Fruit Juice – Friend or Foe?

Orange Juice (sxc.hu)

Fruit juice has been in the media a lot recently and as a Mum/Dietitian it’s something I often get asked about.

It’s true that many adults and children struggle to achieve their “5 a day” and it could be argued that fruit juice is a one vehicle for getting more fruit into our diets. However, a lot of attention has recently been directed, by the Department of Health, at the high levels of sugar in fruit juice and how fruit juice is one of the main sources of sugar in the UK diet. Kids do love fruit juice and according to recent National Diet and Nutrition Survey (NDNS) data fruit juice accounts for 9% of the sugar intake in 4-10 year olds (soft drinks were 11%).

Essentially, sugar is sugar, whether it is added to your food or from natural sources. Sugar has been linked with addiction, weight gain, obesity and diabetes. Fruit juice is also strongly associated with tooth decay. Currently 150ml of pure fruit juice counts as a maximum of one of your “5 a day” and smoothies count only as 2 of your 5 a day but it looks like the government may be soon revising these guidelines and recommended we drink less.

My top tip
Do offer your child the occasional glass of diluted fruit juice but otherwise give water as their main drink.

Weaning Top Tips from Dietitians

Apple on books small

WEANING TWITTER CHAT

Last night dietitians from all four corners of the world, came together on twitter to chat about weaning. There were more than 500 tweets in 1 hour and lots of tips and experiences were shared so I thought I would capture a few for your benefit.

  • A variety of tastes and textures is key to successful weaning and a lower risk of fussy eating later in life
  • Mum is an important role model. Its important for mum to not influence her little one with her likes and dislikes
  • Having family meals together may help your baby accept new flavours (a spoon for baby and a spoon for mum) and gets them ready for fmaily meals later
  • Never give up, after many attempts they may eventually accept that new flavour
  • Babyled weaning may encourage self feeding but may not be suitable for slow developers. Its ok to combine spoon feeding with self feeding.
  • Spoon feeding has its place if done properly. Let your baby come to the spoon and not the other way round.
  • Weaning is great time for the whole family to start some new eating habits
  • Don’t feel you have to cook new recipes when weaning. Amend family favourites to make sure they are low in salt and sugar
  • Cook in bulk and freeze for days when you are not cooking.
  • Keep commercial weaning foods for when you need the convenience, they are not for everyday.
  • If you are worried about the choking risk, do a first aid course so you know what to do if it ever happens.
  • Expect lots of mess but have fun!

Catch up on the full twitter chat here: Weaning

Cow’s milk protein allergy

Caution milk

Do you think your baby might have an allergy to milk? Not sure what to look for and how it is managed?

Last week a few dietitians came together with the Anaphylaxis Campaign and some parent support groups to tweet about cow’s milk allergy. 2-4% of children in the UK are affected by it and many of them are misdiagnosed or mismanaged for many months. Some good information was shared in the hour long twitter chat including tips for weaning and where to go for support. The twitter chat is well worth a read if you want to know more.

To read the full twitter chat: Cow’s Milk Allergy

Weaning on twitter

Apple on books small

Social media really can be a great thing for sharing information. We had a really exciting twitter chat last month on weaning. Lots of dietitians, mums and bloggers came together and shared their tips on all things related to weaning.

To read what we discussed, click here: Weaning Twitter Chat

We run these #rduk nutrition chats monthly so join us live for a future one!

Healthy Eating for the Whole Family

Eatwell Plate

Sorry its been ages since I have written anything but have been swamped with work.

Oscar is now 1 year old, onto family foods and feeding himself with a lot of mess! A friend asked me recently what she should be aiming for when it came to family foods and thought it was time I shared some tips on this.

Its all about balance…

There is no such thing as a perfect diet but really we should be aiming for a balanced one…a range of foods that provide different nutrients to ensure our little ones grow up happy and healthy. Our diet falls into 5 food groups (more info on each of these below) as shown by the picture. And how much we have from each food group is nicely shown by the slice of the pie!

Imagine you could put all the family meals you have in one week onto one large plate, would it look like this image? Maybe you are eating more meat? Less fruit and veg? Too much dairy?

This picture captures how our diet should look from 2 years onwards so applies to your diet too Mum! Children under 2 will have a larger proportion of dairy in their diets.

