Q&A: feeding solids but not purees

Onward and upward! writes:

"As a new mom, I am often questioning little details of raising my son. The vast amount of information and opinions available on the Internet just seem to make it worse.

For example, he's having trouble with constipation (despite breast milk and trying just about every formula out there), so I started him on pureed veggies and fruits, hoping it would create looser stools. It hasn't made a difference so far. But then I go and read an article in the BBC news that says skip pureed foods altogether, and only give them solid foods after about six months or so. The premise is that your baby needs to learn how to chew first, and only after he is ready to do so; and pureed foods can leave them constipated AND postpone their ability to learn to chew. Huh. What do you think?"

Veeery interesting. And, yes, there's definitely too much information on the internet. If you click away now I won't be insulted.

First of all, before we get to the actual topic, are you absolutely sure it's constipation? Many babies (especially breastfed ones) don't poop every day, and some can go for days without pooping, and this is absolutely normal. If they have gas and strain to fart it can look like constipation, but the key is to check the consistency. As long as the poop (I'm not going to call it "stool," people) is soft and a normal color (not hard or black), it's not constipation.

Now to the article: I don't think any of this is that shocking. Even the most recent recommendation from the AAP (American Association Academy [thanks for catching that perhaps not-so-surprising typo, Sarah] of Pediatrics, with whom I have a one-way "eh"-hate relationship) is not to start food until six months. Before that there's really no need for it (barring feeding problems like GERD) and milk or formula has all the nutrition they need. There's a reason babies that young can't chew, and it's because they're supposed to be getting their nutrition in liquid form. There's also some thought now that introducing carbohydrates (rice cereal, etc.) too early can mess with babies' systems so they don't regulate insulin as well and are more prone to developing diabetes later on.

So the recommendation not to start with solids until 6 months isn't making me take any particular notice.

Some of you are aware that my favorite study is about a baby-led approach to starting solids. That study was written by Gill Rapley, the same health visitor (I love that term--it just seems so civilized, like she just pops 'round for a chat and a cup of tea) who's mentioned in the BBC.com piece. If you haven't read the study yet, you should check it out because it's pretty interesting. They looked at what happened when babies were allowed to shove food into their own mouths on their own schedules, and what they discovered was that most babies actually started swallowing it at around 6 months, which seems to indicate that they know how to control their own intake for what their bodies need. This article also suggests that babies choke less when they control big chunks with their teeth and tongues than when they have purees shoved to the back of their mouths.

So a little autonomy with feeding themselves sounds like it's helpful. It's certainly less work for the parents than having to mash and mix and puree and then hope to shove it in. And it makes sense that if they don't get practice chewing they won't chew as early as they will if they get to practice it.

Does anyone else have opinions about whether or not feeding purees makes kids picky eaters? My only experience is with my two, and the one I fed pureed foods to eats nothing, while the one I tossed huge chunks of stuff to eats everything. But the second one is only 2, so there's plenty of time for him to stop eating over the next few years. What have you guys observed?

Comments

[PumpkinMama]

I'm now feeding my 7month old with big chunks, in the hope she does not turn out like her puree-fed finicky eating older brother. She does wonderfully managing the large chunks and the smaller bites she ends up gnawing off. No choking yet, and in fact she is not terribly agreeable to spoon feeding when I have tried it (yougurt, applesauce, etc).

[Katy]

On the constipation issue, our son BJ went through a no pooping phase when he was 5 months old. The longest stretch was 2 weeks with no poop at all! We took him to the doctor after the first long stretch and she also recommended starting with some pureed fruits (especially prunes) which we did, but it didn't seem to have much effect. In fact, the 2 week 'dry' spell happened when we were visiting family in England, so we visited the local GP (who happened to be Spanish!) and he recommended giving him orange juice. BJ pooped not long after that but I don't know if it had anything to do with the juice. After the 2 week stretch he had to strain and push a bit and seemed in a little discomfort, but the poop was still soft and light in color, so I don't think he really was constipated, just a slow pooper. The doctors both said that as long as he wasn't in any discomfort and had a soft belly he was fine - breast milk is just such a perfect food that it makes hardly any waste! Anyway, so it ended up that we started purees first, skipped rice cereal in favor of oatmeal (more fiber) and then went to finger food like toast. BJ always preferred to feed himself, and as of right now (13 months) will eat pretty much anything, so fingers crossed that it stays that way!

[casey]

My son is 11 months old (omigod he turns 1 tomorrow) and he started out on homemade purees and we still give him purees with other foods now. He has not rejected anything we've given him at all, loves all foods.

[Kate]

If all pediatricians followed the AAP guidelines, there'd be a lot more "extended" (i.e. past 3-6 months) breastfeeding and no solids before 6 months. But with my first baby--and first pediatrician--I, the NEW MOTHER, had to say at my daughter's 4 month well baby appointment, "No, I don't want to talk about solids for another two months." Grrr.

After about 2-4 weeks of mushed foods, neither one of my kids really liked being spoonfed. (My second to an extreme--I can't really give him yogurt, cottage cheese, oatmeal, applesauce, etc. because he wants to do it himself. That can only happen at dinner and segue to a bath--he's 15 mos.)

