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INTRODUCING SOLIDS

by Amy Schwimmer and Kristin Nash
Reproduced with permission from the Diaper Rag (November 1998)
newsletter of the San Francisco Mothers of Twins Clubs

After months of up and downs with feeding your babies on bottle and/or breast, you've finally got a routine going that usually works. You've figured out how to schedule and manage feedings and still get out of the house now and then. Life is good.

And then suddenly it's time for "solid" foods (if you can call watery rice cereal and mushed up fruits and vegetables "solid"). In a way, this marks the transition from babyhood to personhood. And it's a first, small step toward weaning. Are we moms emotionally or logistically ready for this? Most moms agree that introducing babies to food (and food to babies!) can be a fun adventure for everyone as well as a whole new arena of parenting "challenges." But as with all the other challenges, it somehow gets done, and we've compiled suggestions from the New Moms Group in order to hopefully help increase the fun and adventure and decrease the frustrations as you help your babies make their way into the world of "real food." We do want to clearly state that we are not doctors, and that any special concerns about your twins' diets should be addressed to your pediatrician!

In The Beginning... Most moms we talked to started solids when their pediatrician suggested it was time -- usually in the traditional four to six month window. Many pediatricians these days err on the side of later rather than sooner (as opposed to when we were babies and our moms were feeding us meat by three months of age!). And because twins are often premature, this seems to be even more the case with multiples. In addition to doctor's advice, moms also look for babies' increasing interest in food as a barometer of when to begin. Signs include a baby watching you intently or mouthing when you eat, or even reaching out for your fork or dinner roll. Another common rule of thumb is to wait until a baby has fairly good head/neck control. Most of us chose the five or six month mark to begin solids.

Our moms definitely didn't rush things or push the babies to eat. If they tried to introduce solids and one or the other baby had problems swallowing or wasn't interested, mom would wait a few days with that baby and try again. (For some babies, the swallow reflex is not yet competent, usually indicated by a consistent cough while trying to eat—after a few tries spaced a few days apart, swallowing should come more easily.) One mom said it took a month from when she initially offered food until her son was really ready. Another key to successful feedings is to make sure the babies are not too tired or too hungry. Timing approaches include: feeding solids shortly after naptime; doing a solid feeding between milk feedings; or feeding solids in the middle of a milk feeding. As with so many things, trying out different options will help you find what works best for your particular babies.

Tried and True Rice Cereal

 Most moms followed the age-old wisdom of introducing rice cereal as baby's first food. This is offered one or two times a day just to get baby used to the idea of eating. Instructions for mixing the cereal for new feeders are on the box, but the basic formula is 1 T. cereal mixed with 4-5 T. warm breastmilk/formula. As your babies get older, they'll enjoy a thicker mixture.

Some babies like their unadorned cereal just fine, but many moms found that eventually their growing children highly preferred cereal with fruit added. There are cereals with "fruit" in them, e.g. rice with bananas and 3-grain with berries, but even these can lack the flavor added bottled or pureed fruit can provide.

What Goes In Must.... Up til now your babies' digestive systems have only been dealing with milk. Solids will change the consistency, hue, and odor of what comes out the other end, and they will change how often and easily "by-products"are produced. Note particularly that a number of foods can be constipating. Rice cereal itself can plug things up. If your baby tends toward constipation, you might try another single-grain cereal (baby cereals are available in barley, oatmeal, and wheat to name a few) and avoid following it with other constipating foods such as apples or bananas! Other ways to relieve "back-up" are small amounts of prunes or diluted prune juice, as well as offering a bottle of good old water. (Your pediatrician may recommend adding some water to the babies' diets at this point anyway).

Life After Cereal... When you feel your babies are doing reasonably well with cereal, even if it' s still in small amounts, it's time to move on to vegetables and fruits (usually between 5-7 months). The order in which these are taken varies. Some pediatricians recommend getting babies' taste buds used to veggies before introducing them to the often-preferred sweeter fruits. Babies may only take a few spoonfuls for a while, increasing their consumption with time. Which foods you offer at which meals is also entirely subjective. A common approach is to feed cereal and fruit at breakfast, and various combinations of fruits and vegetables at lunch and/or dinner.

