EP 24: Why Feeding Skills Matter with Solid Starts

What if the perfect baby food plate is not what your baby needs most? In this episode of Nutrition for the Early Years, Dr. Liz Daniels talks with Kim Grenawitzke and Kary Rappaport from Solid Starts about introducing solids to baby with less fear and more confidence. They answer common parent questions like “when to start solid foods for baby,” “when should babies start eating solids?” and “when can babies eat baby food?” You’ll hear what is baby led weaning, why chewing skills matter, how gagging can be part of learning, and how to think about baby allergic reaction concerns. They also discuss feeding schedules, how a baby feeding chart can help without adding pressure, and why early exposure to flavor and texture can support more confident eating as babies grow.

Kim Grenawitzke is a pediatric occupational therapist with specialty certification in feeding, eating, and swallowing; an international board-certified lactation consultant; and certified neonatal therapist. For more than 15 years, she has worked in both home settings and pediatric acute care, including Children’s Hospital Los Angeles and Lucile Packard Children's Hospital Stanford with speciality practice in neonatal cardiac feeding rehabilitation and breastfeeding high risk infants. Kim earned her Doctorate of Occupational Therapy from the University of Southern California and is the mom to two young girls.

What You’ll Learn:

• Why chewing skills are built through practice, not perfection
• How gagging can help protect babies as they learn to eat
• Why the 6 to 9 month window matters for flavors and textures
• How to support picky toddlers with calm limits
• When feeding struggles may need extra support

Episode highlights:
(1:03) Meet Kim Grenawitzke and Kary Rappaport from Solid Starts
(10:07) How real food helped babies in clinical care
(18:29) Oral motor milestones and chewing reflexes
(27:22) Flavor exposure during the 6 to 9 month window
(34:32) Gagging, choking fears, and safe practice
(43:21) How often babies need meals and practice
(50:52) Toddler picky eating, hunger, and boundaries
(59:20) Red flags that may need feeding support
(1:05:49) Confidence, anxiety, and Solid Starts resources

For an amazing gift from Solid Starts, head over to http://link.solidstarts.com/BaYvFF for 25% off an annual app subscription.  Coupon is NEWSTORY25 - use the promo code on the website for the app!

Learn more about Solid Starts:
solidstarts.com
@solidstarts
hello@solidstarts.com
https://solidstarts.com/authors/kim-grenawitzke/
https://solidstarts.com/authors/kary-rappaport/ 

NEW COURSE! "Read the Pattern: Feeding Your Baby 0–4 Months" — because a healthy relationship with food starts earlier than most people think. Course Link!

Disclaimer: This podcast is for educational purposes only, not medical advice.

Transcript

SPEAKER_02 0:00

You can build the most nutritionally perfect plate with super high iron foods paired with drizzle of vitamin C with a beautiful amount of fat and carbohydrate balanced with enough fiber. But if your baby doesn't have the skill to figure out how to eat and chew it, and they don't have the interest in exploring it, it doesn't matter. We want to help them learn to eat, but also learn to love this wide variety of nourishing foods that we are sharing with them.

SPEAKER_00 0:30

Welcome back to the Nutrition for the Earliers podcast with me, your host, Dr. Liz Daniels. I'm a nutrition first kind of pediatrician, and this podcast is for the parent who's second-guessing their grocery cart, worrying if their kid is gonna end up with the same food struggles that they once had. I love getting into the weeds of what kids actually need and then putting it into context of where they're at in growth and development so you can let go of the shame and guilt and focus on what actually moves the needle together. Let's get into it. All right. Thank you guys so much for joining us today. Welcome to the Nutrition for the Earliers podcast with me, your host, Dr. Liz Daniels. I am joined today by Kim Grinowitzki and by Carrie Rappaport, both from Solid Starts. They are amazing occupational therapists who have helped with the Solid Starts app. And we are gonna talk about babylide weaning and introducing solids. We're gonna talk about some of the nuances of where parents often get stuck in introducing solids and some of the things that hold parents back from being able to explore and grow in this process with their kids. So welcome to both Carrie and Kim. Thank you so much for joining me. Thank you for having us. We're excited to be here.

SPEAKER_02 1:41

We're so excited to be here.

SPEAKER_00 1:42

Both of you have an incredible background and a wide skill set. You have worked with really challenging clinical scenarios as well as just the everyday ones. And in what you do now, you are impacting a tremendous amount of families and supporting them. What is the mission that you both feel like is calling you to this work and helping you stay grounded in?

SPEAKER_02 2:08

I love that. And um, I think that you're right. We have seen the spectrum of very serious feeding disorders with babies and children who require around-the-clock tube feeds to kids and babies in home with their families who are just struggling a little bit with, you know, what on the spectrum would be considered much smaller kind of feeding concerns. But one of the things that I know initially brought Carrie and I to this work and keep us coming back to this work is that eating is one of those things that we do every single day, multiple times a day for our entire lives. And whether that means it's through a tube or it's at the table with your family, every one of those experiences is a time for connection and a time to share who you are and who you're becoming. And I think about sitting at the table with my kids every single night and my husband. And whether my husband's in town or I'm traveling or somebody's got gymnastics or whatnot, we still do our best to sit down at the table and spend at least five minutes connecting. And if we can do anything to help families show up at the table a little bit less stressed and ready and open to spend some time talking to their kids, getting to know their kids, learning about their kids and their kids learning about them, I think we're doing our job right. And as you know, probably you know from practice as well, these habits start early. And if we can support families coming to the table even as early as six months old and starting these habits, I think that we're winning. So that's at least what brings me deeply to this work.

SPEAKER_01 3:50

Yeah, I love that, Kim. Um, I think there's a few different things. I mean, we can go back, we can go all the way back to the beginning. And I know that my childhood, I had a really significant um uh uh foundation laid by my family who ate together. Uh, every Sunday, my entire family would come together and my grandma would cook for us. And that continued from as early as I can remember until I left for college and then eventually moved out of the city. But my entire family came together on these at these Sunday dinners, and it was a really wonderful uh tradition that we protected pretty substantially. Very, very few people missed Sunday dinners. I only remember missing one or two through my childhood. Um, and they were moments of connection and joy, a lot of um fun and just a grounding in feeling like I was part of something and that I was well supported, always a moment for people to ask questions and um get to know me and for me to feel like I had this network around me of support. Um, I also was a picky eater as a kid. I was a very severe picky eater as a kid, so much so that I one time threw up at the table when I was sort of encouraged to take one more bite of a food that I was not interested in. So I came to this work with a lot of strong beliefs that food could be so connecting and joyful, and that when you experience picky eating, it can be very challenging for the child. It can be very challenging for the family. So as a therapist, I was very interested in this practice area from the start and basically have worked in this entire this area the entirety of my career, um, over 20 years now of helping families start solids and prevent picky eating and then work with children who are picky eaters. Um, and then with solid starts, it really came kind of came full circle with me as a parent to understand, like Kim was saying, this is such a huge part of our parenting journey. So much of what we do as parents is feed ourselves and feed our kids. It's a gigantic part of our daily life. And so much of who we are as parents and the approach we use as parents is built at mealtimes. It's built through breast and bottle feeds early on, and then at table meals as we kind of find our way as parents with how much we respond to our kids, where we set boundaries, where we show love, how we connect. And so the fact that it's so deeply tied into everything we do as parents, it just seemed like the obvious choice to really focus on this area and create tools that helped parents to feel as confident as possible, both at mealtime, but then again, in their parenting journey in its entirety.

