An infant feeding assessment is a guided conversation about how your baby is feeding and how this relates to their symptoms, growth and digestive functions.  I like to observe a baby feeding and look at a nappy whenever possible.  For this reason face-to-face appointments are always better than zoom!  Looking at growth charts helps to see if growth changes or growth faltering are related to symptoms over time. And of course family and medical background is helpful. Where food allergy such as cow’s milk allergy is suspected, an allergy focused clinical history is taken.

Feeding difficulties in early infancy 0-6 months

Feeding difficulties in early infancy arise for a number of reasons. I listen to a detailed history as a first step in understanding how and why the feeding difficulty has arisen.  It’s absolutely essential to understand this before considering the best approach and first steps  for each infant. Feeding aversion and refusal to take milk feeds – either at the breast or with bottle feeding – is concerning, and if persistent then weight gain is likely to falter.  An infant feeding assessment takes a close look at all aspects of feeding from birth through to the present, before considering potential reasons and discussing solutions.

Feeding difficulties in infancy 6-12 months

Feeding difficulties in infancy and into the early toddler years may have a variety of causes, and are often (but not always) distinct from difficulties in early infancy.  It’s important to know that feeding skills are learned behaviours, which include sensory as well as cognitive and fine motor skills. A baby’s development of those skills come at particular ages, in the same way as smiles, sitting up, crawling and walking do. Babies will learn these skills at different rates. However, the more often feeding with solid foods is practiced and repeated, the quicker infants learn and develop these new skills.  Infants then build on and adapt those skills to introduce new foods, textures and flavours over time. 6-12 months old infants can get behind in developing age-related feeding skills for a variety of reasons; the most common of which is illness during the sensitive window of introducing solids.

Nutrition education 

Limited knowledge or understanding about feeding babies and/or infant nutrition, or indeed confusion about what is good practice, makes it more difficult for parents to transition from milk feeding to a balanced family diet.  By the age of 9-12 months, the optimum diet is a well mixed variety of foods and textures at least three times per day with regular milk feeds. Although all infants have their quirky differences, self feeding, finger feeding as well as being fed from a spoon are all important skills whilst establishing solids. A bit of nutrition education about infant feeding may also be helpful.