 It's generally recommended that new foods be introduced one at a time, with four to seven days between each new food in your babies' repertoire. Some moms even keep a journal of foods to note any bad reactions, as well as babies' budding likes and dislikes. However it cannot be stressed enough that the favorite food of the day or week may be grimaced at the next day or week, and conversely and more importantly, what is shunned today may be lapped up tomorrow. This applies for many, many months down the road! If a new food is rejected on any given day, try it again (and again) in a few days or weeks and you may very well have an entirely different customer reaction!

If you want to make your own fruits and veggies, cook them well and mash thoroughly or use a hand-held grinder/blender. One popular method for keeping home-pureed food "fresh" is to freeze it in ice-cube trays. After it's frozen, dump the cubes in a zip-lock, and thaw-and-serve as needed!

 Don't worry so much about a balanced diet at this point (since your babies are still getting nearly all their nutrition from milk, plus some extra iron from cereal) and enjoy experimenting with different foods. Nearly all fruits or vegetables are fair game as long as they are highly pureed. Strawberries are one to avoid as they have a higher tendency to cause allergic reactions.

By 6-8 months, you can add a range of foods from the protein and milk groups, e.g., meat, chicken, fish, beans, cottage cheese, plain yogurt, cooked egg yolk (hold off on more allergenic egg whites until closer to 12 months), tofu. These should still be fairly well strained/pureed at first, but over time you can begin trying out chunkier bits and see how your customers do with them. Some children will have several teeth by now, which helps immensely in moving into "finger foods," but it is amazing how strong babies' gums are in and of themselves!

There are several foods that are usually seen as not appropriate for younger babies due to higher chances of allergic or digestive reactions. Some of these include fish, strawberries, honey, egg whites, chocolate, and citrus. Advice on when these can be introduced ranges from 8 months to a year or so--ask your pediatrician what they recommend!

How many meals per day and at what times?

These questions are highly subjective ones. Some parents stick with just one meal for a while, others quickly move up to two or even three, depending on philosophy as well as logistics. Many moms find that the new meal regimen is very time consuming, especially with twins, and that one or at most two meals per day is all they can squeeze in or handle for a while. Keep in mind that for many months the prime goal of feeding solids is to accustom your children to food and to eating. The goal is not to fill them up with calories or nutrients, as they are still getting almost everything they need from breast milk or formula. Be sure in fact that you do not displace too much milk with food, and that you do not switch to cow's milk, which is neither easily digestible nor appropriately fortified for a baby less than a year old.

As quantity does increase, you will want to move into offering solids prior to milk, rather than after or during. Milk can then follow, either immediately or after a reasonable interval. One meal that often is an exception is breakfast, which frequently is served an hour or so after the first morning bottle. One baby in our group though refused breakfast with a vengeance until his mom tried feeding him cereal shortly after he awoke, giving him his bottle afterwards. He became an instant breakfast convert and chowed down his meal with gusto!

At first, finding the optimal times of day to offer meals to your babies can be a breeze or a puzzle worthy of Rubik. Do you feed them at the times you eat your meals? Do you feed them before they're really hungry, or will they lack interest in this new goop unless they ARE really hungry? Does a 5 p.m. dinner seem to work better than 5:30 p.m.? You can really drive yourself nuts with this in the early stages, but know that in a month or two, meals served pretty much at standard "grown-up" meal times should work well for everyone. And by 9-12 months, you will probably move into three meals a day plus one or two snacks in between – much like the parents' schedule.

How much of a good thing?

It's hard not to obsess over how many spoonfuls or ounces your children are eating, but the bottom line our moms have drawn is that babies will eat as much as they want and need, after which point they will stop. If a baby turns their head adamantly away, screams, throws their food, etc., chances are they've had enough. On the other hand, if they keep eating, chances are they really do want more food. Most pediatricians advise that as long as you're not forcing your baby to eat when they don't want to, you won't overfeed them. By 6 or 7 months, some of our babies' meals could still be measured in fractions of ounces while others were plowing through one or even two 2.5 oz jars at a sitting!

