To force or not to force - that is my question

[Evans_mom]

I am feeling very conflicted on how hard to push solids with my 8.5 month old DS...

Quick history: we introduced solids at 5.5 months - he ate rice cereal like a champ but it made him feel crappy so since then he is tighly sealing his lips shut when the spoon is offered and won't consider BLW attempts either (will put EVERYTHING in his mouth other than food).  Sometimes he'll let me put food near his lips, he'll smell it and even if it is something yummy-smelling like pears, he'll give me a face of complete and total disgust!  Sometimes we trick him and put some food in his mouth when he laughs but he gets wise to that and seals his lips more tightly after.  There have been a few cases where we were able to get more than a few reluctant spoonfuls in but several times those days ended with vomiting only a few hours later.  His pediatrician thinks he may have FPIES but that is a whole other post....

Right now the doctor is saying that we need to try as hard as possible (even if it means some gentle forcing) to get him to eat so that we can test different foods for reactions etc and that we don't miss the "window" for him to learn how to eat properly.  She is clearly in the camp that solids are a must at this age unless we want to usher in all kinds of issues... She says that kids that don't learn to eat by 9-10 months have an incrementally harder time after... So she'll say that my clock is basically ticking...  She is very loving and kind about the whole thing but she is clearly concerned with our lack of progress (even though he isn't losing weight or anything).

Then I have read several posts here and elsewhere online suggesting that I should not be worried until 1 year and that I just need to be patient...

So who is right?  Do I force or do I not force...  Also, BW says consistency is key but I have taken several breaks over the last 3 months since he shows no interest.  Could my lack of consistency also be the issue?

Thanks for your help!!

[becj86]

His pediatrician thinks he may have FPIES but that is a whole other post....

It might not be... if food makes him feel bad every time he eats, why would he want to eat?

Can you do BLW but in settings where he's not used to eating (or being required to eat) - so maybe a picnic or something, with some finger foods (since he can get stuff into his mouth) that are as gentle on his tummy as possible?

[Love, laughter, & PJs]

IMO, it's no big deal at all at this age.  Both of my kids were slow to start with solids. DD probably didn't eat much at all until around 10m and now she packs it away like there's no tomorrow!! I do totally agree with BLW as well.  DD would not eat baby food but she would play around with food herself and eventually started eating it.

I'm not sure what the literature is to back up what your pedi is saying, although I do know it's a common stance.  Milk is the biggest thing for the first year.  They will not not eat food if they don't eat at 8m old!

[*Kara*]

I wouldn't worry either... my DD was off to a roaring start with solids and then got horribly constipated at 8 months... she clearly had a thing against solids, and rightly so, for a few months after that... would only eat jarred food until 14 months, then whammo!  Suddenly one day, she was eating like she had always had solids her entire life

My SIL has three kids and didn't intro solids with #3 until 11 months because of the number of allergies that the first two kids had.. My niece is a happy, chubby 5 year old now   And she isn't picky.. at all.  Will eat anything... I wouldn't worry.

[amayzie]

Hi hon- I'm a speech path in my work- and there is some truth in there being a 'window' for oral eating skills- so ideally you want to be introducing solids by 7 months or so. BUT you have done this already. They don't need to be eating HEAPS all the time- and don't panic about eating the full range of flavours- it's more about trying to adjust the textures as much as you can. So one thing you could possibly do is if you have one food that is a safe food you could offer this in a more solid form- so soft cooked  or mashed rather than blended- then the flavour is the same but the texture is different. THe texture difference is probably the main thing you want to be trying as best you can to move along with. So solids ARE fun till one- but you can't leave them out completely...

The other thing though that concerns me is that although there is some consideration to be given to a 'window' for feeding skills- you are likely to be doing more 'damage' in the long run if you 'force' feed him. (damage is a strong word- i more mean that you may make her eating aversions worse). Food aversions are very strong- and as a result of the vomiting he has learnt that food=pain and so doesn't want to go there. Ideally you would want to stick to the foods that he accepts and working slowy from there- but this will be challening to then introduce foods that he is unfamiliar with that are required to establish issues with the diets.

You can try to involve as much play as possible into the meal- not for to distract him- but to use as a reward and motivation for tasting /eating the foods. So if you get a toy that is repetitive and interesting- i like a car ramp thing (something like this http://www.toysrus.co.uk/medias/sys_master/8611001540819408.jpg ) - and starting with a food he likes offer a mouthful - or have him take a mouthful and run the toy- giving lots of positive feedback. Then once he realises that food=fun toy then you can introduce something more challenging like a different texture, or a different food.

Remember getting him to play with food as much as possible is great- put puree and mash on his tray, give him pieces of your foods (that are appropriately prepared) to play with while you have your dinner, hold him on your lap at meal times. At these times he may get little tastes- or at least become more comfortable with the foods.

I would heavily suggest going to see a speech pathologist if the food aversion continues and you are concerned...  As the previous ladies have said- it could well resolve itself in time- but some of the above tips may help you in the interim..

