Archive for 28/09/2011

A sweet tooth

Oscar Apple Smile close up

Oscar definitely shows a preference for sweet foods like fruits. This is natural. Research has shown that babies are born with an inherent liking for sweet foods. Newborns that were given sugar water (prior to bottle feeding or breastfeeding) showed an expression of ‘satisfaction’ accompanied by eager licking of their upper lip and loud sucks. Those given just distilled water remained sleepy and disinterested (Steiner, 1977). It is thought that survival of the fittest ensured this preference for sweet foods as they are higher in calories, providing energy and so aided survival.

I do understand how parents bargain desserts against main meals. I found myself inclined to do it too and Oscar is only 6 months old! Keep perservering with the less sweet foods. These will take more attempts before they are accepted but worth it in the long term. It may take as many as 21 attempts before your child accepts a food.

TOP TIP: Don’t give up trying vegetables. Mix them with a fruit or sweeter vegetables like sweet potato to make them more appealing but still keep trying them by themselves.

 

Reference

Steiner JE “Facial Expression of the Neonate Infant Indicating the Hedonics of Food-Related Chemical Stimuli” in Taste and Development, ed. JM Weiffenbach, Bethesda, MD;US Department of Health, Education, and Welfare, 1977 pp. 174-175

Weaning on the go

Baby food close-up, isolated

We went to a hotel last weekend and I was dreading it. It was nice to get away but how would I feed Oscar away from our kitchen? Should I take a small break from weaning? PANIC!

This is where ready made purees play a role. I think that ready-prepared baby foods are often demonised and you are a ‘bad mother’ if you ever consider using a jar! But I am a realist. Homemade weaning foods play a key role in forming future eating habits but they are not always easily portable. Ready made purees can help you continue weaning when you don’t have access to a kitchen. I especially liked the squeezable sachets as I only needed to carry a spoon and a bib.

Here are a couple of things to consider;

  • Check the ingredients list. Avoid those that contain added salt or sugar.
  • Choose the right stage of ready made food for your little one (they are classed by stage). If they are having textured at home, try to get one that is textured.
  • Use your pram as a high chair if they need support. It can get so messy having them sit on your knee, if they can’t sit in a restaurant high chair.
  • Carry spare bibs. I found some disposable bibs I could throw away or use a plastic one you can easily wash in your hotel room.
  • Always carry a change of clothes for you and your baby
  • Be wary of distractions. Oscar was so distracted at breakfast in the hotel, he refused to eat. I found it easier to feed him in our hotel room beforehand.
  • Weaning on the go gets easier. As babies progress through the stages, they can start to eat your food (minus salt and sugar!). Just mash some of the boiled vegetables with your fork or cut a piece of toast into soldiers.
  • The occasional meal out can still be homemade. Just get a plastic container that you can put your homemade puree in
  • Food safety is important. You may want to consider a cooler bag for your purees so they remain cool when you are out and about.

TOP TIP: Don’t worry about using some ready made purees. They are great for travelling or that one day you are short on time and don’t have anything at home. 

Weaning with a cleft palate

Oscar smiling at me

Unfortunately Oscar was born with a cleft palate. It’s quite common in the UK and 1 in 700 babies are born with a cleft palate. Feeding has been slightly more difficult as he is unable to suck (he can’t get a vacuum to suck) and so we have use a special squeezy bottle to give him milk. We effectively ‘squeeze’ the milk into his mouth and he drinks it. Sometimes the milk goes up his nose and he does get a lot of wind but he is doing very well and thriving.

Weaning presents it’s own challenges but being a dietitian has given me confidence to overcome these.  Here are a few things I have learnt along the way;

  1. Weaning is really messy. Food does go up his nose and he sneezes alot. Never wear a white t-shirt when serving carrots!
  2. Give drink breaks. Between mouthfuls of food give some sips of milk (formula or breastmilk) or water to help your baby clear out his mouth/nose.
  3. Play with the texture. Stage 1 purees were too runny for Oscar. They kept going up his nose. I found that by adding baby cereal, rice or porridge to fruit/vegetable purees to make them thicker helped a lot. Every baby is different so you may need to play with the texture to get it just right for your little one.
  4. Be careful with citrus fruits. Oscar has not had any of these yet but I have heard these can be harder to tolerate due to the acidity
  5. Get advice from your cleft team. We were advised to start weaning at 4 months so Oscar would be used to solids by the time of his operation. Please follow guidance from your cleft team.
  6. Alot of the normal weaning advice still applies. Like all babies, your baby still needs to experience a range of textures and flavours by the age of 1 year. this is to ensure that good eating habits develop for life. Don’t be put off by the cleft palate!

