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Baby Led Weaning

Montessori Meets Baby-Led Weaning: On NPN Today

You can find me over at the Natural Parents Network today, where I discuss the Natural Approach to Introducing Solids that worked for us when Annabelle first began exploring the world of food.

“The Montessori method for introducing solids has always appealed to me on some level, but the practice of baby-led weaning, popular among natural parents, also caught my eye. I went back and forth a good deal as I tried to work out the best approach for us, but in the end, I found out that the two can actually work together in perfect harmony.”

Head over to NPN for the full article.

Feeding with Love and Respect

This post is the second in a series examining the principles of Attachment Parenting. The goal is to explore what the principle is, why it’s important, and what it looks like in different families and different homes. That last bit is where you come in! I can share how these things play out in my home, but I would truly appreciate hearing wisdom from your journey as well. 
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The second principle of Attachment Parenting: Feed With Love and Respect is nicely summed up on the Natural Parents Network resource page“Practice exclusive and full-term breastfeeding if possible, and feed with love and respect regardless of whether it is at the breast or with a bottle; parents continue to nurture when introducing solids, and strive to offer healthy, wholesome foods when babies are ready.”

Exclusive and full-term breastfeeding

This is another principle that’s not just for ‘attached parents.’ Exclusive breastfeeding for the first six months of an infant’s life is a medical recommendation, not just a philosophical one. The American Academy of Pediatrics is on board, as is the World Health Organization, which maintains that mothers should, “Practice exclusive breastfeeding from birth to 6 months of age, and introduce complementary foods at 6 months of age (180 days) while continuing to breastfeed.”  I go into a bit more detail on these recommendations here.

Full-term means different things to different people, but the AAP recommends continuing to breastfeed until at least one year and the WHO recommends at least two years. Many experts consider the natural age of weaning to be at least 2.5 years old or older. A popular choice among attachment parenting families is child led weaning (not to be confused with baby led weaning), where mothers continue to nurse until the child makes the decision to stop. This does not work for every family, of course, and that’s okay. 

The important bit to note is that it says if possible. While almost all women can breastfeed, there are bona fide cases of insufficient glandular tissue and women who try everything to produce enough milk for their babies, but their bodies refuse to cooperate. Of course there are adoptive parents as well, and they are not disqualified from the ability to call themselves Attachment Parents either (but good on them if they can try relactation!) In these more challenging scenarios, the next best thing, of course, would be donor milk. Each family has to deal with the challenges inherent in their own parenting situation in the way that best meets their family’s needs.

…With love and respect
For many attachment parents, this translates to nursing ‘on demand’. Rather than scheduling feedings, caregivers nurse or feed the child whenever they display signs of hunger. What else feeding “with love and respect” means will vary from family to family.

Continue to nurture when introducing solids
Many consider the introduction of solids to be the beginning of weaning, since the intake of solid foods will slowly increase until they completely replace breast milk as a source of nutrition. Continuing to nurture a child during this time may simply mean remembering the importance of breast milk in the baby’s diet and allowing the same regular access to it, rather than making abrupt changes that could be upsetting to the child. Again, there is no right way to do this, and “continuing to nurture” may look very different from one family to the next. Some families may choose lap feeding instead of placing their infant in a high chair, or may make it a priority to sit and focus only on being with their child during mealtimes. There are no rules, just a desire to provide the best and gentlest possible journey into the world of solid food.

Strive to offer healthy, wholesome foods when babies are ready
The idea that parents should provide healthy, wholesome foods wherever possible does not really need qualifying. One important thing to note here, however, is the words, “when babies are ready.” Not every child will be interested in, or developmentally ready for solids at six months, which means that it may be in the best interests of some children to wait even longer. 

Then there is the wholesome and healthy bit, about which there is much disagreement. What one parent considers wholesome and healthy may be viewed as a very poor choice by another. It’s up to each of us to analyze the information available and make a decision from there. On opposite ends of the spectrum are strict veganism and the traditional foods diet. Both are common among AP families, and both are considered to be the most healthy option by many of the people who follow them. Other families fall somewhere in between, or on a completely different spectrum altogether. The important thing is simply to do our best to provide a nutritious diet for our children.

