Especially if you’re just starting the process of introducing your baby to food,
what is it that you fear the most when giving your baby solids? Most likely it’s that your baby might
choke on the food or have an allergic reaction. Have you been wondering what you can do to safely
introduce solids? In this video I’m going to talk about the 5 things you can do to ensure
that your baby swallows food safely and prevent episodes of choking from happening regardless of
whether you’re spoon feeding your baby purées or doing baby-led weaning, or a combination of both.
If this is our first time meeting, I’m Dr. Belousov. I’m a board certified pediatrician
and I equip parents with knowledge, so they can care for their children with confidence.
I put together this Youtube video series to show you how simple and enjoyable the process
of starting solids can be for both you and your baby. Be on the lookout for more videos
like this released on a weekly basis. Hit the subscribe button and ring the bell so you get
notified when the newest video is released. As a pediatrician I’ve been encountering
more and more parents who are interested in doing the baby-led weaning approach
to introducing solids. Although this approach has been around for decades,
our main way of introducing solids to babies has involved the parents or caretakers spoon feeding
the baby purees. Whereas with baby-led weaning the babies feed themselves all their foods,
in the form of graspable pieces, or using a preloaded spoon if the food is the consistency of
a puree. Studies done by the medical community that looked at both feeding approaches,
have found that choking is no more likely with baby-led weaning than spoon feeding purees.
And they found that there are certain guidelines surrounding feeding the baby
that parents need to follow inorder to lower the risk of choking or eliminate it all together.
The following are the basic safety precautions that if followed will ensure that you are safely
starting solids with your baby regardless of which feeding approach you’re doing.
First we need to make sure the baby is developmentally ready to start taking solids.
Starting solids with a baby who is not developmentally ready for it,
puts them at increased risk of choking on the food and/or breathing it into their airways or lungs.
So what are the developmental signs that the baby is ready to safely start taking solids?
The baby should be able to sit upright on his own with little to no support. The baby needs to have
good head control. The baby should no longer have the tongue thrust reflex. The baby needs
to show an interest in food. And the baby should be reaching for and grasping objects and bringing
them to the mouth. I actually have a separate episode that goes into more detail on this, it’s
titled “How to Know When Your Baby is Ready to Start Eating Solid Food?” It’s linked up here if
you would like to check it out. A lot of parents tell me that their healthcare providers recommend
starting solids as early as 4 months, but keep in mind that both the American Academy of Pediatrics
and the World Health Organization recommend starting solids around 6 months of age. From
my experience most babies are not showing all the developmental signs of readiness to eat until 6
months. Some babies will need to wait even longer, especially those who were born premature. Usually
they are ready around 6 months adjusted age, rather than chronological age. And if your child
has other underlying developmental or medical conditions, please follow the guidance of your
child’s healthcare providers regarding when and how it’s safe to introduce solids to your baby.
Second make sure your baby has a proper sitting position in the high chair. In order to have a
safe swallow, the baby needs to be sitting upright in the high chair with feet resting on a foot
rest. This actually stabilizes the baby’s core and facilitates a safe swallow. Your baby will
also feel more comfortable sitting in the high chair when he has a stable sitting posture. Babies
who have their feet dangling may end up rushing through their meals because they're uncomfortable.
In addition, it’s best to have a high chair that doesn’t recline back. I know that with
some chairs the back is at a slight recline, and that’s ok. But if you have a chair that
allows you to adjust the angle, make sure the back is in the most upright position possible.
When a baby is eating at a reclined angle, and has the feet dangling instead of being
positioned on a foot rest, it increases the risk of choking. Unfortunately most high chairs on
the market either don’t have a foot rest, or the one that comes with the chair is not adjustable.
In my video titled “Must Haves When Starting Your Baby on Solids” I talk about high chairs
that meet all of these criteria. That video is linked up here if you would like to check it out.
As your baby gets older and becomes mobile, even into toddlerhood, continue to sit him
in the high chair at mealtime, even if he puts up a fuss. I have seen a case where
a 1 year old child was running around while eating, he unexpectedly tripped and fell and
breathed some of the food into his airways, and had to be hospitalized for treatment.
