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Disclaimer: This is not a sponsored post. This post does contain affiliate links.

I’m a big believer that preparing wholesome food for your family shouldn’t cost a lot.

While cooking more at home is a great way to save money vs. eating out, there are a few home kitchen tools that will make your life a lot easier as you and baby embark upon this solid food experience together.

Here are 10 of my favorite baby feeding kitchen tools that I hope will make your time in the kitchen more enjoyable and efficient :)

 1. Instant Pot

I am super late to the Instant Pot insanity, having just purchased one of these combination slow-cooker, pressure-cooker and yogurt-maker kitchen contraptions recently.

I’ve always had a 3-in-1 Fagor cooker (this one: pressure, slow and rice cooker) but I wanted to see what the IP hype was all about.

We have 7 kids, so I cook in what you might consider larger-than-normal quantities and was looking for a second multi-functional cooker anyway. I went with the largest Instant Pot, the 8-quart capacity (click here for link).

I’ve only been using it for a few weeks, but so far so good. I think a lot of the “controls” are just different names for variations of slow or pressure-cooking, but the ability to make yogurt really stands out as a unique feature in the IP.

A few IP recipes that work great for baby-led weaning that I have made so far:

  • Instant Pot Black Dal (lentils) from I Am a Food Blog - click here for recipe

  • Instant Pot Hard-Boiled Eggs from Taste of Home - click here for recipe

  • Instant Pot Steel-Cut Oats from Skinnytaste - click here for recipe (omit honey for babies)

CLICK HERE FOR 8 QUART 10-IN-1 INSTANT POT



 2. Grape Cutter

I feel like not a week goes by that I don’t sing the praises of the grape cutter.

When I first heard about a tool that cuts grapes for you, I rolled my eyes too.

…but hear me out: whole, intact grapes are a choking hazard for babies; but, you can easily and safely serve babies grapes (and cherry tomatoes) by quartering them.

But quartering grapes is TEDIOUS.

When my quadruplets were doing baby-led weaning and we got to grapes in their 100 First Foods sequence…I was pulling my hair out trying to cut individual grapes in four. For four babies.





The grape cutter isn’t perfect - I wish you could cut more than 1 or 2 grapes at a time, but it is faster than slicing, especially if you’re doing a lot.

Here is a link to the OXO grape cutter on Amazon.

CLICK HERE FOR OXO GRAPE CUTTER ON AMAZON


If you think a grape cutter is gimmicky - here is a really cool article from OXO behind how they built the grape cutter. I love that it was invented by a parent equally as annoyed at quartering grapes as I have been!

 3. Lucky Iron Fish

The Lucky Iron Fish is an iron ingot used during cooking. It acts as an in-home fortification system for iron transfer.

There’s some research to indicate cooking with cast iron can increase iron release from food. One study from India showed 16% increase in iron content of foods cooked in cast iron vs. teflon.

While the Lucky Iron Fish doesn’t have exact data as to how much iron release occurs when cooking with this tool, it has been used successfully in Cambodia where anemia affects 44% of women.



It should be noted that some of the product material says not to use with babies. I tried to speak to the manufacturer about why this is and they were unable to provide any explanation as to why it might be dangerous, just that they include that language out of an “abundance of caution”.

I have used it to make iron water I then use in some soups and stews and sauces. And I’ve also made this Creamy Carrot Soup from the Lucky Iron Fish website that is pretty good too.

It helps to keep in mind that other factors increase or decrease iron absorption; including vitamin C containing foods (like carrots) can help increase iron absorption from other sources.

CLICK HERE FOR LUCKY IRON FISH ON AMAZON  4. Little Partners Learning Tower

A few years back Little Partners sent me one of their “Learning Towers” to try out, and I’ve been a fan ever since.

This is an adjustable kitchen counter step-up so you can safely get your kids to the counter to cook with you. Now I guess technically this isn’t a baby feeding tool - but if you have bigger kids, include them in prepping food for the whole family when you can.

This helps increase their interest in the foods the family is eating and a food they prepared is a food the potentially picky eater is going to be more interested in eating!





There’s probably a manufacturer limit of how many kids max you should put in the learning tower - and I’m sure I’m violating it most days at my house, but you can pretty easily fit 2-3 toddlers in there to help you out (…gets a little too close for comfort after that I think :)

CLICK HERE FOR LEARNING TOWER ON AMAZON  5. Crinkle Cutter

True confessional: I have had a crinkle cutter languishing in my kitchen tools drawer for years. It never got any use - until I started working with Dawn Winkelmann, MS, CCC-SLP (@msdawnslp) on a number of baby-led weaning projects.

Dawn LOVES the crinkle cutter. And she got me hooked too, here’s why.

The crinkle cutter is a really cheap tool that can mix up the texture of some of the foods your baby is eating. Dawn uses it for foods like tofu, zucchini and cooked veggies like carrots and sweet potato.

Not only does it provide a new sensory experience for baby with the variety of jagged edges, but the crinkle cutter provides grip to help your early eater get at some of those trickier and more slippery stick and spear foods you’re offering early on in baby-led weaning.

In the recent course we developed “The 100 First Foods Field Guide” Dawn spends a lot of time professing her love for the crinkle cutter, and I spent a lot of time crinkle cutting foods with her for our 100 foods videos inside of the course!


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Disclaimer: This post is sponsored by Sharp Healthcare.

News of the world’s smallest baby ever to survive - Baby Saybie - has been circulating for a few weeks now.

If you missed it, Baby Saybie - the name given to her by her care team at Sharp Mary Birch Hospital for Women & Newborns in San Diego - weighed only 245 grams - which is just over 8 ounces (a half-pound!) when she was born at 23 weeks gestation, a full 3 months earlier than planned. (You can read Baby Saybie’s amazing birth story here).

Baby Saybie at Sharp Mary Birch Hospital

My family is very familiar with the hospital and Neonatal Intensive Care Unit (NICU) where Baby Saybie received her life-saving care. This is the same NICU where our quadruplet babies Charlie, Claire, Henry and Dillon spent their first few weeks of life! Our experience began 3 years prior to Baby Saybie’s arrival.

The quadruplets were born at 34 weeks gestation and each weighed between 2 and 3 pounds when they were born at Sharp Mary Birch. The quads went right to the NICU and stayed there for help eating, breathing and growing until they started going home one by one, and thankfully not all at once!

{If you want to hear more about our incredible experience before, during and after the quadruplets’ delivery, Sharp Healthcare featured us in their Sharp Experience documentary series “Defying the Odds with Quads” which you can view here.}

WATCH SHARP HEALTHCARE'S "DEFYING THE ODDS WITH QUADS"  Pre-Term Babies Need More Nutrition

It’s hard to even fathom the magnitude of what keeping a 23-weeker alive entails. And then just think about the incredible team of professionals who got her to the point where she could go home and be with her family 5 months later!

With pre-term a baby misses out on a lot of the important developments that should occur in the latter stages of pregnancy. Because of this, optimal nutrition for pre-term babies is extremely important.

I recently had a chance to learn more about neonatal nutrition from the incredible clinical team at the Sharp Mary Birch Hospital NICU here in San Diego. This is the largest unit of its kind in California, so they know a little bit about lifesaving nutrition interventions for tiny babies!

If your baby is a preemie, here are a few of the basic nutrition guidelines your care team will implement during baby’s time in the NICU…many of which are the same we experienced during the quadruplets’ NICU stay.





 Primary Goals for NICU Nutrition

It’s kind of a mouthful, but per the American Academy of Pediatrics Committee on Nutrition (AAPCON), the goals for very low or extremely low birth weight infants is “the achievement of postnatal growth similar to the intrauterine growth rate of a normal fetus at the same post conceptional age.”

Basically, the care team in the NICU is working to make sure baby on the outside is getting what baby on the inside WOULD have been getting at this stage if baby were still in utero.

The neonatologist physicians, registered dietitians, pharmacists, occupational therapists, physical therapists, nurse practitioners and nurses are all working with the pre-term baby to:

  • Maintain and develop lean body mass and bone density

  • Optimize neurodevelopment and growth

  • Prevent or offset complications like chronic lung disease, necrotizing enterocolitis and infections

At the same time they’re working towards optimizing nutrition to prevent later in life complications that all babies can be at risk for later in life, such as diabetes and obesity.





 What About Breastfeeding Preemies?

I knew pre-term birth was all but certain with my high-order multiple pregnancy (quadruplets). Full term pregnancy is 38-40 weeks. The average gestational age for quadruplets is 28 weeks. So I was over the moon to go 34 weeks with my quads, which is as far as my high risk OB felt was safe before we had a scheduled C-section at Sharp Mary Birch Hospital.

One of the many reasons we chose Sharp Mary Birch for this high risk delivery and post-natal care is because they are now a designated baby-friendly hospital, meaning the entire staff is trained to provide the support, education and confidence to help you achieve your breastfeeding goals.

I knew my babies would be born early, and I knew that optimizing their nutrition to help them eventually “catch up” would need to start the day they entered the world.

