Wednesday, April 17, 2013

Encouraging Interest in a Variety of Foods Through Books



While there are only a small handful of studies out there about how to truely get kids to eat and fix picky eating habits, we do know certain things that do not work:

- Forcing, pushing, even just "encouraging" our kiddos to eat certain foods actually makes our children percieve those foods as less desireable and causes them to consume less of them

-Same findings in this study, although, try as I might I can't find the actual study- just a few blogs and online journals talking about the study.  Here is one of them.

- Giving rewards for trying new foods (such as tv time or dessert) also causes our children to see the new food as less desireable.

So if we can't talk about these new foods and gently encourage our kids (ok, probably we aren't always being exactly gentle about it anyways and we're often far more than encouraging when we want them to try a bite of something healthy or new or even worse- something you just know they would love if they would just take a bite of it!) well, then what can we do????

For starters, take the battle away from the table.  One of your best weapons--ok, now I'm just being dramatic-- one of your best tools is found on your child's book shelves.  Children's books are super helpful with teaching leasons, encourging desired behavior, and opening a discussion with your child.  This is not groundbreaking stuff here.  Stories have been used for years to help with maners, potty training, preparing for a new sibling, and even for talking about healthy eating.  Books are fun and the focus is off of your child and on an imaginary character.  It also provides a subtle social pressure without need for a real life friend to model the behavior you want: "Charlie and Lola ate a carrot, I wonder if you can too?" Addtionally, it increases your child's exposure to that food so it's not so new (and we know neophobia is a common issue around food- especially in toddlers).

If you're not sure where to start, here is a list of books from the blog Delightful Children's Books (which is great, by the way): 10 Children's Books about Food.  There are a bunch of great books listed and to add to that, I also like The Very Hungry Caterpillar (for young ones), Blueberries for Sal, and Stone Soup.

A nice use of these stories is to pick one you like, read it with your child a few times (at bedtime or wheneven you typically read books) then suggest an activity some other time that incorporates the food that was the focus in your book.  I.e. If you read Stone Soup, make a soup with your child and really let her help prepare it (maybe not chopping with knives but they can probably successfully wash veggies, pour broth into a pot, add pre-measured spices, and stir it all up before you put it on the stove, etc.)  Talk about the story, your own experiences, what you think it might taste like, who you may share it with.  When it is ready, let your child help serve it if you think this can be done safely.  Let your child brag about making it with you to whoever is around to listen.  Even better, take some picutres of you guys making it, serving it, and tasting it, for showing to friends or printing to make your own "book."  In this scenario, not only does the reading help to encourage trying new foods, but research has also shown that kids who help in the kitchen are more likely to eat the items they helped prepare!  Win-win!

Let me know if you have any favorite kids books about food.  I'm always looking for good ones.

Tuesday, April 16, 2013

10 Tips for Transitioning from Bottle to Cup



I get asked about this frequently, so I thought I’d do a post about making the transition from bottles to cups. This developmental progression can happen whenever you and your baby decide but ideally is well suited to occurring between 6-12 months (12-24 months is fine too, but can be a bit more difficult.) During the 7-10 month window especially, your love bug has the ability to sit up unsupported, hold a cup, tilt their head back, separate the movements of their jaw, lips, and tongue, and drink from a spouted cup, a straw, and an open cup. They are motivated to learn new skills and do things for themselves at this age. They are also a bit more amenable to changes in their routine than a toddler, so often the battle-of-the-bottle is not so epic (and may even be quite smooth).  
It's important to note that the transition from bottle to cup does not have to mean weaning from breastfeeding.  You can continue to breastfeed while also transitioning to the cup by only offering water in the cup or by pumping and offering your pumped milk in the cup at table meals with solid foods or even by offering formula if you don't have enough breastmilk or are ready to give up pumping.  If your baby is spending any time with a nanny or in daycare, you can work towards providing your baby's pumped breastmilk or formula in a cup instead of a bottle whenever he or she is away from you, but continue to directly breastfeed in the morning and in the evenings.  
Lastly, if you notice increased incidence of coughing and choking while drinking, this is a sign that your child might not be quite ready yet or at least may need a slower flow of liquid (so possibly a sippy cup with a no-spill valve instead of an open cup, for example). Always follow your child's lead and your intuition.  If you find that your child is getting constipated, this might also indicate that he or she does not have the skill and coordination yet to take in the necessary volume from a cup and should continue practicing while also receiving bottle or breastfeeds for the time being.  In all situations, if something seems amiss, consult with your doctor.  

Here are the 10 Tips for Transitioning from Bottles to Cup:
1. Start early. By this I mean like before your baby turns a year, ideally but also early like well before you actually expect your baby to make the transition. Starting before a year is helpful because toddlers are creatures of habit and they love consistency and routine.  Trying to break a 2 year routine of bottles can be a big challenge.  Also, starting early before you actually expect your baby to make the transition will allow your stress levels will stay low as your baby learns this new skill becasue you won't be up against any time crunches to get the transition completed.

