Weaning with Sense with Kath Megaw

I just think it’s so wonderful. It’s a lovely way to almost have you and me in their pockets while they’re going on the weaning journey. And they really get to just hear nuggets of advice that’ll just make the journey so much easier. I mean our goal ultimately with the course and with the book and even these type of podcasts is to allow parents to have fun on this feeding journey with their children. And so to cut out a lot of the noise to give them good sound advice. And I think they will find that very valuable as along with all the wonderful recipes and meal plans and just the great interaction that they will have with us while doing that weaning program.—Kath

Intro

This is Kath Megaw, a pediatric dietician, the founder of Nutripaeds and my co-author of the bestselling Weaning Sense book. Kath holds a wealth of information and is a true expert in nutrition for babies and children. She joins me for this podcast where we discuss some of the controversy around weaning your babies onto solids. We discuss baby-led weaning, making sensible choices for your little one and what we call the two-bowl approach. We go on to talk about the weaning sense online course which is available in the Parent Sense App. Keep listening for this and more as we explore weaning and make it a stress-free and enjoyable experience for you and your baby.

Welcome to Sense by Meg Faure, the podcast that’s brought to you by Parent Sense, the app that takes guesswork out of parenting. If you’re a new parent, then you are in good company. Your host, Meg Faure is a well-known OT infant specialist and the author of eight parenting books. Each week, we’re going to spend time with new mums and dads, just like you to chat about the week’s wins, the challenges and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here every week to make the most of that first year of your little one’s life. And now meet your host.

Meg: Hi, mums and dads, welcome back to Sense by Meg Faure. As we do each week, I join you on your journey as a new parent, to chat about all things parenting, whether it’s sleep or feeding, your baby’s discipline, or potty training. And very often I’m chatting to real moms who taking us through their journey as they parent their little ones, the highs and lows of each week. But as you know, occasionally we are joined by other parenting experts, people usually in the medical field, who’ve come alongside me and have worked with me over the years. And this week I am particularly excited to be joined by Kath Megaw. Now, Kath is a clinical pediatric dietician. She’s been in practice for 22 years more than 22 years, and Kath and I have worked together on numerous projects. Kath is the author of numerous titles, including Real Food, Healthy Happy Children, she is the co-author of Feeding Sense with me. She gave input on Pregnancy Sense on the pregnancy side of nutrition. And then more recently we wrote Allergy Sense and Weaning Sense together. Kath is, as far as I’m concerned, the authority and the wisdom when it comes to weaning your little ones. She is always researching things. I think she grows her knowledge annually. And every year she comes to me and says, Meg, we’ve got to update one of our books because I’ve just found this new thing or science has just found this new thing and we need to keep up to date. And that’s really what Kath’s mind is all about. She is curious, she holds four medical qualifications, including a Pediatric Dietetics qualification from the Johns Hopkins University in Baltimore USA. We are very, very lucky to have her here with us today because she is, as far as I’m concerned, one of the authority voices that we listen to when we talk about infant feeding. So Kath with that introduction, welcome to the podcast.

Kath: Thanks Meg, always great to chat to you.

Meg: Yeah, we do, we have work so wonderful together over many years, both clinically referring babies between our practices also on our books and then often in speaking engagements as well. So it’s just wonderful to have you and Kath, I reckon probably one of the most thorny topics in early parenting is of course, weaning and feeding your baby. Because just as adult diets are highly polarized, like high-carb low fat versus keto versus paleo versus—I’m losing track. Little baby feeding is also highly polarized with some moms advocating or some experts advocating weaning very early and others delaying until after six months. And we knew the mom caught in the middle or the dad caught in the middle, it’s highly confusing. And so we going to kind of demystify it today. We’re going to talk about all of those thorny issues.

And so I guess the best place to start is when should we actually start the weaning journey? So we’ve been on breast milk until a certain age or formula milk, and at that point, we start to think about weaning our baby and when is the right time to start weaning little ones?

Kath: Well, yeah, that is always been a constant issue, especially as signs studied more and more about the babies and meaning and their digestive systems. And so what we know, kind of doing full circle from saying, do we feed early? Do we delay it? We’ve kind of come full circle to saying we probably the best age to introduce between four and six months of age. And that is actually very intuitive. It’s when most moms will get the feeling that their baby is ready for solids and the physiology of the baby is in line with that. So the baby’s digestive system is mature enough to handle solid food. The baby is physically strong enough to actually hold its head unsupported it and is able to then focus on opening his mouth and taking in the new solids and using the jaw muscles to feed the solids. And what’s really interesting is recently they discovered a new muscle in our jaws that they didn’t even know existed until very, very recently. And what’s interesting is that they date that muscle to its development just before four months of age.

