What advice should be given to the mother of a 6-month-old breastfed infant regarding self-feeding?

Self-Feeding Guidance for a Breastfed 6-Month-Old Infant

The nurse practitioner should advise the mother that at 6 months of age, her breastfed infant is developmentally ready to begin self-feeding with appropriate complementary foods while continuing breastfeeding. 1, 2

Timing and Readiness for Self-Feeding

• The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months, followed by the introduction of complementary foods while continuing breastfeeding 1, 3
• At 6 months, infants typically show developmental readiness signs for self-feeding:
  • Ability to sit with support
  • Good head control
  • Interest in food (watching others eat, reaching for food)
  • Ability to bring objects to their mouth
  • Beginning to develop pincer grasp

Appropriate Foods for Self-Feeding at 6 Months

• Start with iron-rich foods as first complementary foods 2:

  • Finely ground meats, chicken, or fish
  • Iron-fortified infant cereals
  • Well-cooked, mashed beans or lentils

• Progress to include a variety of foods:

  • Soft fruits and vegetables cut into appropriate sizes
  • Soft, well-cooked vegetables
  • Avoid foods that pose choking hazards (whole grapes, nuts, popcorn, raw vegetables)

• Food preparation for self-feeding:

  • Cut food into finger-sized pieces that baby can grasp
  • Ensure food is soft enough to mash with gums
  • Avoid added salt, sugar, or honey (honey should be avoided until after 12 months due to botulism risk)

Self-Feeding Approach and Practices

• Allow the infant to self-regulate intake 2:

  • Respect signs of hunger and fullness
  • Never force-feed
  • Let the baby explore food at their own pace

• Create a positive feeding environment:

  • Use a high chair with proper support
  • Establish regular meal times
  • Join the baby during meals to model eating behaviors
  • Be patient with messiness - it's part of learning

• Continue breastfeeding as the primary source of nutrition while gradually increasing complementary foods 1, 2

Safety Considerations

• Always supervise the infant during meals
• Avoid foods that pose choking hazards
• Introduce potential allergenic foods one at a time, with several days between new foods to monitor for reactions 1
• For infants at high risk of peanut allergy (severe eczema or egg allergy), consult with healthcare provider before introducing peanut products 1

Practical Tips for the Mother

• Start with one meal per day and gradually increase
• Begin with small amounts (1-2 tablespoons) and increase based on the infant's interest
• Offer a variety of flavors and textures to develop diverse taste preferences
• Use appropriate infant feeding equipment (silicone-tipped spoons, suction bowls)
• Be prepared for messiness as the infant learns to self-feed

Continuing Breastfeeding

• Emphasize that breastfeeding remains the primary source of nutrition during the initial introduction of complementary foods 1, 3
• Breastfeed before offering solid foods in the beginning stages
• As the infant consumes more solids, the pattern may shift to offering solids first, then breastfeeding

By following these guidelines, the mother can support her infant's developmental progression to self-feeding while maintaining the nutritional and immunological benefits of continued breastfeeding.