Annabel Karmel’s Top Tips on How to Successfully Wean Your Baby Ellie Thompson 20 August, 2018 Baby, Features, Interviews, Parenting Best-selling author and the UK’s number one baby and child nutritionist Annabel Karmel sat down with us to discuss all things weaning. We’ve pulled on Annabel’s years of expertise and first-hand experience to answer all of your reader questions on babies, toddlers and food. Annabel’s latest book Weaning launched today, you can pick up your copy here. How should I incorporate weaning around bottle feeds? From around six months a baby’s regular milk will no longer provide them with all the nutrients they need – in particular, essential fatty acids and iron – and their stores of these start becoming depleted by this stage. This is one reason why now is the ideal time to begin weaning, as missing nutrients need to be provided by food. Your baby will still need at least 600ml of breast milk or formula each day until they are at least twelve months old when their diet is varied enough to offer the correct balance of nutrients. The transition to solids is more about introducing food than giving a full meal if introducing solids before six months. Parents sometimes (and understandably) make the mistake of giving food when their babies are hungry, when really they need a milk feed. Giving too many solids too early may be damaging for an immature digestive system and can lead to anaemia. However, from six months your baby will need more than just fruit and vegetables – babies will need critical nutrients like iron and essential fatty acids in foods such as red meat or vegetarian sources of iron like fortified breakfast cereals or lentils, as well as essential fatty acids from oily fish like salmon. Most parents find it easiest to continue with the morning and evening feeds and fit the other milk feeds around mealtimes, gradually giving a little less as their baby takes more solids. Feed your baby their milk after their first tastes instead of before, so that they are hungrier and more willing to try foods on offer. You can top them up with a milk feed once they have had a few spoonfuls of purée. We’ve only just started weaning at 5 and-a-half months, but my child has now gone off her milk. What can I do to encourage her to have her daily quota? It might be that during this exciting milestone, with so many new and interesting tastes and different foods to explore, she has become momentarily distracted when it comes to her milk feed. As your baby starts on solid food they will naturally cut down on the amount of milk they consume. If you are bottle feeding, you will clearly notice that she is drinking less than if you were breastfeeding, as you can more closely monitor the amount she’s taking with each feed. It is still very important to remember that your baby’s milk will continue to form a significant part of her nutrition for many months to come. The good news is that formula or breast milk added to purées will count towards her overall milk intake. Breast or formula should still be given as your baby’s main milk as it’s richer in vitamins and iron than cow’s milk – however you can give cow’s milk with cereal or in cooking from six months. Stick to full-fat milk (for example, if you’re making a cauliflower cheese) as the calories will help fuel your baby’s growth and you can perhaps then start to give some of their formula or breast milk in a cup. My 7-month-old has a very sensitive gut and experiences terrible reactions to any ready-made pouches and randomly, spiralised courgette. She’s been skin prick tested for allergies but everything so far has come back clear. We know she’s CMPA non-IGE. What foods and meals would you recommend for more sensitive guts and any known foods to avoid? I would recommend going back to some of those first foods which are simple, easy to digest, and unlikely to provoke an allergic reaction. Root vegetables such as carrots, sweet potato and butternut squash are very popular first foods which are packed full of nutrients and easy on sensitive tummies. However at seven months it’s really important that she also has meat or vegetable protein sources for protein, iron and zinc. As your baby already has to avoid dairy foods because of her CMPA, her diet could be at risk of becoming nutritionally deficient so work with your dietitian to ensure any imbalances are addressed. I would definitely recommend going to see your GP or Healthcare Professional who will be able to advise further on your baby’s specific concerns but I would suggest avoiding acidic foods such apples, oranges, tomatoes, peppers (and courgette). Try my Butternut Squash, Chicken & Sage Mash – it’s super simple. The butternut squash will be soothing on her stomach and it has a good dose of all-important protein from the chicken (which blends really well with root veggies and fruits). My child will only tolerate BLW and will not be spoon fed anything (unless it’s really tasty!). I’ve