As an exclusively pumping mom (…no way I could manage breastfeeding 4 at once!) I felt totally supported during my time at Sharp Mary Birch. I have delivered all 7 of my children at this hospital, starting with my oldest, a full-term singleton.

With the quads, everywhere I turned staff in the NICU were there to ask me how it was going, “What do you need to help achieve success with your milk supply?” …“Do you want to use the private nursing lounge to pump?” …“Do you want to meet with the lactation consultant again?”

The Sharp Mary Birch NICU staff were so positive and concerned about my babies’ nutrition, that I really don’t think I could have made it 10 months pumping for 4 babies if it weren’t for their initial encouragement and support!

I always had to supplement my breastmilk supply with formula, but as a Registered Dietitian, I do know that a lot of their catch-up growth and current status as healthy, thriving toddlers is attributed to the excellent nutrition care the quads received early on in the NICU, from the combination of breastmilk, to fortified formulas and nutrient supplementation.





 Supplemental Nutrition Needs

In the NICU, mom is encouraged to pump breast milk early and often - at least every 3 hours.

You’re tired and exhausted and worried about your baby; but I actually liked pumping because I felt like it was the one thing I could do to help my babies.

Despite all of these efforts, my breastmilk supply only ever met half of the quadruplets’ needs. They had feeding tubes, I needed donor milk and additional supplements, but in some way - by pumping - I was doing a small part to help the babies get stronger and go home sooner.

Early intravenous nutrition is provided on day-of-life #1, containing all of the important nutrients these very tiny babies need.

Very small amounts of breast milk or donor breast milk are then fed through a feeding tube into the baby’s stomach by day-of-life 2 and 3 (in most cases).

Human Milk Fortifier (HMF) is added to breast milk shortly after plain breast milk is tolerated. Fortifiers give baby extra protein, calcium, phosphate, vitamins and iron to the infant diet.

At the Sharp Mary Birch NICU, all breastfed and some formula-fed babies receive a vitamin D supplement in addition to fortified breastmilk per AAP guidelines for pre-term infants.



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Disclaimer: This is not a sponsored post. I did receive a complementary copy of the “Eat the Eight” book that I review in the post. The author of the book Dr. Ron Sunog is an advisor to PUFFWORKS, a company I have worked with in the past; however, I received no financial compensation for this post. All of the ideas and thoughts contained within this post (with the exception of Dr. Sunog’s quotes) are my own. This post does contain affiliate links.

Have you heard about the “Big 8”? They’re the 8 foods that account for about 90% of food allergy in North America.

Despite emerging research, updated guidelines and lots of buzz about earlier introduction of allergenic foods, many parents don’t realize that incorporating the Big 8 early on can help prevent food allergy down the road.

So why aren’t parents feeding babies The Big 8 “early and often”?

Well…I was wondering JUST the same thing, which is why I sat down with Ron Sunog, MD, author of “EAT THE EIGHT: Preventing Food Allergy with Food and the Imperfect Art of Medicine” to learn more.

 Eat the 8 Movement

In case you’re curious, the 8 foods that cause most food allergy are milk, egg, peanut, tree nuts, wheat, soy, fish and crustacean shellfish. (Food Allergy Research & Education, FARE points out that allergy to sesame is an emerging concern too.)

Dr. Ron Sunog is a Boston-based pediatrician and advocate for food allergy awareness. He has made it his mission to get other pediatricians and parents to start recommending and implementing an “Eat the Eight” approach starting in infancy.

Much like the public health campaign “Back to Sleep” for infant sleep safety that started in 1994 (now called Safe to Sleep), Dr. Sunog is trying to help bring evidence based recommendations into the world of infant feeding advice, with the catchy, easy-to-remember and informative title: “Eat the Eight”.

Don’t be surprised if you hear more “Eat the Eight” advice soon - and you’ll have Dr. Sunog to thank for bringing this info to the forefront of pediatrician offices everywhere!

 One Giant LEAP Forward

The medical community’s understanding of preventing food allergy has changed dramatically in a short period of time.

When I was studying nutrition as an undergraduate (only) 20 years ago, we learned the American Academy of Pediatrics (AAP) recommendation to “delay introduction of peanut in high-risk children until age 3”.

Fast-forward to 2015 when the Learning Early About Peanut Allergy (LEAP) trial results were published in the New England Journal of Medicine. LEAP showed us that “feeding peanut to high-risk infants early and often could prevent them from developing a peanut allergy.”

In fact, in the LEAP trial, early introduction reduced risk by 81% compared to control groups who avoided peanuts completely for 5 years. (For more interesting facts about the LEAP studies, check out this article from FARE.)

As a result of the LEAP study outcomes, by early 2017 the National Institute of Allergy and Infectious Diseases (NIAID) officially changed their addendum guidelines to support early introduction of peanuts as a recommended way to reduce risk for peanut allergy.

Although we have the strongest evidence to support early introduction for peanut allergy prevention, other emerging research appears to also support early introduction of other “Big 8” allergenic foods, as Dr. Sunog outlines in his book “Eat the Eight”.

CLICK HERE TO GET THE "EAT THE EIGHT" BOOK ON AMAZON  First, Do No Harm

But as you know…just because the info is out there, it doesn’t mean people are using it!

One study published in the Annals of Allergy, Asthma & Immunology found that almost 70 percent of parents were unwilling to incorporate peanuts into a baby’s diet at or before 6 months…and nearly one third of them didn’t know anything about the new peanut guidelines.

So…if research supports early introduction…and updated guidelines recommend early introduction…why aren’t parents actually introducing allergenic foods to their babies early and often?

As Dr. Sunog points out - it’s because they aren’t hearing this advice from the very place they go to seek health information: the pediatrician’s office.

By October 2017, 10 months after the addendum guidelines were published, only 11% of pediatricians had put this into practice. As Dr. Sunog states in the book, “Physicians are not immune to the inclination to cling to obsolete information.”

 The “3-5 Days Between Foods” Farce

I couldn’t agree with that last quote more! And from interactions with my students, clients, peers and social media community, I know firsthand that parents are routinely STILL being told by their pediatrician to “wait 3-5 days before trying new foods”.

In my opinion, this whole 3-5 day “waiting game” is an outdated, unnecessary, and unsupported recommendation that only instills fear in parents about trying new foods with baby.

Instead, parents and caregivers should be ENCOURAGED to introduce the wide variety of foods, flavors, tastes and textures that we know babies need to become independent eaters, prevent picky eating AND prevent food allergies.

And, if you want to bring common sense into the conversation - as Dr. Sunog points out in his book and during our interview, if a reaction is going to occur, it will be within hours and not days following the ingestion of the offending food.

Five days after your baby has a strawberry, if his diaper looks different or there’s a new rash around his mouth - do you really think it was the strawberry that caused the “reaction”?

That’s not how reactions or the anaphylactic responses work, and I stand by Dr. Sunog’s efforts to help shift pediatricians away from this outdated practice of recommending to wait 3-5 days between new foods.

(For more information on how you can get your baby to try 100 Foods Before Turning One check out my free online workshop “Baby-Led Weaning for Beginners” here.)

  SIGN UP FOR FREE WORKSHOP: "BLW FOR BEGINNERS" Turning the Tide

In his book, “Eat the Eight” Dr. Sunog does an excellent job outlining the current environment of food allergy advice at a typical pediatrician’s office…it’s generally a conversation that isn’t happening, unless mom or dad asks about it.

And given all the OTHER things there are to worry about as a new parent, the conversation about food allergies often falls to the wayside.

Besides outlining all of the relevant research, historical recommendations, new guidelines and suggestions for introducing allergenic foods, Dr. Sunog’s “Eat the Eight” book includes some very important commentary about why parents aren’t hearing this advice and how a concerted campaign or effort called “Eat the Eight” may help turn the tide.

 Allergenic Food Answers from Dr. Sunog

Because I work as a dietitian specializing in infant feeding, I am in constant contact with parents of babies approaching, at, or just after the 6 month mark - that magical age when babies start the weaning process through initial introduction of solid foods.

And in this line of work I get a TON of questions about food allergies. So why not ask the expert to help answer them?

I surveyed my audience and curated some of the most popular questions about food allergies, and brought them to my interview with Dr. Sunog.

Basically I asked him every allergy question in the book, and his straightforward, evidence-based answers were a breath of fresh air in what can be a confusing space to try to sort things out on your own.

Below are some selected questions from you - with answers from Dr. Sunog - all about starting allergenic foods with your babies in an attempt to help prevent food allergy down the road:

 “If my baby doesn’t have an allergic reaction to a food on first exposure, could he have it on second or subsequent exposures?”

Dr. Sunog’s response: Your first exposure to anything that you’re going to react to essentially “primes the pump”. On the second exposure you actually react. It should be a second or later exposure…it can happen on the first time baby is “eating” that food - but “eating” it might not be the actual true first exposure.

He went on to explain that testing dust samples from a baby’s crib almost always yields trace amounts of peanut and other food proteins - so baby may be exposed outside of traditional food “tasting” before first bite of that food.

 “What are the signs and symptoms of a reaction that parents should be on the lookout for when trialing new foods with babies?”

