How Much is Enough Food?

Rarely do I give a workshop on introducing solid foods to babies or feeding toddlers and preschoolers (including picky eaters) where a parent doesn’t ask how much food they should feed their child. It’s quite an easy question for me to answer. And, the answer applies to any meal or snack for a child of any age:

As much as they are hungry for.

If this answer surprises you, you’re not alone. This answer usually is met with confused faces. So, let me expand. As the adult, it’s your role to provide opportunities to eat 5 or 6 times a day. It’s your child’s role to choose how much to eat.

I recognize that it’s difficult to trust them to know how much to eat. But it really is best to do so.

We’re born being able to know when we are hungry and when we are satisfied. Over time, through social pressures, we learn to not listen to our bodies and instead look to external cues for how much to eat. This is associated with higher rates of eating disorders and obesity.

Studies show that when kids are raised in households where they’re told to stop eating before they’re satisfied (i.e. because the adult believes that their child has “had enough”), they learn to sneak food and gorge on food when they get the opportunity.

On the flip side, when kids are forced to eat more than they are hungry for, they learn to over-ride their bodies’ signals and they learn to overeat.

Instead, trust your child to listen to their bodies and eat as much as their bodies tell them. Expect this to vary from day-to-day. Some days they’ll eat so much that you don’t know where they’re putting it all. Other days they’ll eat so little that you won’t know where they’re getting their energy from. I recommend serving a very small portion. If kids want more, allow them to have seconds.

You’ll know that your child is getting enough to eat when they have lots of energy and their growth is tracking along their curve on their growth chart.

My kid used to eat just about everything…

Does this sound familiar?

“My kid used to eat just about everything and anything but she stopped eating meat all of a sudden. She's now 2.”

This, hands-down, is the single most common question that parents come to me wondering. Well, it’s not always meat that their children suddenly won’t eat. It may be vegetables, fruit, or most foods (i.e. they’ll only eat something like 5 foods).

If you’ve recently experienced this, the good news is that you’re not alone!

Most (but not all) kids will happily eat almost everything when you’re first introducing solid foods. From about 6 months onwards, these happy babies keenly gobble up most foods you put in front of them. In fact, they’re delighted with all the different textures, shapes, and tastes that you introduce to them.

Then, all of a sudden, something changes. This change can happen as young as 9 months, and most commonly happens somewhere between 18 months – 2 years.

Welcome to the picky eating stage.

It’s a completely normal developmental stage that most kids go through.

No, you didn’t cause your great little eater to suddenly “hate” foods that she loved previously. If you’re like most of the parents I’ve worked with, I know that I need to tell you to turn down the volume of the Mommy-guilt (or Daddy-guilt) voice in your head that’s telling you that it’s all your fault, that you did something wrong to cause this. That you “broke” your child. Let me tell you definitively: you didn’t.

The science doesn’t tell us why kids all of a sudden become picky. Some scientists have theorized that it’s a protective thing. From back when we lived in caves. At this age infants become toddlers and start wandering away from parents. It would be evolutionarily protective to have kids become scared to put random (i.e. potentially poisonous) plants in their mouths. It’s an interesting theory but who knows if this is true.

What I do know is that picky eating is a developmental stage. Kids become wary of foods. They honestly become scared to try things (yes, even if they’ve eaten them before). They don’t have the language skills to tell you that they’re feeling trepidatious about trying that food. So they simply say “I hate it!” (before they’ve even tried it.

The good news is that you don’t just have to wait until your daughter or son grows out of this stage. You can support them to be confident enough to try new foods, to increase the range of foods that they’ll eat, and to get the good nutrition that they need.

The bad news is that I can’t solve your question in 1 short and snappy blog post. I can, however, point you in the right direction.

As first steps, I encourage you to:

• Continue serving your child small servings of every food that you eat in your household.
• Role model eating these foods by joining your child at as many meals and snacks as possible.
• Plan meals and snacks that include both familiar and challenging foods.

And of course, keep your eyes on your peeled for other strategies I'll share to help your picky eater transition smoothly through this difficult phase (while ensuring that they’re meeting their nutrition needs).

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What’s the Right Age to Start Solid Foods?

Parents have been sending me a lot of questions lately asking what is the right age to start introducing their baby to solid foods. They’ve heard 6 months before. Now they’re hearing 4 months from other health professionals. And, some places online say 4 – 6 months. They’re right to be confused with all this conflicting information. If you’re wondering what age to start your baby on sold foods, here’s the scoop…

The recommendations haven’t changed. The World Health Organization recommends 6 months¹. In Canada the recommendations from Health Canada, the Canadian Pediatric Society, Dietitians of Canada and the Breastfeeding Committee for Canada say 6 months². The American Academy of Pediatrics recommends “around 6 months”³.

I suspect that reports from a new, and important, study on preventing peanut allergy are behind the advice that these health professionals are giving parents. Now I’m not in the doctor’s office when the parents are being given this advice, so this is a best guess. But the study is being talked about a lot in the health provider community, which is why I’m suspecting it’s behind the advice that parents are receiving. Unfortunately the researchers chose to use a phrase that I’m suspecting is creating some of this confusion.

The research study found a significant decrease in peanut allergy with their intervention⁴. What was their intervention? To introduce, and regularly feed, peanuts to children starting as babies versus waiting until they were 5 years old. Giving peanuts to the babies reduced the incidence of peanut allergy. But here’s where I suspect the misunderstanding comes in. The children in the “early” introduction of peanuts group were between 4 – 11 months old. Because this is “early” versus introducing peanuts at 5 years old. The article doesn’t compare introducing peanuts at 4 months versus 6 months. However, I suspect that busy health professionals could have glanced at articles describing the study and mistakenly concluded that the “early” group meant introducing peanuts at 4 months versus 6 months of age. Especially, since the researchers didn’t report the older children’s age as 5 years, but as 60 months.

