Spoon or No Spoon? Introducing Solids to your Breastfed Baby

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Katie Madden RN, BSN, IBCLC BalancedBreastfeeding.com katie@balancedbreastfeeding.com Spoon or No Spoon? Introducing Solids to your Breastfed Baby Growing with the Flow, 2014 1

Wow Can you believe it is time to start thinking about starting solids food already? You have done such an amazing job breastfeeding your baby. Although introducing solids is often referred to as weaning, it certainly isn t the end of breastfeeding You are about to embark upon a new phase in your baby s life where you get to have fun introducing her to all the tastes, smells and textures food has to offer her. Remember, this isn t rocket science Have fun and take lots of pictures Much love, Growing with the Flow, 2014 2

General notes about feeding your baby solids: Offer healthy food in age-appropriate portions at meals and snacks Let your child decide what and how much to eat Avoid foods that are heavily spiced, salted, buttered, or sweetened. These additions prevent your child from experiencing the natural taste of foods, and they may be harmful to his long-term good health. Offer water with meals in a sippy cup. It s ok if your baby actually drinks little to no water. This is just a great way to practice the skill. Growing with the Flow, 2014 3

GAGGING ISN T CHOKING If baby is coughing or crying, she isn t choking. Take a deep breath and just wait for her to move it out of her mouth. If baby is truly choking and you don t hear any coughing or crying, pull her out of her high chair and perform back blows Babies have a strong gag reflex, and for a good reason In order to accept solids, they need to learn how to manage and desensitize their gag reflex. Choking is when food occludes baby s airway and she can t breathe at all. Growing with the Flow, 2014 4

Bite-Sized Milestones: Signs of Solid Food Readiness It s not coincidental that many of the physical skills necessary to embark on solid food feeding are reached at right about the same time that babies can rise to the occasion. And just when breast milk or formula consumption often isn t enough to tide them over, their digestive systems become ready to take on the challenge of solid foods. When your baby learns to master the following mealtime milestones, she is likely to be ready, willing, and able to start out on her feeding adventure. Hold Her Head Up High. Although some babies are able to lift their heads in a show of strength from the day they are born, it s usually not until 3 or 4 months of age that the ability to hold one s head up consistently higher and for longer periods sets in. Sitting Pretty. Babies typically start sitting albeit initially with a fair bit of propping at about 6 months of age. Fortunately, several modern-day high chairs and feeding chairs come with convenient recline features that offer additional support for those not quite ready to sit fully upright on their own. Big Enough to Take It. As a rough rule of thumb, babies are big enough to tackle solid foods right around the time when they double their birth weight and reach a minimum of about 13 pounds. Open Wide. As babies become more aware of the world around them, they also tend to become more interested in food often watching food intently and opening their mouths in eager anticipation when they see some headed their way. Last Updated 3/26/2012 Source Food Fights, 2nd Edition (Copyright 2012 American Academy of Pediatrics) Which food should I give my baby first? For most babies it does not matter what the first solid foods are. By tradition, singlegrain cereals are usually introduced first. However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. Though many pediatricians will recommend starting vegetables before fruits, there is no evidence that your baby will develop a dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this. If your baby has been mostly breastfeeding, he may benefit from baby food made with meat, which contains more easily absorbed sources of iron and zinc that are needed by 4 to 6 months of age. Check with your child s doctor. Growing with the Flow, 2014 5

