food issues with 14 month old

[Vio]

Hi!
I am worried because I don´t know whether I´m doing the right thing with my DS.
He is a bit underweight...
This is his EASY rutine (Spanish schedule):
E 7am: breast
Sleep until 9 or 9,30 am
E 9 or 9,30: solids
A
E 1pm solids and puree
S 2-4pm
A
E 5pm solids and puree
A
E 8,45pm breast
S 9pm

I am confused with various things.
What I normally do the 3 meals where he eats solids is I give him a few veggies in pieces while I heat his puree.  for example, I give him a bit of broccoli, then a bit of spinach, then half a tomato,... He eats a few bites of each and then plays with the food, leaves it on the tray o throws it. After that I give him his puree. Until now he used to eat it well, but lately he nods his head and desnt want more than 3 spoons, or he even wines before tasting it and moves his head away. I used to try and distract him by giving him an object while I fed him the puree. (I know it´s a mistake but I was worried because he was underweight.). If I dont get him to eat his puree I sometimes cook some fish wich he eats happily.  After that I offer 3 kinds of different fruit and yogurt. When he starts throwing food to the floor I end the meal usually, unless it is done at the begining where I just take away the veggie and give him something else.

So, I am worried because I think I have taught him to eat chaotic meals, to choose whatever he prefers, and that after a meal he will always get his favourite food: banana.
I have thought of limitng the options but dont know exactly what I should offer, for example, if he only gets 2 main dishes to choose, can he get various tipes of veggies? When he doesnt like the options, should I assume he isn´t hungry and end the meal? or maybe I haven´t offered him anything he feels like eating? Do you think he will eventually learn he has to eat whatever there is?
I dont know whether I should still try to give him purees. I do it because it seems to me that when he eats it, he is eating more quantites of food. With finger food it seems to me he eats very little (yes, I have read the post about portions, and it is still little) - he only has 6 teeth yet-.

Pease help!!!

[Haribo2012]

Hi, I would stop the purée at this age, offer the finger food and if doesn't get eaten don't offer lots of alternatives, also maybe only offer 1 pudding.

Have you offered a fork or spoon and a small amount in a bowl on the tray then you have a separate bowl to feed from?

My LO likes a bit of independence so I always offer him a utensil and finger food.

Try not to make too much of a fuss over food so it doesn't become an issue, teething can always put a spanner in the works too x

[Buttonbobs]

I agree with everything that Zoe has said. Also, might he be more interested if you offered more "adult" like food with a bit more flavour than  a puree? Can you offer him what you are eating? Can you ensure he's getting more calorie-rich foods, like dairy products and meat and fish, and good fats like legumes (beans) and avocado.

When you say he is underweight, has he always been small but tracking his curve, or is he dropping curves on the growth chart?

Perhaps you could also introduce some snack times during the day - maybe at about 11am and when he wakes up from his nap at 4ish and then you could move dinner a little later, say 6pm?

[jessmum46]

Hi Vio,

At his age I'd be getting rid of the purees.  Babies need to have more textured food as they grow so they can work on the development of their oral muscles which are very important for speech development.  It's very possible he's just not interested in such "boring" food any more and needs more texture and variety to be excited about eating. 

Have you let him try to feed himself?  DD was well on the way to managing a spoon by that age and really liked the independence.  Perhaps worth a try?

What sort of food does he have in his purees at the moment?  Does he get plenty of protein e.g. Meat, fish and some good fats/dairy?  Perhaps if you suggest some tastes he likes we could help you with some suggestions of how to prepare it?

What I did when first introducing DD to textures (although she was much younger) was to purée part of her meal, and then roughly chop some of it and stir them together.  If your DS is used to finger foods already you should be able to move to a very rough chop or small pieces of food quite quickly.  I can see he eats fish - how do you tend to prepare that for him?

With offering options - really it's up to you but personally I provide one main meal which I know DD likes (or likes most of, there may be one thing on her plate which is new or she is less keen on) and then leave it up to her whether she eats it or not.  Similar to you when food gets thrown the meal ends.  I just say 'it looks like you've finished if you're throwing your food, let mummy take your plate away' or something similar.  I then offer one option for pudding e.g. A yoghurt or some fruit, sometimes a biscuit/cake.  If she doesn't want it that's fine but she doesn't get another option. (Exceptions to that would be when ill or possibly when the thing I've offered is something very new which she tries and then doesn't like).  I see it as my job to provide a good, varied diet and the opportunity to eat it.  It is DDs job to eat it bit she doesn't eat much at one meal, she'll make up for it at the next.

