Reflections on motherhood #6: introducing solid foods

This post is the sixth in a series about my experiences of motherhood and what I wish I’d known before I had a baby. You can see the original post here.

When I was six months pregnant, my husband and I met up with one of his childhood friends, along with her husband and son, in a cafe a couple of  days before Christmas. Her son was 13 months old, and we watched him polish off an entire slice of cake. Conversation turned to his eating and I mentioned that I had no idea how one went about introducing a baby to solid food. His mother agreed and said she had felt so in the dark that she had gone on a weaning course. Wow, I thought to myself, weaning must be really complicated, and promptly decided to ‘park’ that issue of parenting until I felt able to cope with the more pressing ones.

Hindsight is a wonderful thing. I wish I had known then that, in almost all cases, for every milestone a child has to reach in her development, you don’t actually have to do anything, it will just happen on its own, of its own accord, in its own time. This is true of rolling over, sitting, walking, talking, sleeping and, yes, eating.When I stopped to think about this, I sort of knew it in theory, but theory doesn’t help when you’re sleep-deprived and suffering from child-related anxiety. I wish I had surrounded myself more with voices who reminded me of this fact, because I would have avoided a lot of stress over the last year and a half. Unfortunately, most of the voices that surround us (sometimes our family, our peers, and some health professionals, but mostly profit making companies with aggressive advertising campaigns, and as a result our own feelings of guilt as mothers) insist that we need to intervene and get our baby to the next stage, usually (and not so coincidentally) by having to purchase expensive and unnecessary equipment. I reckon that, after the multi-billion pound industry of getting your child to sleep through the night, the complementary food industry is the next biggest troll eroding our instinctive mothering knowledge.

But I didn’t know any of this before my daughter was born, nor in the first few months of her life. At various baby groups I had come across different approaches to weaning, and I knew there were two buzz-words that were bandied about. One was purees and the other baby-led weaning. I followed a thread on a friend’s Facebook profile about the latter, and sadly witnessed the very worst of the so-called ‘Mommy Wars’ where debate about the relative merits of the different approaches got, shall we say, somewhat heated. To me, the name baby-led weaning sounded like a trendy new fad, just like co-sleeping did. Looking into it a bit more, I discovered that it was entirely messy (not something I welcomed), and for all its benefits of sensory-motor development, I reckoned I’d turned out ok, and I hadn’t created Picasso-like artwork with my spag bol when I was one.

But as the time to introduce solid food neared, I was motivated simply by what was least effort. And to my mind, pureeing up food, freezing it in an ice cube tray, defrosting it and heating it up again sounded like way too much effort when I could just offer her whatever was on my plate. I decided I had better do a bit more research to help me decide which approach I was going to go for.

The first thing I learnt was that, unlike when we were babies, research has shown that no solid foods should be introduced until the baby is about six months old. This recommendation is endorsed by, among others, the World Health Organization, UNICEF, the American Academy of Pediatrics, The UK Department of Health, and the NHS, and with good reason. You can read a short summary of the research on this page. Research shows, for example, that a baby’s gut is not mature enough for foods other than breastmilk or infant formula. Quoting from the link above, we read that babies under 6 months or so have an ‘open gut’, meaning that

“… the spaces between the cells of the small intestines will readily allow intact macromolecules, including whole proteins and pathogens, to pass directly into the bloodstream. This is great for your breastfed baby as it allows beneficial antibodies in breastmilk to pass more directly into baby’s bloodstream, but it also means that large proteins from other foods (which may predispose baby to allergies) and disease-causing pathogens can pass right through, too. During baby’s first 4-6 months, while the gut is still “open,” antibodies (sIgA) from breastmilk coat baby’s digestive tract and provide passive immunity, reducing the likelihood of illness and allergic reactions before gut closure occurs. Baby starts producing these antibodies on his own at around 6 months, and gut closure should have occurred by this time also.

