Saturday, 24 May 2014

Introducing Solids Part Two

Last week I shared my go to resources and links for introducing solids. I had a great response to the post and have had some fantastic enquiries and inspirations for more pieces. Stay tuned!

Following on from that post, here's some questions and answers. Most of these were questions I had myself and was able to find most of my answers through our wonderful Birthing and Babies classes thanks to the local branch of the Maternity Coalition.

Before hitting the publish button I realised how much is in this post -it's huge! And as a mum I know there is so much to read and many written resources out there, but what I really wanted was for someone to *just tell me*. So I think I've worked out how to record my answers and if I've appeased the gremlins you should be able to play back each section.

Again let me start by saying I am *not* a nutritionist, dietitian, nurse, speech pathologist or any other type of medical professional. I am a mum. Please speak with your GP, child health nurse, or relevant health care professional to find out what information is current and specific for your individual needs.

When do you start?
(click on image for source)
Each baby is different and will be ready when they are ready. There are many signs to look out for - and wouldn't you know it someone has created a fabulous info graphic for it too! This one comes from Smart Nutrition blog in Canada so some of the info is a little different to what the current advice is in Australia, but you get the jist.
Nutritionally speaking, your baby doesn't need anything other than mother's milk (literally or formatively - I'm not getting into a thing about that here) until *around* 6 months. This is when their stores of iron start to deplete and the sleepless nights are taking their toll on mum they are growing at such a rate that they may need a little extra.
Developmentally speaking your bubba needs to be able to sit unsupported for the length of time it takes them to eat. I'm talking sitting by themselves, not propped up in a highchair or Bumbo. They need that strength in their core so their digestive system can do what it needs to, to get the job done - so to speak. Once you are satisfied they can sit for that time (ten minutes maybe?) strap them into a chair! You don't want to be trying to feed baby while they can escape. Your bub needs good head & neck control - that food's got to get to their belly in a relatively straight line :-) They also need to show an interest in eating. This generally manifests itself by baby stealing your food and shovelling it into their mouths. One of the signs which I found harder to spot was when the tongue thrust reflex weakens - basically when they don't spit out everything you put in is a good sign it's subsided.

(click on image for source)
What do you feed them?
Again, each to their own, but the current advice is that so long as you introduce iron rich food first you can pretty well do whatever you like. Try for vegetables, fruit and wholegrain cereals followed by some dairy. Dairy by the way only counts if it is milk, yoghurt or cheese. Those 'dairy snacks' in the supermarket don't count. And custard doesn't count either! The only foods you need to hold off on are honey (until 12 months due to botulism risk), milk (as a stand alone drink until 12 months) and any choking hazards (whole grapes, stringy foods like bean shoots, hard nuts or seeds etc) If you have allergies or intolerances you are wary of, please speak to your health care professional as you will have to pay extra attention to a few details.
So what did you do?
With Miss M I spoke to my child health nurse at 5 months (because she was stealing my sandwiches!) and she advised me to start on rice cereal. I did the same with Honey, although by that stage she had already munched on teething rusks, a pizza crust, nibbled on some lemon curd tart and snuck some of my chocolate - shhh! don't tell! So at 5 months the girls had one meal a day of rice cereal. Most people suggest breakfast, but I chose lunch - it suited our routine better and we could be relaxed and take our time with it.  The rice cereal was mixed with either breast milk, formula, cooled boiled water, cows milk or vegetable water. At 6 months we officially introduced them to 'real food' starting with vegetables. With Miss M it was pumpkin first, Honey had sweet potato (that pizza doesn't count, remember ^-^)We started with veges, then fruit and added some meat when they were up to being able to handle minced meat texture. I used the seasons, a rainbow, and store bought food as a 'flavour guide'. I picked one or two readily available commercial baby food combinations and introduced those foods first. I figured that way if we ever got 'stuck' away from home I could always feed them something in confidence it wouldn't have any negative affects. This is such a huge topic, I might come back and do a whole post on it. (Please let me know if you want more of this or not)
[EDIT: I found an app! It's free, and it's a start to get you thinking about eating a rainbow. Goodee Rainbow Food Journal Lite]

How much?
How long is a piece of string? Like everybody your baby will have hungry days and not so hungry days. They will have favourite foods and ones they aren't keen on. I know that the advice says that a baby will not over eat (they stop when they are no longer hungry), but I don't think anyone has told my two that! Especially Honey. I can offer her breakfast, say porridge with fruit, thickened with rice cereal. She'll have a good go at it, break for a drink and go again. Once we've done the 'are you done, do you want more' dance with food and water I would normally 'wash' her and her high chair down, pop her on the floor and clear away. Unless of course I'm still eating, in which case I will often give her a crust of my toast, or a few pieces of Little Bellies cereal. *And. She. Eats. Them* Don't tell me she'll stop when she's full - she'll stop when her porridge belly is full and then want what I'm having! That's not supposed to start yet!
Back on track - oops! Start out with a teaspoon or so of solids. See how that goes. Those very early days are all about getting the idea of something other than straight fluid. Gradually increase as your baby's appetite grows. When they turn away, push food away, look distracted & not interested, they've had enough. If they're lunging at you and bouncing up & down like a wild thing every time they see the spoon you could probably give them some more :-)
Here's a link for suggested intake for a 1-3 year old. The up to date information can be found in your Queensland Health Red Book.

