Ask Dr. Marla: Babies' Transition to Solid Foods

By Dr. Marla Shapiro on May 19, 2011

Q.
When our baby was younger, he had some weight issues. Our doctor thought he may have been allergic to cow’s milk protein, so we supplemented with a hypoallergenic formula. This seemed to work and he’s feeding much better. Now at nine-and-a-half months, his solid food is still puréed. He takes a couple of little spoonfuls but then he starts to hold the food in his mouth. We try distracting him but we either have to give him water or formula to have him swallow or he pushes those away and just holds it in his mouth. We have tried putting food in his hand and directing it to his mouth.
I have tried breastfeeding or bottle feeding
before the meal or feeding him first and then breastfeeding. It doesn’t make a difference.
Can you offer any advice?

A. Did this behaviour start as soon as you added solids or is it newly developed? If newly developed, it might be as simple as teething that is preventing your child from chewing and swallowing. Have you tried to stop pureeing the food? It might be that the delay in transitioning to different textures has encouraged your baby to be more fussy. A fussy baby can often refuse new tastes and textures – all of which are important for motor muscle growth. Solids are introduced not only for the nutritional value but also for the development of their oral motor skills. Think of all the actions that go into eating – from sucking and licking at the start to biting and chewing. The same muscles that we use for speech we also use for eating.
The change in textures – from the purée you refer to all the way to more solid consistencies – is important. At the beginning we will often tell parents to mix the cereal so it is quite runny. But it is important to allow the texture to firm up to encourage chewing.
I went to Dr. Glenn Berall, Chief of Pediatrics at North York General Hospital in Toronto, for some practical advice. He suggested you put food on your son’s tray and let him play with it. We want your child to become more active in feeding so rather than put the spoon in the child’s mouth, try holding it an inch from his face at the level of the bottom lip and then let him come to it and take it off the spoon. You must not move the spoon while he does that. If he chooses to take the spoon let him. Then refill it. Start with foods that are soft, easy-to-chew, crunchable and dissolvable.
My nutritionist colleagues say that by nine months, solids should be taken easily. Babies’ co-ordination has improved so they can feed themselves, which will encourage chewing.
See your physician to assess the developmental milestones. An occupational therapist would be able to assess your child’s motor development.

Published in June, 2011.

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By Dr. Marla Shapiro| May 19, 2011

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