In addition, this study found that the “majority of normal full term infants are not developmentally ready for the transition from suckling to sucking or for managing semi-solids and solid foods in addition to liquids until between six and eight months of age”, suggesting that babies are not ready for solid foods until they are developmentally ready for them. What does that mean? There are several signs of readiness for solid foods, and a baby needs to exhibit all of them to be developmentally ready, according to the research quoted above. This list is taken from Kellymom.com:

  • Baby can sit up well without support.
  • Baby has lost the tongue-thrust reflex and does not automatically push solids out of his mouth with his tongue.
  • Baby is ready and willing to chew.
  • Baby is developing a “pincer” grasp, where he picks up food or other objects between thumb and forefinger. Using the fingers and scraping the food into the palm of the hand (palmar grasp) does not substitute for pincer grasp development.
  • Baby is eager to participate in mealtime and may try to grab food and put it in his mouth.

The discerning reader will notice that the above list basically boils down to – if your baby can feed himself, he’s ready for solid food. This means that pureeing food (or buying canned baby food) is, at the very least, unnecessary. Marvelous, I thought to myself, I’ll just offer whatever I eat and she’ll clearly just pick it all up, literally and figuratively.

I couldn’t have been more wrong. I noticed how, at about 5 months, my baby was grabbing everything and putting it to her mouth. Signs of readiness for solids, I thought! We duly bought a high chair. This coincided with a GP appointment about her reflux, because I’d finally got to the stage of being completely end of tether about it. I had to hold her upright all day, she sicked up after every feed, she arched her back and cried in pain a great deal, and let’s not even talk about sleep. I knew in my heart that frequent nursing helped her a lot and so had put off the idea of medicating it, knowing how silent reflux is often over-diagnosed. But I took her to the GP nonetheless. Quite apart from the fact he expressed surprise that she ‘still’ woke up at least three times a night (and this is a man who has three of his own children…), he said that, in addition to Infant Gaviscon, I could try treating solid foods as ‘medicine’ and giving her some a bit early, because the idea is that if one’s stomach contents are thicker, they won’t reverse up the oesophagus as much.

I duly returned home, cut up and boiled a carrot, sat her in her high chair, and placed them in front of her. People, this was her face:

 

20140902_120547

Let’s just say that that little experiment didn’t work. A few days later, having offered many different types of boiled vegetable, I bought a jar of Hipp Organic baby food in desperation. I didn’t care about principles when all I wanted was my daughter to not be in pain any more and for me to be able to not have to hold her upright all day. Since we had had absolutely no luck in administering any kind of medicine for her reflux (either Gaviscon or Ranitidine), I wasn’t holding out much hope that she’d take any puree off a spoon. I got that one right. I realized that there was not a chance I was going to be able to spoon feed this baby. Baby-led weaning it was to be. She made that decision for me!

Looking back, I’m glad she refused solids at that age. I know now that she wasn’t ready. For one thing, she couldn’t sit up independently (only managing this at nearly 9 months), and when, a couple of weeks later, she did start experimenting with putting food to her mouth, she gagged horrendously. Oh my goodness, the gagging! It was so awful, it looked like she was dying! I knew then that I needed to do my homework properly. Other mum friends said that they were scared of their babies choking and that was why they chose to feed them purees. I needed to know a bit more about weaning in general. So I bought this book by Gill Rapley, a former health visitor, which had come highly recommended by many friends who wanted to let their babies feed themselves.

It was an eye opener. I discovered that far from BLW being a new fad, it was (by and large) how most people had fed their babies for millennia before the infant feeding industry got on the bandwagon and realized they could make money out of mums (think of all the paraphernalia you need even if you make your own purees … containers and blenders and microwaves and fridges and special spoons and bowls and bibs etc etc). Now I’ll be honest, I don’t think there’s much evidence-based research to advocate one method over another when it comes to weaning, but, philosophically, letting your child feed themselves when they’re ready made intuitive sense to me. So much of eating is really about social convention, such as how many ‘meals’ a day one should have and whether one should finish one’s plate etc – I knew that cultures differ with regard to these things. I hated the idea of making a ‘thing’ about eating, or playing games to trick her into eating food she didn’t want. It didn’t sit right with me. My baby already knew how much milk she needed, and knew when she was full, so why would she be any different with food? I had already learnt to trust the baby, they come programmed to survive, so it seemed logical for me to trust her with this too.