Dr. Sunog’s answer: For an infant, look for things like a rash around the mouth or elsewhere, fussiness, vomiting, any kind of respiratory distress.

We also discussed how other things happening concurrently can cause reactions too, like teething, or baby having a cold and being immunocompromised. So it’s not always the food’s fault if a reaction happens!

 “If mom had to remove dairy while breastfeeding because of skin and gut problems in baby, should she avoid introducing solid dairy foods and milk protein to baby at 6 months of age and onward?”

Dr. Sunog’s response: if baby’s symptoms resolved during breastfeeding when mom removed dairy, it does not necessarily mean baby is “allergic” to dairy foods. Over the ensuing months, baby’s gut has developed to the point where baby may be able to tolerate these food proteins more efficiently, so after checking with your own doctor, it’s likely safe to trial these foods.

He went on to point out the importance of understanding the difference between food allergy and intolerance - they’re not the same thing: an allergy is a potentially life-threatening allergic reaction to what is usually the protein component of a food.

An intolerance - while it’s an inconvenience and may be uncomfortable for mom or baby - is not life-threatening.

Knowing the difference between allergy and intolerance - and using those terms correctly - is important when relaying your baby’s medical situation to the healthcare provider.

 “LEAP and new guidelines have redefined ‘high-risk’ for peanut allergy as being baby with severe eczema and/or established egg allergy…how do you know if your baby has severe eczema and therefore falls in this high risk category?”

Dr. Sunog’s answer: Consider these statistics:

  • 12.97% of children have eczema

  • 7% of these children with eczema have severe eczema, therefore

  • 0.9% of children have severe eczema, and

  • 2% (at most) of children have egg allergy

(…and those statistics are for all “children”, they’re probably smaller for infants.)

Eczema is a break in the skin’s barrier. The worse the eczema, the higher your risk is for food allergy. There’s no blood test for diagnosing severe eczema, it’s not a quantitative thing, but if you look at the statistics, very few infants actually are “high risk” for peanut allergy.

Yes, there are high risk criteria for peanut allergy, but determining severe eczema is essentially a judgement call on the part of the pediatrician…the pediatrician who may make that call or refer baby to a dermatologist to do the same.

 “What should I do if I think my baby is at high risk for food allergy?”

Dr. Sunog’s response: babies with severe eczema, egg allergy, or both should strongly consider evaluation with peanut-specific IgE and/or skin prick tests, and, if necessary, an oral food challenge. Then based on these test results, introduce peanut-containing foods at four to six months of age, per the guidelines.

For the mild to moderate eczema categories, introduce peanut containing foods at around 6 months of age.

And for your babies with no eczema or any food allergy, introduce peanut containing foods at an appropriate age and in accordance with family preferences and cultural practices (…from the NIAID addendum guidelines).

Dr. Suno recommends peanut containing food and all the Big 8 for low risk children as it is likely to reduce the risk of developing food allergy and these are nutritious foods for baby.

 “Should I park my car outside the pediatrician’s office or emergency room to try a new allergenic food with my baby?”

Dr. Sunog’s answer: No. Allergic reactions are scary…I liken it to a febrile seizure - any seizure is terrible to look at - even as a professional. But febrile seizure is utterly safe, results in no harm…although yes, you’re still super scared.

With food reactions, parents are assuming the worst. But the good news is that a first time reaction is rarely life threatening…fatality is all but unheard of, especially in young infants like the ones who are trying these foods for the first time at or around the 6 month mark.

Most reactions don’t require anything more than at-home administration of Benadryl. And Dr. Sunog reminds you to still check with your pediatrician, explain the symptoms and get confirmation about preferred Benadryl dosing for baby.

 “How many grams of potential allergy food is considered an effective dose? We see 2 grams 3 times per week from LEAP of peanut protein, but what about other foods?”

Dr. Sunog’s response: there are no established guidelines about dose. We don’t know anything about that. Even with peanut, for better or worse, that was just the “dose” that was tested…nobody could say less wouldn’t work. If my child was high risk I would push harder to do it early and often.

 ‘What are some safe ways to introduce peanut protein to a baby at 6 months of age if intact peanuts are a choking hazard and peanut butter in globs may be too challenging for babies this young?”

Dr. Sunog’s answer: I have done a lot of research helping to develop a peanut puff that is appropriate for babies. As an advisor to PUFFWORKS, I helped bring their PUFFWORKS Baby line of peanut puffs to market. These are an improvement on existing puff products for a number of reasons.

PUFFWORKS Baby puffs are:

  • Softer than other peanut puffs on the market, so they’re easier for early eaters to eat even without teeth

  • Lower in salt with no added sugar; other commercial products have added salt and sugar that babies don’t need

  • Comprised of non-GMO ingredients and include whole gain ingredients that are less processed than other baby puff products.

15% OFF PUFFWORKS ON AMAZON WITH CODE 15BABYLED



 “What about this trend of ‘medicalizing’ introduction of allergenic foods? If a baby can eat food at 6 months of age or more, why should parents be told they have to buy fancy, high-priced products that have arbitrary amounts of the allergen in them?”

(Full..

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Disclaimer: This is not a sponsored post. I did receive a complementary copy of the “Eat the Eight” book that I review in the post. The author of the book Dr. Ron Sunog is an advisor to PUFFWORKS, a company I have worked with in the past; however, I received no financial compensation for this post. All of the ideas and thoughts contained within this post (with the exception of Dr. Sunog’s quotes) are my own. This post does contain affiliate links.

Have you heard about the “Big 8”? They’re the 8 foods that account for about 90% of food allergy in North America.

Despite emerging research, updated guidelines and lots of buzz about earlier introduction of allergen foods, many parents don’t realize that incorporating the Big 8 early on can help prevent food allergy down the road.

So why aren’t parents feeding babies The Big 8 “early and often”?

Well…I was wondering JUST the same thing, which is why I sat down with Ron Sunog, MD, author of “EAT THE EIGHT: Preventing Food Allergy with Food and the Imperfect Art of Medicine” to learn more.

 Eat the 8 Movement

In case you’re curious, the 8 foods that cause most food allergy are milk, egg, peanut, tree nuts, wheat, soy, fish and crustacean shellfish. (Food Allergy Research & Education, FARE points out that allergy to sesame is an emerging concern too.)

Dr. Ron Sunog is a Boston-based pediatrician and advocate for food allergy awareness. He has made it his mission to get other pediatricians and parents to start recommending and implementing an “Eat the Eight” approach starting in infancy.

Much like the public health campaign “Back to Sleep” for infant sleep safety that started in 1994 (now called Safe to Sleep), Dr. Sunog is trying to help bring evidence based recommendations into the world of infant feeding advice, with the catchy, easy-to-remember and informative title: “Eat the Eight”.

Don’t be surprised if you hear more “Eat the Eight” advice soon - and you’ll have Dr. Sunog to thank for bringing this info to the forefront of pediatrician offices everywhere!

 One Giant LEAP Forward

The medical community’s understanding of preventing food allergy has changed dramatically in a short period of time.

When I was studying nutrition as an undergraduate (only) 20 years ago, we learned the American Academy of Pediatrics (AAP) recommendation to “delay introduction of peanut in high-risk children until age 3”.

Fast-forward to 2015 when the Learning Early About Peanut Allergy (LEAP) trial results were published in the New England Journal of Medicine. LEAP showed us that “feeding peanut to high-risk infants early and often could prevent them from developing a peanut allergy.”

In fact, in the LEAP trial, early introduction reduced risk by 81% compared to control groups who avoided peanuts completely for 5 years. (For more interesting facts about the LEAP studies, check out this article from FARE.)

As a result of the LEAP study outcomes, by early 2017 the National Institute of Allergy and Infectious Diseases (NIAID) officially changed their addendum guidelines to support early introduction of peanuts as a recommended way to reduce risk for peanut allergy.

Although we have the strongest evidence to support early introduction for peanut allergy prevention, other emerging research appears to also support early introduction of other “Big 8” allergen foods, as Dr. Sunog outlines in his book “Eat the Eight”.

CLICK HERE TO GET THE "EAT THE EIGHT" BOOK ON AMAZON  First, Do No Harm

But as you know…just because the info is out there, it doesn’t mean people are using it!

One study published in the Annals of Allergy, Asthma & Immunology found that almost 70 percent of parents were unwilling to incorporate peanuts into a baby’s diet at or before 6 months…and nearly one third of them didn’t know anything about the new peanut guidelines.

So…if research supports early introduction…and updated guidelines recommend early introduction…why aren’t parents actually introducing allergen foods to their babies early and often?

As Dr. Sunog points out - it’s because they aren’t hearing this advice from the very place they go to seek health information: the pediatrician’s office.

By October 2017, 10 months after the addendum guidelines were published, only 11% of pediatricians had put this into practice. As Dr. Sunog states in the book, “Physicians are not immune to the inclination to cling to obsolete information.”

 The “3-5 Days Between Foods” Farce

I couldn’t agree with that last quote more! And from interactions with my students, clients, peers and social media community, I know firsthand that parents are routinely STILL being told by their pediatrician to “wait 3-5 days before trying new foods”.