I started giving food in chunks quite early, things that mash up easily (ripe banana, very ripe pear, avocado, baked sweet potato) in hands/with gums.

My son is a better eater than my daughter (3 yo) at this point, but I fully expect him to be living on a diet of cereal, pasta, fish sticks, string cheese, and fruit by the time he's 3.

[Kate]

Oh, and my daughter was an infrequent pooper too. Usually every 5-7 days; once went 13 days. Never constipated though.

[Andromeda]

My almost-six-month-old has no teeth, so I don't see how anything but puree is an option. So far she's been very enthusiastic about the *process* of feeding, and accepting to enthusiastic about the foods I'd tried (except rice cereal, which she hates, but seriously, that stuff looks like industrial slurry; who can blame her?).

[paola]

My 2.5 year old was a choker and so everything was pretty small until way past a year. He never even went thru the finger food stage and went straight from me giving him the spoon to him using the spoon. Now he uses his fingers just to rile me up as he knows I want him to use the spoon/fork. I started solids with him at 6 months and not before as I suffer from deadly nut allergy and my hubby and I are both fairly allergic so breast milk until 6 months and then lots and lots of breast milk thereafter. I believe they have all there lives to try other stuff and it is my job to let them try healthy food when they are ready and curious.

[Kate]

Re: no teeth, the first teeth kids get are not for chewing anyway. Hard gums are sufficient to do the job on soft foods. Some kids get no teeth until they are a year old--and most kids that age want to feed themselves finger foods.

[holly]

When I do it all over again, I am going to follow the child-led approach to solids - not introduce anything until the babe is reaching for food on my plate, and not starting with purees/cereals exclusively. My son is almost two years old, and has some pretty strong aversions to some solid textures. I really do attribute this to lack of exposure and experience. Humans have been feeding their babies for millions of years, and most of that time without the convience of food processors!

[Papaya]

I took the BLW (Gill Rapley style, self-feeding, baby-led weaning, whatever you want to call it) route with my now 13 month old, and I highly recommend it. We started out by offering her bits and pieces of fruit and steamed veg (cut into long strips she could easily hold onto) when she was around 6 months. Now she eats (almost) everything (she just points at what she wants and I put it on her tray) and people always comment what a great independent eater she is. She can even feed herself with a spoon without making too much of a mess. Mind you, she still got constipated when we started out with solids. It sorted itself out after a two weeks, although giving her prunes (which she still loves) did seem to help a bit. I think it is just their system having to get used to digesting solid food first.
I think it's important to never make food an issue, to never force anything, and to let the child experience (and play) with different types of food. In our house, meals are a social event and we try to always eat together. It makes me cringe when I see some mothers shoving purees down their kids throat while chatting on the phone at the same time. I don't think purees are all bad though, it's just that I was more comfortable with allowing our bee to self-feed (and she would have a meltdown if I so much as approached her with a spoon). Of course, there are still times when she'd rather throw her meal on the floor instead of eating it, but then I just rely on breastmilk to fill the nutrional gaps. Beside the Dutch site Moxie already mentioned, I also found www.babyledweaning.com a great help.
Sorry about the long ramble, I'll mosie on off now.

[Cat, Galloping]

I'll bet this one comes down to the individual child. I pureed lots of fresh and frozen fruits and vegetables for my kid starting at 6 months, and he turned out to be a very "advanced" eater. I have a picture of him eating a whole apple, not even cut up, at 9 months. He also eats a very varied diet filled with fruits and veggies and meats, even strong cheeses and grapefruit juice! It's far more varied than my picky diet, even. (Shall I blame my mom for feeding me cereal at 2 weeks of age?!)

Also, wasn't there a recent study that *waiting* to introduce cereal until after 6 months increased risk of some allergy or other? I have a feeling they experts will flip and flop on this one for centuries...

[Shandra]

My son was a slow pooper too towards 5-6 mo. His doctor theorized that by then some babies are just really efficient at using all the breast milk nutrients so there isn't a lot of waste.

We did a dual approach: we let my son gnaw on a few things on our laps while offering purees (started with brown rice cereal; it didn't agree with him so went to sweet potato and then oatmeal). He isn't picky but is only 23 months so lots of time yet. I actually sort of believe that pickiness can be trained, but is really mostly about personality and sensitivity to taste & texture and it scarcely matters what parents do for first foods...

now, at the time I emailed Moxie food questions all the time. It is scary! But whatever you do you will be fine. I grew up in the 70s and had the same three white-carb and ground beef meals over and over, so should be picky for life, and I love all sorts of cuisines and esoteric vegetables now.

[jane]

My daughter went for long stretches (15 days was the longest) without pooping. She was never constipated though; I guess her little body knows what to do with breast milk. As far as feeding solid foods, I didn't give her anything until she was six months old even though she showed interest in food before that. We gave her real foods, starting with sweet potatoes, avocados, bananas and chick peas (peel the outside off and squish them a little). When she was about 8 months old we were going on a trip so I bought some organic baby food to feed her on the plane - she would have none of that. She's been a great eater so far and really likes to feed herself. Incidentally, she only has two teeth now and didn't get those until after we'd been feeding her solids for a few months. I also want to say thanks to Moxie and all the commenters; this site has been so valuable to me as a parent. I don't comment much, but read often and appreciate the opinions and the open, kind, nonjudgmental manner in which they are shared.

