breastmilk, feedings, breastfeeding, blw, solid foods, nutrition

Breastmilk or solid foods? Weighing up the issues

Breastmilk or solid foods? Weighing up the issues

 

Parents who are following Baby Led Weaning (BLW) sometimes have questions or concerns if their baby seems to rely on breastmilk feeds and doesn’t eat very much solid food, especially when they get to around a year old.

First off, I would like to thank Gill Rapley, who wrote the following text about BLW. I’m sharing it because it’s so useful to parents who follow me. Thank you Gill!

Questions include:

  • How quickly should milk feeds be phased out?
  • Does a greater reliance on breastmilk (or formula) lead to slower weight gain?
  • Will cutting down the milk feeds help my baby eat more solid food?

 

For simplicity, I’ll assume that the ‘milk’ in question is breastmilk. Breastmilk has more intrinsic value for the infant than formula. Especially  in terms of protection from infection. However, much of what follows may well apply to formula feeding as well.

(Please note: I’m not in a position to offer individual advice for babies I have never met, and would not seek to override the advice of health professionals regarding babies whose health may be a genuine cause for concern, so this is a general discussion.)

 

Background – why do people expect weaning to happen quickly?

 

For many years babies were started on solid foods at four months of age (or even younger). So the transition to family meals was actively controlled by their caregivers. Parents were encouraged to cut out milk feeds and increase the amount of solid food eaten by the baby. This was to be done according to a pre-determined schedule. Pureed or mashed food would be spoon fed to babies and they were encouraged to drink lots of cow’s milk.

The aim was to completely replace breastmilk (or formula) with a mixed diet of solid food and cow’s milk by the first birthday. At the same time, a huge rise in formula feeding led to a lack of confidence in breastfeeding. Formula allowed parents to control their babies’ intake from the moment of birth. However, it was in a way that was impossible (and undesirable) with breastfeeding. All of this made artificially controlling the transition to solid foods easy because:

  • the quantity of formula taken at each feed could be cut down at a rate decided by the caregiver
  • the baby could be encouraged to take more solid food than he or she really wanted. (Mouthfuls of puree are difficult to spit out and tend to be swallowed quickly, with no need to chew)

 

What could  happen when parents control the pace of weaning?

 

The pace of weaning was put firmly in the hands of care givers, rather than of babies themselves. So the transition to solids was artificially speeded up so that it would occur more quickly than would happen naturally.

The upshot of all this is that many parents, grandparents and professionals are concerned when they see a baby of around a year old eating very little solid food. A one-year-old relying mainly on milk feeds, with just a few tastes of other foods, may appear to be ‘abnormal’. This may give caregivers a possible indication that something is ‘wrong’. If that baby is self-feeding, as in BLW, they assume that the answer is to take control and manage his feeding for him. This is usually done by introducing purees and spoon feeding, or by actively reducing feeds of breastmilk or formula – or both- even though there is no evidence that this does anything to improve a baby’s health.

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For breastfed infants the quantity of milk intake is up to the baby, thus the decision to stop or continue feeding is made by the infant themselves.

What about nutrition?

 

There is no rationale for pushing solid foods at the expense of breastmilk. No solid food comes close to the concentration of nutrients in breastmilk. So, mouthful for mouthful, breastmilk will always provide better total nutrition than any other food. Seeking to replace breastmilk in a child’s diet risks them being less well nourished, not more. (This is the reason many societies give breastmilk to sick or elderly people who can’t manage large quantities of other foods.)

All that babies need, once they’re over six months, is access to small amounts of other foods to make sure they’re getting enough micro-nutrients. Of these, iron (and zinc) are probably the most important. However, the amounts of food needed to supply these needs are extremely small, especially if red meat is included. (Note: An individual baby’s stores of iron can be affected by the timing of the cutting of the umbilical cord at birth. If it is left to finish pulsating, the baby gets the maximum amount of iron possible, making it likely that his stores will last well beyond six months.)

 

How important is breastmilk?

 

As explained above, the rush to replace breastmilk is a throwback from when we didn’t know much about its constituents. As well as when we didn’t understand how inadequate cow’s milk is as a substitute. In the light of more recent evidence of the value of breastmilk it’s clear that, rather than preventing them from eating other foods, breastmilk provides an important safety net for a child whose appetite for other foods is small. Put another way, if a child isn’t thriving on a diet of breastmilk with other foods, the thing that makes least sense is to replace the breastmilk! Plus, there are reported cases of babies who were later found to have digestive problems or allergies, and whose intake of breastmilk turned out to be crucial to their survival and well-being. We need a very good reason to deny babies access to their mother’s breast at any age.

 

Does intake of solids offer better nutrition than breastmilk?

 

Many health practitioners believe that spoon feeding will increase the baby’s intake of solid food in addition to their milk.  This simply doesn’t work if the baby is breastfed. Provided they are allowed to feed whenever they want, breastfeeding babies are always in charge of their milk intake. It’s impossible to persuade them to continue feeding at the breast when they’ve taken all their body tells them they need. This natural appetite control means that, if their tummy is full of solids, they will take less breastmilk to compensate.

