Kamis, 03 Mei 2012

How to wean your baby onto solid food

Wow.  I've set myself a challenge here!  Just to clarify up front, I'm not a health professional and so all of this is what I've learned and from personal experience of 1 child and talking to friends.

There are a lot of 'rules' when it comes to weaning.  I will tell you what people say and why and then like any other information source it's up to you to investigate, digest and make your own choices with the support of your local health visitor or doctor.





Why do people start on solids?

Well I've been there.  It's common for a child to have a growth spurt at around 4 months.  For some kids this passes, for others it doesn't.  Unfortunately mine was the latter.  So people start giving solids thinking that it will help their babies sleep.  Generally it doesn't in the experience of my friends and my child.  It was only when my son started to eat a lot more that it helped.

Some people start because of peer pressure or excitement.  I once overheard someone with a 12 week old waiting to see the health visitor telling her friend "I'm going to start him on solids this week I think".  Fortunately her friend urged her to talk to the health visitor about it.  If you are in the situation of having a 3-4 month old, I'm certain at least one member of your family, perhaps your mum has suggested weaning him / her soon.

When should I start?

The UK health service recommends waiting until 6 months (advice changed in 2003) but generally are reluctantly ok with it after 17 weeks.  Before 17 weeks is definitely a no-no as far as they are concerned and I certainly agree with that.  As for whether you wait till 6 months?  I have to be honest and say I didn't.  I started (very slowly) at 19 weeks but as I've indicated above it didn't make a jot of difference to sleep until he was about 24 weeks anyway so I would probably have been better waiting.  The early foods you can feed your child are also dull so if you're thinking of introducing foods because you're excited by the process; wait!

What about allergies?

With all of this, you're best talking to your health visitor or health professional before introducing these foods if you're concerned or have a history of food allergy or if your child has asthma or eczema.

Generally common allergenic foods, particularly nuts and peanuts were recommended to be delayed until 3 years old.  Now, however, there is a belief that avoiding nuts doesn't prevent nut allergy and may, in fact make things worse.  One thing you shouldn't do though is introduce nuts before 6 months and no whole nuts as they're a choking hazard.  Read down to the foods to avoid section for more info.

What are the signs of an allergic reaction?

If your child does react to a food you might see the following: hives, swelling, itchiness and breathing difficulties.  Also be aware of other types of intolerances which could cause gastrointestinal symptoms (which may take a bit longer to show).

What is traditional weaning?

Until baby led weaning came along, this was just called "weaning" because it was what everyone did.  The idea was to start with thin purees and increase the amount of texture as you go introducing finger foods alongside at around 6/7 months.

What is baby led weaning (BLW)?

With the advice from the world health organisation to delay weaning to after 6 months, some children refused to be spoon fed and some parents realised sensibly that as their babies weren't 4 months old, there was no need to feed them thin purees and so their kids could start self feeding with finger foods and eating the same foods as the family (as the foods were no longer as restricted from 6 months either.) There is an insistence on self feeding with this method so the parent could load spoons and hand them to their child but not put them in their mouth.

Can you combine baby led weaning and traditional weaning?

People often ask this question but I think they're getting confused when they ask it.  Baby led weaning isn't just finger foods (or it doesn't have to be) and traditional weaning isn't just purees.

If you mean by asking it; "can I feed finger foods to my baby who is traditionally weaned" then the answer is "yes, of course you can after 6 months".

If the question is "can I give a meal to my baby which is completely finger foods" then the answer is "yes, of course you can give a completely self fed meal to a traditionally weaned baby after 6 months if they have good enough co-ordination to self feed".  

So although you can't really combine methods as baby led weaning is about never feeding your child, you can introduce some foods or meals which would normally be considered as baby led weaning style foods to traditionally weaned children.

What are the downsides?

Every method has it's downsides.  This is normally to do with how the parent approaches it.

I traditionally weaned but included finger foods and self feeding from an early age.  I found no downsides with this as he was able to self feed in restaurants if we were out to lunch and was exposed to a wide range of flavours early on from my home made cooking.

People do get into traps with traditional weaning though.  Some kids are weaned at 6 months onto smooth purees.  This is unnecessary as they can start to cope with coarser food at this age.  Some babies don't have finger foods.  This can make them fussy and reluctant to accept anything but purees.  Finger foods and coarser mashed foods are great for encouraging speech development.

Some kids get used to the flavours of commercial baby foods and then reject anything else.  There's nothing wrong with baby foods, however, if you feed a jar to your baby for every meal then it's like eating tinned food all the time (as it's heat treated in a similar way).  It's adequate but the flavours are quite same-y, often pretty sweet and I'm always shocked at how smooth the texture is even for toddlers.