[Renee]

I have had the same experience as Moxie. I followed the AAP guidelines with my first. He is now four and hasn't eaten a meal voluntarily in three years. He refuses to try anything new and especially won't eat vegetables. He is also very keen to the texture of what he eats. With my second, who is almost a year old, I let him take the lead when he started snatching from my plate a few months ago. That kid will eat anything and actually loves to eat and try new things.

[Hilary]

Not a doctor yet, but based on my own research (I worked as a medical nutritional researcher and am starting med school in two weeks! EEP!) and the advice of my very nutritionally minded ped:

As long as your baby does not have any serious underweight or nutritional issues, add sips of water when you add solids. It really helped with constipation in both of my kids, and we live in a warm place, so they were sweating and losing fluid, too. I still breastfed.

Add oils. Olive oil is great for babies, and so are fish oils, barring any allergies. There is tons of research out there on oils and children. The WHO recommends fish as an early food for complementary feeding, and it is one of the first foods many Japanese children are given. Please use your own judgment if you child is likely to be allergic, but if you breastfed and the baby did not have any crazy shock reactions to what you ate, your child is probably not severely allergic to any of those foods. Oils are natural lubes and essential nutrients.

[Today Wendy]

My daughter is 8 months old tomorrow, and we've been having a bit of a struggle with the solid foods. It seems like she isn't too good at pushing food out of her mouth, and maybe doesn't produce a ton of saliva, so the first few times I tried to feed her (pureed banana with a spoon, piece of bread on her own) she wound up with a panicked look on her face and then vomited in order to get the unwanted chunks out of her mouth. Pretty ingenious actually. At my MIL's suggestion we've been giving her sips of water from a large spoon, and that seems to help a lot.

I think I'm going to give the steamed (but not pureed) vegetables a shot. Cramming food into her mouth isn't fun for anyone, although I usually put it at the front of her mouth rather than the back.

[Imara]

I found that when I started pureed foods, my daughter was constipated because her stool was just so much harder to pass now that it was a bit firmer than her stool with strictly breastmilk.

I tried to start pieces (chunks) of food at 6 months, but my daughter would gag because she simply did not know what to do with it. At about 7 months though, she automatically "got it" and started chewing. This has really helped with self feeding (freeing up my hands), and also trying different things.

She is 10 months old now and eating all sorts of chunky foods, chewing and swallowing - and she does not have one tooth in her mouth yet.

So, I guess my answer would be that as soon as your son does not gag when you put something chunky into his mouth, feed him chunky pieces of food.

[Katie]

I'm so intrigued by all this and overwhelmed too. We've just started solids and I read that at the start the food should be the consistency of breast milk. But how is that eating then? Last night my partner gave the kid some bananas with bigger chunks in it and he apparently loved that. He's only been "eating" for four days and already I think he's hooked-- reaching out for more and opening up his mouth happily when food comes near it.

But I'm terrified about solid food.

There. I said it. I get all the reasons why to give him chunks of soft food, but I'm just really scared about it. And I don't want to be a scared mother. It's not as much fun.

Can he really eat chunks? I'm off to get a sweet potato today since it seems like bananas have gone well. I'll give some rice cereal in the next few weeks.

I also read about giving water with food, which is a struggle here since he only wants to "drink" from the breast. No bottle. No sippy cup.

I want to be laid back about it all, but in seven weeks I go back to school full time.

[leb]

My experience is the same as yours Moxie.

My puree fed dd has terrible food issues (textures mainly) - and still mashes her food up before eating it (she's nearly 7).

My BLW baby - standard (non salted) family food (fish, vegetables, pasta etc) from day one (i.e. a few days after 6 months old) in chunks - will eat anything.

Who knows why? Maybe personality? My dd was briefly tube fed as a baby. Regardless I adore BLW and think that the concept of self regulation of food intake (as you would with a demand breastfed baby) is a valuable one. Much easier too :)

[Jenn]

I started solids with my twins at four month, but if I had to do it over, I'd wait till six. I think it did make them constipated even with breastmilk and no formula. I did only homemade babyfood and that was much, much chunkier than the jarred stuff. My mother was horrified at the "huge" pieces of food I gave them. At around six months I started letting them practice feeding themselves. They are almost a year old now and terrific eaters. They love a variety of foods and refuse very little. They have huge appetites.

I think with most things if you listen to the baby you're better off.

[Annika]

I have only one child, and he's just 14 months, so my experience isn't very definitive yet. But that won't stop me from sharing it anyway. We did table food from the start, never purees (well, I pureed some carrot once and he laughed at me). He eats table food with gusto, and so far has only disliked one thing I offered him - avocado, which he loves now. I think it is just as much a matter of him being his father's son (that man will eat anything) as it is the way we've fed him, but I do think there is something to be said for allowing a baby to select his own food; it seems logical that his tastes will be more varied and he'll be more willing to try new things.

