Thursday, January 27, 2011

Starting Solids (AKA Weaning in the UK)

When and how to start babies on solid food, a topic recently in the news giving me an excuse to clean up my letter to friends.  Books mentioned are American titles.  Perhaps M&M knows of comparable British titles?  After the jump...

As four months approaches, it is time to talk solid food.  Note please, that the advice I am about to give is not just talk.  I can walk the walk.  I’ve said things like “Give me the snap peas and eat your cookie!”  Christopher Robin already had peas with dinner and was stealing the ones I’d left for Yasha's and my dinner.  There was also the 'You can't have more fruit until you finish your ice cream' incident at Gnomz's.  She laughed at me.  My kids' favorite meal is Salade Nicoise.  (A caveat to good palates here as sometimes your kids will end up with expensive tastes.  Tigger likes smoked salmon.  Christopher Robin and Terremoto have expensive cheese tastes.)  My biggest food problem is getting my kids to eat cooked veg.  They prefer raw.  Of the moms I hang with, many have similar food attitudes and they'd probably agree with much of what I write below.  At those playmates, I generally can't have enough carrots, cucumber, tomatoes, or olives on hand.  Seriously, these kids will forgo chocolate for a tomato.  And I will never again get the head of broccoli out to start dinner while they are all in the flat.  There wasn't any left for cooking.  

In short, my kids eat well, are growing fine, and we don’t have battles at dinner or cook individual menus.  If the stuff about he’s-just-picky or it’s-all-genes were true my children would have been doomed.   Stories of Doc Sissors and I alone are legend.  Yasha worked very hard in his 20s to stop being picky.  

On reading the previous link I’m sure you noticed that the parents indulged their children’s pickiness.  Therefore, you’re probably thinking that you just won’t be so indulgent and the problem won’t exist.  True, but after 7 years experience and observation, I can assure you that no parent intends to be a short order cook.  To them it appears to just happen.  It doesn’t.  

Generally, for a healthy, non-preemie, etc., here’s how it goes: Typical Mommy starts baby on baby food, stage 1.  Mommy dutifully follows modern allergy avoidance recommendations, and slowly, over the course of months, moves to Stage 2 and then 3 in Gerber or the organic jars of choice. She adds a few Gerber finger foods, like those fruit puffs for snacks, maybe some bits of toast and tiny vegetables too.  About 12 months, Mommy might start adding real food when Peanut, who used to happily eat anything she spooned into his mouth, suddenly spits everything out or throws it onto the floor. 

The problems: 1) Try some baby foods and see if you notice a discernible difference in the texture of commercial baby food across food types—carrots, green beans, squash, apples-- most especially across “Stages.”   You don’t get any chunks until finger foods.  2)  Flavor is lacking.  Gerber, et al. use salt and occasional cinnamon in dessert dishes.  Otherwise forget about spices.  Brits have more flavors in their babyfood, and that is a pathetic endorsement. Furthermore, so they can last on your shelf for 6+ months, the food has been cooked a very long time.  The colors and the smells are different, but that’s it.  Plus, all the allergy recommendations fashionable today lead moms who do branch out to opt, slowly, for bland food because they are trying to avoid allergenic ingredients.  3) Mom is still feeding baby with a spoon.  4)  Swallowing solids is a slowly learned skill.  One can’t go from all mush to chicken fingers without some gagging. 

Around 1 year, these problems run headlong into two formidable forces: The Rules and I’ll Do It Myself.  You’ve heard much about I’ll Do It Myself, I’m sure, and it is pretty self explanatory.  Baby would rather try 90 times and fail than watch you do it, whatever “it” is at the moment.  If you’re still spoon feeding Peanut, she might simply start to refuse on principle.  On the other hand, The Rules are a much less known force and their strength depends greatly on the baby’s personality.  Basically, around a year babies start to lock in impressions and experiences into some This Is the Way Things Are Done vault in their brain.  If mommy has been doing the bath and daddy has been reading the bedtime stories, then woe to you if you try and switch jobs one night.  Budding engineers tend to have more of these rules, and get much more upset about them, than budding painters do.  Regardless, when The Rules hit, if all Peanut has had is bland, mushy food, then Peanut thinks that is how food is supposed to be.  You can put a piece of chicken or hamburger or cheese on her plate, but she won't eat it.  And forget about anything with cumin.

At a year, however, Typical Mommy thinks that baby should start eating more adult food.  The Doctor is pushing this as well, so Mommy starts pushing more adult food.   The Rules work in tandem with I’ll Do It Myself and baby digs in, refusing to eat.  Refusing to eat is further helped by lack of appetite that comes on after a year.  I know it seems impossible to believe if you have a 9 month old, but there will come days when Peanut eats 3 peas and a noodle and tells you she’s finished.   Further complicating matters, the whole swallowing thing terrifies Mommy.  She often gives up, choosing to specially prepare baby meals for her picky baby, at least until he learns to swallow better, damn what the Doctor says. (I’ve seen moms mush bananas for 4 year olds.)   Therefore, the mushy and bland rules get reinforced, and things go no better in 6 months when Mommy does another push for adult food.  Things go more poorly, in fact, as Peanut has learned that this is a battle he can win.  A few more cycles of this, and you’re an example family in New York Times Lifestyle section article on the genetic origins of terrible eaters. 