The reality is that the scientific and health communities still don’t know anything definitive about the perfect age to introduce solid foods to minimize food allergy.

What we do know is that babies start to run low on the iron that they’ve stored in their bodies at approximately 6 months of age. And so it’s at this time that we need to start introducing iron from a new source, i.e. solid foods. Iron is important for brain development in babies and young children.

And, babies show the signs of being ready to start solid foods between 4 – 6 months. Just like every other developmental stage, babies arrive here at slightly different ages. The signs of readiness for eating solid foods are:

• The disappearance of the extrusion reflex.

• The ability to sit up (with support) and hold their own head up (without support).

• Can visually track your movement.

• Becoming fascinated with watching people eating.

As we learn more about what causes food allergies and how to prevent them, the recommendations may change. There are some fantastic studies underway that I can’t wait to get the results from. Until we know more, I still recommend starting solid foods at about 6 months. If your little one is between 4 – 6 months, you’re seeing all the signs of readiness, and you’re keen to start – go ahead. If you enjoy the simplicity of breast or bottle feeding or you’re not yet seeing the signs of readiness in your child, hold off until 6 months of age. My advice for the last 7 years has been “start solids at about 6 months”. I’m not changing my advice yet.

References:

1. http://www.who.int/nutrition/topics/complementary_feeding/en/

2. http://healthycanadians.gc.ca/healthy-living-vie-saine/infant-care-soins-bebe/nutrition-alimentation-eng.php?_ga=1.150740528.74375254.1447739252

3. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Infant-Food-and-Feeding.aspx

4. http://www.leapstudy.co.uk

1 Simple (and Overlooked) Step to Get Picky Eaters to Eat More

There’s a very simple technique to get picky eaters to eat more. It’s something that I always look for when working with individual families. I can’t tell you how often it’s missed by parents. Let’s just say a lot. So, what’s this super simple tip? Make sure your child has their feet resting on something solid. Kids eat best when they have something solid to rest their feet on. Take a peek at your child’s feet when they’re sitting in their highchair or booster seat. Are their feet dangling? If you want your child to eat better, get them something on which to rest their feet.

Have you ever sat at a bar stool that didn’t have a footrest? Did it feel unsettling to have your feet dangling? Likely, yes.

This is something that I’ve looked for since I started my practice in 2008. But I never knew why kids ate best when their feet are supported. Then last month I attended a workshop and learned why. The reason is that while eating is a priority for our bodies, there are two priorities that supersede eating: 1) breathing; and, 2) staying upright (i.e. not falling on our heads). When your child’s feet aren’t resting on something solid, their bodies are required to focus on not falling over. This takes away from the focus on the task of eating. Babies and young children under 3 years of age are still novice eaters and they need to pay full attention to the task of eating. By providing a solid footrest, you’re removing a big source of distraction.

Some highchairs are adjustable. These are my favourites. Don’t have an adjustable chair? Not to worry, just MacGyver a footrest for your child. Inexpensive footstools (usually used at the bathroom sink) work well. As do a stack of phone books – although these are getting harder to come by.

The perfect height for your footrest is the height where your child’s feet are 90 degrees from their legs. In other words, your child is resting flat-footed.

Remember, check your footrest every couple of months. Kids grow!

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1 Simple Tip to Help Your Baby Gagging Less During Feeding

Pretty much all babies gag sometimes when then they first start eating solid foods. But, some babies gag more than others. Baby gagging can be very frightening for moms and dads and I get a lot of questions about it when I lead my Introducing Solid Foods workshops. I know that you are busy and exhausted so you like my blog posts short and to-the-point. If you’re really nervous about introducing your baby to solid foods, and/or are looking for a more fulsome description of gagging versus choking, I recommend coming out to one of my in-person workshops or getting in touch with me to find out more!

The focus of this post is on how to help babies who gag a lot to become less gaggy so that they can be more successful at eating solid foods.

For this tip, I’m assuming that you’re starting solids in that ‘just right’ window of about 6 months old. And, that your health professional has ruled out any medical cause for your baby’s gagging.

It’s often said that some babies have a “sensitive gag reflex”. But for most babies this isn’t the case. It’s not that their reflex is too sensitive, it’s that it’s in the wrong place.

You see, babies and adults have different mouth physiology. In adults, the majority of our tastebuds are on the tip of our tongues and our gag reflex is way in the back of our mouths. A fun way to test this is to place food in different parts of your tongue and notice how differently it will taste.

In babies, the majority of their tastebuds are at the very back of the mouth and their gag reflex is at the front of their mouth. This makes sense because for the first months of life babies are nipple-fed (either breastfed or bottle). To feed, babies place nipples to the very back of their mouths. So Mother Nature has the tastebuds at the back, where baby will taste their breastmilk/formula. The gag reflex is at the front of the mouth where it’s out of the way for nipple-feeding and where it protects babies from putting items in the front of their mouths that they could choke on.

Starting at about 4 – 6 months, the gag reflex and tastebuds migrate in opposite directions to swap places into the grown-up positions.

Most gaggy babies don’t have overly sensitive gag reflexes. Instead, their gag reflexes are still too far forwards.

What stimulates the gag reflex to move backwards? Having things in your baby’ mouth. Particularly things that your baby can stick towards the back.

