My infant feeding assessment is a guided and relaxed conversation, where we talk through specific difficulties and symptoms in relation to your baby’s feeding. Feeding difficulties in infancy can arise for any number of reasons. Listening to a detailed history is a first step to help resolve presenting symptoms, identify potential underlying causes and provide evidence-based strategies to help develop feeding skills, promote growth and wellbeing. Feeding skills are learned behaviours, which include sensory as well as cognitive and fine motor skills. The more often feeding skills are practiced and repeated, the more infants are able to develop those new skills. Infants then build on and adapt those skills to introduce new foods, textures and flavours over time.
A guided conversation about what, when and how your baby is feeding, and how this relates to symptoms, growth and digestive functions. Family and medical background is also helpful, and where food allergy is suspected, an allergy focused clinical history is taken. I like to observe a baby feeding and look at a nappy whenever possible, and so face-to-face appointments are always better than zoom! Looking at growth charts helps determine if and when changes in growth or growth faltering have occurred in relation to the presenting problem over time.
Some infants may get behind with developing feeding skills for a variety of reasons. This could be due to a repeated or pronounced illness or surgery during the sensitive window of introducing solids, resulting in aversion, lack of practice and/or limited experience. For infants who have extreme discomfort during milk feeding, (breast or bottle) for example in cow’s milk allergy, this may result in a learned feeding aversion. Again this food refusal will likely slow down the acquisition of feeding skills. Insufficient or limited knowledge about nutrition, or indeed confusion about what is good practice, makes it more difficult for parents to manage the transition from milk feeding to a well 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 – either breast or formula milk. Although all infants have their quirky differences, self feeding, finger feeding as well as being fed from a spoon are all important in establishing solids.
Some infants do need more support, if they have signifiant problems with eating which result in extremes from the norm in growth, experience or practical difficulty, and may benefit from of a multi-disciplinary team approach. This may include behavioural support from psychology colleagues, speech and language therapy and/or paediatric gastroenterology. All of which I can signpost to or support onward referral via Cambridge Paediatric Practice or 8AKP Therapeutic Consultants.