Infant Feeding

Our first 2 weeks with solids

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My second daughter, baby Alex, turned 6 months a few weeks ago.  I help many families on their journey to starting solids and I wanted to chronicle how it is going in our house.  I hope you find this post helpful.  All babies are different, and this journey will look different for everyone.   

We decided to mainly use a baby led weaning approach when starting solids, as well as some purees.  I am going with the flow and not labeling anything we do.  We call it baby led feeding: Baby Alex leads the way!

My goal is to help Alex learn to eat, explore and have fun with food- and also make it work for our family!

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Day 1: Sweet potato!  I wanted to involve my older daughter as much as possible in the feeding journey with Alex.  I let her choose Alex's first food (choices were either sweet potato or avocado).  And good thing she choose sweet potato because we did not have any ripe avocados when it came time to feed Alex!  I baked a sweet potato in the oven, then removed the skin and cut into stick pieces.  I gave this to Alex around our usual dinner time, 5:00pm.  The rest of the family had THIS sweet potato and black bean chili.

 

Day 2: Banana.  We actually skipped a day in between (because, life happens).  So our second feeding day I gave Alex banana during breakfast time.  Sydney was having banana with french toast, so I decided, why not?  Alex had fun with this one.  I tried a few different ways.  I gave her some match stick slices and also a whole banana with part of the skin on (to make it easier to hold).  She loved both ways.

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Day 3: Steak.  Iron is one of the most important nutrients a baby needs starting around 6 months.  I have seen many BLW fans provide children with a chunk of steak (mainly to suck).  Alex loved this one.  The rest of the family had steak, broccoli and quinoa.  

 

Day 4: Amaranth porridge.  Have you had amaranth?  Check out this post dedicated to this wonderful grain.  I made a porridge in my Instant Pot with amaranth, apple sauce and cinnamon.  This was a hit for both girls.  For Alex, I provided her with a loaded spoon (and then gave her the bowl, which she proceeded to eat!).  This one was messy but a great nutritional breakfast!

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Day 5: Avocado.  We had a Hanukkah celebration with some of my family and avocado was on the menu, so this was what Alex had too.  The rest of the family had white chicken chili topped with avocado, cheese and sour cream.  It was a bit difficult for Alex to pick up, so next time I might roll the avocado in breadcrumbs or almond meal.

Day 6: No food.  Opps!  We were traveling to visit my inlaws and because of naps, travel, etc, we didn't feed Alex any solids.  And you know what?  We all survived.

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Day 7: Eggs!  This was the first higher allergen risk food I provided to Alex.  I mashed some cooked egg with yogurt.  An instant hit.  Check out my post about introducing the top 8 food allergens to infants.

 

Day 8: More avocado.  Staying at my in-laws, choices were limited, but ripe avocado for the win!  Alex is great at smashing this.  It looked like she was eating a lot but when I took her out of her highchair she was covered in avocado.

Day 9: Carrots!  We made a carrot cake for dessert and had some leftover shredded carrots.  I steamed these in the microwave for a dinner treat.

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Day 10: Amaranth oat balls and carrot soup.  We were back at home and I had frozen some cooked amaranth before we left for our trip.  I thawed this, made some quick cook oats and added a bit of peanut butter.  These were a great BLW food (easy to pick up) and super soft. 

I also made a curry carrot instant pot soup and gave this to Alex on a loaded spoon.  The soup contained carrot, cumin, curry powder (salt free), full fat coconut milk and vegetable broth.  Lots of new flavors here!

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Day 11: Scrambled eggs with salmon for breakfast and roasted cauliflower for dinner.  The roasted cauliflower was the first food Alex gagged on and although I KNEW she was gagging (not choking), it was still nerve racking.  The roasted cauliflower was soft but a new texture.  In all of my Introduction to Solids classes, I recommend parents and caregivers complete a CPR class - just so you know what to do in case of a choking incident.

Day 12: Scrambled eggs again (I need to add more variety into breakfast!)

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Day 13: Pancakes!  I love pancakes for babies.  They are soft but easy to grasp.  For these pancakes I blended 1/2 a banana, 1 egg, 1/4 cup teff flour, a small handful of spinach and 1/4 tsp baking powder.  Baby loves her greens!

 

 

 

 

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Day 14: Smoothie.  I tried providing this on a preloaded spoon.  The meal ended by wearing her smoothie.  All.  Over.  Her. Body.  I only took the "before" picture.

 

 

 

 

 

 

 

There you have it!  Our first two weeks starting solids.  We tried to include a variety of foods, flavors and textures.  What have I learned?  Baby girl doesn't have much interest in getting spoon fed and she is LOVING to eat! 

Follow me on Instagram or facebook as we continue on our feeding journey!  I will be sure to post lots of great recipes and feeding ideas.