I don’t want to see that happen to any child. From day one, let's teach the baby that eating
is associated with sitting in a chair. And let’s make sure that they have the proper posture of
sitting upright with feet resting on a foot rest. Hey if you’re finding this information helpful,
hit the thumbs up button. The third precaution is that
we need to minimize distractions. When a baby is sitting down for a meal, we want to be sure
to minimize all distractions that will interfere with the feeding experience. Various distractions
will take the baby’s focus off of feeding and swallowing correctly, especially in the early
days of starting solids, and this can lead to a choking episode. There shouldn’t be any
toys at the table, and even having a pet in the room can be very distracting to a baby.
I also recommend that all electronics be turned off. No iPad, no tv to minimize distractions.
It’s also preferable that you put your phone down somewhere that’s away from the table.
Your eyes should be on the baby during the entire meal. And as you are spoon feeding the baby or
watching your baby self feed strips of food or a puree your focus should be on talking the baby
through the process and paying attention to cues that your baby is done with the meal. It’s ideal
if you can have your baby be a part of the family mealtime. Watching the rest of the family eating
provides the baby with visual cues of how it should be done. Let's do our best to create
a distraction free mealtime and model healthy eating behavior for our baby right from the start.
Fourth, offer food in a form and at a pace that is safe.
If you are doing the approach of spoon feeding your baby purees, there is actually a right and
a wrong way to do it. To spoon feed correctly, put a small amount of the puree on the spoon
and slowly bring it toward your baby. And only when your baby opens the mouth,
gently place the spoon on top of the tongue and hold it there until the baby closes the lips. Then
slowly remove the spoon straight back out of the mouth, not at an angle. Let your baby be the one
guiding the spoon feeding process. Never slide the spoon into your baby’s mouth forcefully or
without her realizing what's happening. This can cause the baby to have feeding aversions and fear
of the eating experience. And we don’t want that. I will have a separate video that goes into more
details on how to spoon feed correctly. That video will be linked up here once it’s released.
When doing the baby-led weaning approach, make sure the food is soft enough that it will be
mashed with the tongue on the roof of the baby’s mouth. The way to check for this is to squeeze the
strip of food with your thumb and index finger, and if it easily mashes, then it’s soft enough.
A good rule to follow for the size of the strips of food is to have them about the size of an adult
pinky finger or a little thicker, and about 2 inches long. This way the baby can grasp a portion
of the food and still have some sticking out to put into the mouth. Up until the baby develops the
pincer grasp, which is the ability to use the tips of the thumb and index finger to pick things up,
it’s safest to offer food in strips. Most babies develop the pincer grasp
around 9 months. That’s when it’s safe to start offering food cut up in smaller bite size pieces.
If you give small pieces before the baby is ready, he will become very frustrated with trying to pick
up the small pieces. And in the event that the baby does grab a handful of the tiny pieces, and
gets a bunch of them in the mouth, he has a higher risk of choking on it because at the younger age
the baby doesn’t have the oral motor skills to spit out forcefully or push out with the tongue
tiny pieces of food. But if you give the baby food that is cut in a strip form, then she can
pull that strip out when she starts to gag, and prevent herself from choking on it. Also when the
baby gets offered strips of food, he has to really concentrate to pick it up and get it to the mouth.
Babies who are allowed to self feed, and are not rushed while eating, tend to take smaller bites,
and spend more time chewing before swallowing. The philosophy behind baby-led weaning is not to
do away with spoons and purees, but to have the baby be the one guiding the process and feeding
herself. No one but the baby should be putting the food into her mouth. And the baby should eat
at her own pace and under her own control. It’s the parents job to prepare and provide the food in
a safe form, and it’s up to the baby how much or how little she eats. I will have upcoming videos
that go into more detail on baby-led weaning. Fifth never leave the baby alone with food
I think this one is self explanatory, but unfortunately it still happens. Remember
babies are silent when they’re choking. And the only way you know that it’s happening is from
seeing that your baby is in distress. So if your baby is out of your sight, you won’t know
that it’s happening. In the event that you need to step out of the room for any reason during a meal,
even if it’s brief, for your baby’s safety, remove all food from the baby’s reach.
You can resume the meal once you return. In upcoming videos I will talk about how to safely
prepare foods for your baby, how to respond when your baby is gagging or choking, and what to do if
your baby has an allergic reaction to a food. Hit the subscribe button and ring the bell so you get
notified when those videos are released. See you in the next video.