Meg: Interesting.

Kath: So that is when it’s kind of reaches its peak at four of age, which is when a baby, now we know is ready to start solids. And we also know that from an allergy perspective, it actually is protective to start introducing solids between four and six months of age. So there’s many reasons, both on a physical level, on an allergy protection level and also just on emotional social level because a lot of babies start really engaging around that age, just with everything with life. We say they kind of wake up to the world around that age group. And part of the world is food and watching their mom eat and their dad eat and their siblings eat and granny and grandma. And so it’s really lovely to introduce, and start exposing them around that age.

Meg: So if I’m a mom listening and I know the moms and dads will be asking this question in their head, there is a lot of conflicting advice. And a lot of it, the advice comes that you must wait until six months of age because the World Health Organization has recommended exclusive breastfeeding until six months of age and so therefore we mustn’t introduce. And particularly in the UK, Kath, many, many health visitors are saying do not introduce solids before six months. Now, if I’m a mom hearing, you say 4-6 months, it’s confusing. Why is it that the advice is still sitting out there that it’s six months, is it a historical thing? And is it erroneous or is it okay to only wait until after six months?

Kath: So the World Health Organization is essentially formulated to protect very low income and under resourced areas and especially in the area of infant health. And so the policy guidelines always have to look in light of the bigger at risk population group, which is our under- resource, those babies are most addressed. So in your under-resourced countries and your developing world, those children don’t have access and families don’t have access to a lot of food security. So breast milk for a baby is the highest level of food security that a mom can offer her child. So the longer a mom has been told to feed her baby breast milk, the more healthy the baby is going to be going forward in life because once they start moving onto solids, what we have found in these developing countries is that then the mom automatically starts reducing the amount of milk that she’s feeding her child. Even if the solids are inadequate. In other words, if only a staple is given like a maize, or a bread or something like that, the mother will start to cut back on a breast milk, which is many other nutrients that the baby doesn’t have access to when he moves onto a fully solid diet eventually. So the longer we can keep the breast feeding going the better because also it has an immunity factor. So it’s not bad advice at all, and especially in the developing countries.

But what we know in our first world countries, it’s entirely safe and actually good to expose children to complimentary foods between that age group. And so we do know that other organizations like the European Society for Pediatric Nutrition, as well as the American Academy of Pediatric Nutrition, Australian Academy of Pediatric Nutrition, they have all given now as a go ahead that between the age of four and six months at the discretion of parent and the healthcare professional, we can introduce the baby safely to complementary feeding.

Meg: I’ve got a story to tell you Kath, that happened many years ago when I got married, my husband and I went to Madagascar on our honeymoon, which back in those days, this is the 1990s was really, really, I mean, it still is, you know, a real developing country—poverty stricken, and I’ll never forget. I mean, some of the poverty situations I saw there were very, very frightening. And one of them was actually a mom who had a, a newborn baby and she was feeding—preparing a bottle for the newborn baby. And what she did was she got some carnation evaporated milk and she had a ton of that, and then what she did was she decanted some of that into a bottle to which she took water out of a trough that was on the side of the road because there was no running water, no taps. And so it was kind of, there were puddles of water in the road. And then there were these troughs where I guess some animals would maybe walk up, but there were kind of like little pools along the way. And she dipped the bottle in there and diluted this carnation milk with this water that had been standing, standing out. And I can remember the absolute, sheer shock inside of me that this was happening.

The reality was she couldn’t afford formula or potentially formula wasn’t available in this particular tiny island that we were on just off Madagascar. And she was having to feed a very hungry baby, and the best thing she had was carnation evaporated milk and some water. And it really struck me and has lived with me that diarrhea disease, which I think you can correct me if I’m wrong maybe one of the biggest killers of babies in Africa?

Kath: 100% correct.

Meg: That would be a breeding home for it. So the idea of keeping developed nations on breast milk for as long as possible, you know, in the context of a picture like that really does make sense. I think most of our listeners are fortunate enough to have access to healthy food. And I think the principle there is whether you choosing, you know, the minute you choose not to breast-feed at any point in your baby’s journey, you have to replace that with really good nutritious alternatives, which could be formula milk, or could be nutritious diet from four months onwards. So, yeah, thank you for sharing.