SPEAKER_00 6:35

That is so beautifully said. Honestly, that gives me chills to hear you say both of that, because it is just such a deep part of who we are and who we want to see our kids become. I have a lot of questions that I prepared for this conversation, but before I'm kind of putting them away because I really, I, if you don't mind, Carrie, can I ask a little bit more about like what gave you the insight as somebody who's who's seen both the benefit and the challenge with picky eating? What made you say go to OT school? Like, I mean, learn learn all of that. That's a very, that comes from a deep place.

SPEAKER_01 7:13

Yeah, I didn't know as a kid that that's what I wanted to do. I didn't even know that existed, if I'm being honest. I was very interested in um science, nutrition, and the medical side of things. So I knew that I wanted to go into some medical area, maybe nursing, maybe being a doctor. Um, eventually I landed on physical therapy and I was very excited to potentially go to physical therapy school. And basically in the same time period where I would have gone, would have um sort of focused on physical therapy and all the prerequisites that would have taken me into physical therapy school, I met a woman who became a friend who was in OT school. And after talking with her, decided that I would go to an information session on occupational therapy. And then after that information session, was like, oh yeah, this. This occupational therapy combines a lot more of the psychology and the um the psychosocial elements of how we, you know, move through the world, but also has the very um strong grounding in the physical disabilities and the physical elements of how we achieve certain things and how we move through the world. And I really liked that pairing. And then after a couple of years of OT school, I actually met a woman who was sp who specialized in feeding, eating, and swallowing, and which again, it took me a while to even realize that was a practice area. And as soon as I recognized that, I was like, yep, that that is where I want to focus my entire career. That's what I'm gonna be doing. And I so I just dove in because again, it hit so close to home and it felt like I had sort of an insider peek at what it felt like to struggle in that area and to want to make changes and to um know what somebody was going through. And also was, you know, coming into being a parent or a few years after that and recognizing what it feels like from the parent angle of things and how to empathize with how hard that can be for an entire family. So it just sort of naturally came into place and um it mixed very well with my past experiences and what I wanted to achieve in the world. And it has it just, I hit the ground running and never looked back.

SPEAKER_02 9:24

Carrie was my first mentor at CHLA when I was a um brand new therapist right out of uh our field work, which is basically like your internships that happen after OT school. And so because Carrie was my mentor, I didn't have much of a choice. She basically said, This is really great and this is really important, and I'm gonna teach it to you. So here we are.

SPEAKER_00 9:46

That is phenomenal. So is there a, if you think back from some of the families you've worked with, maybe even your own children, um, I can think of a couple families who really turned the dial for me in cases that were challenging, but I also saw amazing outcomes with. Is there one in particular that sticks in your mind? Either one of you?

SPEAKER_02 10:06

I I don't know if Carrie, this is one that stands out to you too, but it's one we talk about often. And it's when we had started a um finger food program in the bone marrow transplant unit uh when we were both still working prior to solid starts and we were working clinically. And there was a little um a little boy who was born with severe combined immunodeficiency. He basically lived in a, you know, a bubble for the first uh eight months of his life, and he was um having some issues with gross and fine motor development, as you would expect. And of course, he hit that time of starting solids when he was hospitalized. And he had great input from physical therapy. His nurses were so incredibly engaged with him, his family was there, but he really struggled with eating, of course. He was on really high dose medications and throwing up a lot. And anytime that, you know, a jar of baby food would pop open in his room, he would gag. You could tell that there was just this already this negative association. And when we started bringing real food in and giving him the opportunity to sit in a high chair, two main things happened, or I guess three main things happened. First, his mom was absolutely shocked that her son had so much capacity. And she was so incredibly amazed at watching him just do something that was a regular kid thing that he was supposed to do, that was that it just hit her mom heart in a really special place. Second, he had exposure to, of course, the specialized food that he needed for his diet, but he was exposed to regular food that people ate. And third, his physical therapist even said, Oh my gosh, he's sitting better. He's able to hold his head up better, he's reaching better, he has a reason to engage with things in front of him. So, yes, of course, this is a very specialized medical situation that I'm mentioning here, but there was something in that moment that just clicked for me where we're using a technique that has been talked about with kids with without special needs. And we're using it here in a very specialized environment and seeing incredible progress. And if we could just bring more people to this method and talk more about this to people who don't have kids with special needs, wow, what this can do. And the the program still carries on to this day, even though Carrie and I are not there and the nurses in the Bone Marrow Transplanting unit were also so excited to see him be successful. And it was just one of those moments of reminding ourselves how much babies really can do if we give them the chance to try. Um, so that's definitely my like that was a big light bulb moment for me.

SPEAKER_01 12:48

Yeah, I love that I remember those. I remember that baby very well in those days. Um, I'd say mine was further back. Earlier on in my career, I worked for a clinic that was an outpatient clinic. This was prior to Children's LA. So these kids were not the sickest of the sick kids out there, but they were children who had developmental disabilities, developmental delays, children with autism, children who had um cerebral palsy or Down syndrome, things like that. And I was known pretty quickly as the person in the clinic who was happy to work with kids who were having some kind of eating issue. So I got handed off those cases in it filled my caseload within the first year that I was there. And the owner of the clinic was mentoring me at the time because she was a therapist who did a lot of feeding therapy in her day. Um, and I was seeing two types of kids. First, I was working with a whole bunch of toddlers who were extremely picky eaters, and pretty much all of them were stuck on purees. They were stuck on yogurts, they really liked applesauces, they were a few of them were still doing baby foods, but a lot of them were pretty stuck on purees or and like the only other piece that they would eat would were things that we would call meltable. So like they were, they were these puffs and crackers that would sort of melt away in the mouth. And then I had this other set of patients placed on my caseload who were infants, who were um babies, who were struggling to move like between purees to the next texture. So to go to progress through purees to something lumpier and bumpier and more chewable, or babies who were actively completely refusing purees. So the parents were just at a complete loss of where to go next. It was like, where do I start if they won't do the stage one baby foods? Where do I start if they won't do these purees? And so I had all three of these cases or these, you know, groups of cases on my caseload. And what I had learned in OT school and what I was learning in my feeding therapy courses post-school wasn't really addressing any of these patient populations. I didn't have tools in my toolbox. So I started really digging. I started reaching out to friends, I started reading anything I could find, and I stumbled upon the baby-led weaning book by Jill Rapley and Tracy Marquette. And it completely shifted how I thought about how babies learn to eat, about the necessity of baby food and whether that progression was important or necessary at all. And then I started thinking about the habits and the foundational skills that get built over time, but especially the habits. Like if we are serving a baby separate baby foods, the parents oftentimes are building the habit that baby eats something very different than what they eat, which slowly bleeds into the toddler eating something that is very different than they eat. And parents have a really tough time knowing where that line stops and where they can start serving this child the same foods that they're eating. So I started thinking about whether or not that was right. Why are we building habits only to have to undo them during toddlerhood, which is the literally the most challenging time of your baby, your child's life? Worst time to do anything ever. Yeah, let alone to undo habits, you know, like and then started thinking again about if these babies don't want purees, are purees important? Are they necessary? Do they have to do purees before they get to something else? And for these babies who won't progress off of purees, should we have started with something else? Because now they won't they they won't take anything else but these very thin, watery purees? And then for these toddlers, again, how do we now backtrack and build them skills that I think should have been built during infancy, but somehow are missing because they never moved off these purees? Um, and so all of that came together when I read the baby lead weaning book and realized, oh, we don't have to start with purees. There's nothing wrong with purees, but when babies stick with purees for too long, they very quickly believe that that's the only texture that they should be eating and all that they want to be eating. And when we don't build skills early or habits early of serving parents, serving children the foods that we eat and love, they don't build those habits. And now we're trying to backtrack that later where it's really challenging. So those were sort of the clinical shifts in my mind where I was like, oh, we need to be doing something different early on in therapy. But also as somebody who was just starting to get into parenthood, I had friends who were having children. I was thinking of having children at that time. It was a moment of realizing this extends beyond therapy. These, this is like there's a problem with how typically developing children are taught to eat and how we're doing things as parents. And the entirety of how we feed kids in the US is kind of built on something that works out okay for some kids because babies are really resilient. A lot of babies will find their way no matter what we do as parents. So it wasn't holding every baby back, but it was failing a lot of babies. And it really made me think there's got to be a new way to do things, there's got to be a different way.

