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Archive for November, 2009

Baby led weaning

I went to a seminar today by the Australian Breastfeeding Association which was about ‘baby led weaning’. I hadn’t heard of this until a friend told me about it, so I had a look online first and was intrigued.

The basic principle seems to be that rather than feeding the baby pureed food by spoon, that you allow the baby to experiment themselves with tastes and textures and eat when they are ready. So, they suggest that when the baby is ready for solids at around 6 months, you offer the baby a modified version of what you are eating and you all sit down together. The baby uses her hands to pick up pieces (cut into wedges/chips) and suck/bite them when she is ready. They say that developmentally, a baby who can pick up a certain size of food can eat it, and that there is less risk of choking than when we ‘force’ food into their mouths by tricking  them. They showed videos of babies eating florets of brocolli  – shoving it into their mouths!

As a child psychiatrist, I have worked on a team for children with feeding difficulties, usually children who have had aversive experiences with food due to medical issues. One of the main things I would recommend to these families is giving the child control, and allowing them to have small successes to build on rather than pushing food on them and ending up in a battle.

I believe strongly in baby led play (again, something I would teach at work) and baby led routines rather than routines being forced on babies to suit parents’ lifestyles (as suggested by at least one popular parenting book). So this intutively makes sense to me. When in doubt, I always think of the bigger view around the world, or through the ages. Have babies always had rice cereal fortified with iron? No. And do children around the world have their food pureed? No. Babies are pretty well designed to tell us what they need and like and we should allow our child to experiment and experience success and failure until she finds what suits her.

 

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When to start baby on solids

I am amazed at the huge amount of – often conflicting – advice about starting food, as well as most other baby issues. Most advice (including from the Australian Breastfeeding Association and most paediatricians) is that babies don’t need anything other than breastmilk until about six months. The reason for this is that around this time, the baby’s iron stores are becoming depleted and they need the extra nutrients that food can give them.

There is also a lot of talk about the early introduction of solids being associated with food allergies and atopic conditions (asthma, hayfever, eczema). I had a look on the net for the evidence of this (being a good evidence based practitioner!) and struggled to find much. There was, however, an article published in Pediatrics in 2008 (PEDIATRICS Vol. 121 No. 1 January 2008, pp. e44-e52) which looked at over 2000 kids from a birth cohort study, and found that there was no evidence that introduction of solids before 4-6 months was associated with food allergies, asthma or allergic rhinitis. They found that food allergies were actually more common in children who had been started on solids after six months. The results for eczema were conflicting and the authors say that there is a possibilty that eczema is more common in those given foods under 4 months.

I think that parents are often tempted to start solids due to excitement and impatience. Of course, this is completely the wrong reason to start them and we need to follow our baby’s cues as to when she is ready.

 

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