Proponents of BLW also suggest that, developmentally, babies want to learn to chew before they learn to swallow, and spoon feeding can confuse this. That’s because the baby has to suck the puree off a spoon. If they haven’t had a chance to explore texture before they learn to swallow, they often encounter problems when parents introduce ‘mushy’ foods or finger foods, as their gag reflex is triggered. The theory goes that if you allow your child to manipulate texture and play with food first, they discover all by themselves how to get lumpy bits out that they can’t manage, using that very same gag reflex, before they learn how to swallow what they have chewed themselves (and contrary to what I have been told by countless members of my parents’ generation, you don’t need teeth to chew).

My daughter’s gagging was initially of epic proportions. Looking back, I wished I’d just stopped offering her food for a month and tried again when she was actually showing all the signs of readiness. But I didn’t trust her. Without realizing, I trusted the health professionals and advertising that kept telling me that she needed complementary foods because my milk wasn’t enough for her. I mean honestly, did I really think it was like some kind of switch that got flicked when she hit 6 months, and before my milk was enough and suddenly after it wasn’t any more? Looking back it looks so obvious. It didn’t seem that way at the time when everyone else’s babies seemed to eat everything off a spoon that their parents waved in front of them. I hastily learnt the difference between gagging and choking and attended a first aid course put on at my local Children’s Centre. That did help to calm my nerves, but still my daughter didn’t actually eat anything. She picked it up with glee, put it to her mouth, and made the face you saw above.

When she got to about 8 months and was still eating nothing, I was starting to break out into a sweat at meal times. Here I was, nobly offering stuff off my plate (chopped up into stick like chunks so she could easily pick them up), tirelessly cleaning her ridiculously complicated high chair that I wish we never bought (folks, buy the fifteen quid one from IKEA. All the others are a waste of money. Every mother I know comes to the same conclusion, and we all own the same white plastic cheapy one now. Genuinely.) along with five metres of floor space underneath it. I was ready to abandon my BLW principles at any stage just to get her to eat, but she resolutely refused me putting anything near her mouth. What was making me so stressed? Other people.

‘Is she eating anything yet?’

‘It’s strange how she nurses so much still, my children all loved food.’

‘You’ll need to stop breastfeeding her so much, that’s why she doesn’t eat.’

‘You need to give her what she wants! Try ice cream or biscuits!’

‘You should try playing the aeroplane game and distract her and then shove a spoon in.’

‘You just need to heat up [insert brand name] baby puddings, that worked for us.’

Fortunately, my health visitor was wonderfully reassuring. ‘Just keep offering,’ she told me for the Xth time at a baby session at our Children’s Centre. ‘She’ll get there in the end.’

Occasionally, she would eat a little of something, and enjoy it! I would dance for joy, and videoed a few of these triumphant moments with glee. Only, then the next day she would refuse everything again, and I would feel deflated. Slowly I began to worry about her not getting the nutrients she needed. When she reached ten months, and I could count the number of mouthfuls she had eaten since she was six months old on two hands. I had a candid chat with a GP mum friend, who had a child a few months older who also ate next to nothing. I discovered the only thing that she possibly wasn’t getting enough of from my milk was iron, but that this had more to do with the iron stores laid down in pregnancy and the nature of her delivery (in particular, delayed cord-clamping) than it did with anything else (this article from Kellymom is helpful, showing that a baby’s iron stores tend to deplete at some point during the second half of the first year, but see also this article critiquing some of the finer points). I felt myself relax a little. Here was a health professional who understood why I couldn’t just ‘breastfeed less’ (if nothing else, breastfeeding was the only thing that helped my daughter’s reflux), and she helped me to be confident in the choice I had made. I kept offering iron rich food in the hope that she would take what she needed.