In my opinion, this whole 3-5 day “waiting game” is an outdated, unnecessary, and unsupported recommendation that only instills fear in parents about trying new foods with baby.

Instead, parents and caregivers should be ENCOURAGED to introduce the wide variety of foods, flavors, tastes and textures that we know babies need to become independent eaters, prevent picky eating AND prevent food allergies.

And, if you want to bring common sense into the conversation - as Dr. Sunog points out in his book and during our interview, if a reaction is going to occur, it will be within hours and not days following the ingestion of the offending food.

Five days after your baby has a strawberry, if his diaper looks different or there’s a new rash around his mouth - do you really think it was the strawberry that caused the “reaction”?

That’s not how reactions or the anaphylactic responses work, and I stand by Dr. Sunog’s efforts to help shift pediatricians away from this outdated practice of recommending to wait 3-5 days between new foods.

(For more information on how you can get your baby to try 100 Foods Before Turning One check out my free online workshop “Baby-Led Weaning for Beginners” here.)

  SIGN UP FOR FREE WORKSHOP: "BLW FOR BEGINNERS" Turning the Tide

In his book, “Eat the Eight” Dr. Sunog does an excellent job outlining the current environment of food allergy advice at a typical pediatrician’s office…it’s generally a conversation that isn’t happening, unless mom or dad asks about it.

And given all the OTHER things there are to worry about as a new parent, the conversation about food allergies often falls to the wayside.

Besides outlining all of the relevant research, historical recommendations, new guidelines and suggestions for introducing allergens, Dr. Sunog’s “Eat the Eight” book includes some very important commentary about why parents aren’t hearing this advice and how a concerted campaign or effort called “Eat the Eight” may help turn the tide.

 Allergen Answers from Dr. Sunog

Because I work as a dietitian specializing in infant feeding, I am in constant contact with parents of babies approaching, at, or just after the 6 month mark - that magical age when babies start the weaning process through initial introduction of solid foods.

And in this line of work I get a TON of questions about food allergies. So why not ask the expert to help answer them?

I surveyed my audience and curated some of the most popular questions about food allergies, and brought them to my interview with Dr. Sunog.

Basically I asked him every allergy question in the book, and his straightforward, evidence-based answers were a breath of fresh air in what can be a confusing space to try to sort things out on your own.

Below are some selected questions from you - with answers from Dr. Sunog - all about starting allergen foods with your babies in an attempt to help prevent food allergy down the road:

 “If my baby doesn’t have an allergic reaction to a food on first exposure, could he have it on second or subsequent exposures?”

Dr. Sunog’s response: Your first exposure to anything that you’re going to react to essentially “primes the pump”. On the second exposure you actually react. It should be a second or later exposure…it can happen on the first time baby is “eating” that food - but “eating” it might not be the actual true first exposure.

He went on to explain that doing typical samples from a baby’s crib almost always yields trace amounts of peanut and other food proteins - so baby may be exposed outside of traditional food “tasting” before first bite of that food.

 “What are the signs and symptoms of a reaction that parents should be on the lookout for when trialing new foods with babies?”

Dr. Sunog’s answer: For an infant, look for things like a rash around the mouth, fussiness, vomiting, any kind of respiratory distress.

We also discussed how other things happening concurrently can cause reactions too, like teething, or baby having a cold and being immunocompromised. So it’s not always the food’s fault if a reaction happens!

 “If mom had to remove dairy while breastfeeding because of skin and gut problems in baby, should she avoid introducing solid dairy foods and milk protein to baby at 6 months of age and onward?”

Dr. Sunog’s response: if baby’s symptoms resolved during breastfeeding when mom removed dairy, it does not necessarily mean baby is “allergic” to dairy foods. Over the ensuing months, baby’s gut has developed to the point where baby may be able to tolerate these food proteins more efficiently, so after checking with your own doctor, it’s likely safe to trial these foods.

He went on to point out the importance of understanding the difference between food allergy and intolerance - they’re not the same thing: an allergy is a potentially life-threatening allergic reaction to what is usually the protein component of a food.

An intolerance - while it’s an inconvenience and may be uncomfortable for mom or baby - is not life-threatening and is often caused by the type of carbohydrate (sugar) in the offending food.

Knowing the difference between allergy and intolerance - and using those terms correctly - is important when relaying your baby’s medical situation to the healthcare provider.

 “LEAP and new guidelines have redefined ‘high-risk’ for peanut allergy as being baby with severe eczema and/or established egg allergy…how do you know if your baby has severe eczema and therefore falls in this high risk category?”

Dr. Sunog’s answer: Consider these statistics:

  • 12.97% of children have eczema

  • 7% of these children with eczema have severe eczema, therefore

  • 0.9% of children have severe eczema, and

  • 2% (at most) of children have egg allergy

(…and those statistics are for all “children”, they’re even smaller for infants.)

Eczema is a break in the skin’s barrier. The worse the eczema, the higher your risk is for food allergy. There’s no blood test for diagnosing severe eczema, it’s not a quantitative thing, but if you look at the statistics, very few infants actually are “high risk” for peanut allergy.

Yes, there are high risk criteria for peanut allergy, but determining severe eczema is essentially a judgement call on the part of the pediatrician…the pediatrician who may make that call or refer baby to a dermatologist to do the same.

 “What should I do if I think my baby is at high risk for food allergy?”

Dr. Sunog’s response: babies with severe eczema, egg allergy, or both should strongly consider evaluation with peanut-specific IgE and/or skin prick tests, and, if necessary, an oral food challenge. Then based on these test results, introduce peanut-containing foods at four to six months of age, per the guidelines.

For the mild to moderate eczema categories, introduce peanut containing foods at around 6 months of age.

And for your babies with no eczema or any food allergy, introduce peanut containing foods at an appropriate age and in accordance with family preferences and cultural practices (…from the NIAID addendum guidelines).

 “Should I park my car outside the pediatrician’s office or emergency room to try a new allergen food with my baby?”

Dr. Sunog’s answer: No. Allergic reactions are scary…I liken it to a febrile seizure - any seizure is terrible to look at - even as a professional, seeing a child conscious is terrifying. But febrile seizure is utterly safe, results in no harm…although yes, you’re still super scared.

With food reactions, parents are assuming the worst. But the good news is that a first time reaction is rarely life threatening…fatality is all but unheard of, especially in young infants like the ones who are trying these foods for the first time at or around the 6 month mark.

Most reactions don’t require anything more than at-home administration of Benadryl. And Dr. Sunog reminds you to still check with your pediatrician, explain the symptoms and get confirmation about preferred Benadryl dosing for baby.

 “How many grams of potential allergy food is considered an effective dose? We see 2 grams 3 times per week from LEAP of peanut protein, but what about other foods?”

Dr. Sunog’s response: there are no established guidelines about dose. We don’t know anything about that. Even with peanut, for better or worse, that was just the “dose” that was tested…nobody could say less wouldn’t work. If my child was high risk I would push harder to do it early and often.

 ‘What are some safe ways to introduce peanut protein to a baby at 6 months of age if intact peanuts are a choking hazard and peanut butter in globs may be too challenging for babies this young?”

Dr. Sunog’s answer: I have done a lot of research helping to develop a peanut puff that is appropriate for babies. As an advisor to PUFFWORKS, I helped bring their PUFFWORKS Baby line of peanut puffs to market. These are an improvement on existing puff products for a number of reasons.

PUFFWORKS Baby puffs are:

  • Softer than other peanut puffs on the market, so they’re easier for early eaters to eat even without teeth

  • Lower in salt with no added sugar; other commercial products have added salt and sugar that babies don’t need

  • Comprised of non-GMO ingredients and include whole gain ingredients that are less processed than other baby puff products.

15% OFF PUFFWORKS ON AMAZON WITH CODE 15BABYLED



 “What about this trend of ‘medicalizing’ introduction of allergen foods? If a baby can eat food at 6 months of age or more, why should parents be told they have to buy fancy, high-priced products that have arbitrary amounts of the allergen in them?”

(Full disclosure: this was my question - and it’s one of my biggest pet peeves. Six month old babies can eat real food, I just..

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This is not a sponsored post. The post does contain affiliate links and the modest income I receive from these affiliate partnerships helps me offset the cost of running this site.

Oh No: Teething Time

If there’s one thing I don’t like about babies, it’s when they’re cutting teeth.

Teething messes EVERYTHING up: nap time, milk feeds and the new solid food schedule you’re probably just adopting!

Now your baby might be developing his first teeth anywhere along the infant spectrum. Some babies are born with teeth (weird, I know…but it’s true) and other babies might not get their first tooth until after their first birthday.

Both of those are outlier situations - but there’s no rhyme or reason about when a baby gets teeth.

It’s also important to note that having teeth is not a pre-requisite for starting solid food…so don’t let the lack of teeth hold you back from getting started with baby’s first bites!

 Signs of Teething

You probably don’t need a medical degree to know when your baby is teething.

You can usually tell SOMETHING is up.

