13 March 2015

MPASI Awal / Introduction to Food (Baby Led Weaning or Traditional Puree/Porridge?)

*updated with latest MPASI conditions when baby is 11 months old*

Honestly, I don't like to put labels on any parenting style, because it seems idealistic and theoretic (no offense, hey). In the real world, most parents combine some parenting styles or even create some. But in my opinion, all (sane) parents' vision is the same : having happy children. The strategies and tactics may come in different ways because every child is unique. Parents instinctively know what's best for their children.

I learned about baby-led-weaning method when my first baby was 4-months-old (that was not long ago, in December 2014).
Was I interested in using it? NO WAY!
I was even petrified with the idea of putting mushy non-liquid things in my baby's little mouth, not to mention solid food. What if she was choked? Susu aja doi suka keselek, apa kabar dikasi makanan geluntungan gitu? Yes, the features of a paranoid-first-time-mother that made my own mother shake her head.
'Oh well,' I thought, 'I'll just do it the conventional way. Introducing semi-liquid food (making porridge from rice flour and mashing steamed fruits or raw banana/avocado/papaya, adding breast-milk into it), which will be transitioned to mush (shredded steamed/raw fruit and porridge), then to strained steamed rice, and then finally leaving the strainer behind. I intend to introduce table food when she is 1-year-old.
I also planned to introduce vegetables before fruits to avoid sweet-teeth (since her father doesn't like vegetables and his genes are strong in the baby).

Well, plan is a plan, apalah aku selain manusia belaka, nan labil dan centil. One day when my baby was 5.5 months old, I was eating melon beside her. She was watching me eagerly, smacking her lips and making chewing sounds. Curiously, I put soft side of the melon in front of her. Dicaplok dong! She gnawed on it ferociously like a little hungry cub. Well actually her mouth's movement is more of sucking rather than chewing. *Mamak penasaran dan keasikan liat anaknya makan* I asked my mom to steam a big half slice of melon (about 120 gram) for my baby. When it had cooled, I waived it in front of my baby's mouth. Dicaplok lagi! Hap! She was in the put-everything-inside-my-mouth-even-if-it-was-Mama's-toe period (just kidding, I never gave her my toes to be sucked) so I was quite sure she would be happy to have something other than her thumbs and her teether inside her mouth. And yes she was! She ate all the big slice of melon in no time! Mama is happy, kiddo! Melon helps her constipation, too. We gave her steamed melon every two days for a week (because it was just an early introduction), held it for her and arranged its position to ease her.
 
This is the first time she tried raw melon (left)  and steamed melon (right). Despite of her serious face, she really enjoyed it.

On day 2, she gagged after a lump of melon got inside her mouth and she screamed. I immediately turn her over so her stomach is on my lap, and pat her upper back (under the neck). The lump fell on the floor and I hugged the crying baby. I knew that she wasn't choked (or else she wouldn't even be able to cry). Thank God, thank God, thank God! She was fine but she refused to continue eating. We thought that she will be traumatized, but the next day she eagerly received another serving of steamed melon. She even 'bit' a lump again, but this time she casually just threw it out using her tongue. Since then, she don't panic if any lump that she can't swallow get inside her mouth. She'll just try to chew it using her gum (no teeth yet) and if it fails, she'll spit it out. Sometimes she gagged but she managed to cough the lump out casually; no cry.

When she reached 6 months (WHO's suggested age to start solid), we introduced her to white rice porridge (made from powdered/ground white rice) and other spoon-fed foods like mashed banana and apple puree. Some other time, if she seems to like it and can handle the food, we let her eat the food in its true form and even hold it by herself.

Our feeding method was clearly not traditional, some even called it 'combined method', but was it really BLW? Babyledweaning.com said NO, because we direct her to take the food so it's totally not BABY LED (self feed). Although some parents call it BLW, I just call it finger food.

I don't really care whether we're using BLW or traditional. In this first stage of solid food (or what we called MPASI in Indonesia), it's all about introducing the joy of eating. Every baby has her own preference and readiness. According to several sources, "caretakers just have to make sure that they introduce many kinds of healthy food and make the meal time enjoyable. Don't worry if the baby refused to eat; she still gets her nutrition mostly from milk. Be creative. Some babies like weird stuff that adults won't eat, for example: rice porridge with banana".

Sucking zucchini
She loves to gnaw on broccoli florets
Happy meal!
So, what is Baby Led Weaning?
To put it simple, it's a method to let the baby SELF-FEED. We prepare the food, serve it to the baby, let her do anything she likes with it. The term 'weaning' here is British English term for giving babies additional nutrition other than milk. In the US, the term is used when the baby stops having milk.

Why Baby Led Weaning?
People used to introduce food to baby when she's 4 months old instead of 6. Babies in that age haven't improved their digestive system very well so they'd better start with semi-liquid food. Six months old babies have better skill : they can sit (even with help) and grasp their food, they outgrow tongue thrust reflex, their digestive system is ready. Breastfed babies have the 'experience' and antibodies against allergies.
Choking or gagging is scary, but babies are fast learner. They'll eventually learn to spit the lump or chew it.
Some testimonies said that their BLW babies learned to use eating utensils faster and had better motor skills than their non-BLW siblings, but I think that every baby is different. Faster learning process is just a bonus.

