Exposure and practice with foods and feeding

Feeding difficulties in infancy can mean being fussy or difficult to feed eg. pushing food away or clamping the mouth shut! It may also mean refusal to eat or over reliance on milk feeding – whether at the breast or with bottle feeding. In more extreme cases it may mean a complete refusal to eat any food or more than a couple of mouthfuls.  Of course this is a worry, not least because infants need to learn to eat a wide range of foods at regular intervals for optimum growth and development of brain, body, bones and muscle.  It is quite usual for infants to be sensitive to food refusal when over-tired, distressed or unwell. Over-hungry infants can also get stressed and refuse to eat.  However, it does becomes important to address, when food refusal is ongoing or chronic and feeding times become “a battle”.  Importantly if weight gain slows or growth faltering is present. Limited practice with eating solids impacts on learning key physical feeding skills, those which help infants to eat, accept and enjoy a wide range of foods, flavours and textures. The time of greatest impact of feeding difficulties is during the “sensitive window” at 6-12 months – the time when infants are primed and ready to learn how and what to eat. Infants are at higher risk of growth faltering and nutrient deficiencies eg. iron deficiency anaemia at this time due to especially high needs for calories and nutrients during this time of rapid growth and development.

Repeated illness during the first year

Feeding difficulties in infancy are most often linked to viral illness, eg. episodes of prolonged or severe vomiting bugs like rotavirus, bronchiolitis or other respiratory infections, when breathing and eating together are difficult. Conditions such as painful reflux or cow’s milk allergy can limit the desire to eat; infants learn very quickly when eating is followed by pain or unpleasant body sensations. For infants who have been repeatedly unwell or had hospitalisation during this sensitive window, feeding may have been difficult to establish. There are many factors that can impact on an infants willingness to eat solids, and those infants who have been difficult to feed from birth are often those most sensitive. Very often feeding skills may need to be re-established and so returning to an earlier step in the weaning process is needed: A few immediate tips:

  • Reassurance is helpful – either directly or by seeing other family members eating is helpful in and of itself
  • Continuing to expose infants and young children to foods – the sights, smells and observations of other family members eating foods, without pressure to eat, is a good way to maintain sensory stimulus
  • Gentle and consistent encouragement, without pressure
  • Try not to stress over this – you will already know how super-smart infants are and how they pick up on those “invisible” cues
  • Relax with familiar songs, games, smiles, praise and lightness
  • Keep to your usual routines and mealtimes; this helps to reset expectations, sensory stimulus, observation and regular exposure to foods and eating
Growth Faltering and Nutrient deficiencies

The first nutritional need for all infants is sufficient calories (energy); 3 times the needs of an average adult woman. Addressing any growth faltering at the earliest point is helpful to support early brain and cognitive development as well as growth going into childhood.  An infant feeding assessment is the first step in identifying how your child’s particular feeding difficulties have arisen, before addressing how best to support the  (re)learning of key feeding-skills and meeting needs for energy and nutrients.