So, like it or not, the solid food will replace breastmilk, not add to it. This will reduce, not increase, the baby’s overall nutrition. (Note: This approach can be made to work with formula feeding because it’s possible to encourage the baby to continue feeding beyond the point where they would naturally stop. Unfortunately, this also teaches them to routinely ignore signs of fullness and is one possible reason why formula feeding is linked to obesity.)

baby, formula feeds, nutrition, intake

 

What about weight?

 

As well as providing energy, most of what babies eat and drink maintains their body systems and growing new cells. Of course some weight gain is expected as babies grow. We should note that what is recognized nowadays as ‘normal’ weight gain is less than it used to be. We no longer believe that ‘bigger is better’ where babies are concerned. However, we have a legacy of attaching huge importance to weight that is hard to move away from. In addition, weighing has wrongly been seen as a good way to assess whether breastfeeding is ‘working’. There has been an inappropriate additional focus on weight for breastfed babies.

 

It’s important to bear in mind that weight gain is rarely regular or constant. The overall pattern over a period of weeks or months is more meaningful than one or two weights taken individually. Some babies and toddlers’ weight slows down for a while to compensate for an earlier period of rapid gain. Plus, if there weren’t some naturally small (and large) babies, the centile lines on the weight charts wouldn’t be there.

 

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 What are the other health indicators ?

Weight is only one guide to a child’s health. Equally important observations are length, head circumference, muscle tone, appetite, bowel habits, temperature, color and energy levels. Any one of these may temporarily give rise to concern but on its own rarely indicates anything sinister. Although it may trigger a need to undertake further investigations. In particular, length and head circumference can often be better indicators of a child’s growth than weight. If both these are on target then it’s unlikely there’s anything wrong.

 

Babies are weighed primarily to signal any illnesses that might otherwise have gone unnoticed (digestive disorders, growth hormone deficiencies and heart defects). Given the calorie content of breastmilk, it is very unlikely that a baby whose appetite for solid food is small but who is feeding well and frequently at the breast will not be getting all the nourishment they need. The response to any concern about weight should therefore be to compare it with other observations. Then if necessary, investigate further, not to use the weight as a reason to swap breastmilk for solid food. If there are any suspicions that an individual baby’s gentle (‘slow’) weight gain may be due to an underlying illness, then those suspicions should be acted upon – because whatever it is won’t go away just by forcing the baby to eat more.

 

The key message

In summary, we need to adjust our expectations about what babies should be eating in the last part of their first year. Unless there is good reason to suppose otherwise, we should assume that those who choose to eat only small amounts of solid foods are simply letting their parents know that breastmilk is doing a great job. They will phase out breastfeeding when they are ready. Meanwhile, all we need to do is carry on including them in healthy, relaxed family mealtimes. This way they can make their own decisions about when they feel ready to share those meals more fully.

 

To get all the information you need about introducing complementary foods, sign up for my online course at blw.jessicacoll.com . You’ll get my unlimited support and all the answers to your questions.

 

What’s your main concern about your baby making the switch from primarily milk feeds to solid foods? Comment below!

 

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My baby isn’t a good eater

My baby isn’t a good eater

 

It’s common for parents (and grandparents) to worry because their baby is ‘not eating well’, especially as the baby gets older. Parents are often told that he or she should be eating a full family diet by their first birthday. But is being a ‘good’ eater really necessary for the baby?

I would like to thank Gill Rapley, the one who coined the term Baby Led Weaning (BLW) who wrote the text below. Please check out her website for more information at rapleyweaning.com.


What’s normal?

 


BLW babies follow their own patterns when starting solid food. For example, your baby may:


• Set off enthusiastically, munching on everything in sight, gradually swallowing more and more of it and never looking back. (Probably the least common pattern)


• Progress slowly but steadily through looking, experimenting, licking and tasting, and then eating, gradually increasing the amount she consumes.


• Eat almost nothing for weeks or months (with or without being keen to touch and taste) and then suddenly show enthusiasm for food.


• Set off enthusiastically and then seem to lose interest in food altogether.


None of these patterns suggests a problem. Most BLW babies don’t eat significant amounts of solid food until they reach 8 or 9 months, and some not until after their first birthday. Those who start off enthusiastically and then lose interest simply enjoy the novelty of food more than those who start more slowly. When that wears off, they slow down for a while. [Note, though, that if a baby of 6-8 months shows no interest in picking up food or any other objects (such as toys or keys) and exploring them with her mouth it’s possible there’s an underlying reason, such as delayed development, so she should be checked by a doctor.]

 

baby,eating,good,eater,solid foods,blw
This baby is thoroughly enjoying her meal!

Putting things into perspective

A normally developing, healthy baby who appears to be ‘not eating well’ is probably just eating less than his parents or others think he should. In the second half of their first year, the only nutrients babies need in addition to breast milk are iron and zinc. A few licks or bites (not mouthfuls!) each day from foods rich in these minerals, such as meat and eggs, is almost certainly enough to provide this. Babies don’t starve themselves – if they are hungry, they will eat. The problem is that our expectations of how much babies should eat tends to be based on the amounts they eat when they’re spoon fed. But …

 

  • Spoon feeding (by someone else) is not a natural part of babies’ development. It just became the usual method of feeding when it was thought babies needed solid food before they were old enough to feed themselves.
  • Spoon feeding and purees make it difficult for babies to follow their appetite. They tend to swallow mouthfuls faster and end up eating more than they really need.
  • Pureed food contains a lot of liquid – so it may look like more food than it really is.
  • Pressuring a baby to eat certain foods, or more than they want, can lead to problems
    such as picky eating or food refusal.
  • Breast-milk (or formula) can continue to provide most of a baby’s nourishment well beyond one year.

