba.ie
The Irish multiple birth association is an organisation that looks after the needs of
Early Feeding Clinic
Expert advice on nutrition for babies and children from qualified dietitians
www.earlyfeedingclinic.ie
Irish Nutrition and Dietetic Institute
Find a qualified dietitian in your area
www.indi.ie
These guidelines were produced with the help of Sarah Keogh, Dietitian at the
Early Feeding Clinic, Albany Clinic, Lower Fitzwilliam Street, Dublin 2.
Tel: 01 6612222
Email: [email protected]
www.earlyfeedingclinic.ie
Contact details in Irish Premature Babies
Tel: 01-8880882
Email: [email protected]
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