Just one last thought though - you mention your LO is underweight, what exactly do you mean by that?  Is he just on the small side for his age (ie on a low centile line) but gaining weight fine along his own line, or does he actually have issues with weight gain?  If there is an actual medical issue with weight gain then I would discuss his diet with a dietician/paediatrician, but if it's just that he's small but growing fine then try not to worry about it - children won't starve themselves!

[jessmum46]

Oops posted with Naomi and Zoe!

[Vio]

Thank you all for your great advice!!!! I really appreciate it... and quick response too!!
I have already reduced the number of foods I offer to a main dish, a side and a desert. Today he ate well at 1pm but at 5pm wasn´t hungry apparently... 
I have bought a plastic bowl that sticks to his tray and will try to let himself use the spoon.... let´s see how he does!
When I say he is low weight I mean he is Pc 20... Since he was a new born really... However, when I reduced from 4 breastfeeds to just 2, I didn´t insist on him eating and he lost A LOT of weight -We were doing BLW). That´s when I worried and introduced pureed foods (adding loads of healthy fats: meat, olive oil, butter, avocado...) and he went back to his Pc 20. That´s why I´m afraid of eliminating his purees totally!!!

[Buttonbobs]

Why did you drop the Bf from 4 feeds to 2? Was it prompted by something? We did BLW and E kept hold of her milk feeds for a lot longer than LOs of children who didn't do BLW.

Hopefully the fact that you started out BLW will mean your LO will pick back up with the self feeding more easily.

[Vio]

I dropped 2 Bf because I thought that by 12 months he didn't need that much milk... Also, while he knew he could breastfeed, he ate practically no solids.... I guess I was also influenced by the pressure of my pediatrician... Babies here are put on purées and only 2 BF since they are 5 or 6 months...

[Buttonbobs]

Wow that is very early to drop so many feeds at 5/6 months, i think my DD was still on 7 or8milk feeds then.

Perhaps adding another milk feed back in for a little while would enable you to go a bit more slowly on the self-feeding and see if she gets more interested again. I wouldn't normally suggest adding in feeds at this age, but if it gives you a bit of reassurance that she's getting enough calories then it may be worth a try.

Hugs xxx

[Vio]

I know, it did seem too early to me too.. That's why I continued with every feed until 12 months...
I will try to introduce another Bfand yes, that would definitely make me more relaxed about his nutrient intake...
Thank you very much!!

[Lemonthyme]

To be honest at 14 months you can do what works for you both in terms of BF but I would stop the purees and start offering only more textured foods.  There is a bit of a chicken and egg with milk and solids when it's at this age IMO.  You could be feeding more because he's not eating as much or he might not be eating as much because he's eating more.

I'd stop with the alternatives though.  Just offer him the food; there can be choice within that, e.g. fish with three different vegetables he can then chose which he eats or all if he likes but that's it, no plan B.  All kids will be fussy if they think if they refuse something they will get an alternative.

[Vio]

Hi again!
I have followed your advice on not offering so many options and also on reintroducing another BF after his nap:
7 BF
9 solids
12,30 pm solids
4 pm BF
6 pm solids
9 pm BF
What happens is, either he doesn't eat much solids at 6pm; or he doesn't practically BF at 9pm...
Do you think at this age it is still healthier for him to drink more breast milk even though he gets less solids??? I am a bit lost on this matter as, here in Spain, peds recommend substituting BF with purées very early... However, I think breastmilk is the best food I can give him (plus it is high caloric)... Where is the balance?
Thank you!

[Haribo2012]

Hi would it be worth trying solids first at 7am with some milk in a cup? There isn't that long between first and second solids so might not be too hungry! I used to try and have a 4 hour gap between food, even now at 19 months we do breakfast 7.15/7.30 lunch 11.30/12 depending how tired DS is before nap then dinner 4.30/5 and milk in a cup 6.30/6.45. What time is nap? It is a hard age to fit everything in.

[jessmum46]

At 14 months he should be getting most of his nutrition from food, not milk.  A max in terms of volume is about 500mls/day - I know that's hard to measure when bf though.  Although breast milk is very nutritious, for older children it doesn't provide the balance of nutrients needed for full healthy growth.  So if his milk intake is compromising his solids, at this age I would hold back on the milk x

[Lemonthyme]

My son had his tea at around 4pm at that age and then just had milk before bed, lasting until 6am before more milk.  It's surprising how long they can go without food but it seems most toddlers have a very early tea so it's digested by bedtime I guess?