An infant feeding assessment is a detailed, guided conversation about how your baby is feeding and how this relates to symptoms, growth and digestive functions. I like to observe a baby feeding and look at a nappy where possible. Generally speaking, growth is the most important determinant of wellbeing in an infant, and the use of growth charts helps track weight, length and head circumference for each infant. Changes to the growth pattern or growth faltering can be related to feeding difficulties and/or symptoms which affect their feeding . If food hypersensitivity such as cow’s milk allergy is suspected, an allergy focused clinical history is taken alongside. Depending on the presenting problem, an early feeding history can provide a good explanation of both what is happening now, and help consider suitable approaches to dietary management going forward. The infant feeding assessment often takes a closer look at feeding behaviours, experiences or difficulties a specific stages of their development.
Feeding behaviours in early infancy 0-6 months
Discussing feeding behaviours in the early months of infancy is a useful tool to understand what the baby is communicating about his feeding experience. Is he taking good volumes, feeding regularly, sleeping well? Does feeding feel difficult? Is he turning away from feeds or crying to excess around feeding times? What is happening after feeds? I listen to an early feeding history as a first step to understanding how and why any feeding difficulty has arisen – before considering immediate advice and longer-term options.
Feeding difficulties and assessing feeding skills in infancy
Feeding difficulties in infancy and into the early toddler years can have a number of causes. Between the age of 6-12 months is a sensitive window for introducing solids and developing feeding skills. This can be demonstrated by the fact that everything goes in their mouth! If this time period is influenced by adverse feeding experiences, ongoing symptoms or illness, or if establishing good routines and practicing eating solids has been challenging, infants can fall behind in developing their feeding skills. Skills such as chewing, swallowing, self-feeding, hand-to-mouth coordination, trying new textures, new flavours and drinking from a cup etc. are all learned behaviours, and use sensory as well as cognitive and fine motor skills. Eating alongside your baby is super valuable and supports them copying you, practicing alongside, learning and gaining confidence in those skills. And although babies will learn these skills at different rates, the more often they’re practiced and repeated, the quicker infants will learn. This is a necessary foundation for the early toddler years, where the focus of their attention changes from food and becomes more about practising walking and playing!
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. Transitioning from milk feeding to a balanced family diet is a busy developmental period for infants, and sometimes things can get in the way of this running smoothly. Up-to-date nutrition education and current thinking about infant feeding may also be helpful at any given appointment.