 

Iron Rich Foods for Infants and Toddlers

At your baby’s 4 or 6 month checkup, your doctor may discuss starting your baby on solid foods.  It is an exciting time – up until this point your baby has been taking in all of his nutrition from breast milk or formula, and you get to shape his palate with new flavors and textures over the next 6 months and beyond.  Your doctor may have talked to you about introducing iron rich foods early on.  This is because iron stores in your baby typically start to become depleted around 6 months of age.  I typically recommend families wait until 6 months of age to start solids (although I have heard pediatricians recommend between 4-6 months). 

It is common to hear that infant fortified cereals are a good first food.  Why?  Infant cereals are typically fortified with iron and lots of other vitamins and minerals, which is why foods like rice cereal have historically been discussed as a good first food.  BUT now we know that iron fortified cereals are not the only option, and many parents skip them altogether to start on solid foods.  Another benefit of skipping these cereals is that early exposure to more tastes and flavors has been shown to increase baby’s interest in the tastes and textures of new foods in the future.  Here are some great iron rich foods to offer right from the start:

Meats: meats can be a great food to introduce early on.  Try stewing meats or using a slow cooker to allow for a softer texture.  If you are introducing pureed foods, you may need to add a bit of water with meats to allow the food to blend or try blending with other great first foods like avocado and sweet potato.  If you are using a baby led weaning approach, try soft meatballs with minced chicken or beef.   Make chili and soup with chicken, beef, turkey and lamb. 

Lentils and beans:  I love these as dips, added to a sauce or as finger foods for a bit older baby.  Beans and lentils are super easy to make.  Mash on their own or add to a sauce.  And if you take my introduction to solids class, I always bring in a sample that’s mom and baby approved, such as my green pea hummus or lentil []- you can use these interchangeably as a puree for baby or a great dip for a slightly older toddler or an adult.  

Greens: spinach, chard and kale are a few food sources of iron.  Sautee them with other vegetables or combine them in a puree with meats.  As your baby learns to drink out of a straw or an open cup add greens to a fruit smoothie for some added nutrition.

 Left side: Make ahead and freeze egg bake - On the right French toast cup  with strawberries

Left side: Make ahead and freeze egg bake - On the right French toast cup  with strawberries

Eggs: Eggs are a good source of iron.  An egg scramble with veggies is a great way to get in some iron, and lots of vitamins and minerals.\

 

Grains: Often overlooked, but some grains are high in iron.  Some of my favorites include Teff, Amaranth, Quinoa and Millet.  Make cereals with these grains, use in chili or stew or make muffins or bread.

These are only a few great sources of iron.  Although breastmilk is typically thought of as a poor iron source, the iron is breastmilk is absorbed very well by baby.

And one more tip – iron is better absorbed with a source of vitamin C.  So for better absorption of iron pair an iron rich food with something like citrus fruits, berries, broccoli, apples or tomatoes.  Also- breastmilk is an excellent source of vitamin C!

And remember that providing a balance of nutrients is important – iron is one of several important nutrients once baby starts solids. 

Want to learn more?  Join me at one of my upcoming classes on introducing solids.  

Offering whole milk after one year of age: Is it really necessary?

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My clients and students often ask  - is cow's milk something all kids need?  Most parents hear from pediatricians not to provide cow's milk prior to one year of age, but after the child turns one year old, to start providing a few cups per day.  Below, I examine the recommendation and the nutrition facts parents should know.

 Why no whole milk before one year of age?

Whole milk is on the list of foods not to provide to your baby until they are one year old, because pediatricians do not want to replace the breastmilk or formula your child is receiving with whole milk.  The nutrients in whole cow's milk are significantly different from the nutrients in breast milk and formula, and are not what your infant needs at this time.  Whole milk has more protein, less fat and carbohydrates than breastmilk or formula, and a different variation of some key vitamins and minerals.  For older infants starting solids or purees, using whole milk in a recipe is typically fine as are other dairy products like cheese and yogurt.  I review the practicalities of this in detail in my class, Introduction to Solids.

Can I meet my child's nutritional needs without whole milk?

Yes.  I recommend families start by thinking about offering a variety of fruits, vegetables, lean proteins and whole grains.  At this age, variety is key.  Here are some foods that are high the same nutrients that are provided by milk:

  • Saturated fat: full fat cheese, full fat yogurt, coconut milk, avocado, oils
  • Protein: fish, beef, chicken, turkey, lentils, beans
  • Calcium: yogurt and cheese, nuts, beans, greens, legumes, kale, salmon, chia seeds
  • Vitamin D: mushrooms, egg yolks, fatty fish (some doctors may recommend your child take a supplement)

[Further Reading: Cows' Milk in Complementary Feeding ]

Wait a minute- are you saying not to provide whole milk to my child?

