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You're Feeding Your Baby WHAT??

May 24, 2015

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You're Feeding Your Baby WHAT??

May 24, 2015

 

Over the past couple of years, I have seen a good handful of infant clients. Generally, these babies mostly need help getting on an effective feeding schedule, increasing the volume of milk or formula per feeding, or structuring feedings to minimize reflux symptoms. In addition, some of these babies have been just at the cusp where some solids can be introduced. In these cases, I typically recommend some of the standard first purees. I help parents phase them in gradually to be mindful of allergens and potential tummy upset, and all is good. However, about a year ago, I started hearing about Baby Led Weaning (BLW). Honestly, it sounded a little bit unbelievable: A baby who has been consuming liquids exclusively is able to grab a strip of beef and just start going to town on it at the drop of a hat?? I’m up to date on my CPR training, but I’m not really in any big hurry to put my knowledge to the test!

 

 

In a nutshell, Baby Led Weaning eschews purees and spoon feeding in favor of table foods, which babies self-feed right out of the gate. The idea is that it makes more sense to feed babies what the rest of the family is eating, and if the baby is developmentally able to self-feed, why not let them do it? I found this to be a very interesting idea indeed. Plus, I figured that it is only a matter of time until one of my families asks my thoughts on BLW or asks me to help them implement it. So I decided I should probably develop some thoughts on it! Naturally, I used my own sweet little guinea pig (ahem--baby), Remy.

 

 

Remy was about 6 months old at the time that I introduced BLW. I had already attempted some basic purees around 4 ½ months, because that’s when Big Sis started eating solids successfully. However, Remy did not appear ready (accepted a couple of bites, tongue thrust reflex still significantly present, immediate loss of interest followed by clenching of her lips). I shelved the idea of solids until 6 months, when she began showing some visible interest in what the rest of us were eating. The first couple of attempts at BLW were pretty successful, all things considered: She successfully brought the strip of cooked zucchini to her mouth and gummed it a bit, repeated a few times, and was able to manage the bits that broke off without coughing or gagging. When she dropped a strip on the ground, she would instantly start whining, so I made sure to have backups ready at future meals! With a roasted strip of mushroom, she sucked the juice out and very persistently gummed it until it was too small for me to feel comfortable with, so I replaced it with a new, larger piece.

 

 

However, after the first few days of BLW (I was not super dedicated, so I gave her some strips every couple of days or so...basically whenever I had something appropriate on hand), I noticed that Remy would start whining and appeared to be what I can only describe as frustrated. She would start gumming the food, but after a couple of “biting” attempts, she would throw the food down and start crying. Based on what I was seeing, it appeared that she really wanted to eat the food, but the delay in gumming the food until a piece broke off was more effort than she was willing to put forth. And I kind of couldn’t blame her! For a baby, just picking the darned piece of food up off of the tray and keeping ahold of it, bringing the food up toward the mouth and actually successfully getting it into the mouth is a lot of hard work! Then, to have to work on breaking down the food until a piece breaks off...well, Remy quickly went from hungry baby to HANGRY baby! This would not do.

 

 

My next step was to focus primarily on tiny bits of soft food and just reserve the large strips of food for “practice,” at times when she wasn’t actually so hungry. Remy took to the bits of food surprisingly well! With very minimal practice, I could observe her pushing the bits of food onto her gums (where her molars will someday be) and engaging in an actual chewing motion. She was super excited about the foods...and the praise I was showering her with too! The only problem was that, although she was able to pick up the tiny pieces pretty consistently, they were not making it into her mouth very often. (Cue hangry baby sequence). Even though I know that one of the main points of BLW is the self-feeding component, I decided that I would help fill in the delays while she worked on getting the food into her mouth by actually putting a bite into her mouth. I placed the tiny piece right into the front of her mouth so that she could control the placement. Sometimes the food was so close to falling out of her mouth that she had to use her little fist to push it back in...so cute! This appeared to work perfectly for Remy, but I will note that the BLW website does not recommend the parent to give the bites. She still got plenty of practice with her fine motor skills, and the feeding didn’t end with a bunch of tears.

 

 

Even after seeing this progress with the tiny pieces, it still seemed like Remy wasn’t eating enough solids to be satisfied at any given feeding session. She was getting a lot of volume from her bottles, so I wasn’t concerned that her needs weren’t getting met. But to me, it appeared that she would have been interested in eating more solid volume than the 10 or so pieces of food that she would finish before she started to lose steam on the self-feeding and chewing process. I decided to supplement with some low texture food (Gasp! I mean puree!) As expected, she did great with those foods too. What can I say, the girl loves to eat!

 

 

Of the solid volume that Remy currently eats, I would say it’s about 50/50 table food to puree. It’s working great for her, and I am also able to fork mash a variety of foods on the fly as needed (like soft fruits, pasta with sauce, cooked veggies, etc.), and she can eat that very successfully as well. Plus, having purees available has been helpful when she is at Grammie’s house for the day. Grammie just doesn’t feel comfortable giving her table foods yet, and that is ok by me. Gagging happens very rarely, and in those situations she does not seem to get scared or upset; she kind of just works it out and moves on. I have never experienced a choking episode, but that doesn’t mean that I didn’t have some scares!

 

 

On that topic, I do have a couple of things to say. In addition to Remy’s frustration with the (lack of) food volume, my concerns for safety also contributed to using lower texture food to supplement. When I initially introduced the table texture solids, I would observe her suck very hard on the food strips, to the point where it looked as though if she had let go of the strip, she would have sucked it down and choked on it. Granted, that may have been paranoia on my part, but it made me nervous. I watched her like a hawk, my hand hovering by her face, ready to snatch the food out of her mouth. There was one incident where I had given her a wedge of watermelon, minus the rind. She was happily gumming away and appeared to be biting off only small pieces of the melon and sucking the juice. She gagged a couple of times, but worked through it. However, at one point she stopped, and I could see that something didn’t look quite right about her facial expression. She spit out one...two...three...four! nickel sized pieces of watermelon onto the floor. She wasn’t upset, she didn’t choke, but wow, did I take that watermelon away as fast as I could! I guess maybe that incident was evidence that she was learning what she could handle and what was too big...but again, I’m not all that excited to try my hand at resolving an airway obstruction!    

 

 

Through my continued observation of Remy’s feedings, her exposure to a wide variety of textures, and the natural progression of her feeding skills over the last three months, I have become confident in knowing which foods Remy can handle, and which items might be overly ambitious. She is self-feeding much more consistently now, and I am relaxed during meals. I had an exciting moment yesterday when I sat down for lunch with both of my girls: We all ate ravioli, meatballs, and peas. The bites on our respective plates may have been cut into different sizes, and a little bit of Remy’s portion might have ended up on the ground, but wow! They now can both eat what I’m eating! As a mom and feeding therapist, it was a great feeling.

 

 

It’s hard to say if the relative ease in which Remy took to table texture foods (compared to my older daughter, who was started on purees exclusively) was due to the exposure from BLW, or from other individual differences. Ultimately, it doesn’t really matter to me. By taking from the BLW philosophy the points that I was comfortable with, adding in some procedures tailored specifically to what I observed with Remy, and using low texture foods as needed, I truly feel that I couldn’t have gone about introducing solids in a better way. I would definitely recommend looking into the BLW approach if you have a baby around 6 months (and if the pediatrician has given the go-ahead for solids), but do make sure that your baby is giving you signs that he or she is ready, and only follow it to the point that you feel comfortable. This is my experience; I would love to hear yours!

 

 

Until next time,



Michelle

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