TOP TIP: Weaning is pretty much the same with a cleft palate baby. You may need to make a few minor tweaks but it is still a fun adventure and Oscar is really enjoying his food. 

Fine tuning a new skill. The first week

Oscar Sweet potato close up

 

Day 2

Today I tried 2 spoons of baby rice again. He is still unsure. He looks like he has just sucked a sour lemon!

Day 3

Pear for afternoon tea today. His first taste of something that isn’t milk. Despite it being sweet, he is still not convinced. He still sticks his tongue out but every now and then he gets the hang of it.

TOP TIP: when Oscar was unsure, I broke up the solids experience with a few sucks on his bottle. He then relaxed and was happy to try another mouthful.

Day 4 

Sweet potatoes are a total success!!! He not only mastered the tongue action today (well, it still comes out first on his tongue before he swallows it) but he also asked for more. I couldn’t believe it. He has gone from two tentative mouthfuls of pear this morning to more than five of sweet potato.

TOP TIP: Coloured vegetables like sweet potato leave coloured marks! Weaning is meant to be messy but be prepared. We needed to change clothes afterwards. Oh and giving your child sweet potato just before you take him to meet family friends for the first time is not a great idea. And I was wearing white…nice!

Day 5

It’s amazing how quickly your baby masters swallowing. Today Oscar wolfed down his cube of sweet potato (fast becoming a firm favourite) and I had to quickly defrost a cube of pear. I could not keep up!

TOP TIP: be ready with the next spoonful. Remember that a liquid diet can be consumed quickly so your little one easily becomes impatient with solids!

 

How to progress

Oscar eating baby rice

How quickly you progress depends on when you decide to start weaning. If your baby is 4 months you will go at a slower rate than if your baby is six months. Allow your baby to guide you.

As a rough guide, start with a spoonful once a day for the first week so your baby can get used to it. As he accepts solids you can start to introduce a second spoonful and add less liquid (making the puree less runny). Then introduce solids at a second feed. When your little one is ready, introduce solids at a third feed.

Below is a rough schedule to aim for;

First Feed Milk-feed
Breakfast Cereal/Porridge/Rice with milk
Lunch Vegetable puree
Afternoon Milk-Feed
Dinner Fruit puree
Bedtime Milk-Feed

This first stage of weaning is about your baby learning a new skill and trying new tastes. Breast milk/formula remains the main source of  nutrition so don’t cut out any milk feeds until solids are more established. When your baby is taking a few mouthfuls of solids you can start with the solids first and then top up with milk.

TOP TIP: You can play with the texture. The carrot puree I made was too watery so I added some baby rice to thicken it all up. You can add breastmilk or formula if you want to make the purée runnier. As your baby advances, make the purée thicker.

 

That first spoonful…

Oscar eating baby rice

It’s exciting but needs some planning

  • Choose a time when your baby is happy and alert (usually mid morning after a feed and a nap) and you are relaxed
  • Help your little one sit up supported (car seat, bumba seat, a bouncer or a high chair if they are able)
  • Make sure you sit facing your baby so they can see your face
  • Start with a smile. Remember this is a new experience and your baby will look for reassurance from you.
  • Eating food is a new skill that needs to be learnt. Babies naturally push their tongues forward when they drink milk so need to learn another tongue movement with solids.
  • Don’t push them. Some babies need more time and one spoonful may be all they can manage at a time
  • Once a day is enough for the first week
  • Allow no more than 30 minutes per meal time
  • Put the spoon in your baby’s mouth gently. You can use your baby’s top gum and lip to carefully remove the puree from the spoon

I decided to start with baby rice. Making it up to runny yoghurt texture was not straight forward even though I followed the instructions. It came out very runny so I added a little more rice to get the right consistency. I also discovered it needs some time to thicken.

Oscar’s first mouthful was not how I imagined. I started with a smile and I expected him to be equally as happy. He opened his mouth and I gave him a small spoonful of baby rice. He didn’t know what to do with it! He frowned and stuck his tonque out and the food came out with it. I tried another spoonful and he gave me a disapproving glance, spitting it out again. It made me laugh and he smiled back. I suppose it a new skill he has to master (like rolling over) and so will take time. We’ll try again tomorrow.

TOP TIP: Let your baby suck the spoon. This is a good transition step from drinking milk to swallowing solids