#asktheexpert how many feeds for a 5 months old and can I start solids … my 5 month old baby Refuses direct feed

Question

Accepted Answer

At 5 months old, most babies are still primarily breastfed or formula-fed, but some signs may indicate they are ready to start solids. Here's some guidance on feeding frequency and starting solids:

### 1. **Feeding Frequency for a 5-Month-Old Baby**

For a 5-month-old, feeding is still mostly breast milk or formula. The frequency can vary depending on whether the baby is breastfed or formula-fed:

- **Breastfed Babies**: Typically, breastfed babies will feed about every 3 to 4 hours, or around 5-7 times per day. However, some breastfed babies might feed more frequently, especially if they are going through a growth spurt.
- **Formula-Fed Babies**: Formula-fed babies usually feed every 4 hours, or about 4-5 times a day. Each feed might consist of about 6-8 ounces (180-240 ml) of formula, depending on the baby's appetite and weight.

### 2. **Can I Start Solids at 5 Months?**

The World Health Organization (WHO) and most pediatricians recommend exclusive breastfeeding or formula feeding until around 6 months of age. However, some babies may show signs of readiness for solids around 5 months.

**Signs Your Baby Might Be Ready for Solids:**
- **Good Head and Neck Control**: Your baby can sit upright with minimal support and hold their head steady.
- **Interest in Food**: Your baby shows curiosity about food, such as watching you eat, reaching for food, or opening their mouth when food approaches.
- **Loss of Tongue-Thrust Reflex**: Your baby no longer pushes food out of their mouth automatically with their tongue.
- **Doubling Birth Weight**: Many babies are ready to start solids when they have doubled their birth weight, often around 4-6 months.

If your baby shows these signs and your pediatrician agrees, you might start introducing solid foods.

**First Foods to Introduce:**
- **Single-Grain Iron-Fortified Cereal**: Start with rice or oatmeal cereal mixed with breast milk or formula.
- **Pureed Vegetables and Fruits**: Begin with simple purees like carrots, sweet potatoes, peas, apples, or pears.
- **Pureed Meats**: Pureed chicken or turkey can be introduced if your baby is ready.

### 3. **Tips for Introducing Solids:**

- **Start Slow**: Begin with 1-2 teaspoons of a single food once a day, and gradually increase the amount as your baby gets used to eating.
- **Wait Between New Foods**: Wait 3-5 days before introducing another new food to monitor for any allergic reactions or sensitivities.
- **Continue Breastfeeding or Formula Feeding**: Solids should complement, not replace, breast milk or formula at this age. Keep offering breast milk or formula as the primary source of nutrition.

### 4. **Refusal of Direct Breastfeeding**

If your baby is refusing direct breastfeeding, here are some possible reasons and tips to manage it:

- **Nipple Confusion**: If your baby has been bottle-fed, they might prefer the faster flow and different sucking technique required for a bottle.
- **Teething or Discomfort**: Babies sometimes refuse to nurse if they are teething or experiencing some other discomfort.
- **Milk Supply or Flow Issues**: If the milk flow is too slow or too fast, babies may refuse the breast.

**What You Can Do:**
- **Offer Breast When Baby is Calm**: Try breastfeeding when your baby is calm, such as right after waking up or when they are drowsy.
- **Experiment with Different Positions**: Sometimes changing the breastfeeding position can help.
- **Pump and Bottle Feed**: If your baby continues to refuse the breast, you can pump breast milk and feed it via a bottle to ensure they are getting enough nutrition.

### Conclusion

At 5 months, your baby should still primarily be receiving nutrition from breast milk or formula, with about 5-7 feeds per day. If your baby shows readiness for solids, you can start introducing them, but always consult your pediatrician before starting solids. If your baby refuses to breastfeed directly, consider alternative methods and check for any underlying issues that might be causing the refusal.