So, your baby sticking their hands (and feet) in their mouth is really them working to move their gag reflex backwards. So is mouthing Sophie the Giraffe and other chewable toys that babies can stick deeper into their mouths. Toys like teething rings that stay at the very front of their mouths won’t help because it’s the presence of things ever deeper into your baby’s mouth that stimulates the backwards movement of their gag reflex.

So what’s the 1 tip to help baby gagging?

Let them play with toys they can safely stick in their mouths.

Now to be clear, I’m not recommending that you allow your baby to chew on things that they can choke on. I said “safely stick in their mouths”. What I’m recommending is to allow your baby to play with chewable toys and other objects that can safely go further back in their mouths. You want to look for long things that your baby can’t get a bite off of. Examples include:

• Their own hands (and your fingers).
• Sophie the Giraffe.
• Toy key rings.
• The spoon that you feed your baby with.
• Whole, big, raw carrots or parsnips (big enough in diameter that your baby can’t bite off a chunk).
• Ice cubes in a mesh feeding bag (I only recommend plain water ice cubes, not frozen foods).

Given the opportunity, babies will do lots of chewing on these objects. Know that they’re not just playing. They’re playing with a purpose. Playing is their job at this age. Your baby is playing with the purpose of developing the skills to eat.

How Much Should You Focus on Your Child’s Table Manners?

Before I chat about child table manners, I want to explain this photo. Yesterday I had the opportunity to see Ellyn Satter speak live. Ellyn's work is the foundation for mine. She's easily the most influential person in my career. And while I've thoroughly studied her work and used it with families for more than 7 years, I had never met her. By the time that I was finished university, had started to pay down my student loans, and could afford to travel to a US destination for her in-person training seminars, she retired. But yesterday she came out of retirement to present in Vancouver. You bet that I was going to be there - I may have been the first to register :) The table manners question was asked of her, and it was fantastic to see that she responded with the same answer as I give parents.

Table manners, like most matters of etiquette, can cause a strong reaction in us - really getting under our skin. When it comes to table manners, parents usually approach me in two ways (which really are about the same thing). Either they ask about how to best teach kids to have good table manners. Or, they’re embarrassed about their child’s messy eating and apologize to me for it.

When it comes to table manners, the best course of action is to not sweat about it. Like many other things, your actions speak louder than words. Kids naturally have an internal drive to master things and grow up. Eat together with your child on a daily basis. Use good table manners yourself – use utensils, a napkin, say “please” and “thank you” when you ask someone to pass you the pepper, don’t get up and down from the table like a jack-in-the-box. Your child will pick up your good habits.

That is, as long as they aren’t staring at a screen during the meal (iPad, phone etc).

Don’t sweat your child’s messy eating. It’s normal for kids to use a combination of utensils and fingers into the school-age years, depending on the food and how hungry they are. And like all things, some kids learn to use utensils faster than others.

The most important factor for kids to learn to love healthy eating is to enjoy eating at the table. This requires the table to be a pleasant place. Constant nagging about table manners (“elbows off the table”, “use your fork”, etc) can really get in the way of kids enjoying meals.

It takes a lot of effort to organize yourself to plan and prepare meals and snacks and to have an adult sit down with your child to eat together. Congratulate yourself for accomplishing this and know that over time your child will learn good table manners.

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Can Kids Have Too Much Fruit?

Here’s what a Mom recently asked me: "I have what may be a silly question. Should I be concerned with my 8 month old getting too much fruit? In other words, can kids have too much fruit?

Can Kids Have Too Much Fruit?

In a word: yes. Let me expand with 2 key points.

1. All of us (i.e. adults too) can get diarrhea from eating too much fruit at once. If your child’s stools are getting loose, then it's a sign of too much fruit.
2. Of course, fruit is a healthy food. But human beings need a wide variety of foods from all the food groups to meet our nutrition needs.

In particular, for babies, toddlers and preschoolers, iron is a key nutrient that we’re looking to provide through food. Fruit is low in iron. It’s recommended that you offer iron-rich foods twice a day.

It’s normal for kids to have food preferences. However, kids aren’t at a developmentally ready to understand that human beings can’t survive on a favourite food alone until they’re well into their school-age years.

How to Make Sure Your Child Doesn't Get Too Much Fruit

If you notice that your child will always choose one or two favourite foods, I recommend starting a technique that I call “controlling what’s on the menu”.

Here’s how. You choose what foods you will offer, i.e. what foods are on the menu, at meals and snacks. Your child gets to choose what they’ll eat from what you’ve provided. And, they get to control how much of each food they eat (yes, including zero bites).

This way you are creating a situation where your child eats a balance of food groups throughout the day. And, your child gets to express themselves by controlling what they eat from what you’ve provided. You’ve created an environment where you’re making sure that your child is getting good nutrition at the same time as your child’s personal boundary with their body is respected.

For example, for this mom’s 8 month old, at one solid food time each day serve an iron-rich food either on it’s own, or with another food that isn’t fruit – maybe it’s a vegetable or a grain. Feel free to offer fruit at the other solid food time where you’re offering the iron-rich food. If your child eats a particularly huge amount of fruit one day and you notice that his stools are loose, hold off offering fruit for a day or two. Create balance by offering vegetables, protein foods, and grains.

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When to Ignore Messy Eating. When to Nip it in the Bud.

I’m often asked about kids' messy eating. Parents often wonder what’s normal and at what age kids will learn to use utensils. Recently I received this question from a Mom:

My question is regarding messy eating.  My daughter (just turned 4) often eats with her hands and then has food obviously all over her hands but also on her face from ear to ear.  She also plays with her food a bit (ie:  bites a few holes in her bread and then pauses to see what shape she has made).  How much emphasis should I put on eating neatly with a fork and spoon and how do I do this or should I just be happy that she’s eating?