SPEAKER_00 17:48

So you are so right. I'm curious if you, you know, would mind, would you be able to walk us through from an oral development standpoint? Because I think as a pediatrician, that's not something we spend a lot of time in our training with. And families, when we're like looking at our developmental milestones at two months, four months, six months, a year, we're looking at gross motor, we're looking at fine motor, but I don't know that many people think about oral motor. So, what are some oral motor milestones that you wish more parents and maybe clinicians knew about?

SPEAKER_02 18:28

I want to start by also pointing out that we don't think about learning to eat in the same way that we think about babies learning to do anything else. Because we think about babies learning to grasp an item through a reflex, right? They have a reflex that helps them figure out how to close their fingers around something. They do it over and over and over again. They're building motor patterns in their brain, then they're getting the cognitive feedback of, oh, it's I have someone smile at me when I when I grasp their finger. Oh, I actually get to hold on to something when my fingers close. As that reflex starts to fade, that motor pattern is now more ingrained in their brain, and they have that feedback loop of wanting to do it. That happens to be about grasping, but that's how babies and kids and adults learn all kinds of motor skills. Those motor skills start really big and then they go down to that fine, more fine motion. So there's for some reason a disconnect with feeding that we don't learn those skills in that similar way. Carrie and I happened to be talking about this exact topic just before we hopped on the phone with you. That there for some reason, whether it's the Gerber history or, you know, our our fear about choking or weight gain or whatever the fear may is, may be, feeding became a thing that we do to the baby, that it's not something the baby is learning. And whether that's, you know, and and that can start as early as bottle feeding as well, right? Um so I feel like it's important for us to frame the oral motor development discussion kind of within that in that same framework of there are skills that babies have and skills that they are learning, but we we also the baby needs to take charge and allow them to do this this learning, right? It's learning, it's not just something that that happens, if that makes sense.

SPEAKER_00 20:32

So do you mean like they need to be presented with the opportunity to grow in that? Like they have to have feedback and input, and feedback and input from an oral motor standpoint to develop that skill, is what you're saying. Exactly.

SPEAKER_01 20:45

And instead of thinking about um develop oral motor development as skills that show up at certain ages, it's very much about the interplay between exposure to things and skills that develop because of that exposure. So with these reflexes that Kim was talking about, which help us help babies learn how to reach and grasp, reflexes are the foundation of how babies learn to roll and how to push up, reflexes are the foundation of how babies learn to walk. We have oral motor reflexes that are in place that help a baby naturally learn to chew and eat solid foods. So if you think about babies' oral motor skills as being dependent on those reflexes that are there automatically for all babies or for the vast majority of healthy, typically developing babies, those reflexes get stimulated through the foods that we offer. And then motor patterns build on top of those reflexes. So, for example, babies have what's called, we call a chewing reflex. You can get technical, it's a phasic bite reflex, but we call it a chewing reflex, which when you touch their gums, even as Early as two and three and four months old, they will open and close their jaw in a chewing motion. So it looks like they're chewing. Babies also have something called a tongue lateralization reflex, which is just a reflex that moves their tongue to the side of the mouth when you stimulate the side of the mouth. That actually is a reflex that persists on even into adulthood, which is why when we go to the dentist and the dentist puts a tool in the side of your mouth, your tongue naturally wants to dart over there and touch it. But we have enough volitional control of our tongue that we can move it away and keep it in the center. So those two reflexes, once a baby can sit up and keep their body up, when you allow them to stimulate those reflexes through touch. And you can touch with your finger, you can touch with a teether toy, but foods carry with it so much more sensory input. They have flavor to them, they move in different ways than a toy or a finger moves. They are dynamic. So when you stimulate those reflexes with food, baby will naturally practice the motions of chewing as, and then that will help them slowly build chewing skill so that when those reflexes fade away and are gone, baby now has the skills to be able to chew a wide variety of things. And I think what Kim and I like to stress for parents who are like, oh, okay, that lands. That's interesting. But how do purees fit into this? Purees are processed in the mouth very similarly to a liquid. So purees come in and their tongue cups it, moves it back, and swallows. There's a little bit more to it than that. So it's not that it's exactly like swallowing a liquid, but it's similar. Finger foods, bigger pieces of actual food, do not need to be brought into the mouth, moved back, and swallowed. They need to be brought into the mouth and moved to the side of the mouth so that we can chew them really well and break them down and mix in saliva, which has enzymes in it, to digest that food and to pull it together into a little ball so that we can swallow that. So baby needs to practice, not the oral motor patterns of drinking liquids. They're really good at that because they've been drinking breast milk and formula since the time they were born. So the purees will stimulate that same pattern. What we want them to practice as soon as they're able is the skills that help them learn how to chew. So those reflexes, which are really strong between, again, a little early. It's between even like three months and four months, those reflexes will show up. But we really need some foundational skills and strength in the baby's core and other things to support their respiration and get them sitting up so that they can use those reflexes to learn to chew and that we know that those reflexes will slowly start to fade out. Some of them as early as around six and seven months old, but by around nine months, they start to become a lot less dominant.

SPEAKER_02 24:50

And we can kind of think about this exactly the same way as we do everything else in development, because I'm sure when someone comes into clinic and their baby's not crawling beautifully at, you know, the seven, eight-month visit, a lot of parents are really worried because that's a milestone that they're supposed to hit by that time. But we all know that when you've parented your own baby and also when you've worked with as many babies as we have, it's a lot of it's dependent upon their exposure. How often have they been on their belly? How often have they had the opportunity to put weight through their hands? Are they given the opportunity to be on carpet and hardwood and grass and a variety of different surfaces giving their bodies different inputs? Yes, of course, there is motor planning and strength and a variety of underlying factors that impact how quickly that baby will learn to crawl, but their exposure is truly what is actually using those reflexes and helping them learn. So my daughter, who never was spoon-fed, probably has different or had different oral motor skills at six months than a baby who was primarily spoon-fed from six to eight months, because they were, like Carrie said, using oral motor patterns of suck to swallow, or even just kind of suck, bring the food in, like Carrie said, move it around slightly and then swallow it. And that's what that child was doing, as opposed to the child that's exposed immediately to finger foods. They're practicing and doing very different things, not because one hit a milestone and one didn't, but simply because one had the exposure and could use those reflexes and the other one didn't yet.