In our family
Annabelle was breastfed exclusively for the first seven months and has slowly increased her intake of solid foods ever since. We started with fruits and vegetables, soon added beans, legumes, nuts, and seeds. The last thing we introduced was whole grains at about nine months. We chose to practice baby led weaning as a way of giving Annabelle the maximum amount of control over her early experiences with solid foods. 

I have always nursed “on demand,” and provide other foods based on Annabelle’s cues. Until recently, I made sure to nurse first, and then offer solids. This allowed breast milk to keep it’s place as the most important part of Annabelle’s diet. At thirteen months, I still nurse whenever I believe she needs it, or when she asks. 
We eat our meals together, with breakfast, lunch, and snacks taking place at Annabelle’s table and dinner in the dining room with Annabelle in her high chair. As for what constitutes healthy, wholesome food in our household, I follow a vegan diet and so does Annabelle, for now. The daddy’s diet includes both meat and dairy products, and I will not restrict these things if Annabelle wishes to eat them when she gets older. I am pretty adamant, however, about avoiding cow’s milk at all costs. Annabelle had absolutely no sugar prior to her first birthday, and we still avoid giving her sugary foods. I do often use blackstrap molasses to sweeten her breakfast cereal as it’s also a great source of iron. I buy organic wherever possible, though there is embarrassingly little in the way of fresh, organic produce on Guam. We avoid the “dirty dozen” fruits and veggies altogether, except when I manage to find them organic. Then I hoard them – sorry fellow crunchy Guammies! We avoid things like canned and processed foods, high fructose corn syrup, and artificial colors in favor of whole foods, made from scratch. We’re not perfect by any means, and we do break our own rules from time to time, but we do our best.

What does feeding with love and respect look like in your family? What practices related to feeding have worked for you, and what has not worked? Please share your experiences! If you have a post of your own on this topic, or even a favorite resource written by someone else, I would love for you to share the link!

Grains, Infants, and the Enzyme Amylase

When it comes to introducing foods to infants, grains are about as confusing as it gets. I already briefly discussed rice cereal and the many reasons why serving it as a first food is ill-advised, but what about grains in general? Knowing that grains can be among the more difficult foods to digest, I was waiting to introduce them to Annabelle, but I didn’t know for certain why or how long I would wait. So, I did some research. There are three things it seems one should consider in making decisions on when to introduce grains to infants and toddlers: allergies, the enzyme amylase, and phytic acid.

Allergies

One of the reasons rice cereal has been so popular, despite its drawbacks, is that it is “hypo allergenic,” meaning that since it’s gluten free, it is unlikely to cause any type of allergic reaction. Since gluten is a common allergen, many recommend that it be avoided until sometime closer to the end of the first year. Some sources say eight months, others ten, and still others recommend waiting until after the first birthday. However, for those children whose families do not have a history of food allergies, it’s not a grave concern. If you are concerned about allergies, you can always offer gluten-free grains like rice, quinoa, millet, or amaranth.

Amylase

Amylase is the enzyme in the body that breaks down grains. It is present both in saliva and in the pancreas. My own amylase research began when I read an article suggesting that grains should not be given at all, at least until the first birthday. Since this information was so different from anything I had heard before, I set out to see if I could find any supporting evidence. I couldn’t, and the author couldn’t provide any. There was something to it, however.

It is true that newborns produce only very small amounts of this enzyme, and therefore are unable to properly digest grains. I had a difficult time finding good studies that looked into the issue, but I did eventually manage to find this one from the American Journal of Clinical Nutrition on salivary amylase, and this one from the European Journal of Pediatrics on pancreatic amylase. In the American study, some infants tested had salivary amylase levels comparable to those of adults by the age of three months, while most all had comparable levels by five months. The European study found that infants tended to have pancreatic amylase levels close to those of adults by eight months.

Of course we all know that every child is different, and all children develop at different rates, so basing our decisions purely on an average is not always the best thing to do. When it comes to giving a child something that will potentially rot in their gut, I’d rather wait a couple of extra months. It seems to me that waiting until eight or nine months is prudent, but that is of course a decision that every parent will make for themselves.