 

breast milk, breat feeding, blw, nourishment, nutrients, food, eating, eater
Despite baby’s introduction to solid foods, breastfeeding (or formula) remains the primary source of nourishment.

What are the signs of a ‘ good eater ‘?

 

If you think your baby is a ‘poor eater’, the solution is not to try to change what the baby is doing but to redefine what you think makes a good eater. A good eater is a baby who:


• responds to his own appetite (eating when he’s hungry, stopping when he’s had enough)
• drinks as much breastmilk or formula as he needs
• has the opportunity to try lots of different foods, without any pressure
• can choose the nutrients he needs (from healthy food offered)
• is interested in exploring food and practising self-feeding skills
• enjoys mealtimes

If your baby does all of these things, he’s a good eater – even if he doesn’t actually swallow very much at all!


What should I do?

 

  • Continue to offer breastfeeds or formula whenever your baby wants. Restricting milk feeds (as parents are sometimes advised to do in the hope the baby will eat more solid food) is likely to mean less nourishment not more.
  • Continue to share mealtimes with your baby, giving her the opportunity to explore and taste a range of healthy foods.
  •  If your baby is over 10 months, don’t keep giving her back food that has been deliberately thrown on the floor. This is her way of saying “No thanks”.
  • Try offering foods in smaller pieces, or introducing cutlery. Some babies get bored with being treated as newbies and want to practise more advanced skills!
  • Don’t make a fuss if your baby doesn’t seem to like something. Just carry on offering some of whatever you are eating. (Some babies persistently avoid certain foods and are later found to be allergic to them, so it may be wise to trust your baby.)
  • Remember that it’s normal for a baby who is unsettled for some reason (starting daycare for example) or becoming unwell, to go off solid food for a while and want more milk.

 

Baby-led weaning is about nurturing a good relationship with food, not about persuading babies to eat what we think they should. All babies spontaneously move on to other foods in their own time. As a parent, all you need to do is make food available, within reach, and to act as a role model by including the baby in your own mealtimes. Your baby will take care of everything else.

 

To get all the information you need about introducing complementary foods, sign up for my online course at blw.jessicacoll.com . You’ll get my unlimited support and all the answers to your questions.

 

I’d like to know: is your baby a good eater? Why or why not? Comment below!

 

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Sitting upright – what does it mean?

Sitting upright – what does it mean?

 

‘ Able to sit upright ‘ is recognized as one of the key signs of readiness for solid foods, and especially for BLW. But what does it mean and why does it matter? Let’s start with why it matters …

First off, I would like to thank Gill Rapley, who wrote the following text about Baby Led Weaning (BLW). I’m sharing it because it’s so useful to parents who follow me. Thank you Gill!

 

Why does sitting upright matter?

 

  • Readiness: If your baby can’t yet sit upright, that’s a fairly good sign that his wider development hasn’t reached the point of readiness, either. Chewing skills and digestive abilities tend to develop at the same pace as a baby’s ability to sit upright. If your baby is offered food before he’s developmentally ready to manage it, his gut may be exposed to food too soon and he will be more at risk of choking.

 

  • Safety: Babies need to be upright to coordinate swallowing and breathing easily. They can’t do this if they’re slumped forwards or sideways. They also need to be able to control food inside their mouth. This is so that it doesn’t slip backwards, towards their airway, before it’s ready to be swallowed. A leaning-back position makes this very tricky – and therefore dangerous. Imagine lying back to eat, or trying to chew with your chin on your chest. See how uncomfortable and unsafe these positions would be?

 

  • Self-feeding: Babies need to be able to lean forward to reach food, pick it up with both hands, and look around – all without losing their balance. To do this they must be stable in an upright position.

 

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This baby is able to lean forward without losing her balance.

What is ‘upright’?

 

Definitions of ‘upright’ depend on a baby’s developmental stage. This can be confusing when you’re looking for the one that means your baby is ready to start BLW:

From birth a baby can be held in an upright position if the whole trunk and spine is supported. She can’t do it alone.

Sometime after 5 months babies start to be able to hold their head and trunk erect if they are supported around the hips.

 

sitting, upright, blw, solid foods, support, baby
Here is a 5 month old baby who is able to hold it’s head and trunk upright since there is support at the hips.

By 7 to 8 months most babies are able to stay in a sitting position for a minute or so on the floor, with no support.

 

 

By 8 to 9 months babies are starting to be able to get into a sitting position from a lying down or crawling position.

