Mealtime - Connection Time
Starting solids can be such a big topic - it's helpful to know that its not all about food though. To understand this important developmental journey, we can start by looking at the two key parts, mealtimes being about food and about the relationship! Food Starting from the beginning, it is helpful to look at the digestive system. The young gastrointestinal tract does not produce digestive enzymes as a child or adult does. Breastmilk is the most gentle food on the young digestive system, containing enzymes (amylase and lipase) that aid digestion. Breastmilk grows/develops a healthy gut culture. Infant formula and first solids will take longer to digest, and too early can interrupt the development of a healthy gut culture. Gut culture is linked to how the nervous system develops and linked to behaviour and wellbeing. Guidance: "WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. Thereafter, they should be given nutritious complementary foods and continue breastfeeding up to the age of two years or beyond." - World Health Organisation Link to WHO guidance - click here Transition Food Making the transition to solid foods, the young digestive system benefits from having food full of nutrients and in a consistency that the new digestive system to get those nutrients easily. Fruit and vegetables are easy to digest and are packed full of nutrients. Now lets look at consistancy, here are three ways that we can transition from milk-to-solids in a way that is gentle on the developing digestive system. Veggie Soup - using a smooth veggie 'soup' is a great place to start and cup feeding, then progressing to the spoon as we slowly increase the consistency to be less soup-like and more solid. Puree - mashing vegetables and fruit into a smoothy consistency and delivering with a spoon. Chewed - before the invention of kitchens, it is thought that mothers would first chew the food into a smooth consistency before offering it to the baby. The enzymes in the mothers' saliva start digesting the food for the baby. Cultural Ideas It is important to acknowledge that there are cultural beliefs around the transition to solids, and here we look at a few. What about 'baby rice'? There are rice or cereal mixtures on the market claiming to be the 'best start' - however, research overrides the marketing of these products showing that there is little to no benefit for the baby to start on these grain-based foods. Read more - click here. What about stopping milk? Important to note that starting solids does not mean that breastfeeding ends. The World Health Organisation says to keep breastfeeding until the child is at least 2 years old, or older. Both breastfed and formula-fed babies may require a continued feeding relationship - the transition is important and can be longer when led by a childs needs instead of current cultural expectations. What about 'baby-led weaning'? The idea behind baby-led weaning (BLW) is that we offer young babies solid food to choose from. While the ingested foods go through the body, they often travel through the digestive system undigested. What about starting solids at 6 months old? At around six months of age, the iron stores brought from the placenta become low; this will be especially true for those who had their cord cut before 30% of their blood, rich in iron and stem cells, had returned to the body after birthing. This six-month marker is also when many infants cut their first teeth, the start of growing the built-in utensils for chewing and masticating food. What about the high-chair? The high-chair has become a symbol of starting solids. Often, the baby is placed and strapped into the chair long before they can hold themselves up in a sitting position (either trained or naturally). This switch from the lap with the breast or bottle, to the independent chair at a specific date, could not be called a 'smooth transition'. "Coming together for mealtime provides an opportunity for connecting and leisurely enjoying our time together- refueling not only the body, but our relationships. Until a child is able to come to the table, you’ll find her secure in the arms of her Primary Caregiver – even the maturing baby sitting up on her own." - Nicole Vigliotti Link to the full article - click here Relationship Mealtimes are well known for being a time of connection, getting together to share food and being nourished by each other's company. We must consider and replicate this physical and emotional nourishment when feeding our young too. In a relationship, what is essential is the 'serve and return' found in working 'with' another, rather than doing something 'to' someone - this is the quality of how we relate to each other (relate - relationship). "Feeding-eating is a sensitive point of the relationship between the adult and the child. We must not forget: the feeding, eating of a child can be a pleasurable experience for both of them four or five times a day, or it can also be a dreary obligation for the adult and miserable torment instead of joy for the child. We