SPEAKER_00 26:17

That is fascinating. Oh, I love hearing that. You know, I it reminds me so much of when, you know, babies are given the opportunity and practice and exposure with flavors. They have this amazing ability to recognize things. Um, sometimes I share with families that, you know, um when a mom is pregnant, they get the opportunity to actually smell, but it's perceived as taste, smell, you know, flavors through amniotic fluid. And then those babies are also able to recognize that as soon as they start breastfeeding, some of the more um aromatic compounds. And so I I I love the conversation about flavor and food from day one, right? And I'm really curious, in your experience, if you see flavor being a tool in helping build that framework for babies and and and or do you feel like it's more just the physical um tool in their hand, like whether it's the shape or the texture, you know, which one makes more difference, or is it both and?

SPEAKER_02 27:22

Yeah, I I think both and, right, Carrie. Like 100%. You've you've completely hit it on the head there that, you know, my we we talk a lot about the fact that especially if you're a feeding therapist or you're working with a toddler that's selective or having trouble with food, your child can never learn to eat a food or learn to taste or like a food that they've never been offered. And the research is is is, I can't say that this is the strongest, you know, perfect clinical trial research, but there are a handful of studies out there that talk about this this flavor exposure window and how the more flavors a baby is exposed to, especially in that six to nine month window, the more likely they are to learn to appreciate and enjoy those textures. And even after they've gone through a selective pokey phase in toddlerhood, more likely to come back to those flavors. And Carrie recently said to someone, you know, it always makes me think of the movie Inside Out, but that your baby's disgust or sense of disgust is very, very different in infancy than it is in toddlerhood. And Carrie and I have also joked before that if you ask your mom friends, like, what's the grossest thing you've taken out of your baby's mouth? It's like a cockroach. Or, you know, during COVID for me, it was my hospital shoe. Like your baby will put the weirdest, most disgusting things in their mouth. At least to us, they're disgusting, right? Um, and so that is the perfect time to give them opportunities to explore bold flavors or even, you know, hot or spicier flavors, um, sour flavors. My my second daughter loved kimchi when she was like eight, nine months old. Like one of her favorite, favorite things to eat was kimchi. And I I won't even touch it now. It's too spicy for me. Um, but yeah, that that flavor component is is so critical and and forgotten because a lot of um baby foods are pretty homogenous, with with uh the first the first ingredient being applesauce and a lot of them too.

SPEAKER_01 29:20

Yeah, I think we as speeding therapists talk a lot about texture and the importance of texture and those big pieces of food because we know a lot of people don't understand that. And because there has been such a history of this idea of a gradual progression of texture that somehow that is going to teach your baby to eat, that we spend a lot of time trying to debunk that myth and talking about why that doesn't necessarily hold up. But just as important is the discussion about flavor. And like Kim said, I am, I mean, I love the this concept. I listened to a podcast years ago on it and then kind of fell down a rabbit hole thinking about it. But we have a strong disgust response, most adults. But the infant, especially between zero to about 12 months, has a very low disgust response. And they do not have the preconceived ideas of what is going to be disgusting or going to be gross that us adults carry. Um, so it's this window of time where they will put just about anything in their mouth and are actually developmentally driven to explore things in their mouth, especially things that we might think are going to be gross. Infants don't perceive it that way. So they just put it in their mouth and they start exploring it and try and figure out what it is through their sensory receptors, because the hands and the mouth have the most sensory receptors of almost any part of our body. So babies are learning through that, but they also again are learning how to enjoy the flavors that they're exposed to. So we know that repeat exposure to flavors helps to build tolerance to those flavors, and then that tolerance turns into enjoyment of those flavors. So the flavors that we are exposed to frequently early on matter. And we know that toddlers around 12 months, sometimes 18 months and up, are significantly less likely to put a new flavor in their mouth, texture as well, but they are very resistant to exploring new flavors. So it is much harder, exponentially harder to get your toddler to explore new flavors, which is important for them to even learn to tolerate those flavors, let alone enjoy them. So there's this window of time where we're like, this is it, guys. It's you want to introduce your baby to as many flavors as you can possibly introduce them to in flavor combinations, even flavors that you might not think of as delicious or as good because baby doesn't know that yet. And the more you expose them to that, the more likely they are to continue eating those flavors in toddlerhood, even as they become naturally selective in their eating patterns and then beyond.

SPEAKER_02 32:00

And something you've said before, I've heard you say before, Carrie, too, that I always love and come back to is this idea of making an educated guess. And our um our elementary school kids learn this, right, in science, that you're going to make a hypothesis about something, but that exposure to these flavors and textures gives your baby the ability to make an educated guess about what something's going to be like when they're a toddler and they're faced with something brand new. So they are at a restaurant, they're at grandma's house, they're at a friend's, you know, birthday party, and they see something that maybe smells similar to some flavor that they've had before or looks kind of like something that they were served at dinner before, and they can their brains are able to start making these connections, which makes that food less scary. It can help decrease the that neophobia or that worry about that new thing that's different because they have they have some history in there to think back on.

SPEAKER_00 32:51

Thank you so much. So just to say that again, you're saying that it's really that six to nine month is a critical window in your mind.

SPEAKER_01 32:58

The research calls it a critical window. We we like to think of it just as this really important window because again, it's not that the window slams shut and then it's gone, but the window starts to narrow and we have less ability to influence our child's flavor preferences. So when it's wide open at that six to nine month stretch, we want to take advantage of that.

SPEAKER_00 33:22

So if you had a kiddo who was sort of struggling, so I'm gonna give you a little scenario and I would love to hear how you would walk a parent through this because I know that you know it well. So we have a seven-month-old baby who parents were really excited in the beginning, and they both work, so they're offering something at dinner time, but they want to be there for every little bit that they're introducing their baby for. So they do just one meal in the evening, and now the baby is a little bit older and they're still struggling. Parents were a little worried to do big textures, so they're doing either huge or a puree, and they're kind of wanting to get their foot closer and closer to those chunkier textures, but then their baby gags one night at dinner and they start to feel like, I don't know what to do with this. And so they're afraid to continue that same food or that same texture, and they're getting closer to that eight-month mark. How would you counsel them to embrace and to progress through that if they're seeing a little bit of what they think might be resistance in that developmental skill or both interest?

