Tuesday, July 16, 2013

Dealing with gagging and introducing lumpy foods

Baby feeding problems - such as gagging while eating and refusing to eat lumpy foods - can be very worrying... and can make mealtimes stressful for you both.It can help if you understand how the "gag reflex" works and how babies learn to chew their food.

Baby feeding problems - Baby food beginners
When you introduce your baby to solid foods for the first time, nine times out of ten he will push the spoon out of his mouth!

Babies are born with this "tongue thrust reflex", which gradually diminishes over time. By around 6 months of age, this reflex may be absent and this is just one indication that a baby is ready for solids.

In some cases, though, a baby may still push out the spoon the first couple of times he is fed, because the sensation is unfamiliar and takes a little getting used to!

Don't try to force your baby to eat if he continues to reject the spoon...

It is possible that he is trying to tell you that he really isn't interested in solid food yet. It is an uphill - and pointless - struggle to persist with spoon feeding if your baby is constantly refusing the spoon.

Wait a week or two, then try again.

Overcoming baby feeding problems - Learn how baby uses his mouth to "explore"
Interestingly, studies have shown that there may be a connection between how babies "mouth" their toys and how ready they are for solid foods.

Up to the age of 6 months, babies tend to place toys and other objects in their mouths, but "mouth" them in a random fashion. However, after 6 months of age, they tend to display a much greater interest in actually discovering the texture and shape of an object with their mouths, tongues and lips.

Watch your baby closely when he places objects in his mouth -...

do you notice this type of sensory perception in his behaviour? If not, then it may be too early for solid foods with any real texture, as babies who are not using their mouths to explore in this way tend to have difficulties in dealing with textured foods.

Overcoming baby feeding problems - Gagging

You may find that your baby will readily take food from a spoon, but will gag as soon as the food is in his mouth.

This is your baby's natural defence against choking...

although it looks quite scary and can make you panic if you've only just started with solids!

When a baby is introduced to solid foods, he doesn't really know how to deal with the food in his mouth. Foods such as thinly pureed fruits are generally easy to cope with at first, but moving on to slightly thicker textures can cause gagging - this happens when the food is moved to the back of your baby's tongue and he "coughs" it forward to prevent it from entering his airways.

This type of gagging is common and perfectly normal - it will pass as your baby becomes accustomed to eating solid food.

It is, of course, essential to watch your baby carefully just in case any food DOES get stuck - this guide to dealing with choking from the British Red Cross is well worth a read.

Do remember that gagging can also be an indication that your baby is simply not hungry - after all, he has no other way of letting you know!

Baby feeding problems - My baby won't eat lumpy foods!

This is one of the most common baby feeding problems we are approached with!
Some babies will refuse lumpy foods altogether... some will take them from the spoon but then gag constantly (sometimes even vomiting)... and others will develop a remarkable ability to "filter" a mouthful of food by eating only the smooth part and spitting out every single lump!

Lumpy foods cause gagging in the same way that smooth foods do when introduced to your baby for the first time.

In other words, your baby hasn't yet learned to deal with lumps and gags in order to stop any food at the back of his tongue from entering his airways. Ideally, he then learns to chew his food into smaller particles, which then prevents the gagging.

For some babies, though, this must seem like too much hard work and they end up refusing the lumpy food altogether.

In this situation, it is VERY important to be calm, relaxed and patient.

In most cases, your baby's aversion to lumpy foods will pass as his feeding abilities develop. But by trying to force your baby to eat lumpy food, or displaying anxiety when he refuses - you can make mealtimes traumatic for your child and greatly increase the problem.

Some parents report that their children become hysterical at the mere sight of their highchair if they know they are going to be made to eat something that they simply don't want.

This is a situation you want to avoid at all costs.

Mealtimes should be fun and something your baby looks forward to - creating a pleasant atmosphere at the dinner table can have a huge impact on the way your child views mealtimes for a long time to come.

Overcoming baby feeding problems - Successfully introducing lumpy foods

WHEN SHOULD I GIVE MY BABY MORE TEXTURED FOODS?
There is no "fixed" answer to this question - babies develop differently and some may be ready for lumps in their food sooner than others.