The months rolled on. Still she did not eat consistently, or really at all. It got harder to drown out the usually surprised but often negative voices, especially as my daughter still wanted to nurse around the clock. But cutting back on nursing wasn’t an option, I knew that. And I was satisfied that she was thriving and healthy. And do you know what, folks? She didn’t start consistently eating until she was 14 months old. Even then, it was totally hit and miss, but it was then that she discovered that she could actually enjoy food. We started to notice that when my husband took her away from me all day (not something she could cope with before that age, she’s always been very needy of me), she would eat more. She started to ‘like’ certain foods, and became more predictable in what she would eat. But still, I could count the number of malted wheaties each breakfast (7 was a good day), and she often refused a meal altogether.

I then read this majorly reassuring book by a Spanish paediatrician and recommended at LLL, which made me grow in confidence and shut out the critical voices much better. There were three things I took away from the book. The first was that unless your child lost more than 1kg in a week, they were doing fine, however little they ate (my daughter had barely put on any weight in a year, so I was a bit concerned by weight gain). The second was that how much a child eats depends more on rate of growth than on age. So, for example, a 9 month old might well eat more than an 18 month old because his rate of growth is greater. The third is that it is really, really bad to force feed your child. I knew I was doing the right thing in trusting her.

And sure enough, at 26 months, she now eats. I say ‘sure enough’, but I know a lot of similar aged toddlers who barely eat anything. But I did get to the bottom of why my daughter showed little interest in solid foods for so long, and I suppose some of the nay-sayers were right in a way: she loved her milk too much. It’s only when my supply dwindled at the beginning of my second pregnancy that she started to eat more, because my milk was no longer filling her up. Suddenly she started to eat 5 bowls of cereal in one go, mountains of potatoes, and many many beef sandwiches (her favourite). ‘Should’ I have denied her milk earlier to ‘get’ her to eat more solid food? It would never have worked even if I’d tried, because milk was so important to her back then. And I know now that breast milk adapts to your child’s age, and it’s still the perfect food for her. It doesn’t magically lose nutritional quality when they get older.

breastmilk in the second year

Do I think my choice of weaning method contributed to how much food she ate? Not really. I was a pragmatist, not a purist, and clearly your kid can turn out just fine whether you follow a traditional weaning route or a BLW one. But I am so glad, on reflection, that I trusted her, and let her feed herself. I could see how her fine motor skills improved in just a few short months. She was delighted with the sensory play that food provided her with. I relish the fact that I always let her determine when she’d had enough or when she wanted more. I also know that it is not normal in our society for babies to be nursed past 2 years old, but this is not true of other cultures. Perhaps, if more babies reached the WHO recommended milestone, it would be more normal for toddlers to prefer milk over solids. Anecdotally, it is certainly normal among my ‘extended nursing’ mum friends.

Oh, and we haven’t (yet!) had any kind of choking incident, and the gagging died down after a few weeks. I remember the first time I saw how she manipulated a chunk of food she couldn’t manage by gagging. It was amazing to watch. She’d learnt all by herself how to deal with something too big for her to swallow. We relaxed a lot, because we knew that when she took a bite she would just spit out what she couldn’t manage. BLW was easier to cope with after the initial few months, during which I could feel everyone (mainly grandparents) holding their breath around the table. It was messy, but a lot of fun, and the messy stage actually passed quite quickly. It was wonderful to include her in the family mealtime, even if she didn’t seem bothered by actually eating. It meant I could also eat my own meal and she was occupied. Although she still often likes to sit on my knee and help herself from my plate (which let’s be honest is sensible from an evolutionary point of view!) she mostly has her own plate and cutlery and eats in her high chair with little need for parental help.

We now go for an approach where we as parents determine what and when, and she determines if and how much. This works well, but like any toddler she can be very picky about what she does and doesn’t want to eat. I try not to stress about the fact that she has only ever eaten one type of vegetable in her entire life (courgette, and she’s been refusing that for the last year, too!) I figure that, if I eat vegetables and a healthy diet generally, so will she once she’s out of the toddler years. We have found some foodstuffs that she likes that we are happy for her to eat unlimited amounts of, in addition to restricting certain things. We are now all very relaxed at meal times, and enjoy each other’s company immensely. My daughter knows it’s a time to reconnect as a family, and I love that. And the best thing – nine times out of ten, she just eats what we eat (carefully picking out all the vegetables, obviously!) She’s one of us, as she should be.

 

 

 

 

 

 

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