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A Solid Start to Solid Foods

Friday, 29.07.2016

Welcome to the wonderful world of weaning, where babies begin to explore the new tastes and textures of solid foods in what is likely to be the biggest dietary adventure yet of their young lives.

During the first few months of its life, a baby is typically sustained on a liquid diet of milk. However, in order for babies to continue thriving as they grow older, it becomes necessary to supplement their energy and nutritional requirements with a more varied range of foods. This is usually achieved in a process known as weaning, which, according to the World Health Organization (WHO), is the “introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months”.

While weaning your baby is a significant milestone that marks the transition to toddlerhood, it can feel daunting to new parents; a “warzone” of mess, dribbling and spills. To help build your confidence in feeding your baby, we have compiled some must-know answers to your feeding questions.

Can I introduce solid food to my baby before 3 months?

While it is tempting to let your baby taste actual foods other than fluids, most pediatricians recommend introducing solids to your baby from 6 months of age. Beginning weaning too soon could result in a higher risk of babies developing digestive disorders. This is because the renal and gastrointestinal functions of younger babies are still developing and have not matured sufficiently to metabolise the nutrients found in solid foods. 

What is the ideal age for a baby to be weaned?

Some parents remain conflicted on whether they should introduce solids to their baby at between 4-6 months instead of waiting until baby is half-a-year old. To address this concern, we take a closer look at the “official” advice.

As stated earlier, WHO recommends that infants aged 6 months can start to be fed solids – or what it refers to as complementary foods, since this is in addition to, and not meant to fully replace, the milk which most babies will still be consuming at this age. When necessary, for example in the case of babies who are underweight, WHO advises that “fortified complementary foods or vitamin-mineral supplements” can also be introduced in baby’s weaning diet.

In general, the advice of most professionals is aligned with WHO’s current guidelines on feeding infants and young children. According to the Singapore General Hospital’s Department of Neonatal and Developmental Medicine, beginning weaning at the earlier age of 4-6 months should be done only when there is a need for this exception to be made. Valid reasons can include babies who are below their recommended weight and physically smaller than their expected size, or if they are anaemic with an iron deficiency. 

Sometimes, however, the best responder of this question could be your baby! Babies are reactive and responsive intelligent beings, so monitor baby closely and she may just give you some vital clues herself.

What are the signs that baby may be ready for solid food?

From the time they are born, babies have very few food preferences, but they do have a strong innate ability to learn to like new foods. Weaning is thus a great time to let baby try a range of foods with different tastes and textures. This variety could also pave the way for baby to be less inclined towards fussy eating as she grows. How then, will baby “show” to you that she is ready to take the plunge?

“Signs of readiness include showing great interest in what you’re eating, perhaps trying to grab your food, and being more steady when sitting upright,” says Sarah Shamila, Dietetics Manager at Mount Alvernia Hospital.

“You will also notice that baby will also have lost the tongue-thrust reflex where she will push food back out of the mouth. These actions tend to occur at around 6 months of age, with some babies displaying them a little earlier and later for others.”

Besides these signs, babies may also pick up toys to gnaw at more frequently, or put their hands – or feet! – into their mouths, which could also indicate the onset of teething (and having teeth = chewing!).

Babies ready for weaning will also get hungrier within shorter intervals, and may swallow their feeds with bigger and faster gulps.  Their bigger appetites are in tandem with their increasing energy requirements, which is crucial in order for them to thrive. According to Singapore’s Health Promotion Board, a newborn’s average energy requirement is about 370-410 kilocalories (kcal) per day.

Babies will need about 560-600kcal/day at 6 months, and by the time they are a year old, their energy needs will have risen to up to 880kcal/day for boys and 810kcal/day for girls. That is why having a well-balanced and nutritious diet is so important for growing babies in the months leading up to their first birthday.

In terms of suitability and nutrition value, what foods are recommended as great starting foods for weaning babies?

While there is no singular specific food that is highlighted as a first food, single-ingredient foods are recommended to be introduced first, one at a time. This is to allow parents or caregivers to observe if the baby develops possible food allergies,” says Mount Alvernia Hospital’s Sarah Shamila, who recommends single-grain infant cereal as baby’s first supplemental food. Typically, most parents start their child’s weaning with fortified rice cereal as it is least likely to cause allergy and is a rich source of iron. Start with one to two teaspoons a day.

Iron is often highlighted as an essential mineral for baby’s physical and mental development. Emphasis is placed on its importance as babies are born with a store of iron (accumulated in their bodies during the third trimester), but after they turn 6 months old, their iron levels will begin to run low and need to be replenished.

Vegetables and fruits are also ideal first foods that are a good source of vitamins and minerals. Choose root vegetables such as sweet potato and carrot as they can be easily pureed, have low allergen risk and are also rich in vitamins A and C.

During the initial weeks of weaning, baby’s diet will still seem limited, especially if parents follow the advice of introducing one ingredient at a time, followed by a three- to four-day wait before exposure to the next food item. However, this slow and steady progress is the safest way to minimise potential food allergies. Once it’s determined which foods have no adverse effect on baby, parents can go ahead and prepare mixed meals for feeding; for example, brown rice porridge with carrots or organic rice cereal with pureed banana.

What are some of the important points to note in the issue of food allergies?

As a useful general reference, dieticians and nutritionists have identified eight core foods that are mainly responsible for triggering food allergies. These are: milk, egg, wheat, soya, fish, shellfish, nuts and peanuts. Signs of an allergic reaction include: breaking out in rashes/hives, wheezing, difficulty breathing, vomiting, excessive gas, diarrhoea, or blood in the stools. Call your pediatrician if you notice any of these symptoms or go to the A&E if the reaction is severe.  More serious cases could signal anaphylaxis, which is a potentially life-threatening allergic reaction that warrants immediate and professional medical attention.