Group 1 – Starchy Carbohydrates

  • E.g. cereal foods, pasta, bread, rice, potatoes
  • Give us lots of energy and fibre
  • Try to choose less refined alternatives for slower release energy and more fibre (e.g. brown rice, whole grain pasta)
  • Should account for 1/3 of your diet

Group 2 – Fruit and Vegetables

  • E.g. Carrots, tomatoes, oranges, bananas, broccoli
  • Potatoes are not in this group (they are in Group 1)
  • Give us vitamins, minerals, fibre
  • Try to eat a rainbow. The more colourful, the more antioxidants they contain.
  • Try to eat 5 a day.
  • A portion is a ‘handful’
  • One glass of fruit juice (150ml) can only count as 1 of your 5 a day
  • Should account for 1/3 of your diet

Group 3 – Meat, Fish, Eggs, Beans, Pulses

  • E.g. chicken, cod, lentils, chickpeas, tofu
  • Full of iron and protein
  • Try to eat two portions a day (a portion equates to the size of the palm of your hand) or three a day if you are a vegetarian
  • Choose lean alternatives (trim visible fat off meat and try grilling or roasting instead of frying)
  • Drink a glass of orange juice with your vegetarian protein (e.g. beans & pulses) to help iron absorption

Group 4 – Dairy

  • E.g milk, yoghurt, cheese
  • Great for calcium and good bone health
  • All children should be on full fat milk until 2 years of age. At 5 years of age you can introduce skimmed milk.
  • Adults should choose low fat alternatives where possible
  • Try to have 2-3 portions a day
  • A portion equates to a match box piece of cheese, 1 yoghurt, average glass of milk

Group 5 – Foods high in fat, sugar and salt

  • E.g. biscuits, chocolate, sweets, fried food
  • Try to eat only as treats (on top of and not instead of any of the other groups
  • For better heart health try to choose vegetable fats such as olive oil or rapeseed (or spreads made from them) over animal fats like butter and lard.
  • Don’t worry about fat intake for little ones as they need the calories

TOP TIP: Eating well is all about balance. Have a think of one change you could make to your/your family’s diet after reading this…one more fruit a day, try to eat whole grains etc

Reference

NHS Choices Website – The Eatwell Plate (accessed April, 2012)

http://www.nhs.uk/Livewell/Goodfood/Pages/eatwell-plate.aspx

Spoon Feeding – friend or foe?

Oscar spoon feeding

Following my last post I have had some questions about correct spoon feeding. I thought I would share my response with you all as I think some more clarification is needed.

Spoon feeding can be a valuable part of weaning in the ‘right hands’.

Even though it is often the parent holding the spoon, spoon feeding also needs to be ‘baby led’. As a parent, you need to be attentive to your baby’s needs and wishes at all times. It is easy for spoon feeding to go wrong and I have seen mothers jabbing spoons at their babies and their babies obviously not enjoying it. Spoon feeding should be like a dance partnership where the parent and child read each other’s signals and feeding happens in synchrony. Here are some tips, from my personal and professional experience, on how to do spoon feeding correctly.

How to spoon feed in a supportive manner

  • Get your baby to sit in front of you and face you. Putting them in a high chair at a table with you can help as you are at the same level and this is a good precursor to future family meals
  • Use a baby safe spoon. Using a shallow soft weaning spoon can help. Its soften if they play with it and stops you putting too much on the spoon
  • Don’t over fill the spoon. Too big mouthfuls can be off putting!
  • Hold the spoon in front of them. Hold the spoon laden with food about 10 cm away from his/her mouth.
  • Get his/her attention. Make sure the TV is turned off and nothing too exciting is happening at meal times. 
  • Let them lean forward. Let them come to the spoon instead of you leaning forward.
  • Try a taster on their lips. If they are unsure or it is a new food, put a little on their lip.
  • Read their signals – Each baby is different so watch carefully and see when they are ready for the next mouthful. Try to match their pace.
  • Let your baby touch the food. Engaging with food is an important way of learning textures, even if it means squashing a pea and not eating it!
  • Make meal times social. Sit and eat a little with your baby. Let them watch you trying the food yourself and they may be more likely to give it a go. Have a chat about the food they are eating and plans you might have for the day.
  • Stop when he/she has had enough. Never be tempted to try sneak in mouthfuls. One extra spoonful won’t make any difference nutrition wise. It will just upset your baby and make meal times a stressful experience.

