Introducing solids to a child … it’s always a scary proposition. How early should I start? What’s a good ‘first food’? Will my child have an allergic reaction? As a first-time mum, I relied heavily on my daughter’s two grandmothers to lead the way and guide me on how I should diversify my child’s diet, after she turned six months old. Two items that I remember introducing to her were egg yolks (she made a face, refused to eat it) and boiled lentil water (she absolutely loved it). One of the easiest lentils to digest is the washed moong dal, and for a baby that young, you don’t even mash the dal. I was carefully advised by my mum-in-law to just boil the dal in mineral water and skim the water from the surface and just introduce that to the little one, who was around eight months old then. To this day, and she is now three years old, she absolutely loves her ‘dal soup’.
Another food group that we introduced early were fruits. With a netted teether, which is designed to let kids gnaw at the food safely inside a baby-friendly net, my mum would introduce the little one to the flavours of apples and oranges, pears and more. Unfortunately, while she enjoyed going at the fruits as a one-year-old, she has lost all love for fresh fruits since.
Thankfully, though, despite my lack of experience and knowledge regarding handling an infant, my daughter’s journey from only milk to semi-solids to solids was without any adverse allergic reactions, gently guided by her two loving grandmas.
- Indian expat and mum-of-one Huda Tabrez
They have absolutely no idea what’s coming – will it be delicious or yucky? All they really know is, it’s different. The first six months of their lives, they’ve been sustained by mum’s milk or formula or a bit of both; comforting, slightly sweet compounds. Now, there’s an explosion of flavour – it can definitely take some getting used to. Dr Puneet Wadhwa, Specialist Peadiatrician Prime Hospital, explains that while a baby’s taste buds are not extra sensitive, the fact that they are being exposed to something for the first time will elicit some sort of response and that may not always be pleasent.
But it’s an important development milestone. “An important factor to consider when introducing solids is the infant gut microbiota which mainly develops over the first few years of life. It begins as a relatively simple community with low microbial richness and diversity, to one that resembles an adult-like state by the age of three. Taking into consideration the importance of gut microbiota in reducing future risk of conditions like allergies, eczema, autoimmune conditions, and even obesity, the infant gut has received major attention over the past few decades. The introduction of solid foods triggers a shift towards an adult-like microbiota driven by changing ratios of dietary fat, protein, carbohydrate and fibre. A diverse diet stabilises the composition of the gut microbiota during solid food introduction,” explains nutritionist Farah Hillou.
How do you know your child is ready to eat solids?
Before offering food make sure that the baby is ready, look for the following signs, say nutritionists Feda Kilani and Hillou.
- Baby can sit without support or with a little support.
- Has good head control.
- Doesn’t automatically push food out of mouth; tongue-thrust reflex started fading.
- Continues to feel hungry between milk feedings.
- Shows an interest in food.
Kilani adds: “Also make sure that the food offered to the baby is prepared correctly and to the appropriate consistency, use breastmilk, formula or water to moisten food.
“If the baby refuses eating try offering food an hour after he/she had their milk, because if the baby is too hungry they usually will refuse food. If the baby still won’t eat wait couple of days and try again.”
So, what sort of food should you start with?
Dr Wadhwa says it could be anything. “It can be premade food or homemade recipes. As long as it’s pureed or blended, it works. Try feeding him/her fruits or vegetables first. The goal is to introduce a large variety of foods and help them get used to different textures and tastes.”
Liquids such as dal soup or vegetable soup or chicken soup or fresh juice made at home are perfect to begin with. “Potatoes, beans, carrots, apples, bananas, oranges - anything soft and mashed/pureed can follow,” he adds.
Hillou calls for a diverse flavour palate. “While preference for sweet foods is common in the first year of life, research shows that between five-seven months of age, babies will also accept salty, umami, sour and bitter tastes. Therefore, this “flavor window” can significantly shape the infant’s diet in months and years to come, simply by adding more variety early on such as bitter (like green vegetables) and sour (like lemon, raspberries, kiwi). Studies have also shown that introducing vegetables in the early weaning period correlates with higher vegetable intake in childhood.”
1. Eating meals together at a table as a family, undistracted promotes healthy eating habits - circumstances may vary - some families may not have access to a formal dining table but eating together is the more important aspect.
2. Minimising screen time is associated with better outcomes - especially minimising risk of childhood obesity.
3. Children having the right amount of sleep is linked to better physical and mental health - there is increased of obesity in people of all ages that compromise on the amount of sleep they get.
