Saturday, April 14, 2012

Month 5 Week 1: Solid success

We introduced B to solids today as he's been able to hold his head upright steadily, developed a strong grip, shown more interest in adult food/eating, control over his drooling, and seems to have lost his appetite for an all-milk diet.  Since he checked in at 8.3 kg (18 lbs) last week, we also feel quite comfortable weaning him now.  For starters, I got him wholegrain rice cereal, mixed 1 spoon of cereal with 3 spoons of expressed milk and viola.  He took to it quite well and from what I can tell, the organic cereal tastes like Nestum which I grew up eating :). I plan to keep serving cereal alternating with milk, followed by simple fruit and veggie purees over the next few weeks.  It's fairly easy to get started -  a steamer and blender for preparation, small airtight food containers for storage, and baby food planning and cooking library books for inspiration.

General rule of thumb below, though some moms I know do baby-led feeding and are more "liberal."

(4)-6 months:
  • Offer the same solids 3 days in a row to ensure no allergies
  • Start by alternating milk and pureed solids for lunch/late morning feed (after he's satisfied his overnight hunger), and then do the same at dinner and finally breakfast/early morning feed
  • Maintain 800-1000 ml total daily milk intake (=4 to 5 bottles of 6-7 oz/180-200 ml milk).  Between 5-6 months, no milk should be needed after 7pm (B did this at 4.5 months)
  • Once he takes to solids, also offer some water to help with digestion and hydration, esp. during the mid-day
  • First foods - give them a runny consistency (add milk or reserve cooking liquid to dilute) as he'll need to overcome his protective reflex that prevents him from swallowing thick solids
    • Cereal - rice, maize
    • Veg - carrots, sweet potato, yam, butternut squash, pumpkin, potato, zucchini, sweet peas
    • Fruits (non-citrus) - avocado, banana, cooked apples, pears
    • AVOID - gluten (wheat, bread, rye, barley, oats), eggs, citrus, nuts, dairy/cheese, fish/shellfish, coffee, honey, excessive spice, sugar and salt
  • Tips and tricks:
      • Offer initial, small tastes (2-3 spoons) with a plastic, shallow weaning spoon - let him suck it off the end first, and gradually, he will learn to swallow without sucking
      • Don't worry if he rejects, it may take up to 10 to 15 tries so try and try again 
      • Crying in between spoonfuls usually b/c they are frustrated that feeding isn't continuous
      • Sit him on your lap to reduce stress
      • Don't mix solids with milk in a bottle -- this amounts to force feeding and may cause choking, faster weaning than needed, and doesn't enable baby to communicate 
    7-9 months:
    • Introduce single portion breakfast with milk, and lunch and dinner meals accompanied by cooled boiled water and diluted juice
    • Total daily milk intake (inclusive of milk used for food prep) ~600-800 ml (=3 to 4 bottles of 7-8 oz/200-220 ml milk) with milk primarily given after meals now in addition to the mid-afternoon and late night/early morning feeds, as needed
    • New foods - give a variety / coarser texture (minced/mashed vs blended) with iron and protein:
      • Meat (usually mix with blander foods e.g. rice, potatoes, and offer at least once a week) - fish, poultry, lean meat e.g. lamb, turkey 
      • Veg - artichoke, asparagus, broccoli, watercress, spinach, brussels sprouts, cabbage, carrot, cauliflower, cucumber, leek, cooked lettuce, parsnip, rutabaga, squash, carob, green beans
      • Pulses - lentils, split peas, chickpeas, haricot, flageolet and kidney beans
      • Fruit - cooked apricot, blueberry, cherry, cranberry, peach, nectarine, plum, prune + citrus (mixed with other fruits to counteract sugar and acidic content) + dried fruit (mixed)
      • Finger foods - soft peeled fruit, steamed veg sticks/raw soft veg, bread, rice cakes + nut butters
      • Wheat (pasta, cereal), full fat dairy (natural yogurt, well cooked egg, cheese, soy)
      • Olive oil, herbs and spices can also be added now, starting mild, one at a time, as well as finely ground nuts, seeds - amaranth, quinoa, tapioca root, poppy, pumpkin, sunflower
      • AVOID - cow's milk (wait till 2 years old), shellfish, soft boiled eggs,  coffee, honey, excessive spice, sugar and salt
    • Tips and tricks:
      • No need to sterilise everything all the time now
      • Offer finger foods and water (in a beaker/sippy cup) in between meals, as needed. Get them involved in feeding themselves to encourage independence and coordination.  Finger foods also help relieve teething pressure 
      • Talk to your baby while feeding
      • If full, baby will close his mouth or turn head away
    10-12 months:
    • Establish routine with healthy snacks - 3 square meals a day with the family, eat together but beware his emerging personality (self-feeding, fussiness, food throwing, refusal to eat alone)
    • Total daily milk intake falls to 500-600 ml. Reduce late night milk feed and supplement the mid-afternoon milk with finger food snacks and water
    • Foods:  Try new things to stimulate appetite and senses, finely chopped and minced. Basically, almost all the food you eat yourself within reason:
      • Fiber - peas, fruit, veggie juice. Avoid bulky fiber in brown rice or whole wheat
      • Meat - at least one portion per day, wider range of fish - mackerel, tuna 
      • Herbs and spices - parsely, oregano, basil, coriander, onions, garlic, cinnamon, ginger, vanilla pod
    • Tips and tricks:
      • Drop milk intake to allow room for solids.  Keep up water and juice to avoid constipation 
      • Offer drinks in cups rather than bottles to help development of baby teeth as cup drinking is much faster - minimising contact with teeth
      • Nutritional balance towards strength vs immune boosting - starch, protein, sugar, unsaturated fat for calories and absorption of fat-soluble vitamins
      • Lots of energy rich food with fiber, esp. for breakfast (cereal, fruits) - his biggest meal 
      • Eat small portions but varied types of food, as often as needed
      • Enjoy the possibilities!

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