2. Start with a week or two of “cup play” before you put any liquid to drink in the cups. Put a cup in the bath and use it to pour water on your baby. Put a few cups on their play may and fill with cotton balls or interlocking rings to let them practice holding the cup and to familiarize themselves with it. 

3. Let your baby watch you drink from a cup and straw and then offer sips of water from your “grown up” cup. As he watches you, most likely your baby will reach for your cup.  Let him help hold it while you guide the cup to give small sips. (You’ll probably end up with backwash in the cup and most of the water down the front of you both, but that’s part of the fun!) Do this every time they reach for your cup for the first few days or weeks to help develop the interest and coordination to take small sips of a drink.

4. Consider trialling a few different types of cups. Lidded cups are awesome, of course, to prevent spills but that doesn’t automatically mean a sippy cup. You can try straw cups or sports tops too, even at 6-7 months. I prefer these to a standard "sippy" cup because sippy cups are a short-lived solution--a stepping stone--until you move on to an adult type cup (standard cup, a straw cup, or a sports bottle.) If you’re brave, forgo the lids right from the beginning in favor of an open cup or even a nosey cup (also called cutout cup, which has a cutout so your babe doesn’t have to tilt his head back to take a drink.)  Either way, with a few different options, you should hit on at least one that your child has more aptitude for or more interest in. 

5. Don’t push it. Have the cup of choice out at meals and let her play with it and drink as she wants.  Let her reach for it and initiate.  Once she does, feel free to help her manage it. 

6. Try offering both water and milk (or formula) in the cup of choice so your child get used to the idea that many different drinks can be in a cup. 

7. If you’re trying a sippy cup:
- consider the soft spout that feels similar to a bottle nipple, which may be more familiar than a hard spout intiiatlly. 
-trial removing the slow flow/no spill valve until he gets the idea that something comes out of the spout. Once he starts sucking on his own, put the valve back in. (Use caution with this method if your child has any swallowing difficulties.)
-Let your child hold the cup but you help tilt the cup back as needed to take a sip.

8. If you’re trying a straw cup:
- consider using one that has a slight amount of “give” in the cup so you can squeeze it while they have the straw in their mouth, which will push liquid up the straw. This will cause them to automatically seal their lips around the straw and will help them understand that liquid comes out of the straw. (Avoid squeezing too hard and flooding them! Also use caution with this method if your child has any swallowing difficulties.)


- if she is not getting the concept of the straw at first, try taking the straw out of the cup then use your finger to trap water in it and bring it to your baby's mouth.  Then let your baby hold the other end of the straw as you remove your finger:



This gives them the idea that liquid comes out of a straw. Once they tolerate this several times, hold the straw lower when you put it in your baby's mouth with your finger still over the other end to hold the liquid in, and see if she sucks at all to get to the liquid. If so, put the straw back in the cup and try again to let them drink straight from straw/cup. 
-use a short straw (or cut the straw in half) so that even a small suck will be enough force to draw liquid up the length of the straw and into your baby's mouth. 

9. Once he gets the hang of a certain cup, start increasing the amount of milk he takes from this cup or even offer a full feed once per day in that cup.  You can hold your baby as you would if you were going to give a botle, or if he doesn't seem to mind, let him sit up and drink. Meanwhile, reduce the bottle feeds by 1 feed per week. (If your child is a rock star, you can go at a faster pace than this, but this gives plenty of time to adjust.)  If you your baby is under 12 months and you are breastfeeding, wean out one breastfeed per week but pump to give that milk in a cup, or just stick to water in cup, milk from breast until your're ready to wean.   If your baby is over a year and you're ready to wean, wean out one breastfeed per week and replace with whichever milk you are using (cow, sheep, rice, almond, etc.)

10. As you get down to only 1 or 2 bottles of milk, if your baby/toddler is still super attached to the bottle of milk, consider adding small amounts of water to the milk that’s in the bottle, little by little to make it less desirable. Concurrently, give her the regular milk only in a cup. This should be enough encouragement to get her to make the switch.

Monday, April 15, 2013

Baby Led Weaning In Action!



One of my Birdie’s first attempts at solid foods: roasted beets.  She’s 6 months and 1 week in this video.
I roasted them in a bit of olive oil to soften, then let them cool and just placed them on the (clean) table in front of her.  She had a nice time trying to pick them up, then sucking and munching on them.  She needed some help picking them up and she never really managed to swallow them, but I loved watching her discover the flavor and texture while also working on tongue lateralization and early chewing patterns.  
Notice that the piece is big enough for her to grab and hold while feeding herself.  I’m there the whole time for supervision but she never needs help asside from picking up the slippery pieces! Also notice that I never push or force, I let her natural curiosity guide her.  
Last, try not to notice our dog, Henry, licking the table and waiting for the baby to drop her food.

Saturday, April 13, 2013

Celebrate Nursing in Public!


