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FAQs

Obesity

FD FAQ Obesity Image 685

Can training healthy eating habits really help prevent lifelong obesity?

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Absolutely! We now know that eating habits and relationships with food developed prior to your child’s 2nd birthday are likely to be what he carries through into adulthood. So a diet laden with deep-fried food and sugary beverages, and eaten in excess (overriding fullness cues), especially to overcome boredom or emotional needs rather than hunger, can and does result in significantly higher rates of weight-related issues. 

Conversely, healthy eating habits developed before his 2nd birthday can and do remain with him for life! Learning what is healthy, how to develop and enjoy preferences for these foods, when to respond to cues of fullness to promote appetite regulation, and why to not offer foods as rewards and/or for anything other than hunger, are all imperative. Guiding your child through these skills will ensure he has the start in life he deserves. [12, 16, 17, 23, 24, 30, 52, 60, 69, 85]

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Why do humans like sweet foods?

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Both breast milk and formula are predominantly sweet. Through evolution, we are all born with an innate preference for sweet (high calories, safe to eat) and salty (minerals) and a natural aversion for bitter foods (poisonous) [16, 23, 27, 30, 69]. Couple that with an environment laden with convenience options, often high in sugar and low in essential nutrients, targeted at infants and toddlers,[29] it is little wonder children aren’t growing up reaching for the veggie draw.

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How do I ensure baby's emotional needs are being met?

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Trying something new is a challenge, even something as simple as eating. Like anything else new in their world, they will be looking to you for guidance and emotional support. They need to feel comfortable, familiar, and safe, in order to accept the new challenge and make it a happy experience. Therefore: 

  • The atmosphere throughout his sensory journey of moving to solids is essential to feeling secure and confident to try new things [91]. Setting up positive healthy relationships with food can never start too early. If he associates food with stress and frustration, this not only has an impact on what he eats now but also into the future. These formative stages set the foundations for healthy relationships and preferences for life. 

  • Eat with him. Eating is a social experience, and for babies this is no different. It offers them a sense of connectedness and belonging. Eventually you will be able to integrate him into the family meal, but for now, sit down with him, preferably at eye level, and share a meal with him [92]. Your social interactions with him during mealtimes all contribute to future acceptances of various flavors and textures. So keep it stress-free, positive and as enjoyable as possible, take his lead [36], and offer plenty of praise!

  • Choose a time/day/week when you are both free from further challenges or disruptions, e.g. starting a new day care, outings, visitors, disruptions to sleep patterns [2].

  • Choose a time of day when you both are well rested and have plenty of time to enjoy these new experiences, i.e. don’t be in a rush.

  • Choose a time of day when he is not overly hungry. In these early stages they do not yet associate solids with satisfying hunger. Rather, look at this as another form of play and exploration [44]. 

  • Don’t make a fuss. If it didn’t go as well as you anticipated, such as he didn’t want a bar of it, got distracted or upset, that’s OK and all completely normal! Riding a bike with no training wheels was the same, right? The most important thing is to not make a fuss and try again some other time. 

Get messy! He will spit most of these first foods out. He will want to try and grab the spoon or hold onto his own. He will want to play with his food. Eating involves touch, sight, smell, and even sound [44]. Engaging these senses is a critical part of learning to eat, learning about food, and even triggering the digestive process. Start this learning process early. Try offering the real deal alongside the puree you are offering. For example, if offering a carrot puree, have a whole carrot for him to hold.

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What’s best to feed beyond 6 months old?

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Nutrient-filled spoonfuls of flavor! As he approaches 6 to 7 months his nutritional demands to support and optimize healthy growth and development are high, and are no longer able to be met by his milk feeds [14]. However, his tummy is still very small so it is important not to fill it up with nutritionally ‘empty’ foods. Most of us interpret malnutrition to be ‘not enough food’ and a Third-World problem. But malnutrition is rife right here in our ‘land of plenty,’ as children are not ingesting food with the best nutrients. Even at a healthy weight (and indeed overweight), an individual can suffer from malnutrition if their diet is limited to a select handful of foods, or the wrong foods (often at the expense of nutrient-dense foods [23] and milk feeds). It is therefore important to consider all his nutritional needs, now and going forward, not only in terms of flavor, but also composition.

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Should baby be eating breakfast, lunch, and dinner?

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When first introducing him to solid foods, it is important to choose a time in the day [21] that is free of stress, when he is well rested, and not overly hungry. When starting out, this is most likely not going to fall at regular meal times in the day. All babies are different so listen to their cues [36] and follow your gut instinct.

A feeding schedule may look like this:

Exploration phase: 4 to 6 months

  • 1—2 ‘meals’ per day. ‘Meals’ during this period may only be a teaspoonful, most of which may end up on his face. That is OK! He is still exploring and will be gaining from the taste experience.
  • Milk feeds during this time should be offered first to ensure he is not overly hungry. He is still unable to associate hunger with solids so will likely get upset if overly hungry. As milk is still his number one source of nutrition it is important that solids do not replace milk but rather complement it.

