DEAR DOCTOR, My one-and-a-half-year-old is still breastfeeding and I want to get her off but she has completely refused anything else. She barely eats and even though I pump sometimes, she refuses milk from the bottle. How do I go about this? Isn’t she too old to be breastfeeding? What can I introduce to her feeding that might ease the transition? BARBARA DEAR BARBARA, It is a good sign that you still have enough breast milk to feed your baby. As such, breast milk is the ideal food for a new-born till she sustains life and grows. It provides necessary calories and nutrients to a new-born, is safe and hygienic. Moreover, it provides antibodies to the baby for first six months of life, which protects against infectious diseases. It also helps in creating bond between the mother and baby. Hence, it is a good idea to breastfeed the baby as long as possible. World over, babies are breastfed till one to two years or even longer. However, there is a drawback to exclusively breastfeed for long as well. To begin with, it becomes exhausting for the mother. As babies grow some teeth by this time, suckling on the breast can cause cuts and bruises to the mother. Breast milk lacks in iron, therefore, exclusively breastfed babies tend to develop iron deficiency anaemia. A growing baby needs more calories, for which she needs some ‘adult’ food as well, i.e. some other foods apart from milk. Hence, it is important to wean the baby gradually from the breast. Initially, it should be on demand only, other times try feeding her with some top feed. Some babies are emotionally dependant on breast milk and refuse other feeds. Diverting her attention by someone playing with her at that time, would be useful. Some other family member, maybe the father or grandmother, may feed the baby some top feed. Seeing a familiar face, but not that of the mother, may make the baby accept the food offered. Some encouragement/reward on taking the food offered would also be useful. A baby can be offered solid top foods anytime from four to six months. Let it be one single item for two to three days, then introduce another item. The food offered should be in liquid or semi-liquid form which the baby can swallow easily. Start with a small quantity and then increase gradually. If the baby feels some discomfort or develops rashes after eating any kind of food, avoid repeating it. Avoid using hot spices, oil, white sugar and salt for first few months as they are not healthy and a baby’s still growing systems may not be able to eliminate it properly. Focus on nutritious healthy foods and avoid readymade junk foods. Fresh vegetables, fruits, eggs, lean meat, milk products like fresh yoghurt, and et cetera, are good in this regard. Dr. Rachna Pande is a specialist in internal medicine. rachna212002@yahoo.co.uk
