Feeding FAQ: 6-9 months – Weaning/Solids

My daughter, now aged 7.5 months, started to sleep through the night after the 10pm feed when she was four months old. Following the health visitor’s advice, I started to wean her when she was five months old, and everything continued to go well with her sleeping and feeding until a month ago when she caught a really bad cold. Although she has now recovered from her cold, she is refusing most of her solids, and is waking several times in the night, often taking up to two hours to settle. My lack of sleep over the last few weeks has meant that my milk supply has decreased dramatically. I have resorted to introducing more formula milk, in the hopes that it would help her sleep longer at night, but it has not really altered anything. Her daytime sleep is never more than 3 hours in total, between 7am and 7pm, so I am convinced that it is the lack of solids that is causing her to wake so much in the night. How do I get her back to eating the right balance of solids and milk during the day, so that she sleeps well at night?

She is currently having short breast feeds at 8am, 9.30am, 11.15am, 12.15pm, 3pm and 5pm, with an 8oz bottle of formula at 6.30pm and 10.30pm. I offer her solids at 8.15am, 11.30am and 6.15pm, but she rarely takes more than 3 or 4 teaspoonfuls. During the night she is having at least one quick breast feed and sometimes two.

The problem that you have encountered with your baby refusing solids after an illness is a fairly common one, and be reassured that it can take a few weeks before a baby fully regains her appetite. When a young baby is ill it is often necessary to reintroduce night feeds, and also extra daytime feeds if they are refusing solids during the day. However, once the baby is over the illness, it is important to look at the overall milk intake during the 24 hour period if she continues to refuse solids.

A baby of your daughter’s age, who is established on three solid meals a day, should really only need three to four milk feeds. At present your daughter is having between five to eight breast feeds and two full formula feeds. Although she is only having short breast feeds, a baby of her age can easily take a full feed in ten minutes, so it is likely that she is taking a lot more milk than you realise. Breast milk is digested differently to formula milk, and as your daughter’s tummy has previously only been used to breast milk, the introduction of two formula feeds in such a short space of time will also have had an impact on your baby’s appetite for solids. In order to increase the amount of solids that she is taking and achieve the correct balance of milk and solids, you need to reduce the number of milk feeds that she is currently having.

Until she is taking more solids during the day, it is likely that your daughter is genuinely hungry when she wakes in the night, and so it is important that you feed her when she wakes, to avoid her being awake and unsettled for lengthy periods at night. But you must count any milk she has in the night as part of her daily intake, and consequently reducing the amount she takes during the day. We would suggest that, for now, you concentrate on trying to establish two meals a day, ideally these two meals should be lunch and tea. At your daughter’s age, protein is very important for healthy growth, which is why we suggest establishing lunch and tea first as opposed to breakfast and tea (as lunch is the meal when she will be getting her greatest quantity of protein). We would advise that you give her a breast feed first thing in the morning, but cut out the 9.30am and 11.15am breast feeds. You may well have to bring the time of her lunch forward to 10am, but that doesn’t matter at this stage, as the aim is simply to get her to eat a reasonable amount that includes some protein. To ensure that she sleeps well at lunchtime we would advise that you continue to offer her a breast feed at 12.15pm, but you should eliminate the 3pm breast feed, and instead offer her a drink of well-diluted juice or cool boiled water from a cup. She should then be offered her tea at 5pm – or earlier if she is hungry, followed by a breast feed after the bath. As you will have dropped three of her daytime feeds, you should have plenty of milk in your breasts to give her a good feed and ensure she settles at 7pm. However, if she is unsettled then you should top her up with some expressed milk or formula to ensure she settles. By eliminating three of the daytime breast feeds you should start to see an improvement fairly quickly in the amount of solids that your daughter is eating, which should in turn help to reduce the number of times she wakes in the night.

As your daughter is waking in the night despite being fed at 10pm, it may be worth dropping the 10pm feed and simply giving her a formula feed when she next wakes. If you decide to do this, it is important that you give her a full feed when she wakes, so that you know she has had enough milk to get her through to the morning without being fed a second time. The aim is to get her to feed only once during the twelve-hour night, and sleeping soundly until 7am from whatever time she has fed. Once she has done several nights where she has fed once and settled back to sleep until 7am, you can then gradually start to dilute the middle of the night feed, every two or three nights. It is important not to rush this process, as you do not want her waking up twice in the night. As she starts to reduce the amount she takes in the night, you should then start to see a further increase in the amount of solids that she is taking during the day.

Once your daughter is taking only one small, diluted feed between 7pm and 7am, and eating a reasonable amount of solids at lunch and teatime, you can then reintroduce some breakfast. Start by giving her a little yoghurt and some fruit. Gradually increase the amount of solids she is having at breakfast and push the time of her lunch to nearer 11.30/12 noon. Provided she continues to eat well at lunch and tea you can look to replace the yoghurt at breakfast with a small amount of breakfast cereal or porridge. When you reach a stage where she is taking three good solids meals a day, as well as a full milk feed morning and evening, and is taking only a small amount of diluted milk in the night, you can then reintroduce her mid-afternoon milk feed. If she continues to wake in the night for the small, diluted milk feed, it will probably now be more from habit than hunger and we would advise that you start to try to settle her back to sleep with some cool boiled water.

We would also suggest that you keep a detailed feeding and sleeping diary for a week or two, so that if things do not improve you have the information available to show your health visitor or GP.