Starting Solids at Six Months - A Fun New Adventure

The past week or so has been filled with lots of new tastes and textures for Evelyn as we've been introducing her to solid foods.  We have really enjoyed watching her learn about and experience meal times and it is helping us to start some healthy family traditions.

Evie started eating solid foods a few days before she reached six months of age (mainly because Craig wanted to be home to see it happen, and he was off work for a couple days recovering from his planned appendectomy).

We decided to try an approach termed "Baby-Led Weaning" (BLW) for introducing solid foods.  This is not a really new approach and lots of parents will be familiar with it, but I've also received lots of questions about it, so I thought I'd provide a bit of a description on the blog.  I want to preface this post by saying that I have nothing against first introducing a baby to infant cereals and purees - this is just the approach we decided to use and like many decisions in parenting, there are lots of methods that will work just fine and every parent knows what is the right choice for their family.

Quite simply, I would describe BLW as allowing your baby to herself a variety of healthy foods from the family meal right from the start.  "Weaning" in the name just refers to the fact that they are starting to complement their milk feeds with other foods (e.g. breast milk is still the primary source of nutrition at this point).

Craig and I both read the book Baby-Led Weaning by Rapley and Murkett to obtain a basic understanding of BLW.  It describes what BLW looks like quite well:

• The baby sits with the family at meal time, and joins when she is ready
• She is encouraged to explore food as soon as she is interested by picking it up with her hands - it doesn't matter whether she manages to eat any at first
• Food is offered in pieces that are the size and shape that the baby can handle easily, rather than as purees or mashed food
• The baby feeds herself from the start rather than being spoon fed by someone else
• It's up to the baby how much food she eats and how quickly she widens the range of foods she enjoys
• The baby continues with milk feedings on demand and she decides when she is ready to reduce them.

This approach appealed to me for a few reasons.  First, I think it allows a baby to continue regulating their own food intake (which happens in breastfeeding) and staying in tune with their internal hunger and satiety signals.  When Evie is breastfeeding, I have no idea how much she is getting - she decides that on her own and I'm not measuring how many ounces she's eating each day.  By feeding herself solid foods, she can continue this habit.  In a world where our eating habits are often influenced by external cues (e.g. stress, people around us, marketing, portion sizes etc.), I don't think it hurts to try and develop good hunger/satiety regulation.

Second, I find it to be consistent with recommendations about the feeding relationship between parents and children.  Most notable in this area is the work of Ellyn Satter, who describes the appropriate Division of Responsibility in Feeding in her Feeding Dynanics Model:

• The parent is responsible for what type of food is served, and when and where it is served
• The child is responsible for choosing whether to eat and how much to eat.  In BLW, the baby takes on this role right from the beginning. 

I also considered the recently updated Infant Feeding Guidelines in Canada (joint recommendations released in April 2014 from Health Canada, the Canadian Pediatric Society, Dietitians of Canada, and the Canadian Breastfeeding Committee). I didn't find these guidelines to conflict with the BLW approach, and compared to previous guidelines they are a little closer to BLW in my mind.  A few of the key recommendations from the Canadian Guidelines include:

• Exclusive breastfeeding until 6 months of age, at which point solids can be introduced to complement regular breastfeeding (same as BLW) 
• Ensuring that iron-rich foods and/or commercial infant cereal (which is fortified with iron) are offered frequently as iron is a nutrient that babies need more of starting at 6-months (compatible with BLW).  
• Iron-rich foods are recommended as first foods for babies, but after that the guidelines state that a variety of nutritious foods from family meals can be offered.   There is no recommendation to start with one food at a time, wait a few days between new foods, or go in a certain order (e.g. start with a single grain cereal, then introduce vegetables, etc).  These practices were more based on tradition than evidence it turns out.  On an individual level, if there is a family history of allergies or intolerances, this recommendation might be changed by a physician, but this wasn't a concern for us.
• Lumpy textures should be introduced no later than 9 months according to the guidelines (BLW is even earlier) - this helps to teach babies good chewing skills and move beyond sucking/swallowing off a spoon
• Avoid choking hazards (hard, small round foods, sticky foods) - same recommendation in BLW
• Encourage responsive feedings based on the child's hunger and satiety cues, offer finger foods to encourage self-feeding, and encourage use of an open cup (initially with help) - again, these recommendations are consistent with BLW.

So....those were the main things I considered before starting solids (can you see the dietitian side of me coming out?)

