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Introducing Solids: Traditional Methods and Alternatives

Introducing Solid Foods, Part 2gerber

The “traditional” method of introducing solid foods has been around for decades: spoon feeding single-ingredient, pureed “baby foods” and gradually increasing variety and texture as baby becomes older.
As we discussed in part one, the “Traditional” method of introducing foods to infants in the US is actually unsupported and increasingly contradicted by research, and may be gradually falling out of favor. Even so, most pediatricians and baby books still recommend a slow and careful introduction of spoon-feeding specific pureed foods and avoiding others.

The “Feed Baby Almost Anything” Method
Several alternatives to the “traditional” method exist. One option is to continue to offer pureed or modified table foods but introduce a much wider variety of food types and flavors (including egg, fish, wheat and combination foods) sooner. Earlier exposure to these foods, rather than avoiding them, may actually help reduce the risk of allergy and celiac disease. Dairy foods and protein foods (pureed meat) are also offered much earlier than in the traditional method. Check with your pediatrician for specific advice.

Baby-Led Weaning (or, Baby Self-Feeding)
Another option rising in popularity is called “Baby-Led Weaning”. I’d prefer to call it “Baby Self-Feeding” because here in the US, “weaning” commonly refers to the reduction or stopping of breastfeeding. In Europe, where Baby-Led Weaning first became popular, “weaning” refers to the introduction of solid foods. This method is all about allowing a baby to explore food on her own terms and gradually learn to chew and swallow. Spoon-feeding purees are not used, and the saying “Food Before One is Just for Fun” narrates the attitude that the amount of food the baby eats may be minimal, and that’s ok. We’ll talk more about “finger foods” vs Baby-Led Weaning/Baby-Self Feeding in Part 3.

Traditional Method of Introducing Purees:
If using this method, it is common to first introduce a cereal, then an orange vegetable, a green vegetable, and then a fruit. Then, simply alternate remaining single-ingredient fruits and vegetables one by one, adding one new food every few days until all of the following have been introduced. This should take several weeks or a month. Remember, there’s no rush or reason to push. These foods aren’t particularly nutritious, are less caloric than your baby’s milk, and won’t help your baby sleep longer: in fact, feeding too close to bedtime can cause gas and digestive upset.

Cereals, Iron-Fortified: Oatmeal, barley cereal, brown rice cereal, mixed with breastmilk, formula (if already introduced) or water.
Vegetables: Carrots, sweet potatoes, winter squash, peas, green beans, beets.
Fruits: Applesauce, peaches, pears, apricots, plums/prunes, bananas, avocado.

Continue to offer cereal at each meal, along with the fruit and/or vegetable. Cereal is the bulk and the main calorie source of the “meal”. The vegetables and fruits are fairly low in calorie and high in water. Peas, bananas, avocado, sweet potato are about twice as caloric than green beans, carrots, winter squash, applesauce, peaches, pears.

Remember that your baby’s milk source is still their primary source of nutrition and is a complete food, and in fact is more caloric and nutritious than these “solid foods” you’re offering. 4 ounces of breastmilk contains about 100 calories and the perfect mix of fats, proteins, vitamins and minerals for your baby to grow. 4 ounces of applesauce or pureed carrots contains less than half the calories of breastmilk or formula, and only trace nutrients.

Try to avoid any tension or struggling over feedings and do not push to finish the portion or play the “just one more bite” game. You have far too many years of feeding your child ahead of you to create struggles over food!

Dairy foods are traditionally offered starting around 7 months (unless there are special concerns about cow’s milk protein sensitivity – check with your pediatrician). Start with whole-milk (full fat) plain yogurts. You may feed it plain or stir in some pureed fruit.

Protein foods are usually introduced next, around 7 to 8 months- pureed chicken, turkey, beef, tofu, egg, small amounts of low-mercury fish like scrod and salmon. Check with your pediatrician for recommendations about giving whole egg vs. egg yolks, and if fish or shellfish should be given or avoided.

Purred meats are thick and pasty. Try adding a tablespoon of pureed chicken to applesauce and feed it alongside a vegetable or cereal.

