Hellobee

My husband and I couldn’t reach a mutually agreed upon common ground in solids because I wanted to do no purees; I thought it would work against her wanting to pick up food for herself when she saw how much easier the spoon was. He, on the other hand, was very concerned about the possibility of choking. My husband’s hesitation with baby led weaning, in addition to his fear of choking, was that it seemed all too anecdotal; we were relying on some very gung-ho attitudes of internet moms. I do agree with him, that in the baby community, there are a lot of opinions that are very strongly held to be right and wrong, to the eye of the beholder.

My doctor told me to read up on BLW and we would discuss it at our 6 month appointment, and when I had, she admitted that Winter would be the first baby in her 10 years of practice to do BLW. To the end of safety, we brushed up on our infant choking with a first aid DVD I had kicking around from my days as a CPR instructor, and we bought a bottle of liquid Benadryl in the event of an allergic reaction.

There is a largely UK-based online community about baby led weaning, with a website and forums for information. I borrowed the Baby Led Weaning book from the library, and while it was nowhere near as unbiased as this journal article and probably wouldn’t single-handedly convince my husband, it was a good start for me. There’s a sizable preview of the book here, and I’ll highlight what I found interesting below.

There is something called the “International Code of Marketing of Breast-milk Substitutes,” which restricts the promotion of any food or drinks for babies under 6 months old. In Canada and the UK it is a voluntary code, and other countries have even gone so far as to adopt it as part of their law. However, the US has not adopted it in any form, so manufacturers are able to label their products as “suitable from four months” whereas such marketing would not occur in many other countries. So while the American Academy of Pediatrics currently recommends that babies be exclusively breastfed for about the first 6 months of life, there are many foods commercially available for babies younger than this.

The AAP used to recommend starting solids as early as 4 months, and if this was still the case, then purees would make perfect sense to me. But at 6 months, I felt like my daughter would be more than capable of feeding herself. The underlying tune of BLW, although never stated explicitly in the book, is allowing your child autonomy. BLW will perhaps best enable my child to do what Ellen Sattyr in Child of Mine: Feeding with Love and Good Sense promotes as a healthy approach to food: letting your child decide if and how much she wants to eat. Allowing my daughter to experience foods in their original form and texture is something I value. Babies who feed themselves also benefit from improved hand eye coordination and dexterity, which, I was excited to read, and may help with writing and drawing skills later. Chewing food also helps develop facial muscles for talking.

NUTRITIONAL VALUE

In medicine, liquids get into your system faster than tablets which have to be broken down in the GI tract. The book suggests that food that has been chewed versus pureed has the benefit of being exposed to the enzyme amylase in the mouth for longer, which helps to digest starchy foods. Pureed food is usually sucked off the spoon with little time in the mouth to expose it to amylase.

I did worry that she wouldn’t be ingesting as much food as her little comrades who were doing purees, but I’m a believer of the mantra that food before one is just for fun. The book attempts to allay such fears by pointing out that ideas about amounts are based on pureed food, which are often mixed with water or milk for consistency and makes purees look like more than than they really are. (To that end I wonder if purees would lead to less constipation than whole foods because purees do have the additional liquid that my chunks of avocado do not).

The author asserts “most people’s ideas about the amounts babies should eat are not realistic and are a relic from days when mothers wanted to produce the fattest baby around because chubby meant healthy.”

The key in BLW is offering a variety. Apparently it’s a very North American trend to eat the same thing for breakfast day in and day out. I am very guilty – I’ve been eating cereal every morning for as long as I can remember.

SALT, SUGAR AND BRAN

I loved the idea of not fussing with purees and not worrying about cleaning out a blender. I had been steaming sticks of vegetables alongside foods I made for myself for the first few weeks when I realized that I wasn’t reaping the full benefits of BLW – cooking something for me and my husband that our baby could eat – one meal and done. So I set out to make something other than the rabbit diet I had been feeding my child.

I like to make home-cooked meals, and I very rarely add salt during cooking, but I didn’t realize how much I rely on canned and bottled sauces and bases, especially for crock pot recipes. I always use some sort of liquid base that isn’t water. I had wanted to finish eating all the canned foods in my cupboard to minimize the BPA in our diet, but I realized what was worse than mystery amounts of BPA were clearly labeled amounts of sodium. There was sodium in my Costco organic canned tomatoes, tetra pack broths, curry pastes…

I realize that a few slivers of meat and veggies cooked in any of these options won’t throw her salt intake off the charts, but in a few months I think she’ll be gobbling down a fair sized portion of food and I’d like to get in the habit of cooking with minimal salt. It sounds like I’m overthinking it, but since I spend time cooking anyway, I would love to use real, whole foods, like fresh tomatoes instead of canned.

Store bought sauces, stocks, and canned items are usually high in salt. Babies up to a year should have no more than 1 gram of salt per day. Sometimes salt content is disguised as sodium; 1 gram of salt is equivalent to 0.4g of sodium, so when reading labels, you would multiply the sodium by 2.5 to reveal the amount of salt in a serving. Cheese can contain over 1 gram of salt per 100 grams, and some breads can have 1 gram in just a couple slices. A food is “high in salt” if it has more than 1.5 grams of salt (0.6 grams sodium) per 100 grams, and a low salt food has less than 0.3 grams of salt per 100 grams.

