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Pediatrics/Weaning a 4.5 months baby


Hello Dr.
My 4.5months old baby girl has been on exclusive breastmilk feed (without water water) till yesterday. I gave her soyabean flour mixed with corn flour, after I had cooked it to become very light and watery. This morning, she had a somewhat rock-hard poo. Is this normal? Am trying to wean her, are there steps I should take in weaning her?
What should I do?

Hi Blessing,

Ideally, babies should be breastfed exclusively till 6 months of age.

After 6 months of age, solids are introduces, while continuing breastfeeding. With change in diet, change in colour, consistence and smell of stoold is expected and is normal. Following write-up would be helpful in deciding about complementary feeding:

1. There is no doubt that breast milk is the best for a baby and one should not switch to any other milk. Complementary feeding is started, while continuing breastfeeding as before.

For preparing cereals like suji-kheer etc, you can use small amount of toned milk. However, make sure that the final consistency is paste-like and not liquid (see below for details).

2. Whatever is given has to be semi solid (thick paste consistency), rich in fat (ghee/ oil) and very little added sugar and salt and almost no spices. The idea is to give condensed food: small in volume (as baby's stomach capacity is small) but high in calories (since baby has to grow fast). Liquids like daal paani, fruit juices, soups etc. fill baby's stomach easily but do not provide enough calories. Instead, baby should be given thick dal (with added ghee/butter), mashed fruits and vegetable puree.

3.Commercial infant formulae like “Cerelac” provide only one advantage: that they are easy and quick to prepare. They are ideal when baby suddenly demands food or during travel etc. Otherwise home-cooked food is much better: it has no preservatives, and baby does not need transition from "infant food" to home food at a later age and is used to all that you eat from a very early age. Still, if one wishes to use infant formula, it comes in various stages, as you know: stage-1, 2, 3 and 4. You have to stat from stage-1 and gradually move to stage 4 over several months. In stage 1, usually there are 2 variants: Rice and Wheat-Apple. One needs to start from Rice and then move to Wheat-Apple.

4. The food items which are usually started are: Moong-dhuli Dal with added ghee (NOT daal paani), Moong-dhuli daal  and rice gruel (khichri) with added ghee, suji-halwa (sweet or saline) rich in ghee, mashed banana, other fruits in mashed form (mango, papaya, melon, water-melon: practically any fruit without seeds in mashed form (NOT juices). After a few days, roti( mashed) can also be started. Move to paratha in next few days. add vegetables in paratha/ rice gruel/ suji. Jaggery (Gur) can often be used in place of sugar, as it is rich in iron.

5. Amount and mode of administration: Breast feeding is continued as before. In between two feeds, small amount (1/2 to 1 spoon only) of above food items are offered. gradually amount is increased as the baby's acceptance improves. As baby's solid diet increases, the interval between breast feeds automatically increases.

6. All babies require iron supplement from 6 months to 12 months of age. Please consult your doctor regarding the brand and dose according to weight.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India



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Dr. Puneet Kumar


I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query that requires diagnosing, since it is not possible to examine a child online.


I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 17 years of experience in the field.

Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (

(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. (f) Regular column, “How do I treat” in Pediascene ( (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 ( ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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