Starting Safe, Staying Safe

As parents, we do our very best to keep our children happy and safe, but there’s so much to learn and only so many hours in the day to figure it out. All the while, baby is growing (and growing and growing). These early months might be crucial to baby’s healthy development, but you don’t have to learn everything at once. Here are our top tips for keeping baby safe during feeding times.

Understanding feeding difficulties

Where do feeding difficulties come from?

The critical window for introducing lumpy solid foods to an infant is 9-10 months of age. Research shows that babies who aren’t introduced to new textures during this time will be less likely to accept new foods later in life. Eating foods of different consistencies and textures is important for development of chewing and oral motor skills, and to ensure nutritional needs are being met.

If baby stays on smooth purees for too long it can result in feeding difficulties. These include reduced consumption of important food groups, increased chance of food phobias and an increased risk of allergies.

Age-by-age feeding guide

Eating a wide variety of foods and textures is a crucial step in the transition to solid foods. All babies are different, but you can use the following as a guide for what baby should be eating and when.

*Reference: American Academy of Pediatrics.

The difference between gagging and choking

Watching baby transition to solid foods is exciting - but you might find yourself holding your breath as baby coughs or splutters. Is baby gagging? Or choking? And what do you do in either event? 

The tongue-thrust reflex

Babies have a natural tongue-thrust reflex until they are 4-5 months old. At this stage, babies don’t have the ability to work food to the back of their throat so they can swallow. As a result, they instinctively push anything out of their mouth that isn’t related to the act of drinking milk. Therefore, introducing solid foods too early can cause them to gag.

Gagging

Gagging is where baby pushes their tongue out of their mouth in a retching movement, attempting to clear food from their throat.

Signs of gagging include:

• Noisy cough and splutter
• Watery eyes
• Pushing tongue forward or out of their mouth
• Retching noise
• Vomiting
• Seeming not too concerned

If baby is gagging, the best thing to do is to let them continue to gag and cough until the food is cleared. If you intervene you could make the situation worse, causing the food to dislodge further down baby’s throat. Try to remain calm, and once the situation resolves itself, offer reassurance and support. 

Choking

Choking is where baby’s airway is partially or fully blocked which prevents breathing. If baby cannot clear the food or is showing signs of choking always contact 9-1-1 immediately. 

Signs of choking include:

• Trouble breathing
• Coughing or gasping when breathing
• Looking scared
• Inability to make noise
• Turning blue in the face

Choking can be life-threatening so it’s important that you know how to act so you can jump right in. While it’s a good idea to take a first-aid course, you can also use this step-by-step guide to educate yourself on what to do if baby is choking:

Step 1: Check to see if the item can be removed easily, and try to remove it. If it cannot be removed easily, or you can’t see the object causing baby to choke, remove your fingers from baby’s mouth.

Note: If baby starts to cough loudly, leave them to it as this may be enough to dislodge the object. 

Step 2: If step one does not help, or if baby starts to go silent (but still conscious), move to back blows. Sit down, lay baby face down on your thighs, supporting their head with your hand. Position baby so their head lower than their bottom, and with the heel of your other hand, administer 5 sharp back blows between the shoulder blades, checking them in between each blow.

Step 3: If this has not dislodged the object, turn baby over and lay them face up across your lap, continuing to support the head with your hand. In this position, the head should be slightly lower than the tummy.

Step 4: Place two fingers on their breastbone and apply 5 sharp chest thrusts, assessing them in between each.

Step 5: Repeat if this has been unsuccessful but only if they are still conscious.

Step 6: If they fall unconscious immediately call 911 for help and commence CPR.

Preventing choking

While choking can be a terrifying experience for babies and parents alike, rest assured it’s not as common as you think it’s going to be! By taking proper precautions and knowing the signs of choking, you can help reduce the risk.

There are a number of ways you can help prevent choking incidents. Follow these important procedures to keep baby safe:

• Seat baby at a 90-degree angle: When feeding, baby should never be slouched or reclined. It is important to keep baby positioned at a 90-degree angle at all times.
• High chair safety: A safe high chair is sturdy enough that it cannot be tipped easily and includes safety straps. Keep away from the counter or table so baby can’t push against this and topple the chair.
• Supervise eating from front-on: Never leave baby alone when feeding. Supervise all mealtimes from front on so you can monitor how much baby is eating and the facial expressions they make as they eat.
• Know foods that pose a choking risk: Be aware of hazardous foods such as hard or round vegetables and fruits which are common choking hazards. Cut and prepare foods appropriately for baby’s age and development.
• Avoid putting too much food in at once: Watch out for ‘chipmunk cheeks’, an act where baby stores food in their cheeks which can lead to choking. To prevent this, make sure all food has been swallowed before providing more.

