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| 10.5 months, 2 front-top and 2-front bottom teeth. Corn on the cob to much on |
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| 8.5 months, 2 front-bottom teeth. BBQ ribs with minimal sauce |
Musings of a feeding therapist on raising healthy eaters.
Sunday, May 12, 2013
More Baby Led Weaning...In Action!
Friday, May 3, 2013
5 Tips for Dealing with a baby refusing solids: 6-9 months
Ok for starters, super common! I get asked this question by worried mamas all the time. Not every baby is interested in or ready to start solid foods at 6 months. With this type of baby, often she or he isn't ready until 8 or 9 months to jump into the solid foods-deep end, if you will. But once they are ready, often they dive right in, especially if you haven't pushed them or fretted over them for 2 or 3 months about their behavior.
You might find that each time you offer your baby food, he or she:
- Gags
- Cries
- Turns or shakes head
- Pushes spoon or food away
- Arches back
- Throws the food
- Spits it out
Food refusal at this age (6-9 months) is usually perfectly normal and can often be easily remedied with either a tincture of time or a few small changes to your current approach.
Of course, before I go on, I should say that, yes, these behaviors can be a sign of a medical issue that needs to be addressed- like reflux, gastritis, swallowing issues, or food allergies. However, these things are usually associated with other signs as well- such as poor weight gain, weight loss, rashes, diarrhea, etc. If you suspect your child has a medical issue, consult your pediatrician. Even if you suspect your child does not have a medical condition, you should tell your pediatrician if your child is having difficulty transitioning to solids.
That being said, if your 6-9 month old is doing any of these behaviors at meal times, you're not alone, and he is telling you in every way he can- "Stop!" She might be saying, "I'm not ready, mama!" Or "I'm not sure what to do with this." Or even, "this is scary!" In most other situation when our babies tell us things like this, we of course listen and stop what we're doing to help them. But with feeding, I see that often parents are so anxious about starting the process and eager for their child to take the foods we lovingly prepared or purchased, so we ignore those pleas as we push, cajole, trick, and beg.
While it's a common practice to start the transition to solid foods at 6 months, and in the U.S. to start this process with cereal or other pureed food, some babies just aren't ready at that time. From birth until you start offering solid foods, your baby is using one type of oral motor pattern: sucking, to eat. Once the transition to solids has begun, your baby is being challenged to learn a new skill entirely. With most other skills they learn (rolling, sitting, crawling, etc), babies develop these skills slowly over the course of months of practice and gradual increase in skill and coordination. However, with feeding we expect our babies to be ready from day one to have the skills needed to eat solid foods (purees). This is unrealistic and while some babies respond amazingly well to purees and this transition, many do not. Those babies tend to refuse and fight this transition to solids and while it can be frustrating for us as parents, it's actually a very smart and adaptive response to refuse when something is too hard or doesn't feel safe. If this is your baby: take a deep breath (maybe meditate or drink a glass of wine) and try to see it as a smart move on their part. Back off and do not force or even worry (worry will only lead to bad feelings and axiety for you and the baby around mealtimes). Most parents seem to be ok with this advice for a hot minute, until they look around and realize that if they aren't pushing or encouraging eating they don't really know what to do instead to encourage the transition to solids. For those of you who are in this position, here are a few suggestions for how to help your baby when he or she refuses solid foods at 6, 7, 8, or even 9 months.
1. Model the behavior you want to see. This is such an important one, yet it's so often under-appreciated, under-valued and under-utilitzed (maybe because it seems to simple?) All babies learn best from immitating what their parents do. (Envision anti-drug ad campaign circa 1987, "I learned it from watching you!") Our kids soak up everything we do and repeat the same behavior back to us so tap in to this by...(move on to #2)
2. Sit your baby on your lap at mealtimes, rather than the high chair at first. This way, they are part of the meal but they are not the focus of the meal. They are able to watch you, your food, and anyone else at the table from the comfort of their favorite arms (yours, of course). When on your lap, you may be surprised to see your baby reaching for and trying to grab food items off your plate or from your hands. This is fabulous (the same baby who typically cries and gags with foods is now so interested in what you're eating that he or she just independently tried to grab it!) This is perfectly tapping into their internal motivation to explore while keeping them close enough to you that you can immediately respond to them and help them but also keep them safe. If you find that your baby sits politely in your lap and never attempts to participate in the meal by reaching or grabbing food, this is a sign that he or she is not ready yet for solid foods and just feel confident that you are giving more time and when the baby is ready (in 2 weeks or 2 months, maybe) he will show you by suddenly reaching for everything!