Side note: teething might actually be MORE uncomfortable for parents and caregivers than it is for some babies - because not all babies are bothered by teething.

But here are some signs to look out for during teething:

  • More drool from babies than usual

  • Area around tooth may be swollen and tender

  • Temperature may rise slightly

When it comes to the temperature thing - a 2016 Pediatrics review found that although temperature might rise during “primary tooth eruption” - but it’s usually not to fever levels. Since true fever is not usually associated with teething it may instead be a sign of illness or infection, so be on the lookout for that.

And about all that drool…excess drool can lead to rashes around the mouth and changes in your baby’s diaper. Sometimes these two side effects of teething actually get blamed on feeding.

Keep in mind that your baby is trying new foods and textures and possibly potential allergen ingredients during the same time he or she is teething. What “might” seem like a reaction to a new food (rash around the mouth or changes in the diaper) may in fact be due to excess drool and saliva associated with teething.

 Interventions for Teething

You can’t really stop the process of teething, so it may give you peace of mind to know there’s not a whole lot you can - or should do.

But if you feel the urge to give your baby a break, here are a few interventions for teething to consider:

  • Medication - ask your doctor about weight-appropriate doses of acetaminophen (Tylenol) for 6 month+ babies or ibuprofen (Advil or Motrin).

  • Don’t offer remedies that include the plant poison belladonna, gels with benzocaine or amber teething necklaces (the FDA advises against teething necklaces because of choking hazard & the AAP backs up claim that they are not supported by science).

  • Chew toys - plastic and rubber toys are good for aching gums (…but then again the AAP also recommends against BPA in hard plastic, go figure).

  • Massage - you can gently rub or massage your baby’s mouth / gums, but make sure to wash your hands first.

  • Sleep schedule - “try” to keep your sleep routine regular even when baby is teething; avoid disrupting the schedule to prevent further sleep troubles down the road.

  • Cold temperatures can also help - try damp washcloths that have been twisted and frozen but avoid teething rings that are frozen solid (they’re too hard for baby’s mouth and also present an opportunity for potential bacteria contamination).

 Food Tweaks When Teething

Your baby does not need teeth to transition to solid foods.

But there are some foods that are a bit safer when babies are teething. Personally I like to hold back on the following foods until baby has 1 or more teeth poking through:

  • Corn on the cob

  • Chicken legs on the bone

  • More challenging raw vegetables like cucumber with skin and bell pepper strips

Some babies find frozen foods feel good on their gums, so try out frozen yogurt bites or cubes to suck on.

Chilled cucumber strips (with or without skin and/or seeds) work as well.

 Frozen Yogurt Teether Treats

These frozen yogurt teether treats are one of my favorite foods to offer teething babies. This recipe idea is from the book “making mealtime ezpz: fun ways to fill the happy mat”. I adapted the recipe by adding yogurt and then putting the yogurt mix in my deviled egg dish because I didn’t have the freezer space for spreading it out on parchment paper. You could also do this in mini ice cubes too!

If you’re looking for really easy ways to make mealtime FUN - definitely check out the “making mealtime ezpz” book. It’s one of my favorite resources for food art and you can 10% off this book and all ezpz products with code KATIE10 - click here to check their products and the book out.

  GET 10% OFF ALL EZPZ WITH CODE KATIE10  Frozen Yogurt Teether Treats RecipeIngredients
  • 1 cup whole milk (full fat) yogurt

  • 2 cups strawberries

Instructions
  1. Rinse strawberries and remove green stem / top of strawberries.

  2. Combine hulled strawberries and yogurt in a blender and blend until liquid. Add additional yogurt or milk to achieve desired consistency.

  3. Pour yogurt mixture into a zip-top bag, then snip the bottom corner and portion liquid mixture into deviled egg plate, food molds or ice cube trays. Freeze for 2 hours or until set.





If your yogurt mixture is a tad thicker you can also just portion it from the zip-top bag direct onto parchment paper. Mine was a little too runny to do this - which is why I opted for the deviled egg plate, which helped keep the spread contained!





Now I want to know…what’s your go-to M.O. when your baby is teething?!

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Disclaimer: This is a sponsored post. Although the thoughts and sentiments contained in the post are my own, I received complementary product and financial compensation from the sponsor of the post, Kabrita USA. This post also contains affiliate links. To learn more about Kabrita USA click here.

I get many inquiries from parents asking about alternatives to cow’s milk for their toddlers.

Fluid cow’s milk is not appropriate for babies under age 1, but for infants who have had GI or skin issues during breastfeeding, these symptoms sometimes improve when the breastfeeding mom removes dairy from her diet.

But once their baby turns one, these same moms are left wondering, “Should I introduce cow’s milk or try an alternative that might be easier to digest, like goat’s milk?”

Before we dive in - let’s talk for a second about how intolerance is different than allergy …

 Allergy vs. Intolerance: What’s the Diff?

It’s important to differentiate between allergy and intolerance:

  • Food allergies are potentially life threatening medical conditions that involve the immune system and elicit an immune response

  • Food intolerances are inconvenient and uncomfortable…but not life threatening and sensitivity encompasses reactions that do not involve immune system

When it comes to foods most likely to cause allergy:

  • There are 8 major food allergens that account for more than 90% of food allergy

  • Milk, egg and peanut represent about 80% of common childhood food allergy

  • The most common childhood food allergy is milk, affecting about 2.5% of those under 3

 Cow’s Milk Intolerance

Many moms are first introduced to cow’s milk intolerance when they are breastfeeding and baby has a skin or GI reaction.

Symptoms that might indicate dairy or cow’s milk intolerance in young children include:

  • Reflux

  • Gas

  • Constipation

  • Eczema

Now of course these symptoms could be caused by a myriad of food or environment-related issues, but it doesn’t hurt to experiment with eliminating cow’s milk on a trial basis.

Your pediatrician or a pediatric dietitian can give you more information about how to conduct a trial elimination if it is medically indicated for your young child or baby.

If your pediatrician suggests that you as a breastfeeding mom go off of dairy , that means eliminating fluid cow’s milk, cheese and yogurt from your diet.

This can help alleviate symptoms in your breastfed baby…but if after your baby turns 1 you are weaning off of breastmilk, you might be wondering what fluid milk or milk alternative to offer your child?

What about goat milk?



 Should I go with Goat Milk?

Goat milk is a good alternative to transition to for babies who have struggled with gut or skin issues possibly related to cow’s milk.

The proteins in goat milk form a gentler curd in the stomach and are broken down more quickly than cow milk protein.

So goat milk formula may be a good solution for children who have had issues digesting or tolerating cow milk consumption.

It should be pointed out though that lactose is still the primary milk sugar in goat milk, so this is not appropriate for lactose intolerance. And goat milk also is not ok if there’s diagnosed cow’s milk allergy as both animals have similar proteins in their milk.

One of the products I like and have personally used is Kabrita Goat Milk Toddler Formula. I love that it is gentle on tiny tummies and the added iron in this formula is especially helpful during the critical weaning period.



I wrote about our family’s previous experience using Kabrita with one of our quadruplet sons Charlie had some cow’s milk related eczema. That post is here …and I also shared one of our favorite Goat Milk Smoothie Bowl Recipes in a separate post with Kabrita here.

CLICK HERE TO READ EXPERIMENTING WITH GOAT MILK FORMULA FOR ECZEMA


 Goat Milk Case Study

I recently consulted with a mom who had been through the rigamarole of trying to eliminate cow’s milk protein in her diet as it had led to gut and skin issues in her breastfed baby.

The mom Courtney is a member of my virtual baby-led weaning membership group THE BABY-LED WEAN TEAM. But we live close by each other in San Diego, so I had the opportunity to meet and consult with Courtney and her daughter Julia in person.

Julia just turned 1 and Courtney had been trialing a number of allergen-free formulas after she stopped breastfeeding. She was very knowledgeable about infant nutrition and had researched the product Kabrita, a toddler goat formula on her own.

As she was approaching age one, Julia was ramping up her solid food intake with baby-led weaning…but her mom Courtney was using the Kabrita goat milk formula in addition to the solid foods Julia was eating.

The Kabrita Goat Milk Toddler Formula has helped their family provide Julia with additional nutrition, iron and an alternative to cow’s milk which was gentler on the child’s stomach and gut.





 Taking Goat Milk Toddler Formula for a Test Drive

If your young child has had GI or skin related side effects that you suspect are caused by cow’s milk, it doesn’t hurt to give goat milk toddler formula a trial run.

I think a product like Kabrita is a good alternative for families not on cow’s milk because - in addition to its ease of digestibility:

  • It is iron fortified - as baby is weaning off of breastmilk or iron-fortified formula, the additional iron from foods and a product like Kabrita can help meet iron needs

  • The fatty acid profile is ideal - Kabrita carefully selects their fats to mimic the long and short chain fatty acids in breast milk

  • Carbohydrate is key - Kabrita Goat Milk Toddler Formula features lactose, a natural carbohydrate that is also the same primary carbohydrate source in breastmilk

If you are interested trying out Kabrita Goat Milk Toddler Formula, you can get a free 14 oz goat milk toddler formula tin from Kabrita (a $25 value) for just the cost of shipping and handling by clicking here.