 

The importance of upright positioning

 

What matters for safe eating, and for BLW, is that your baby can support her head and trunk in an upright position for long enough to explore some food – and to eat it, if she’s ready. If she needs a bit of support around her hips to do this, that’s fine. There’s no need to wait until she can stay upright with no support at all. No need to wait until she can get herself into a sitting position. There’s also no ‘60-second rule’, as some believe. It’s the position and balance above her pelvis that she needs to be able to maintain. A normally developing baby will be able to sit upright well enough to allow her to handle food and eat safely by six months or soon after. If you notice that this is not the case with your baby, I suggest making an appointment with an occupational therapist or pediatric physical therpist.

 

baby,blw,sitting,up, upright,stability

 

How to help your baby to sit comfortably and safely

 

There are several options for helping to make exploring food easy and safe for your baby:

  • Sit him on your lap, facing the table, and support his hips with a hand on either side of his bottom (not around his waist, which will restrict his movement). Many babies like the reassurance of this closeness at their first few meals
  • For picnics, or eating on the floor, sit your baby between your legs, facing forwards. This allows you to have both hands free while also providing the support he needs.
  • If your baby is happy in a high chair, then a rolled-up towel around his hips can fill the space between his bottom and the sides of the chair. If the seat is slippery a small towel between his legs will help to stop him sliding forward.
  • Older babies, and toddlers, are likely to find a foot rest helpful. (Worth remembering when buying a high chair!)
  • So, your baby is ready to get started with baby-led weaning as soon as he is able to sit upright securely and stably enough to handle food safely and effectively – with a little bit of support from you if he needs it.

 

To get all the information you need about introducing complementary foods, sign up for my online course at blw.jessicacoll.com . You’ll get my unlimited support and all the answers to your questions.

 

Have you noticed your baby sitting upright and would like to try BLW? Comment below!

 

How early is too early to start introducing solid foods?

How early is too early to start introducing solid foods?

I am often contacted by parents whose baby of 22-24 weeks is showing interest in solid food. They are wary of starting too early,  yet feel their baby is giving them a clear lead that s/he is ready. While I am unable to offer specific guidance for individual babies, my general response to this dilemma is as follows.

 

I would like to thank Gill Rapley, the one who coined the term Baby Led Weaning (BLW) who wrote the text below. Please check out her website for more information at rapleyweaning.com.

 

The 6-months ‘rule’

I always refer to the 6-months ‘rule’ because it keeps babies safe from premature interference with their eating. However, my actual position, based on my research and clinical experience, is that whatever an individual baby is ready to do is probably what’s right for that baby. There is good reason to believe that those developmental abilities that are visible to us (sitting upright etc.) are a reliable indicator of the maturity of that baby’s (internal) digestive system – nature very rarely makes mistakes. So, if a full-term, healthy baby can (genuinely) sit upright, grasp food and get it to his mouth UNAIDED, then he’s probably ready to do just that. If he’s also ready to chew it – and perhaps even swallow it – that’s fine, but it is more likely that these skills will follow in due course.

 

I make a point of emphasizing the six months ‘rule’, even though I don’t consider it to be cast in stone. This is because it’s all too easy for those who don’t understand the concept of BLW to misinterpret any suggestion that starting earlier than this is acceptable. This can be the beginning of a slippery slope into dangerous practices, which I absolutely do not condone.

 

baby, blw, introduction, solid foods
It’s really exciting to start foods but this baby isn’t quite ready yet!

 

What is the ultimate goal?

The problem is that it’s tempting to see more ability in one’s child than is actually there, and to offer that little bit of help to enable them to achieve a particular goal. This includes: providing extra support to sit up or reach out, guiding their arm towards their mouth, or – worse – putting the food into their mouth ‘for them’. Mostly, this doesn’t matter, but when it comes to eating, a baby’s ability – or inability – to manage the necessary sequence of actions is an important safety factor. ‘Helping’ them over a hurdle they cannot yet manage for themselves is potentially hazardous.

 

It’s useful to remember that the ‘achievement’ of eating is the adult’s goal, not the child’s. The baby doesn’t know that’s what the point of all this is. She is just finding out how her own body, and the things around her, work. If she doesn’t manage to get the food to her mouth, sowhat? She hasn’t ‘failed’ – and she has no sense of needing help. Her parents’ role is to give her the OPPORTUNITY to do whatever she is ready to do. Whether that be touching food, picking it up, licking it, biting it, chewing it and/or swallowing it – or none of the above – not to enable her to do something she can’t yet manage. Six months represents an average age of readiness, in the same way that most babies take their first step around their firstbirthday.

 

Is 6 months the ‘magic’ age?

Clearly some will be ready to walk earlier – and some later – than that. We don’t try to prevent those who are ready earlier from walking before the ‘correct’ age. If we are prepared to accept that a good proportion of babies will not be ready to feed themselves with solid foods until they are seven, eight or nine months, then it is perfectly reasonable to allow that there will also be a few who may begin before they reach the ‘magic’ age of six months. The crucial point, as I see it, is that the move should be spontaneous and autonomous.

 

In my opinion, arguments about the ‘right’ age for introducing solid foods are important only if it’s the parent, not the baby, who decides when putting food into her/his mouth should begin – as happens, of course, with spoon feeding. Such arguments are redundant if the decision is made by the baby because all babies develop eating skills in a set sequence, in line with their overall maturity. Theoretically, there is no reason why a baby of one or two months old should not be offered the opportunity to sit upright and pick food up from a plate.