This is my sister and I, nursing our littles, curb-side, after a 5k race!

http://www.drmomma.org/2009/07/breastfeeding-in-land-of-genghis-khan.html

I wanted to share this link to a great article about nursing practices in Mongolia.  I loved this article written by a woman who raised her son in Mongolia, on breastfeeding practices there.  It is interesting, very funny, and a bit shocking.  But overall it’s just fabulous and it makes me proud to be a breastfeeding supporter and current nursing mama.  
My favorite line: 
From the time Calum was four months old until he was three years old, wherever I went, I heard the same thing over and over again: “Breastfeeding is the best thing for your baby, the best thing for you.” The constant approval made me feel that I was doing something important that mattered to everyone- exactly the kind of public applause every  new mother needs.  
I find this so perfect because this is what lacks in our society: the feeling that, when nursing, you are doing something that matters to everyone.  Too often mamas who are nursing in public get asked to cover up or made to feel embarassed about feeding their child.  At best people tolerate it or “don’t mind” if you nurse around them.  But nursing benefits everyone- not just you and the baby.  A nursed baby has less incidences of illness, less incidence of SIDS, and is less likely to be obese throughout his or her life. Each of these things means less healthcare costs for society, over the course of that baby’s life.  It also means less missed work for parents, less coworkers who get sick from a sick parent, less tax dollars spent on healthcare overall.  Also, your tax dollars don’t need to pay for formula for a breastfed baby (which they currently do, through programs, like WIC).  Breastfeeding means less trash in our landfills (compared to each canister of formula or bottle of pre-prepared formula) less synthetic chemicals used to make the cans and bottles, and less gas spent trasporting formula around the country to stores and into homes.  
Women who can and do nurse should be supported and celebrated and never made to feel ashamed.  We are doing something great for society!  I think about this each time I nurse in public, and I feel a sense of pride in what I am doing for my baby and for everyone around me- even if those around me don’t know it yet.

7 Tips to Improve Meals Out with Your Baby



FYI- These are tips for actually enjoying eating out with your baby at an adult restaurant in an adult sort of way- without having to skip the conversation to stroll around the restaurant for half the meal, or eat at the “early bird special” hour, or get a to-go box and pay as soon as the meal arrives so you can dash as soon as you shovel your food in.
This morning, my husband, Birdie, and I went out to breakfast at our favorite local spot. This is the first time we have done this since our little lady has started eating solid foods and crawling. Honestly, I’ve sort of been avoiding going out to eat with her because I figured it would be a lot more difficult now that she wants to get into everything and move around.  It was a beautiful morning and we got a table after only about five minutes of waiting! We sat down, quickly ordered our coffee and suddenly I had a small twinge of anxiety. I did not bring any food for my baby! Actually, I didn’t bring anything for my baby. Well, I did have my breasts with me thankfully so she could always have some milk if she needed.  No matter how tired and stressed out I get- I never forget my boobs!  However, I was not sure how we would entertain her for the next 20 minutes while we waited for the food to arrive, and then for the second 20 minutes while we ate our meal and paid. What if Birdie makes a scene? What if she starts crying and we have to leave? What if she starts banging or throwing the silverware?? Other diners might think that our daughter was destined to be a prison inmate (banging an old tin cup along the cell bars. ) I want people to see my daughter and assume she is destined for greatness: Harvard, Nobel prizes, amazing discoveries. Not jail.  She already has crazy, patchy hair that makes her look capable of wild outbursts. Spoon-throwing would not help.  BUT! None of this happened. We had a really lovely, really fun breakfast out with Birdie acting totally reasonable the whole time! My husband and I got to enjoy ourselves and our meal- no rushing and cramming.  No apologizing and slinking out to the car. Overall, it was a really awesome morning and I look forward to eating out with her again in the near future. I think that there were, in fact, a few things that I did have with me or that I did during the meal that made this outing go smoothly, so I decided to share. Also, a few things occurred to me while I was eating that probably would really help for next time.

Here are my tips for eating out with your baby (6-12 month old.) Some of this may seem obvious to you impressive parents out there. But, some of us are a little slower on the draw. For us newbies, and for those who agree that brain power is hard to come by first thing in the morning before we’ve had our coffees- here are my insights.  Will these work for every person, every time.  Nope. If your baby has an ear infection or is crazy tired, or just having a super fussy day, maybe just skip the meal out today.  But these tips are a pretty sure bet in most circumstances with a healthy baby
1.  Use table and purse items as “toys”.  If you’ve got nothing- you were blurry eyed and didn’t think to grab any toys for your baby- maybe you’re lucky you remembered to put pants on before you walked out the door- scour the table or your purse for “toys”. I use the term “toy” in the most liberal sense here- spoon,  creamers,  sugar packet container or ask for an extra plastic cup or to-go box to open/close/shake/fill/etc.  Stick with things that wont break if dropped and even better of they wont make a loud clanging noise if (really, when) thrown. The little plastic creamers and a to-go box are probably your best options- better than a spoon or a plastic cup. In your purse- keys, wallet, tic tac box, glasses case, make up bag w make up removed. Stick with things that can be mouthed, shaken, opened/closed; not things that can be ingested, broken, destroyed, or completely made a mess of.
2.  Try a “busy wallet”. If you can be the teensiest tiniest bit prepared I recommend this idea for a “busy wallet” from The Acts of Grace blog, which is easy to have on hand at all times so you don’t have to think about it when you’re heading out the door.  I saw this wallet idea on pinterest a while back and thought it was genius.  One of Birdie’s favorite things is my wallet. I don’t mind her playing with it because it keeps her interested (opens/closes/has different textures to mouth) but it’s probably a bit dirty for a traditional “toy” and I do dislike opening it up several hours later to find vomit where I traditionally keep my credit card. Also, I worry that I will lose important things from my wallet: drivers license, money. So I am excited to try this faux wallet toy for the next time we go out.  It’s small enough that I can keep it in my purse at all times so I won’t have to worry about packing a toy for Birdie when I go out.
    