To be clear - my primary message is that parents have choices.  Milk can be part of a child's balanced diet.  BUT there are alternatives if you prefer not to provide this to your child (or your child is refusing milk).  Additionally, keep in mind the recommendation for milk is 16-24 oz per day (2-3 cups per day).  Too much milk can fill of a child's small tummy and may not leave room for other solid foods, which can deliver some of the other nutrients such as iron.  [Further Reading: American Academy of Pediatrics Committee on Nutrition: The use of whole cow's milk in infancy.]

What about non-dairy milk alternatives?

I typically do not recommend a non-dairy milk to replace whole cow's milk in a young toddler's diet.  Most (not all) non-dairy milks are fortified with Calcium and Vitamin D, which is helpful, but those beverages do not have significant fat, calories or protein, which are very important after one year of age.  If you are thinking about using a non-dairy milk, don't think of it as replacing cow's milk, but in addition to you child's balanced diet, and do check the nutrients listed above to be sure it is adequate.  And note not all non-dairy milks are created equally, there are some non-dairy alternatives that are similar in nutrients to cow's milk, like soy and hemp milk.

Have other questions about milk?  Contact me or let me know in the comments below.

Decoding the new "prevention of peanut allergy" recommendations

Over the past several weeks I have received a lot of questions surrounding the new Clinical Guidelines for Prevention of Peanut Allergies issued by the National Institute of Allergy and Infectious Disease (NIAID).  You may have heard "introducing peanuts between 4-6 months of age can prevent peanut allergies."  It seems new research continues to be published surrounding food allergies.  

But let's look at the facts:

The new guidelines came from the 2015 LEAP Study, which focused on the prevention of food allergies in high risk infants.  The NIAID issued this summary for parents and caregivers, which broke infants into three categories and provided recommendations for introducing peanut containing products:

Guideline 1 states, "that if your infant has severe eczema, egg allergy, or both (conditions that increase the risk of peanut allergy), he or she should have peanut-containing foods introduced into the diet as early as 4 to 6 months of age."  The NIAID Strongly recommends evaluation by a medical professional to perform specific tests for this allergy.  Key takeaway: SPEAK WITH YOUR MEDICAL PROFESSIONAL

Guideline 2, "suggests that if your infant has mild to moderate eczema, he or she may have peanut containing foods introduced into the diet around 6 months of age to reduce the risk of developing peanut allergy."  The use of the term "suggests" in this guideline shows that this recommendation is not as strict as guideline 1.  KEY TAKEAWAY: If your child falls into this category, start introducing peanut containing foods around 6 months to reduce the risk of developing a peanut allergy.

Guideline 3,  "suggests that if your infant has no eczema or any food allergy, you can freely introduce peanut-containing foods into his or her diet."  This guideline goes on to state that "This can be done at home in an age-appropriate manner together with other solid foods, keeping in mind your family’s dietary routines and preferences."  

Bottom line?  If your child is at a higher risk of food allergies, speak with your health care provider before adding peanut containing products and they may recommend you begin these products between 4-6 months.  If your child is not at a high risk for food allergy, introduce peanut products when you feel comfortable.  Take a look at this post for ways to introduce peanut containing products in a safe way and environment.

Meeting Your Toddler's Nutrition Needs: Iron

I work with many clients who want to know about about adequate iron intake in their infant and young toddler's diet.  The Recommended Dietary Allowance (RDA), or average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals, is 11 mg iron for babies 6-12 months of age and 7 mg of iron for children 1-3 years of age.  Here are three of my favorite iron rich food sources that I feel are not given enough credit, along with some great toddler approved recipes. Lentil pasta sauce

Lentils: Half a cup of lentils contains 3.3 mg of iron.  Lentils are easy to make (here is an easy way to make them on the stove) and a big batch can be prepared and last for a few days.  Add lentils to pasta sauce, or mash into a dip with garbanzo beans (lentil hummus anyone?) or sprinkle cooked lentils on a grilled cheese sandwich.  The possibilities are endless and the health benefits are huge!

Add 1-2 tbsp of Blackstrap Molasses into your french toast batter. Serve with a side of fruit for a complete (and iron rich) breakfast.

Blackstrap Molasses: The nutritional king of molasses.  Blackstrap molasses has 3.5 mg iron in one tablespoon.  And not only is blackstrap molasses high in iron, it is a great source of calcium, magnesium, vitamin B6, selenium AND low in sugar.  Blackstrap molasses can be added to oatmeal, french toast batter, and topped on pancakes or waffles.  It can also be added to a multitude of baked goods.  Two of my favorite recipes that can be nutritionally boosted with blackstrap molasses are these baked oatmeal bars (add a few tablespoons into the wet ingredients) and this chocolate zucchini bread.

Black bean brownies: recipe coming soon!