[Charisse]

Hmm...we started rice cereal and purees with Mouse a 5 months (she was grabbing stuff off our plates and big for her age--of course the ped cautioned us to not actually give her what was on our plates), and they were always homemade, i.e. not perfect purees. She tried to spoonfeed herself from the start and then pretty much refused the spoon from about 9 or 10 months on--except at daycare, where they did homemade chunky baby food. She ate a lot of avocado chunks during that time.

She's always been a touch prone to constipation since starting solids--as long as she gets fruit and fiber she's OK, but she'll get backed up if she has bananas or rice (interestingly, she hates bananas).

Anyway, she's been picky-ish during her 2-year-old year, but still willing to eat 5 or 6 veggies and 5 or 6 fruits, chicken, beef, & so forth. She's been coming out of that lately and eating a much bigger range now she's 3.

Which I guess is to say, middle of the road on both--purees aren't a disaster necessarily, but try other stuff too?

[hedra]

For those terrified of the choking and chewing thing, I highly recommend those "baby safe feeder" things - mesh bag on a handle, pretty much. Insert food, give to baby (even use a pacifier clip to keep them from throwing it too far overboard), and let them chew. They practice chewing, they get to have lumpy or slippery foods that make ME panic (avocado!), they get more control and self-feeding practice. Super invention, IMHO. Even good for chunks of meat. :)

I'm paranoid about choking (oldest choked at 2, though I wasn't there I still wig out over the thought), and the safe feeder is really helpful for the sanity. That said, some kids just won't tolerate it - the twins pretty much ignored the things, and one of them was a choker, BIG time (had to rescue her twice in 5 minutes once, yay for Infant/Child CPR training). But a coarsely ground approach also works - still gives them enough to 'chew on', and not so much to gag/choke on if they're prone to shoveling it in too fast.

We did one on purees - the oldest. That may be one of many of the factors contributing to him being in a feeding clinic by the time he was 6, with clinically significant picky eating. Only one of the reasons, though. I mainly switched to table foods because the second just detested purees, and only became interested in eating when he tried foods with garlic and onions and black pepper. So, our foods it was. The twins, the idea of spoon feeding two for ages just sucked, though we did have a low iron issue with one, so I did use some rice cereal for a bit. But quickly moved up to other foods, off our plates as soon as possible. Majorly into self-feeding, to the point of refusing to eat at all if we offered to feed them.

As for the fish thing and allergies, FIN fish is generally considered safe, it is SHELLFISH that is the allergy risk. There is a cross-contamination issue, but unless you suspect a risk (one or both parents have any kind of allergy, say), fin-fishes are usually okay. Watch the first two tries, but after that, don't fret. Even with our highly allergic family, the pediatric allergist was totally okay with fin fish being on the menu after a year old. Just not shellfish (one of the twins is also directly reactive to histamine triggers, like chocolate and strawberries, so we're extra careful of shellfish with her).

All our kids eat well except the oldest, who has the multiple oral issues (oral trauma, choking, sensory integration, supertaster, and possibly the over-use of purees early on). The oldest still struggles to eat a normal amount or range of foods - it likely will be a lifetime problem for him at this point. If we'd tried solids/chunks sooner, chances are pretty good that I'd have spotted the dietary resistance sooner, and would have gotten him in treatment before he was so old that he was borderline for outgrowing at all. So even without any other reasons, I'd go for the 'jump to solids or at least coarse ground table foods ASAP after 6 months' as the ideal.

[Kathy B.]

I could type a ver long reply here - but I'll condense it to the "Cliffs' Notes" version. Our pediatrician (who I love dearly because he is so practical) told me "I have been doing this for many years; I have gone through all the fads; feed; don't feed; nurse for 6 months; nurse for a year; no solids before 6 months; no solids before 1 year; purees vs solids . . . and so on. In my opinion, assuming the child is otherwise healthy, it doesn't make a whole lot of difference. Do what you think is best and follow the child's lead."

[deezydubya]

My son is 2 in 2 days, and he's never eaten pureed baby food in his life. He wouldn't have known what it was, honestly. I tried once to feed him some of my cream of wheat, and he gummed it for a second before drooling it out of his mouth with a disgusted look on his face.

We did child-led feeding - he ate what we ate smooshed with a fork a bit at first. He also had a feeder bag when he was little - those things are awesome, he must have eaten a whole box of mandarin oranges himself that first Christmas with the feeder bag! He is a control freak (I'd say independent, but it's beyond that KWIM? ;)), so feeding him was not an option. It was usually a sign he was getting sick, actually, if he let us do that!

He eats way more food than either my husband or I - and we're not particularly fussy people. But he's the only raw tomato eater, olive eater, avocado freak, etc....

[AmyinMotown]

Huh--mine ate almost exclusively purees (because I choke easily and was terrifed of her doing the same) until like 10 months when I finally decided I had to get some ovaries and let her try some real food. She is not at all picky (knocking wood furiously right now) at 2.5--like most of us she has food preferences but there's nothing she won't at least try and loves veggies. Her teachers tell me that eating is the one thing they can always get her to do! Her grandparents purposely get asparagus when we're coming over because they love to watch her chomp it down spear after spear.