How do you feed them?
Again, it's up to you. There are many different ways and many different theories about parent led vs baby led weaning. For me, in those early days spoon feeding rice cereal while baby is locked into a Bumbo, preferably on a verandah or easily hosed off surface, made the most sense. As they progressed through textures and foods our tools changed too. From changing the spoon/s we used to introducing food pouches and finally finger foods. One thing that it took me a while to learn is to eat when the baby's eating! They watch you and it's much easier to show them how to chew food if you have some in your mouth (gross, I know, and I hate chewing with my mouth open - ugh! but it works). And you need nutrition too! Also don't forget to offer water with each 'meal'. One of the leading causes (in my opinion) of constipation around the time of introducing solids is the lack of fluids to . . . well. . . keep things subtle, shall we say.
I found preparing a tray for lunch the easiest option. A muffin tin would also work well. You will need: water for you, water for baby; something to eat for you (with utensils if need be), something to eat for baby (and your chosen utensil/s), bib, and a damp cloth. Honey is somewhat of an independent soul and is quite fond of doing things for herself. Hence my three spoons for this lunch. One for each of her busy little hands and one for me to wield. Oh, and don't think I only get to wield the one either, they all get chopped and changed during the meal :-)
In an attempt to contain the mess feel free to lay down a 'splat mat' - a table cloth or shower curtain work wonders! And so much easier to then hang on the line & hose off after
I'm in the process of taking photos of all of the feeding equipment I've accumulated & will post a 'tools of the trade' soon - children & flu permitting. I'll also do up some of our 'one-cook, three ways' meals.

(click on image for source)
How do you introduce new foods or flavours?
If you have no concerns about intolerances or allergies, you can simply go for it and see how your little one reacts. Generally speaking if you want to be cautious, or if you think there might be something awry and you want to narrow your suspects, try one new food every three days. For example, you start baby on rice cereal mixed with their favourite milk (breast or formula). If after three days everyone's happy you can add a new flavour, say pumpkin. Try for three days, and if all's well add another. Let's say potato this time. Three days later you can add a third. I'm going to go against my rainbow and stick with conventional carrot. You now have multiple options for mix and match meals. You can have any of these ingredients as stand alones, or any combination. Don't forget you also have water in the mix too if you are wanting to thin out any of your purees. And if you want to get tricky you can save and reduce your vegetable cooking water to add to your rice cereal for an added nutritional boost and a different flavour to boot. This is particularly handy if you are breast feeding and are not all that successful with expressing - speaking from personal experience.
Rememebr that baby's taste buds are very pure and haven't had years of coffee and salt bombarding them. Anything you think tastes bland will probably be the most exciting thing they've tasted! Anything you think tastes a little spicy/hot will most likely blow their minds, so be mindful of flavour enhancers.

(click image for source)
What sort of negative reactions should you look out for?
Apart from anaphylaxis which I've been fortunate enough not to encounter (touch wood), you may notice a change in diaper/nappy changes (both frequency and 'intensity'); rashes; hives; general dissatisfaction. Choking or gagging. Sad realisation that your baby is growing up and is one step closer to your Tim Tam stash.
And what can you do about them?
If you suspect an allergic reaction or anaphylaxis; shortening of breath or swollen airways, stop everything & call 000.
If the reaction is mild and you have a fair idea of what's caused it, you can experiment by removing the offending food for a few days and let things return to 'normal'. Then in a controlled way introduce it again to see if the reaction is the same. Not all reactions/intolerances are permanent. Miss M would break out in a facial rash when she ate strawberries early on. By the time she was 12 months old she had out grown it.
Intolerances are harder to identify and you may find you need intense dietary investigation. Speak to your health care professional for more information.
For constipation ensure baby has access to plenty of fluid and has a fibre rich diet. Some things which may help include pears and prunes. You shouldn't be administering anything as a preventative, although I would always serve bananas and pears together just to even the playing field. If the problem is ongoing, seek medical advice. Don't forget the 13HEALTH number too. You can speak to a child health nurse any time of the day or night.
The ties that bind. . .
Different foods do it for different people. Some foods that I've noticed can have a binding reaction include: bandanna (yes, really), potato, avocado, eggplant, blueberries, too much rice (rice cereal for breakfast, rice cakes for snack, rice-rice with dinner - oops!)

