Marie Beam and Heidy Guzmán co-Chairs, Concept Review Committee, LLLI Board of Directors

The Concept Review Committee was created this year to take a fresh look at the La Leche League concepts. The committee is composed of 19 Leaders from around the world, working to review each of the ten concepts of LLL philosophy and accompanying Concept Explanations in Appendix 17 of the LLLI Policies and Standing Rules to ensure that they are consistent with the most current research available and serving the LLL mission. At the conclusion of its review, the committee makes recommendations to the LLLI Board of Directors.

The Board voted unanimously September 25, 2019, to revise the wording of the  “Introducing Solids” Concept and Concept Explanation, changing it to the “Introducing Complementary Foods” Concept below. This was the second of two votes required to change the wording of a concept; a first vote had approved this wording July 24, and Leader comments were requested and considered.

For the healthy, full-term baby, human milk is the only food necessary until the baby shows signs of readiness for complementary foods, about the middle of the first year after birth.  (Sep 19)

For the full-term, healthy baby, human milk alone provides optimal nutrition for growth and development until about the middle of the first year.  Research has shown that exclusive breastfeeding for six months fortifies the baby’s immune system against infection.⁽¹⁾ Every baby is unique, and so when  deciding whether to introduce other foods and/or drink, it is important to focus on awareness of the baby’s specific nutritional needs and signs of readiness, rather than upon the baby’s age or outside factors.

Physiological and behavioral signs of readiness for other foods and drink generally include, but are not limited to, the following changes in the baby:

• ability to sit up unsupported, facilitating eating and swallowing
• loss of the tongue-thrust reflex and emergence of chewing patterns
• hand-to-mouth coordination, bringing food to the mouth in conjunction with
• anticipatory opening of the mouth
• increase in the desire to nurse that does not subside after several days of intensive nursing.

A breastfed baby is accustomed to being in charge of how much to eat and recognizing the body’s signals for hunger and satiety.⁽²⁾ By encouraging the baby to be actively involved in self-feeding and paying attention to signs that the baby has had enough, parents can help ensure continued self-regulation of food intake. If all other signs of developmental readiness are present but a baby exhibits gastrointestinal symptoms following the introduction of complementary foods, this may indicate that the baby is not quite ready to advance from exclusive breastfeeding, or may need a greater portion of human milk in the diet. The World Health Organization recommends continued breastfeeding as part of a mixed diet until two years of age or beyond.⁽³⁾

(1) “Exclusive breastfeeding for six months best for babies everywhere,” World Health Organization statement, 15 January 2011.

(2) Li, R., et al. (2010). “Do Infants Fed From Bottles Lack Self-regulation of Milk Intake Compared with Directly Breastfed Infants?” Pediatrics: peds.2009-2549.

(3) “Guiding Principles for Complementary Feeding of the Breastfed Child,” World Health Organization, 2001.

(April 93, rev Mar 19, rev Sept 19)

Original Concept wording

For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.  (April 93)

Former Concept Explanation

For the full-term, healthy infant, human milk alone provides optimal nutrition for growth and development until about the middle of the first year. When introducing other foods and/or drink, the focus shall be on awareness of the baby’s specific nutritional needs and signs of readiness, rather than upon the baby’s age or outside factors.

Physiological and behavioral signs of readiness for other foods and drink generally include, but are not limited to, the following changes in the baby:

• an increase in appetite that does not subside after several days of intensive nursing
• an ability to sit up unsupported, facilitating eating and swallowing
• reaching for, tasting, and swallowing foods
• an ability to digest other foods and drink, as evidenced by the appearance of the baby’s stool and no signs of food intolerance
• other signs of readiness for foods in addition to milk

(April 93, rev Mar 19)

Rationale for revising the Concept wording

1) Changing “breast milk” to “human milk” makes this concept consistent with the “Human Milk” Concept and emphasizes the importance of babies receiving human milk, not the milk from another species. We recognize that for all other mammalian species, their milk is identified by the name of the species and not the organ that produces it.

2) Changing “needing” to “readiness” puts the emphasis on the baby’s readiness, rather than need, for other foods.

3) Using “complementary foods” instead of “solids” is consistent with global policy and research.

Rationale for revising the Concept Explanation

1) The explanation has been updated to reflect current evidence-based information to prevent premature introduction of complementary foods.

2) The order of the “signs of readiness” was changed to promote the most obvious, ability to sit and loss of tongue-thrust reflex.

3) Additional signs were added to encourage awareness of overfeeding and symptomatic reactions to introduction of foods.

Marie Beam has been a Leader since 1992 with the Bethesda/Kensington Group in Maryland, USA.  She filled many Leader Accreditation Department roles from 1996 until 2019, when she was elected to the Board of Directors of La Leche League International.  Marie and her husband Eric live in Kensington, Maryland.

Heidy Guzmán lives in Guatemala and has been a Leader since 2011, Area Coordinator of Leaders and a  member of the Board of LLL Guatemala. Heidy currently serves as a member of the Board of Directors of La Leche League International.