It's normal for preschoolers (3 - 5 year olds) to eat with a combination of their hands and utensils. Most are still working on the dexterity involved in using utensils. They're curious about the world, so yes, they'll likely explore their food too (like the example you give with the bread).

As long as her behaviour is coming from a place of eating and interest in her food, don't sweat this mess. Because we want her to continue feeling confident with eating. We don't want to make her feel self-conscious about the way that she eats.

Teach through role modelling. Have an adult join her at as many meals and snacks as possible. Her internal drive to grow up will motivate her to copy your use of utensils and other actions at the table (e.g. wiping your mouth with your napkin when you finish eating).

In the meantime, go ahead and start teaching other manners like saying please and thank you, taking turns to speak during a conversation, asking to have someone pass you the peas, and asking to be excused when finished eating.

On the other hand, pay close attention to see if her behaviour is motivated by naughtiness. That is, if she's acting out and purposely taking actions to get negative attention. You'll recognize this right away. If so, then do nip the behaviour in the bud and explain that we don't play with our food.

How do I Help My Baby Feed Himself/ Herself?

I’m often approached by parents of babies between 9 months and 12 months old who are concerned that their children aren’t learning to self-feed as quickly as other babies. Here’s an example of what one parent asked me: “My son is 9 months and has been eating finger foods since about 7 months however he will not feed himself. Is there something I can do to help this? Or will it just come to him? How do I help my baby feed himself” Without doing a full assessment of a child, I can’t say for certain what’s causing a child to learn self-feeding slower than their peers. But I can share the common causes that I see and their solutions.

Common Causes for Baby Not Self-Feeding:

1. Medical conditions or developmental concerns. Because you didn't mention it, I'm assuming that your son doesn't have any medical conditions or developmental concerns that would affect his dexterity/ motor control.
2. Missing role models. Kids learn from watching others - particularly older kids and adults. If no one else is eating there isn't anyone to act as a role model for how to do it. Also, eating is a social activity for us human beings. Kids of all ages eat better when adults join them at the table.
3. Temperament (also known as personality). Some little ones are what I call "outsourcers". They're happy to sit back and let others do things for them instead of doing the hard work of figuring it out themselves. Because learning to self-feed does take work at this stage.
4. Over-helpful caregivers. Sometimes parents (and other caregivers) have such strong desires to help their little ones that they jump in and "help" instead of sitting back and allowing their little one figure things out for themselves. This can sometimes also be fuelled by impatience and/or anxiety about your little one getting enough to eat. The result is a learned helplessness.

Solutions to Help Baby Feed Himself:

If the cause is #1 then working with an Occupational Therapist can be a great help.

The solution to #2 is to sit and eat with your child. Ideally, eat the same foods too. This way you're sending a message loud and clear that you want him to eat what’s in front of him. And, you’re creating the social environment that’s most conducive to eating and learning.

The solution to #3 and #4 is the same. Resist the urge to jump in and "help". You're actually being more helpful by holding off and allowing him to learn the skills himself.

Take Home for How to Help My Baby Feed Himself:

Note that the most common cause that I see are # 3 and 4. In other words, a combination of a child’s natural temperament and parents who are either overly anxious or keen to help.

It’s a classic case of fantastic intentions inadvertently taking things in the wrong direction.

Thankfully, it’s super easy to fix! Babies this age are compelled to master the skills that they see others doing. Just like learning any new skill, kids learn to feed themselves with finger foods at different rates. They want to learn how to self-feed, we just need to create the environment that supports them in mastering it. When you do, they’ll learn this new skill in their own timing that’s perfect just for them.

When Should I Introduce Dairy to my Baby?

{Guest Expert Blog post at Love Child Organics} Many parents ask me about when they can introduce dairy to their baby. The recent recommendation from Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Breastfeeding Committee of Canada is*:

“If parents and caregivers are introducing cow milk…delay until 9 – 12 months of age…limiting cow milk intake to no more than 750mL (3 cups) per day.”

A similar (but not exactly the same) statement from the American Academy of Pediatrics says **:

“Once your baby is past one year old, you may give him whole cow’s milk, provided he has a balanced diet of solid foods (cereals, vegetables, fruits, and meats). But limit his intake of milk to one quart (32 ounces or 946 ml) per day.”

These statements leave many parents asking me questions. Let me address the most common ones that I receive.

But first let me explain the reason behind the recommendations because I think that it will help you understand what to feed your baby. It’s not that there is something in dairy that’s unsafe for babies. The recommendation is related to iron. Iron is important for babies’ growth and in particular their brain development. There are 3 ways that dairy foods can be a concern with respect to iron:

1. Dairy foods aren’t a source of iron.
2. Many babies love drinking cow’s milk and eating other dairy foods. Thus, the dairy foods can crowd out iron-rich foods.
3. Dairy foods can interfere with babies’ absorption of iron.

So the recommendation was created to provide advice on how to include cow’s milk in a way that doesn’t interfere with babies’ need for iron.

Here are my responses to the questions that I’m frequently asked:

Question: Does this mean that I need to wait until 9 – 12 months to give my baby cheese and yogurt? What about foods that contain cow’s milk?

Answer: No. Any time from about 6 months onwards, feel free to introduce small amounts of yogurt and (pasteurized) cheese amongst the wide variety of foods that you’re introducing to your baby.  Just don’t make yogurt or cheese a food that you’re giving large amounts of, day after day. Make them a ‘sometimes’ food, not a ‘frequent’ food. The same goes for other foods that use cow’s milk as an ingredient, such as sauces and dips.