(click image for source & great article from Active Mama)
How do you progress through the textures, and when should they be doing that?
Like anything new it's best to start with something familiar. Very first foods should be similar in consistency to breast milk. Awkward for trying to spoon feed I assure you, so it won't take long for *you* to be increasing the consistency to something a little easier to handle. You may find a drier mix of rice cereal easier for bub too, so they can learn to use their tongue and roll it around their mouths. They'll also like to get their fingers in there and feel what you're feeding them. This is a good experience for them, although you may find more food out of their mouth than in. Just remember at this stage breast milk/formula is still their main source of nutrition.
The general run of textures goes: Liquid - thin puree - thick puree/mash - lumpy mash - finger food. My general rule of thumb has been if you can need a spoon it's puree, if you can eat it with a fork it's mash, if you can stab it with a fork it's finger food.
If not earlier, you will most likely find your little one wanting to self feed around 9-12 months old. As messy as this can be, do encourage this behaviour.
If you have any concern about moving through the textures, seek help from your medical professional. Don't forget that speech pathologists, dieticians, and even occupational therapists can offer advice on this matter. It is easier to help early on and there's no harm asking for confirmation if nothing is wrong.

But what about choking. . .?
Unfortunately there's no easy answer. Baby needs to progress through textures so they can develop their oral muscles which are needed to eat, communicate and talk. Your baby has a gag reflex for a reason. There is a difference between gagging & choking, but until you see it in person, nothing can quite prepare you. I was surprised at how quickly I could tell the difference between eating, gagging & choking noises (or lack there of). There's a certain cough/wheez/lack of sound. . . you know how you can hear baby crying & you know they're just ticked off that you're not paying them any attention, and then all of a sudden it changes -there's a pitch or intensity to it that just sets of the mummy alarm, you turn around to find they've caught their fingers in a set of drawers - it's sort of like that. . . only of course you will be nearby and paying close attention when bub is first learning to eat. Keep your eye peeled for those times when bub brings up their choking hazard. It's strange how reassuring it is to see it happen for yourself.
Here's an info sheet from St John Ambulance
Some pictures for quick reference
I tried to find an Australian video to link to but couldn't load the one on the Raising Children Network. Here's one from the UK showing how to perform back blows.
All you can do is trust your baby's reflexes and your own judgement. You know your baby best. Don't forget you can always ask for help! Some tips that may help - give baby a long handled soft spoon to play with. They can use it to find their own gag point. When you move on to finger foods, go for softer foods if you are nervous. Ripe banana, over ripe pear, well cooked pumpkin or sweet potato. Anything you could mash with a spoon to give you an idea of the 'solidness' to look for if you are nervous.

So. . . water. . .?
When you start introducing solids, you should start introducing water too. Boiling water (and letting it cool) before serving it to baby helps to kill off any nasties that might be lurking in the plumbing. It is advised you continue to boil baby's water until 12 months of age. Personally I didn't see much point when they started eating off the floor ;-D
Baby can't drink too much water! Well, maybe half a litre might be pushing it, but if they are to have 100-odd mL on top of their milk feed and solids, that's fine. Remembering too that bub will have thirsty days, just like you do.
There are many different cups, bottle etc out there and unfortunately it comes down to trial & error to see what will work for you & yours. If you've been feeding baby with a bottle, you know you have one avenue to try offering water through. You can always try a regular cup straight up. One tip is to use a cup in the bath as a toy. That way they get the notion of it & it doesn't matter if they get wet in the process! Try blowing bubbles in it and then letting them have a turn.
As with most things, it's monkey see monkey do. My girls both seemed very keen to drink from a pop-top water bottle like I use during the day. Come to think of it I rarely drink from a cup unless it's for a hot drink. My bad. I do like that, even though it's a little messy, I know I can always buy a pop top water bottle while we are out & Honey won't go thirsty. I also discovered that to get her to drink through a straw, all I had to do was stick my finger in her mouth, then slip the straw in next to it. She got the idea very quickly and now her favourite cup is a straw one.
When you look for a cup or bottle for your little one be mindful that a lot of the spill-proof ones need bub to 'bite down' on it before they can suck any liquid out. Not necessarily good for wear & tear on straws, but it's not like you can't get replacement parts for most things these days. Check out your mothers group, the park, or random kids in the shopping centre - if you see a product you think you might like, ask about it! You might even be able to have a cup swap meet and experiment with a different design for a week or so.

Phew! That was a lot more than I thought I'd write. Can you see why my posts are normally all about the pictures? It's so much easier to show you what I'm talking about :-) And speaking of which, here's a link to my Pinterest Board where I've been collecting all these fabulous info graphics.

I'd love to hear what you think of the series so far, and what you'd like to hear about next! Please feel free to leave a comment here, on social media, or drop me a line LovingLunches at gmail dot com.

Details of my tools & toys can be found on this page.

Disclosure: This is not a sponsored post. This post was written for Loving Lunches. No product was received for this post. All opinions expressed are my own, based on personal experience with the product.

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