Saturday, September 12, 2015

Starting Solid Foods: What to Eat and When

Every couple of months, a good friend will call or e-mail me to ask my opinion on when they should start feeding their baby solid foods and what they should offer.  Because this is a topic I care about, I usually end up writing a very lengthy e-mail response.  I am by no means an expert on this subject and did not major or master in dietetics or   nutrition—so please consult with your pediatrician before accepting my advice.

Before my daughter was born, I read a lot of parenting books and knew the basic 5S’s. I knew that the first few months were going to be challenging, but I really did not know what to expect post-swaddle. I assumed that my child was going to be a Gerber-baby—because I was one—and because I did not know that there was an alternative.

At playdates I started hearing moms talk about a feeding philosophy called “Baby-led weaning” (BLW). The name confused me at first because I associated the buzzword with breastfeeding—but it really references a term popularized by Gill Rapley, a British public-health nurse and mother of three — babies skip spoon-feeding altogether and parents let baby self-feed at 6 months using finger foods like softly cooked vegetables, soft fruits, avocado slices, strips of meat/cheese, or toast strips. Basically, baby eats what the family eats, with the exception of honey and fluid cow's milk (but other dairy like yogurt and cheese is OK as long as it’s tolerated by baby). Allergenic foods are introduced around 6 months as well, as the American Academy of Pediatrics now states that introduction of allergens around the 6 month mark actually decreases allergy risk. Introduce allergenic foods one at a time to watch for reactions. Allergenic foods include wheat/gluten, nuts, dairy, shellfish, non-shell fish, soy, eggs, and peanuts. (Source: http://aapnewsde.aap.org/aapnews-open/201302_o?pg=13#pg13)
My toddler with veggie sushi (no raw seafood included)


I read a lot about BLW and decided it was great for my family because:

1.      I am lazy.  I don’t want to be a short order cook and make one meal for my kids and one for my husband and myself.
2.      I am cheap/poor.  Baby food in pouches and jars is really expensive. (supportive article here)
3.      I think parents have an important role in helping their children create a healthy relationship with food. (One of the many supportive articles here)
4.      One of my parenting goals is to inspire my children to be curious about the world and to become globally aware. Eating foods from other cultures and discussing the country’s customs and beliefs at the dinner table is—according to literature-- the #1 way to raise globally aware kids. (More on this below)

Baby Led Weaning is NOT for everyone. It’s easy for me to share the benefits of BLW, but I would be remiss if I didn’t share that it is a controversial feeding philosophy. I have many dear friends who have also followed this method with great success. However, one friend—a pediatrician—had a terrifying encounter when she had to administer the Heimlich maneuver on her child. There is a lot you can read on the risks (or not) of choking and BLW (Great article here).  We fortunately never had any choking scares—but I also would only allow my baby to eat pureed foods when being supervised by anyone other than my husband or myself (i.e. the babysitter). 

I carefully followed my pediatrician’s instructions when introducing solids and only introduced one new food every three days so that I could carefully watch for an allergic reaction in the form of diarrhea, rash or vomiting. I modified the BLW principals and started with purees for the first two months and then moved to soft solids.

My husband and I decided early on that we were not going to “assume” that our daughter would prefer “kid-friendly” foods like hot dogs over more nutritious and flavorful meals like stir-fry or curry dishes.  Many toddlers start rejecting new foods at around 18-24 months so parents really only have a 1-year window to challenge or push the child’s pallet.

I am a big fan of introducing textures early on. I put Quaker rolled oats oatmeal in the food processor and used it as our very first food (cheaper and less processed than baby cereal). The second food I introduced was quinoa cooked in the microwave at 75% for 30 seconds with breast milk.
Then I introduced one new purée every three days. For example: sweet potatoes + quinoa + BM. After I determined my child was not allergic, I introduced another food ( avocado and carrots were early favorites). Once I went through all of the traditional firsts, then I started making combinations of foods. For example: broccoli+ lemon juice + quinoa + carrot was a favorite. Around 8 months, we started eliminating purées and gave her small, soft bite sized bites of foods (like broccoli). Around 9 months I started giving her modifications of our dinner.

Other fun simple puree recipes:
Sweet potato and cinnamon – Roast whole sweet potatoes until tender, remove skin, and puree with 1 pinch of cinnamon per sweet potato, working up to ¼ tsp. Thin with water or plain yogurt. Other add-ins: ground ginger, nut butters.