TOP TIP: Spoon feeding can be a valuable part of weaning in the ‘right hands’.  Spoon feeding should be like a dance partnership where the parent and child read each other’s signals and feeding happens in synchrony

Baby Led Weaning vs. Purees

Oscar BLW

A lot of people have asked me recently about skipping purees and going straight into baby led weaning. There are pros and cons to every weaning approach. You need to find the approach that works for you but here are some of my thoughts if you are looking for guidance.

Baby Led Weaning

The theory is that if you wait until 6 months your baby can skip purees and start feeding themselves with finger foods. The baby takes part in family meal times and the baby decides how much she/he will eat. Your baby is in the driving seat but finger foods have their limitations.

Traditional Weaning 

This approach starts with spoon feeding of purees which progresses through four stages of textures. Using a spoon can be helpful when trying to achieve variety as some foods are not good finger foods. It’s very much a parent led agenda and the risk is the parent does not respect the child’s refusal and spoon feeding becomes intrusive.

Supportive Weaning

I believe there is a good middle ground and both spoon feeding and finger foods have their place in the weaning process. Just as long as you, the parent, fulfil your feeding role then there is no risk that spoon feeding becomes a negative experience.

  • Attentive feeding is at the heart of this approach. Respect your role in the feeding realtionship (see earlier post) and watch for signs that your baby wants more or has had enough.
  • There is nothing wrong with spoon feeding if it is done properly. When you first start with weaning your child will most likely be unable to feed themselves sufficiently. Spoon feeding will provide taste exposure and nutrition until they can adequately eat by themselves. I have known some babies to start waking up at night again because baby led weaning did not fill them up.
  • Let them play with food even whilst you are spoon feeding e.g. give them a soft cooked carrot stick to chew on. That way they get to feel the texture and engage with the food.
  • Be wary of iron deficiency.The foods that are good sources of iron (chicken, meat, fish, beans/lentils) are often hard to give a 6 month old as finger foods so spoon feeding is handy for these.
  • The stages of weaning are not time specific. Your child may progress very quickly through purees and textured foods to soft finger foods. Let your child be your guide to the right texture for them at that stage.
  • Encourage family meals. Try to involve your baby in your meal times (have them sit at the table with you) and try to eat something when they eat. And instead of cooking separate meals, try to tailor your meals to your little one (no sugar and salt).

TOP TIP: Let your child’s development determine how you progress with weaning and what type of foods you offer.

Creating a positive feeding relationship

Oscar eating broccoli

Feeding Roles

When you have a child you have to start thinking about the best way to feed your child. And getting it right from the start will stand you in good stead for the future. Understanding your role as a parent in the feeding process will make meal times easier, relaxed and more fun. I recently came across Ellyn Satter’s work and she explains the feeding roles of the parent and child really well. Here’s a quick summary for you.

THE PARENT is responsible for

  • What your child eats. You choose the meals you cook and serve and can ensure your child has a balanced and varied diet.
  • When your child eats. Setting routine meal times is important to make sure your little one does not go hungry and their energy levels remain topped up. Having meals together with the family is great because then your little one can watch you eat..
  • Where you child eats. Meals are best at a table and together with the family.

THE CHILD is responsible for

  • How much they eat. You have to trust your child and that they know when they have had enough. Research indicates that children have very good satiation and hunger cues. Let them listen to their internal cues and stop when they have had enough
  • Whether they eat. Remember when your parents’ asked you to eat up? I am sure it didn’t make you want to eat. There will be some days your child does not feel like eating. Respect this wish and your child will respond positively when they want to eat.

These roles apply to solid food as well as any milk feeds you give your child.

TOP TIP: You can make meals a positive experience if you provide balanced meals at the right time and place but respect your child’s right to choose how much they eat.

Should I be giving my baby vitamins?

Fruit Vitamin Pills

This is a common question I get from other mums. Vitamin D is particularly topical at the moment with rickets making a reappearance. Here is the latest guidance on vitamin supplementation.

Vitamin drops containing vitamins A and D should be given to;

  • Babies over 6 months drinking less than 500ml of formula
  • Children that are fussy eaters
  • Those of Asian, African or Middle-Eastern descent
  • Children in northern areas of the UK
  • Breastfed infants over 6 months of age
  • Breastfed infants over 1 month of age if their mother did not take vitamin D during pregnancy or has poor vitamin D status

Please speak to your GP, health visitor or pharmacist if you fall into any of these groups to ensure that you take the correct supplementation. You may be eligible for Healthy Start vitamins. Please don’t self prescribe as taking vitamins can be harmful if they are not necessary.

