We are excited to welcome ElBea Stonier as our guest blogger this month! ElBea works with Easter Seals-Goodwill NRM and the Provo Early Intervention Program. She has a Masters of Science and a Certificate of Clinical Competency in Speech language Pathology.
One of the most fulfilling aspects of my job as a Speech Language Pathologist in Early Intervention is to be with parents as they experience their baby’s firsts. From first smiles to first steps, those milestones are sure to bring a smile and applause from proud moms and dads everywhere. It should come as no surprise that first foods are no different and bring just as much excitement as those first toothless grins. However, for some parents transitioning to solid foods can be a daunting task that brings up many questions and uncertainties.
Why is starting solid foods such a big deal?
Many parents of young children find themselves inundated with information and opinions when it comes to food choices and eating preferences. With so many different views on topics such as childhood obesity, picky eating, food additives and ingredients, it can be hard for parents to navigate as they prepare to offer baby those first delicious bites of food. So where do we start?
First, it’s important to understand that eating is a very complicated task! Eating is the only activity that children engage in that involves every organ of the body and incorporates all of the senses. There is a lot of information that our bodies and brains process as we eat, and for infants who are learning to eat solids for the first time this can be an overwhelming experience. But, there is a lot that parents can do to help their little ones be successful during mealtimes.
How do I know if my baby is ready for solids?
It’s important to introduce solid foods to your baby when he or she is developmentally ready. This means we should look at what developmental milestones they’ve met, not how old they are. Most babies are ready between 4-6 months (the American Academy of Pediatrics recommends starting solids no earlier than 4 months of age), but some may be ready later than this. It’s important that infants have good head control before starting solid foods. This means that he or she should be able to hold their head up on their own and freely turn their head from side to side. A baby with good head control will be able to better manage their food and more easily avoid choking.
Even if a baby does have good head control and is showing they’ve met other developmental milestones, they may still need more time. Look for other signs of readiness such as showing interest when you eat (watching you eat, reaching for your food), not being satisfied by breastfeeding or bottles or acting hungry between meals, more frequent nighttime waking, etc.
What foods should I introduce first?
Start with a thin puree. Many parents choose iron-fortified infant cereals such as rice or oatmeal, or another single-ingredient, smooth puree like apples or peas. The first few times parents introduce solid foods to their baby tend to be messy, and it seems like infants push more food out of their mouth than they swallow. This is because they are learning to use their tongue in a brand new way, and are learning how to move food from the front of the mouth to the back so they can swallow. It takes a lot of practice, but using a thin puree can help your baby learn to use this new tongue movement in a safe way and minimize the risk of choking. With practice your child should learn to swallow purees.
How do I know if they like it?
Most babies will make some funny faces the first few times they try a food, and may even gag. This doesn’t necessarily mean that they don’t like the food though, it could just be them adjusting to a new oral experience. If your baby is simply adjusting to a new food, look for signs of acceptance such as learning toward the spoon, looking at the food while it’s moving toward their mouth, reaching for the food, opening their mouth for the spoon, or closing their lips around the spoon. If your baby is having a hard time managing the new food (perhaps because of difficulty with the flavor or texture), look for signs of refusal such as turning away from the spoon, not opening his/her mouth, or consistently looking away from the food or from you while eating. Remember that infants and children need to try a new food at least 10 separate times before they will decide if they truly like it or not. If it doesn’t go well the first time, try again later.
We tried our first food, what’s next?
In the beginning, use only single-ingredient foods like pureed fruits, vegetables, or single grain cereals. Introduce one food at a time, add one new food to your baby’s diet every 2-3 days. Look for signs of allergy or other intolerance such as diarrhea, rash, or vomiting. If you notice any of these signs after introducing a new food, avoid that particular food and be sure to talk to your pediatrician.
Once your baby has eaten five single ingredient foods without any sign of intolerance (we consider these “safe foods”) begin introducing one new food along with a safe food. These can be mixed together or given separately during the same meal, and it’s a good idea to try it both ways. We do this to help babies learn to manage and accept complex flavors, which will help them be more accepting of new foods and avoid picky eating in the future.
When is my child ready for finger foods?
In order to safely chew and swallow foods like baby cereal puffs, it’s important that they have mastered the ability to use their tongue to push food to the side of the mouth and hold it in place while also biting down on the food. This is a very complicated oral skill and usually will begin emerging shortly after children have mastered crawling. Remember that children need to show developmental readiness for foods, regardless of their age. Some babies will be ready for finger foods earlier than others.
How do I know if there’s a problem?
One of the biggest indicators of when there’s a problem with feeding is when a parent consistently reports they are overly stressed by feeding their child. Eating is a social activity that can be very rewarding when it goes well, and very stressful when it’s a challenge. If you find that mealtimes with your child are difficult and causing you stress on an ongoing basis, Early Intervention may be a good resource for you.
Other signs of difficulty may include the following:
• Ongoing problems with coughing/gagging/choking
• Ongoing poor weight gain, weight loss
• Ongoing or recurrent respiratory illness
• Difficulty accepting purees by 10 months of age
• Difficulty using a cup by 16 months of age
• Difficulty weaning off of baby food by 16 months of age
• Avoiding all foods in a specific food group or food texture
What do I do if there’s a problem?
Your local Early Intervention agency may be able to help. If you have a concern with how your infant or toddler is eating, call for a no-cost evaluation. Find your local agency here: http://utahbabywatch.org/localprograms/index.htm
What other resources may be helpful for me?
Resources that I highly recommend include:
Child of Mine: Feeding With Love and Good Sense, by Ellyn Satter
Above all, remember that mealtime is a social experience. Being together to share smiles and talk with each other during meals will help your baby not only learn to eat, but learn to want to eat.