Should you get an allergy test before giving your child certain foods?
While Dr Wadhwa concedes that some foods are considered highly allergenic, he says there’s no test that needs to be conducted before giving your child a meal. “It is now known and studied that early introduction (around six months of age) of these foods has a role in preventing food allergies. We also know that delaying exposure to these foods might increase the risk of food allergies later on,” he explains.
“That being said, we still have to be cautious about introducing these foods. These are probably not the first food I would recommend giving your child. Include them in the diet once your baby has been exposed to a variety of other fruits and vegetables,” he adds.
Kilani offers tips on introducing your baby to new foods. She says: “When introducing a new food wait three days before introducing the next food, and keep an eye for any reactions that may occur like hives, rash, diarrhea, vomiting, swelling of face or tongue, or difficulty in breathing. Offering a gap between the introductions of new foods will make it easier to identify the food allergen if allergy occurs.”
“For higher risk babies such as those with family history of allergy or those diagnosed with allergy before, wait five days between introducing new foods and one-two weeks for common allergens and give a very small amount.
“If any allergic reactions appear on your baby don’t introduce the allergen food again and talk to your baby’s doctor,” she adds.
What should you feed the child?
Infants can initially be introduced to a variety of vegetables as a starting point, which are seen as more nutritious than rice, says Hillou. Examples include: sweet potato, broccoli, carrots, pumpkin, zucchini, and bell peppers – all rich in a variety of nutrients such as vitamin C, beta-carotene, magnesium, potassium and other important nutrients. Avocadoes are also an excellent starting point, considering they are rich in healthy fats which support brain development. Chicken and red meat are rich in zinc, vitamin B12, and iron, all necessary for growth and development and can also be introduced at an early stage. Bone broth is also a great source of collagen that supports an infant’s gut and this can be added to purees/soups.
Hillou adds: “Salmon is an excellent source of omega-3 fats which supports brain development, while yogurt is a great source of beneficial bacteria and is considered a probiotic food.”
To spice or not to spice?
That shouldn’t be the question. “Cooking with herbs and spices allows your child to become accustomed to different tastes, now and later in life,” explains Hillou.
Tips on introducing your baby to solids:
- “Keep on breastfeeding or offering milk during the first year of age, food is complementary to milk at this stage,” says Kilani.
- “Offer sips of water after each meal,” she adds.
- “Encourage baby to eat with their hand or with a spoon but never leave them unattended. Always keep an eye on them to avoid choking hazards,” says Kilani.
- “Gradually change texture of food from pureed to more textured (finely minced, ground, lumpy …etc.) as the child grows, let your baby guide you (but as reference make changes between 8-10 months of age). If your baby coughs or has difficulty with a thicker texture, move back to a thinner texture and wait a few more days before trying the thicker texture again,” adds Kilani.
- “Be patient and don’t give up when your baby refuses a type of food; don’t force them and reintroduce it later after few days; it can take up to 15 times of trying over several months before they accept it,” she adds.
- Hiliou says experimenting with different flavors and textures is crucial. Moreover, offering a variety of textures is linked to greater acceptance of different textures later on and less likelihood of food fussiness or other feeding problems in childhood.
- “Be responsive to your child’s cues. Some may prefer finger foods, while others love to hold a spoon and experiment their own way. Some may love blended foods, while others like some more texture,” she adds.
- “It’s probably best not to pressure kids to eat or punishing them if they don't. This could make them actively dislike foods they may otherwise like. Also, parents should try to avoid using food as a reward or restricting food as a punishment. Children may inadvertently associate negative feelings around food,” explains Dr Waleed Ahmed, Child, Adult and Forensic Psychiatrist, Priory Wellbeing Centre.
Media and food
Children learn through observation, so it’s important to model the behaviour you want to see. Dr Ahmed explains that even media consumption can impact what a child eats. “In the first two years of life, children develop food preferences, and some of them are innate. But one cannot ignore the influence of media and a care giver’s behaviours in developing some of these preferences. Parents can arm themselves with the knowledge of nutritional content of their children’s readily available snacks and meals and watch out for high sodium and sugar content. They can also monitor their children’s media consumption and exposure to food ads that promote unhealthy snacks and give very little attention to healthy ones. Media also distorts what an appropriate portion size should look like,” he explains.
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