I've seen forum arguments rage about traditional vs. baby led weaning.  Some say the latter makes their kids less fussy, some argue the opposite.  Certainly I've had contact with people who have fussy children weaned on both methods so I'm unconvinced, but a recent piece of research claimed BLW caused children to have greater preference for carbohydrates and spoon fed kids preferred sweeter foods.

Babies also develop at different rates and have different personalities from day 1.  My son is very clever, speaks fantastically now at nearly 2 years old but has always been slower physically and gets very frustrated with himself.  He has a very large appetite as well.  If he wasn't in the mood for a self fed meal and I tried to get him to eat it, he would get too frustrated and it wouldn't work.  I think you have to be in tune with your child's needs and adapt to them. This is why some researchers have recommended finger foods alongside spoon feeding.

I worry too about how it would be possible to include enough iron in a BLW diet, especially as I often hear a mantra of "food is for fun until they're 1".  For all the good bits of BLW, my opinion is food is more than just fun.  I like the sentiment of the statement because it takes pressure off the parents but it also neglects the nutritional needs of a baby.  If you are concerned, it might be a good idea to supplement your child's diet with a vitamin supplement for babies (it's a good idea to supplement with vitamin D anyway.)

A word of warning; all weaning is messy but BLW can be very messy.

What equipment do I need?

You can survive with nothing.  After all, your baby can sit on your lap and eat.  In fact, lots of BLWers do this early on.  That said, it is useful to have a high chair.  I recommend the Ikea Antilop high chair.  It's cheap, has no nasty bits on it where food gets caught (and even if it did, you can dismantle it).  It's easy to take the legs off and put in your boot to take to the in laws (although at that price we just bought a spare for them!)

You don't need some kind of special pureeing machine especially for babies.  If you start at 6 months, you might not need to puree at all or you might just mash foods in which case a fork or potato ricer might be useful (but you'll probably have those in the house).  I inherited a baby food processor from my eldest sister which was worse than useless.  A normal blender does the job fine.

If you are traditionally weaning you will need some plastic spoons which are not too hard and have long handles.  You will also need some plastic bowls (they will get knocked out of your hands eventually) and for both BLW and traditional weaning a bowl which sticks to the high chair tray is a good thing for when they're self feeding.

You will also need bibs.  I found to start with fabric bibs worked best but then moved to pelican bibs as he got older.

What are the best first foods for traditional weaning?

Basic fruit, vegetable purees and baby rice.  Yawn.  Yes I know.  This is another good reason to wait.  After all, the first foods you can give are fairly low in calories too.

What I used to do is boil the vegetables in water or simmer the fruit in a little water and then puree in a traditional blender.  You do not need some special baby pureeing kit!  A traditional blender gives the smoothest puree but a hand blender is fine.

Puree it with the smallest amount of water possible to get it to blend.  You can thicken it with baby rice if needed or thin it down with breast milk, formula or water if wanted.

I normally made purees in batches and froze them in silicone ice cube trays (which are BPA free) transferring to bags once the cubes were frozen.  I then reheated in a microwave until boiling throughout and allowed to cool or cooled down with a little breastmilk.

Great first vegetables include parsnip, carrot, sweet potato, swede, potato, mashed raw avocado; be careful not to include too many orange ones though because their little noses do go orange!  You can then move onto peas, broccoli etc.

Great first fruits include, apple, pear, plum (mixed with apple) or mashed raw banana.

What are the best first foods for baby led weaning?

This is an area outside of my experience but from talking to friends, the key things are making foods for all of you and serving foods initially which your baby can hold and nibble on, e.g. broccoli is good because it has a natural 'handle', banana can be in big enough pieces to hold one end and chew the other.

How to start with weaning?

Babies don't know that adults eat three meals a day.  They certainly don't need three meals themselves.  You can start slowly with one meal, my health visitor recommended late morning for us which fitted in nicely with breastfeeding times and naps.  I fed him about 90 minutes after a breastfeed so he wasn't starving and wasn't full.  By feeding him in the morning it also gave me the opportunity to check if he had any adverse gastrointestinal reactions to the food rather than being kept up all night.

Chose a time you're both calm, happy and not too tired.  Make up the food, bring to the boil if serving warm and allow too cool so it's only just warm (test it on your lip).

Put your child in the high chair (or sit them on your lap) and either let them feed themselves or spoon feed if you're following a traditional weaning method.  Never force feed.  If they're not interested, e.g. turning away, not opening their mouth then stop.  Also even with traditional weaning give them some to play with and touch.