Don't underestimate chocking, either--mine choked on a apple at like 20 months. She was fine and singing "Wheels on the Bus" within 5 minutes--I still have not recovered.

[ikate]

We half-heartedly offered some purees at about 5 months and they were soundly rejected. As soon as she started reaching for our plates (around 6.5 months), we started giving her little bits of what we were eating. We got a little hand-held food mill that ground things up but leaves a pretty good texture for some things (like meat, harder veggies and fruits, etc) but now at 9.5 months she's pretty much only a self-feeder. She only allows a spoon if she really loves something (like yogurt). I also never gave her bland foods - I spiced up back beans with cumin, put cinnamon in applesauce, etc. and now she prefers bold flavors. When my mom asked what she was eating at about 2 weeks ago and I said pasta with garlic and olive oil my mom gasped and said "you'll give that poor child an ulcer!" HA!

[Jenn (dish)]

When we offered purees (homemade) they were rejected until I thickened them up a LOT with cereal. Essentially, food the consistency of paste was fine, anything thinner was not. But mine was a choker, so I moved to non-mushy solids slowly. Now he eats pretty much anything. Well, expect meat- he hates meat most of the time. Then he'll have a day where he gobbles down a huge plate of chicken. Then it's a meat ban for another few weeks (we get his protein in with other sources, don't worry). But he is the only two year old I know that gets excited when we have dishes of salad and steals from our plates (he won't eat salad from his own plate, only ours...whatever).

[Helen]

To the original poster, if he's getting formula, is it possible the iron fortification is constipating him? If he's even truly constipated, that is. More breastmilk makes things move smoothly (although possibly not every day). If you are having supply issues or pump resistance if you WOH, it's best to deal with those factors, if at all feasible.

I am pretty big on a child meeting readiness signs for self-feeding before introducing solids. Including sitting unassisted, no more tongue thrust, pincer grasp, and interest in solids. It's rare to find all these things coming together before 6 months. There's a great article about this at Kellymom. We did soft chunks for my daughter, and she actually preferred things with more texture. The few purees I offered were soundly rejected. Yes, she has "learned to swallow" without ever having purees, although I am sure this fact disappoints my SIL infinitely. She did not really start feeding herself til about 8.5 months, when she started eating like she's been starving all her life. Now at 13 months, she eats anything we eat (except for a few allergens, like peanuts and shellfish). People are shocked to see her down spicy bbq or Indian food, but not bland, single vegetable sides. The girl needs a little flavor, apparently, although this could still change with age. And feeding a toddler is nervewracking anyway, in that it's basically performance art, but she eats more if allowed to eat it herself, like say bites of sandwich. For a subsequent child, I would not do anything differently.

[Maureen]

I have twin boys (a tad over 2 yrs old) so it is nice in that I can compare easily since I know I started them with the same foods at the same time. We were lucky in that I found this great homemade babyfood delivery place so they got amazing fresh, wonderfully smooth baby food with great flavors (Kale/sweet potato, asparagus, butternut/apple, etc.). They both did really well with that. We then moved on to steamed/chopped finger foods and tried to keep up with the same freshness and healthiness. One of my boys LOVES his veggies - he'll gobble up broccoli, asparagus, etc. - but he hates the meats/chickens. I think he is more prone to choking so those are typically harder things to eat/swallow (shredded chicken/meatballs, etc) and he doesn't like them enough that they are worth the effort. My other boy, loves his proteins... he loves chicken and meatballs but needs a lot more "encouragement" on the veggies. They both LOVE their fruit as that is really the only sugary-type thing they get so fresh fruit tastes super sweet to them.

Anyway, after going on for too long, what I'm trying to say is that I truly think that my kids tastes have more to do with their natural tendencies/taste buds and only a little to do with my efforts. That said, I think my one twin that likes his chicken/meat more would be a horribly picky eater if we hadn't already laid the foundation of having lots of fresh fruits and veggies and taught him that that is part of our meals so he has to at least try.

Lastly, I think on the choking, for those that are scared (I totally understand as I still chop up the boys grapes, berries, etc.), two pieces of advice. Take a CPR class. I think many times we are scared of things where we feel unprepared. If you could get some confidence that if your child started choking, you'd know what to do and handle it just fine, it might not be so scary anymore. Second - it is good to be a little scared just to keep you on your toes - NEVER leave your child eating by him/herself. If you are always with them and know CPR, you and your child should be just fine.

[Kathleen]

My daughter is 15 months old, i started her out on homemade purées at six months, skipped the rice cereal & opted for oatmeal, gave her some o-shaped cereal a month later as finger food, & to this day, she eats anything & everything. Keeping fingers crossed. Good luck !

[shirky]

we give prune juice for constipation followed by a turn in the bungee bouncer. This always works.

it's constipation if the stuff is pebbly or hard (according to dr.)

we know he's constipated if he strains and cries and fusses.

[Josie]

My son just turned six months and I held off on introducing solids based on the Rapley info I found here. Today, he vomited after I tried feeding him chunky mashed up carrot, but he likes his maize porridge (essentially baby grits) if it's really thin. I have to admit I am scared of him choking so I have one of those mesh feeders...