3.  Wear a teething necklace.  A necklace also serves as an easy toy in a pinch and this one in particular, I love:​
I found it on Etsy a while back when I was searching for a rattle.  I though these necklaces were both pretty and nicely functional- non-toxic dyes, non-treated wooden beads that are made to be mouthed- but I hesitated to purchase until I saw one on a friend of mine recently.  It looked so good on her and she said her son loved it so I went for it.  So glad I did.  Lucy loves it.  She loves to mouth it, to hold it, to pull on it, to wear it to put it on and take it off.  It keeps her attention and it  and works as an accessory- two birds with one stone!  This necklace did the job today when I realized I did not bring a toy and I wasn’t in the mood to let Birdie launch a spoon across the restaurant.
4.  Bring a small snack and a lidded cup.  If you’re really the impressive, boy-scout-type, bring some small snacks, which also would totally entertain while waiting to order and waiting for your food to arrive.  Even better- bring a cup (zippy, straw, etc.) to let your baby play and also drink so you don’t have to pay for a child’s drink that they take 2 sips of and leave.  While I love this plan, I am pretty much almost never that thoughtful to bring anything useful with me ahead of time.  I have repeatedly forgotten to bring an extra diaper and wipes with me, which is probably the most basic baby item I’m supposed to bring on outings.
5.  Don’t be afraid to nurse!  No matter what you bring or don’t bring, I highly suggest nursing in public to pass the time, soothe a fussy or hungry baby, and generally make going out with your baby easier.  I have a few friends who don’t feel comfortable doing this (with or without a nursing cover) and I can say it’s very limiting for them.  You have to be one of those “prepared” mamas who feeds their baby at home before you leave, packs a bottle just in case, and has milk or formula on hand.  That is 100% not me.  Also, even in the best of circumstances, Birdie sometimes really wants to nurse right in the middle of an outing.  It can be a little intimidating at first, but with some practice, it’s so liberating, so easy, and so helpful.  I find that the more confident I am about it, the less anyone else seems to care or even notice.  2 things that helped me build confidence with this: using a nursing cover initially   (or possibly always, if you have a baby that is so distracted by everything around them that they can’t focus to nurse in public, a “hooter hider” can really help block out distractions) and nursing with other mamas in public.  When you nurse in a group it takes away the feeling that everyone is looking just at you and this helps you get past that initial fear, which is good because the more you practice, the easier it gets.  Now I find that nursing in public- especially at a restaurant to help pass the time- is the lazy mother’s best tool.

6.  Order something that your baby can self-feed.  This is probably the most important tip.  I can’t stress this one enough.  This frees you up in a few ways- allows you to not have to pack and bring extra food for your baby, engages your baby and keeps them distracted and quiet at the table, helps them to stay seated in their highchair while the food is being served, and allows you and your partner to enjoy your own meal without having to directly feed your child.  So, instead of bringing separate food for your child or ordering them a separate meal, just share. Pretty much every child is more motivated to eat what you are eating and will want what you have anyways.  Just about every restaurant has something on the menu that you and your baby will both enjoy, just keep your child’s skills and interests in mind as you order.  This can be purees if you’re giving purees (you just have to be ok with giving up the spoon to let your child “feed” herself) but I think works even better with table foods, which can safely be done as early as 6 months old.  For example, my husband and I both ordered our favorite meals (his: eggs benedict with roasted potatoes and mine: french toast with citrus banana caramel topping- yum!!)  Lucy is 7 months old and she has no teeth.  She’s just learning how to chew and mostly she mouths things and sucks on them.  I gave her strips of my french toast, cut up bits of banana, and large pieces of roasted potato.  She LOVED the strips of french toast I gave her and spent at least 10 minutes picking them up, sucking them, mashing them, and exploring them.  If I was concerned she couldn’t handle the texture, or large chunks, I could have given mashed up bananas but this approach works best when she can pick up an item herself and attempt to self-feed.  We also gave her a few of the larger pieces of roasted potatoes, which she could grab and hold to suck and munch on. Again, this is key. Pieces that she can hold and munch or suck on kept her busy for the entire duration of the meal, which allowed us to chat, eat, and generally enjoy ourselves without having to have one parent feed while the other scarfs, then switch off and have one parent hold/walk/distract while the other scarfs.  It was awesome to have all three of us enjoying our meal at the same time.  By the time my husband and I were done with our meals, Lucy was just starting to get tired of going after pieces of food so we all wrapped up around the same time.
7. Leave a generous tip.  Don't worry about the mess- just tip well and hold your head high as you walk out the door.  This is a suggestion that a few mom friends have shared with me and as a former server, it resonates well with me.  I certainly felt a bit sheepish about the state of the floor beneath my daughter's highchair, but with a slightly larger tip, I was able to smile and say goodbye to the server, rather than running out the door feeling like he was cursing us as we left.  
I hope these help you get out there and enjoy social time with your family!  I know that having a baby can feel really isolating when you don't leave the house.  Let me konw what you thinnk and if these suggestions help.  If you have any other go-to's, I'd love to hear them!