TOP TIP: A balanced diet should provide all the vitamins and minerals we need but in some cases supplementation may be required

Reference: Venter C (2011) First Tastes. Journal of Family Health Care 21 (5): 14-17

Variety is the spice of life

IMG_1654

There is some evidence to show that the more foods, textures and flavours you can introduce to your baby during weaning, the less fussy he/she will be later on in life. Don’t be scared to rattle through new foods but repetition of foods is also important. Tasting a food or drink more often increases the liking for it so don’t give up!

TOP TIP: Try to strike a good balance between introducing new flavours and repeating old ones.

Reference: Harris G (2008). Development of taste and food preferences in children. Curr Opin Clin Nutr Metab Care 11 (3): 315-319

 

 

When your child says no

Oscar sweet potato grimace

It’s official. Oscar does not enjoy broccoli. I found myself performing tricks like a circus monkey to sneak in an extra teaspoon. And then he just got more annoyed. Fair enough. I remember the same response to my mother’s cajoling when I was a child.

Try not to force your child, even if you have slaved over that meal. You wouldn’t want them to develop negative associations with solids, would you? Learning to like foods takes time.

Here are some signs that your little one has had enough;

  • Keeps his mouth shut
  • Turns head away
  • holds food in his mouth and refuses to swallow
  • Cries or screams
  • Gags or retches
  • Pushes away the spoon or food offered

TOP: No means no. Accept it and put the spoon down.

 

Types of drinks

Oscar Drinking

Water

  • This is the best drink alternative to milk. 
  • Before 6 months boil tap water (from the mains tap in the kitchen) and allow it to cool before serving. If you are abroad and unsure of the water quality, do boil the water before giving it to your little one.
  • Bottled water is not a better alternative to tap water as it is not usually sterile. It may also have high levels of minerals such as sodium. 

Milk

  • Cow’s Milk – Before 1 year, formula and breastmilk are the best drink options as cow’s milk does not have enough iron. You can use full fat cow’s milk in cooking. After 1 year, you can introduce whole cow’s milk as a main drink.
  • Follow-on milk – These milks are marketed at babies over 6 months as these have higher amounts of protein and some minerals. There is no need to change to follow on milk as your baby should be getting these additional nutrients from solid food.
  • Pasteurised sheep’s and goat’s milk are also not advised before 1 year
  • Rice milk should not be offered at all until 5 years old to reduce exposure to inorganic arsenic.

Juice

  • There is no need to offer fruit juice at all if your baby is eating fruit. The longer you can avoid offering sweetened drinks the better. 
  • If you do offer fruit juice, please ensure it is well diluted with water – 1 part juice to 10 parts water.

Other drinks

  • Squashes, flavoured milk, fizzy drinks and juice drinks should be avoided due to their sugar content. 
  • Drinks with sweeteners should also not be offered (check any labels that say ‘no added sugar’!). 
  • Tea and coffee are not suitable as they reduce iron absorption.

TOP TIP: Water or milk are the best drinks to offer at meal times

Beaker or Cup?

Freeflow cup

As you progress with solids, your baby will be thirsty at meals times. Offer your baby some sips of water during the meal.

Before 6 months

Exclusive breastfeeding or formula milk

6 Months

Help your baby learn to sip and not suck. Introduce a lidded free-flow beaker with two or three small holes. This is a new skill so you may want to hold the beaker and gently tip it so your baby gets small amounts at a time. Over time they will learn to hold it themselves. Non-spill (valved) beakers are not recommended as your baby does not learn how to sip.

9 Months

From 7 months you can start to decrease the amount of milk you give your baby as they start to eat more solid food. Outside of meals you can continue with breastfeeding/bottle feeds (approximately 600ml/day) until 1 year of age. During meals offer sips of water from an open cup. Some babies find the doidy cup as a good transition to the open cup. As your baby masters the beaker or cup you may want to offer milk feeds in this instead of a bottle. When out and about you can also start to offer water from a beaker.

12 Months

From 1 year, your little one no longer needs a bottle. Continued bottle use is associated with tooth decay and may delay speech development.

 

TOP TIP: Be prepared learning to drink can be very messy!