 

What stops this being a sensible option is not that this is the ‘wrong’ age but that the baby simply isn’t capable of it. The same would apply at three, four and five months. It is extremely unlikely that any infant under about five and a half months would, without any ‘help’, be able to get more than a taste of solid food. Those that can are the exception, not the rule. Provided this is fully understood, starting solids ‘early’ does not, in my view, constitute a problem.

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         Here’s a 5-month-old baby who is not ready to start complementary foods

What are the words to describe what is happening?

A key challenge in all this is that we don’t have the right words to describe the introduction of solid foods when the baby is in control. ‘Starting solids’ with spoon feeding and purees means someone else putting food into the baby’s mouth on a day decided by them. But ‘starting solids’ using BLW simply means providing babies with the opportunity to eat if and when they want to and are able to. It’s up to the baby to take it from there.

 

To get all the information you need about introducing complementary foods, sign up for my online course at blw.jessicacoll.com . You’ll get my unlimited support and all the answers to your questions.

I want to know: how early did you start solid foods with your baby? Comment below!

kiwi, blw, baby led weaning, baby, babyfood, food

How to Serve Kiwi to Your BLW Baby

How to Serve Kiwi to Your BLW Baby

Looking for a new fruit to serve your baby? Do you want your little one to experience something other than bananas and oranges while doing baby-led weaning? Why not give the kiwi a try! This fuzzy fruit is actually a berry, and pound for pound contains more vitamin C than oranges.

Ripe kiwi has the ideal texture for an infant just starting their real food journey. All that hairy skin comes in handy too. Not only is it edible, but it helps tiny hands get a good grip on an otherwise slippery fruit. Ki-Oui!

 

Watch this video to see how easy it is to prep kiwi for your BLW baby:

If you found this video useful and would like to see more like it, subscribe to my channel today!

 

How to Prepare Kiwi for Your BLW Baby

You want to start by choosing a soft and ripe kiwi. If the fruit is underripe, the white middle section can be tough for babies who are just starting to eat on their own.

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Gently press the skin of the kiwi; if it gives way, it is ripe!

 

Next you want to give the skin a gentle scrub under cold water. It is important that the skin is clean since it will without a doubt go into your curious baby’s mouth.

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Take a sharp knife and cut the kiwi into quarters with the skin on. Cut the end corners off each quarter to ensure none of the hard stem area is included.

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Remove the corners to make this kiwi BLW safe

 

Serve it just like that to your baby. If you find the middle section is still too tough, you can remove it before serving. If you don’t feel comfortable leaving the skin on and your baby does well without the skin, you can remove it. It’s just that the skin tends to help the kiwi slide less in their mouth. Your choice! Make sure you always supervise your baby when he or she is eating.

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The “key”-wi to your babies health is fresh, whole foods

 

Which fruits do you like serving to your BLW baby? Tell us in the comments below!

How to Practice Safe BLW During the Holidays (2 of 3): Foods to Avoid

How to Practice Safe BLW During the Holidays (2 of 3): Foods to Avoid

During this festive season, we want you and your family to stay happy, healthy, and of course, safe. That is why we developed part two of our series on how to practice safe BLW during the holidays.

There are many holiday foods, during any occasion whether it be Christmas, Chanukah or Kwanzaa, that are safe for baby with modifications. However, certain foods should be avoided if you want the challah-days to stay safe, and we have listed several of them in this post.

 

Watch this video to see which foods should be avoided during the holiday season for BLW infants:

Like this video and want to see more free BLW content by a registered dietitian? Subscribe to my channel today!

 

Traditional Holiday Foods to Avoid in BLW

 

Certain Appetizers or Snack Foods 

Any small, hard and round snack food is a choking hazard for baby. This includes festive popcorn, fancy escargot and many items on a charcuterie board, including olives, nuts, grapes or hard cheeses.  Holiday candies or chocolate should also be completely avoided.

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Certain Fruits and Vegetables

The cherry tomatoes or raw vegetables you see on a holiday platter are often too hard or are the wrong shape for baby. Other common holiday foods to be avoided are peas, cranberries (including sauces), and pomegranate seeds.

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Pomegranates are delicious but are too small, round, and hard for your BLW baby.

 

Fresh White Bread

Fresh white bread is often an accompaniment to holiday meals, but for baby it can become very sticky while they try to manipulate it in their mouth. Fresh bread mixed with saliva can get stuck on the roof of the mouth and is therefore a choking hazard.

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Raw Fish or Raw Meats

Even though smoked salmon or oysters may seem like the right texture, they have not been properly heat treated to remove the risk of contamination. For this reason, they should be avoided.

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Follow these tips during the holidays and throughout the year to keep your little one safe.

 

Do you feel comfortable about which foods to avoid during the holidays? Let us know in the comments below!

How to Practice Safe BLW During the Holidays (1 of 3): Foods to Include

How to Practice Safe BLW During the Holidays (1 of 3): Foods to Include

🎶Fa-ba-ba-ba-ba, ba-ba-ba-baby led weaning🎶! It is that time of year again (the holidays!), full of yuletide and cheer, family and friends, and of course, good food and drink. We think you should spend this time with loved ones, not lugging around jars of baby food or stressing over finding the microwave in a turbulent holiday kitchen.