Food Is for Fun Until Age 1!



I love this phrase.  It’s catchy, it’s simple, and it’s true.  This is a phrase that has flowy alliteration and a nice little rhyme to it to help you remember, yet sometimes is still so hard to remember.  Like when our babies are learning to eat and barely getting anything in and wasting the food we spent time preparing and throwing that food on the floor, and (argh!) suddenly I’ve totally forgotten this phrase or I just don’t trust it anymore and I’m stressed and I sweetly ask my baby to “just try one more bite” and when she turns her head I follow her mouth with the food, “just to be sure” because maybe if she tasted it again she would see that it’s good and eat a bit more of it so I don’t have to throw it out.  Crazy town!  But then I inhale and we leave the table and maybe today my Birdie takes a good nap so I get to relax and calm down and suddenly my hazy mommy brain clears and my feeding specialist background surfaces again and I return to this phrase.  This is a phrase that is my strong comeback whenever someone questions how my baby is learning to eat, or worse, whenever I get antsy and question how my baby is eating.  “It’s fine!” I tell myself.  “Food is for fun until age one!”
 Ok, so for starters, the same way that we wait for 12-ish months for our babies to build their motor coordination in order to take their first solo steps, it’s important to give our kiddos several months of exploration and practice before we expect them to eat. They have spent the first 4-6 months of their life using very specific oral motor patterns to take the breast or bottle and now we are asking them to manage something completely different.  Compared to those 12-ish months it takes to learn to walk, 6-ish months (from 6 months to one year) to get ready to take larger quantities of solid foods is really not that long actually!  In the mean time, our babies are getting everything they need by way of nutrition and calories, from breastmilk or formula (ok, the only caveat here is iron- some babies may need iron if they are formula fed).  They don’t need anything else until around one year, though many babies will eat plenty more before one year old.  Many won’t though and that’s ok.  One more time: they don’t need anything but your milk or formula until one year, and many babies really won’t eat much besides your milk or formula until one year.  This is so important because when we start to prioritize solid foods for nutrition, it can make us eager and even anxious to get more quantity in them than they can physically handle.  We worry that they won’t gain weight or they won’t grow well or be healthy if they don’t eat a bit more of the foods we are giving.  But pushing more food than our babies want or can handle undermines their ability to listen to their bodies and causes a power struggle.  It can scare them.  It can make them feel like eating is hard and not enjoyable.  When they are scared, stressed, and not having fun, they do not want to eat.  So at the same time that we are stressing about how much they are eating, they are refusing more, and this makes us all the more anxious, setting up a vicious cycle.  Our anxiety makes mealtime more stressful and less enjoyable for us and our babies and babies do not generally perform their best under this type of pressure.  They refuse, we push; when it comes to feeding, baby will always win the power struggle.



So what does motivate babies to eat and what do we do with our babies between now and a year to encourage strong eating habits?  For starters, we model.  We let our babies watch us eat and we eat as large a variety of foods as we can to show them that food is safe and delicious and wonderful.  Babies want whatever we have.  They want to do whatever we are doing, so modeling the behavior and skills you want them to have is key to setting up life-long positive eating habits.  At the same time, we safely and slowly help them work on improving their oral motor skills and adjust to new oral sensory experiences by giving them real food- bites of the same foods we eat (see Baby Led Weaning for more in depth info on what this looks like).  Yes, there are some foods that we eat that our baby can’t/shouldn’t have (ie- honey, raw nuts, super salty foods).  But on the whole from 6 months on, our babies can usually have al least a part of almost everything we eat. (Having chicken and roasted veggies? Your baby can munch on small pieces of chicken or hold and gnaw on most roasted veggies).  Yes, you will need to provide very close supervision- but who let’s their 6 month old eat without supervison?  And, yes, giving them some of your food can be really tough to watch because most babies can’t really chew and swallow very much (if any at all) of the foods we normally eat.  It can feel like it’s not working because they didn’t really swallow anything!  But then we remember that they are getting everything they need from our milk and formula and we recall that “food is for fun until age one!” and it helps us relax.  When we relax, it’s easier to see that, in fact our baby learned way more about food and eating when given regular food.  They are doing exactly what they should be doing- mouthing, tasting, exploring, moving their muscles, and learning from each mouthful…but not necessarily swallowing.  And when we relax, they do too. Then they can enjoy the exploration and that’s the best way for them to learn.

