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Feeding a six-month-old

There’s an art to feeding a six-month-old baby and – for the new parent – a sense of trepidation. Everybody seems to have a different opinion: start with purees, gradually introducing texture; avoid purees, and go straight for “finger foods”; begin with bland food, such as rice cereal; rice cereal will set your child up for obesity and diabetes, just let them eat what you’re eating; fruit adds fibre – but might give your child a sweet tooth. With all these conflicting messages, just how do you decide what, when and how to feed your baby?

Amelia had her first taste of food at 4.5 months. It was a smidge of roasted pumpkin, proffered on my fingertip. She enjoyed it immensely – but this was hardly what I would call “starting solids.” Every few days (maybe once or twice a week) she would try out a little morsel – a mouthful of rice cereal (she hated it, and with good reason – it’s completely bland and disgusting), a lick of banana (not keen, surprisingly), a munch of strawberry (winner!). She had her first meal at 5.5 months: a packet of Rafferty’s Garden vegetable puree. She gobbled up around 100 grams in a sudden feeding frenzy! But it was not quite a thing yet: I fed her when she seemed particularly hungry in the evening, and wasn’t concerned if she didn’t – breastmilk was, and still is, her primary source of nutrition.

It was around the six-month mark that she really began to take an interest in food, and regular, nightly dinnertime became necessary. I decided to feed her purees because she was genuinely hungry, even after breastfeeding. Some babies this age are more into playing with the food, and aren’t so bothered with how much ends up in the tum. Milly needs her belly filled, so offering cut up pieces of food that require more chewing than she is capable of won’t help much. However, I’ll also offer finger foods during the day: rusk sticks, cut fruit and vegetables, a piece of bread (well, that one time), little bits of whatever I’m eating. She has tried cheese, avocado, cucumber, the foam off my soy decaf mocha, and a whole heap of other things. She’s a keen and somewhat adventurous eater, currently learning to chew soft things, and generally enjoying the challenge of picking up food and directing it to her mouth.

So how did we make these decisions? (I say we, but really, my darling husband has mostly just been watching in fear and trepidation, questioning my every feeding choice, worried about choking hazards and germs and allergies – God bless him). I reasoned that whether she eats purees or finger foods, she will inevitably learn to chew and swallow. I can feed her only savoury foods until she’s five, but I can’t delete her natural preferences – either her individual taste, or nature’s built-in drive to stock up on salty, fatty and sweet stuff. She’ll like what she likes and the best I can do is encourage healthy eating by providing opportunities to try a wide range of different flavours; limiting unhealthy foods; and best of all, leading by example and choosing a healthy and varied diet for myself.

Feeding your baby doesn’t have to be so complicated that you’d need a degree in nutrition just to make a basic meal plan. The main points to keep in mind, for safety, are:

  • Never leave your baby unattended while eating. If your little one starts choking on a piece of food, you need to be on hand to help out. Please make sure you know how to respond to a choking hazard – maybe talk to your GP or maternal health nurse if you’re not sure where to find this out.
  • Do not feed your baby honey. It can cause botulism, a nasty, life-threatening disease.
  • Finger foods are best served in pieces smaller than a pea, to reduce the risk of choking.
  • Hard foods, such as boiled lollies, nuts and seeds, popcorn, etc are best avoided as they can cause choking, or small pieces can become lodged in the airways and cause irritation and infection.

It is no longer recommended to avoid common allergens before the first birthday, but it is a good idea to introduce new foods gradually at a rate of one every few days, so that in the case of a reaction you can identify the problem food easily.

This is all pretty general advice, and in no way intended to replace the advice of your doctor, paediatrician or health nurse.

