Infant Food Introduction
There is a large debate in the world of infant feeding these days in terms of Baby Led Weaning vs. Purees. As Dietitians specializing and women’s and children’s health we are asked quite often which is “better”. Our answer is not clear cut. We like to inform our clients of all the facts and then let them decide what is best for their baby and family. If you have wondered about this topic, then this article is for you. We are going to share 7 topics to think about when initiating infant feeding and within that discuss BLW vs. purees.
1) Wait until baby is 100% ready. The timing of ideal food introduction is when baby shows ALL signs of readiness. Many infants will show interest in food well before they are physiologically ready for it. Mothers can be tempted to start feeding their child solids earlier than ideal with hopes of longer sleep times or concern that breastmilk or formula is not enough. But in reality it is more adventitious to wait for baby to be 100% ready. This means that their extrusion reflex has diminished significantly, they are holding their head up independently, and they are able to sit up in a chair designed for infant feeding. If food is offered before these milestones choking could occur. Also, once these developmental milestones are reached, the gut has usually reached its milestones for increased digestive needs as well.
2) Go slow! Whether you choose BLW or purees it is ideal to introduce foods one at a time with 2-3 days between each food intro. Aim to offer first foods early in the day so that you have time throughout the day to watch for a reaction. This slow process can be anticlimactic for may moms who have been anticipating the day of first foods for months! But it is safest for baby if we take it slow until we know what they are able to tolerate well and what foods may cause gas, reflux, and/or an allergic reaction.
3) Nutrient content matters. One of the main reasons we introduce foods is to ensure adequate iron availability for the child’s growing body and brain Iron allows for Oxygen to be delivered throughout the body and brain and is essential for brain growth and development. Full term babies are born with about 4-6 months of iron stores. One of the main reasons we introduce food around 6 months is to provide additional sources of iron (on top of what is available in breastmilk and iron fortified formula) as the stores deplete. Meat, pork, chicken, fish, lentils, avocado, eggs, oats, and spinach are all foods rich in iron. Plant based iron sources are not as absorbable but when paired with a source of vitamin C can be absorbed quite well. Because of this starting with high iron foods and then high vitamin C containing foods are great places to start with infant food intro. Iron fortified cereals are also available.
4) Texture matters. Now for the topic that the most people ask about…puree or texture. The reality is that by 7-8 months it is very important that texture is offered to a child to help them develop a pallet for foods that are not just uniform and smooth. Prior to that (so in the first 4-6 weeks of feeding), it is truly up to the child and parent to decide. Some children truly hate purees. They want to explore a big chunk of avocado and gnaw on it and mush it and experience the food. Other children would prefer to have the safety of mom helping with those first bites and start to explore once they know how this whole “eating thing” works. You know your child best and what their personality might lean towards in that area. Don’t let the gag reflex alarm you. It is very normal and part of the development of eating. Here are two things I tell all parents that I work with. The first is that if you start with purees, try to increase texture by the time your child is 7 months. The second is that if you start with BLW, still follow the “introduce one food at a time” rule. It can be tempting when you are offering foods to your baby that the family is enjoying , to then offer them a variety right away. This could lead to an allergic reaction without truly knowing what food caused the issue.
5) Don’t be afraid of flavor. It is important to limit sodium in an infant’s diet, but offering spices is encouraged. Allow for your child’s pallet to learn about different flavors from a young age; thereby creating tasty and interesting food. There is a lower risk of excessive food jags and picky eating behaviors for a child who was exposed to flavor early on. As I mentioned with food, introduce spices one at a time with separation in between as well.
6) Remove your food biases. When offering food to you baby (or children), be cautious of your words, facial expression, and body language. If they notice that you are not a fan of a food they may choose to not like even before trying it. Also if there is a food you do not enjoy, remember that your child may like it and it is still important to have as part of your food offerings.
7) Be aware of allergens. Certain foods are more likely to cause an allergic reaction in children. Most recent guidelines state that we are to go ahead and integrate these foods into food intro from early on; however, we may use a little more caution when introducing them. This is especially important if someone in the family has an allergy, asthma, or eczema. When introducing a higher allergen food, try touching the back of the babies hand with the food and watch for any signs of redness or bumps or irritation. If all is well in that area for 24-48 hours then you may want to touch the cheek and/or lip with the food. Again watch for any abnormal coloring or behavior or swelling. IF all is okay after 24-48 hours then you can offer a small amount of the food. If all is well both externally (no hives, swelling, or redness of the skin) and GI (no gas, diarrhea, or vomiting) wise after 48-72 hours the offer it again. Sometimes an allergic reaction comes upon the second food exposure. If all is clear after that you can assume that all is well unless a reaction occurs down the road. This sounds painfully slow and it is, but it is also very worthwhile.