Baby cereals are available premixed in individual containers or dry, to which you can add breast milk, formula, or water. Whichever type of cereal you use, make sure that it is made for babies and iron-fortified. When can my baby try other food? Once your baby learns to eat one food, gradually give him other foods. Give your baby one new food at a time, and wait at least 2 to 3 days before starting another. After each new food, watch for any allergic reactions such as diarrhea, rash, or vomiting. If any of these occur, stop using the new food and consult with your child s doctor. Generally, meats and vegetables contain more nutrients per serving than fruits or cereals. Many pediatricians recommend against giving eggs and fish in the first year of life because of allergic reactions, but there is no evidence that introducing these nutrient-dense foods after 4 to 6 months of age determines whether your baby will be allergic to them. Within a few months of starting solid foods, your baby s daily diet should include a variety of foods each day that may include the following: Breast milk and/or formula Meats Cereal Vegetables Fruits Eggs Fish Iron Supplements Most babies are born with sufficient reserves of iron that will protect them from anemia. If your baby is breastfed, there is sufficient, well-absorbed iron to give her an adequate supply so that no additional supplement is necessary. When she is between about six months old, you should be starting your breastfed infant on baby foods that contain supplemental iron (cereals, meats, green vegetables), which should further guarantee sufficient iron for proper growth. When you add solid foods to your baby s diet, continue breastfeeding until at least 12 months. Last Updated 2/27/2012 Source Adapted from Caring for Your Baby and Young Child: Birth to Age Five (Copyright 2009 American Academy of Pediatrics) Growing with the Flow, 2014 6

Your Starting Solids Chart A great resource: http://wholesomebabyfood.momtastic.com/ 6-8 Months offer solids 2-3 times per day Cereals & Grains Date introduced Love it? Like it? Hate it? Reaction? Rice Barley Oats Fruits Avocado Apricots Apples Bananas Mangos Nectarines Peaches Pears Plums Prunes Pumpkin Veggies: Sweet Potato Growing with the Flow, 2014 7

Butternut squash carrots green beans Broccoli peas summer squash kale Protein Chicken Turkey Tofu Dairy Plain Whole Milk Yogurt 6-8 month Yummy Combinations Squashy Sweet Potato Blend acorn or butternut squash together with sweet potatoes Squashy Apple Sweet Potato Blend apples, acorn or butternut squash together with sweet potatoes Green Beans and Apples or Pears Blend green beans with apples and/or pears Apple Cereal Blend applesauce together with oatmeal or rice cereal Pumpkin Cereal Blend pumpkin puree together with oatmeal or rice cereal Growing with the Flow, 2014 8

Banana-'Cado Blend Avocado and Bananas for a great meal or add the blend to baby's cereal. Apple-Pear Sauce Blend Apples and Pears (yummy when both are cooked together.) Pumpkin Bananas Blend pumpkin puree together with bananas Pumpkin Bananas Applesauce Blend pumpkin puree together with bananas and applesauce 9-12 months offer solids 3-4 times per day Enjoy all the 6-8 month foods and ADD: Cereals & Grains Date introduced Love it? Like it? Hate it? Reaction? Flax Pasta Quinoa Wheat/ Wheat Germ Crackers/Bread Fruits Blueberries Cantaloupe Cherries Grapes (peeled and quartered Kiwi Veggies: Acorn Squash Growing with the Flow, 2014 9

Artichokes Asparagus Cauliflower Eggplant Zucchini Peppers Protein Beans Egg yolk Turkey Dairy Cheese Cottage Cheese Sour Cream 12-24 months 3-4 meals and 1-2 snacks per day as desired Growing with the Flow, 2014 10

Fun Recipes for Babies 8 months and older: Breakfast Ideas Banana Pancakes Bites Cereal Ingredients: Pancake batter Sliced Banana Simply take banana slices and dip them into pancake batter. Cook as you would regular pancakes, and serve Ingredients Any combination of grains o Oats, Quinoa, Barley, Rice, Kamut, Millet, Buckwheat Water, for cooking (usually two parts water to one part grain) It s a good idea to soak grains overnight before cooking so they are easier to digest. Another option is to blend the grains to a powder before cooking. Cook grains until very soft, and serve. Baked Apple Cereal Ingredients 1 apple Scrambled Eggs ¼ cup dry grains ¾ cup water Peel, core, and cut apple into small pieces. Place in a pan with ¼ grains and ¾ cup water. Bring mixture to a slow boil. Simmer covered, stirring frequently, until fully cooked. Mix in formula or breast milk as needed. Another option is to add a bit of cinnamon and ginger. Ingredients 1 egg Breast milk, formula, or cows milk Olive oil Mix egg and milk in a bowl. Heat olive oil in a skillet over low/medium heat. Pour in egg mixture and cook, stirring frequently, until eggs are fully cooked. Another option is to add veggies before cooking. Growing with the Flow, 2014 11