The Problem with Purees


Actually, that’s a pretty loaded title, more for effect and attention grabbing…the problem is not with purees so much as with the practice of introducing only purees as first foods and for those first few months of feeding.  Of course, every baby is different and all approaches and suggestions should be thoughtfully considered based on your baby's skill level, development, and interest, as well as your own skill set.
As it happens, ​​I actually quite like purees- humus, yogurt, applesauce, butternut squash soup...the list goes on! But, after seeing parents introducing only purees for several months of feeding, and hearing the anxiety in parents voices when they worry over why their baby is refusing, and the confusion over how to know when their baby might be ready to move towards more "solid" foods, I feel like I'd like to get the word out there about why the prevailing method of introducing solids (rice cereal and only purees from 6-8 months) might not be the best idea for many babies and why parents might consider introducing some true solid foods from the start (after 6 months of age).  My goal with this post is to help parents understand why other approaches should be considered and what the benefits of those approaches are, as well as the draw backs.  I think the benefits of purees is clear: easy to control how much food goes into the baby's mouth with each bite, not too messy, easy to manage with baby's current sucking patterns, nothing to "choke" on. (Though babies can actually choke on purees, and this may cause a lung infection, purees won't block their airways entirely, so I think parents don't worry as much about this outcome). Of course, some babies have medical issues that might necessitate a more conservative start.  
Some parents may give only pureed foods here and there for a few days or even a week to ease into the transtion to solids, or may mix it up and introduce some pureed meals, some standard solid food meals.   This practice is not what I am addressing here.  Also, some people and babies love purees and progress fine to other solid foods from a full puree start.  But there are also those babies that sleep through the night almost immediately with no work from their parents, as those that potty train themselves.  I think the babies that do these things are the exception, not the norm so this should be considered when people argue that it worked for them so it will work for you.  
Many babies do not do as well with a pureed start and aside from just being stressful for parent and baby, I believe they are slowly building the foundation of picky-eating behavior.  In fact, even some of the babies that appear to do well, eating good amounts of purees from the get-go, I would argue may still end up as picky-eaters because of a full pureed diet during those first crucial months of feeding.  Often we may not see the picky eating behavior show up until the baby is closer to 12 or even 18-24 months.  Yes, this is theoretical, but it is not completely pulled out of thin air.  It’s a theory that is grounded in correlational evidence: right now the primary way food is introduced to our babies is through purees and the rates of parents who describe their children just a few years later as “picky” eaters is estimated to be at high as 50% and at the same time we have up to 1/3 of our nations children falling into the overweight or obese categories (which can also be a direct result of picky eating habits.)  What a baby learns during those first few months of feeding will set a tone and a foundation that will last them for a lifetime (or at least many years until it can be changed.) So, I’d like to think that there might be a better way to introduce solid foods to babies. I’ll go into what that better way might be more later, but for now, I’m going to focus on “the problem with purees” as a way of teaching our babies to eat.  Let’s break it down into different sections: The power struggle problem with purees, the oral motor/oral exploration problem with purees, and the progression problem with purees.
The power struggle: when you give purees, you, the parent, are the one who is in control.  You hold the spoon.  You decide when the bite is offered.  You choose how much food is on the spoon and when the meal is over.  While this of course makes a certain amount of sense (your baby can’t hold a spoon very well and definitely can’t scoop well at 6-8 months) it puts your baby in a passive possition.  This is a big problem because this is a time in their lives when they are so totally and completely interested in doing it themselves and figuring out how to be somewhat independent.  Every single moment during this time in your baby's life, he or she is learning, exploring, searching.  She doesn't do this because you tell her to, she does it becasue she is inherently motivated to do so.  This is wonderful.  It is what drives them to learn to walk or talk and read and it is what drives them to learn to eat.  We, as parents, want to foster this drive.  Do we need to teach them this at every meal? No, probably not.  But when we never given them the opportunity to do anything else but purees, spoon fed by you, you’re spending 1-2 months of precious time (feeding them usually 2-4 times per day, so this a lot of time) dampening their inner drive to explore and telling them, “I do this better than you and you should rely on me to figure this eating business out for you.”  
In the best of situations with spoon feeding, you have a child who is content to sit back and let you feed them.  If that’s the case, there is nothing really wrong with this, some babies are happy being led and they will continue to develop beautifully.  But you are certainly not helping them learn to tap into that inner drive to figure it out for themselves and you are not telling them that you value exploration or intrinsic motivation. In the worst of situations, you have a baby who is not at all content to let you feed them and it becomes a constant battle ground, each and every meal for 1-2 months, setting up a routine of fighting and stress during meal times.  This perception of mealtime as a stressful event where they can get what they want through crying and fighting will persist for a long time- only getting worse when they become toddlers. They are always searching for ways to take back their power at mealtimes and when they are bigger they do this in bigger and more intense ways.  I think this is part of what makes slightly older babies love the squeeze packed purees.  They take the power back!  They get to manipulate the package and feed themsleves, which is what they’ve been wanting all along.  
Babies who refuse spooned purees but will take the squeeze packages highlight two additional problems with giving purees that are not necessarily inherent to the purees but rather are just common practice with purees and therefore an easy trap to fall into:
 1. Spoons: they're hard to avoid with pureed meals, out of habit and concern for social graces and baby's don't manipulate spoons well at first.  However, letting a baby use their hands to feed themselves purees can alleviate some of this power struggle.  
2. Quantity-focused-feeding: It's very easy to measure how much a baby takes when we give purees (1/2 a jar, 8 bites, 4 spoonfulls, etc.) and we tend to want to improve upon the last meal and the one before that.  It's a very easy trap to fall into, but when you focus on gettin in one more bite, or you focus on how much your baby takes, this can make you push your baby outside their comfort and interest zone.  It also causes you to see the feeding as successful or not based on how much the baby took in.  But at first, quantity does not matter at all!  (Not at all- see post "Food is for Fun Until Age One" for details). Your baby is learning and exploring and they will take in and swallow ocassionally but that's not really the goal at first.  Just like they will crawl and cruise before walking, they will lick and gnaw and spit out before learning to swallow.  They don't learn this in a day. If you give purees, keep this in mind and stop looking at quantity as a marker for those first few months!  