Food allergies

Difference between allergy and intolerance

Food allergies and food intolerances are often confused. A food allergy stimulates an immune response shortly after eating a particular food. Symptoms of allergy can be mild or severe and include difficulty breathing, swelling around the face, itching and hives, and vomiting. Food intolerances, on the other hand, result in a range of mainly digestive symptoms that can occur 12-24 hours after ingesting food. Symptoms of intolerance include bloating, diarrhea, nausea and indigestion, eczema flare-ups or asthma.

How food allergies develop

It’s impossible to know for sure if baby will develop a food allergy. Even if mom, dad or a sibling has an allergy to a certain food, it doesn’t necessarily mean baby will end up with one. It does however put them at a slightly higher risk so it may pay to discuss this with your health professional. 

However, for most, recent research indicates that early and frequent exposure can actually lower the risk of developing food allergies. Research also indicates that a healthy microbiome, which supports a strong immune system, can also decrease the chances of developing a food allergy.

What are the most common food allergies?

Foods which are the most common cause of allergies are:

• Peanuts
• Eggs
• Fish
• Tree nuts
• Shellfish
• Soy
• Milk
• Wheat

Introducing potentially allergenic foods

While you might feel a little apprehensive about introducing baby to potential food allergens, it’s important to do so as soon as possible. According to the American Academy of Pediatrics new guidelines for infant food allergy prevention, parents should introduce allergens as early as 4-6 months as this may help prevent baby from developing food allergies. 

These guidelines recommend early ‘purposeful’ introduction to allergens to help reduce food allergy risk. In fact, one study found an 80% reduction in peanut allergy in a group of children who consumed it early and often as babies.

When introducing an allergen to your baby, ensure your baby is healthy so you can detect an allergic reaction. Feed baby at a time of day when you can monitor them for a potential reaction and only introduce one new food at a time so you can easily identify problem foods if a reaction occurs. As you work through this process keep a food log of baby’s responses. 

If you’re concerned about baby developing a food allergy, speak to a doctor who may have specific advice or medication on hand to help ease your concerns. 

Signs of an allergic reaction

Allergic reactions range from mild to severe. Severe allergic reactions are called anaphylaxis and require immediate medical attention. Here’s how you can tell the difference between the two.

Signs of a mild to moderate reaction:

• Swelling of lips, face and eyes
• Hives (reddish, swollen, itchy areas on the skin)
• Eczema flare (a persistent dry, itchy rash)
• Redness of the skin, particularly around the mouth or eyes
• Itchy mouth or ear canal
• Nasal congestion, runny nose, sneezing, cough
• Abdominal pain, vomiting, distress
• Diarrhea

If you suspect a non-severe allergic reaction, contact your baby's health care professional to discuss next steps.

Signs of a severe allergic reaction or anaphylaxis:

• Difficult/noisy breathing
• Swelling of the tongue
• Swelling/tightness in the throat
• Wheeze/cough
• Pale and floppy
• Loss of consciousness

How to handle an allergic reaction

If you suspect an allergic reaction contact your healthcare professional and call 9-1-1 immediately.

Food safety

To keep baby safe from illness, ensure you store, heat and reuse food correctly.

Once open, all baby food must be kept in the refrigerator. Remove the amount of food to be used and place it in a separate dish rather than feeding directly from the container so the unused food can be covered for later use without the risk of contamination. Homemade food should be kept in the refrigerator for no more than 3 days. After 3 days, homemade food should be discarded and not fed to baby.

Food should be heated until it is steam hot. Allow it to stand and then check its temperature using a food thermometer, it should be at least 165 def F. After heating baby food in the microwave, stir it thoroughly to disperse any hot spots. Allow it to cool to an ideal serving temperature.

Harmful germs from baby’s mouth can be introduced into food which multiplies after refrigerating and reheating. Don’t feed multiple meals from the same container or spoon and throw away any leftovers.

Staying present when feeding

To keep baby safe, it’s important to ensure they are well supervised during feeding to watch baby's face for signs of choking or allergic reaction.

Of course, eating together as a family isn’t just a safety precaution! Watching adults eat teaches children good eating habits and helps them learn more about food.

Highchair safety

When it comes to feeding baby, a freestanding highchair is the best and safest option. If you choose one that hooks onto the table, make sure it locks securely and the table is heavy enough to support the baby’s weight without tipping. Make sure baby’s feet cannot touch the table as they could push against it and dislodge the seat.

When using a highchair make sure it’s in a secure position and can’t be tipped. If it’s a folding chair, ensure it is locked in position away from counters and tables so baby can’t kick or knock it over.

Finally, make sure the baby is strapped in and actively watch them at all times while feeding.

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.