Q: 9 – 12 months is a big age range, should I wait until 9 months or 12 months?

A: The reason behind the age range is that you want your baby to be regularly eating a good amount of solid foods multiple times a day before you introduce cows’ milk. Like learning any new skill, some babies master eating solids quicker and some take longer to actually get any significant amount of food in them (as opposed to on their face and clothes, in their hair, and on the floor). If your baby is eating lots of solid foods (particularly iron-rich foods), feel free to start introducing small amounts of cows’ milk after 9 months. If your baby is slower to get the hang of eating solids (particularly iron-rich foods), wait until 12 months.

Q: Why do the statements give a limit per day?

A: It’s above 3-4 cups per day that we start to see the negative effects of cows’ milk on eating iron-rich foods and iron’s absorption. This can result in iron deficiency.

Check back to this blog next month when I’ll cover when to introduce cow’s milk alternatives such as soymilk, almond milk, etc.

*  http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-eng.php

** http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Formula-Instead-of-Cows-Milk.aspx

Why Not Both Purees and Baby Led Weaning (BLW)?

{Guest post at Love Child Organics} I receive questions from many parents asking me whether they should use purees or finger foods (a method called Baby Led Weaning or BLW) as they start to introduce their babies to solid foods. I believe that there isn’t only one right way to start babies on solid foods. Why not use both purees and finger foods?

When introducing solid foods you’re achieving several goals:

1. Meeting your baby’s nutrition needs.
2. Providing the opportunity to learn eating skills.
3. Minimizing the risk of choking.

All three of these can be achieved through offering your baby purees, finger foods, or a combination of both.

Further, I’ve been practicing long enough to have met babies with all different temperaments (personalities). Some are little independent souls who never accept being fed by a parent. Parents of these little ones need to have a ton of patience as their child learns how to pick up food and actually get it in her mouth. On the other hand there are babies whom I call “happy little outsourcers”. They figure out that their parents are much more efficient at getting food in their mouths and so they’re happy to sit back and let you spoon every bite into them. Most babies fall somewhere in between these two extremes.

I’ve also seen that babies catch onto the skills of eating finger foods at a variety of ages – typically somewhere between 6 and 10 months.  This isn’t surprising since there’s always a range of ages when babies reach any developmental milestone. Some babies roll over before others, some crawl before others, and some pick up finger foods before others.

In my opinion, what’s most important is to:

• Provide a wide variety of healthy foods,
• Include iron-rich foods (twice a day is a good frequency),
• Follow your baby’s lead,
• Match your technique to your baby,
• Provide your baby with the opportunity to learn eating skills, and
• Use techniques that you’re comfortable with.

The result: you’re teaching your baby to have a positive experience with food.

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Puree vs Baby Led Weaning (BLW): Can't We All Just Get Along?

{Guest post for Modern Mama} In a previous post I shared the pros and cons of the pureed and Baby Led Weaning (BLW) methods for introducing your baby to solid foods. I had a number of people call and email me with questions from that post. So I wanted to clarify and add to the points I shared in it.

In a nutshell, I believe that you shouldn’t feel the need to choose either puree or Bab Led Weaning (BLW). Combine the best from both methods and follow your baby’s lead.

Let me explain.

Having taught parents how to introduce solid foods to their babies since 2008, I welcome a number of the contributions that BLW is providing to the baby feeding conversation. However, I’m also seeing some negative effects too.

Positive Contributions of Baby Led Weaning

Feed Your Baby Family Foods

Children from about four to twelve months are fascinated by what the people around them are eating. In Baby Led Weaning you don’t make separate foods for your baby. Instead you provide your baby with the foods that you’re feeding the rest of your family. This is a great strategy! A favorite quote of mine from Child-Feeding Expert Ellyn Satter is:

“The goal of feeding your baby is to have him join you at the table…not for you to join him at the high chair.”

• Uses his curiosity about what everyone’s eating to your advantage. Many babies will reject pureed foods and reach out to grab what’s on other people’s plates.
• Teaches him that by sharing the same foods, he belongs as a member of your family. Sharing food is powerful for human beings. Every culture marks significant occasions by gathering to share food.
• Is less work than making your baby one meal and the rest of your family something completely different. Teaching your baby that she gets something completely different than other family members can lead to picky eating because you’ve set the precedent that she gets something different. Kids who have always eaten the same meal as the rest of the family don’t know that having something different is an option.
• Can be a wake-up call to how healthy (or not) your eating habits are. If you’re eating foods that you’re not willing to feed your baby, should you really be eating them?

Move Along to Finger Foods

Sometimes I see parents who love the idea (and control) of feeding their baby purees so much that they get stuck, keeping their baby in this phase too long. Babies are ready to try finger foods anywhere between six and nine months. Yes, it’s messy. And it can be painful to watch a child clumsily work for 10 minutes to get a single piece of food in his mouth. But, this is an important learning opportunity. Eating is a skill that must be learned through practice. It’s great that you’re an expert at using a spoon to get food into your baby’s mouth. But he needs to have the opportunity to learn how to do it himself. And finger foods are the first step. Because when we’re feeding our babies, we’re actually doing two things: 1) meeting their nutrition needs and 2) teaching eating skills. I’ve seen prolonged spoon-feeding of purees result in babies who are:

• Undernourished because they’re reject being “babied” and reject the spoon.
• Picky eaters because they didn’t get to experience the huge variety of tastes and textures that food comes in while they are still in the food-curious stage. A stage where kids are suspicious of new foods often starts somewhere between 12 to 24 months (although I’ve seen it start at nine months in a number of children). Some people call this stage “food neophobia”. I call it “food-wariness”.

