Did you know there are things you may be doing, most likely without knowing it, that could lead to your baby developing a negative association with eating food?
5 mistakes I see parents make that could lead to the development of feeding aversion. Babies can have a feeding aversion towards taking breastmilk, formula or food. My definition of feeding aversion is that, a baby who is physically capable of feeding or eating – so this means the child doesn’t have a medical or developmental reason that affects the ability to eat solids – but shows partial or full refusal of food. An aversion is the avoidance of a thing or situation that the baby associates to be an unpleasant, stressful or painful stimulus. Keep in mind that when we’re starting solids we’re laying the foundation for the baby’s eating patterns, and their perception of food and the feeding experience. Therefore we want to create a positive association with eating and give babies an opportunity to start learning how to listen to their hunger and fullness cues. With most of the things I’m going to mention, a lot of parents do at least one of them, but they don’t realize that it’s causing the baby to have a negative experience and can potentially lead to the development of feeding aversion. I’m going to make you aware of the things you should not do when giving your baby food, but what you can do to correct it, so your baby has a positive feeding experience instead.
The first thing that you should not do, is start solids too early.
And by this I mean introducing the baby to food when the baby is not developmentally ready to start solids. And of course I encourage you to follow the guidelines that are recommended in your country. The concerning trend that I have been seeing, at least in the US, is that many parents are advised to start their baby on solids as early as 4 months, even though the American Academy of Pediatrics recommends that solids be started around 6 months. There are certain developmental signs that the baby should be showing that indicate a readiness to safely start taking solids. And by 6 months of age is typically when most babies show all of these developmental signs.
Signs that the baby is ready to eat solid:
- the baby should be able to sit upright with little to no support.
- the baby needs to have good head control.
- the baby should no longer have the tongue thrust reflex, which is also known as the tongue protrusion reflex.
- the baby needs to be showing an interest in food.
- and the baby should be reaching for and grasping objects and bringing them to the mouth.
It’s not until around 6 months that most babies will be showing all of these signs. So what’s the big deal if you start giving the baby food too early? Not only can starting too early cause the baby to have digestive upset, but for some babies it can be a negative and frustrating experience when they’re truly not prepared. Also starting solids before a baby is developmentally ready increases the likelihood for gagging and choking episodes to happen. These make for very unpleasant mealtime experiences that can lead to the baby developing a negative association with eating solids. So if you’ve started solids and are realizing that you started too early, and your baby is not developmentally ready for it, then stop giving the food and go back to solely giving breastmilk or formula until your baby is showing all the signs of readiness to take food. And if your baby was born premature or has other underlying medical conditions, you might need to wait a little longer before your baby is ready for solids.
The second thing that can lead to the baby developing feeding aversion is spoon feeding incorrectly.
Did you know that there’s a right and a wrong way to spoon feed? I’ve noticed that many parents place the spoon towards the top of the baby’s mouth and at an angle. And then they scrape the food off the upper lip or gums so it comes off the spoon. Scraping food off a spoon is not the normal, natural way for a baby to eat. And offering the spoon at an angle causes the baby’s head to be tilted up and back, which is not a good position to facilitate a safe and comfortable swallow. If you think about the position of your head when you’re eating, it’s typically in a neutral or slightly downward and forward position instead of being up and back. It’s definitely easier to swallow when the head is in the neutral position or a little down and forward. Instead of dumping the food into the baby’s mouth by scraping it off the top lip or gums, we want the baby to learn to suck the food off the spoon. Babies develop better lip control and movement by actively being involved in removing the puree off the spoon. Also spoon feeding correctly helps position the baby’s tongue in the proper place to push food back towards the throat to swallow.
So here are the steps you can take to ensure that you’re spoon feeding correctly.
- You should be sitting instead of standing when feeding the baby. While standing, you will have the tendency to offer the spoon at an angle, and the position of your baby’s head will be up and back in order to be able to look at you. This makes it more difficult to swallow comfortably.
- Start with just the tip of the spoon dipped in the puree. Then gradually work up to offering a spoonful. Hold the spoon several inches in front of your baby’s face, parallel to the feeding tray, instead of at an angle. Wait for the baby to notice the spoon and open the mouth. Gently place the spoon on top of the tongue and hold it there until the baby closes the lips around the spoon. Then remove it straight back out of the mouth. This allows the baby to suck the puree off the spoon while you are bringing it straight out of the mouth.
- Give your baby time to move the puree back and swallow. This typically takes a second or two. When you’re just starting solids, the baby may push some of the food back out and then swallow. With time, this forward/backward motion will begin to fade and the baby will start to swallow more food.