Keeping them interested In some cases, the initial novelty of eating wears off and baby loses interest in food. According to the moms we talked to, getting involved in the meal and making mealtime fun will go a long way toward keeping babies eating and moms sane. Some suggestions... Babies love to imitate mom and dad. Pretending you're taking bites before feeding baby (or actually doing so) is always a pleaser. Cheering them on with "open up" and then opening your mouth wide, followed by an exaggerated chewing motion will give them the idea. Singing songs, playing tapes, letting baby hold a spoon or chewy toy, and making silly faces works for some. Whatever you do, try to have fun with your babies while you feed them. And again, if they really refuse to eat more (or even to eat at all from time to time), don't feel compelled to stand on your head or shovel food into a screaming mouth. Just end the meal and try again next time. General wisdom says that when baby wants to eat, s/he will eat. . General wisdom also says that it's best if everyone is relaxed and having fun; a tense or tired parent, or a parent trying to feed solids in a hurry before leaving the house, is not likely to make for a happy feeding.

Feeding two open mouths

Most moms sit their babies side by side and feed them at the same time, using one spoon and bowl (except when one of the babies is sick) for convenience and speed. Some prefer alternating spoonfuls while others like to feed the hungriest baby first (with the other ready to go in the high chair, but occupied with toys), before starting with the second baby. Try different approaches to see what works for you and your twins.

Infant or bouncy seats are most commonly used during the early feedings. Placing the seats on a table or counter might save your back (but of course don't leave them unattended in a high place). As babies gain back muscles, move them to high chairs (these may be usable sooner if they have a recline position). If the high chair seems too roomy, try propping babies with towels. If they don't seem comfortable in the high chair at first, consider other alternatives. One 6-month baby who had eaten fine in her bouncy squirmed with unhappiness when moved to a high chair. In desperation, mom tried "picnicking" with the baby by sitting on a splash mat on the kitchen floor. In this less claustrophobic setting, the baby regained her comfort with eating and in a short time made the transition back to high chair without complaint.

Most moms agree it's hard to keep babies' hands out of the food when you're feeding two. A suggestion is to have a wet washcloth handy. When you see a mess in the making, gently wipe off the hands before their hair, your clothes and the kitchen floor are covered with strained carrots. Note also that many experts advise that letting babies "dive in" at meals (within reason!) can help promote enthusiasm about eating and eventually independence in self-feeding. Especially as your twins begin to eat more and more finger foods, you'll need to let go of at least some of your urge to keep everything spotless. Some moms of older babies even let them eat in their diapers, and follow meals with a full-body wash-down.

Meals on Wheels

Feeding solids while on the go isn't as difficult as it may seem. In fact, many moms think it's downright easy and it can provide a great change of atmosphere for moms and babes alike. Just set the stroller in its upright position and feed away... in the park, the mall or wherever. In fact, many babies eat with far less fuss and more enthusiasm when they have new sights and sounds around them. It's also a great way for parents to get out – one mom often went for a morning coffee and shoveled baby food while she sat and watched the "real" world – a real treat for mom and babies alike! My kids LOVE to eat while in their stroller in Golden Gate Park and consistently chow down with greater intake and zeal than they ever display in their highchairs at home (passers-by probably think we've been starving them for days by the way they're nearly falling out of the stroller to get to that last pea or piece of string cheese!).

The toughest part about feeding on-the-go is dealing with packing up everything you'll need. But having a short list on the fridge or by the door can help, and after you've done it a few dozen times, it really does become pretty automatic. Some items to include on your list: spoons, bibs, damp washcloths, sippy cups with juice or water, plastic bowls or paper plates. Bring portable seats if you're going to be at a friend's home or a restaurant — both the plastic kind that strap onto the top of a chair and the metal kind that clamp onto a table are easy to use and transport. If you use the clamp kind, you might want to stick a towel or placemat under the arms to avoid scratching a nice surface. Portable fold-up walkers are also good and don't threaten the furniture. A plastic/wipeable blanket or drop cloth is good, too—to sit on and eat on if you're outside, or to put under the booster seats if you're at a table.

A great alternative for sitting at the table that will literally fit in a purse is the "Sit 'N Secure," a fabric and velcro belt that straps a child to an already existing chair! Available for around $11.00, this won't bring your baby up to table level, but you can always bring the food down to him/her!

Most moms begin feeding their babies mushy foods like cereal and pureed fruits and veggies when they are five or six months old. After a month or two of this, you can widen the variety while still sticking to very soft or pureed cuisine. Possibilities include cottage cheese, plain yogurt, tofu, cooked egg yolk (don't feed egg whites until around 11 or 12 months) and strained or pureed meat, fish, chicken, and beans.