Follow Your Baby’s Lead

Baby Led Weaning places a lot of emphasis on following your baby’s lead regarding how much food to eat.  Babies are born knowing when they’re hungry and when they’re satisfied. It’s normal for them to sometimes eat a lot and other times to eat very little. When babies are allowed to control how much food they eat, they have a normal growth pattern. When spoon-feeding your baby it’s very easy to force them to take extra bites by playing games (e.g. “here comes the airplane”), or sneaking in spoonful’s when your baby is distracted. Resisting this urge is important to allow your baby to grow normally and not be overfed (which may lead to obesity).

Negative Impacts

You Need to Choose

The negative impacts that I’m seeing when speaking with parents and reading Mom blogs and chat boards is the idea that you need to choose a method. You’re either on the puree team or you’re on the Baby Led Weaning team. We already have enough “mommy wars”, judgment, second-guessing ourselves, and guilt regarding breastfeeding and formula feeding. The last thing that we need is this baggage continuing into introducing solid foods.

Puree Traps

There’s nothing inherently wrong with pureed foods. In fact, today I’ve eaten oatmeal, yogurt, and butternut squash soup – all of which are purees! Purees are a texture that adults eat too. The warnings that many in the Baby Led Weaning camp attribute to purees actually has nothing to do with purees themselves. They’re just easier traps to fall into when spoon-feeding. But they’re also easily avoidable. For example, you can offer your baby pureed versions of family foods and follow their lead when spoon-feeding.

One Size Fits All

I’ve seen many different babies with different temperaments (personalities). Some love being spoon-fed and take more slowly to finger foods. Others never take anything off a spoon, and rely solely on finger foods. I believe that following your baby’s lead and providing a wide variety of tastes and textures is the way to go – including both purees and finger foods.

In summary, why pressure parents into feeling that they need to choose? All the positive contributions that BLW have provided can be realized with the inclusion of both puree and finger foods. Let’s celebrate that there are a multitude of “right” ways to parent!

Limiting Cow's Milk for Toddlers

Recently a parent asked me this question: “How much cow’s milk to offer toddlers. Do you allow them to regulate/drink as much as they want or just fill the cup up once and then when it's empty that's it? Being only 17 months, he can fill up pretty quick on milk during the meal, but I also don't want to be taking it away. I would prefer to just allow him to self regulate, but not sure what to do once the sippy cup is empty.”

Regulating Cow's Milk for Toddlers

It’s common for little ones to fill their tummies with milk instead of eating foods. To make sure that your child is getting the nutrition that he needs, use what I call the ‘control what's on the menu’ strategy regarding beverages (the same as with foods).

• Choose which meals/snacks you offer milk. In other words – you control what’s on the menu.
• Let him drink as much (i.e. as many glasses) of milk at those times as he wishes.
• At the other meals/snacks offer water.

This way there's no battle over how much milk he drinks. But he won't be able to fill his tummy with milk instead of eating at every meal/snack. Approx 500mL (2 cups) of milk provides calcium and vitamin D that little ones need without crowding out other nutritious foods. Little ones who drink more than 750mL (3 cups) of milk daily increase the risk that they’re not getting the nutrition that they need from eating a variety of foods. But again, it's not your job to referee how many cups he drinks at a meal/snack. Instead, use this as a guideline for how many meals/snacks to offer milk at. Restricting access (i.e. limiting the number of servings at a meal/snack) to a food or drink only increases a child’s desire for it. While restricting access usually comes from good intentions, it actually interferes with learning self-regulation. Another technique that can help make sure toddlers aren’t drinking too much cow’s milk is only offering milk in an open (lidless) cup. Often, toddlers who are drinking too much cow's milk are drinking it from a bottle or sippy cup. An open cup is more difficult for little ones to manage so it slows them down.

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Will Starting Solid Foods Make My Baby Sleep Through the Night?

{Guest Post at Love Child Organics} Exhausted parents often ask me: “Will starting my baby on solid foods make her sleep through the night?” I understand why Moms and Dads (desperate for some sleep) grasp on to this myth. However, it is a myth. Feeding your baby solid foods won’t make your baby sleep through the night.

Does Starting Solid Foods Make Baby Sleep?

It’s true that some babies start sleeping for longer stretches through the night at about the same time that they start solid foods. But it’s not that the solid foods have caused the sleeping. It’s that for many babies, the developmental stage when we start to feed them solid foods coincides with the developmental stage when they start sleeping for longer periods of time. Sorry exhausted Moms and Dads, it’s not the solid foods causing longer sleep.

While I’m at it busting myths related to starting solid foods, I’ll take the opportunity to address a couple more.

Do Big Babies Need Solid Foods Early?

Myth: Big babies need to be fed solid foods early. This is false. There’s no evidence to support starting solids early for babies who are at the top end of the growth curve. Breast milk and formula are very rich. And, your baby is likely an expert at breastfeeding or formula feeding by this age. Therefore, continuing exclusively breastfeeding or formula feeding until about 6 months is recommended (the same as average-size babies).

Do Small Babies Need Solid Foods Early?

Myth: Small babies need to be fed solid foods early. This is also false. There’s no evidence to support starting solids early for babies who are on the small end of the growth curve. As I mentioned above, breast milk and formula are very rich and your baby is an expert at breastfeeding or formula feeding by this age. So continue to exclusively breastfeed or formula feed your baby until about 6 months (the same as average-size babies).

In summary, starting solids early won’t provide big babies or small babies with extra nutrition. Nor will it make your baby sleep through the night.  Introduce solid foods when your baby is about 6 months old.