SPEAKER_02 34:32

I feel like gagging gets such a bad rap. It's one of those things that people are so worried about, even if it's there's of course the camp of people that are worried about gagging and choking and like the whether gagging is choking and whether the baby's choking when it's happening, or there's the family of the that you're describing here who feels like the baby is gagged and something went wrong, or the baby doesn't like it, or there's a problem there. And I think one of the first um the first strategies that we always address is to try to help the family understand that gagging is the baby's way of saying something's not working right, I'm gonna do what I know how to do to make sure that I don't swallow it because I'm not so sure about it yet. And I also don't want it to go into my into my breathing tube. So whether it's a puree, whether it's a pacifier or a new bottle they're not in, they don't know how to use yet, or it's a food that they're unfamiliar with, if it gets in the baby's mouth and their brain's like, this just doesn't seem right, it's not moving in a way that's predictable to me. I don't have control of it in the way that I'd like to, I'm gonna gag and get it out of my mouth. It's just a solution to the baby somewhat just not knowing what's going on with that food in their mouth at the moment. When they gag, their airway shuts down, so the food can't go in the wrong way. And their their food tube helps push that food forward and out. Sometimes we see babies gag food out, they pick it up with their fingers and put it right back in their mouth. And again, that disgust response as a parent is you're like, oh my gosh, why would you want to do that? But to the baby, they're like, Well, my body did what it was supposed to do. Now I'm gonna put it back in and I'm gonna try again. One of the things we love seeing as babies do gag is when they gag food forward, but they don't spit it out. And their brains go, okay, wait, all right, I moved it back to the forward of the forward part of my mouth. Now what do I do? This is when I gotta move it to the side. Okay. And you can see their little brains start to kick in that the gag can actually help them build these skills. So in addressing or helping this family, a little bit of education about what gagging is, but then also reminding them that nothing went wrong and that they didn't do anything wrong. And what do they need in that moment to help them feel calm about that that step that can feel a little scary or can look a little scary, but what will help them calm their nervous system and allow that baby to continue practicing and building those skills?

SPEAKER_01 37:01

Yeah, and I love, I mean, there's this is a whole conversation, but like the the idea of the just right challenge, which is a therapy term that Kim and I love. And I think as a parent, I really love it, which is the idea that um there is a sort of just right level of challenge that children need, and adults too in therapy, but children need to build skills. If you are meeting them at exactly where they're at skill-wise, they're gonna have low motivation to continue with the activity because it's too easy. If you raise the challenge up just a little bit so that it is still achievable, but that it is actually a challenge, our brains are actually driven to work towards that challenge and try and figure it out. We get a bigger dopamine hit, we have more internal motivation. It's it's we're more compelled to keep working on it. So giving babies purees gives them exactly the input where they're already at because they pretty much already know how to manage a liquid texture. So it might be a little bit of a challenge right at first. So again, they might be into it, but then after a while, it just becomes the normal skill. Those finger foods are a little bit of a challenge. Those soft finger foods, especially that baby can can grab and mash, they're not easy. You're the this parent is right. It's not that the child is going to get it and then, or the baby is gonna get it and then immediately figure out how to chew it. It's a little bit of a challenge. They need to fumble through it, they need to figure out how it spreads around the mouth and then gag those pieces back out. Those are normal parts of the learning process, but that we know as therapists, and you intuitively know as a parent, your child has to fumble through something to figure it out. And the more they practice something, the more exposure they have to that activity, the more skilled they build over time. So the parent who is so nervous that they're not willing to give their child those foods is getting in their child's way when they have all of these foundational reflexes in place to help them learn this skill. And when it's this wide open period of time where we know they're most open to learning to accept these flavors. So we like to help parents understand that gagging is normal. And the other big piece that I think really helps parents who are anxious, I think there's a couple of things, but one is understanding that choking is very rare. I know we are so worried about it. We have this oversized fear that choking is gonna happen, but it is a very rare occurrence based on the literature, which I think is really nice to hear as a parent. You're like, okay, good. So we have all of these reflexes in place to help them learn to chew. But I think what parents don't realize is that babies also have all of these reflexes and anatomy and mechanisms in place to help keep them safe as they do that. It doesn't mean that that you could never choke, it just means that the risk is so much lower than you believe it is because of those protective mechanisms. So your baby's gag is one of those protective mechanisms. It is not a problem that's getting in the way for most babies. Of course, there are instances where an excessive amount of gagging can kind of get in the way of some babies. And that's an instance where we may need a little bit more support. But the average baby, the gag is helpful and protective. And they have a series of other mechanisms in place to help reduce the risk of choking as they fumble through and figure out how to chew. So when you recognize that those mechanisms actually are their strongest from about six to nine months, that same window that flavor interest is its highest, that is why we strongly encourage parents to go ahead and take that leap, even though they're feeling nervous, to help their baby build skills. Because again, we know skills compound, skills build over time. And the baby who's practicing a lot from six, seven, and eight months is gonna be a better eater at nine months than the baby who doesn't get started until eight, nine, or 10 months. And we know that that window slowly starts to narrow. Not close. If you're past that window, I don't want to scare you and think that you'll never get there. They will. The research shows that it just takes more effort after that window starts to close. So there's a lot more work you have to do to get there versus this wide open window where baby not only is very open to learning these skills, they also have really strong protective mechanisms to keep them as safe as possible as they do so.

SPEAKER_02 41:32

It's the balance bike versus the training wheels. You know, like the training wheels are the purees. And are there some kids that you remove the training wheels and they just figure out how to ride the bike immediately and they are around the block in a moment? Absolutely. But most kids really struggle with those training wheels come off and they can't figure out how to balance on the bike. Babylon weaning, we kind of think about as more the balance bike analogy, where you're going to keep them really low down to the ground. They can have their feet on the ground, they don't need to really, they don't need to pedal, they don't need to move anywhere. And they practice that balance component, which is the harder part. That's the texture and the flavor learning. And then as they get stronger figuring out how to move and balance on that bike, they start picking their feet up more and they start, you know, whizzing around the corner a little bit. And before you know it, you can add pedals to that bike. And it's it's almost a more seamless transition for a lot of kids. And of course, no kid perfectly fits these molds. But that's kind of one of those examples that seems to click to parents sometimes because it's something that they can like visible visibly see.

SPEAKER_00 42:42

That is so helpful. That is so helpful. So, like as you're navigating some of that, I'd love to hear how you counsel families or how you would suggest in an ideal world if you could rewrite the recommended feeding plan for kids. Like, I think the idea is like there's food before one is just for fun. And I used to say that. I sometimes am ashamed. I but I think there's more to it, right? So if you could walk a family through building a plate for a six-month-old versus a seven versus an eight-month-old, what would you recommend they have practice with? How much is enough? Is it once a day, twice a day? What do you think?

SPEAKER_01 43:20

Yeah, so babies right at first don't need a ton of practice. I think we get excited as a parent. And again, practice is important. It's going to build skills over time. But if you think about starting soccer with your kid, if you decided you're going to practice soccer three times a day, they would probably get pretty frustrated and lose interest in soccer pretty quickly. Again, not all babies. Some babies you can start doing twice a day or even three times a day right off the bat because they are so excited and interested in it. But most six to eight month old babies are napping enough that you don't really have the time in the day where they are awake, alert, not tired, not doing Other things to practice that often. So most six-month-old babies, once a day is plenty. It gives them enough excitement and encouragement and motivation to get interested and get in there, just like they would explore a toy. And it hits, you can plan it at a time of day that works for you and for a baby where they're awake, alert, and ready to participate. As they get a little older, we want to try and move towards twice a day. We usually say by around nine months. But again, some babies are ready to go to twice a day immediately. Some babies are still like more of nappers, more uh, you know, stuck in daycare patterns where the parent just doesn't have the time to do that. Most babies who are still doing once a day at around eight and nine months old, they're just again, they're going to be progressing a little bit slower, but they're still progressing. And you just have to recognize that as a parent. When your anxiety starts to come up little by little, because you compare your baby to other babies and think, oh, they're behind. The reality is probably they're not behind. They just haven't had as much practice. So they will get there if you continue down that pattern. And when you are able to add in a second meal, again, ideally by around nine months if you can, and then aiming towards a third meal by around 12 months old. So it's a balance between letting them practice as much as possible while also not um overdoing it so that they're like, oh, this is too hard and they want to give up.