More learnings after Oscar’s operation

Oscar close up

Oscar’s recovery has been remarkable but he has struggled to drink from a bottle during this time. The specialist nurse had warned me that it might be two weeks for feeding to get back to normal but it has still made me feel stressed that he might not be getting enough hydration. Below are some ways I dealt with the situation

  • Add formula/breastmilk to meals wherever you can – I added it to everything I could
  • Thicken some breastmilk/formula and offer it on a spoon – I mixed in banana porridge and offered in addition to all meals
  • Offer yoghurts as desserts or as snacks to ensure your baby still has some dairy
  • Little and often – Offer yoghurts or thickened milk between meals
  • Watch out for wet nappies – these are a sign of hydration status. Your little one should have roughly 6 wet nappies a day
  • Contact your specialist nurse if you have any concerns – Even as a dietitian I wanted to check I was during the right thing. Don’t feel you cant’t call, that is what they are there for.
  • Keep trying with the bottle but don’t force it
Last night Oscar finally accepted his bottle. I felt quite tearful I was so relieved. And he even made some sucking noises (something he could never do before the operation)! It’s funny that accepting the bottle has been such a milestone for us but I guess it accompanies a sense of things returning to normal. We are so grateful to modern medicine and that we have been able to have this operation in the first place.

TOP TIP: Keep an eye on the number of wet nappies if you are worried about your little one’s milk intake

Feeding around a cleft palate operation

Oscar High chair

Oscar had his palate repair operation this Monday. It’s been an emotional and exhausting week but we are relieved to be the other side of the operation. We have been amazed by how quickly Oscar has bounced back. We had our first smile on day 2 and he has been smiling ever since. We are so proud of our little boy for getting through it all and a big thank you to all the doctors and nurses at Great Ormond Street Hospital. A truly amazing and humbling place.

Below are some of my learnings. I hope these can help you if you have a child with a cleft palate. Please feel free to share any thoughts you may have as every child is different and other parents can benefit from your experience.

Before the operation

Oscar’s operation was booked for when he was 7 months old. I was pleased with this as we had ample time to get him used to solids before the operation (we started weaning at 5 months) and would have plenty of time after the operation to progress weaning before he turned 1 year old (the key milestone for getting babies off the bottle and onto family meals).

  • Get to know your child’s eating habits and what they like eating. This will be important when encouraging them to eat after the operation e.g. enticing them with their favourite food.
  • Get your little one well established on solids as the liquids like milk may not be accepted soon afterwards.
  • Introduce the free flow cup. This may provide another option if your baby refuses his bottle
  • Prepare for the nil by mouth period. We knew Oscar would only be going into to surgery after 8.30 in the morning. A few mornings beforehand I started delaying his 7.00 milk feed so he would not be completely distressed on the morning of the operation. Distracting him with a few new toys also helped!

After the operation

It’s an emotional and tiring time but there are things you can do to help.

  • Try to get your baby eating asap after the operation (only if advised by your cleft team). The surgeon informed us that those babies that get eating soon after the operation bounce back quicker.
  • Solids were accepted before liquids. Oscar did not enjoy liquids at all. Apparently this is because liquids are harder to swallow with a sore mouth. Instead we made up some baby porridge with formula so it was runny but could be eaten off a spoon. We also managed to squeeze some puree into his mouth from the ready made baby food pouches.
  • Hydration is important. If they are not drinking, try to sneak liquids into them another way. Add formula or breast milk to purees or prepare baby rice/porridge/cereal with formula or breast milk. We also syringed small amounts of milk into his mouth every now and then.
  • Play with textures. I tried several textures with Oscar before he accepted one. Just keep some milk to hand and mix it in with the porridge until it is just right for your baby.
  • You know your child. Banana porridge was Oscar’s favourite and we had that for all meals for 3 days. He also loves his bouncing chair so we brought this with us to the hospital. He refused to eat anywhere else for the first week. It was a challenge for us as we had to hold it when I fed him so he did not bounce onto the spoon but he was happy so worth it!
  • Try to give milk off the spoon if they won’t accept a bottle.
  • Try feeding little and often. Oscar could not manage much at a time so we fed him whenever he was up for it.
  • Don’t push your baby. I was desperate to get food into Oscar but had to remind myself that he had just had a big operation. Its important for them to eat but you don’t want them to get more upset than necessary. Take a break and try another time

TOP TIP: Don’t worry about how much they are having or giving them balanced meals after the operations. Just feed them their favourite meals and go for the ‘little and often’ approach.

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.