Unsweetened Cocoa Powder: Who would have thought cocoa powder would be a source of iron?  Two tablespoons of unsweetened cocoa powder contain 1.4 mg of iron.  Try this powder in some great baked toddler approved recipes, including the chocolate zucchini bread listed above,  or adding a few tablespoons into this zucchini banana oat bread.  I have also made black bean brownies using this powder (recipe coming soon!).

There are many more sources of iron that I love to include in my family's meals like:

  • red meat and dark poultry
  • fish sources like tuna and salmon
  • eggs
  • tofu
  • beans
  • dried fruits
  • grains (like quinoa, barley, teff, amaranth, oat bran, wheat bran
  • dried fruits
  • green leafy vegetables
  • iron-fortified breakfast cereals
  • and MANY more!

Stay turned for future blog posts which highlight some of these foods.  Do you have a favorite iron rich recipe? Let me know in the comments below, or contact me with questions.

How to Help Your Little One Feel Full

This is my second post in a three-part series about introducing solids to your little one.  To learn more and to sign up for an upcoming class on introducing solids to your little one click here. In my previous post  I addressed a parent’s responsibilities for the “when” (setting meal time) and the “what” (the food to be served).  This approach is generally referred to as the “feeding relationship.” [1]  The relationship is between parent and child, and between the child and the food they eat.  Now that we’ve established the parent’s responsibilities, we can move to the child’s responsibilities – whether to eat, and how much to eat.

By controlling the WHAT, parents introduce foods, and should be actively monitoring how children respond. Getting started is fairly simple: you offer the food, and your child decides how much and WHETHER they want to eat it.  Yep, that’s it.

However, this will surely bring a challenge (and for some, the harder obstacle to overcome) to be okay with how much and whether your child accepts the food.

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When introducing solids to your little ones, starting small is essential to help him learn to physically accept solid food and learn to taste, chew, and swallow effectively.  Offer a small amount of a pureed food to your little one.  If the child opens their mouth toward the spoon, help guide the food into their mouth.  If the child turns away from the spoon, trust their instincts they do not want that food or simply are not ready.   If you choose to use the baby led weaning approach, start by placing food in front of your child on their high chair tray or the table. Trust that your baby knows what they need.  And keep in mind, especially when starting out, breast milk or formula will make up the majority of your little one’s calories and nutrition until they are close to a year old.  Your job is to help them learn how to eat.  You are letting them know they can choose how much and whether they would like to eat.

When you move beyond purees and toward more complex foods, offered more frequently, this approach can, and often will, get more challenging.   As your child gets older and enters toddlerhood, less of their nutrition may come from breast milk or formula.  However, this is when it is more important than ever to keep in mind your child’s ability to self regulate.  As you offer more food at a given meal, you’ll be looking for signs that baby feels hungry.  That feeling (rather than a specific amount of food) helps your child to learn appropriate eating habits.

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Allow your child to experience the physical and cognitive effects of being hungry before eating - their young body’s regulatory reflexes come from feeling hungry and then knowing when they are full.

Research shows that children who are taught in this manner develop positive food attitudes, interest in eating a variety of foods, an intuitive sense of how much to eat, and long term skills for healthy eating and meal planning.[2]

There are a few things you can do to encourage your child to feel hungry and full, such as only offering a meal or snack every 2-3 hours (allow your child to feel the hunger and sensation of fullness) and only offering water in between meals (rather than juice or sugary beverages).

Sit and have meals with your child, as time allows, and eat the same foods as they eat.  Not only will you be in a better position to monitor your baby’s preferences, but you can encourage her choices and ease her frustrations through words and sounds.  When baby tries a new food or enjoys an old favorite, you can show him that his choices matter to you.  Another benefit is cognitive: take the opportunity to teach your child the names of the foods he’s eating!

Keep in mind it can take up to 20 exposures of a new food before a child accepts it.  This is true when introducing solids to an infant as well as more complex foods to a toddler.  Before you rule out a food and dismiss your child as disliking it, keep offering it.  Chances are, after enough exposures, your child may have a change of heart.   While some degree of pickiness is normal, if you feel if you feel concerned with your child’s feeding habits, consult your pediatrician or a registered dietitian.

With the principles above, you’ll be on your way to raising a healthy eater!  For practical tips for introducing solids,  stay tuned for my next post, “Age-appropriate portions for toddlers (and parents)”.

[1] Satter, Ellen M.,  Child of Mine: Feeding With Love and Good Sense, Bull Publishing Company; Revised edition (March 1, 2000) http://www.amazon.com/Child-Mine-Feeding-Revised-Updated/dp/0923521518

[2] Satter, “Eating Competence: Definition and Evidence for the Satter Eating Competence Model” Journal of Nutrition Education and Behavior ● Volume 39, Number 5S, September/October 2007  http://www.ellynsatterinstitute.org/cms-assets/documents/101150-596171.ecdefandev.pdf