SPEAKER_02 45:16

And I think something else that parents um it's just a mistake that we all make is that we think we want to bring baby to the table really hungry. So, you know, it's their first meal, we're ready to go. We want to bring them, we're gonna like not breastfeed and we're gonna bring them to the table. And what happens? The baby loses their mind because they're hungry, they're cranky because they're hungry. Like if in adult words, they're hangry, they're like, I need something in my belly right now. And even if you're doing spoon feeding and purees, they still don't have a super strong skill to be able to feed, like get enough food in their belly that they feel satiated. So along the lines of we're starting with once a day, also, we like to recommend offer a breast or a bottle feed about half an hour, 45 minutes before coming to the table. So then baby can come to the table in a good mood and ready to learn. Because those early meals, again, whether they are purees and spoons or finger foods, are not about getting that exact food in the belly. It's about learning how to sit in the high chair, learning how to tolerate the sounds of the room, learning how to touch things, learning what it feels like to get it in the mouth, learning about the flavors, the textures, all the things that we've been talking about today. But there are 500 things going on in your baby's brain during those eight minutes that they are sitting in the high chair in the beginning. And it's a lot. And being starving, you have a skill and a hunger mismatch there. You can always breastfeed or bottle feed the baby after the meal, no big deal. The important stuff is in that breast milk and formula. They're getting really important nutrition from that. The food, it's not that it's just for fun, but it doesn't need to provide this depth of nutrition at that, at that first moment. Yes, of course, as we're moving towards toddlerhood, we want that, you know, more nutrition coming from table food. But like Carrie keeps saying, if they don't have the practice and the exposure, it's like having to take off the training wheels immediately. And that, and a lot of times that's when we see toddlers kind of fall off the bike, so to say.

SPEAKER_01 47:23

Yeah, and yeah, there's definitely a lot of anxiety for parents who believe their baby needs to eat a certain amount of food. So I think again, that phrase food is for one or food is for fun until age one can be helpful for a parent who thinks that the food needs to provide that nutrition. The reality is your baby doesn't even know that food at the table is food that can fill their belly at first. They are driven to explore food in the exact same way that they're driven to pick up any toy that you put in front of them with their hands and their mouth. That's what they do with pretty much anything you put in front of them. They're gonna do it with food, and it takes them a while, usually it takes a couple months, for it to click for a baby that this is actual food that tastes good, that can fill my belly, and it can make me feel good in the same way that a breastfeed or a bottle feed makes me feel good. So, as they are figuring out that, you want them to have all of their nutritional needs and their hunger needs met through breast and bottle feeds. So the food that they're eating is just icing on the cake at that point. And again, our goal is to help them build skills so that they can eat those nourishing foods. And Kim says this a lot, and it's, I think resonates for parents, which if you think about some of the most nourishing foods out there, they're they tend to be the foods that are the hardest to chew. Fresh fruits and vegetables, meats, you know, things like that are, I mean, beans and legumes and um nuts. All of those require quite a bit of chewing precision, chewing strength, chewing endurance. They require a lot of oral motors capacity. So the child that doesn't build that oral motor capacity early is going to be the toddler who avoids those foods because they're too challenging. Toddlers are a lot less driven to keep going with that challenge than an infant is who is just kind of excited about building that uh oral motor map and who is exploring them in their mouth, but then tends to spit them out because they have the safety net of breast breast milk and formula, so that they're building skills gradually without them having to eat those foods, so that by the time they're a toddler, they're actually fully capable of eating even some of the really challenging foods if we let them.

SPEAKER_00 49:36

If there was one food that you could tell every parent to start with, how would you do it?

SPEAKER_02 49:41

So interestingly enough, and we talk to parents about this all the time, you can build the most nutritionally perfect plate with super high iron foods paired with drizzle of vitamin C, with a beautiful amount of fat and carbohydrate balanced with enough fiber. But if your baby doesn't have the skill to figure out how to eat and chew it, and they don't have the interest in exploring it, it doesn't matter. We want to help them learn to eat, but also learn to love this wide variety of nourishing foods that we are sharing with them.

SPEAKER_00 50:16

I couldn't say that any better. I mean, I feel so strongly that we want to set our kids up for success. And parents come into parenthood like with all these books, all these resources, all these desires and dreams for everything to be perfect. And then they get a toddler. I often tell parents, like, it's not your fault. You know, you you knew exactly how many ounces they were doing, like for 365 days, and then suddenly they get to their birthday, they smash a cake and they're like, forget it, veggies. And so now, you know, you know, parents will get frustrated because they feel like, now I've entered this toddler toddlerhood, and maybe we did baby lead weaning, but now they're a toddler. And I love that phase. And I think you do too. What would you say to that parent who's experiencing a toddler who's now picky or who's struggled, even though they did everything right?

SPEAKER_01 51:02

Yeah, we get this question sometimes, like, well, was it worth it? Why did I do all this legwork? And we like to reassure parents that the foundation that you laid matters. All that work was not for nothing, that you introducing your baby to all of those foods and flavors and textures early on and letting them build internal motivation and letting them build autonomy at the table, all of that matters and will help. So those babies who explored all those foods and flavors might grow into a picky toddler, to a toddler who is more selective, but they're also the toddler who's more likely to move through that phase and go right back to the foods that the family eats and loves, so long as you set appropriate boundaries at the table during toddlerhood. And two examples of this that undermine everything that you did. One is letting your toddler avoid hunger. So we tend to focus on the same feeding patterns that we used in infancy. Like you said, 365 days, you knew exactly what your baby was eating and when, and you had some control over that. So we tend to approach it the same in todd and think we need to feed our toddlers just as much, just as often. We need to make sure they're getting a bunch of milk and we may still be breast or bottle feeding, which is completely appropriate, but not recognizing that those breast and bottle feeds are meals, just like a food meal at the table is a meal. So we will hear parents say, well, now they're a picky toddler, but the reality is their toddler is eating five meals a day of breast milk in the middle of the night, maybe first thing in the morning, at dinner time, before bed. And then they're not eating their meals at the table, but it's because the toddler isn't hungry. They haven't had the chance to build natural hunger. The same thing goes for snacks. We tend to be on the go and over snack our toddlers so that they're not developing natural fullness and hunger. And so they're they're just not motivated when they come to the table to explore the foods that you have served them for, you know, the past year that they should love or that they used to love. So we tend to see parents struggling with that boundary of understanding that it is perfectly fine now to start stretching out how frequently we serve our toddler food, to start setting some boundaries about around how often we're letting them breast and bottle feeds, or at least recognizing that those breast and bottle feeds might be undermining your table meal meals. And then the other one is understanding that it's okay to respect your toddler's no at the table. If they say no, you don't have to go back to the fridge or back to the kitchen and find a new set of foods, a new meal menu to serve to your toddler. And that actually doing that will undermine their ability to continue to progress with the foods that you've been serving. So those are two examples where the foundation matters, but then how you behave in toddlerhood matters and the boundaries you set and the rules you set at the table matter and will help your child move through that or will keep you kind of stuck in a cycle that's hard to get out of.