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Reflux and Our Decision To Mixed-Feed

Today our girl is seven weeks old. She’s growing and learning and I swear she’s becoming even more beautiful with every passing day! But life hasn’t been all smiles and long nap-times these last few weeks. Around the four-and-a-half week mark we hit a growth spurt, and Little Miss became unsettled: she slept in short bursts, fed every hour or two, and grizzled constantly. Our placid baby had become impossible! A day or two later she settled, now noticeably bigger than before! Within a few days, however, she became unsettled again. Reading through Facebook posts from other mums, I started to wonder if it might be reflux. At our 6-week check-up, the doctor agreed that this was likely the case. We had noticed the symptoms gradually; on their own, they just seemed like normal baby things, but when we finally put them together, it became pretty clear that something was wrong.

Not happy Jan!

Not happy Jan!

Clues that Amelia has reflux:

  • Vomiting a lot. Little dribbles of reflux became chunky, projectile spew. She vomits after every feed (sometimes DURING a feed, ew!) and in between feeds.
  • “Wet” hiccups. She started to get the hiccups more and more, and we could hear the liquid plopping up and down in the back of her throat with each one.
  • Random fits of screaming, with no apparent cause.
  • Refusing to be put down – she’d seem to fall asleep in our arms, then cry and scream when we put her in her cot.
  • Feeding often, but not getting enough at each feed. She would pull away before reaching the “hind milk” (where the milk changes from thin and watery to creamy, fatty milk), which just left her hungry again.
  • Pulling away from the breast, screaming and arching her back. Feeding her was becoming a nightmare!

I decided to Google “reflux” and found these exact symptoms (Huggies.com has a helpful page on reflux). The doctor prescribed Losec, an antacid that comes in tablet form. These are supposed to be swallowed whole, but may be dissolved for those (such as babies) who can’t swallow them. You’re not meant to crush them, or even break them; they presumably taste nasty; they don’t dissolve so much as break down into little flakes. I tried mixing it with expressed breast milk and bottle-feeding it after she refused to take it from a syringe, and it just got caught in the teat. I went back to the doctor and got a new prescription which I took to a compounding pharmacy, where they made a banana-flavoured liquid version. Much easier!

I spoke to the paediatrician about mixed feeding as I was concerned that she wasn’t getting quite enough food, between her fussing at the breast and vomiting up half of what she got. According to her growth chart she needs to put on a little more weight, so I felt that my concerns were validated. The paediatrician agreed that formula top-ups could be helpful to fatten her up and help her settle. She recommended starting with plain NAN or S-26, but said that if that wasn’t working out we could try a thickened formula that’s specially made for reflux.

We went with NAN, which is what we had been using for top-ups at the hospital and in the days after coming home. She took to it immediately. She had spent the previous hour sleeping lightly and refusing to be put down (Sean had her while I was at an appointment) but after a bottle of formula she sunk into a deep sleep and has been happy since!

Sleeping Beauty - with a full belly, she is content and completely out to it :)

Sleeping Beauty – with a full belly, she is content and completely out to it 🙂

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Eating Fish During Pregnancy and Breastfeeding

Fish is a healthy source of protein, and oily fish are a valuable source of Omega 3 fatty acids. However, pregnant women need to be cautious about the kinds of fish they eat. Some fish have high levels of mercury, which can impact the developing fetus. In Australia, we have range of fish options, and finding information for each variety can be difficult. As a breastfeeding mother who got over-excited and bought nearly a kilo of Blue Grenadier (also known as Hoki) to eat over a couple of days, I suddenly wondered if this could be potentially harmful to my newborn bub.

Googling the mercury levels of Hoki, I came across this fantastic resource from the New Zealand government. It points out that the level of mercury in breastmilk is very low, and it does not pose a high risk to eat fish while breastfeeding, as it can in pregnancy. There is a useful chart included which lists a wide variety of fish under three restriction categories: no restriction necessary, 3-4 servings per week acceptable, and 1 serving every 1-2 weeks acceptable. Luckily for me, my Blue Grenadier/Hoki is in the “no restriction necessary” category. I’m having fish tonight!

I'm having fish tonight!