[Sarah]

I started our 16 month old on purees when she was 5-1/2 months (she acted ready at 5 months), and although her diet is much more varied now she is still eating some purees. She eats a wide variety of foods now. Our main issue with food has always been: her lack of teeth. Here at 16 months she has exactly six teeth, and none of them are molars, so her ability to chew food up is limited. If she had more teeth and some molars, I'd have stopped feeding her purees entirely by now, but as it is, it's the only way I can get vegetables into her (given that I'm not willing to cook vegetables to the point where they turn to mush, I think it renders them largely nutritionless).

FYI, when I was a baby I was one of those "poop once every 3 days" type of kids, even while I was being exclusively breastfed! My daughter, on the other hand, poops three times a DAY, regardless of what we feed her. Vive la difference.

[Diane]

My gosh, I just did a post on the overabundance of parenting advice! The reason I enjoy this blog so much is that you offer suggestions and encourage the readers to do the same. It's what makes it work. Anyway, as for solids, my son is 13 months old and I still offer him purees as well as chunky stuff. I've just kept an eye on him to see what chunky stuff he can handle and what he can't. Now he could probaby do all chunky stuff, but quite frankly, he seems to like the variety. And let's face it, there's no good way for me to make cooked spinach chunky.

[me]

Sarah, I'm SO glad to hear someone else who's child "goes" so often. I have two boys, and they EACH poop 3 - 4 times a day. It's making me crazy. I can't potty train them fast enough...

To original poster: if baby is really constipated (as opposed to slow pooper) prune juice works, but it's all powerful - make sure you dilute it, or otherwise make plans for her daddy to give it to her and move out for a day. :-) With the exception of potatoes, if the food starts with a P, it will make your baby poop. Pears, peas, prunes, peaches, etc... those will all get things going.

[laura]

We started our (highly allergic) 9.5 month old on banana yesterday. I gave her some teensy chunks (one "coin" of banana cut into fourths) and then made a breastmilk pudding. She was lukewarm to the whole thing, both my spooning (she's great with small chunks of ice off a spoon) and self feeding.

I read the BLW article last night and today for lunch she ate FIVE "coins" which I'd cut into halves. She could actually pick them up without them totally disintegrating and she loved it.

I could tell that she definitely was chewing much better today - and I think that has a lot to do with the bigger chunks. Small chunks are like, "Hmm, do I bother chewing or just try to swallow?" and seem to be a bigger choking hazard. With the bigger chunks there's just no question: you have to chew.

Thanks for the timely post, Moxie! You are, as always, such a wealth of info...as are your superb commenters! :)

[hedra]

ON those frequent poopers, keep an eye on the fructose load in their diet. That can play a role - from ~1-3 years old, the capacity to digest fructose is pretty low. How often they go is really individual, but more than 2-3x/day may indicate a dietary issue that could be moderated (we tend to overestimate how much fruit they need, and there's a lot of fructose in 'healthy snacks' and other foods in the US - high fructose corn syrup, or fruit snacks, or things sweetened with applesauce, raisins, etc. Adds up fast!).

Oh, and I forgot - I knew a mom whose breatfed baby only pooped every three WEEKS. But talk about blowout when the time came. YIKES. All changes were done in the bathtub for good reason. Still, not constipated, just very very slow. Soft and delayed is fine in infancy. Hard isn't good any time. I've got one child who is prone to constipation, and she calls poop 'rocks' - accurate description of her poop some days. She knows exactly where we keep the prune juice, and will ask for it to 'help the poops come down'.

[me]

Thanks for the suggestion on the fructose, hendra, I'll have to watch it. They hardly eat processed food, but mostly frozen veggies and fresh fruit. I can't give them raisins without a blowout, and have to watch the amount of blueberries, citrus, and believe it or not, tomatoes which they love. More than a little will cause blowouts and rashes. But for some reason they could eat grapes by the pound without bad results. Go figure. (Sorry for the off-topic.)

[Sprengblingbling]

We started cereal at four months on my pedi's suggestion (with all breastmilk accompanying it) and my son's bowels freaked out and I freaked out and we stopped the cereal. He started pooping again two weeks later. At five months, he seemed to want more than nursing and we started pureed veggies, moving on as appropriate.

He is still eating baby food veggies at 17 months. He will not even put regular peas or carrots or green beans (all things he loves from a jar) near his mouth. I am convinced it's because we fed him pureed food early on. Picky is not even the word. He refuses to eat any fruit, except applesauce or sometimes banana, which he will only bite off if the peel is still attached.

With No. 2 (due in January) we will not intro food until six months and then it will be chunky. I can't go through this again!

[Maria]

No time to read the other comments, so I apologize if this is redundant. My experience with Mio was that he was not interested in experimenting with chunks / finger food until about 11 months. Which happened to coincide with the appearance of his two bottom teeth - he'd had the top two 2 months earlier. I know they can use their gums to bite quite well (ouch!), but for Mio, biting down on something (food, my finger, my nipple: OUCH!!!) only really clicked when he had those four teeth.