taken to holding her spoon in her hand with my hand and guiding the food in. She seems to accept this. Do you have any other advice on how to progress with her being able to do things herself? Don’t worry too much as there are lots of positives associated with the baby-led weaning approach and you clearly have a very independent little girl who has taken to it really well. Baby-led weaning is all about your baby being in control so you need to ensure you allow them to go at their own pace. It can take some getting used to as your baby is the one taking the lead and deciding for themselves what they like and don’t like along with how much and how quickly to eat. As well as soft finger foods you could also offer her a mini portion of what you’re having (just remember to leave out the salt). Use a suction bowl to secure onto their highchair tray and invest in a wipe-clean bib and a splash mat for the floor! To begin with they will use their hands to spoon the food into their mouth, and most likely the floor, their face (and places you didn’t even know food could find its way to!) but they will soon start to get the hang of it all. Don’t worry about how much or how little your baby eats at the beginning; as long as they are experiencing a variety of tastes and textures and eating lots of different delicious and nutritious foods then you’re on the right track! What three top tips would you offer parents going down the BLW route? Baby-led weaning is all about your baby being in charge of what and how much they eat so you need to ensure you allow them to go at their own pace. Although it might take a little bit of getting used to, it’s important not to rush your baby. Start with softer foods such as steamed carrot or sweet potato, broccoli florets, chunks of banana or pieces of pear or peach. You can leave some of the peel on foods like pear and peach otherwise they can be quite slippery and difficult to hold, plus a lot of the nutrients are in the skin. Babies around six months tend to use their whole hand to pick things up. They need to be able to close their hand around the food, so avoid making the pieces too wide. Fairly long pieces (about 5 to 6 cm sticks) should be long enough for your baby to hold in their fist with some sticking out. It’s good to be aware that baby-led weaners may be at increased risk of iron deficiency as the main sources of iron such as red meat, dried fruits and egg yolk are not the easiest textures to manage whole. From around six and a half months after first tastes are accepted it’s important to offer strips of slow cooked red meat, wedges of boiled egg and non-meat sources of iron such as fortified breakfast cereals to your baby. Ensure that these are accompanied by a vitamin C-rich food, such as fruit or an uncooked vegetable to increase the absorption of iron. Remember that no ‘one-size-fits-all’ when it comes to weaning. Some feel a need to go with one method or the other, but I’ve always believed that you don’t have to choose. At around six months, you have the freedom to combine an element of baby-led weaning alongside spoon feeding if you feel that’s right for you and your baby. How does one go about instilling good table manners in a baby/toddler? At what point should one start to tell them it’s wrong to throw food, and how should this be done? It’s important that parents know that eating is a learned skill that babies and toddlers must master, just like crawling or walking. Part of this skill development is understanding what happens to each food when it is touched, played with or dropped. Your baby is listening to the sound it makes when it lands on the floor, how it feels as it’s squeezed through their fingers, what it smells like etc. It’s a sensory experience and looks a lot like playing with their food! The problem is that toddlers in particular have short attention spans which is why they start to get distracted at the dinner table, so once their innate self-regulation mechanism has kicked in and they’re full, they want to get down from table at every opportunity, and us as parents try and stop them…cue the tantrum! For everyone of all ages, gathering at the dining table provides an opportunity to build family bonds and learn how to conduct conversations, observe good manners, serve others, listen and compromise. Babies and toddlers learn from example and so it is really important to lead by example with both good eating habits and good table manners from the earliest opportunity. Putting a splash mat under your baby’s high chair will also allow you to recycle food that hasn’t quite made its intended target! If my child is not interested in food and wants to get down (even though she doesn’t seem to have had enough) should I clear away the food so she learns, or let her graze? We know that children stop eating when they’ve had enough. They have an innate ability to self regulate food intake, which lasts until they are around five years old. The problems