The oral motor/oral exploration problem with purees: Around 6 months, babies are used to using a sucking pattern to eat.  They are used to liquids and they cup their tongue and then move it forward and backward, not so much side to side.  Purees fit perfectly within that model of oral motor patterns…but they do not challenge those patterns to progress very much at all.  That is a problem, because our babies are already very good at those patterns and we want them to get better at more mature patterns (tongue lateralization, rotary chewing, bolus formation).  At 6-8 months, babies have very nice protection against choking (very anterior gag reflex, tongue protrusion movements, small tight spaces that make it very difficult for chunks of food to move backwards, etc.) so it’s a great time to help them practice and learn more mature oral motor patterns.  At 6-8 months, babies also have immature fine motor skills that make it more challenging to put small choking hazards in their mouth.  When we give purees for a few months, we do not encourage new patterns, and instead we let our babies grow out of the phase when they have nice protection against choking, then we challenge them to work on more difficult foods.  This is completly backwards to me.  This poor building of oral motor patterns I believe is a huge part of later picky eating.  I can’t tell you how often I see toddlers who are very picky eaters, who, when I look closer at their oral motor skills, are not able to manage resistive and mixed textures with well coordinated oral motor patterns.  So they just don’t!  It’s very smart of them, really.  They know those foods do not feel safe (raw or even partially cooked veggies for example can be very resistive and fiborous, which makes them difficult to swallow safely unless you have solid oral motor skills.) Parents just assume that because their child is now 2 or 3 and they can chew things like chips, that their child has strong oral motor skills.  But this just isn’t the case (chips are pretty easy to chew and break down) and their child is being picky about which foods he or she will eat in part because of that lack of coordinated motor skills.  Getting in there early to teach the foundational skills of eating solids will help your child feel safe with eating a variety of foods. Eating purees will not help with this.  Delaying true "solids" past 8 months will only make it more difficult for your child to learn these skills.

The progression problem with purees: Lastly, when you are giving only purees from 6-8 months, how and when to do you advance to more solid foods?  I see situations all the time where parents have no idea how to get out of the puree pattern and are scared to progress so they just don’t until the child is a year or beyond.  Or they start true "solids" around 8 months but they have no idea what to give so they over challenge.  When you only give purees you have no idea what your baby’s oral motor patterns look like and you really don’t get any good feedback about what solid foods would be good to advance towards.  You also don’t really know which foods your child likes- we so seldom eat just one food at a time (ie- we don’t often eat just kidney beans, we eat chilli, or broccoli as part of a casserole, not just plain broccoli) and parents have no clue which combinations of foods their kids will accept or like after several months of just purees. Additionally, by 8 months a fine pincer grasp has developed (or is emerging) and your child can easily pick up choking-hazard-sized pieces and quickly put them in his mouth.  He is also much faster than a 6 month old at grabbing large amounts of food and shoveling it into his mouth and since he hasn't been practicing for the last 2 months, his mouth will be less likely to have the motor patterns ready to protect his airway from choking.  6 month olds defintely grab handfuls and over-stuff their mouths, don't get me wrong.  But again, they are a bit slower at it, a bit less coordinated and less able to pick up small choking-hazard-sized peices, which gives you more time to help or stop them when you start at 6 months vs 8 months.  It also helps them learn early on not to do this, so that by the time they are a bit older and you are giving more resistive foods in larger quantities, they have the ability to manage them safetly.  
I could go on but I’m going to wrap this one up.  I will probably re-visit this a little later.  And, just for the record now that I’m off my soap box- my Birdie does seem perfectly content to let me feed her a puree every now and again and I must say, it is quick, clean and kind of fun to spoon feed her and watch her scarf down something like yogurt or mashed potatoes!  I just also enjoy watching her explore other foods in addition to purees!