Why not Baby Led Weaning?
- The baby refused it. My baby prefers puree for several kinds of food.
- You don't like mess. Personally, I hate throwing away food - it's against our family rules - so I minimize the waste by giving the baby small portion first, then more if she can handle it.
- Doctor suggests you to feed the baby to boost her weight but it seems that more food ends on the floor rather than in her stomach. Better just spoon-feed her until her weight is ok.
- You're not ready to handle gagged or even choked baby.

So how to do Baby Led Weaning?
- Prepare yourself and learn a lot about it! Google it, read the book, watch the video. Be prepared when your baby gagged or choked, learn Heimlich Maneuver.
- Have the consent of family since it's not traditional. Or just do it while they're not present *wink*. At first my mother (who's taking care of the baby when I'm working) agrees to try it but then she bailed out LOL (it was related to my baby getting fussy when teething). Some doctors don't even recommend this method.
- Consult the doctor before starting solid. Some babies are told to feed early to boost her weight. Some even given a strict 3-times meal direction or more. My friend's baby have to get 3 'big' meals (carbo) and 2 snacks (fruit or biscuit) a day because her growth was below normal. This condition is not suitable for BLW, except the baby can promptly do it.
- Be prepared for the mess. Spread newspaper sheet or waterproof carpet; anything to make it easier to clean. Bath the baby AFTER the meal time, not before.
The mess after broccoli session. I still consider her a clean eater.
- Make the baby sit well (on your lap, in her bouncer, whatever). Chair with tray is the best option. Some parents prefer to have the baby sit with family on meal time so she can watch how adult eat. Make sure that the baby is IN GOOD MOOD and NOT HUNGRY. Hungry and cranky baby won't be patient enough to grip the food. We give my baby meal between her milk feeds. For example: she drinks on 8 AM and 10 AM so we give her food on 9 AM. Not too full but not hungry, too.
- Put the food in front of the baby (e.g.: on the tray), a little (2 or 3 pieces) at a time so the baby is not overwhelmed. Better not to use plate or other thing that will distract her. Bibs can also be distracting; some parents even prefer to let the baby eat naked.
- We can give the baby anything natural (just remember, no sugar, no salt, no honey until 1st birthday). Some parents still use the 4-days-waiting rule (give the baby new food for 4 days in a row) to monitor her reaction (constipation, allergy, gas, etc). We don't have to make puree. If we want to introduce rice, we can make rice balls (like small onigiri) so the baby can grip it. Some theories say that baby can eat ANYTHING when she's 6 months old so the baby can have table food (with no sugar-salt), but some parents (like me) like to postpone some food (fish and meat, egg, dairy, bread and pasta) until her 7th-8th month. We also avoid chemical-added food and small round food (nuts, grapes, etc).
- (According to idealistic BLW method) NEVER put the food inside the baby's mouth. Let the baby do anything she likes with the food. Smash it, throw it, put it inside her mouth, spit it out. Anything. Even if she doesn't eat it. Some parents worry about how little the amount of food that gets in her stomach. Remember, she still gets most of her nutrition from her milk. BLW is about experience. 
- NEVER leave the baby alone, not even for 2 seconds, especially when she's still learning to self feed. Always be prepared to grasp her when she's gagged or choked. Maintain confidence and be calm. If the baby gags but she seems not to panic and tries to get it out by herself, just help her by patting her back gently. Babies are badass!
- When the baby is bigger, better to give a time limit (more or less, 30 minutes) then clean all up, especially if she just plays with the food. If she eats it, I usually become more lenient.
- We don't have to rush to have the baby eat by herself; she's still learning. She will self-feed when she's ready.

Now after 1 month of introduction to food, my baby can hold broccoli and zucchini and put them inside her mouth quite easily but sometimes she got frustrated when she didn't find them so we helped her. Avocado became messy mush (we also helped her most of the time), while porridge and mashed fruits are spoon-fed to her. Now that she can 'chew' using her gum, we give her textured food and stopped making porridge from rice flour.

First-food that she likes in the form of finger foods (not pureed): broccoli, zucchini, cauliflower. Some that she still needs help to hold: pear, steamed melon, watermelon, avocado, banana.

Update: my easy-fed baby got her first tooth when she was 7 months old and since then, she was teething almost-non-stop. During teething period, she got very fussy about eating. She refused porridge (except on very rare occasions) and steamed rice. Sometimes she ate fish like a piranha but at other times she just spitted it out disgustedly. We don't understand what to do. She still likes to hold her own food so we usually let her. She also likes to snatch (ngejambret) food from our plates so when she was 10,5 months we let her have table food. She doesn't eat much but she eats better when she can hold the food by herself. She likes bread, any kind of pao, fruits, vegetables and kerupuk.

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