SPEAKER_02 54:13

And something I think that's important to remind parents about toddlerhood is that it's rarely about the food. We think in our heads that it's about the food, but it's really not. You know, it's about them learning to say no. It's about them remembering that yesterday they had marinara sauce and today it's different and they want that thing from yesterday. It's not even about the fact that they don't like the dinner you served, it's about the fact that they were expecting something else and now that's leading their brain to just completely blow their lid, right? And so if we can approach the table and meals in general as another moment of your toddler learning and building skill, they're learning to manage disappointment, they're learning to manage change, which hey, I'm bad at change. I mean, we're all bad at that as adults too, right? But they're they're actually learning skills that have nothing to do with the food in front of them. And yes, are there kids that have sensory issues and struggle with food? Absolutely. Are there kids whose temperament makes it more challenging for them to be flexible at the table? Absolutely. And Carrie and I like to share the fact that we both ended up with one pretty chill, easygoing kid and one explosive, they're either gonna change the world or blow it up, kind of kids. Like, and and we we joke, like, and Carrie's is a son and mine is a daughter, so they're gonna get married and it's just gonna who knows what's gonna happen. But the the highly sensitive explosive ones, a hundred percent are predestined to have the challenges at the meet at the table. Every little change mattered, every expectation you know, was high alert. They were they were primed to have eating challenges. And both of them are excellent eaters now. And did they both have times where they'd scream and cry and want nothing at the table and go off and have a tantrum in the other room and only want a nurse and throw their food on the floor? Absolutely. The videos of Theo and of Maeve where they're at prime toddler, toddlery toddler stage can be really, really hard to watch. But through those moments, through connection and empathy and love, but also boundaries about what was okay, like what was acceptable behavior in our family and what wasn't, they learned that they could have those big feelings, they could be really upset, they could be really disappointed, they could want something else. And that doesn't mean that mom's gonna go into the kitchen and get the Cheerios or the whatever it is that they have decided that they are, you know, the only thing that they can have today. Our other, you know, Carrie's daughter and my other daughter, like probably would have been fine no matter what. You know, they probably could have eaten purees for six months and then probably would be fine because they're just they're the more seaweed kids. But we have done, we've done this, you know, this these strategies or we've practiced these strategies even in our own homes with the with the spectrum of temperament. And while really hard to set boundaries around food, they do help the kids learn that they have capacity, they have agency, and they're not in charge of the menu because I have 30 plus years of experience choosing foods that are nourishing for my family. My two-year-old does not. And so she should not be in charge of deciding what's on the plate every single day.

SPEAKER_00 57:50

Absolute mic drop. I love that. And I I say the same thing in my office every day. And honestly, that's that's what I I love about your content. That's why I wanted to engage with you and and share your voices with my audience in another way because you get it. And and you know, parents have this all the time. In fact, I find the conversations that are the most stressful for families are when they have children that are different, which I don't know a family who doesn't, but like it's usually the kid who they have one kid that is an excellent eater and usually their firstborn. Um and then the second one or another one who's really different and has different needs, and they feel like I've they take it, it's easy to take it personally, and you feel like I've done something wrong or I should have done something different. And I I find that those are the conversations that I lean in a lot, and I love that you have your own experience with it because it it makes it even more valuable and important when you have walked the walk and talked the talk, you know? So um I have two final questions for you with this. Number one, what would you say are the like red flags that you would encourage families to bring up with their healthcare team if they saw happening with their baby or their toddler that make you as a feeding therapist say, I think they need some some more help. And it's not, it's not, you see the writing on the wall, like we want to get help early because it matters.

SPEAKER_01 59:20

Yeah, for the six-month-old babies, the young ones who will not participate at all, if they cry going into the high chair or you put them in the high chair, bring them to the table, and they just want nothing to do with the food, even though you've tried a lot of strategies, even though you've maybe given them a few weeks or you've, you know, taken a pause and come back, the not participating at all should be a red flag. A lot of parents will worry that their baby is spitting out food, they're not swallowing enough food at first. All of that is normal. Very, very normal. Babies are learning skills, so we expect them to spit out food. We expect them to not swallow food because they don't know how to chew it fully yet. Very normal. But if they're not engaging with the food at all, and it's been now a couple weeks or even a month of time, I would say they need a little bit more support to figure out what the block is, why they're not engaging with food. Is there a fine motor delay? Is there a gross motor delay? Is there, again, a more sensitive temperament and the parent has been pushing a little bit too hard? And this baby has decided that they're just gonna pull back. Are they not seeing the parent eat? So they don't know what they're supposed to do. What are the reasons that that this baby isn't engaging? And a lot of parents think that this means there's something really wrong. It's usually not. It usually means there's something small, some small barrier that needs to be removed to help them get over that hump and get started. But not participating at all is a much bigger concern to me than any other story that a parent tells me about, like, oh, well, they're, you know, they're spitting out all these foods or they haven't swallowed yet or they haven't figured out, they are they're still breastfeeding and bottle feeding a lot, as long as they're engaging and exploring, I'm usually not concerned. Babies that gag excessively to the point of throwing up at most meals, those are also babies that after giving them a couple weeks of practice, I would say maybe we want to look into that. Usually we recommend those families try resistive food teeth. And you can find more about resistive food teeth in our app or on our website what those are. But there are certain types of foods that can be easier for babies who are really gaggy. But if you've tried that and baby is still gagging so accessibly on everything that they're throwing up their milk feeds, that's a sign that we probably need a little bit more support because a lot of parents think, oh, okay, I need to go back to thin, watery purees, but those are the babies that get stuck on thin watery purees and won't progress off of them. So it's actually not a great strategy to just go back to those puree textures. Um, and a little bit of support can go a really long way. And then the the last one that I see is just any time the parent is consistently like anxious and avoiding meal time, where they're like, oh, I dread this. I don't want to come to the table with my baby or my toddler because it's gonna be such a battle, or because I am so nervous about my baby choking, or about, you know, any element of what's going on at the meal. If you are feeling so much dread and anxiety that you're not wanting to come to the table with your baby or your toddler, I would say that's a great opportunity to seek out a little bit of support to try and figure out what's going on. And the whole point of feeding therapy is for somebody to dig underneath to figure out what's causing this issue so that we can help you move through it. It's not to necessarily identify, you know, that there's a major problem. It's to say, how do we help you get over this hump?