We didn't really know what to expect with Evie's first few meals - The BLW book explains that babies likely won't eat a whole lot in the first few weeks, so we were prepared for that.  Evie actually did much better than we thought.  Most babies this age are capable of picking things up and bringing them to their mouths, so Evie seemed to apply those skills well at meal time.  She spits out the majority of the food she bites off, but she will take a bite and chew for a while.  It was pretty neat to see her bite and chew (even though she has no sign of teeth yet).  She will chew for a while and then spit out most of the food down her bib--this is normal, and protects the baby from choking (they don't yet have the ability to use their tongue to move large pieces of food to the back of their mouth, so as long as they are sitting upright the choking risk is minimal and only little pieces make it to the back of the mouth).  

As you can imagine, this approach is very messy and there is quite a bit of waste at the beginning but even in the last week I've seen Evie's skills improving.  She is better able to grasp food and pass it between her two hands and I can tell that she is eating a decent amount from what's coming out the other end (never thought I'd say that I miss those breast milk poops!).  The dogs love the mess though - Hudson is like a little vacuum cleaner under her high chair (though our side project is re-training them not to beg at the table).

We have tried a lot of new foods over the past week, which has been fun to watch.  At each meal, I generally try to include a good source of iron, make sure the foods are low in salt and sugar, and that there are 3-4 different foods offered.  I've used infant cereal in different baked goods, as it is a really high source of iron but the cereal itself isn't conducive to self feeding (BC government has some good recipes that use iron-fortified cereal).  In general she does well at meals, but I've found she isn't a big fan of breakfast (she often just sits there and doesn't pick anything up), but that's okay - I just have to not take it personally when she chooses not to eat my cooking!

Some examples of foods we've tried over the past week (we've yet to find anything she disliked):

• Iron sources: black bean fingers (patties formed into finger shapes), infant cereal biscuits, pancakes made with infant cereal, chicken drumstick, steak (she really loved the steak - a true Albertan), eggs, beef meatballs (hers were formed into finger shapes)
• Veggies: Cucumber, stir fried red pepper, roasted carrots, parsnips and sweet potatoes, broccoli
• Fruits: Oranges (she loved these), pears, banana (still hasn't managed to eat much banana because it's so slippery), kiwi, canteloupe, watermelon
• Grain products: Plain rice cakes spread with avocado, pasta noodles, toast with peanut butter (very thinly spread to avoid choking risks), French toast, Naan
• Dairy : Cheese, whole milk yogurt (we let her use the spoon to feed herself...very messy)
• Meats: Salmon cakes, butter chicken (we just gave her a little because it is higher sodium, but she didn't mind the spices)

The hardest rules of BLW to follow are not helping Evie out (we are supposed to let her figure out how to get the food from her tray to her mouth on her own) and not making her the centre of attention at meal time (the baby is supposed to be treated just as another member of the family at the table, and you aren't supposed to focus on them too much or pressure them to eat).  We have definitely broken these a few times, particularly the second one - it's really hard not to focus on watching her eat and taking pictures/videos as it's so entertaining, but we are getting better at just carrying on with normal dinner conversation.

Starting Evie on solids is also having a positive influence on our eating habits as a family.  I am being forced to always plan meals that are balanced and healthy (I've always tried to do this, but a baby is good motivation to do it all the time) and we are also eating all our meals together as a family (well, just Evie and I during the day).  It's definitely a change for us to start eating dinner at 5:30, but I think it will be good in the long run.  I want Evie (and any future kids we may have) to be used to eating meals together as a family whenever possible. 

I'll share a few pictures and videos now to show you Evie in action.

Banana French toast and pears

Carrots, parsnips, rice cake with avocado, salmon cakes with dill and lemon

Kiwi, cucumber, avocado and bean fingers

 Chicken drumstick, cheese, cucumber

Hudson really wants this drumstick....I think it kills him that Evie eats so slowly

Eating her bean finger (she really liked these - good thing because a can of beans makes a lot of fingers so they were reheated in the oven a lot)

Sucking on a strip of steak (She'll still benefit from iron in the juices of the meat, while getting used to the texture at the same time)

Evie seems much older now that she is eating (seems like such an adult skill).  So far though, this has been one of the stages I've enjoyed the most as a parent.  It's so neat to watch her pick up food and examine it visually and with her hands, and then her mouth (she has some pretty priceless faces).  Hopefully her skills continue to improve and more food makes it into her mouth and less on the floor!