Common Questions About Feeding Young Children

 

By Howard J. Bennett, MD

When do I start solid foods?

Most pediatricians recommend starting solid foods at six months. At this age, babies have good head control and can sit comfortably in a highchair. Their intestinal tract is also ready to digest more complex foods.

Pureed foods are traditionally introduced one at a time. This makes it easier to figure out if your baby is having an allergic reaction to the food. Parents typically start with cereals, fruits and vegetables and introduce pureed meats and poultry a month or two later. (I’m not a fan of infant cereal because it’s mostly a source of carbohydrates. In addition, concerns have recently been raised about the amount of arsenic in rice.) Soft table foods like Cheerios, cottage cheese, yogurt and tofu are usually started around nine months.

When you first introduce solids, your baby may push the food out with his tongue. This occurs because babies to move their tongues forward when they nurse or bottle-feed. It usually takes a few days for them to learn how to eat from a spoon. Once your baby gets the hang of it, he will eagerly open his mouth for the next spoonful.

Babies may briefly scrunch up their faces when they try new foods. This does not mean your baby doesn’t like the food. Unless a baby turns his mouth from side to side or purses his lips, you can assume he’s not rejecting the food.

When breastfed babies begin solids, you should stop their daily Vitamin D supplement and begin giving them a liquid multivitamin with iron. The reason for this is because the iron in breast milk is not well absorbed once spoon-feeding has begun. The amount of iron in a daily supplement will not constipate your baby. (If a parent is opposed to using a vitamin with iron, it’s important for the baby to get iron-fortified infant cereal once or twice a day.)

If a baby rejects a new food, you should stop offering that food for a week or so. In most cases, the baby will eat the food when it’s offered in the future. However, if your baby continues to reject the food, eliminate it from his diet for a longer period of time. You should not try to sneak in the rejected food or your baby may stop eating because he’s become suspicious about what you’re feeding him.

Eating is a tactile experience for babies. They like to play with their food as much as eat it. A fair amount of messiness is to be expected at every meal.

Lots of babies want to use the spoon themselves after they have been eating pureed foods for a month or two. They aren’t very effective at the beginning, but it’s important to give them some control over the eating process. This means letting an 8- to 9-month-old have his own spoon even if very little gets into his mouth. We call this “two spoon feeding.” If the baby is unsuccessful feeding himself, you can help by feeding the baby with the spoon you’re using. The same “standby technique” can be used if a baby has difficulty getting table foods into his mouth.

By nine months, most babies eat three meals a day of pureed and finger foods. He may drink less breast milk or formula because he’s getting more calories from solids. This is a good time to introduce water in a sippy cup.

In the past, pediatricians did not recommend egg whites until 12 months and peanuts until age three. The current recommendation is to introduce peanut butter around six months. It should be mixed with pureed foods like applesauce or banana. Bamba is a peanut-based puff that you can buy at most grocery stores. This is an excellent finger food for older babies.

I recommend starting eggs (the white and the yolk) at around nine months. Scrambled eggs work best initially as long as your baby has demonstrated the ability to chew and swallow soft foods.

Do not give your baby honey until his first birthday. Ingesting honey can cause a disease called infantile botulism. Raisins are choking hazards and are best not given until 18 months.)

What should I do if my toddler doesn’t want to eat a meal?

From a developmental perspective, the second and third years of life are about competence and independence. When it comes to eating, toddlers are driven to use their new motor skills and often do not want to stop what they’re doing to eat—or have a diaper change for that matter! This can make playtime a higher priority than eating. We know from research that healthy children get the calories they need to gain weight. As a parent, your job is to prepare meals for your child and make sure he eats in a safe environment. (That means he should never eat when he’s walking around.) It’s your child’s job to determine how much he eats at any particular meal.

What should my child sit when he for mealtime?

Toddlers and young children need to sit in a safe place for meals. This can be a highchair, a toddler’s chair or your lap. Your job is to offer healthy food to your child, but it’s his job to eat it. If a young child wants to be done eating after five minutes, little will be gained by forcing him to sit at the table. I suggest letting him get up and play as long as he is supervised or in a safe environment. Take what’s left of his meal and set it aside or put it in the refrigerator.

If your child indicates that he’s hungry 15 minutes later, remind him that lunch, dinner, etc. is over. Avoid the temptation to say if he had eaten his meal, he would not be hungry now. Instead, say that he can have a snack in a little while. Making him wait 30 minutes to eat his “leftovers” will get the point across that he can’t boss you around too much. When the 30 minutes have passed, tell your child he can have his snack. Get the plate of food and sit with him while he eats it.

Your child may have a tantrum when you ask him to wait or when you serve the same food he rejected earlier. The best approach is to say you are sorry he’s hungry or frustrated, but he has to follow the eating rules in your house. Most children quickly learn to eat when food is presented to them.

What should I do if my child throws food from his highchair?

Children usually throw food when they’re no longer hungry. If this is the reason your child is throwing food, the best approach is to calmly end the meal, clean him up and let him play.

In some cases, a child will throw food if he was given something he doesn’t like. You can deal with this situation in a few ways. First, don’t offer certain foods if your child repeatedly throws them on the floor. Second, if your child throws food, turn his highchair around so he is facing the wall for one minute. Don’t say anything while he’s facing the wall. When the minute is over, turn him around and start interacting with him. If he throws food again, turn him around to face the wall. Stay emotionally calm during this period. As soon as he eats something, smile or show your approval in some other way. If he throws his food a third time, end the meal.

What does in mean if a child’s growth percentiles are changing

Doctors keep growth charts on children that follow their height and weight. These charts are used as a general guide to ensure that children are growing normally. Parents often think that being in the 85% for height or weight is better than being in the 60%. While it’s true that a grade of 85 is better on a test than a 60, the same is not true on a growth chart! More importantly, children often change their growth percentiles in the first few years of age. Therefore, moving up or down percentiles is usually not a sign of a problem. Your doctor is in the best position to explain how your child is doing in terms of his growth.

How do I know my child will eat enough if I don’t push him to eat?

Research studies have shown over and over that a healthy child knows how much he needs to eat. If parents stay out of the struggle, kids will eat enough to maintain a normal growth for them. If parents go overboard to make their kids eat, the opposite will happen.

That being said, it’s important not to give your child “empty” calories like juice because that will fill him up and may interfere with his intake of solid foods. Similarly, children may not eat if they get too much milk. A general rule is that children over 12 months should only get 16 to 24 ounces of milk per day.

Why does it bother parents if children are picky eaters?

When a child rejects food, it’s not uncommon for parents to feel like they are being rejected as well. You may not be aware of this on a conscious level, but feeling rejected can bring up feelings from your childhood, especially if you had feeding issues with your own parents.

There is another fact to keep in mind as children enter their selective eating phase. Lots of newborns have difficulty breastfeeding and may not gain weight adequately in the first few weeks of life. Also, when your child was a newborn, there’s a good chance the doctor told you to wake him every few hours to feed. This was recommended because newborns will sometimes sleep through feedings if they have not yet learned how to respond to their hunger signals.

Doctors stop asking parents to wake their babies to feed once they are steadily gaining weight. However, this early experience often sticks with parents, especially moms. If parents do not accept that their older infants (or toddlers) will eat when they’re hungry, the early feeding experience might set the stage for an eating problem in the older child. This usually happens unconsciously, but it’s important to recognize the process or it may be difficult for you to believe your child knows how much he needs to eat. [SEE ALSO, my article on picky eaters.]

© 2016 Howard J. Bennett. All Rights Reserved.

For more articles and other information, please visit Dr. B’s website at http://www.howardjbennett.com

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