CLICK HERE FOR A FREE 14 OZ CONTAINER OF KABRITA GOAT MILK TODDLER FORMULA

To learn more about Kabrita Goat Milk Toddler Formula - check their great resources on their website here.

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Disclaimer: the content in this post is from a Plant Based Nutrition Leadership Conference that I attended as a guest of The Wonderful Company and Wonderful Pistachios. I was not compensated to attend the conference and the information and sentiments contained herewithin are my own. The photos in this post are credited to Wonderful Pistachios. This post does contain affiliate links.

 Putting Plants First

With 7 kids and a full time job, I don’t get to attend in-person nutrition events as often as I would like anymore. But when I hear about a good one, I want in! And this was the case with the recent Plant-Based Nutrition Leadership Symposium (PBNLS) sponsored by Wonderful Pistachios.

Full disclosure: I am not a vegetarian. Far from it. My husband is from Texas, so he thinks his birth right is to have meat at every meal!

In addition to being a mom of 7 kids - in my professional life as a dietitian specializing in baby-led weaning, I teach introduction to solid foods and very much value the nutrients, particularly iron, that animal foods can provide in a baby’s diet.

While I value and personally eat both plant and animal foods, I’m also a huge advocate of Michael Pollan and his sentiments about structuring your plate in his book Food Rules, “Eat food. Not too much. Mostly plants.”





 So What Does “Plant-Based” Look Like Today?

One of my favorite parts of the Plant Based Nutrition Leadership Symposium were the extensive conversations with presenters onstage and informally with my fellow attendees all about, “What exactly does plant-based mean”?

I didn’t realize that much of the general population hears “plant-based” but thinks that means “plant-only”. To me, “plant-based” always means mostly plants - like more than half your plate.

There was no consensus statement put out about defining “plant-based” but I enjoyed the education sessions, research briefs and commentary from practitioners about the various ways to eat more and reasons for encouraging more plant food intake.

 Powering Baby’s Palate with Pistachios

Most of the attendees at this particular conference worked with adult populations. There were university researchers and integrative wellness professionals from many walks of life. And I was one of a handful of professionals representing infant and child nutrition clientele.

I do a fair amount of work with Wonderful Pistachios promoting this product to adult populations, but I also use it some of my baby-led weaning materials since pistachios are a tree nut and research is increasingly demonstrating the importance of early introduction of potential allergen foods in preventing food allergy.

Because intact nuts and thick globs of nut butters are potential choking hazards for babies, one way I encourage introduction of tree nuts like pistachios is to pulse them in a food processor or use a blender to finely chop so they can be sprinkled on or incorporated into other recipes as ingredients.

You can coat slippery foods for babies like avocado slices or cooked apple or pear slices to add grip for babies, but they also work to roll proteins like tofu or even fish in as a crust before baking or frying.

There were no shortage of amazing plant-based recipe ideas and actual foods presented at this conference, and I saw a lot of crossover between the foods the adult attendees were eating and those that could be enjoyed safely by babies and toddlers.





 Must Follow Plant People

At the Plant-Based Nutrition Leadership Symposium I had the opportunity to hear from a few of my favorite speakers in the nutrition world.

Chef Julia Nordgren

I was so excited to see one of my favorite physicians who is ALSO a chef, Chef Julia Nordgren, MD on the speaker lineup.

Chef Julia Nordgren, MD - who also goes by Dr. Julia Cooks (her website is here and her instagram is here) recently published a cookbook “The New Family Table” (click here to see it on Amazon).

I had a chance to chat with her about her book - which is filled with NORMAL recipes families can make and many of which can be safely fed to babies.





One of my favorite parts of Dr. Julia Cook’s talk was her “Will Cook for Screentime” approach she uses with her 2 pre-teen sons. If they want to play video games or use their tablet, she “trades” them time in the kitchen helping her prepare meals for the family.

I’m going to be doing some collaborations with Dr. Julia around her book and family feeding in the near future so stay posted!

CLICK HERE FOR THE NEW FAMILY TABLE BOOK ON AMAZON


Christopher Gardner, PhD

Another all-time favorite speaker of mine is Dr. Chris Gardner from Stanford who researches and speaks about the intersection of meat, protein and the environment. I’ve heard him speak before at the Healthy Kitchen, Healthy Lives conference and I love love love his talk on protein - basically breaking down and dispelling the notion that ANY of us aren’t getting ENOUGH protein.

Dr. Gardner is down to earth, steeped in science and factual info, but with a great presentation style that keeps even the nerdiest nutrition folks in the audience laughing.

Another soft spot for Dr. Gardner is he did his PhD at UC Berkeley - in the same department where I used to teach undergraduate dietetics - and he has some great history and stories to share about conscientious objectors and testing baseline protein needs that would NEVER fly in today’s research world…but that served an important role in helping us reach modern day understanding of actual protein needs.



 Jessica Mathews, PhD

It was also a special opportunity to get to travel to and from this conference and spend time with another friend in attendance, Jessica Mathews, PhD who is the Program Director of the Integrative Wellness Master’s of Science in Kinesiology program at Point Loma Nazarene University.

Jessica and I used to teach together in San Diego and even though her background is in fitness and integrative wellness, our professional paths cross often. She works closely with Registered Dietitians and other credentialed healthcare professionals teaching about the importance of Integrative Wellness and plant-based diets.

If you’re interested in Integrative Wellness, Jessica’s program is doing some really amazing work at PLNU and you can check out their page here.



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Starting solid foods means some serious changes are coming to a baby’s diaper near you! And constipation is a very real - and really challenging - side effect of moving away from a liquids-only diet.

Let’s explore what’s making your baby constipated, when constipation is a problem (or isn’t) and what you can do to ease your baby (and your baby’s gut) comfortably into the transition to solid foods.

Be sure to check out the bottom of this post for my favorite DIY apple-prune puree recipe that works wonders for infant constipation!

 What is Constipation?

I know it’s hard to watch your baby grunt and strain to pass a bowel movement…but just because she is having less frequent bowel movements (BMs) doesn’t necessarily mean your baby is constipated.

Signs of constipation include:

  • Hard or pebble or pellet-like stools (NOT followed by a soft BM)

  • Bowel movements that are accompanied by pain or difficulty in passing (your baby will be likely wrenching his back and crying during BMs)

  • Less frequent bowel movements…although this can be misleading and doesn’t always signify a “problem” (…more on that in a moment)

Keep in mind that your baby has a lot of things going on at once: yes she is learning how to eat, but her body is still developing and the intestinal muscles are not the strongest quite yet.

So… when do you need to be worried about constipation?

 When Constipation is Concerning

Constipation may be more of a reason for concern when:

  • Your baby has repeated hard or pebble or pellet-like stools (NOT followed by a soft BM)

  • Your baby is continually in pain or has discomfort upon passing BM and that BM is hard

  • Your baby has blood in his or her stool

But not all drop in frequency of bowel movements is reason for concern and much of what parents worry about is just the gut’s normal reaction as baby is transitioning from an entirely liquid diet to one that now contains solid foods.

Finding pictures of constipated babies is no easy feat. Here’s Gus who might be constipated…or just hungry :)

 When Constipation is NOT Concerning

In infancy, just because your baby is straining during defecation does not necessarily indicate that the baby is constipated.

If your baby is straining but then ends up passing a soft stool, he is likely fine.

And if frequency of BMs drops (as it does when you’re transitioning to solid foods), even if your baby is going 3-5 days without a BM but then eventually does have a BM, she is likely fine.

You’ll notice that as your baby nears the 1 year mark, and especially when crawling and then walking kicks in, that added movement helps gets things going in your baby’s gut too!

 What About Interventions for Constipation?

If you’re concerned that your baby has true constipation or your primary care provider recommends and intervention, there are a number of routes you might take.



Suppository

Recommendations differ on when to involve medical interventions for constipation. Some pediatricians may recommend a glycerin suppository; however, these should be reserved for occasional and not regular use.

The American Academy of Pediatrics (AAP) advises against the use of mineral oil, stimulant laxatives or enemas for infant constipation.



Fruit Juice

Fruit juice is another fast fix for infant constipation. The AAP advises against the provision of juice for infants less than 1, although that is for regular consumption and doesn’t address constipation. (Click here to read my post about the AAP “no juice for babies” guidelines.)

If you do want to use juice, stick to these guidelines for infant constipation:

  • 4-8 month old babies, 2-4 oz of 100% fruit juice per day

  • 8-12 month old babies, up to 6 oz 100% fruit juice per day

Certain types of fruit juice are more effective at promoting BMs, and these include:

  • Pear juice

  • Prune juice

  • Apple juice

If you do utilize juice on occasion to promote BMs, don’t forget to offer regular feedings and return to breastmilk, formula or water only for liquids for baby one constipation has resolved.



Food Fixes for Constipation

There are a few food fixes you can employ when dealing with infant constipation. Prunes and pears have a tendency to induce BMs because they have sorbitol, a naturally occurring sweetener (sugar alcohol) that acts as a laxative.