Ready to start your baby on solid foods? Here's how to start your baby with purees or Baby Led Weaning (BLW)

Solid-Food Strikes: Should You Worry & What to Do

Thank you to the VIP who asked me this question: “[My son is] 19 months. I still nurse him quite a bit, and for the last 4 days he has refused any kinds of foods…and wants to nurse every 30 mins. (He does this when he has a cold, and people tell me teething).  Besides driving me crazy, I am concerned about his nutrition...are these breastfeeding [solid food] strikes still providing him with what he needs?” 

Why Babies Do Solid Food Strikes

In general, it is quite normal for little ones to regress to just breastmilk or formula when they aren't feeling well, such as with a cold/flu or teething. It's similar to when we adults are sick with a cold or flu and all we consume for a couple of days is chicken soup.

Solid Food Strike: Should You Worry

Breastmilk or formula alone doesn't meet all of a 19 month old's nutrition needs. As long as it's just for a few days it doesn't have a significant impact on his overall nutritional health because our bodies store carbohydrate and fat for exactly these types of situations. Of course their bodies are smaller than ours so they can’t go as long without adequate nutrition as we adults can. If a breastfeeding strike, or perhaps a more accurate term is “solid-food strike”, lasts more than a couple of days I recommend having your little one seen by your health professional to determine if something else is going on and whether any supplemental intake is required. In other words, this is the point when individual assessment is needed – my generalized advice that I can provide in this form of Q & A is no longer appropriate.

Solid Food Strike: What to Do

Even if he’s refusing to eat solid foods, continue to provide the same opportunities to eat solids as you would normally. Although perhaps prepare smaller servings so that you waste less food if/when he refuses to eat. I recommend this for two reasons:

1. Just as quickly as kids get sick, they get better. The next opportunity to eat may be the one that he’s feeling better at and decides to eat a ton because his appetite’s returned.
2. Sticking to your routine will make it easier to transition back when he’s feeling better.

If you suspect that it’s teething that’s causing the solid-food strike, then plan snacks that are soothing for sore gums. Cold and/or smooth are characteristics that can be soothing for sore gums. Examples include:

• Healthy ice pops
• Dairy-free, sugar-free banana “ice cream” or fruit granitas
• Fruit or fruit/veggie purees such as unsweetened apple sauce
• Yogurt

How Long Should I Breastfeed?

I shared this post previously with the Modern Mama Community. It got lots of attention so I wanted to share it with you too.

When leading my workshop for 9 – 18 month olds, I’m often asked this question. Sometimes moms are planning to return to work after being on maternity leave and are wondering how to make the transition. Other times, moms are receiving pressure from friends and family members to wean their babies (often these folks express their unsolicited opinion in an un-delicate ways).

The answer that I share with parents is actually quite simple (and perhaps surprising):

From a nutrition point of view there is no age that you need to stop breastfeeding.

The recommendations from the World Health Organization that both Health Canada/ Public Health Agency of Canada and provincial health ministries have adopted is:

“Breastfeed until 2 years or beyond.”

When you first start your little one on solid foods (baby food), breastmilk will meet the majority of your child’s nutrition needs. Gradually over time, other foods and beverages will play a larger and larger role in meeting your child’s nutrition needs.

I’ve been asked this question too so I want to be really direct here – even after your toddler is eating meals and snacks with lots of finger foods, breastmilk still provides more than just water. They’re still receiving a variety of healthy fats, carbohydrates, vitamins, minerals, and immune support. And of course there’s also the comfort and snuggle factor when breastfeeding.

From a nutrition point of view there are no hard and fast rules around when to stop breastfeeding. Some little ones wean themselves – at a wide range of ages. Some Moms stop breastfeeding because they’re returning to work. Some Moms stop because they feel “done”. No matter what age you stop breastfeeding, unfortunately, you’ll likely receive judgment from people about your decision. It’s another example of how we need to stop the “mommy wars”, put away the judgment and instead celebrate that there are a multitude of “right” ways to parent.

The bottom line: Breastfeed as long as you feel comfortable doing so - you are supporting your child’s nutrition needs.

My Son Doesn't Feed Himself. What Should I Do?

{Guest post I contributed to the Love Child Organics blog. } Thanks to the Love Child Organics community member who asked a question regarding her 9 month old son. “My son doesn't feed himself. He is 9 months and has been eating finger foods since about 7 months. Is there something I can do to help this? Or will it just come to him?”

 Without doing a full assessment I can't tell you for sure why he isn't feeding himself. Here are common causes that I see and their solutions.

Why Babies Don't Feed Themselves

1. Medical conditions or developmental concerns. Because you didn't mention it, I'm assuming that your son doesn't have any medical conditions or developmental concerns that would affect his dexterity/ motor control.
2. Missing role models. Kids learn from watching others - particularly older kids and adults. If no one else is eating there isn't anyone to act as a role model for how to do it. Also, eating is a social activity for us human beings. Kids of all ages eat better when adults join them at the table.
3. Temperament (also known as personality). Some little ones are what I call "outsourcers". They're happy to sit back and let others do things for them instead of doing the hard work of figuring it out themselves. Because learning to self-feed does take work at this stage.
4. Over-helpful caregivers. Sometimes parents (and other caregivers) have such strong desires to help their little ones that they jump in and "help" instead of sitting back and allowing their little one figure things out for themselves. This can sometimes also be fuelled by impatience and/or anxiety about your little one getting enough to eat. The result is a learned helplessness.

If the cause is #1 then working with an Occupational Therapist can be a great help.

The solution to #2 is to sit and eat with your child. Ideally, eat the same foods too. This way you're sending a message loud and clear that you want him to eat what’s in front of him. And, you’re creating the social environment that’s most conducive to eating and learning.

