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Monday, December 9, 2013
Newborn and Infant Care
My baby is refusing to accept formular foods
I have an eight month-old daughter who refuses to accept infant formulas or start on solid meals. She is rather absolutely dependent on breast milk which does not provide lasting satisfaction. I am highly worried especially now that I am 2 months into another pregnancy. How do I make her less dependent on breast milk and enhance her appetite for formula/solid food?
That must be so frustrating! The most important thing I can start with is by recommending that you not force your child to eat. Ellyn Satter's two rules are the rules to feed by for all of us with normal, healthy children. Rule #1: The parent is responsible for selecting, preparing, and offering nutritious foods and drinks at regular times during the day. Rule #2, the child is responsible for deciding whether or not to eat and how much to eat.
A few other suggestions to enhance the feeding environment include doing your best to be upbeat around feeding times and relaxed. Also, while you should never leave your child alone while she is eating, some children will feel less pressure to eat if you are not right in front of them watching them or encouraging them to try eating. Be VERY, VERY tolerant of messy eating. Let your child use her hands if she hates the spoon. And finally, many children refuse new foods after one taste. As their mental growth progresses towards the end of the first year, when they are putting so many things into their mouths and exploring the world with their new crawling and cruising skills, their minds become cautious about new foods, new people, new everything. It's protective but can certainly be frustrating around feeding.
Congratulations as well on choosing to nurse your baby and give her this wonderful start in life! It is no wonder she does not want to give it up - it feels as good to snuggle close as it does to nurse. However, it is important to help her expand her food intake at this point. Some babies are just hard to entice into eating solid foods. As you have discovered, delaying the introduction of solid foods a good bit past 6 months of age, makes for tough going for some children.
Here are a some strategies that may help in getting your child to try to expand her eating:
1) Offer a baby cookie or biscuit she can handle on her own and will likely suck on willingly. Wheat free products are a good idea if food allergies run strongly in your family. Otherwise, commercial baby products are fine.
2) Once the cookie or biscuit is accepted, dip the cookie in the baby food, pureed table food or yogurt of your choice. Offer it to her, and, if she refuses to take, place it on her tray and do something else nearby while she considers giving it a taste test. If she pitches a fit, let her go on her way.
3) Place a small amount of baby food on her lips and let her lick it to try it. If she is interested, offer more. If she fusses, let it go, but do offer it again.
4) Place small non-wheat cereal such as Kix or an "o" cereal on her tray. When she eats them well, the next time place the cereal on her tray and dab on a bit of baby food. Let her self-feed.
5) Try non-commercial baby food. She may not like the smooth texture or bland taste. Pureed or chopped family foods may be more intriguing. She is old enough for chopped cooked vegetables, chopped canned or cooked fruits, grated cheese, mashed potatoes or mashed cooked beans, crackers without a lot of salt, strips of bread, pita, or tortillas. She can fingerfeed all of these things herself. Comment in a positive, relaxed tone about what a big girl she is for trying on her own.
6) Don't insist on a spoon. Put her in charge of eating. Comment positively on her efforts to eat, but don't get enthusiastic, just positive and matter-of-fact.
7) Pump your breastmilk and then mix it with baby formula in a 3 parts breastmilk, 1 part formula mix for 2 days. Then make it half breastmilk and half formula for a few days, then 3/4 formula and 1/4 breastmilk. a few more days. Then formula only. Most children will accept this transition. If she won't take it from a bottle, try a cup she can hold with or without a lid. Let her sit on your lap, co-hold the open cup, and practice drinking on her own.
8) Many, many infants and toddlers need 10 or more tries at tasting a food to learn to accept it. So do re-offer rejected foods until familiarity is built and the food is accepted.
9) Do avoid highly allergenic foods such as egg whites, citrus fruits and juices including strawberries and watermelon, peanut butter, milk, and shellfish until after one year of age.
9) Like our beloved furry, family pets, our children learn to read us and manage us very well. Thus it is very important to remain calm and non-forceful around feeding solid foods and offering formula even if your child pitches a fit. Giving in to her demands reinforces the undesirable behavior and even an angry reaction and yelling is preferred to no reaction. Calm responses are no response. The undesirable behaviors will go away soon and the ones you praise modestly and smile about will be adopted.
I hope these ideas prove helpful. Congratulations on your pregnancy too! I hope all goes very well.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University