So how can you include your BLW bonhomme-de-neige in the festivities safely? With baby-led weaning, your baby can eat the same thing as the rest of the family, with some simple modifications. Brace your elves because we have a foolproof ‘how-to’ guide coming up!

 

Watch us explain how simple BLW during the holiday season can be in this video:

If you enjoyed this video and would like to see more like it, subscribe to my channel today!

 

Common Holiday Foods Modified for BLW

 

Turkey

This classic holiday protein is delicious and nutritious. For baby, offer the dark meat as it is usually more tender, and contains more of the iron and fat that baby needs. Remove the skin, which contains most of the salt, and choose a piece that is about the size of an adult pinky finger.

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You’ll be stuffed with ideas once you have read through this guide.

 

Steamed Green Beans

Tender steamed beans are perfect both in shape and texture for BLW babies. Make sure to rinse off any sauces that may be served with the beans.

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Steaming the beans locks in the nutrients but makes them tender enough for little mouths.

 

Potatoes 

Mashed potatoes can be offered right on your babies platter, or on a preloaded spoon. Another option is scalloped potatoes, which have a wonderful soft texture and if cut thick enough, are easy for baby to grab and bring to their mouth.

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Make sure mashed potatoes are made extra creamy, so there are no lumps.

 

Anything Else!

Having something other than these three common foods? Try it out yourself before serving it to baby! First, always make sure the food is about the size of an adult pinky finger or larger. Then, pretend you have no teeth and squish it against the roof of your mouth with your tongue. If it comes apart and is easy to swallow, it is safe to offer to baby.

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Will you include baby at the holiday table? Tell us in the comment section.

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Choking and Baby Led Weaning

Choking and Baby Led Weaning (BLW): What does the most recent research say?

 

 

Last week during one of my webinars about BLW, a registered dietitian harshly interrupted me to voice her concerns about choking. She told me that what I’m saying is very scary and I should take my videos down. She said that my babies are cute and all but I should temper my enthusiasm about BLW. I’m sure this dietitian isn’t the only one to be scared about choking. That’s why I wrote up this blog post that addresses why babies who do BLW safely are not more at risk of choking compared to babies who eat jarred baby food, using the most recent research. I would like to thank Gill Rapley and dietetics intern Natalie Quathamer for their support and assistance in addressing this.

 

Choking: the main concern

When it comes to Baby Led Weaning, both parents and healthcare professionals find the risk of choking as a major concern. This is a very fair concern, as a baby’s first bite is a brand new experience of mastering chewing, swallowing and breathing all together for the first time, putting them at an overall higher risk of choking. To help quantify the current state of the issue, more than 12,000 children from age 0-14 have a non-fatal choking incident attributable to food in the US each year, as found by Chapin et al. in 2013 (1). No parent wants their child to choke, and as a professional it is your duty to protect the wellbeing of your clients. Unsurprisingly, choking is reported again and again as the #1 fear with regards to BLW in studies such as that by D’Andrea et al. in 2016 (2). That’s why I will spend a considerable amount of time addressing this very warranted concern.

 

What’s my objective with this post?

The goal here today is to focus on making you feel more comfortable with the fact that BLW babies are not more at risk of choking than babies fed with traditional spoon-fed approaches, using the most recent science.

 

What about baby’s motor skills?

First, let’s take a look at the average feeding timeline for a baby, to better understand the physiology of feeding. As many seminal studies, such as that by Woolridge in 1986 (3) have seen, at birth babies are able to feed themselves on their own. Physiologically, they have the innate reflex to suckle at the breast. Babies know when to feed, how to feed, when to stop and at what pace. Once they hit 1 ½ or 2 years old, we can again assume that most babies can feed themselves without help. This leaves a gap, starting at around six months, where we assume we have to feed babies with a spoon. However, babies do not lose their ability to self-regulate on when to feed, when to stop and at what pace, but are simply developing new physiological traits that change how and what they eat. These motor skill changes that develop around 6 months, like coordinating the grabbing and bringing of big objects like toys to their mouth and being able to sit upright with minimal help, make self-feeding a reasonable endeavour for most healthy infants at this time, as indicated in a literature review done by Cameron, Heath and Taylor in 2012 (4).

 

Traditionally speaking, we don’t tend to respect these new developmental milestones which can be a problem. Babies are then subject to being fed, at someone else’s pace and on someone else’s schedule, which has the power to lead to unexpected bites, overconsumption and a more stressful feeding environment.

 

What about oral motor skills?

So babies can maintain the correct position and bring food to their mouth, but what about oral motor skills? Well in their 2017 study, Cameron, Heath and Taylor (4) continue by noting that infants are able to handle foods that are soft in texture at 6 months by “munching” which is using up and down jaw movements to mash the food and eventually form a bolus. With this linear practice of munching, biting and chewing with age, babies get to apply and tweak their oral motor skills as they come in, rather than waiting in a spoon-feeding approach. This may have the power to prevent possible feeding difficulties in the future as well as choking episodes, since they have already developed, tested and fine-tuned their skills.