A personal side-note is that my daughter wasn't eating much of her daily cereal, and the doctor was concerned about her iron intake. So I started cooking lentils every few days and offering them at lunch — they were a hit! I just cooked them so they were soft, then would smash a few together and feed them to her. Later when she could feed herself, I'd form little "lentil tents" on the high-chair tray, which she could pick up and navigate into her mouth.

Another point is that I was shocked when I learned that I could feed my kids dairy products; I'd had it in my mind that you had to wait until 12 months for this, but that only applies to switching from formula/breast milk to whole milk. Note that with all dairy products, it's fine and often desirable to stick to whole milk products rather than the low-fat ones we're used to as adults. Within reason, babies actually need "healthy" fats like those in whole milk products.

Finger Foods

When are babies ready to start picking up actual "solid" foods and feeding themselves? Every baby is different, and as usual, you should consult your pediatrician for customized guidelines. However an average time is around eight months, give or take a month. Start with softer, smaller pieces of food and as your babies gain manual and mandibular dexterity, move into foods with more texture and bulk. Accept the fact that the next few months/years of eating will often be a messy process. Remember that eventually you want your kids to be independent eaters, and they can only learn this by doing some squishing and dropping and exploring. Give your babies spoons to hold and wave and chew on, and when they seem ready, help guide them to navigate spoonfuls of foods into their mouths. Babies are often capable of doing this sooner that you might think!

Gagging Every parent's nightmare, right? Of course this always has the potential to be serious, but generally it is amazing what a reliable gagging reflex these babies have! Always wait a second to see if whatever is stuck will come up on its own, which it usually will (to be rechewed and swallowed again!). But if the gagging persists, don't be afraid to swoop your pinky down their throat and dig up the offender (read up on hints for doing this as safely and effectively as possible prior to the actual event!).

Sippy Cups

As babies get older (often around seven months), it's time to introduce cups. This is not at all expected to be the main mode of liquid ingestion, but it's the first step in moving that direction. Sippy cups come in a range of styles and designs, as well as a spectrum of spill-proofedness. A popular one is the Playtex non-spill sippy cup. Experiment with different types or ask friends for recommendations. It's generally suggested to offer water or diluted fruit juice first.

SFMOTC Book of Revelations

Rev.I: Toss out your little cloth bibs and buy plastic ones!!! There are soft plastic bibs that come in various sizes: some hang over the traditional torso area, others extend to the shoulders, and some even go over baby's arms like a shirt! Choose from velcro, snap, or tie fasteners, and a range of patterns and cartoon characters. Another hugely popular bib choice is the hard plastic bib with the pelican on the front. These come in two sizes, last forever, and clean up beautifully.

Rev.II: Meals are a great time to work on your babies' communication skills. Try teaching them a gesture such as raising both arms up to indicate when they are "all done" with a meal.

Rev. III: When they reach about 18 months, let them sit at the table with you with a placemat instead of using the high chair tray (in their high chair or a booster seat).

Rev. IV: Lunch doesn't have to be served at noon. Especially if your child has had a late snack and is down for an early nap, serve lunch after they wake up and have had a few minutes to get oriented.

Rev. V: You can make your life a little easier by cooking large batches of foods and freezing leftovers in meal-sized portions, to be defrosted and served as needed!

Greatest Hits

What follows is a list compiled of finger food "hits" from a number of moms in the SFMOTC club. It probably goes without saying but what works for you and your kids is highly individual based on personal taste buds, dietary preferences, degree of ease desired, etc. Also note that some of these items are more suitable for early finger-eaters (8 months or so) and others will be more appropriate for one-year and up gourmands.

Almost everything listed is meant to be cut up/torn into small pieces.

Fruits (fresh is always best, but during out-of-season times, canned or frozen ain't bad!)
Blueberries (cut in half at first, then whole later on) Cantaloupe
Peaches
Bananas
Apples
Pears
Pineapple
Mango
Strawberries (save for later in the 1st year due to possible allergies)

Vegetables (all are good fresh, frozen, or canned; most should be cooked until soft and large pieces cut up)
Peas
Green Beans
Carrots
Cucumber
Lima beans
Baked potatoes, yams, sweet potatoes (my kids LOVE holding half a potato and biting off little chunks)
Avocado

Dairy
Yogurt (plain or with fruit; Brown Cow brand is a good one and comes in whole with cream at the top. Yoplait also makes the ever-popular strawberry-banana)
Cottage Cheese
String Cheese