So here’s what you do.  This is a very rough timeline.  Much will depend on your baby's development and when her teeth come in.

4-6 months
When it seems appropriate (nursing moms that means when the baby hits a food demand that you can't get out of), try spooning some solids into her mouth.  Rice cereal, applesauce, whatever.  I used the Baby 411 book as a guide for first foods.    Unless Peanut has current problems or allergy in her genes, don’t worry about allergies and that one food every few days stuff.  All the first foods are the least allergenic (formula, a cow’s milk or soy derivative is far higher on the allergy list—8 and 9, if I recall—than apples, carrots, peas, or squash).  Make the food runny with lots of milk or formula.  For a while you won’t need more than a tablespoon of food.  Put it on her tongue.  If she thrusts it out by thrusting her tongue against the roof of her mouth—like when she’s nursing—then give it up and try again tomorrow.  Eventually she’ll figure out how to get it to the back of her mouth and swallow; she might suck on her fist--or toes--to help herself out.  

When she learns to swallow properly, start to thicken the mush over the course of a month or so.  Also, start to add more volume taking a few days to work up to a full meal.  Hold there for a week or so then add another meal the same way.  There is no real timeline here save if you go too quickly or if you try to use cereals for more than two meals (more of us got confused by that, you only need a cereal meal once a day) you will constipate Peanut.  You know your baby.  Use your judgment.  Use commercial baby food; you can’t get it this fine textured at home.  Note well that this stage is much messier than you’d expect.  If she doesn’t get a bath every night yet, she’ll need one as soon as you start solids. 

6-8 or 9 months
At 6 months or so, she’s probably swallowing well and might even have 3 full solid meals.  Most of her diet is still milk, but that is getting ready to change.  Find the Top 10 Allergy foods in Baby 411, and make a mental note to avoid them for a while longer.  Start transitioning from commercial baby food to stuff you mush yourself.  Lots of things can be mashed with a fork, but things like carrots and green beans need a trip in the food processor. 
 I highly recommend investing in a stick blender.  Having pot roast?  Pull out a few potato pieces, peel the skin, and mash ‘em up.  Sure your stew has thyme, pepper, red wine, and beef stock in it—So?    How about a spoonful of pumpkin pie filling?  Or maybe plain old mashed yellow squash?  Or how about zucchini stuffed with cheese and breadcrumbs left over from your client dinner the night before?   And that’s just squash.  Make things finer in the beginning, over cook them a bit so they are soft, peel the skins, and thin stuff out with milk, slowly introducing her to the varied textures and taste of food.   

Around 9-12 months
Sometime around now, perhaps much sooner, Peanut will start to use her thumb and forefinger to pick things up.  As soon as she does this and demonstrates decent swallowing skills--swallows well and figures out how to push the food to her jaw and gum it-- start putting mushy bits of food on her tray while you spoon her real meal into her mouth. Bits of buttered toast, hamburger, overcooked diced carrots, small bits of avocado, banana…If you can easily mush it with your tongue against the roof of your mouth, you’re good to go.   At first she will probably play with or even eat 2 or three pieces for a whole meal.  When she eats or drops the pieces, add a few more.  Don’t make much of a fuss of her feeding herself or of the mess she is making.  If she seems more interested in the bits than what you’ve got on the spoon then go unload the dishwasher.  Don’t leave the room because swallowing is a learned skill.   Let her have a go at feeding herself, though.  

Soon she’ll get pretty good at finger foods and most of her meal will be finger foods.  You’ll love this because it will take her a while to eat, and you can Do Something Else.  She’ll probably want a go with a spoon.  Get some of those chunky toddler spoons, and give her mushy food to her too—perhaps a bit at a time so it doesn’t all hit the floor in one sweep.  Same for cups.  You can start with a sippy cup, but frankly they all leak.  Just give her one or two sips at a time in a little cup.  

As for allergies, just avoid the top 3.  You’ve got plenty of variety at your disposal now that you shouldn’t miss peanut butter or clam chowder.  Those are nasty allergies and the only allergies that kids tend to not outgrow and therefore the only ones worth getting worked up about anyway.  I even started my kids on regular milk at this time.  Mine still still nursed first thing in the morning and right before bed so most of their milk was from me, but milk at meals was from a carton.  (I wanted the Vitamin D, especially for the Things as we were in not-so-sunny London.)

Your goal: At 12 months Peanut should mostly feed herself and be off baby food.  The only difference between your food and hers should be how much you chop it up. 

A few additional notes:
Kids eat in streaks, in type and volume.  She’ll want bananas every day for 3 months and then won’t touch them again for 6 months.  Or she’ll have 2 days of a protein kick.  Fruit and veg and carb streaks are the longest to the extent that they often seem to be the default state of a kid’s diet.  Or she’ll eat like a horse for 2 days and like a bird for the next 3 weeks.  If doc says she’s growing fine, then blow it off.  Offer a wide variety of foods, respecting streaks when able.  Left to her own devices she’ll eat the food pyramid probably over the course of a week, but certainly over the course of a month.  Over the course of a day?  Rarely. 