SPEAKER_02 1:02:41

Yeah, I think that's an important thing for parents to talk to their provider about. Um, and just saying, I we like to say chase the why, but we want somebody to actually dig in and figure it out. Just like Carrie was talking about the toddler that's selective who is potentially breastfeeding all night long. Well, there's a reason there. We don't need to do, you know, all kinds of oral motor work with toys and and blowing bubbles and chewing exercises. No, this this child just needs to develop a little bit of hunger. And maybe we help them develop a little bit of hunger and things don't progress. Okay, well, then maybe we can we can chase a different why that's maybe a little bit more of an in-depth explanation. But like helping, whether it's you talking to your pediatrician about it or getting a referral to a dietitian or feeding therapist or whomever is available in your network, um, to like problem solve through these, through the the more obvious things. Because for most kids, it's probably a handful of small tweaks that a parent can do that don't require really intensive intervention, so to say. But like Carrie said, so much is normal. And we talk to families all the time, especially when it comes to spitting. I feel like spitting is one of those ones that parents are so worried about. My nine month old is still spitting, my 10 month old is still spitting, my 11 month old is still spitting. And like Carrie mentioned, if they are still picking up the food, they're putting it in their mouth and they are practicing, the therapy, like the therapist that's very familiar with typical kids in me, that person says it's okay. They are doing exactly what they're supposed to do. They're just the kid that has their feet on the ground on the balance bike a little bit longer, right? That's just their trajectory. And Carrie can even tell you her easier kid, her her baby that was the like, you know, super easygoing one, spit until what, 15, 16 months before she finally had it click that, yeah, I'm gonna swallow this and I'm gonna start weaning a little bit. Um, that one other thing that I think is um a fourth one, Carrie, is the kids that are really, really struggling to wean. So struggling to get off breast and bottle feeds and the family's having a hard time figuring out how to drop them. Um, or uh they they drop a feed and then the child doesn't in even they, you know, they drop a feed and they've given it a week or so and the child still isn't isn't increasing the amount of food that they're eating. So any of those kind of tricky issues around breast and bottle weaning, I think can best be addressed also by a uh clinician.

SPEAKER_00 1:05:06

Thank you. That is really helpful. And if I recall, um on your website, you do have a search for more support kind of section where families can sort of kind of find some specialists that um that can help them. Is that right?

SPEAKER_01 1:05:19

Yeah. We have a list of therapists and providers who are familiar with our approach, have used our resources, who use a similar approach that we use.

SPEAKER_00 1:05:33

Awesome. And then, you know, one of my last questions would be if you had a family who was feeling really anxious and you wanted them to feel confident and not take some of those behaviors personally, what would you steer them towards in terms of getting that confidence back?

SPEAKER_01 1:05:49

I love our Instagram page for this because you can watch hundreds, if not now thousands of different videos. I mean, it's different thousands of videos, but different babies at different ages and stages. Eating and exploring food to get a sense of the wide range of normal out there. So that can be a pretty helpful place for a parent who's anxious. Um, I mean, parent anxiety is such a fun, interesting topic because I feel like so many of us struggle to certain degrees with anxiety. I think that's kind of pervasive in parenting communities in this day and age. And there's a lot of questions around where it comes from and why. And but I think it's important to recognize that those early days, a lot of parents perseverate on feeding breast, bottle feeding, and starting solids, because it is an area where they feel like they can control things. And so the anxiety can sometimes creep up and up and up when you realize it's actually not something you can control. This is a dance between you and baby. So baby as an individual has a role to play and will do things that you are not expecting in their role. So you are not in complete control. You're going to have to, you know, figure out this dynamic dichotomy with baby. And so when you are struggling with that over and over and over again and your anxiety starts to go up, those are areas that I want to encourage parents to go to their primary care provider to talk about postpartum anxiety and depression and things like that. Because sometimes we push parents towards tools and towards like trying to get better at, you know, managing the feeding when reality it's underlying anxiety that's sort of making you feel like you can control something that you can't. So you can only sort of shape your experience of things and encourage your baby to participate, but we we're not seeking perfection there. So the tools are great, but if you are feeling so incapacitated by your anxiety or your desire to make things perfect, I would say consider that there might be something there postpartum-wise that needs to be addressed, which is incredibly common. I think I know that if you look at the spectrum of postpartum, like baby blues through postpartum depression and then postpartum psychosis, it's like one in four women experience some level of postpartum anxiety, depression issue there. So I think that this is a really important one where yes, we can encourage parents and give them the tools. That's why we created solid sorts. We want you to feel empowered. But if you are really stuck in the loop of trying to perfect things or your anxiety is so high that you feel like you can't progress, like that's that's an issue that you want to address with your primary care provider. Awesome.

SPEAKER_00 1:08:31

I so appreciate that. Yeah, do you have anything else you wanted to share?

SPEAKER_02 1:08:34

No, I was gonna say, I don't think I have anything great to add to that. Um, like the interesting thing about solid starts in general is that our app experience can it has so many different pathways you can follow. If you want to use it just to look up how to cut foods, you can do it that way. If you want to use it to read our guides and the long form articles that Carrie and our team or Carrie and I and our team have written over the years, you can do that. If it makes you, if it if you're the type of person that feels good having a plan, we have a guided plan that will walk you through every single day. Try this food today, try this food tomorrow. But perfect example is that Carrie and I aren't those, aren't that mom, right? Um, like my kids, my baby's food always was just something off my plate, what we were eating as a family, because the plan doesn't work for my brain. That's just, that's just me. Just like babies are different, moms and dads and grandmas and aunties and the people that are feeding babies are also different. So there are so many different ways that you can use even the tools that we have available, but you have to find the right fit for what makes you feel good at the table. Because if I had to follow day-to-day meal plan that was was drawn out for me, that would make me that would make me more stressed because I want to have the flexibility of just pulling something out of, you know, the out of the fridge that I love. But I we know hundreds of people who want somebody to say, nope, just tell me how to do it, tell me what to get at the grocery store on Sunday, and we're set. So it just kind of depends on what kind of parent you are, too.

SPEAKER_00 1:10:03

Thank you. Oh, that is so helpful. So we will have in the show notes links to um solid starts for the app, as well as um their book and their Instagram handles. So um I think that's really helpful. Any final thoughts that you want to share with our audience?

SPEAKER_02 1:10:17

I I think one of the things that I always come back to as we do this work is that your baby gets to start solids one time. You know, don't have to consider it just the first day, but there's just one period of going through this. And before you get started, if you can take a deep breath and just think about what can what can I do for myself or what can my family do for me to help me show up at the table and enjoy this moment in the same way that you enjoy pulling out the, you know, the your phone to videotape your baby rolling the first time or or walking the first time. But think for yourself what would support you in thinking about the fact that this is a really cool thing that you get to do together with your baby. It's not about perfection, it's not about like, you know, having the gold star of parenting because your baby ate a certain thing or stayed at the high chair for a certain amount of time, but being able to sit there and share something that you love with your baby and do it together. Like what's going to set you up for success in that moment? Um, we we used to work with a woman who was a had been an OT for years and years and years. And once she became a grandma, she had all of her grandkids have ice cream as their first food. And she just gave it to them off her finger, like just a teeny little taste. But for her, that was like her special little grandma thing that she got to do. And all of her, her girls, she had three girls, they also took this as this really cool, special this moment that grandma got to share with with the with the kids. And so for for you again, as a parent, how can you think about that moment or that time as something that's a really beautiful, cool thing that you get to experience with your baby and what's going to set you up for success?

SPEAKER_00 1:11:54

I love that. Thank you so much. This has been fantastic. And I really truly, from the bottom of my heart, so appreciate every minute you've spent with me and with our audience because, you know, I am excited for them to explore this world of solid food, explore feeding their kids all the way through. And and to be able to have a tool that breaks it down in the moment in real time and navigate them through some of those challenges is just a gift. So thank you for sharing your gifts and your talents with us and with our audience and with the world. Thank you so much for your time, guys. Thank you for having us, Liz. Yeah, thank you. Thank you so much for listening all the way to the end. I would love for you to be a part of my newsletter so that you get a chance to be encouraged throughout the week. You can sign up on my website at newstorynutrition.com or the link is in the show notes below. And at the end of the day, I want you to be encouraged to feed your family well without guilt and with good food. Thanks so much for listening. Bye, guys.