Phytic Acid

Anyone who pays much attention to food or nutrition blogs has probably read a great deal about phytic acid, a substance present in grains in relatively large amounts. Phytic acid is often referred to as an “anti-nutrient,” as it blocks absorption of minerals, like iron, magnesium, zinc, and calcium, in the body (one reason why soy has fallen from grace in the eyes of many). I won’t go into great detail, because many a food blogger has done so already, but the best method of reducing the phytic acid content of grains seems to be by soaking, or fermenting them. I have yet to purchase it myself, but everywhere I go, I read recommendations for a book titled Nourishing Traditions, which I’m told has excellent advice on the subject. It’s on my list, though I know it does not advocate a vegetarian diet at all.. I was first introduced to the idea when I found this post over at The Nourishing Gourmet.

So what are we doing?

At almost nine months old, Annabelle had her first adventure with grains yesterday when she tried a bit of fermented pumpkin oatmeal for breakfast. There is no history of food allergies in our family and Annabelle has shown no adverse reactions to any foods so far, so I felt that we were safe in that department. Since she is well past the eight month mark now, I feel confident that she has the enzymes necessary to digest grains, but I also know that iron deficiency runs in my family, and I was borderline anemic early in my pregnancy, until I educated myself on iron absorption, so I am particularly concerned with phytic acid. I am taking care at this stage to only give her fermented grains.

When did you introduce grains? How did you make your decision? What was your child’s reaction to them?

What are the Best First Foods, Really?

Three friends share a lime
There are so many schools of thought on the introduction of solid foods, but I’m finding that there is a great deal of information out there that is perhaps only loosely, if at all, based on good science. I wanted to share a bit on what I have learned, and the resources I have found so far. I am, of course, neither a dietitian nor a health professional of any kind, so I present this to be a starting point for research and for discussion with other parents. I would be very interested in any resources others recommend on the subject.
One More Time: Wait Six Months to Introduce Solids At All
I say it all the time. Blah, blah, blah, right? Still, I think it is important to note that the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding until around six months of age and notes its importance throughout the first year and beyond (link).
Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life{ddagger} and provides continuing protection against diarrhea and respiratory tract infection.30,34,128,178184 Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.185 Complementary foods rich in iron should be introduced gradually beginning around 6 months of age.
Then, the World Health Organization (WHO) gives their guideline (link). See this link for guidelines for the feeding of non-breastfed infants.:
“Practice exclusive breastfeeding from birth to 6 months of age, and introduce complementary foods at 6 months of age (180 days) while continuing to breastfeed.”
These two sources, taken together with others, led me to the conclusion that there is no basis for the introduction of solid foods prior to six months of age. As I discussed before, I waited to introduce complementary foods until Annabelle was about six and a half months old.
After Six Months: Where to Start