Bran also has a laxation effect, but watch out for lots of added sugar in bran muffins. And go easy on bran because it’s very high in fiber and can absorb a lot of water, thus taking up valuable room in your baby’s stomach if you overdo it.

If you are using an infant or white rice cereal, consider switching to a whole grain option like barley, whole or bulgur as they have more fiber.

Anecdotally, other parents have found success in helping their baby’s constipation with:

  • Sweet potato puree

  • Cooked soft apples

  • Dates (prepare appropriately as sticky dried fruit is a choking hazard for babies)

  • Prunes or pears (soft, intact or puree version of both)

You probably notice in your own baby certain foods that may be particularly constipating. Gut health is a highly personal thing - and what stops one baby up might not for another. Some foods that are considered to be constipating include those that are low in fiber, so meats and refined carbs and processed and fast foods.

Make Your Own Prune Puree

Yes you can use prune or other juice to stimulate a BM, but it’s also very easy to make your own prune puree at home.

This Apple-Prune Puree is one of my favorite recipes as it’s so easy and definitely does the trick! I like to mix my prune puree with apple for added flavor and to extend the prunes, which can be kind of pricey.

If you can’t find prunes this recipe also works with plums, but you do have to peel and pit the plums first. You can freeze these in individual ice cube portions to thaw and defrost later as needed.


Apple Prune Puree RecipeIngredients
  • 15-20 pitted prunes

  • 3 apples, peeled, cored and sliced

  • 8 cups water

Instructions
  1. In a Dutch oven or large saucepan add prunes, apples and cover with water.

  2. Bring to a boil and cook for 5-8 minutes or until apples are mushy.

  3. Use an immersion blender to puree prune mixture; or transfer to a blender and puree until desired consistency for baby.

 Want to Learn More?

Interested in learning more about the inner workings of your baby’s bowels?

Kidding…kidding…but if you do want more info about baby-led weaning and the effect of the foods your baby is eating right now, come check out my membership group The Baby-Led Wean Team.

The Baby-Led Wean Team is a supportive online community with tons of BLW tips, exclusive recipes, weekly live trainings, coaching and Q&A sessions.

Each week I am live inside of the membership doing an in-depth training on topics like reflux, iron deficiency, how to choose a safe seat for your baby to eat, introducing allergen foods and tons of other baby-led weaning topics.

You can get 1 month free when you sign up for a 6 month membership. Click here to learn more.

CLICK HERE TO JOIN THE BABY-LED WEAN TEAM MEMBERSHIP GROUP
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Certainly nobody sets OUT to feed their baby the wrong way…but mistakes happen for sure. Here are 5 common mistakes I see parents and caregivers make when starting solid foods and a few ways YOU can avoid them.

 We All Make Mistakes…

Before we launch into all the feeding stuff you’re doing wrong (…kidding, kidding…) let’s just say, if you have made ANY of these mistakes, you are not alone!

We are all a work in progress when it comes to feeding our family - and the following suggestions are offered not out of a place of judgement, but rather to help you give baby the safest start possible to solid foods as you work towards raising an independent eater!

 Mistake #1: Putting Food Directly on Tray for Baby

It seems logical that the high chair tray is where food goes.

But putting food directly on the tray leads to a few problems.

First off - when baby just starts solid food he can only rake and scoop and has not developed a pincer grasp. As a result, baby will swing his hands around and knock food onto the floor, frustrating baby (and possibly infuriating you :)

The solution to this problem is to use a feeding plate or bowl with pliable silicone that gives when baby maneuvers food.

All-in-one placemats + plates (like ezpz mini mats, tiny bowls and mini bowls) are great because they suction to the table also which helps stabilize during feeding.

These are the mini mats from ezpz and they enable self-feeding success by suctioning to the table.

You can get 10% off all ezpz products with code KATIE10 at ezpzfun.com. And for more information about all of this baby plate business check out my post “5 Benefits of Using a Baby Plate or Bowl” and additional information on the ezpz blog - written by my friend and colleague Dawn Winkelmann, MS, CCC-SLP who is also the feeding expert for ezpz.

GET 10% OFF EZPZ WITH CODE KATIE10  Mistake #2: Serving Only “Healthy” Foods

Many parents mistakenly serve babies mostly fruits and vegetables. Sure, these are healthy foods, but produce alone will not meet baby’s increased iron needs at 6 months of age or sustain baby as he approaches the 1 year mark.

It is wise to include fruits and vegetables in your rotation…but don’t forget about proteins and carbohydrates also.

The solution to this problem is to include a variety of foods including fruits, vegetables, proteins and carbohydrates. For your vegetables add fat like butter and oiled to increase fat intake and calories when baby begins to need more calories from food.

Serve baby a variety of foods including meats and carbohydrates in addition to fruits and vegetables.

If you’re interested in more information about increasing variety and really pushing your baby’ palate, check out my free online workshopBaby-Led Weaning for Beginners: How to get YOUR baby to try 100 foods before turning one without YOU having to spoon-feed purees or buy pouches!”

Click here for to sign up for the workshop.

FREE WORKSHOP: BABY-LED WEANING FOR BEGINNERS  Mistake #3: Offering Portions that are Too Large

Spend ANY amount of time on Instagram or social media looking for #babyledweaning and I guarantee you you’ll come across ridiculously oversized portions of food being offered to babies by well-meaning parents and caregivers.

Those who need baby often feel like they need to “fill up” the baby bowl or plate..or tray…oftentimes not realizing that the portions they are offering are way off base for babies.

Pushing big portions on baby is problematic for a number of reasons, but mainly:

  • It’s confusing to a baby who has stopped eating because she is full as to why there’s all this food still on my plate?!

  • Parents end up feeling dejected or frustrated when baby doesn’t “finish” all the food that is on the plate (…even though it was arbitrarily chosen and likely too much to begin with).

The solution for this mistake is to think in terms of tablespoons. As in…babies may only need a few tablespoons of food per meal. Some will eat more, and that is ok - but don’t push your baby to eat more than he knows he wants or needs.

Ideally, you want to set out the amount of food you are offering baby for the meal on a plate or mat or bowl. This helps baby visually prepare for the amount of food he or she is about to eat…and if baby eats more - or less - than this, that’s ok too.

Whoah mama…that’s a huge plate of food! I just need a few tablespoons at a time please.

 Mistake #4: Wiping Baby’s Face and Mouth During Feeding

I have TOTALLY fallen victim to this mistake in the past…in fact, I used to do it all of the time before I started working in the field of baby-feeding.

Don’t wipe baby’s face during feeding.

This is a very important piece of information I picked up from working with my friend and colleague Dawn Winkelmann, MS, CCC-SLP (@msdawnslp) feeding therapist and feeding specialist for ezpz.

As Dawn likes to point out, “Do you know ANY baby or child who likes having his or her face wiped?”

Wiping my face while I am eating upsets me and can lead me to have negative associations with food.

Constantly cleaning up while baby is trying to eat interferes with the joy and process of self-feeding.

This intrusion by your wet wipe or washcloth is also unappealing to baby from a sensory standpoint…which can lead baby to have negative associations with food.

The solution?

Chill out about your baby’s mess. Allow baby to self-feed during the meal - no matter how messy it is - and resolve yourself to clean up the mess AFTER feeding (…but do it quick, because dried food is the DEVIL!!).

You can use splash mats on the floor or silicone feeding plate and bowls that suction to the table to minimize mess. I like the splash mats from Bapron Baby and you can get 10% off with code KATIE10.

These are the splash mats and bapron bibs from Bapron Baby.

GET 10% OFF BAPRON BABY SPLASH MATS WITH CODE KATIE10

If you’re into this sensory feeding sort of stuff, check out Dawn’s two-part blog post series about pitfalls to avoid with BLW on the ezpz blog here and here.

 Mistake #5: Intervening During Baby’s Gag

If I had to go back and ask the thousands of families I have now had the honor to teach baby-led weaning to, “What’s the number one thing you were scared of when you started BLW?”… it would definitely be gagging.

Knowing the difference between a gag and a choke is of key importance when starting solid foods. It is always advisable to take a refresher infant CPR course when baby starts solids at 6 months of age.

But to sum it up - the difference between a gag and a choke is:

  • Choking is usually silent aspiration (no noise) and baby will turn blue

  • Gagging involves noise (coughing) and baby’s face turns red or pink

And when it comes to intervening:

  • If a baby is choking, an adult needs to intervene and follow CPR protocol

  • If a baby is gagging, the baby will self-correct and adults should NOT intervene



So, why not jump in on a gag?

Well, lunging at the gagging baby can startle or frighten baby further, causing him to suck food in to the airway and actually increase the risk of choking on what was originally just a gag.

Furthermore, gagging is a natural and necessary part of learning how to eat….baby will not be able to fully master feeding milestones if she is not allowed to practice along the way.

If you are freaking out about not intervening during a gag, keep this learning to walk analogy that Dawn Winkelmann cites often, ”When your baby is learning how to walk, he or she falls over, right? Do you then stop all attempts for baby to learn how to walk because he or she is going to fall down? No.”