Food to avoid Reason When is it safe?

Honey

Spores cause infant botulism – muscle weakness & breathing problems  After 1-year old
Nuts & seeds
Popcorn
Raw vegetables
Candies and gums
Grapes, cherries
Choking hazard After 3-years-old
Raw or undercooked eggs, fish, or meat Risk of salmonella infection After 5-years-old
Cow’s milk (other than baby formula) Infants are unable to digest protein from whole milk After 12 months

For introduction of low-fat or skim milk, after 2 years of age (or as advised by your paediatrician/dietitian)

Interestingly enough though, rather than avoid these foods altogether, several recent studies have actually reversed this precautionary measure. Researchers found that repeatedly digesting allergenic foods at an early age may condition and accustom the body’s immune system to tolerate these foods, thus reducing or even eliminating allergy as the child grows older.

In the May 2014 edition of the Singapore Medical Journal, Alison Joanne Lee, MBBS, MMed (Paeds) and Lynette Pei-Chi Shek, MBBS, MRCP, reflected this emerging stance in the article, “Food Allergy in Singapore: Opening a New Chapter”. The authors note that the low rates of food allergy in Singapore could be due to the maintenance of traditional dietary practices such as early introduction of egg and fish in rice porridge, and peanut in soups. This, the authors continue, would be in keeping with current knowledge and theories that early consumption of peanut and egg may prevent food allergy.

Another article in the January 2013 edition of Asia Pacific Allergy, which looked into paediatric anaphylaxis in Singaporean children, was of a similar view. The nine authors jointly conceded that “evidence is accumulating that early introduction of peanut, egg, wheat, milk, and fish to the infant diet – rather than delay or avoidance – may be helpful in inducing tolerance rather than allergy”.

Despite these medically-backed findings, however, some parents may still prefer to be safe rather than sorry when it comes to introducing foods that could potentially trigger allergic reactions. As such, because the controversial nature of this issue remains, there is no hard and fast rule to rigorously adhere to, and the ultimate decision parents make could be just as personal as it is informed.

What are some tips for food prep?

Before you begin preparing baby’s meal, follow basic hygiene rules of washing your hands and ensure preparation surfaces (eg. cutting boards, tabletops) and appliances are clean to avoid cross-contamination and transfer of germs or bacteria.

That said, all households should invest in a food processor which, unlike blenders, allow you to conveniently prepare larger portions to freeze in advance for future feedings. Processors also come with interchangeable blades that are ideal for pureeing, mashing and chopping solids into the desired consistency and texture for baby. According to the Children’s Services Department of KK Women’s and Children’s Hospital, 6-months-old babies should begin with foods blended into a “smooth puree with a consistency slightly thicker than milk”; babies between 7-9 months can be upgraded to “soft lumps with thick consistency”; and from 9 months of age, babies can be fed “roughly chopped or minced foods”.

While fruits can be washed and served chilled or at room temperature, other ingredients – from rice and meat to vegetables and fish – may need more prep and cooked to become palatable. Just remember not to add salt, sugar, artificial seasonings and other preservatives during the cooking process. In order to retain the nutrients of food, abstain from overcooking and choose steaming, boiling or microwaving.

Healthy Meal Options for Baby

Nowadays, busy parents-on-the-go have daily schedules filled with back-to-back activities. Bracing themselves for the first weeks of weaning baby is stressful enough as it is, without having to rack their brains to conceive unnecessarily complicated solid first meals!

Fortunately, parents have the convenience of commercial infant cereal which has been precooked, dehydrated then packaged for maximum freshness. What’s more, these cereals are usually fortified with iron and essential vitamins and minerals. Some of them may even be further supplemented with polyunsaturated fatty acids such as Omegas 3, 6 and 9, or probiotics (believed to be beneficial for brain development and the digestive system respectively).

Parents are also spoilt for choice: just head to any supermarket and you’ll notice a variety of baby cereals available – common variants include plain white rice, brown rice, wheat, oats, barley and multi-grains. Some brands also group their cereal products according to age, and these usually have a core carbohydrate (eg., rice) with one or more added ingredients such as honey, mixed fruits or veggies, soya, anchovies or chicken. 

Preparation is easy: simply add the required amount of milk, juice or water, stir to the desired consistency and you’re all set to feed junior!

Babies accustomed to single-grain cereal as a first food and who have already been gradually introduced to other ingredients may be served with different food combinations. Here are some homemade ideas, which can be pre-prepped and mixed together first, then again blended into, or served alongside, plain single- or multi-grain cereal:

  • Beginners (6-8 months): Green beans and pears / butternut squash and sweet potatoes / avocados and bananas / applesauce and pumpkin
  • Intermediate (8-10 months): White potatoes and green beans / peas, carrots and applesauce / sweet potatoes, yoghurt and a pinch of cinnamon
  • Advanced (10-12 months): Turkey with sweet potatoes and carrots / Chicken with pumpkin and squash / tofu, avocados and pears

You can even choose to make your own homemade porridge with one type of grain or by cooking a few kinds together. To make brown rice porridge*, first grind ¼ cup of rice in a food processor or blender (add small quantities for a finer powder). Bring 1 cup of water to a boil in a saucepan, then stir in the rice powder. Reduce the heat to low, then simmer gently for about 10 minutes, stirring constantly to prevent the rice from sticking to the bottom. When the porridge is cooked, turn off the heat and allow to cool for 5 minutes before adding breastmilk or formula to achieve the desired consistency.

*For other porridge variants, substitute the brown rice with another grain of your choice. You can blend this into a powder and store in an airtight container which you may then freeze or chill for future cooking.
 

This article first appeared on Mummys Market Expert Tips.

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