Getting the hang of it! 5 to 7 months

  • 1—2 meals per day. By now he should be able to enjoy 2—4 tablespoons of puree at each sitting. Most babies are having two meals per day, but this can change daily. Just remember the responsive feeding [36] rule of letting him guide you. If you offer and he clearly is uninterested or upset, no problem. What he may really want is a milk feed and a sleep.
  • Milk feeds should still be given first thing in the morning and before naps and bedtimes. During the day you may start to experiment with offering a milk feed before or after meals. If he is a big drinker you might want to offer it after a meal, or if he is only a moderate drinker you might try the opposite. 

Whoop whoop, we got this! 7 to 12 months

  • 2—3 meals per day. Once he starts to get excited and interested in food, you can slowly start introducing scheduled mealtimes. This might start to resemble the family mealtimes of breakfast, lunch, and dinner, but the key here is not to be too rigid. Routines can easily be derailed by poor sleep, teething, tummy upsets, stress, even having visitors. Go with it, and find out what works for you and your family.

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What about snacks in between meals?

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Snacks really don’t have a place in the first year of life and here’s why: The evolution of snacks is to provide a quick easy solution to fill a gap before the next mealtime. Many snack options tend to be something to grab on the go, and are often highly processed (the obvious exception being fruit). One snack as a stop-gap measure can quickly turn into two, and before you know it, the demands for favourite snacks start encroaching and undoing all the hard work to develop preferences for healthy whole foods [29]. Establishing and maintaining a nutritious eating regime in the first year of life is imperative. Three meals a day, plus milk feeds as top-ups in between, leaves very little room in their tiny tummies for nutrient-empty fillers. The second reason for reaching for a snack food is generally to comfort, clam, or distract him in times of stress [83]. Now, there is no harm in this if it’s once in a while. The problem begins if every time he is upset he is rewarded with a snack, he will quickly start to associate food with emotions rather than appetite. Ever wondered where the term ‘emotional eating’ comes from? Bingo! So before you reach for the cracker packet, stop and think if he is genuinely hungry and/or how else you might be able to give comfort.

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How do I train my baby not to be fussy?

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The crucial period [5] of the hardwiring of the brain toward food preferences occurs in the early stages of the introduction to solid foods. It is therefore necessary to continue to build on creating healthy preferences and making the most of every opportunity to do so. Plenty of research and study has shown that the introduction to a wide variety of vegetables [11] on multiple occasions and building on the range of vegetables offered in their single form [12] all help to form preferences and acceptance, both in the short and long term [14]. It is also important that caregivers aren’t swayed by their own preferences/dislikes or get locked into their own preconceived ideas on what their infant will like/dislike [45, 51]. Vegetables first, vegetables in variety, and vegetables in repetition is the key message [11] here. Responsive feeding [36] and his learning experience and environment also play a vital role. Parents, and mothers in particular, are inclined to feed their children as often and as much as possible (the survival instinct). However, these good intentions can actually lead to poor relationships with food and later fussiness, if it turns into a battle of the wills.

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What are good sources of carbohydrates?

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Starchy vegetables (pumpkin, potato, sweet potato, yams) are all excellent sources of carbohydrates. So too are the rest of vegetable family as well as fruit. However, we know that fruit, although natural, can have a high sugar content (sugar is a carbohydrate in its simplest form) and so needs to be given in moderation as part of a healthy diet. When his gut is mature enough [58], further good sources of carbohydrates are wholegrain cereals, pasta, and rice.

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What if baby doesn’t want to eat what I give him?

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For some infants, it may take several exposures (up to 10 or more) to a certain food before it is readily accepted [2, 3, 18, 46]. The key is to not be concerned but offer it again on another occasion. Use this important phase as an opportunity to offer a wide variety of vegetables on multiple occasions and extend his palate without the worry of having to meet nutritional requirements [13]. 

As new flavors and tastes are introduced, it is not unusual for infants to display an element of surprise or even disgust [6, 22]. This is normal. Focus on the infant’s willingness to continue eating rather than their facial expressions and persevere. Limiting the diet by reverting back to familiar and readily accepted foods (usually those with a sweet and/or salty base) not only cements a life-long preference for those foods and the health consequences that these habits bring, but can also put infants at risk for nutritional deficiencies. 

So, the next time he screws his nose up at broccoli, don’t make a fuss and get into a battle of the wills. and don’t try and sneak it in while he is distracted or mix it with his preferred fruit or vegetable [12]. End the feeding session without fuss [37] and try offering it again another time. And no, babies will not starve themselves—that extra spoon of broccoli is not going to make a difference to him sleeping through the night! Exposure and repetition are the keys to healthy eating preferences and habits [11, 15, 70, 91].