Up until then, I spoonfed him pureed food with small chunks, and he was not really into eating. Now he feeds himself and loves it.

[hedra]

The exact fruits each child reacts to vary wildly, within the fructose sensitive set. Some people tolerate strawberries fine, others not at all - maybe the eact ratio of sugars plays a role, they really don't know - too new a diagnosis to have enough data.

Tomatoes have a very poor fructose-to-glucose ratio. They're on the 'very small doses' list. Bad rashes (acid burns!) and blowouts ensue.

Bluberries my kids can tolerate in moderate amounts. Strawberries, only if commercially frozen (breaks down some of the fructose, changes the balance toward more glucose than fructose) and only in SMALL amounts.

Grapes - green thompson seedless and other 'european' grapes (that is, the skins don't slip off whole if you squash them) have a reasonable fructose-glucose balance, and no natural sorbitol (which really kills the GI tract of anyone with fructose issues - avoid avoid!). Concord grape juice, bad. Raisins, even from thompsons though, are not only highly concentrated fructose, their balance has changed in the drying process. So, again, blowout. Go over a max dose level, and problem. Miss the balance point, and problem. Ugh. Way annoying.

You can check back through Ask Moxie for some of the fructose commentary from me.. but the short list is: Only foods with more glucose than fructose (there's some suggestion that dipping high-fructose foods in dextrose - a form of glucose - may make these foods tolerable, haven't tried it yet) - finding a listing is hard, though (I pulled mine from some online nutrition databases, and sorted it myself). NO foods with sorbitol (artificially sweetened, or naturally occuring) - which includes apples, pears, and any fruit with a 'pit' (cherries, peaches, nectarines, etc.). Mannitol, Malitol, Erythritol, Xyletol (in toddler and older toothpaste, especially the 'swallowing is okay' kind!), etc., bad bad bad. High fructose corn syrup for our kids is a disaster, but the reactivity is veriable - some people function very well with it, others totally go haywire with even microscopic doses.

Our 'safe-ish' list includes:

Thompson seedless grapes (limited quantities in our case)
Clementine oranges (no other fresh oranges)
Canned mandarin oranges in syrup (no canned in fruit juice)
Frozen concentrated orange juice (no fresh sqeezed)
Bananas (under-ripe)
Blueberries (better if frozen)
Strawberries (frozen only, in very limited amounts, 2-4 small ones per DAY)
Gooseberries
Tomato sauce (cooked sauce), moderate amounts
Tomatoes, fresh MINUTE amounts.
Pomegranate (juice in small amounts, freeze dried seeds, fresh seeds)
Lime or lemon juice
Cane juice seems okay as a sweetener, so far, but plain sucrose is better. Glucose, dextrose, and corn syrup (mainly dextrose) are fine.

Total daily intake, 1/4 - 1/2 cup any form total MAXIMUM, though they can sometimes 'get away with' a whole banana if it is pretty green.

So far, nothing else we've tested has passed. Wahhh! M can only have ONE grape, even. Sigh. Applesauce is completely forbidden. Fruit snacks are mainly applesauce. Whee. Whole grains tend to have more fructose, so we go with white (ugh). White potatoes instead of sweet potatoes - pretty much all the things they say NOT to eat!

BUT, it has made a huge difference in the digestion, and fructose malabsorption can affect a) behavior (it reduces production of seratonin, which means more anxiety, more depression, and behavioral outburst similar to ADHD), and b) nutrition (too fast gut transit means less absorption of micronutrients).

About 1/3 of the world population has difficulty with fructose. Toddler diarrhea is attributed to this low fructose tolerance up to age 3 or so. It can and does carry on past that. IBS, depression, very commonly tied to fructose malabsorption. So, worth a check! No apples a day, here. (There's a site called 'apples away' that has some info on FM or 'dietary fructose intolerance' - just be careful if you google, as there's a life-threatening genetic disorder that is called 'fructose intolerance' that is NOT the same thing.)

Sorry, concluding the aside here...

[Eva]

My ten-month-old has mostly had table foods from the beginning and eats any old thing you put in front of her--except she draws the line at sauerkraut. We'll see if she keeps this up.

[Melissa]

I haven't read all the comments so I apologize if this has been mentioned before - but I have read in a number of places that eating in general before about a year old is really just for practice. Babies aren't going to get the majority of their nutrition from solids in any form (pureed or chunked) at this stage.

That said, I tried giving my little Bean bits of banana and steamed sweet potatoes at about 9 months but she hated it. We did the pureed foods and she seemed to like those okay, but only the fruit based ones.

Like many others here she could go for days without pooping around the 5-6 month mark. I remember panicking about it and emailing her doctor who replied not to worry, that she was probably going to go through a growth spurt that would make us "sit up and take notice". :-)

She did suffer abit of constipation when we first started giving her baby food regularly but it worked itself out after a couple of days. Now if it seems like she is getting backed up a bit we feed her a prune oatmeal that is actually quite tasty and which is one of her favorite meals.

As for chunks of food there are lots of them out there that are soft enough to eat without teeth - banana, avocado, steamed veggies, berries, and don't forget tofu! For kids that are food shy tofu is great because it is so nutritious and bland, soft and squishy. My girl prefers to squish the absolute crap out of any chunk of anything I give her, then whatever comes out of the top of her fist goes into her mouth.