Pastas
Whole wheat pasta—plain or with toppings (comes in spaghetti, corkscrew, shells).
Macaroni & cheese (homemade or boxed)
Tortellini or ravioli stuffed with cheese, veggies, chicken, prosciutto
Spaghetti with pesto or marinara sauce (without cheese, not too spicy)
Linguini and clams (take care with fish allergies)
Vegetable ravioli with marinara sauce
Lasagna

Breakfast/Lunch/Dinner (these are pretty interchangeable with babies and moms)
"Real" oatmeal (instead of baby cereal, when babies are older. To make mornings easier, make a big pot every few days instead of every day; keep it in the fridge and heat daily portions, adding milk/fruit/.)
Waffles (real or boxed frozen ones which come in plain, blueberry, whole wheat, with or without maple syrup)
French toast (homemade or Krusteez microwave french toast with cinnamon)
Muffins (poppyseed or banana-nut are popular, either homemade or Otis Spunkmeyer brand which doesn't get stale quickly)
Whole wheat bread, toasted plain or with a topping (we like Oregon Stoneground Wheat with Hazelnut)
Whole wheat pancakes with blueberries Jelly and/or Peanut Butter sandwiches (save peanut butter for closer to one year)
Cream cheese sandwiches (on croissant, soft white bread, or whole wheat bread)
Turkey lunch meat sliced up
Tofu
Rice
Shepherd's pie (mashed potato, mushrooms, tomato sauce, ground beef, topped with cheese, all on a pastry shell layer)
Bagel with cream cheese
Cheese quesadilla (Mexican restaurant standard; chicken or vegetables can be added easily)
Eggs: Over 10-12 months, serve whole egg hard boiled or scrambled, plain or with veggies or cheese mixed in. Under 10 or so months, serve egg yolks only, hard boiled or soft scrambled with breast milk or formula.
Tuna
Meatloaf or ground turkey loaf
Chicken/turkey/fish
Nancy's Mini-quiches (in the frozen food section)
Garden Veggie Burgers (particularly "Veggie Medley"; another frozen item, great for picnic lunches when broken into smaller pieces)
Snack items
Fruit bars (e.g., Nutrigrain, Entemanns)
String cheese
Cheerios (a perennial favorite; relatively low in sugar and has decent nutritive value)
Oyster crackers

Foods to Avoid

In general: Chocolate, Sodas, Caffeine

Under 10 or so months: Peanut butter, egg whites, honey.

If there are allergies in your family, ask your doctor how to proceed. Foods such as strawberries, wheat, nuts, etc. may require particular caution, especially under 10-12 months.

A huge thanks for Robin Bradley for the following recipe suggestions:

Stealth-Egg Pancakes
Using a nutritious pancake mix (such as Krusteez All-Bran), substitute eggs and cottage cheese for some of the water and cook in small-diameter sized pancakes. Applesauce can be offered as dipping sauce.

Tortilla Chips Scrambled Eggs
For those toddlers who don't like eggs, toss some low-salt tortilla chips into the pan once the eggs start to cook (so that the chips are coated but all the egg is well-cooked). Shredded cheese can be tossed in at the last minute before serving.

Parmesan Penne and Asparagus
(from a recipe by Janet Fletcher in SF Chronicle Cookbook) 1/2 cup finely grated parmesan 2 T butter 1 1/2 cup dry penne pasta Asparagus - one bunch with tough ends trimmed and cut into lengths similar to that of the penne A few twists of grated nutmeg Salt and Pepper to taste Put penne into ample boiling water, add the asparagus once the water starts to boil again. When done (approximately 8 - 10 minutes), drain and then put back into pan, adding butter and stir gently. When butter is melted, add parmesan, seasonings and toss gently. Serve immediately. Merry munching!

This article may be printed out for personal use but may not be reproduced in any other manner, including electronic, without prior written consent from the authors. For more information, call us at 415-440-twins or log on to our web site San Francisco Mothers of Twins Club
 
 


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The information in this article is not a substitute for professional medical or psychological advice. Please consult with your health care advisor about specific questions or problems.



Pat Malmstrom
Twin Services Consulting
P.O. Box 10066, Berkeley, CA 94709
510.524.0863
twinservices@juno.com
http://www.twinservices.org


Copyright © Patricia Malmstrom 1978-2006.