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Feeding Difficulties in Infancy

Feeding difficulties include a range of scenarios where infants are not willing to feed in order to meet their nutritional needs. This may present as bottle aversion, breast refusal, food refusal, taking a long time to eat, gagging, vomiting or crying excessively during feeding. For sensitive infants, force feeding is unlikely to be helpful, and can often make matters worse.

Parents can feel very distressed when their infant is refusing to feed, and under pressure to meet nutritional or fluid needs. Parents can also feel they are doing something wrong and need help, reassurance and support.

Supporting Feeding Conditions

Many factors impact on infants’ willingness to eat solids, and those with diet related conditions or who have been difficult to feed early in infancy are often more sensitive. Feeding skills may need to be re-established by returning to an earlier step in the weaning journey.

The trick is not to get stuck and to continue to progress forward, at a level that is safe but gives just enough challenge to be developing new skills. Conditions such as reflux or cows milk allergy can limit an infant’s desire to eat; who learning very quickly when eating is followed by pain or discomfort. Reassurance, gentle praise and encouragement all help.

Learning How to Eat

During the sensitive window around 6-12 months, infants are primed to learn how to feed themselves. Their natural curiosity and the desire to eat or feed themselves are helpful for feeding skill development.

Introducing Solids

When introducing solids has been difficult to establish, the limited experience slows down the early learning and can affect the normal age related development of physical feeding skills.There are many factors that impact an infants’ willingness to eat solids, eg. repeated illness, respiratory difficulties and conditions like cow’s milk allergy or reflux. Those infants who have been difficult to feed soon after birth are often the most sensitive.

The importance of Iron

Iron is a component of haemoglobin, the oxygen carrying part of red blood cells, and because infants are growing so rapidly, new red blood cells are being made at a high rate. Introducing iron-rich foods is really important during weaning; eating iron-rich foods will help to establish the tastes, smells and textures needed to become familiar and learn to enjoy eating those foods. Good Sources are red meat, egg yolk, apricots, dried fruits, green vegetables, lentils, avocado and nut butters. Vegan infants will need an iron supplement.

Managing Growth Faltering

Infants with ongoing feeding difficulties or poor feeding are more likely to experience growth faltering. Their nutritional needs for growth at this age mean they have high calorie and nutrient requirements. Attention is needed if weight drops more than two centile lines away from the usual curve. Small fluctuations in the weight centile are common during infancy because of short-term illness that affects food intake.

Mindful Parenting

Being mindful is a skill that can be cultivated through practice, and has huge benefits for parents and children. Intention is a good place to start! By nature, mindful parenting is responsive, attentive and accepting, both to your child and to yourself. So often parents worry and become self-critical when things don’t go to plan. Feeding is an emotive issue for most parents; mindful parenting can help you to be open to your own emotions, without being taken over with their intensity.

Learning how to be in the moment, with whatever is happening for yourself and for your child is being mindful.
Practising this can help to ease those tensions in family life, and can be applied to food and feeding, and many other (if not all) aspects parenting.”

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