Help me form a feeding plan!

[*Liz*]

Hi, my lo is approaching 7 mths now and is really not into his solids at all. I started to introduce them slowly after 20 weeks as he  has reflux and it was hoped solids would help. It didn't. And all that rice cereal just made him horribly constipated.

He has recently seen paeds after his milk intake fell to about 15oz of milk a day, with no solids, and he started to lose weight. He has been put on omeprazole and neocate formula. He had a reaction to a fromage frais at 6 months, and his reflux got much worse once I started to wean from BF to formula, so he may have a milk protein intolerance. He essentially has food aversion due to pain. I have never tried to force him to eat. If he refuses the spoon 3 times then I stop and offer a finger food instead.

His reflux is better on the new meds and his milk feeds are improved.

This is a typical day at the moment
7am Milk (4-5oz of EBM/neocate mix)
8.30am Bfast usually 1 spoon of wheetabix, sometimes refuses completely - rarely will eat 1oz so I know he likes it, then finger of toast.
11.30am Milk (4oz)
12.30am Lunch (never takes any puree, sometimes eats a rice cracker)
3.30pm Milk (5oz)
5pm Dinner (try a vegetable puree - usually refuses, fruit puree 2-3 spoons, perhaps a little finger food)
7pm BF

He seemed to prefer the purees at about 5.5 mths when they were mixed with baby rice and milk, but I don't do it anymore as he got so constipated. His fluid intake can be quite low also as if he has a bad reflux day and his milk intake falls, he still doesn't really take water from a sippy so he gets a bit dehydrated and this makes the constipation worse.

What he will eat - pear, apple, carrot, broccoli with cauliflower and sweet potato, butternut squash, wheetabix, rice crackers, toast fingers

What he won't eat - porridge, banana, courgette, sweet potato alone, parsnip, potato, pea

I need some new ideas! I keep offering everything above, even the ones he doesn't seen to like so that he might get used to some new flavours..

Its just so boring - I feel like I am constantly preparing food to be faced with pursed lips. My HV wants me to do 3 meals a day now, and increase the quantities, but I don't see now. TBH I am just pleased he is drinking some milk, and waking less at night.

I'm worried he is going to become a very fussy eater - but I'm just not sure what I can do to stop it.

I think he would eat pear puree all day if i let him - its the only thing he never seems to refuse. I always give it once a day as I need something to hide his meds in as he won't take then from the syringe either.

And, of course, I can't give dairy due to the concern about milk intolerance.

And ideas??

[Mashi]

Hmmmm - a few ideas to think about....

If you are still giving the BF at night, have you eliminated all dairy from your diet?  If not, then I would suggest that to start with, as he will still get the milk YOU consume through your breastmilk.  It may be that he is still having some tummy pains from that trace of dairy and it is putting him off of eating.

I personally disagree with your HV about getting him onto the 3 full meals at this age. Especially if he is not enjoying his solids, then it would only cause him that upset and stress more often in the day. My thought is to cut out the dinner time meal, and stick to just twice a day, for starters. You may find (hopefully) that he takes more milk as a result.   I'd also keep giving him pear puree for his breakfast, if that is what he likes to eat, then he may come to enjoy it even more, and be more relaxed at mealtime.  Actually, looking again at your list of what he likes to eat, I think it's a pretty good and varied list for a baby not even 7 months old yet!  Offer him in a relaxed way, his morning purees, something he does like, and do it in a chilled out way.  Does he sit in a highchair or a bouncy chair or something? If so, is it possible he's not comfortable or doesn't like where he is sitting?  Even though my DS is more than happy in his highchair 90% of the time, there are days he refuses to eat because he just isn't happy sitting there. I pick him up and either sit him on my lap or hold him on my hip and feed him that way. A bit less comfortable for me, though!

You can also mix milk in with his sweet potato or other creamy purees, to get him an extra half ounce here and there.

I also would take him off of the weetabix.  Wheat can be allergenic (perhaps that is causing him some tummy discomfort and food aversion?) and it's also very bloating, so at this age, maybe just try the fruits, not adding a grain.  Even cut the toast out for a while. 

Although there is sort of a "window" of opportunity to get LOs to eat a variety of foods so they aren't as fussy, I wouldn't stress about it at 7 months old.  Your LO is only just starting to "get" the idea of eating, and you've got loads of time. Just try to stay relaxed about it or he will pick up on the stress of the situation.

I would also listen to your HV with a wary ear.....there doesn't ever seem to be any consistency in what they tell people, they all just go on their own personal guidelines and half of them (in my experience) don't know what they are talking about.  Smile and nod and say "oh yes I feed him loads...."  The HV at my clinic told me she had never ever ever heard of waiting until 6 months to offer solid food, that my son was suffering because of it, and that whoever had told me that was horribly wrong and didn't know what they were talking about!   

Milk is most important and your LO still needs a pint a day -- about 21 - 24 ounces -- and so I would concentrate on getting his milk up and not letting him fill up on solids.  Adding milk wherever you can to his food can help increase that.

Not sure if any of those ideas give you something to think about?

[Mashi]

Also can you try mixing foods he does like with some other things? For instance we do squash and pear. I put both in a bowl, not mixed. Then I give the first bit of pear only, then add a teensy bit of squash. Each bite I add a bit more squash.  As we near the end I mix what is left together, about half and half, leaving a glob of squash on one side of the bowl.  Each bite I mix in a bit more squash, and by the end of the meal, DS is eating 99% squash with the only pear in it the dregs that I have scraped off of his chin and bib to mix in with it! 

DS won't eat cauliflower or zucchini, but will do cauliflower and zucchini mixed together with apple.  Won't eat carrots but will eat them if mixed with corn.  I now mix less and less apple into the mixture and he still eats it, while when I first introduced it, it needed to be mostly apple.

[*Liz*]

Thanks so much for this. It is helpful 

I have limited to dairy in my diet, but not completely eliminated all hidden dairy. I am in the process of moving to complete bottle feeding with the neocate. I do feel bad about this as I realise it is completely pointless to be on neocate if he is getting milk proteins from me but there are so many things I can't eat anyway, and adding dairy in as well makes it too hard.

I know his milk quantities are low, but the HV doesn't seem concerned about that, only about the fact that he is hardly on solids. His milk intake today was awful - 4oz at 7.30am, 1oz at 12pm, 5oz at 4pm, 5oz at 7pm. But don't worry, he didn't eat any solids at all either! Its hard to hide his intake at the mo as he has been losing weight so its pretty obvious that he isn't eating much. I agree with you about some of the advice though  .

I like the idea about mixing things into the fruit to make it mare palatable (to him I assume - sounds horrid to me!).

So, I can just carry on 'messing about with fruit and veg purees' at the moment? That is a HV quote btw!

I'll move the fruit to breakfast. It would help to get his omeprazole into him earlier on in the day anyway!

Thanks again!!

[LucySol]

my dd is the same as in she wont eat much-milk or solids but loves finger foods! do you think he would cope with more finger foods? maybe take a look on the BLW thread???