3. Try a different spoon. Or better yet, drop the spoon entirely and replace it with a long hard stick of food that the baby can use instead as the "spoon," such as celery, a zucchini stick, an apple slice, a carrot stick, or even a raw broccoli floret. *If your baby has teeth this should be approached cautiously with direct 1-on-1 supervision to make sure that your baby never bites off a piece he or she can't handle (obviously that could be a choking hazard.* You will be surprised how often babies who are totally upset when a spoonful of puree comes near them, will eagerly participate and eat some puree off of a celery stick. The spoon at that point probably has negative associations connected with it, which a zucchini stick or a broccoli floret does not.
4. Hand over the spoon (or the food item filling in for the spoon) to you baby's control. At this age they want to do it themselves! They are so motivated to explore and try on their own. When we come at them with the spoon, often their first response is to try to grab it from our hands. When we bat their hands away, they become frustrated. What's the worst that will happen if we give them the spoon? They will probably spill on themsleves, on you, on the floor? Yup! But they will have fun, learn, and probably eat a bit in the process. Maybe not the whole jar of food, but they will eat some and that it all that matters. That is all that you need them to do at this age: taste, explore, and practice the motions of eating solids- not actually eat them. At this age (6-12 months) all of the baby's calories and nutrients are coming from milk feeds. (See my other post: Food is for Fun Until Age One for more on this). Quantity really should not mattern for the first several months, which is good because spoon skills are often rocky at first. However, if you are concerned with quantity, try bringing 2 spoons to meal time, load one and place it on the table with handle facing your baby. Let her pick it up and feed herself as best she can. While she does this, you load the next spoon and place it on the table, just like the first. When baby reaches for this one, get the first one back from baby and repeat the process.
5. Consider trying a different approach entirely. If you've been offering purees, look into Baby Led Weaning (see this video of my daughter for additional info on how to do this approach, which focuses on taste and mouth play using whole pieces of foods instead of purees). If you've been trying Baby Led Weaning as your primary approach, consider stopping that for a while and try purees by spoon. Sometimes just changing things up can break your baby out of the negative behaviors and routines that have formed.
In the mean time, keep on breastfeeding or giving formula as needed until your baby shows more readiness and interest in making the transition (most likely closer to 8-10 months).
- Gags
- Cries
- Turns or shakes head
- Pushes spoon or food away
- Arches back
- Throws the food
- Spits it out
Food refusal at this age (6-9 months) is usually perfectly normal and can often be easily remedied with either a tincture of time or a few small changes to your current approach.
Of course, before I go on, I should say that, yes, these behaviors can be a sign of a medical issue that needs to be addressed- like reflux, gastritis, swallowing issues, or food allergies. However, these things are usually associated with other signs as well- such as poor weight gain, weight loss, rashes, diarrhea, etc. If you suspect your child has a medical issue, consult your pediatrician. Even if you suspect your child does not have a medical condition, you should tell your pediatrician if your child is having difficulty transitioning to solids.
That being said, if your 6-9 month old is doing any of these behaviors at meal times, you're not alone, and he is telling you in every way he can- "Stop!" She might be saying, "I'm not ready, mama!" Or "I'm not sure what to do with this." Or even, "this is scary!" In most other situation when our babies tell us things like this, we of course listen and stop what we're doing to help them. But with feeding, I see that often parents are so anxious about starting the process and eager for their child to take the foods we lovingly prepared or purchased, so we ignore those pleas as we push, cajole, trick, and beg.
