Responsive Feeding

In one of our previous blog post we mentioned responsive feeding, let’s dig a little deeper.  

Our little ones are the experts at communicating hunger, appetite, and satiety – unfortunately a skill we either loose or choose to ignore as we get older.  An infant’s fundamental needs whilst feeding are communicated through crying, decreased interest, cooing sounds or playfulness or aversive facial expressions, we as parents have the responsibility to read and interpret these cues correctly – and that is responsive feeding.  Responsive feeding is -important to nourish a child without force, been found to prevent obesity, as well as set the standard for a healthy relationship with food.  Now that's a mouth full!

The World Health Organisation (WHO) describes responsive feeding as:

  • Feeding slowly and patiently, and encourage children to eat, but do not force them.
  • If your child refuse many foods, experiment with different food combinations, tastes, textures and methods of encouragement.
  • Minimize distractions during meals if the child loses interest easily or change the scenery if the child gets easily bored.
  • Remember that feeding times are periods of learning and love – talk to children during feeding, with eye-to-eye contact.

    Eating is as much a social skill to acquire as any other, let your baby get used to the ‘hows’ of eating—sitting up, resting between bites, and stopping when full. It is never too early to develop healthy eating habits. 

    As your baby grows older and it is more possible or over weekends, introduce family mealtimes. 

    Your child will not sleep better with an overfed tummy, watch for cues that he/she has had enough to eat. Do not overfeed!

    Tips for the parent to make changes when feeding and responding to these cues are to focus on the following variables:

    • Consistency, start off with pureed, mashed or semi-solid foods. You can make it more interactive and tactile by providing steamed versions of the vegetable or fruit, this ensures nutritional adequacy with direct feeding but also opportunity to explore with the food itself.  Just be sure not to cut the food too small to avoid a choking hazard – topic for another day. From 8 months onwards an infant should progress to finger foods and more textured meals and build to family-like meals to reach this goal by 12 months of age.
    • Frequency, as your baby grows, they require more energy and nutrients but their stomach is still too small to tolerate big quantities. Then we increase the meal frequency from 1 meal per day to two, three and eventually a snack in-between.  The milk feeds will also become lesser, but still very much needed during the weaning phase. 

    Changes your baby will experience when starting solids, this is important for you to also respond to appropriately:

    Yes the ‘bliss’ is over, if you thought a poo nappy was intimidating now, you have not encountered these, stools will become more solid and variable in colour and have a much stronger smell.  Some veggies also change the colour, so before calling the Paed, remember  beetroot may make it red/pink, green vegetables may turn the stool a deep-green colour.   The more textured or whole the food, stools may contain undigested pieces of food.   All of this is normal.

    Signs to be aware of and be a cue to go slower or review preparation methods are when stools frequency is much less or harder to pass or if your infant’s stool is really loose, watery, or full of mucus.  If the stools continue to be loose, watery, or full of mucus, or your infant are constipated without resolve, contact your clinic or Paed. 

    Additional breast milk feeds and/or a little water when starting solids using a sippy or straw cup can be given, limited to no more than a cup a day. 

    Each and every child is different and some days can be easier, some more tough.  We often get caught in the rush, try and remind yourself, your infant or child is not aware of the rush or the deadline you need to make.  They are simply learning a required skill and only needs patience and a parent to be present. 

    - Nadia J van Rensburg 

     

    References

    Meiselman HL.  Handbook of Eating and Drinking: Interdisciplinary perspectives. Hetherington MM. Infant Appetite: From Cries to Cues and Responsive Feeding.  1st Ed. 2020, p 373-389. 

    Pérez-Escamilla, R, Segura-Pérez S, Lott M.  Feeding guidelines for infants and young toddlers.  Nutrition Today.  2017, 52(5), p. 223-231. 

    WHO.  Infant and young child feeding. 

    Healthychildren.org