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Baby screws up his face at certain foods. Does this mean he doesn’t like it?

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As new flavors and tastes are introduced, it is not unusual for infants to display an element of surprise or even disgust [22]. This is normal. It is important to focus on the infant’s willingness to continue eating rather than their facial expressions and persevere [6, 46, 91]. It is also important to not react negatively, make fun of or show disappointment as these can reinforce undesired behaviour [37] or put him off trying again. Remember, this is a journey of sensory education!

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How do I know baby has eaten enough?

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Infant self-regulation through responsive feeding [36] is another important learnt behaviour. A well-meaning caregiver’s natural instinct to ensure their child has had enough to eat can override satiety cues, in turn leading to over-consumption and obesity risk [17, 31]. It is important caregivers can recognize the signs of satiety and foster the early entrainment of appetite control. Some signs that he may be full are:

  • Turning his head away when the spoon is coming toward him
  • Pushing the spoon away with his hand
  • Fussing or playing with his food
  • Loss of interest

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Why a vegetables-first approach?

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We are all born with an innate preference for sweet foods and a dislike for bitter. However, we all know that vegetables are nutrient powerhouses and as a nation we don’t eat enough of them. What if there was a way to not only get children to eat them, but want eat them [2]? Well, there is! [19, 51] Numerous studies have indicated that the beginning of introducing solid foods is a very sensitive time in terms of learning and processing. If we capitalize on this window of opportunity [5, 45] it is possible to train preferences for a wide range of flavor profiles, including bitter and sour. Offering small tastes of a wide variety of vegetables, in their single form not masked with a sweet puree [12], on multiple occasions, helps to promote willingness and acceptance of new foods beyond infancy and into childhood / adulthood [10, 11]. A spoonful is all that is required [5] as this is about exposure to different tastes, not nutrition or satisfying hunger. The focus is very much on taste experiences and building the foundations for healthy preferences [3, 14, 15, 21, 32]

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What is responsive feeding?

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Although infants can’t verbally tell us when they are hungry or full, they do tell us in nonverbal ways. Responsive feeding is when caregivers acknowledge and respond to these cues in ways that will foster and reinforce healthy eating habits [30, 49, 71]. Failure to do so can lead to overconsumption, poor appetite control/regulation, emotional eating, and result in an increased obesity risk [31]. It is not OK to say “just two more mouthfuls” or “finish this before you can get down” or “I know you’re not hungry but have this anyway.” Forcing your baby to eat will create an unpleasant environment, cause elevated anxiety (for both you and him), and may lead to food phobias or not wanting to eat at all.

Responsive feeding is crucial for supporting babies and children in developing appetite regulation and form the basis for healthy feeding practices [37].

Signs of hunger at 6 to 12 months old:

  • Reaches for the spoon
  • Points to the food
  • Gets excited when food is presented
  • Leans forward with mouth open
  • Distress when cues aren’t listened to

Signs he’s had enough:

  • Shakes head
  • Turns head away
  • Pushes spoon away
  • Easily distracted
  • Indicates wants to get down

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Baby-led weaning or purees—what’s best?

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The traditional method of transitioning babies onto solid foods is to offer smooth purees on a spoon, gradually moving to thicker and then textured purees. However, more recently, baby-led weaning (BLW) has taken favour. A BLW approach is to introduce or offer foods in their intact form, instead of pureeing, and allow the baby to feed himself. By offering only finger foods, in appropriate sizes, e.g. cooked vegetables, meat, and soft fruits, parents allow their babies to choose and be directed as to what they do and do not want to eat. This helps to engage all the senses while eating, and develops key motor skills and the muscles involved with chewing. It can mean the foods are more nutritious, if the alternatives are poor-quality, watery puree. However, it is one thing to offer highly nutritious foods, but it is a different matter if they are not consumed. We know that by 6 months, an infant’s requirements for iron in order to optimize growth and development [14] increase considerably. Iron-rich sources include red meats [24] but they are generally more difficult to consume as a finger food in the early phases. The variety of vegetables can also be somewhat limited to consume in a safe way. Peas, for example, pose a choking risk [41] if not mashed and green leafy vegetables are difficult to process without adequate motor skills. And when healthy alternatives are not on hand, it is easier to turn to processed, prepackaged foods such as bread, rusks, or biscuits [39]. 

A great compromise is to provide a highly nutritious puree, alongside some appropriate finger food. Thus, allowing autonomy and a sensory experience, while ensuring the exposure and consumption of a wide variety of flavors, textures, and nutrition. Regardless of feeding method, a responsive-feeding approach [36] is paramount.

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Disclaimer: The information provided is the opinion of Good Feeding, it has not been evaluated by healthcare professionals, and is for educational purposes only.  Before starting any new foods or feeding practices, please consult your baby's healthcare professional.