A misnomer… starting solids

“Starting solids” is a ridiculous expression for teaching a baby to transition from breast milk/formula to table foods. The whole concept is misleading.  It makes you think of sitting a baby in a highchair and putting a spoon in his mouth.  In reality, babies can and should have many opportunities to learn about the whole process of eating long before their butts hit the highchair.  Please don’t misinterpret this to mean you should be spoon feeding your baby before they are safe to do so.

The term “starting solids”  makes parents think that they have to wait until 6 months of age to venture into the process of eating.… NOT TRUE.  Let’s redefine starting solids.   I haven’t yet developed a more accurate and concise expression.  I have been toying with: transition to everyday foods, breast to table…. however, none of them are ideal.  I’ll keep working on it.  DSC01116

This transition is significant. Most healthy babies obtain approximately half of their energy needs from table foods by the end of their first year.  Breast milk or formula, initially the exclusive sources of a baby’s energy, gets downsized to 50% [1].  This change really occurs over the short course of  6 months.  In addition to the dramatic change in energy source, the table food transition also imposes abarrage of new textures: runny liquid, dissolvable food, lumpy puree, and soft food!  So many new sensory challenges…..talk about a lot of work!

Okay, so:  readiness signs.

Baby should have:

  • Interest!  (looking at you when you are eating and drinking, reaching for your food)
  • Trunk control (able to push up on arms when on their tummy, sitting with support, able to lean forward and open his mouth to indicate desire)
  • Head control (able to hold up his head in supported sitting, able to turn his head away to tell you he doesn’t want any more)
  • Decreased tongue thrust (pushing tongue straight out of their mouth when something is placed there) [2,3,4 ]

Previous recommendations have suggested that solids be introduced  between 4 and  6 months of age.  Newer recommendations suggest introducing solids at 6 months of age [5].  World Health Organization (WHO) and Canadian Pediatric Society recommend exclusive breastfeeding for the first 6 months of life.  Most babies are developmentally ready for solids around 6 months of age.  In addition,the 6 month mark is  the point at which a breast-milk exclusive diet is inadequate to support a baby’s nutritional demands; the volume of breast-milk required to meet his needs for energy, protein, iron, zinc and other vitamins is untenable [6].

Also, later solid introduction (i.e. much later than 6 months)  may put babe at risk for developing oral aversion (not wanting anything in the mouth).

So how we do set the stage for success?  We all dislike abrupt change.  Opportunities to learn about different shapes, textures, and temperatures will help your baby feel more comfortable with something other than breast-milk or formula in her mouth. This needs to happen before she is put into a high chair!

What if the interest is there but you are not sure if motor skills are?

What if the motor skills are there but the interest isn’t?

There is no reason you can’t teach your baby about the eating process before all of the readiness indicators are present.  If she is awake and you like babywearing, put her in a carrier as you prepare dinner so she can be exposed to the smells.  This might be a necessity anyways for those cranky babies during “witching hour”.  Someone is always needy when it’s time to make dinner at my house.  Always.  Since my kids were tiny, dinner hour has  been witching hour.   If it’s not the cranky one holding her little arms up, the older one is demanding to sit on the counter and help!DSC01236

Unless you just plain need a break from baby or you have your hands full with older kids,  hold baby in your lap as you eat dinner.  Give her intermittent kisses as you eat.  She will smell the food on your breath and maybe even get a taste if you give her a smacker00 right on the lips.  I recently attended a feeding conference and the presenter suggested the idea of “kiss therapy” for  kids who are ultra-sensitive.  I like the idea for all kids before they end up in a high chair for meals.

Once she has the ability to grasp an object and bring it to her mouth, be creative with the object you offer her to play with and mouth.  angelcare_toothbrush_blue Obviously make sure they are safe, but you don’t need to stick with baby toys.   Her hands and toes are wonderful things to shove in her cheek, lick and drool all over.  It teaches her about her tongue, jaw, lips and cheeks.  Your fingers are great too!  Think beyond hard plastic toys… she can hold one of your raw carrot sticks as she sits on your lap during dinner.  It’s safe if is is thick enough that she cannot bite through it.  Or a piece of beef jerky.  A lick of your apple as you eat it (you would control handling the actual apple).  Baby toothbrushes are usually textured and some even come with a guard that prevents baby from gagging herself over and over.  Try freezing teethers or links.  zoli-gummy

These ideas are not meant to replace therapy recommendations for babies who are identified as at-risk feeders.  Default to your physician or therapist if your baby has medical differences and has been deemed to be an unsafe swallower. 

References:

1. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. AUAgostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, Michaelsen KF, Moreno L, Puntis J, Rigo J, Shamir R, Szajewska H, Turck D, van Goudoever J, ESPGHAN Committee on Nutrition: J Pediatr Gastroenterol Nutr. 2008;46(1):99.

2. Food and Agriculture Organization of the United Nations (FAO), World Health Organization (WHO) and United Nations University (UNU): Human Energy Requirements. Chapter 2: Energy requirements of infants from birth to 12 months. Available at: http://www.fao.org/docrep/007/y5686e/y5686e05.htm (Accessed on January 21, 2013).

3. Committee on Nutrition American Academy of Pediatrics. Complementary feeding. In: Pediatric Nutrition Handbook, 6th ed, Kleinman RE (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2009. p.113.

4. Eiger MS. Feeding of infants and children. In: Primary Pediatric Care, 4th ed, Mosby, St. Louis 2001. p.184.

5. Canadian Paediatric Society, Community Paediatrics Committee. Weaning from the breast. Paediatr Child Health 2004;9(4):249-53

6.Agostoni C, Decsi T, Fewtrell M, et al. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2008; 46:99.

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3 thoughts on “A misnomer… starting solids

  1. […] already established that long before getting to the high chair, babies benefit from experience […]

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