Avocado and cumin – Mash 1 avocado with 2 pinches of ground cumin. Thin with water or olive oil. Other add-ins: squeeze of lime, cilantro (baby guacamole!).

Butternut squash and sage – Halve a butternut squash, scoop out seeds, rub with olive oil, and roast skin side up until tender. Puree squash flesh with ½ tsp finely chopped fresh sage. Thin with water or olive oil. Other add-ins: parmesan cheese.

Quick advice:  One time I thought I was being “ambitious” and made a stock pile of freezer pureed baby food.  I made way too much and most of it didn’t get eaten because my daughter wasn't as interested in being fed as she was feeding herself.

Sample “Daily Meal” Plans:
10-12 months
 6:30 a.m. breastmilk (on tap)
8:30 a.m. toast and fruit with breastmilk in sippy cup.
11:00 a.m. chicken pot pie with veggies and fruit with a sippy cup of breastmilk
2:30 p.m. goldfish crackers and sippy of breastmilk
5 p.m. Breastfeed
6:00 spaghetti with meatballs and peas
7 p.m. breastfeed before bed.

Global Babies:
In many countries, babies are not fed bland rice cereals as their first foods rather, they introduced to spices from the start. In India for example, they think nothing of adding a bit of curry spices to baby's foods at a very early age. Thai families often incorporate coconut milk, lemongrass, tamarind and even chili when feeding their babies solid foods. Latino babies are exposed to taste of wonderful herbs and spices such as cumin, cilantro and even chili peppers!

I have a heart for internationals who transplant in the US.    My daughter has been such a fun “American Ambassador” by genuinely loving food from other cultures.  When she was around 11 months old, she impressed my friend Manal from Saudi Arabia with her love for dates and hummus.  When my dear friend Nihal from Turkey’s mother came to the US and made us a special traditional Turkish breakfast, Elizabeth ate two very generous helpings. She’s tried and loved Ethiopian, Chinese, Japanese, Korean, Turkish, Italian, German and Indian foods (probably others!).
My toddler eating Korean dish with chopsticks


My daughter at 16 months eating traditional Ethiopian food

On Marketing to your Children:
Companies like Kellogg’s and Kraft spend millions of dollars (maybe even billions) annually marketing food to kids.  If it’s OK for them to do it—why can’t parents do a little branding of their own?  Even though my daughter is a very good eater, she has picky moments.  It’s during these difficult times that I get creative.  Here are a few examples:

  •           I made something for dinner and my daughter decides she doesn’t like it (even though she liked it the last two times I made it).  I then ask if she would like for me to add “magic sprinkles” to the meal (also known as chia seeds) and instantly the meal is transformed into something desirable and edible.
  •           The oatmeal I made for breakfast doesn’t taste good (even though it’s the same recipe I often use and she loves). Instead of forcing her to eat it, I double the recipe, add an egg white, put it in pink polka dot muffin tins and bake at 350 for 10 minutes.  If I offer her the “cupcakes” thirty minutes later she is asking for “more, more”.
  •          I re-brand food items with more fun names.  For example: homemade granola bars=cookies
  •         I bought a spiralizer recently and made homemade macaroni and cheese using zucchini instead of noodles
  •          “Dessert” at our house is often berries
  •           To encourage more milk drinking, my husband makes my daughter “lattes” or lightly warmed milk that he steams.  She feels like such a big girl!
  •          We occasionally invite “Minnie Mouse” (stuffed animal) to eat with us.  Minnie LOVES (insert food toddler wont touch) making it more appealing.
  •           I always serve my toddler food on my real (everyday) china. I treat her like a “big girl” at the table and expect her to have big girl manners.  By treating her like a big girl, there is a sense of pride and privilege. Presentation matters to her—if I just put food on her high chair tray, she would feel like a baby.
  •           I always serve food in courses starting with the vegetable item when she is most hungry.

Books or resources I recommend:

https://www.facebook.com/groups/littlefoodiesofstl/ The best BLW Facebook group moderated by a friend of mine who happens to be a dietician and mother.

http://pediatrics.aappublications.org/content/129/3/e827.full.html Great resource by the American Academy of Pediatrics for breastfeeding mothers on infant nutrition


http://www.babyledweaning.com/some-tips-to-get-you-started/

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