While it's a common practice to start the transition to solid foods at 6 months, and in the U.S. to start this process with cereal or other pureed food, some babies just aren't ready at that time. From birth until you start offering solid foods, your baby is using one type of oral motor pattern: sucking, to eat. Once the transition to solids has begun, your baby is being challenged to learn a new skill entirely. With most other skills they learn (rolling, sitting, crawling, etc), babies develop these skills slowly over the course of months of practice and gradual increase in skill and coordination. However, with feeding we expect our babies to be ready from day one to have the skills needed to eat solid foods (purees). This is unrealistic and while some babies respond amazingly well to purees and this transition, many do not. Those babies tend to refuse and fight this transition to solids and while it can be frustrating for us as parents, it's actually a very smart and adaptive response to refuse when something is too hard or doesn't feel safe. If this is your baby: take a deep breath (maybe meditate or drink a glass of wine) and try to see it as a smart move on their part. Back off and do not force or even worry (worry will only lead to bad feelings and axiety for you and the baby around mealtimes). Most parents seem to be ok with this advice for a hot minute, until they look around and realize that if they aren't pushing or encouraging eating they don't really know what to do instead to encourage the transition to solids. For those of you who are in this position, here are a few suggestions for how to help your baby when he or she refuses solid foods at 6, 7, 8, or even 9 months.
1. Model the behavior you want to see. This is such an important one, yet it's so often under-appreciated, under-valued and under-utilitzed (maybe because it seems to simple?) All babies learn best from immitating what their parents do. (Envision anti-drug ad campaign circa 1987, "I learned it from watching you!") Our kids soak up everything we do and repeat the same behavior back to us so tap in to this by...(move on to #2)
2. Sit your baby on your lap at mealtimes, rather than the high chair at first. This way, they are part of the meal but they are not the focus of the meal. They are able to watch you, your food, and anyone else at the table from the comfort of their favorite arms (yours, of course). When on your lap, you may be surprised to see your baby reaching for and trying to grab food items off your plate or from your hands. This is fabulous (the same baby who typically cries and gags with foods is now so interested in what you're eating that he or she just independently tried to grab it!) This is perfectly tapping into their internal motivation to explore while keeping them close enough to you that you can immediately respond to them and help them but also keep them safe. If you find that your baby sits politely in your lap and never attempts to participate in the meal by reaching or grabbing food, this is a sign that he or she is not ready yet for solid foods and just feel confident that you are giving more time and when the baby is ready (in 2 weeks or 2 months, maybe) he will show you by suddenly reaching for everything!
3. Try a different spoon. Or better yet, drop the spoon entirely and replace it with a long hard stick of food that the baby can use instead as the "spoon," such as celery, a zucchini stick, an apple slice, a carrot stick, or even a raw broccoli floret. *If your baby has teeth this should be approached cautiously with direct 1-on-1 supervision to make sure that your baby never bites off a piece he or she can't handle (obviously that could be a choking hazard.* You will be surprised how often babies who are totally upset when a spoonful of puree comes near them, will eagerly participate and eat some puree off of a celery stick. The spoon at that point probably has negative associations connected with it, which a zucchini stick or a broccoli floret does not.
4. Hand over the spoon (or the food item filling in for the spoon) to you baby's control. At this age they want to do it themselves! They are so motivated to explore and try on their own. When we come at them with the spoon, often their first response is to try to grab it from our hands. When we bat their hands away, they become frustrated. What's the worst that will happen if we give them the spoon? They will probably spill on themsleves, on you, on the floor? Yup! But they will have fun, learn, and probably eat a bit in the process. Maybe not the whole jar of food, but they will eat some and that it all that matters. That is all that you need them to do at this age: taste, explore, and practice the motions of eating solids- not actually eat them. At this age (6-12 months) all of the baby's calories and nutrients are coming from milk feeds. (See my other post: Food is for Fun Until Age One for more on this). Quantity really should not mattern for the first several months, which is good because spoon skills are often rocky at first. However, if you are concerned with quantity, try bringing 2 spoons to meal time, load one and place it on the table with handle facing your baby. Let her pick it up and feed herself as best she can. While she does this, you load the next spoon and place it on the table, just like the first. When baby reaches for this one, get the first one back from baby and repeat the process.
5. Consider trying a different approach entirely. If you've been offering purees, look into Baby Led Weaning (see this video of my daughter for additional info on how to do this approach, which focuses on taste and mouth play using whole pieces of foods instead of purees). If you've been trying Baby Led Weaning as your primary approach, consider stopping that for a while and try purees by spoon. Sometimes just changing things up can break your baby out of the negative behaviors and routines that have formed.
In the mean time, keep on breastfeeding or giving formula as needed until your baby shows more readiness and interest in making the transition (most likely closer to 8-10 months).
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