Again, these suggestions follow the “traditional method” of introducing solid foods, and many experts feel they are outdated and unnecessary. However, they are still the most common recommendations given by pediatricians and baby care books, and many parents feel most comfortable using this traditional method as a guide.

 

Next up: Making or Buying Baby Foods, Is Organic Important, Finger Foods and Baby Led Weaning

 

Introducing Solid Foods

"Give Peas a Chance"!
All we are saying, is “Give Peas a Chance”!

Rice cereal at four months or at six months?
Or, don’t start with cereal at all – instead, offer avocado or sweet potato to begin.
Don’t give egg whites, wheat or fish during first year, and only introduce one new food at a time. Offer pretty much anything, including traditional allergens, any time after 5 months.
Spoon feed purees. Don’t spoon feed purees, instead, let baby learn to feed herself. Don’t let baby feed herself, she’ll choke. 

When it comes to the topic of introducing solid foods, there are so many conflicting recommendations and opinions, even among the experts and research.

For the past 50 years, the common advice has been along the lines of “sometime between 4 to 6 months, introduce rice cereal (oatmeal if baby becomes constipated), then orange and green vegetables and pureed fruits, one at a time.” It’s possible that all of that is wrong, but on the other hand, going that route may not hurt, either. Yes, it’s clear as mud…

The American Academy of Pediatrics’ recommendation is for exclusive breastfeeding for the first six months of life, (iron-fortified infant formula if breastmilk is not available), with iron-fortified solid foods introduced gradually thereafter to complement the milk intake. This message has been the same for the past 15 years, and reaffirmed in a 2012 policy statement, yet, you will find many conflicting recommendations about when to begin solid foods, how to feed your baby, and what to foods to start with or avoid. Your pediatrician may give you suggestions that are very different from what your friend was told by her pediatrics practice. Some recent research questions the typical recommendations to introduce foods in specific orders and avoid common allergenic foods like egg whites and wheat. It’s possible that delaying the introduction of these foods could actually be causing more allergies, rather than fewer.

What introducing solid foods is all about: Socializing baby to the feeding experience, introducing new flavors, textures and oral motor skills.

What introducing solid foods isn’t really about: Packing in foods in hopes that he’ll sleep better.

Signs of readiness: Typically around 5-6 months, you’ll notice your baby watching, grabbing, and otherwise showing interest in your own meals and snacks, and she should be able to sit up with support. The best sign of readiness, however, is that once you do begin offering food, your baby gets the hang of it within a few “meals” or over the course of a week: quickly learning to open mouth for the spoon, seeming interested or eager, reaching for it, wanting more. If your baby seems to find it unpleasant and fusses, squirms away, gags or extrudes most of the food back out repeatedly, continue to offer, but don’t push or force your baby to put food in his mouth. If after three or four “meal” attempts, it is not going well and your baby is not enjoying the experience, shelve the food and try again several days or a week later. It’s okay to have a false start and then wait another week before “re-starting”.

Often a baby is happy just to have a bowl and spoon to play with, and to join you at the table in a highchair. Sometimes they want the “tools of the trade” but not necessarily the food just yet. There’s no rush: once your baby starts eating, he’ll be eating for the next 90 years. A few more weeks won’t make any difference.

How much should my baby eat? Some babies sample only a teaspoon or tablespoon of oatmeal or avocado at a meal, while others will eat an entire bowl of cereal and fruit and holler for more when it’s done. Follow their cues; don’t push them to eat more than they ask for. When she leans forward and continues to opens her mouth for the spoon, continue feeding. When her mouth is closed and she is turning away, she’s done. Try to avoid any tension or struggling over feedings and do not push to finish the portion or play the “just one more bite” game. You have way too many years of feeding your child ahead of you to create struggles over food already!

Give baby her own spoon to hold so she won’t grab at yours (she still will!). Let her suck the food off her hands or plastic spoon or teether. Learning to eat is a tactile, sensory (almost) play experience. Babies first learn to swallow by sucking, so it’s common for babies to put their fingers or a toy in their mouth along with the food, to help organize their swallowing and tongue movements as they employ the more familiar suck-swallow-breathe pattern.