[ENMS]

Hey hon,

I've BTDT... my son was diagnosed with FPIES at 6 months old. He has just recently been diagnosed with an enzymatic deficiency now at 10.5 months old so we know if was not FPIES, but we had many, many issues with solids. He has outright refused anything but pears from 7 months old until just 2 weeks ago. I have received fantastic advice and support from the wonderful ladies here. If you want you can have a look at my thread for some more ideas:

refusing new foods

I will tell you what worked for us.  I have kept offering and offering at pretty much every meal. It broke my heart because he just flat out refused everything, and I ended up throwing so much food away. Then after his latest reaction to pears, I stopped offering because we were going to the hospital for a scope for him 2 weeks later and I wanted to keep him on his formula only until then. So for those 2 weeks, I sat him in his high chair, and didn't offer any food. Gave him toys to play with, little forks and little spoons, but didn't pay extra attention to him - we ate our meal as a family and discussed, involved him but that was it. Then when we came back home from his 3-day hospital stay, I offered him some green beans on his tray... and he just started eating them! I added some chicken that I was eating and ever since he has not looked back. He is eating!

So this may not work for everyone, but for us I think that watching us eat in a happy setting, healing properly from his last reaction, and also the fact that I just put food on his tray and did not pay attention to him made him want to try it, without feeling the pressure, yk?

So I agree with pp - as much as it's better to introduce foods earlier than later to allow LO's to develop their skills and tastes and textures, you just cannot force him - it will make it worse. You can just offer, offer and offer, making the setting relaxed and happy (and trust me, I know how hard this is!) and hopefully he will catch on eventually.

It is also key I think to carefully choose which food you are offering from an FPIES perspective. Once he accepts a food that doesn't hurt his tummy, he'll be much more confident to try new stuff afterwards.

I'm not sure if you've seen this document, it's basically a survey of FPIES moms as to which foods were well tolerated by their LO's. It can give you a head start to try to pick foods that are not likely to cause a reaction (but remember though that FPIES is totally individual - all LO's do not react to the same foods, so this is only a guide).

Feel free to PM me about this and FPIES.

Hang in there - it seems like it'll never happen but I promise you it will - 3 weeks ago I was desperate and now my DS happily eats at every meal

https://docs.google.com/spreadsheet/viewanalytics?hl=en_US&formkey=dFJKLUhPUWtYRW5RZk1ESGVMOHlVMkE6MA

[Shiv52]

So this may not work for everyone, but for us I think that watching us eat in a happy setting, healing properly from his last reaction, and also the fact that I just put food on his tray and did not pay attention to him made him want to try it, without feeling the pressure, yk?

So I agree with pp - as much as it's better to introduce foods earlier than later to allow LO's to develop their skills and tastes and textures, you just cannot force him - it will make it worse. You can just offer, offer and offer, making the setting relaxed and happy (and trust me, I know how hard this is!) and hopefully he will catch on eventually.

I totally agree with this ^^^^ I would just make offering food a part of your day like you would reading books or singing songs.  No pressure, no discussing, no trying to convince him to eat.  Just let him get on with it and if he doesn't eat its no biggie.

I know it is important to eat to develop the muscles in the mouth for speech etc but your LO is still very young so I really don't think I would worry at this point.  My DD2 wasn't eating an awful lot of solids at this point but I honestly think it would do more damage to force at this point.

You can try to involve as much play as possible into the meal- not for to distract him- but to use as a reward and motivation for tasting /eating the foods. So if you get a toy that is repetitive and interesting- i like a car ramp thing (something like this http://www.toysrus.co.uk/medias/sys_master/8611001540819408.jpg ) - and starting with a food he likes offer a mouthful - or have him take a mouthful and run the toy- giving lots of positive feedback. Then once he realises that food=fun toy then you can introduce something more challenging like a different texture, or a different food.

I personally wouldn't do this at this age.   The understanding of that first-then approach would not be there and honestly I just see you having to with hold the toy as he's not wanting to eat and then you are getting into forcing him to help him see the connection between eat=fun toy and at his age you'd need 100+ repetitions to get that any where near understood.  But I agree with Katie that its the texture is the issue.  I would think going down a more BLW approach at this stage would be your best best. 

He is only a little baby.  HOnestly I would just make it part of your day, every day.  I think by 9-10 months we did 3 meals and 2 snacks.  Sometimes she ate, sometimes not.  But we got there in the end.

I'm not sure what the literature is to back up what your pedi is saying, although I do know it's a common stance.  Milk is the biggest thing for the first year.  They will not not eat food if they don't eat at 8m old!

I also think this is worth considering.  And if your paed continues to push ask her to point you to the resources/research that she is using to be making those recommendations. 

[Lemonthyme]

Personally I'd keep offering at every meal even if there is no interest and eat alongside.  I wouldn't force personally but that's because I don't think it's a reasonable thing to force any person to eat whatever their age but I can see why it' might be a concerning  for the doc.

[Evans_mom]

First of all - let me just say a BIG thank you to all of you - your responses are SO helpful to me (and my sanity ;-).  It feels so great to know that people have been here and made it through!  Though I know it "will pass" intellectually, it is often hard to remember that in the day to day...  I love nothing more than hearing stories of late eaters that became great eaters ;-)  Gives so much hope!

