Feeding Your Child ~ Introducing Textures – Sheryl Jean, Occupational Therapist

Feeding Your Child ~ Introducing Textures – Sheryl Jean, Occupational Therapist

Feeding Your Child ~ Introducing Textures

Do you feel like a short-order cook, making different meals for everyone?  Have you watched your little one assert their independence by tossing a bowl of pureed peas across the room?  Well, then maybe it is time for table foods!   Knowing when a child is ready and in which order to introduce foods and textures can help.

 

Before introducing new textures, first look for signs of readiness:

  • Baby can hold his/her head up and sit up straight while supported in a high chair
  • Baby can swallow thin purees without gagging or choking, or tongue thrusting
  • Baby has mastered thin purees and has been eating them for at least 3 weeks
  • Baby is at least 7 months old (thin purees can be introduced between 4-6 months)
  • Baby opens his/her mouth when spoon approaches and can clear the spoon with lips
  • Baby shows interest in what parents or other children are eating

Texture Progression from Simple to Complex

Stage 1: Liquid – breastmilk or formula

Stage 2: Thin purees – infant cereals, thin pureed fruits and vegetables, beginning with single ingredient, then combined ingredients

Stage 3: Thick purees – meats pureed in a blender, gradually thicken familiar thin purees by adding less water, or adding baby cereal to thicken it, homemade applesauce, yogurt, pudding, hummus, pureed soups, mashed sweet potatoes, mashed potatoes, fork-mashed soft fruits and veggies like mango, cantaloupe, banana, avocado, squash, broccoli, mashed overcooked carrots, dips, make sure fork-mashed foods are of a uniform consistency

Stage 4: Meltable/Dissolvable solids – Mum Mums, Farley biscuits, Gerber Puffs, yogurt melts, Cheerios, baby cheesies, puffed rice or puffed wheat cereal, graham cracker crumbs, fruit juice popsicles

Stage 5: Soft cubes – ripe fruits, overcooked vegetables, avocado, peaches, sweet potatoes, soft breads, egg yolk, banana, kiwi cut into small cubes for finger feeding

Stage 6: Soft solid single texture – pasta without sauce, banana bread, zucchini muffins, pancakes, grated cheese, shredded chicken or fish, sticky rice, strips of ripe fruits and overcooked veggies, strain veggies out of soups (separate from broth) serving the soft contents for finger feeding. (Many babies will refuse Stage 3 jarred baby foods because of the “surprise lumps”.  Mixed textures are challenging for little ones because they learn to eat purees with a sucking motion.  When you add chunks to that puree, they suck the chunks back, along with the puree, causing them to gag or choke.  Skip Stage 3 baby food altogether, and save mixed textures until after your baby can handle individual textures.)

Stage 7: Soft solid mixed texture – pasta with sauce, macaroni & cheese, cottage cheese, yogurt with fruit, berries, soft casseroles, oatmeal, scrambled eggs, toast strips with jam or peanut butter, french fries, sweet potato fries, soft chicken strips or nuggets, halved grapes, fruit cups, soup with lentils, cereal bars, canned beans, flaked fish, mini sandwich with deli meat, icecream cone

Stage 8: Hard solid single texture – raw fruit and vegetables, dried fruit, bite sized pieces of meat, frozen bagel, pretzels, animal crackers, crunchy cereal, veggie chips, Goldfish crackers, rice cakes, cookies (always with supervision)

Stage 9: Hard solid mixed texture – pizza, shepherd’s pie, lasagna, burgers, sandwiches, offer whatever the family is eating as long as it is safe for your toddler.  Don’t be a short order cook!

NOTE:  It is important to introduce new textures and lumpy foods before your child is 9 months of age because studies show that delayed introduction of lumps can lead to feeding difficulties and affects child’s food acceptance at 7 years of age. https://www.ncbi.nlm.nih.gov/pubmed/19161546

It is recommended that foods that may be choking hazards such as grapes and hot dogs be cut in smaller pieces to avoid choking. Many kiddos are “on-the-go” moving and playing, placing them at risk for choking.

Tips for introducing new foods and new textures to your baby:

  • Often it takes 10-20 exposures to a new food before your child will actually eat it.
  • First, the child needs to accept it on their plate, and then be willing to smell and touch it.
  • Ignore food refusal, praise good eating, encourage them to feed you unfamiliar foods.
  • Let them get messy!  Save clean up until the end of the meal.
  • Tactile play with food between meals can increase comfort with new textures.
  • Gagging is a normal protective response.  Don’t react.  Minimize gagging by placing pieces of food to the sides of the mouth, near cheek pouch, over chewing surface.  You can help move the gag reflex back on the tongue by offering “hard munchables” (thick, whole raw carrot) on high chair tray for oral exploration.
  • Eat WITH your child whenever possible, family meals create a positive mealtime relationship, allow you to model good mealtime behaviour, and promotes language development.
  • “Division of Responsibility” in feeding encourages you to take leadership with the what, when, and where of feeding and let your child determine how much and whether to eat what you provide.  Respect your child’s cues.  No pressure or bribes, no distractions.  Try not to say, “take another bite”.
  • Children can begin eating table foods around 7-8 months. Follow the developmental feeding continuum (above) from simple to complex textures.  Pathways.org has a great feeding checklist.
  • Baby should try one new food every 3-4 days to help detect potential food allergies.
  • If your child continues to have (has) difficulty transitioning to new textures, discuss feeding with your paediatrician to rule out medical causes, and schedule a feeding assessment with an occupational therapist.

What if Texture Progression Isn’t Working?

Most adults don’t think about it, but so many factors are involved in feeding.  Occupational therapists are trained to assess all the factors contributing to feeding difficulties. Feeding difficulties can be simple to fix or much more complex – factors from positioning, environment, behaviour, sensory, anatomy, temperament, or even more specific medical diagnoses. If you are concerned about your child’s feeding development, contact your healthcare provider and/or Butterfly Occupational Therapist, or attend our upcoming feeding workshop!

Join us for BUTTERFLY FEEDING FRENZY WORKSHOP:

When: Thursday, May 2 from 7:00 – 9:00 PM

Where: Butterfly Paediatric Therapy

Fee:     $10 per participant

To register for the workshop or to schedule a feeding assessment with an Occupational Therapist please call Butterfly at (905) 206-0300 or email at: info@butterflytherapy.com

We would love to hear what worked for you!  Share your creative feeding ideas or toddler-friendly recipes.  Check out Butterfly’s other feeding blogs to determine whether you have a “Picky Eater vs. Problem Feeder.”

 

Related Links:

Feeding Ages & Stages

Feeding Checklist

Sequential Oral Sensory Approach – Training for OTs when transitions to new challenges are particularly challenging.

Pressuring kids to eat can make mealtime a negative experience and lead to poor eating habits

 

By | 2019-04-22T18:13:58+00:00 April 22nd, 2019|