Good first food options:

Whole grain cereals: Oatmeal, barley cereal, brown rice cereal, mixed with breastmilk, formula (if already introduced) or water. Avoid mixed grain cereals as a first food.

Vegetables: Carrots, sweet potatoes, orange squash, peas, green beans, beets.

Fruits: Applesauce, peaches, pears, apricots, plums/prunes, bananas, avocado.

Meats: Chicken, turkey, lamb, beef.

Iron rich foods can be served with Vitamin C (most yellow/orange fruits and vegetables) to enhance absorption. Meats, egg yolks, prunes, sweet potatoes, beans, peas, lentils, and iron-fortified rice, barley or oatmeal cereals are good sources of iron.

Note: Diaper rashes are commonly a reaction to change in pH balance of stool after introducing fruits and vegetables and don’t have to indicate an allergy. Treat with a generous layer of a thick zinc diaper cream, and switch to warm water and washcloths rather than diaper wipes if the skin is very sore or irritated. Facial rashes are commonly due to acidic fruits smeared on the face and frequent washing after meals – use a soft cloth to wash after meals, dry well with a soft cloth and apply a moisture barrier to treat red skin on cheeks and chin.

Interested in this topic? Watch my webinar on introducing and advancing solid foods.

Continue to Part Two of this “Feeding Your Baby” Series:
How and What to Feed Your Baby – Traditional methods and alternatives (jars, homemade purees, baby-led-weaning aka baby-self-feeding).

 

Tips for New Eaters: Finger Foods

"Bag Cheese" is a real winner here!
“Bag Cheese” is a real winner here!

Are you moving from spoon-feeding purees to starting to offer bits and pieces of food? Here are some tips that address common questions new parents may have during this transition.

1. Not so big. Bits of food for self-feeding should be about the size of your baby’s thumbnail, or smaller than a dime. Bits of toast, waffles, pancakes, French toast, grilled cheese sandwiches and muffin bits are usually well-received by babies and are easy foods for them to manage.

2. Nothing hard, sticky or chewy. Hard foods like raw carrots or apples can be sliced then steamed before offering. Raisins may be soaked in hot water to soften.

3. Avoid round foods and coin-shaped slices. Foods like grapes, steamed carrots, string cheese sticks, hot dogs  (a whole other can of worms) should be chopped small to reduce the risk of choking.

4. Teeth aren’t needed to chew. As long as the foods you offer are soft enough for you to to squish between your thumb and forefinger, your child should be able to chew them just fine with his gums even without molars.

5. Offer a preloaded fork or spoon if your child is eager to feed himself. Reduce frustration by using foods that stick to the spoon (like yogurt) rather than foods that drip off  (like soup). Soft cooked elbow macaroni makes a good introduction to fork feeding.

6. If your baby stuffs too much in his mouth at once (or throws it all on the floor), just offer a few bits on the tray at a time and add more pieces after the first few are eaten.

7. Skip the kids’ menu at restaurants. Offer bits of chicken, baked fish, meatball, potato, rice, pasta, steamed vegetables, baked beans, roll. Make steak “shavings” by scraping at the surface of the steak with a knife.

8. Say “cheese”. Shredded mozzarella or Monterey Jack cheese in the zip-seal pouches (called “bag cheese” in my house) sprinkled on the highchair tray is a speedy snack that can keep a snacking baby busy for awhile.

9. It’s okay to help. Your baby does need to learn how to feed herself, but it’s okay to pop in a bite here and there or spoon feed purees or mashed food in addition to foods your baby picks up.

10. Sensory-Sensitive. Some babies are especially sensitive to the sensation of textures or dislike having their hands dirty. Use dry foods like toast bits, rice cakes or cereal rather than mushy food like banana slices to practice finger-feeding and hand-eye coordination.

Bonus: Respect your baby’s cues and don’t try to push in more food than your baby wants. “One more bite” really won’t make any difference in terms of your child’s nutrition