tend to arise when we as parents attempt to encourage them with just one more bite, or withholding pudding until they’ve eaten a negotiated part of their dinner. Older children often try to eat as quickly as they can to get down from the table to carry on with whatever fun activity they were doing previously. Often it is better to say ‘fine you are obviously not hungry’ and clear away once you have finished your dinner. A hungry child is a less fussy child so by doing this they will soon learn that mealtimes are there for a reason and that there won’t be food available later on. I would avoid grazing – it’s much better to have a meal – snack – routine and ‘close the kitchen’ in between times so that your child has an opportunity to listen to her hunger and fullness cues. What’s the best way to introduce new tastes and textures? i.e. Do you have any sensory games that you’d recommend? From around six to nine months, babies are developing quite rapidly, so this is a window of opportunity to help them master the art of chewing. I would start by making the consistency of their puree thicker. Try mashing a portion of their food then adding it to the puree; gradually increasing the ratio of mashed the pureed food. Once you find that they are open to a thicker texture then you can slowly stop pureeing and simply just mash the food by hand. Rice, lentils, pasta and couscous are also great ways to introduce texture. You can also try stirring mini pasta shapes into your baby’s favourite savoury purees. And by six and a half months they should also be starting to explore soft finger foods. When introducing new tastes, initially, babies will respond to sweeter flavours as this reminds them of the natural sweetness of breast or formula milk. Fruits and root vegetables such as sweet potatoes and butternut squash are great as they have a natural sweet taste. Combining fruit with savoury was my secret weapon when I was weaning my son Nicholas. He liked eating apples but wouldn’t eat chicken so I made combinations like chicken, sweet potato and apple which he loved. It’s also good to experiment with garlic, herbs and spices to liven-up their food and slowly introduce them to interesting flavour combinations. You’ll soon stumble upon your own winning flavour combinations! It’s surprising how these ingredients really pack in a punch of flavour and often it’s a taste your baby will love. Often leafy greens such and kale and spinach as well broccoli can be overly bitter to a baby’s palate and your baby has to learn about these foods. There is a little research which suggests offering these foods frequently and in variety over the six months of weaning is key to teaching your baby to like green vegetables during their childhood. If these are presenting themselves as being slightly too strong in flavour, try mixing them with a cheese sauce or with sweet root vegetables at first, but it’s important that they repeatedly get exposed to them in their natural form. Picky eaters. What do we do about them? As a mum of three myself, I experienced first-hand how difficult it can be to coax your little ones into exploring new foods. It’s so easy to feel frustrated and disheartened when your child simply refuses to eat certain foods. Their eating habits are largely impacted by the way you manage a situation. By only giving them the foods they enjoy, you will simply escalate their fussiness and deprive them of the essential nutrients they need to grow and develop. If you can sit down to eat together, do it. Kids are so impressionable – they’ll want what you’re having, so try new healthy nutritious foods with them. Not only are you setting a good example but it gives kids an opportunity to ask questions and learn about what you’re eating. Enthusiasm is contagious. Offer your toddler a taster of something new in the form of a ‘grown-up’ starter – a little teacup or saucer of vegetables that they could try in addition to their main meal. It’s all about getting them to try as many different foods from a young age. Sticker rewards just for trying new things and tasting them can be really effective. If they even attempt to try something rather than ignore it, they should be rewarded. Introduce tasty, healthy alternatives early on. For example, it’s no secret that children love chips so why not try baking sweet potato wedges and sprinkling with Parmesan instead? They are naturally sweet and baking them in the oven caramelises the natural flavour. My main advice is to persevere. Kids have different preferences. There are so many foods to try so don’t fixate on one and try it again later. Your child may need to try a new food 10 to 15 times before they are willing to eat it. Lumpy foods – is it best to always puree if they reject, or should they / will they get used to the lumps? Dicing vegetables finely is also a good way to introduce texture. Start by softening small cubes of carrots or apple which will allow their gums to squash them