The third thing you should not do is force the spoon into the baby’s mouth or have battles over the spoon with your baby.
Some well-meaning parents, out of loving concern for their baby’s physical wellbeing, start to pressure, force or trick the baby to eat. They hate doing it, but keep forcing the food into the baby’s mouth because they worry that the baby will not gain enough weight or will become unwell if they don’t get the baby to eat what they believe is the amount of food the baby should be eating. However when babies are pressured or forced to eat, it becomes an unpleasant or stressful feeding experience. When repeated, the baby can develop an aversion to feeding. This sets up a vicious cycle. Due to developing a feeding aversion, the baby will fuss or refuse to feed, which in turn stresses the parents out and makes them feel compelled to force the baby to feed. By doing this, they are unknowingly reinforcing their baby’s feeding aversion.
Another thing that I see is that some babies grab for the spoon, and want to be in charge of guiding it into their mouths, especially as they get older. Or they want to keep holding onto the spoon after it’s removed from the mouth. Some parents end up getting into a tug-of-war with the baby over the spoon so they can continue to put puree onto the spoon to feed the baby. But this can cause the baby to develop a negative association with eating. I know that most parents are very nervous when it comes to feeding their baby solids and find it difficult to figure out how much to offer. Wouldn’t it just be easier if the baby would say, “I’m done, I don’t want to eat anymore?” Fortunately even before they can speak, babies do show cues as their way of communicating. When the baby refuses to open the mouth to take more food, turns away from the spoon, loses interest in continuing to eat, or starts becoming very fussy during the meal, those are signs that the baby is done and we should not try to make the baby eat more. Babies need to develop an awareness and learn to trust their fullness cues. Something I find helps parents keep it in perspective is knowing that the baby will most likely only take a few teaspoons at each meal in the first weeks of starting solids. Breastmilk or formula will continue to be the baby’s primary source of nutrition and solids will just be complementary. For most babies it’s not until 8 or 9 months that they really start taking to solids.
Babies need to learn how to safely take and swallow food first before they increase the amount of solids they take. Ultimately we want babies to grow up to be independent eaters, so from day one, we should let them be the ones in control of how much or little they eat at each meal. As far as how to respond when the baby grabs the spoon, this is a sign of progression in the baby’s development and should be encouraged and celebrated. I recommend getting short handled baby self-feeding spoons, such as the Tiny Spoons from ezpz. You can put puree onto the spoon and lay it onto the tray close to your child to pick-up or hand it to your baby to self-feed. The great thing is that the ezpz spoons come as a 2 pack. So while your baby is eating puree off of one spoon, you can preload the other spoon and have it ready to go.
The fourth thing you should not do is scrape or wipe food off the baby’s face during the meal.
Obviously after the feeding session is over, you need to clean the baby, so then it’s fine for you to wash or wipe the baby up. From my experience, most babies get very fussy and upset when their faces are wiped. The process of learning to eat is going to be a messy one. It’s all part of the experience. When we scrape food off the baby’s face with the spoon or wipe the face in between bites, we end up creating negative sensory experiences during the meal. So I encourage you to let your baby get messy. Put a bib on and cover the floor with a splash mat to make clean-up easier, but hold off on cleaning your child until the end of the meal.
The fifth thing that you should not do is stay on purees for too long.
Pureed food feels safe for parents who worry about the baby choking on regular foods. As a result, some parents continue to offer only pureed foods to their child for much longer than necessary. Babies become familiar with taking their feeds as smooth purees, and have more difficulty accepting different textures as they get older. A research study found that babies who were not introduced to other textures besides purees by 9 months, had significantly more feeding problems and limited diets as they got older. We find that babies who experience more textures and flavors early on, are less likely to be picky eaters. Babies aren’t meant to be on pureed food for life. The goal of weaning from breastmilk or formula is to transition them to eat real food that the rest of the family is eating. Of course this happens as a progression over several months. But after a week or two of your baby taking smooth puree with ease, there is no reason why you can’t transition to offering a more lumpy texture of puree and finger foods. By 6 months, most babies are able to grab and bring things to the mouth. Therefore there is no reason to doubt their ability to self-feed strips of food starting as early as 6 months. This will allow for exposure to a greater variety of textures. The safe size of finger food to offer a baby who is 6 to about 8 to 9 months of age is as a strip that is about the thickness of an adult pinky finger. And once the baby develops the pincer grasp, which is the ability to pick things up using the tip of the thumb and index finger, you can offer smaller pieces of food.
Did you know that babies are no more likely to choke on finger foods than purees? A study published in the journal Pediatrics confirmed this to be the case as long as certain safety guidelines were followed.