What about drinks?

Well I'm shooting myself in the foot if I ever want a sponsored post! There is no point in "baby juices". There.  I've said it.  Just give your child water in a free flowing sippy cup.  Some health visitors and websites will recommend giving diluted juice but really there's no point.  I will happily include juice within cooking as a way of sweetening foods but on its own (even diluted), it's not nutritionally great.  Much better if your kids get used to eating fruit and drinking water.

Certainly never put juice of any kind into a bottle!

What should I avoid? 

Before 6 months avoid:

All of the below items as well as dairy, eggs, nuts, wheat (and gluten), sesame, fish, meat, chicken, shellfish, liver, soya,

6 months - 1 year avoid:

Honey, added salt (no more than 1g per day contained in foods), added sugar / sugary foods, swordfish, marlin, shark, mould ripened cheeses / mouldy cheese (e.g. brie or stilton), undercooked shellfish, low fat dairy (they need the fat!)

Note that it's not even safe to feed honey even if it's been cooked because honey can contain clostridium botulinum spores which can germinate in babies guts (but not older children or adults) and cause botulism.  These spores are very heat stable so you won't get rid of them.

What foods should I include?

As I said earlier, iron is really important to introduce after 6 months.  The most bioavailable sources of iron are from meat but you can also include pulses and some dried fruits.  As soon as your child is used to the other tastes I'd start to introduce some meats and fish gradually (so you can check for reactions.)  Just keep in mind how important it is to have balance.  Some carbs, some meat, plenty of vegetables.  Also kids need a lot of dairy before the age of 1, especially if they start to reduce the quantity of breastmilk or formula.  Rather than buying commercial fromage frais with added sugar, I used to make my own fruit purees to mix with yogurt.

Beef stew made with lots of vegetables is a great idea for including some iron as is fish pie to get some dairy and omega 3 into their diet.

When do I introduce more texture?



If you're traditionally weaning, I'd move from smooth purees (or start) at around 6 months on more textured foods.  I don't mean huge lumps but certainly not completely smooth.  Around 8-9 months I'd be introducing soft lumps, e.g. chopping rather than blending; introduce small pasta.

I'm scared about choking.

So was I.  The fact is babies who are weaned on purees and never have finger foods can choke.  (Kids will find bits and bobs on the floor to pick up and choke on as easily as food anyway!)  There are a few common foods which kids have been known to choke on; grapes, cherry tomatoes and sausages.  Even if baby led weaning, I would always cut these lengthways so they don't have that perfect circular shape.

I also learned some paediatric first aid from my local NCT group.  It was an inexpensive course for a few hours which taught us vital skills.  I was unlucky enough that my son did choke one time.  We were away from home a foot of snow was on the ground outside and my husband panicked.  I remembered what to do and it probably saved my son's life.  I definitely recommend people do a course.  In the meantime, here is some advice on what to do if the worst does happen.  Don't be terrified by the prospect, my son managed to bring it up immediately once I turned him onto my lap, I didn't even need to do the back slaps.

Will weaning advice change?

Almost certainly.  In the past it was common to start weaning between 8 and 12 weeks and whenever a weaning debate surfaces on a forum, someone will have been advised by their mothers to "give a bit of baby rice" at some seemingly really inappropriate age.  In fact, a colleague of mine once boasted his son was given baby rice when he was 2 days old and "it didn't hurt him".  This is like saying "my Grandad smoked a pipe, drank 5-6 pints a day and ate a fry up every day of his life and lived to the age of 84" which is all true but without some of that he might have had a healthier life for some of that time or even lived longer.  You just can't tell.  All of the research on weaning and any other lifestyle issue just tells you "this is what will happen on average" not "this is definitely what will happen to your child" so it is meaningless to quote one person who was fine being weaned early.

But this is just an example of how advice changes and it is likely to change again.  There are some research projects ongoing to investigate whether it would be a good idea to introduce allergenic foods earlier into kids diets to help prevent allergies and a recent paper questioned the WHO advice to exclusively breastfeed (no formula, no solids) until 6 months.

All we can do though is go with the best advice we have now.

A last word...

Don't get stressed.  My son is now nearly 2 and I can say with certainty it makes not a jot of difference to him whether he eats a load of food or has an off day (and he does have those).  So relax, remember that food is an enjoyable thing not a battle ground!

I hope that was informative and helpful.  If you want more information on baby led weaning particularly, this website is pretty good.  Also check out the "great finger foods" section of my blog as there are some great ideas in there for all kids.

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