when they try to chew. Be careful when you do this as surprise chunks can really startle your baby and put them off. Making your own baby food will allow you to control the size of the lumps and in turn, you can gradually increase their size. With my son Nicholas I soon realised that if I added baby pasta shapes to his favourite puree then he’s been more receptive because it was a flavour he was familiar with. Give rice or couscous a go too – you might be surprised at what gets wolfed down Often babies will happily chew on finger foods but reject lumpy food on a spoon! Three top ways to hide veg? Hiding veggies in a pasta sauce is my top piece of advice if you have a super strict veggie detective to feed. What they can’t see, they can’t pick out! I like making a tomato sauce packed with blended onions, leeks, celery, tomatoes, pepper and carrots. Or, make veggies such as courgettes into pasta using a spiraliser! I also love to hide vegetables into savoury muffins – from butternut squash and carrot to courgette – they all work wonders. Try my Apple & Carrot Muffins and I guarantee they will be none the wiser! Having said that, babies need to learn to like vegetables. It’s not something they are born with. They need to be offered a variety of vegetables (not just sweet ones) frequently during the second six months of life in order to learn to like them. Research shows that visible veggies, frequently and in variety is the best way to do this. I do think the best thing is to be up front about fruit and vegetables, tell them where they come from and why they are so good for you. Giving them facts is likely to make them more interested about what they are eating. Why not try playing a game and blindfold each child before introducing a new food and ask them to guess what it is. Meat – chicken in particular can seem so tough to eat – any tips? Chicken is packed with protein, zinc and vitamin B12 to help babies grow so it’s a favourite ingredient of mine when weaning. I would advise that as well as chicken breast try also using the thigh and leg meat – the dark meat of chicken contains twice as much iron and zinc as the white and it is tender and delicious slow-cooked in a tagine or a fruity chicken curry. Try the Chicken & Apple Balls recipe in my brand new Weaning book. They are so deliciously tender and flavoursome – not only are they perfect for weaning but the whole family will love them too! It is also really important to introduce red meat from around six months. It is the best and most easily absorbed source of iron. Try a slow-cooked lean beef and root vegetable casserole – you can add herbs and fruits like dried apricot or apple and then puree it to the desired consistency – you can also make delicious mini meatballs that make perfect finger food. My 14 month old eats better with her favourite TV shows on. Is that bad and what do you suggest I do? I completely sympathise as we‘ve all experienced a time when hectic schedules and busy weeks leave us wanting to simply give into their fuss-making and select the easy option. It’s often all too easy to let this become the norm when in fact it was originally set out to be a once in a while ‘treat’. It makes life easier for you, they’re eating their dinner – and it gives you a moment of peace and quiet. However, these early years are so important as it sets the groundwork for encouraging good, healthy eating habits for the future. In this instance, the more you allow your little one to watch TV at mealtimes the more they will rely on this in the future and will miss out on the sensory experiences of learning about food. Remember, eating is a learned experience just like crawling or walking and requires your baby’s full concentration. I would recommend starting to create your own stimulation at mealtimes. It doesn’t have to mean spending hours in the kitchen but adding a little theatre to dinner time will soon distract them from the lack of screen time present. Serve up their own mini portion of cottage pie in a small colourful ramekin or decorate the top with a funny face from peas and carrots for example. Threading bite sized pieces of chicken onto a straw, or fruit for desert also works really well in getting them excited about food. Music at mealtimes – started just beforehand as a prompt so your baby knows what’s coming – is also a good approach. Sitting round the table together as a family is also key in developing your baby’s social skills. They will be kept entertained by you chatting away to them or simply to each other. Plus they will be encouraged to eat up if you are too. From leading children’s cookery author and feeding expert, Annabel Karmel, Weaning (DK £12.99) includes everything you need to know about traditional and baby-led weaning, advice on when to start, critical nutrients, how to cater for allergies and intolerances, and more than 60 healthy and delicious recipes to delight your little one. Available from all good bookstores.