 

The gag reflex

I want to touch briefly on gagging, the protective reflex that helps prevent choking. Babies at six months of age have a gag reflex that is triggered at a much more frontal place in their mouth, as indicated by Rapley in 2011 (5). A possible benefit of BLW is that since only large pieces of food are offered at a time when the gag reflex is at the front of the mouth, this may help keep only well-masticated food to the back. It is important to note that BLW babies may gag more than their spoon-fed counterparts, as seen in the BLISS study by Taylor et.al in 2017 (6). However, by 8 months of age when these babies had a better grasp on self-feeding, they began to gag less than the control group.

 

Safety of jarred foods

Another consideration is the question of whether purees themselves are easy to eat, particularly once the ability to chew has developed. As noted in the thesis by Delaney in 2010 (7), for babies who can chew, purees are actually not that easy to manage, as the puree spreads throughout the mouth with chewing action and is very difficult to gather in a bolus.

 

What does the most recent science say?

Let’s finally get down to the nitty-gritty: what exactly does the newest science have to say specifically about BLW and choking risk? The best evidence to refute the idea that BLW leads to a higher choking risk is again the ongoing BLISS study by Taylor et.al in 2017 (6). This was a 2 year long Randomized Control Trial (RCT), where a control group of spoon fed babies were compared with a group of babies fed using the BLISS method, which is a combination of regular BLW techniques with extra instruction (such as choking prevention and offering high iron foods). Overall, the study found that that there was no difference in the number of babies who choked between the groups. Not only that, but it found no evidence of growth faltering or risk of iron deficiency in BLISS babies.

 

Another RCT by Fangupo et.al in 2016 (8) also showed that infants are not more at risk of choking following a BLW approach than spoon-fed. Better though still, is an editorial in the journal JAMA pediatrics, by Lakshman, Clifton and Ong in 2017 (9). This study pronounces BLW as a safe and effective intervention; no difference in energy intake, growth faltering or iron deficiency were noted, and no more choking incidents than in traditional spoon feeding. They even go so far as to suggest it may be recommended. It is important as purveyors of accurate science to look at all sides of the research. Another study from New Zealand by Morison et.al in 2016 (10), did indicate a possibly higher choking risk with a BLW-style approach. However, this study did not adequately define BLW; parents simply chose if they thought themselves to belong in the BLW group or the traditional feeding group, making the results difficult to state in a conclusive manner. An important take-away from this study was that education regarding inappropriate foods for infants, whether doing BLW or spoon-feeding, continues to be low. This further promotes the role of the dietitian during the infant feeding process, regardless of the approach.

 

What is the takeaway?

In summary, we need to remember that choking is a multifactorial issue; posture, chewing abilities, and distractions all need to be accounted for. However, with a dietitian-led BLW approach, babies are focused on their food, able to eat at their own pace, are under no pressure and most importantly, are not at a higher risk of choking than with purees.

 

How can we make sure BLW is being done safely?

  1. Make sure the baby is sitting upright while eating (none of those lying back bouncy chairs or high chairs that aren’t at 90˚).
  2. Limit distractions: no TV, IPad, cell phone or big crowds for the first few weeks so baby is not overwhelmed and can focus
  3. Make sure the baby is ready to feed him/herself on their own. Don’t start too early
  4. Do not feed the baby by putting foods into their mouth. You can lodge the food further down and actually cause choking by doing this
  5. Offer appropriate foods that they can easily grab and are soft enough to handle.
  6. Sign up for my BLW Online Course today or sign up to an in-person BLW workshop given by a member of my International Baby Led Weaning Network of Registered Dietitians.

References

  1. Chapin, M. M., et al. (2013). “Nonfatal Choking on Food Among Children 14 Years or Younger in the United States, 2001–2009.” Pediatrics 132(2): 275-281.
  2. D’Andrea, E, KIELYN JENKINS, MARIA MATHEWS, BARBARA ROEBOTHAN (2016). Baby-led Weaning: A Preliminary Investigation. Canadian Journal of Dietetic Practice and Research
  3. Woolridge, M. W. (1986). “The ‘anatomy’ of infant sucking.” Midwifery 2(4): 164-171.
  4. Cameron, S. L., Heath, A-L. M., & Taylor, R. W. (2012). Healthcare professionals’ and mothers’ knowledge of, attitudes to and experiences with, Baby-Led Weaning: a content analysis study. BMJ Open, 2 (6), 1-9. doi:10.1136/bmjopen-2012001542
  5. Rapley, G. (2011). Transitioning to solid foods at the baby’s own pace. Community Practitioner, Jun;84(6):20-3.
  6. Taylor, R.W., Williams, S.M., Fangupo, L.J., Wheeler, B.J., Daniels, L., Fleming, E.A., McArthur, J., Morison, B., Erickson, L.W., Davies, R.S., Bacchus, S., Cameron, S.L. and Heath, A-L. M. (2017) ‘Effect of a baby-led approach to complementary feeding on infant growth and overweight: A randomised clinical trial’, JAMA Pediatrics, 171(9): 838-846.
  7. Delaney, A.L. (2010) Oral-motor Movement Patterns in Feeding Development. Ph.D. (Communicative Disorders). University of Wisconsin-Madison.
  8. Fangupo, L. J., Heath, A-L. M., Williams, S. M., Erickson, L. W., Morison, B. J., Fleming, E. A.,…Taylor, R. W. (2016). A Baby-Led Approach to Eating Solids and Risk of Choking. Pediatrics, 138 (4), 1-8. doi:10.1542/peds.2016-0772
  9. Lakshman, R.; Clifton, E.A. and Ong, K.K. (2017) ‘Baby-led weaning – safe and effective but not preventive of obesity’, JAMA Pediatrics, 171(9): 832-833
  10. Morison, B. J., Taylor, R. W., Haszard, J. J., Schramm, C. J., Erickson, L. W., Fangupo L. J.,…Heath, A-L. M. (2016). How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ Open, 6 (5), 1-11. doi:10.1136/bmjopen-2015010665
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Can babies eat foods grilled on the barbecue?