While the above seems to adequately answer the question of when to introduce solid, or complementary foods, the question of what to introduce when is one I am still asking as we go. The traditional practice has been to introduce rice cereal first, but that appears to be terrible advice for a number of reasons, many of which are discussed in this article in Pediatric News. It also appears to be a common cause of severe Food Protein-Induced Enterocolitis Syndrome, as discussed in this study. Despite all this, it is still recommended by many misguided professionals and parents, and the below statement from the WHO’s Guiding Principles seems to be a reasonable explanation as to why.
A review of feeding guidelines promoted by various national and international organizations has shown that there are inconsistencies in the specific recommendations for feeding infants and young children (Dewey, in press). Some of the feeding guidelines are based more on tradition and speculation than on scientific evidence, or are far more prescriptive than is necessary regarding issues such as the order of foods introduced and the amounts of specific foods to be given. To avoid confusion, a set of unified, scientifically based guidelines is needed, which can be adapted to local feeding practices and conditions.” (emphasis added)
In looking around, I have found sources recommending egg yolk as the perfect first food, followed by liver, as well as others that say vegetables and fruits are a perfect way to start. Of course rice cereal still seems to dominate, unfortunately. The advice seems to vary depending on who you talk to. More important than looking for specific foods to offer, then, is considering what infants need and then determining what locally available foods that are enjoyed by the family will help them to get it. The WHO identifies several “problem nutrients,” based on those that infants tend to be deficient in most often. Below, I have listed these nutrients along with some of the most common sources of them in our home. This has really been helpful for me in planning meals for our family with optimal nutrition for Annabelle in mind. Keep in mind that ours is a mostly vegetarian household, so our sources of these foods will differ from those of other families. The WHO has another helpful resource for anyone trying to do the same for their family, called Complementary Feeding: Family Foods for Breastfed Children. I appreciate the fact that it is not prescriptive in terms of listing off specific foods that babies need, but it goes over categories and types of foods, with consideration given to the diets and staple foods of many different populations. Obviously the advice within should be checked with other sources before you radically change anything you are doing with your own family.
“Problem” Nutrients
Annabelle tries some fermented oats with
pumpkin, and hemp seed.
  • Iron: The RDA for infants 7-12 months is 11mg, from 1-3 years it’s 7mg, and for 4-8 year olds it is 10mg. Good sources of iron in vegetarian and vegan households include foods such as: quinoa, blackstrap molasses, tomato paste, white beans, peaches, lentils, and hemp seeds. While leafy greens are a well-known source of iron, the iron many contain is not particularly bioavailable. Iron absorption is enhanced by Vitamin C, but hindered by calcium. Using cast iron to cook can also increase the iron content of foods, particularly more acidic foods.
  • Calcium: The adequate intake(AI) from 7-12 months is 270mg/day, the RDA from 1-3 years is 500mg/day, and from 4-8 years the RDA is 800mg/day. Good sources of calcium that we eat include: broccoli, leafy greens (note that the calcium in some, including spinach, is not well absorbed swiss chard and bok choy are two of the best choices) dried figs, and various beans and seeds. Calcium is one vitamin that has been hotly debated in recent years, and many experts argue that exercise and Vitamin D intake are far more important to the building of strong bones than is calcium. See this letter from Harvard Health for more information. There’s also a great article on PCRM’s website that pertains to children specifically, but readers should note PCRM’s probable bias against dairy products when reading, as they receive a great deal of their funding from PETA.
  • Zinc: 7-12 month olds and 1-3 year olds meet the RDA with 3mg/day and 4-8 month olds with 5mg. Zinc is found in many grains, legumes, and nuts. One great source that has been a favorite in our house lately is shelled hemp seed.
  • Vitamin A: For infants aged 7-12 months 500μg/day is considered to be adequate intake, while the RDA from ages 1-3 is given as 300μg and for ages 4-8 the RDA is 400μg. Vitamin A rich foods in our diet include mango, carrots, pumpkin, and sweet potato.
  • Riboflavin (B2):  The RDA’s are .4mg/day from 7-12 months, .5mg/day from 1-3 years, and .6mg/day from 4-8 years. Sources eaten in our house include almonds, mushrooms, and quinoa. Riboflavin is also found in many fortified foods for vegetarians and vegans such as nut milks and nutritional yeast.
  • Vitamin B6: Between 7 and 12 months, .3mg/day is considered adequate intake and the RDAs for 1-3 and 4-8 years are .5 and .6mg/day respectively. Our favorite sources include chickpeas, bananas, brown rice, and sweet potatoes.
  • Vitamin B12: For ages 7-12 months, the AI is .5μg/day. For 1-3 year olds, the RDA is .9μg/day while it is 1.2μg/day for 4-8 year olds. B12 is a difficult vitamin for vegans to find in regular food sources, so a supplement is almost always recommended. Nutritional yeast is an excellent source.
(Adequate Intakes and Recommended Daily Intakes taken from the USDA’s Daily Recommended Intake Tables: http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140)

The main point seems to be that regardless of what specific foods you choose to feed your infant, you can provide perfectly adequate nutrition with careful planning and consideration of their dietary needs. No child has to eat any one food to be healthy – it is possible to meet the growing infant or toddler’s needs with foods that are available locally and enjoyed by your family.

What first foods did, or will you offer? Would you do the same with future children? What advice or information did you rely on in choosing your children’s diet? I would love to hear from you! 


**I put a great deal of time, research, and thought into this article, so I would love to see others benefit from it. If you have friends who you think may benefit from it, please feel free to email it, share it on facebook, blog it yourself – use it as you see fit!**

Embracing the Mess

Thanks to the excellent mealtime advice I received, I’m now feeling much better about embracing the mess. Today, we finished off the pot of split pea soup I made last week. I just took babe’s dress off, because I knew it would be a mess. We had an excellent time : )
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