A couple of quick questions / comments...

1) For *Elise* - first of all I am so sorry to hear that your baby was diagnosed with FPIES.  We are still at the pre-diagnosis stage and even that is rough so I can only imagine actually getting that confirmed!  My gut really does tell me that it is the reactions to food that are causing him to avoid it...  especially because when we started solids he seemed to love them until he felt crappy.  Did yours start out well and then stop once a reaction hit?  Or did he "know" to avoid food before you even put it in him?  Also - thanks so much for the chart... I will try more of the "safer" ones... so far we've had vomiting after rice, oats and banana but have had a hard time testing much else because he limits what goes in.  Does your little guy get an FPIES reaction with even trace amounts of a trigger food or do you need to get a few spoons in to see a reaction?  Pears seem to be safe like with yours - so I will take the suggestions for greater variety in presenting that food... 

2) For amayzie - thanks for your insights!  I didn't realize until now that there was a link between this "window" that the doctor refers to and his speech (I always thought the "window" was just about eating well).  Are there any other signs that are "flags" on the speech side I could watch for as he develops in the coming months?  He is meeting all his milestones and is very social with his babbling etc but he hasn't added many consonants yet (no dadada, bababa or mamama)...  thanks for being so encouraging that I do not need to be getting heaps in - like you suggest, I will just keep trying and focusing on as many textures as possible.

3) For Shiv52 and becj86 - I love your ideas of just making it part of the day like reading books or singing songs and trying it in different spots (on my lap etc) - gonna start putting less pressure around it - I really need to keep the perspective you've both shared - so I may come back and read your notes on the rough days!  I definitely always try to make it fun and light but I think I could afford to get a little more creative with "presentation"

4) *Kara* - with your SIL's #3, when she started at 11 months did she just take to eating no problem or was it a bit of a road until she got there?  I often find that after I have taken a short break with my little guy he's more open to it when we start up again...

[snowbird]

Hello! Not got time to read all of this thread, but I just wanted to say - NOT to force in my opinion! Ever! We did BLW and as previous people, LJ didn't eat that much for ages and she is doing well now. She goes through stages. I think that forcing will potentially lead to problems with eating. and he'll do it in his own time anyway Hope I've not missed anything crucial in previous posts I've not read. I"ll be back tomorrow! Not sure why the doctor suggested that xxx

[*Kara*]

*Kara* - with your SIL's #3, when she started at 11 months did she just take to eating no problem or was it a bit of a road until she got there?  I often find that after I have taken a short break with my little guy he's more open to it when we start up again...

She took to it like a duck to water   SIL had major allergy issues with her first two so made the concious choice to BF #3 until well past the age of 2 (hoping to reduce future allergies for her) - given that she had 2 toddler boys (all three kids within 4 years!), she simply didn't even think of starting solids until her DD was just past 10 months... she started offering finger foods to her to play with at mealtime... no pressure at all.  She would sometimes eat a bit, and other times not at all. Around 11 months, she started to show a real interest and was willing to try almost anything - she was BLW as opposed to the first two that had been puree weaned...

[ENMS]

Evans_mom - the allergist had diagnosed him as FPIES but after we saw a GI and did some tests, we found out it was a whole other issue after all. So no FPIES for DS, but I've spent a good 4 months thinking that was the issue. I'm so happy though that you've got a knowledgeable dr bc from what I hear, lots and lots of doctors have no clue what FPIES is. I had to explain it every time I see a doctor other than our GI and allergist.

Did yours start out well and then stop once a reaction hit?

Yes! He did great with the first 2-3 foods we tried, then once we tried apples, it was his most severe reaction and after did that he didn't want anything. He accepted pears for a while but ended up reacting to them - interestingly enough, in his new diet for his condition, pears are in the 'ok in moderation' category, while all the other foods we've tried were in the 'forbidden' category. So I'm guessing he instinctively knew that the pears were not making him feel as bad as the other foods he tried before.

Try to be as relaxed as you can about it, no pressure and it'll come eventually. I know it's easy to say now but I totally get how you're feeling. If you've read my thread I'm sure you've seen I was desperate and panicked that he would never eat. But one day, it will turn around.

[amayzie]

Oh- evan's mum.. i did mean a window for eating skills rather than speech skills as such. Speech pathologists in australia also manage feeding issues Sounds like things are going well on the speech side! At his age you want lots of babbling like you are getting. I'd probably be expecting some consonant sounds by 12 months or a bit after- but you don't need the full compliment, just a few. HEre's some other tips:

"red flags" for speech and language

[Evans_mom]

Thanks so much amayzie for the additional detail for the red flags!  I feel better now ;-) 

*Elise* I just find it so interesting that it really is like they "know" it is not a good idea to eat when it makes them feel bad after... *Kara* I love that your SIL had the guts to wait till 10 months with her third and so encouraging that it ended up going so well for her! 

[*Kara*]

*Kara* I love that your SIL had the guts to wait till 10 months with her third and so encouraging that it ended up going so well for her! 

My 2 nephews and 1 niece have so many health issues that by the third one, her momma bear was in full effect