Oh and I also give her the organic multigrain equivalent of cheerios - she likes the texture and they start to dissolve as soon as you put one in your mouth so there is less of a risk of choking.

Good luck!

[Another Erin]

Can I just say that I, personally, love purees? If I could eat all my foods in a pureed fashion I would. So I see feeding my daughter purees as the highest expression of doting motherhood - such luscious smoothness!

That said, I feed my 8 m.o. a mix of purees, chunks, and chopped/mashed table foods. She loves 'em all. She prefers to hold the spoon herself, so I load it and give it to her - she's quite good at getting it in her mouth. I also plop blobs of purees (thick ones, obviously) on her tray and let her use her hands.

Oh, and for Katie - my monkey would not drink from a bottle or a cup, despite our most fervent entreaties (and, to be honest, quite a few tears on my part, WOH and all). So the very moment the weather got warm we started giving her a sippy cup filled with water (and with the valve removed, to make it easier, but messier) to play with. After a few weeks she got the basic idea, and she's now very good at drinking from a cup.

[Foster]

It would be very nice if the AAP info on not feeding solids until 6 months was more widely known. If your childs daycare participates in a CAACP (Child and Adult Care Program) food reimbursement program, the infant sheets for 4-7 months *require* children to be offered 6 Tbs of cereal and 3 Tbs of fruit or veg every day. Parents are supposed to supply doctors notes if they dont want their kids to eat food yet.

Personally, I think it is dumb, and if a parent does not start bringing food in, or does not bring it in after I remind them that their kid ran out, I do not press it if the kid is younger than 6 months. I work with several ladies who are 50 and older, and the prevailing thought seems to be that they need to "learn" how to eat solids. No they dont, they need to grow past tongue thrusting. Also, if you let her, our nutrition lady will cut up the baby and toddler food into VEEEEERY tiny pieces. I dont let her :) I do not try to argue the point with these ladies as a) one of them is my supervisor and b) CACCP says Im supposed to do it whether I want to or not. I can really see why every generation of new mothers has to get all defensive and explanatory, as with every go-round, the so-called experts are telling us something different!!!

Uh, in short to anyone about to send their baby to daycare, find out if the center you are looking at participates in a food reimbursement program (also means free formula and cereal for your babe!). If they do, and you want to skip baby food, all you have to do is get a doctors note!

[me]

Hendra, thank you thank you thank you!! I was reading your post saying, "Me, Me, ME!!" How have I never heard of fructose intolerance before? It makes complete rational sense. I am totally looking into it, and will discuss with Pedi at next visit. Why hasn't he told me about this? I complain about the pooping at every visit - I really like him, he's very progressive... I guess no doctor or expert will ever be as invested as I am in my own child. That was so much info, and thanks for the leads on how to get more info.

Triple sorry for off-topic post!

[Jan]

It's interesting to me that everyone (I think) that mentions thinking their puree-fed baby/kid is pickier than their start-with-chunks baby/kid used the former model with their first child and the latter with subsequent ones.

Every bit of advice I've ever seen about raising healthy eaters says that the most important thing is to offer them food and then remain uninvested in whether they eat it. That so naturally happens more with a second, third etc kid that I have to think it could easily account for the difference in habits.

Now what would be really interesting is if one of you with twins wanted to try one technique with one and the other with the other ....

What, no using your own children as our personal guinea pigs? All right then.

[Katie]

I'm posting again-- I could read all these comments all night, but I'm getting ready to go feed the kid some yams.

I'm happy to read the tip about the cup from (another) Erin.

I also know that I was fed purees as a kid, and I was never a picky eater. Although my mother did let me eat chunks of food too; for example, when I reached for a green onion at nine months, my parents let me eat thinking I would hate it. I loved it.

So far our kid is just excited about food, opening wide for the spoon every time. I think he'd eat all food all the time, but there is no way I'm ready to wean.

[mezzaluna]

i'm going to come out against the mesh feeders. it doesn't make sense to me that this will help them learn to eat. don't they need to learn what to actually do with chunky food to chew it and move it to the back of their mouth and swallow without choking? i was too scared that the mesh feeder would leave DS unprepared for chunky food, so we skipped it. he's never had problems with gagging or choking... i mean he gagged a little while learning to eat chunky food, but i let him figure it out under my watchful eye! he was eating whole apples (skin on) at 7 months and whole grapes by 18 months.

he started solids at 7 months (wouldn't open his mouth for them before that!) and ate table foods in small quantities for 3 months, then started wanting purees and had almost exclusively purees until 14 months, then back to table food. i have no idea why he did this! our second child is now 3 months, and i think i'm going to avoid even offering purees this time.

and speaking of apples and grapes - i've just started hearing about this fructose intolerance thing. DS eats a lot of raisins, apples, grapes, frozen blueberries, and while they've been in season fresh strawberries... and i haven't noticed a problem. he poops once a day and has forever... he's 2.5 now. i don't notice any behavioral issues... just normal 2 year old stuff. should i worry about fructose??