cannot emphasize strongly enough how important these daily four-five pleasure sources are for the quality of that relationship..." - Dr Maria Vincze On the Lap Feeding on the lap means you and your young child can relate to each other during meal times. On the lap is where you and the baby can see face to face; each party reads and moves on the cues of the other, and they are held in your arms yet have the freedom to move. Breastfeeding, bottle-feeding and starting solids can all secure this important relationship position until the child is ready to leave your lap for their own chair. In our culture, we see many examples of solitary feeding, where the infant baby feeds themselves, holding their own bottle or sitting (sometimes alone) in a highchair they can not get into or out of themselves. These examples offer no physical contact with their caregiver, the scene is not set up for eye contact, and often the 'serve and return' of the healthy relationship is missing. On the lap, the infant can rest back into your arm instead of holding up their trunk with muscles that have not yet developed. The angle we hold our arm for them to lean back into will either trigger the reflex to sit upright or allow them to find complete body rest. The hand that holds them securely on our lap can either provide some freedom of movement or lock them in. All these details make a difference for the young person experiencing them. "Hands constitute the infant's first connection to the world (outside of nursing). Hands pick her up, lay her down, wash and dress and maybe even feed her. How different it can be, what a different picture of the world an infant receives when quiet, patient, careful yet secure and resolute hands take care of her - and how different the world seems when these hands are impatient, rough and hasty, unquiet and nervous. In the beginning hands are everything for an infant. The hands are the person, the world." - Dr Emmi Pikler Transition Relationship The transitions are important for keeping that closeness and dialogue of movement in feeding, also for avoiding any unnecessary stress for the infant. The transition from breast or bottle to solids will remain full of connection when we maintain the closeness of 'being together' on the lap, and therefore the transition is peaceful. Establishing the relationship ‘serve and return’ during feeding can be extra helpful for nappy changing and all other cooperative moments between you and your child. The point where solids are introduced and the time when most babies begin to want to get up and not lay on their back coincide (naturally) at around 6 months. Mealtimes offer extra time reading their cues, which in term helps with reading in other areas of caregiving. There are other transitions to take into consideration, the introduction of new foods and utensils. At Pikler House they would only introduce one new thing at a time, for example, they would not introduce a fork and new food in the same meal, instead, by introducing one new item at a time. These are all transitions that the caregiver manages, based on being away of the choices on how to do things, and how we read the baby's cues. "The relationship between the nurse and the infants is formed in a planned way while she is caring for the children and not through the use of so-called organised activities. The greatest attention each child receives is during the time he is being dressed, fed, and cleaned, especially in early infancy." - Dr Emmi Pikler Technique Emmi Pikler is renowned for the way she built the optimum relationship patterns into caregiving, creating an environment for optimal development. Her lap feeding and relationship-building technique has been used on many laps with great results. Pikler's technique is described in detail, for the nurses who trained in her 'approach', in the book 'Bringing Up and Providing Care for Infants and Toddlers in an Institution'. The chapter, 'From bottle feeding to independent eating' by Maria Vince MD, covers all the smaller transitions between starting on the lap and eating at the table. Link to the book - click here "Hold the loaded spoon up at your baby’s eye level about thirty centimetres from your baby’s face. That way your baby can see that you are ready. When your baby is ready for the next mouthful (he or) she will open her mouth to let you know that she is ready. That is elegance in action - true partnership.” - Pennie Brownlee Link to full PDF - click here Experience is the teacher. This exercise will turn the information into body knowledge - take a small bowl of food, a spoon and wiping cloth, and follow the instructions with a partner. One partner will be the feeder, and the other fed. The partner being fed cannot talk, only body language can be used to communicate. The feeder finds the position where eye contact and the 'serve and return' can happen. The feeder holds a loaded spoon at their partner's eye level, about 20 - 30cm from their face - and waits (the 'serve'). Willing, the partner will open their mouth (the 'return'), and the feeder delivers the spoon into the mouth. The feeder will now wait until they see the food has nearly gone before repeating the 'serve and return'. While you are set up, now try this -
