Weaning and enzymes

What is weaning?

Weaning describes the process of moving from a milk-based diet to solid food.

The British Dietetic Association and the Department of Health state that weaning should start by or at 26 weeks. Weaning should not take place before 17 weeks. There is no evidence to show that infants with cystic fibrosis (CF) need to wean any earlier than infants without CF.

Key facts about weaning

• Before the age of one, breast or formula milk provides the majority of the nutrition for your baby. Infants with CF tend to not “drop” milk feeds until late into their first year.
• By 26 weeks, milk (formula or breastmilk) alone will not provide enough of some key nutrients such as iron and calcium. The weaning diet can supplement this.
• Before 26 weeks, only fruit, vegetable and baby rice should be offered.
• After 26 weeks, no foods need to be avoided, with the exception of honey until the age of 1 and whole nuts until 5 years old. Nut flours and butter are allowed.
• The aim of weaning is to progress through the textures so, by the age of 1, the baby can eat family food.

Practical weaning tips

• Babies love to touch, feel, smell, lick and taste the new food so it will be messy. Encourage this as it helps the baby to get used to eating. Use a big plastic sheet on the floor and a large bib.
• Offer food with a big smile and a reassuring face. Eat at the same time as the baby so that they can copy you.
• New food normally needs to be given a few times before being accepted.
• Watch for the baby’s cues. If they turn their head or push the spoon away they are saying “no thanks”. Respect this and do not force feed or coerce.
• Babies are very good at knowing how much they want to eat. If they finish the bowl and want more then you can offer more.
• A free-flowing beaker with water can be offered at meals from 26 weeks. This water does not need to be sterilised.

Weaning a baby that takes pancreatic enzymes can be a daunting experience. Many parents feel concerned that they cannot estimate the fat in food given or how much their baby may eat. Start with a small amount of Creon Micro and build the amounts as required, just as we did when the baby was born.

• Fruit and vegetable puree has no fat. No enzymes are needed.
• With all other foods (such as baby rice and milk, vegetables with a splash of milk or butter) give ½ scoop of Creon Micro.
• As the baby increases their volumes of food increase the enzymes ½ scoop at a time.
• The quantities a baby eats at each meal will vary. If you are unsure how much your baby will eat, divide the enzyme dose and give ½ of the total dose at the start and the remainder partway through.
• Monitor your baby’s poos. It is normal that they will change with weaning. Look for fat in the poo as this is a sign that the enzymes need to increase.

Estimating fat content of food

• If using food with labels on (for example little yoghurts or custard, baby jars or pouches) give 1 scoop of Creon Micro for every 2.5 g of fat.
• For food without labels, some families find using a fat estimation app useful. The Carbs and Cals app for smartphones is very useful. It allows you to select a picture of the meal to estimate fat content. It is helpful when eating out or having takeaways.

As an approximate guide:

Up to 2.5g of fat = 1 scoop of Creon Micro

2.6 to 5g of fat = 2 scoops of Creon Micro

5.1 to 7.5g of fat = 3 scoops of Creon Micro

7.6g to 10g of fat = 4 scoops of Creon Micro