First Foods


People keep asking me what I’m going to give Birdie for her first foods.  This seems like a loaded question to me- I get the feeling people want me to answer either “rice cereal” or “apple sauce” or maybe even “avocado.”  I just keep thinking, “I have no idea what I’ll be having for lunch or dinner the day that Birdie chooses to reach out and grab some foods off the table” and “I don’t really know which of those first foods I give her that she’ll actually swallow.”  

I’m a big believer in the phrase “food is for fun until age one” and utilizing the oral motor skills that are inherent to a 6 months old (tongue thrust, phasic bite, tongue lateralization) to taste and explore solid foods without actually swallowing them.  When you give purees, the goal is generally to get them swallowed, vs just letting your baby taste and explore, then spit out.  That can be very difficult on babies at first (though of course some do phenomenally with this from the get go!)  But since time allows the gut to keep maturing and also allows practice to build well coordinated oral motor skills, I like the idea of letting her mouth foods before asking her to swallow them in any quantity.  

So I will most likely stick with foods that are easily held and easily mouthed: long "sticks" of food or big pieces of mashable foods. She can taste, suck, and gnaw on them until she eventually drops them, pushes them back out or even gag them out of her mouth.  I will definitely edit what I let her put in her mouth- avoiding things that are true choking hazards (small, hard, round food items) as well as things that are heavily salted or sugary, but I don’t plan on choosing a specific food right now.  I think I will just pull whatever is most appropriate from my plate and give her the chance to pick it up and feed herself if she can. At the suggestion of a nutritionist I met, I might try to steer her towards green and yellow veggies, the seasonal ones I get in my CSA delivery and am preparing anyways for my husband and I, because green and yellow veggies do not spike your blood sugar and are low on the glycemic index.  Maybe green beans or roasted squash?  But possibly not- maybe lentils or humus?  Maybe scrambled eggs? Possibly a carrot stick or zucchini slice that she can mouth? (I don’t have any history of allergies, nor does my husband and since Birdie will be 6 months, I am not terribly worried about allergic reactions.)  We’ll see if my mind changes over the next few weeks.  

What were your baby’s “first foods?”  Any thoughts on purees vs “table foods” as your baby’s firsts? This is my nephew enjoying some of his firsts: spinach and crackers.  This boy can eat!


Introducing Solids: Waiting until 6 Months

My little lady is 5 months old this week and I’ve been thinking of her readiness to begin eating solid foods.  At this point I am still exclusively breastfeeding, as per the AAP recommendation and despite some advice (some from friends and some from medical personnel) that solids should be introduced at 4 months or even earlier.  When I look at the research, the benefits of waiting to introduce solids until around 6 months is compelling.  I like the idea of my Birdie having a decreased risk of obesity later in life (and her avoiding all the co-morbidities that walk hand-in-hand with obesity).  I also feel since we know the gut matures and produces additional enzymes to aid digestion and nutrient absorption when  baby is somewhere between 4 to 6 months (though we can’t tell where between 4 to 6 months from baby to baby), I’d rather error on the side of caution and wait until I know for sure my Birdie’s intestines are nice and mature.  

There are many other suggested and probable benefits to waiting until closer to 6 months (possible decrease in allergies, less anemia, continued maximum protection from illness conferred by large amounts of my milk) but the other benefit that I feel strongly about is that at 6 months, my baby has much more control of her arms, hands, and mouth.  As a therapist, I find this reason to be one of the most compelling, since I know from my schooling as well as from 8 years of direct work with infants and toddlers that they are inherent learners and explorers.  They are highly motivated to learn a new skill and to master that skill.  Conversely they get indignant when you try to “force” them to do it your way (anyone tried to make a baby eat or sleep when they don’t want to knows that you’d have more luck trying to persuade a dictator to relinquish their power).  

Somewhere around 4 and a half months, Birdie started to show that increased coordination in her hands and mouth and has therefore started putting everything she comes across in her fists, then into her mouth.  As her coordination improves it will become easier and easier for her to feed herself small bits of actual food when she gets closer to 6 months.  That way, when we give her the opportunity, she will be able to do it herself (obviously with close supervision) and will develop a drive to try new foods, as well as to learn to manipulate small objects in her fingers, just as she has a drive to learn to crawl and sit up.  I won’t have to battle with her to try to get spoonfuls of pureed up food in her mouth, nor will I have to take the time to puree up all our food.  I should be able to offer her small amounts of the foods we eat, directly from my our meal, that are suitable for her.  Additionally, since her lips/tongue/swallow will be more mature, there is less risk of her choking on these small bits of soft foods than she has if I let her do this now by putting these bits of food in her mouth for her.  So my goal over then next month, is to take advantage of her budding interest in what my husband and I are eating to teach her about variety of foods and to set a good example of healthy eating (since I also know from experience and schooling) that babies and toddlers want to do and be just like mommy and daddy.  So bring on the fruits, vegetables, and healthy food choices in my day to day life!