When I think back on experiences I shared with my family during childhood, some of those special memories involved cooking together, baking together and sitting down and sharing a meal together. Whether it was at my grandmother's home on Friday night, at a favorite family restaurant or on a picnic blanket at the park, I loved being able to share the experience together. Now as an adult, I feel a sense of nostalgia when I smell or taste my grandmother's South African curry.
As the olfactory and oral sensory systems are so closely linked with the amygdala and hippocampus (parts of the brain where we process and store memories), it's natural that certain smells and tastes would trigger particular memories.
So when our kids are exploring new foods and flavors, not only are they learning and exploring, but they are developing memories as well.
As memories can form strong associations, it is important that early memories of food and eating are positive ones.
Being present with your little one during the early days of starting solid foods can be a great deal of fun, but like any new parenting adventure and baby milestone, there are so many unknowns.
One of the most common questions I get asked is:
When should I start solids with my child?
The most important factor to consider is looking out for the signs that your baby is ready.
Readiness Signs:
Good head and neck control
Able to sit with minimal to no support
Visually interested and attentive to food and people eating
Reaching out for food
Able to bring hands to mouth
A baby that has good head, neck and trunk control will be able to sustain a more upright position and can better stabilize the structures involved in swallowing. Solid strength and control in sitting will also allow a baby to focus on establishing oral motor and fine motor skills without expending all of their energy on sitting or holding their head up.
Most babies will show these readiness signs around 6 months of age. Some may be a couple weeks early, some may need more time.
If you have a child with neuromuscular involvement and challenges with head, neck and trunk control, they may be able to eat solids safely with adaptations. If your child presents with neuromuscular involvement, reach out to your local provider trained and certified in swallowing assessment and intervention to support you in making appropriate modifications.
BLW or Purees?
Some parents may choose to introduce solids to their baby using blended or pureed foods and others may jump in with table foods using a baby-led-weaning (BLW) approach straight away. Know that both approaches are safe options and that they don't have to be exclusive.
As adults we consume liquids, purees and textured table foods; so offering all of the above mentioned should be fair game for our babies as well. I do encourage my families that opt to start with purees to avoid staying exclusively on purees for too long. Infants that stay on purees for too long are more likely to have refusal and difficulty transitioning to table foods.
With that in mind, offering opportunities for your child to self-feed as much as possible is preferred for three reasons:
Oral motor skill development
A positive relationship with food and eating is far more likely when the child is able to dictate their own feeding preferences independently and without pressure
Significantly decreased risk of choking and aspiration with self-feeding
Tips for preparing and presenting food using a BLW approach:
If you do elect to engage in a baby-led-weaning approach with your little one, larger pieces of food are ideal when starting out. Large pieces of food allow for easy gripping and allows baby to take a self-guided bite-size amount rather than what we (as the adult) may think would be bite-size for our infant. Cutting and shaping foods into long sticks is supportive of oral motor development and also allows baby to easily maintain their grip and pull the food out as needed.
It is recommended to avoid round or coin shapes foods (e.g. whole grapes, cut up hot dogs) as well as raw veggies and hard fruits when your infant is young and still learning to chew textured foods. It is also recommended to avoid foods that require maximum strength and endurance to break down (e.g. nuts, raw carrots, etc.).
Before 1 year of age, an infant's digestive system is not sufficiently developed and they should not be given honey. After 1 year of age, it is fine to give your baby honey, unless directed otherwise by your pediatrician.
How should I support my child when introducing a new food?
Presenting your infant with food on the table or high-chair tray and supervising with space is the first step.
Allowing them to control the size of each bite, when to spit out, and when to release the food back down and take a break is key in creating a safe and positive feeding environment.
Modeling and allowing your child to observe you and any other family members enjoying a meal at the table while exaggerating movements of the jaw, tongue and lips is a great way to teach oral motor skills while enjoying social aspects of the meal.
Mirrors at the table can be great visual tools as well.
Finally, embracing mess at the table can support feeding in so many ways. Remember, food play with the hands preps the nervous system for oral sensory input to come.
My baby keeps spitting out the food, does she not like the food I'm offering?
Okay so, you and your significant other are getting ready for your baby's first solids encounter. You have the food prepared, you know tonight's the the night. So excited to experience this milestone together!! And.............they spit it out. Well, I'm here to share that this is completely normal and to be expected in the beginning.
Babies have a tongue thrust reflex. The function of this reflex is to expel food from the mouth that is unwanted or feels too large or difficult to break down with the skills that baby has right now. When a baby tries solid food for the first time, even blended or pureed food, the sensory experience of free-floating particles in the mouth is completely different than what they have become accustomed to with breast or bottle feeding, and can be overwhelming at first. They may make a funny face, their tongue thrust reflex may kick in, and their gag reflex may kick in as well. This is completely normal as babies work through this new experience. They are curious to explore, but protecting their airway is still very reflexive and priority #1 for the first few exposures. As they get more practiced with solid foods, we tend to see the gag and tongue thrust reflexes diminish.
With that said, If you are not seeing the gag reflex and tongue thrust reduced after your child has had repeated exposure and opportunities with solids and if you are seeing your infant spit out food along with refusal, turning away, clamping their lips closed and this is persisting for longer than a few weeks, reach out to your local provider trained in assessing and treating pediatric feeding disorders.
Gagging vs. Choking:
Gagging is a reflex present at birth on the first 1/3 of the tongue, which moves back after 3 months of age with oral stimulation through breast or bottle feeding. We see this reflex more easily triggered again at the start of the transition to solids. As a child gets more exposure and practice with solid foods, the gag reflex fades, but remains present for the function of blocking off the airway if a piece of food that is too large or has not been fully broken down, travels too far back into the mouth. If your child gags 1-2x, a food particle comes out, and they return to normal breathing, then they have managed and are not choking.
Choking may look like a child repeatedly attempting to expel a piece of food from their oral cavity and not having success, turning blue, unable to breath, speak or cry. In this instance, calmly remove your child from their seating, position them belly facing the floor over your lap with the head lower than their hips and deliver 3-5 hard blows to the back.
****I strongly urge all parents that I work and speak with to take a basic CPR course for infants and children prior to introducing solids so that they will be prepared to calmly handle incidents that could come up.
*****I also strongly encourage parents to hold strict boundaries about remaining seated while eating. When children are moving around the likelihood of choking or aspirating is much higher. The body requires stability for safe swallowing. This is why good head and neck control is such an important readiness factor to consider before introducing solid foods.
It can feel overwhelming at times to be wondering if your approach to feeding your child is the "right" way or if you should be doing things differently, but remember that you got this!! How you feed your baby is how your feed your baby; there is no right way.
Keeping things positive, being present together during mealtime and removing pressures of all kind will allow your child to learn to listen to their body and develop a long-lasting healthy relationship with food.
As always, if you have concerns or just want more support, there is help available and it's okay to ask:)