As a general rule, though, it's a good idea to introduce some texture into your baby's food once he has been enjoying pureed foods for around 3 weeks - this will usually be at around 7 months of age.

Of course, some babies - particularly those that are breastfed - don't start solid foods until towards the end of their first year. In this case, you can often dispense with pureed foods altogether, as these babies tend to be ready to deal with textured foods from the outset.

WHY IS IT IMPORTANT TO GIVE BABY MORE TEXTURED FOODS?

If you give your baby only pureed food for an extended period of time, you may find that he becomes unwilling to accept lumpier textures and baby feeding problems may develop.

Learning to chew - either with teeth or gums - is an important part of your baby's development because
  • it strengthens the jaw muscles
  • it helps with the development of speech
  • it helps ensure healthy teeth
  • it enables him to enjoy finger foods and other foods that the rest of the family are eating.
Food progressions for biting and chewing (external link)

Overcoming baby feeding problems - How to slowly add texture to your baby's food

Start by thickening baby's purees - you could use cereal to do this, or even mashed egg yolk. Although thicker, the puree should still be smooth - this gives your baby the opportunity to become accustomed to a "heavier" type of food before he has to deal with actual lumps.
Next, try using a food mill to grind soft fruits or vegetables - this will give you a texture that is only slightly lumpy.

You can also try grating a peeled apple and adding this to a smooth base, such as yogurt (see our introducing dairy page for more information about including yogurt in your baby's diet).
Another good method is to puree half of your baby's food and grind the other half. Again, this provides texture within a smooth base.

Try offering cottage cheese - a protein-rich food that contains very soft, easy to manage lumps.
Once baby is happy with these foods, you can move on to mashing food and, finally, chopping it.

Will Your Baby be Our Next 'Baby of the Month'?

Each month we choose a new 'Baby of the Month' from photographs sent in by our visitors.
For details of how to send in YOUR baby's photograph - and to see our favourite entries from last month...

Overcoming baby feeding problems - What to do if your baby continues to refuse lumpy foods

Sometimes, your baby's refusal to accept lumpy foods can lead to him losing weight, particularly if you are withholding smoother textures in an effort to "force" him to accept lumps.
It is important that your baby receives adequate nutrition, so you should return to feeding him smoother foods and re-address the situation.

Try feeding your baby on your lap. He may be reassured by the closeness and more likely to experiment with his food. He may even accept a little lumpy (appropriate) food from your plate.
Ensure that mealtimes are fun. Try singing to your baby... and smile often.
Praise him lavishly for any progress he makes.

Always eat with your baby - babies love to mimic others and watching you may be just the incentive he needs.

Offer your baby plenty of finger foods if he is developmentally ready. Many babies won't take lumpy foods from a spoon, but will chew quite happily when feeding themselves!
Encourage your baby to explore toys with his mouth. This helps with the development of the tongue movement which is needed to gather and chew particles of food.
When baby feeding problems become a concern - If you are unable to get your baby to accept any textured food - or if he seems to gag excessively when you offer him any solid food - it would be wise to consult your doctor, as your baby may not be receiving the nutrition he needs.

Hyperactive gag reflex in infants is a condition where babies gag - or even vomit - when anything is placed in their mouths. This can sometimes include liquids, too.
If your doctor suspects that this is what your baby is experiencing, then he may refer your baby to an Occupational Therapist, speech therapist or developmental pediatrician for advice and help in overcoming the problem. He may also recommend vitamin supplements if the problem is severe.

Babies usually outgrow this oral hypersensitivity, which seems to be more common in premature babies.

Many parents find that their babies cope better if they are allowed to feed themselves - understandably, being "in control" seems to reduce the problem.

You can help your baby by following our guide to slowly introducing lumpy foods (above) - also, try giving him the slightly lumpier textured foods in between spoons full of puree.

For further information, visit Feeding your child who has hyperactive gag reflex - a guide for feeding older babies, from comeunity.com

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