I have posted about this to get ideas from other moms but am becoming increasingly concerned as my twins are almost a year old and really are not transitioning well to table foods.

I had tried starting table foods slightly before 9 mos. but backed off when my boys continually gagged and sometimes threw up. My ped. said they weren't ready and not to push. So I didn't. I would occasionally try to see if their gag reflex was improving and eventually have gotten them to eat Cheerios and Puffs (maxing out at about 15 pieces per serving) and a few bites of turkey, one of them ate a few cut up pieces of rotini pasta, a few bites of waffle, but very, very small amounts, not more than a whole noodle or two, or a 1/8 of a waffle.

My concern is that they don't seem to be very interested in trying table foods. For the most part they will eat purees (occasionally Dylan, who is a little better, but not much, with table foods, sometimes will not eat purees either) and they are drinking about 18 oz. of whole milk a day. So I know they get enough to eat, however, I am concerned about their lack of interest in table foods and I have tried TONS of food. Cut up cheese, soft apples, banana, green beans, cottage cheese, Gerber graduates pasta cut into smaller pieces. Even if I get them to eat anything outside of turkey, Puffs or Cheerios, they usually take a bite or two and then just refuse.

I know the transition is supposed to take awhile but I also know as babies move into toddlerhood they become picky eaters. I am concerned that they are behind in mastering the skill of eating table foods and don't know what else I can do to help them make the transition.

Do children w/this issue need feeding therapy? It seems a little bit overkill to me, as they will eat and are getting enough to eat, I just am concerned about their lack of interest in non-pureed foods, especially ones that are not crunchy or dry. They seem to chew very well, and very rarely gag anymore, except w/new textures they are not familiar with (like the cottage cheese).

I should mention that one of my son's is just cutting his first tooth and the other has two bottom teeth and his first upper tooth is coming in. At previous visits my ped. hasn't been concerned b/c Dylan didn't have teeth (although I read this didn't matter if they could mash w/their gums, which he can) but they haven't been in to the dr. since they had strep in November/early December so I am sure the ped. would think they would be eating table foods by now.

Any advice is appreciated.

Hi Stephanie:

When I evaluate babies to see if feeding therapy is truly necessary, I look at several things. First of all, I ask the parents if their babies exhibit hunger behaviors (or are they on scheduled feedings?) Are they gaining weight appropriately? I get worried if they are under the 5% for weight OR if there is a huge gap between their height and weight (those numbers should be relatively close together). I also take an inventory of foods their babies are eating, and I want to know if they are eating a few of the following: liquids, purees, mixed consistencies, and solids. Do they gag or vomit at most meals or when they touch, smell, or look at food? If you answered no to all but the last 2 questions, then most likely the boys need feeding therapy. However, after reading your thread, it does not sound like they do.

Dylan and Keegan sound like they are thriving with their weight. They are also cutting teeth, which can hamper the transition to new food textures AND exacerbate reflux because they pool more saliva in the stomach, thus making the reflux a little worse. I would recommend keeping them on reflux medication until they have successfully transitioned to new food textures. You may even consider asking to have Keegan and Dylan switched to the Prevacid Solutabs. They taste like strawberry candy, and little ones usually love the taste if they do not have a hypersensitive gag. It also gets them motivated to finger feed and try new foods, which brings me to the next point. Gerber and most baby foods are nasty and do not have a lot of taste. They are primarily watered down fruits and vegetables and the teething biscuits and cereal bars are hard and tasteless. Use adult food with flavor….”alerting” tastes to wake up the mouth. I like to use NutraGrain bars. They are soft and babies like them. I also use Keebler club soda crackers because they are buttery and get mushy fast, as do graham crackers with cinnamon. I also take base purees such as mashed potatoes and refried beans with flavor and add consistencies such as crumbled saltines or steamed veggies to transition kiddos from # 2’s to # 3’s. You can puree what the family is having for dinner and add some “chunks.” This is what I call “grading up” the food. Flavor is key when trying to get a GERDling to eat . I am not saying spicy, but not bland. Bland makes kids gag. Heck, it makes me gag!

Make sure the boys are not filling up on the milk. Our GERDlings prefer liquids to solids any day and tend to quickly fill up on them. Their motto is “why eat when you can drink?!?!” Offer the solids first and use the milk as a reward, or alternate bites of food with sips of milk. Is there a reason why they were transitioned to whole milk early?
Hope this helps :drinkalot:

Robynne

Thanks Robynne, this is very helpful and gives me a lot to work with. I did not think they really would need feeding therapy as they have good appetites, it's just the transition is not going so smoothly and they seem to not want to self-feed finger foods, or if they do, very, very small quantities, certainly not enough by itself to sustain them. I didn't know if there was something developmental goin on here and I didn't want to ignore it for too long.

Do you think it is okay to feed them table foods? Meaning, on another mom's suggestion, I got some Chicken Noodle Soup and strained the liquids and tried giving this to the boys. They would only pick up/play w/the foods (Keegan barely did this b/c he doesn't seem to like to touch "wet" stuff) but when I used a baby fork and fed it to them they willingly opened their mouths and took much more this way. They definitely don't seem able to master using a fork themselves so I have to do the feeding. Is that okay or should I be having them self-feed when it comes to table foods? I guess my concerns are not so much about getting enough, do they know how to chew, they seem okay in those areas. It's more like, why aren't they wanting to self-feed and how can I get them to do this.

BTW, they really seemed to enjoy the Campbell's chicken noodle, it was nice b/c it had chicken, veggies, and noodles all in one and was seasoned, which is why I think they liked it so much. I have been giving them table foods first and using purees second, when they lose interest in table foods. We only give milk at lunch, after their solids. Their other bottles are mid-morning (3.5 hours before lunch) and before bed. I give them sippy cups w/water after meals/afternoon snack.

They are a year old in two weeks so I switched them to whole milk last Friday when we used up the last bit of formula. They were on cow's milk formula so that transition has been smooth.

Thanks again for all your feedback, it is very helpful and reassuring to a first time mom!

Hi Stephanie:

You are absolutely right about the table foods. A child who might have some mild sensory issues may not want to pick up a cool wet and soggy noodle. Compare that to the texture of a worm for those of us who are squeamish! If a child will not touch food, how is he going to get it to his mouth???? This is where sensory play is important. This is also where us neat freak moms roll our eyes...lol. Many kids who have sensory issues can be hyersensitive to food textures, clothing textures, don't like their hands to be dirty, don't like to be held or hugged, etc. Some sensory kids may just have 1 or 2 idiosyncrasies. Others have more. It does not mean they are dysfunctional. All it means is you must address the issues that are interfering with everyday life. As children approach 1 year, autonomy becomes more important. Thus, self-feeding puts them in charge and allows the parents to sit back and supervise feedings instead of providing maximum assistance. However, if a kiddo doesn't want to touch the food, we address the sensory issues to overcome tactile hypersensitivity.

Try placing the boys in the high chair before bath time. Put some pudding or strawberry Cool Whip on the tray and make happy faces, shapes, numbers, etc. Takes some tastes to model eating. Throw in some Keebler soda cracker or graham cracker sticks and take "tastes" off of the crackers with the "mmmmmmmmmmmmmm" sounds! Get all messy and then throw the boys in the bath. You are engaging in sensory play. If one can't play in it, they won't want to pick it up :yahoo: Write back if you are still having problems or consider reading The Out of Sync Child by Carol Cranowitz.

Robynne