The solution to #3 and #4 is the same. Resist the urge to jump in and "help". You're actually being more helpful by holding off and allowing him to learn the skills himself.  

Bottom Line: Just like learning any new skill, kids learn to feed themselves with finger foods at different rates. Join your child at the table and give them the opportunity to practice. They’ll learn this new skill in their own timing that’s perfect just for them.

Click this link to get tips on introducing solid foods, finger foods, and more child nutrition topics in your inbox.

Baby Feeding: What Does it Mean When I See Whole Pieces?

Thank you to the parent at a recent workshop in Victoria BC who asked this baby feeding question: "What does it mean when I see whole pieces of food in my baby’s poop?" It’s amazing the topics of conversation that you have once becoming a parent, eh?! This Mom had recently started feeding her baby finger foods and was seeing pieces of food in her baby’s diaper. It’s often not talked about, but when you start to feed your baby solid foods, you will see a change in their bowel movements.

When it comes to baby feeding: Change what’s going in and it’ll change what comes out the other end.

It’s normal for babies to have smellier and more solid bowel movements once they start eating solid foods. This will be particularly noticeable if you were exclusively breastfeeding your baby before introducing solid foods.

It’s also normal for bowel movements to be less frequent. They may not be every day. This doesn’t mean that your baby is constipated. It’s the normal transition from very quickly digested (and naturally low fibre) breastmilk or formula to solids which require more digestion.

Signs of constipation include your baby straining (which is different than the (hilarious) “I’m concentrating” face that many babies make) or being in pain when having a bowel movement.

Baby Feeding: So, What Does it Mean When You See Whole Pieces?

To get back to this Mom’s question, it’s normal to see whole pieces of food in your baby’s poop. Corn is a classic for making diaper appearances. It just means that they swallowed the piece without chewing/mashing it enough for their stomach and intestine to digest it. There’s no harm in this. It’s part of the process of learning to eat.

Another bowel movement appearance that shocks and worries many parents for the first time happens after eating beets. Beets will cause baby’s poop to be dark red. It’s not blood. It’s just the molecules that make beets ruby red coming out the other end. These same molecules can cause urine to be pink too.

The Mom went on to ask me if their baby got any nutrition from the pieces of food. The answer is, for the most part no. The food’s passed through largely undigested so their body didn’t have the opportunity to absorb the nutrients from this piece.

In summary, as your baby starts to eat more solid foods, expect their bowel movements to change.

Looking for more help with feeding your baby? Check out my In-Home Instruction service.

Can I give finger foods if my baby doesn’t have teeth yet?

{Guest Post at Love Child Organics } Both in workshops and when providing in-home child feeding sessions, I’m often asked this question: "Can I give finger foods if my baby doesn’t have teeth yet?

The short answer is: yes! You don’t need to wait until little ones have teeth before feeding them finger foods.

Babies are ready for finger foods by 7 months, if not before. Many won’t have teeth (or very many teeth) by this age.

Your baby is likely ready for finger foods when you see the following:

• She can bring food to her mouth using her hand.
• He can eat thicker purees (the consistency of mashed potatoes).
• She can sit upright with minimal support.
• He is very interested in watching people eat and the food on your plate. He May even be grabbing for people’s food, plates, cups etc.

It’s amazing to watch what little ones can handle with their gums. So go ahead and offer finger food versions of a wide variety of foods that your family eats.

Bottom Line: Enjoy watching your little one discover the amazing variety of tastes and textures that food comes in!

For more info on baby food - both purees and Baby-Led Weaning (BLW), check out this blog post.

Does My 7 month old Baby Need Water?

Thank you to the VIP who asked this question: "Does my 7 month old baby need water?".  The short answer is: No. Seven month olds don’t need water. But, it’ a great time to start offering it to them anyways. Let me explain.

Baby Need Water?

We offer little ones solid foods starting at about 6 months of age for two reasons:

1. To meet their nutritional needs.
2. To provide the opportunity to learn eating skills.

At 7 months old, your baby will still be nipple feeding (i.e. breastfeeding or formula feeding) several times a day.  They’ll be meeting their need for fluids through nipple feeding. So, your little one doesn’t need water to meet their nutritional needs.

Open Cups

Learning to drink from a cup is a learned skill. Any time from 6 months onwards is a great time to start. From time-to-time, when your little one is sitting at the table, offer them a small amount of water (I’m talking an inch deep or less) in an open (lidless) cup. Yes, the first few times the water will pour down their face. A clever mom in one of my recent workshops shared how she dresses her little one in only a diaper when doing this – there’s less clean-up. Over time your little one will learn how to hold on to the cup, tip their head up just the right amount, and close their lips around the cup. It’s amazing how fast and how young they pick up this skill! Now you may have noticed that so far I’ve only been talking about using an open/ lidless cup.

Sippy Cups

That’s because kids don’t actually need a sippy cup. Sippy cups are helpful for parents because it means less spills. But they aren’t actually a developmental need for kids. In fact, sippy cups with the valves/ bladders in them teach your kids to suck – not sip. They aren’t actually any skill progression from a bottle. Removing the valve/ bladder gets kids moving back towards sipping instead of sucking. But it also means more spills. Some speech language professionals recommend cups with straws instead of sippy cups because of concerns about oral movement and development.

The Bottom Line

While your 7 month old baby doesn’t need water yet, it’s a great time to start offering the opportunity to learn how to drink from a cup. Sippy cups and cups with straws are handy ways to limit spills. But they aren’t needed for kids to learn how to drink from a cup.