Don't be a short order cook.  Once Peanut eats adult food, then what you are serving is what is for dinner.  Don't make a PB&J because Peanut didn't like the chicken soup.  If you are serving, say, chicken, green beans, and mash, make her try a bite of everything, but don't push if all she wants afterwards is the mash.  Maybe she's on a carb kick.  Actually, if I just ignored the protests of 'I don't want chicken', the objector would usually eat the chicken after the mash.  If they are hungry, they will eat--unless you make refusal a point of pride to them.  

Much of her texture exposure will depend on when she gets teeth.  The road from mush to beef jerky is a long and leisurely.  Christopher Robin, at almost 4, had just gotten to beef jerky.  Cupcake, with only one set of molars at 2, would eat small pieces of cooked broccoli in her pasta, say, but had almost no interest in raw broccoli or other raw veg.   She had just  gotten to the point of eating small bits of steak but had been a threat to sausage and other ground meats for a year.  Just pay attention to how much you need to chew food.  The more grinding, molar action required, the longer it will be before Peanut will take to eating it.   

Nannies are often a problem in feeding if you aren't around.  They, more than modern moms, like to spoon feed their charges really mushy stuff.  (Paola's nanny was doing that and Paola's youngest had started refusing food at 9 months.  Over there for a playdate for Cupcake, Paolo showed me how she wouldn't eat so I started mashing bits of ham from my sandwich for the little one.  I couldn't put it on her plate fast enough.)  You’ll either have to get yours on board with the plan and hope she does it in your absence, or just make sure dinner and weekend meals are your way.  (Same goes for sleep issues as well.  They often don't like to let babies fuss at all.)

Avoid doughy breads.  They gum up into a ball and choke your baby—in front of Grandma, of course.  (I’d forgotten that my mom had that look of pure disgust in her repertoire.)  Avoid corn chips too. To my non-Texas readers, this might seem obvious, but corn chips are almost staples in Texas and if you are eating out and Peanut grabs one while you aren't looking... Corn chips make great guac or queso spoons when you’re at a Mexican restaurant, but have sharp edges—they require molars and practice.  Avoid dried fruits or anything that keeps its shape after light chewing or gumming.  Think raisins or unpeeled grapes.  Doc Sissors was all on board with my feeding plan, except the raisins, which I didn't even start until the children were much older.  Use your judgment.  You’ll figure it out. 

This plan is a detailed illustration of one of the recurring ideas that I wrote about earlier: children won’t do what they’ve never been exposed to.  In fact, early exposure--of the not-pushy kind—helps with many modern mom issues.  The onset of The Rules is a powerful thing.  Use it to your advantage.  

If you want Peanut to tidy up when she’s older, then around 6 months you start doing it every night.  When she seems capable, at 9, 10, 11 months,—who cares-- give her one instruction at tidy time, like,  "Put your dolly on the shelf."  When that works well, tell her to put her set of blocks in the basket.  When The Rules arrive you’ll have a hard time convincing her on some lateish night that you can skip tidy time, a more pleasant problem than refusing ever to tidy up.  You want potty training to go smoother than your friends?  Then if at 10 months she starts to tee tee when you put her in the tub, just pop her onto the toilet and say, “Sweetie, don’t tee tee in the bath.  You can tee tee on the potty.”  Don’t make her do anything or make a big show or fuss.  Act like this is just how things are done.

Like giving her a bottle early on to let her know food comes in different packages, expose her to as many good behaviors before a year and you will influence many of her Rules.  You won’t avoid all conflict this way, but she won’t look at you like your daft when suddenly at 24 months you expect the toys to be tidy at night and for her to put her tee tee in some weird, cold contraption that makes a racket.  Incidentally, use The Rules inversely too.  If you don’t want her to think that the pink piggy plate from Target is “the” dinner plate, then serve her on lots of different plates.  It is the difference between her being vexed but grudgingly accepting a less favored plate and her melting down because the blue stripey plate is not part of her evening routine.  There are a few exceptions to this, like how to handle separation anxiety.    If in need of guidance, I found Touchpoints very helpful until about a year.  Once The Rules hit, you need a copy of John Rosemond’s Making the Terrible Twos Terrific.   Cheesy title, yes, but excellent book. 

Finally, if you must do organic, at least be informed.  

Good luck.  More later. 


M&M said...

I didn't read any books actually, I just bought recipe books and tried stuff out when I felt my girls were ready to be weaned. However, my friend The Poet bought a wonderful book by Annabel Karmel (well-known in the UK) called "Weaning" last year. She said it was fantastic in terms of advice and recipes.

Those fans of Gina Ford of course will probably buy her book, but as I am not one I didn't.

Anyway, I would say that those two would cater for opposite tastes in all things "baby" and would stand out as obvious UK books to buy.

AHLondon said...

Give me the Gina Ford basics. I've not read it, but from how I've heard it described, I don't think I'd be a fan. I've seen some of the Annabel Karmel products in the grocery store. I didn't know she had a book.