Swap, so that you can both *feel* what it is like to be fed and to feed with these two different qualities of relationship. When we feel what it is like to be in the other position, the position of your partner, we can understand how our actions affect the other person we are relating to. This is also known as the skill of empathy. When we have played the role of both the feeder and the fed, we gain sensory knowledge that cannot be gained in reading information. “When a baby turns her head away when you offer her another mouthful of veggies, she is saying quite clearly, “I’ve had enough”. Why then do perfectly sensible grown-ups offer another spoonful and say, “Just one more for Mummy” or “Open the tunnel for the train. Here it comes!” The message we are sending to our babies is, “I know you have a message that you are communicating to me - but I am ignoring it”. - Dr Emmi Pikler "Ainsworth and Bell investigated the quality and formation of the mother-infant attachment, and the degree of attachment considering different maternal attitudes. This was done in a longitudinal study based on extensive observations. It was found that the manner of care of those mothers who were able to look at things from the point of view of the infant led to harmonious interactions, not only in the feeding situation but in all other situations." - Dr Maria Vincze Sharing a Meal The joy of eating together 'in relationship' and eating together when everyone shares a meal is another easy transition. This transition is often made when the child is self-feeding and still on the lap, at the family table or in the intimacy of a small table. In some cases, the child will get into their own chair first, and in other cases, they will join the family meal first and then move to their own chair. Whatever the situation, these transitions are made based on the child's readiness and will, along with the caregiver's attunement to 'readiness'. Sharing food and mealtimes are also linked to self-regulation in the body and with others, the development of the Social Engagement System. This closeness and connection time developed in these first mealtimes continues to grow, which turns out to be, very important to our personal and social wellbeing. "Human beings are biologically engineered for human interaction – and particularly face-to-face interaction." - Jenny Stevens Link to full article - click here "Mealtimes provide a crucial anchor and comfort in a sometimes confusing and busy day. How comforting and pleasurable a child experiences mealtimes is highly dependent on how much the child trusts the carer, the carer’s ability to pick up the child’s cues, and how calm and predictable the situation is, quite apart from how the food tastes." - Dorothy Marlen Link to the full article - click here Socialisation For the child, this transition from milk-to-solids and the lap-to-the-table is also a leap in social development. There is much to learn about all the utensils of the table and social etiquette. Young children learn fast by being involved (experiential and total immersion learning) and seeing behaviour modelled. When we can provide mealtimes that are consistent in connection - that are smooth, considered and peaceful transitions, along with a secure, stressless and safe relationship, young children are calm and enjoy mealtimes. We can all enjoy the nurturing 'serve and return' cooperation that mealtimes offer. “In one of the lectures abroad, our colleague showed a film where children were eating. A participant asked her, “What would you do if the children poured all the food out of the bowl?” The presenter was surprised at this question because this had never happened at Loczy. Because caregivers were not focused on the negative behaviours there children learned to cooperate without needing to be defiant. They came to see cooperation as a pleasurable moment, where they find good about themselves." - Elsa Chahin and Anna Tardos, 'In Loving Hands' Many mothers find that because every mouthful is welcomed when ready, no bibs are required - because the pace is right for their physical development, no plastic plates-cups-spoons are required - because mealtimes are relationship time, no food is thrown or dropped. Dr Pikler said, "Food should always be a pleasure." Mealtimes are truly a pleasure for the many families who have created smooth transitions and nurturing relationships through the developmental stage of starting solids and beyond. Put together and written by Clare Caro The Pikler Collection creator and curator Extra Links
Judit Kelemen (lead pedagogue at the Emmi Pikler Childcare Center, Hungary) describes cup and bottle feeding on the lap. Click here Dr. Greene who founded the WhiteOut Now to educate on 'delayed cord clamping' explains why waiting for the cord to be white is so important to development. Click here to watch Photos: Clare Caro |