Grilled Cheese with meat or veggies 1 slice whole wheat bread Shredded cheddar cheese Lunch Ideas Mashed or pureed veggie (avocado, sweet potato, tomato, etc) Meat or tofu cut into small pieces (ham, chicken, turkey, etc) Make sandwich as usual (can cut slice of bread in half), except add meat or veggies with cheese before cooking. It does help to mash veggies on one side of the bread before cooking to help everything stick. Yogurt, fruit, and grains (cereal) Soup It is easy to make a quick soup by taking some of the grains (cereal), adding veggies (such as broccoli, peas, and carrots) and also adding some type of veggie puree (butternut squash or sweet potato). Then add veggie or chicken broth to desired consistency, heat, and serve Lentils, whole-wheat pasta, or brown rice with veggies or meat Peanut butter or almond butter sandwich on whole-wheat bread Smoothie Cookies Fresh or frozen fruit o o o o Banana, strawberry, blueberry, mango, etc Yogurt Almond or peanut butter (just a scoop or two) Orange juice (add to desired thickness) Blend ingredients together and serve (goes best in a straw sippy cup). This goes well with cereal or meat and veggies, or by itself for a snack. 1 cup Ground dry oats 1 overripe banana 1 teaspoon to 1 tablespoon oil, coconut oil, or almond or peanut butter o o Mix ingredients together and scoop with a cookie scoop onto a sheet pan. Bake at 350 for about 10 minutes, or until golden brown around the edges. Can serve with veggies or yogurt, or by themselves as a snack. Growing with the Flow, 2014 12

Baked Ziti Dinner Ideas Can serve as you would normally prepare, or a quick version here: Cooked pasta Yogurt Tomato sauce Cubed meat or tofu, if desired Mix together pasta, meat, and tomato sauce. Add a scoopful of yogurt, and serve Tofu, Chicken, or Fish Nuggest 16 oz tofu, fish, or chicken, cut into cubes ¼ cup flour 2 egg yolks 1 cup fine dry bread or cracker crumbs 1 teaspoon garlic powder 1 teaspoon paprika 1 dash of pepper Preheat oven to 350. Spread flour on a small plate. Beat yolks in a shallow dish. Mix remaining ingredients in a shallow dish. Coat each piece of tofu in the flour to cover, then into the egg, and then to the rack. Chilling will help everything set, but you can bake right away. Bake at 350 for 15-20 minutes until crisp. Can serve with dipping sauce, such as pureed sweet potato or peaches. Sweet Potato Fries (or other roasted veggie) Pizza 6 medium to large sweet potatoes olive oil, as needed Preheat oven to 400. Scrub sweet potatoes and peel them. Cut into small cubes or strips (you can always cut them smaller after baking). In a large bowl, add about ¼ cup of olive oil (you can also add cinnamon and/or ginger). Toss in sweet potatoes and coat them in the olive oil. Dump mixture onto a baking sheet and spread out potatoes into an even layer. Bake for 35-45 minutes or until tender. Slice of whole-wheat bread, tortilla, English muffin, bagel, or other bread Diced tomatoes Mozzarella Place tomatoes and mozz on bread and toast until cheese is melted. Teething Ideas Growing with the Flow, 2014 13

Frozen foods work best Teething biscuits (Because you re baby isn t eating anything) Berries or fruit (can put in a mesh feeder if uncomfortable giving frozen fruits) Peas or edamame Bagels or breads The cookies from the lunch menu 1 beaten egg (Optional) 3 tbsp maple syrup 1 tsp vanilla 1 ½ tbsp oil (coconut or olive) ¼ cup milk 1 tbsp dry oats 1 cup flour Blend wet ingredients, add dry ingredients. Dough will be stiff. Roll dough thin and cut into strips or desired shapes. Bake at 350 for 15 minutes on an ungreased cookie sheet. Also can freeze after baking to serve cold. If baby needs water with meals (constipation, etc) can offer a mild-brewed iced chamomile tea (be sure to speak with pediatrician before doing so) as some believe it helps with teething pain. Growing with the Flow, 2014 14