It’s not pleasant or fun to watch our babies fall (or gag), but it is a necessary part of learning how to walk (…and eat too!)

So, now for the solution (…and this is another great Ms. Dawn tip): when baby is gagging, use a soothing voice and talk your baby through it, “That’s good baby, cough it up…you got this…”

If you don’t stress and trust baby’s ability to self-correct, it will happen. If you stress and intervene, you could make the already uncomfortable situation worse!

 Moving Beyond the Blunders

So there you have it - 5 baby-feeding blunders that are now well equipped to avoid!

If you’re looking for more info about getting a SAFE start to baby-led weaning, check out my e-book The Quick-Start Guide to Baby-Led Weaning.

This ebook is 16 pages jam-packed with everything you need to start baby on solids safely, from a nutrient deep dive, to tips about seasoning without salt, what to avoid when you’re feeding, some sample starter foods and a few of my favorite combination food recipes too.

Click here to get the Quick-Start Guide to Baby-Led Weaning…and Happy Feeding!

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Don’t do this! Feeding your baby in a stroller or car seat increases choking risk.

Your baby choking on food while learning how to eat is a rare - but real - risk. I surveyed my audience asking for real life choking stories, and the many responses I received were eye-opening and at times harrowing.

I’m sharing a few of these stories below - but for context I’d like to first briefly address BLW and choking risk.

 Your KNOWLEDGE About Choking Reduces Risk

Parents who want to start solid foods with their baby using baby-led weaning often cite the fear of gagging or choking as their primary barrier. (Click here to read the 5 Biggest Fears that Stop Parents from Doing Baby-Led Weaning.)

READ: The 5 Biggest Fears that Stop Parents from Doing Baby-Led Weaning

Published research supports the idea that babies who start solid foods using a baby-led approach to feeding are at no higher risk of choking than are traditionally-weaned, spoon-fed babies.

The caveat with this research, however, regards education. The studies show that parents who are educated about avoiding choking risk foods and unsafe feeding practices and THEN start solids with baby using baby-led weaning are unlikely to have more choking incidences than spoon-fed babies.

The key is education about choking risk, which is the overarching theme of this post.

Knowing what foods to avoid and what feeding practices to avoid are important for ensuring safety in feeding.

 What Increases Choking Risk?

The American Academy of Pediatrics (AAP) states that approximately 50% of choking incidences in babies occur from food.

One large choking study analyzed data from more than 12,400 children ages 0-14 who were admitted to the ED for nonfatal food-related choking. Researchers found that most of the foods that cause choking are things like hard candy (15%), other candies (13%), meat other than hot dogs (12%) and bones (12%). Other high-risk foods include things like hot dogs, seeds and nuts, and these are more likely than other foods to cause hospitalization for infant and child choking.

  Real Life Stories of Babies Choking on Food

Recently I asked my audience if they would share any first-hand experiences they have with babies choking on food.

The responses were overwhelming - and in most cases difficult to read. But I appreciate all of the respondents’ openness and honesty as well as their willingness to share their frightening experiences to help others avoid ever having to experience the same.

The point of sharing these stories is not to place judgment on the parents or the feeding practice that caused choking, but rather to serve as an opportunity for educating all of us about how easily choking can occur, and what we can do to prevent it.

The parents and caregivers who told me about their choking experiences have authorized me to retell their stories here.

 “We still get stick to our stomach thinking about it…”

One mother shared her story about her then 3-year old who grabbed and ate a grape at a restaurant before she had a chance to cut anything up.

Mom started the Heimlich but could not dislodge the grape. She asked someone to call 911 and her husband took over. When Dad attempted the abdominal thrusts, he was able to get the grape out and the toddler threw up in the middle of the restaurant.

“We still get sick to our stomach thinking about it,” mom shares. And her story shows that while most of us are aware that intact grapes are a choking hazard (one of the biggest hazards, even for older kids), an agile baby or toddler can swipe and choke on a grape in a split second.

If you are serving grapes or cherry tomatoes to baby, cut them in quarters. Even for toddlers, continue cutting grapes or cherry tomatoes in half, and never let children run around while eating grapes (or any food for that matter) as this greatly increases choking risk.





CLICK HERE TO SEE THE OXO TOT GRAPE CUTTER ON AMAZON  “He hadn’t made one noise...”

A friend of mine and a fellow dietitians shared that her son who was about 9 months old was eating leftover pasta she was serving from a container. Mom didn’t realize there were garbanzo beans in the bottom of the container and the baby had a silent choke.

Grandma and mom were BOTH sitting at the table with the baby and they noticed that baby was turning blue. “He hadn’t made one noise,” mom says. The parents had taken infant CPR and other infant safety courses, but in the moment she says, “I honestly just froze. I started screaming, my husband was home and he ran over, put my son upside down and started hitting him on the back. The food flew out of his mouth.”

Should she not have continued trying to feed her baby solid food after this event?

“So many people told me I was crazy for continuing with baby-led weaning after this, but I know that choking can happen at any age. I felt like I was giving him the tools to learn how to have a healthy relationship with food from a young age. Now he is almost 3.5 and eats anything and everything around him!”

This story demonstrates the importance of knowing what to do in the event of a choking risk. Both parents were familiar with infant CPR, and their knowledge of how to administer back blows likely saved their son’s life. Furthermore, the culprit food was an intact garbanzo bean. Foods of this size are the perfect size to block a baby’s airway.

When feeding foods like garbanzo beans, kidney beans, black beans and blueberries, smoosh them with your thumb or fingers to flatten and then serve to baby. These foods are great ways to practice baby’s pincer grasp (which usually develops from ages 8-12 months), but I don’t love them for early eaters (6-7 months of age) because of the choking risk. There is no urgency or hurry to introduce foods like this if you feel more comfortable waiting.





For garbanzo beans I also recommend slipping the bean out of the skin to further reduce choking risk.





 “i’ve been nervous about using the chair ever since…”

Another new mom, also a dietitian, says she just had one choking incident, but it was terrifying. At the very beginning of doing baby-led weaning with her baby, baby choked on a strawberry.

“He was able to clear it by himself,” she said, but noted that the choking incident occurred when the baby was in a travel high chair at a family member’s house. The chair was tough to remove baby from when he was choking, and, “I’ve been nervous about using that chair ever since.”

This story drives home the point about high chair safety. The safest way to feed baby is in a high chair with a foot rest. The foot rest helps support baby during feeding and facilitates the muscle control needed to safely swallow food. Avoid dangling feet, and if baby can’t reach the high chair foot rest yet, construct a makeshift footrest using a cardboard box or other similar support.

When it comes to straps, it may seem counterintuitive but with some chairs it is safer NOT to strap baby in at first. When you start solids at 6 months of age, baby isn’t crawling or able to climb out of the high chair. It is more important at this phase to be able to quickly remove baby from the chair (without straps) in the event of a choke.



Check your high chair to make sure baby isn’t slumping down. Use props such as rolled up towels or receiving blankets to support baby early on if needed. If you use the Stokke Tripp Trapp high chair, use the plastic baby set without 5 point harness at first, and then use straps when baby is older, more confident at self-feeding and more likely to need the harness straps for restraint.

CLICK HERE TO SEE THE NEW TRIPP TRAPP HIGH CHAIR W/ BABY SET  “It was pure instinct…”

Kristy is a mom who tells about her choking incident with a rice cracker when her baby was 8 months old.

Her baby began coughing and turning between red and purple in her face after ingesting the rice cracker.

Mom was watching for a few seconds to see if baby could recover on her own, waiting to see if perhaps it was just a gag baby could overcome by her self. When the baby continued struggling, dad intervened. He took the baby out of her chair and placed baby so she was facing the floor with head lower than her body.

“He just slapped her on the back and the food came right out. We hadn’t had any formal training on what to do in the event of a choking incident, but our reaction was pure instinct”, mom says. “We were all a bit shaken at first, but we fret less now that we experienced it and we now know how we are going to react the next time.”

Kristy’s lesson teaches us that foods that appear harmless - like a rice cracker - can actually be a choking risk. Dry crackers and dry meats are particularly problematic because they get “stuck” in baby’s airway.

Whenever possible, add moisture, sauces or dippers to make dry foods like meat or crackers easier to handle for baby. This also helps facilitate more saliva inside of baby’s mouth, which further facilitates safe swallow.

 “How could a food marketed to babies be so dangerous?”

Another mom shared a story about her oldest, who is now 2 years old. When he was 7 months old he choked on a yogurt puff.

As mom correctly points out, “Puffs get really slimy and it easily lodged in his throat.” She went on to say, “I had never taken infant CPR class and I had no clue what to do. My instincts kicked in, I finger swept him but it was too far back to reach, so I turned him over and smacked him on the back repeatedly until it came out.”

“We both cried for a long while and that’s when I started looking into BLW. I couldn’t fathom how a food marketed towards babies could be so dangerous.”

Puffs are the perfect size to block a baby’s airway. When starting solid foods it is best to avoid circle-shaped foods (like puffs) and stick to longer, spear or strip-shaped foods (think about the size of a fat french fry).




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