Can babies eat foods grilled on the barbecue?

 

It’s getting hot outside and it’s time to light the barbecue. You might be wondering if babies can eat food grilled on the barbecue. The question is: are barbecuing and Baby Led Weaning (BLW) compatible?

 

The answer is yes, starting at around 6 months old. You do want to make sure you do it safely (as with everything else) because research shows that cooking meat, poultry and fish at high temperatures may increase you and your baby’s risk of cancer.

 

Here are a few tips from the cancer.ca website:

 

  • Marinate meat, poultry and fish before cooking. Studies have shown that marinating these foods can prevent the formation of cancer-causing chemicals.
  • When barbecuing, choose lean cuts of meat, poultry and seafood over higher-fat meats. Trim off visible fat. This will reduce the amount of harmful chemicals that develop from the smoke created by burning fat.
  • Barbecue slowly and keep the food away from the hot coals so that flames are less likely to engulf the food to prevent charring.
  • Try grilling vegetables, veggie burgers and fruit slices. Most experts agree that plant-based foods do not form the cancer-causing substances when cooked at high heat.

 

Foods grilled on the barbecue are great for babies because they maintain their shape yet babies can easily bite into them. Asparagus are delicious this time of year. Why not try barbecued asparagus? Here is a 6-month old enjoying asparagus on the barbecue:

 

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Even grilled mushrooms are totally appropriate for babies:

 

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If your baby just sucks on a strip of meat without actually eating any, he or she is still getting some iron. It could also occupy a baby for quite some time!

 

Here are some free barbecue recipes that you can try for your baby:

 

Chicken satay with creamy peanut sauce (includes a cooking demo video)

 

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Simple burgers for babies (feel free to cook these on the barbecue)

 

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Grilled lamb chops for babies

 

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Minty Lamb Meatballs

 

The mouthwatering final product! BLW

 

For more Baby Led Weaning (BLW) recipes for babies, GET YOUR FREE COOKBOOK FOR BABIES HERE.

 

What will you grill on the barbecue this weekend?

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Why you should give sauerkraut to your baby

What’s with all the hype around lacto-fermented vegetables like sauerkraut? What are they, why should your baby eat them and where can you find them?

 

What are lacto-fermented vegetables?

 

Lacto-fermented vegetables (or simply “fermented veggies”) include foods like sauerkraut, pickles and pickled seasonal vegetables. They contain a healthy dose of gut-friendly bacteria, also known as probiotics. Regular consumption of these good bacteria is beneficial to your baby’s health.

 

Why are fermented vegetables good for babies?

 

Fermented vegetables help with digestion and provide a healthy boost to the immune system, improving all-around gut function [1]. Foods like sauerkraut and fermented vegetables have even been shown to reduce the risk of some cancers [1]. For babies in particular, fermented foods might be beneficial in helping with digestive issues like constipation, diarrhea, or gas [2].

 

Aren’t fermented vegetables too salty for babies?

 

While fermented veggies like sauerkraut offer a wide range of health benefits to your baby, it’s important to keep in mind that they’re quite salty. While sodium is a required nutrient for babies, too much of it is not a good thing. Keeping this in mind, if you’re offering small amounts of fermented foods to your baby – like 1 pickled carrot spear, or 1 tablespoon of sauerkraut – the benefits of including them in your baby’s diet is worth the extra salt.  

 

Here is a six-month old enjoying a fistful of sauerkraut:

 

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Here she is chomping down on a fermented carrot. It’s the perfect texture for her where she can easily grab it and it’s soft enough to take bites from:

 

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Here she is about to enjoy lacto-fermented turnips (right) and sauerkraut (left):

 

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Where can I find fermented vegetables?

 

One of my favorite store-bought brands of fermented foods is Tout Cru. They are a Montreal-based company that I absolutely love. I really believe in Pedro and Rachel’s mission. They make a wide range of fermented foods including kimchi, sauerkraut and seasonal fermented vegetables which are all so delicious. Check out their website to find out where you can purchase some near you! 

 

References:

  1. Parvez S, Malik KA, Ah Kang S, Kim HY. Probiotics and their fermented food products are beneficial for health. Journal of applied microbiology. 2006 Jun 1;100(6):1171-85.
  2. Marchand V. Using probiotics in the paediatric population. Paediatrics & child health. 2012 Dec;17(10):575.

 

Have you ever given sauerkraut to your baby?