The book goes on to say that raw bran and bran products often found in “high fiber cereal” like All Bran and some muesli, while often encouraged for adults, aren’t ideal for babies. Bran can irritate the digestive tract and interfere with absorption of nutrients like calcium and iron. They are also very filling and are not nutrient- and calorie-dense.

SAFETY

Young babies have a “tongue thrust” reflex which pushes out anything but the breast or bottle from their mouth. Early spoon feeding goes up against this reflex, which just starts to fade from about 4 months of age, so when people say the baby needs to get used to the spoon, it’s simply just the reflex fading.

I tried to convey to my husband that gagging will happen, but gagging is different than choking. Gagging is

“a retching movement that pushes food away from the airway if it is too big to be swallowed. The baby opens his mouth and pushes his tongue forward; sometimes a piece of food appears at the front of his mouth and he may even vomit a little.”

It passes quickly and the baby continues eating as if nothing had happened. In adults the gag reflex is triggered at the back of the tongue, but it is triggered much farther forward in a 6 month old baby. In this sense, it is activated more easily in a baby, and is activated when the piece of food is much farther from the actual airway. A baby who can trigger this reflex with feeding herself will learn not to do it. Older babies don’t exhibit as much gagging because the reflex has moved toward the back of the tongue by then, but if they haven’t had a chance to experience gagging earlier, this farther back position is less effective as an early warning sign in keeping food away from their airway.

I didn’t experience a lot of gagging with Winter when we started at 6 months. In the first few weeks a lot of what went into her mouth came straight out again, but not from gagging. She has had a couple bouts of coughing to get the food out of her mouth, one of which was unfortunately at my parents’ house and they already had serious misgivings about my approach to solids.

To allow for gagging to act as a safety mechanism to prevent choking, babies need to be upright to easily push the food out of their mouth. In a reclined position, gravity can send the food farther to the back of the mouth before the baby is ready to swallow it.

A baby’s gut isn’t developed enough to digest solid foods at 4 months of age and earlier, and mirroring this, they are very unlikely to be able to pick up foods themselves and get it to their mouth. In a similar way, at 6 months, the baby does not have the pincer grasp to be able to pick up small items like raisins and peas, which coincides with the fact that the baby’s tongue isn’t ready to deal with these items in the mouth. Now at 8 months I realized that her constantly grabbing at our noses and chins meant her pincer grasp was developing, so I realized now she can pick up peas off her tray. The book says that at nine months, they are able to pick up small pieces like raisins and peas, and will be able to dip foods. Some foods are just choking hazards, so grapes and small tomatoes should be cut in half, and nuts are a big choking hazard until at least 3 years of age.

A friend of mine who started with purees and has been moving onto whole foods lately. She gave him a small stick of carrot for dinner. Afterward they had a bath, read a book, and when she was putting on his PJs and fresh diaper 45 minutes after dinner, she found the carrot, still intact in his cheek! So watch for any food that has been squirreled away.

HOW TO BEGIN

Babies at 6 months will use their palmar grasp to pick up food, so it’s important to have the food in a stick-like shape, with enough length to hold and protrude out (think between the size of a McDonald’s french fry and a McCain french fry). I thought a great tip was that skin makes fruits and vegetables easy to hold – apples, pears, avocados mangoes, potatoes, bananas. The first stick of food I gave her was an avocado, but it was way too slippery. I gave her strips of bananas with the peel still attached, and inevitably the peel would dissociate from the banana and she would be left happily chewing on the peel. I realize that in many fruits and vegetables the skin often has great nutrients, bananas, I don’t know. They suggest crinkle cutters to give a little more texture to grip on to, and roasting, which gives the outside a firmer coating that is easier to grip. I found it saved time to boil or steam first, and then roast, otherwise it took a long time in the oven for foods to soften. Also beware, things like carrots, sweet potatoes, and parsnips shrink considerably when roasted.

Examples of good starting foods (ie easy to pick up and to gnaw; in BLW there are no set “first foods,” everything short of a choking hazard is fair game):

• sticks of raw cucumber
• steamed green beans, baby corn, sugar snap peas
• steamed cauliflower or broccoli
• steamed, roasted or stir fried vegetable sticks: carrot, potato, sweet potato, parsnip, pumpkin, zucchini
• thick slices of avocado
• chicken – a strip (divided along the fibers) or on a leg bone with splint bones and gristle removed
• thin strips of beef, lamb or pork cut across the fibers instead of along
• fruit: pear apple, banana, peach, nectarine, mango – whole or in sticks
• sticks of firm cheese such as cheddar or gloucester
• toasted breadsticks
• rice cakes or toast fingers – on their own or with a homemade spread like hummus and tomato or cottage cheese

Dips:

• hummus
• guacamole
• mixed bean dip
• red pepper and butter bean
• dhal
• baba ganoush

OTHER THOUGHTS

Enjoy the time to eat a meal yourself, which establishes a routine for shared family meals. The book says to not be distracting while eating so they can concentrate on eating; don’t make a big fuss if the baby eats, doesn’t eat, something falls on the ground, or if food goes into the mouth and actually gets swallowed. I’m looking forward to summertime when BLW will lend itself well to picnics, and I’ll devote a later post to some of the foods I’ve tried out.

What are your thoughts on baby led weaning?

Eating, one day shy of six months