And then Kath, another question that comes up so often is actually, what do we start to wean onto? So we’ve spoken about the fact that we can do it between four and six months of age, and then how do we choose? Because I mean, it’s quite funny looking back historically, when I was a baby 1970s, what was recommended was oats, porridge and avocado. And it was done very actually early on in the parenting journey. And that was what I was weaned onto was strand oats and avocado. And then fast tracked to where I had my babies in the late nineties and early nineties and of course in those days it was rice cereal. And so we all had these boxes of rice cereal that at the time we were told the reason your baby can only go to rice cereal is that it’s hyper allergenic and they don’t develop allergies. Well, of course my first born is the most allergic child in my family, and then thankfully by the time my third one came along, the recommendation was vegetables. So as a dietician, what do you recommend, are we going for fats like ever, are we going for vegetables, fruit, or are we going for processed carbohydrates as we did in the 1990s?

Kath: Yeah. So I love, I love your timeline that you’ve kind of told us about. And I think what is really good is to go back and look before we knew so much. And before we started getting all this, like what you must, what you must sent and commercialization, we really would feed our babies what were seasonal and was easily accessible. And our forefathers were really looking at what they harvested off the land and what their neighbors had on offer, what you found at the local markets, whether it was in the countryside or in the farms. And that’s really what we gave babies. So with the whole industrialization and commercialization of baby foods, that started to become the blueprint for what we need to start our babies off on. So all for  you choosing seasonal fruits and vegetables whether it’s your avos that are season, whether it’s your oranges that are in season, whether it’s your apples that in season, butter nut, carrots, and it’s really given your babies a range of those different fruits and vegetables on a daily basis. So you don’t have to spend days and days on only one veggie, you can mix and match fruits and veggies so that you can really get through the lovely records while that we have. And I know that in our First World countries, one of the problems we have is we don’t actually know when our fruits and veggies are in season because everything seems available all the time. And especially from our perspective from South Africa, overseas has even more access to different fruits and vegetables on a regular basis. So what I normally say to parents is look at what is really costly because that generally isn’t in season in the moment, the sweeter the veggie is, so the more taste and flavor a veggie has, the more likely it is to be seasonal at that point and the easy accessibility of it. So you might find that there’s one or two shops that will have all fruits and veggies all year round, but you’ll have your mainstream shops might only have certain veggies at certain times. So, that’s one way to tell because they definitely are more nutritious when they seasonal.

So those are lovely and gentles to start with. And another advantage is that it has a lot of fiber and natural, soft gentle fibers are wonderful because one thing parents often complain about when start in solids is constipation. And so if you feed your baby with very refined cereals and carbohydrates, they tend to get very blocked up and very constipated, it’s very uncomfortable and the solid journey suddenly becomes very unpleasant. Whereas if you start by putting in those very soft, gentle fibers, as a first point of call, you’ll find that the tummy will work nicely and will get into nice rhythm before you start adding your other grains and your protein foods down the line.

Meg: Excellent. So principle is fruit and veg and your grain’s a little later. When we are talking about fruit and veg, I had quite an interesting conversation with somebody. In fact, she’s one of our regulars on the podcast Cassidy, and she was advised to start her baby on all the bitter vegetables, because the advice was in the bit of vegetables, like for instance, broccoli and so on so that your baby doesn’t get a sweet tooth. What is your opinion on that? Because that throws out sweet potato and butter nut that, what are your thoughts on that theory?

Kath: So, sadly it doesn’t really hold with science because the bitter of taste buds only develop around about the age of 12 to 18 months. So the baby can’t actually taste those bitter of flavors early on. Babies have a natural propensity to taste the sweetness in food. It’s heightened more than the adults, even broccoli will taste sweeter to them than what it would to us because without the bitter taste bud, and with more sweet taste buds, they will take more of the sweetness of the veggie. And their genetic predisposition to a sweet tooth is stronger than what you choose to feed your baby. So in numerous studies have shown us that and Grades Ormondstry did a brilliant study with regards to testing babies who were fed a group of babies that were fed only sweet and only savory and then how they progress and finding that in both groups equal amounts, chose sweets and savory of both sweet.

Meg: Fascinating.

Kath: So it’s actually got very little to do with what sweets and savory we feed and actually with our genetics.

Meg: That’s very interesting. And then you and I have often chatted about those fats healthy going into diets relatively early on. And so I think maybe that’s something that we can just touch on because breast milk is neither a straight carbohydrate, nor is it straight protein. It’s got some fats in it as well, so what should we be weaning our baby onto in terms of fats and at what point?

Kath: Yeah, that’s so good because breast milk is about 40 plus percent of fat is what breast milk is made up of. So, you know, when we feed straight onto carbs like you and I were told with our first-borns, it’s totally changing the whole physiology of digestion so quickly and it’s actually makes sense why they would struggle with it and increase the risk of obesity and lifestyle diseases later on. So definitely moving onto your fruit veggies with fats very quickly is so wonderful because whether it’s fats in the form of your coconut fats, which is really healthy and good for the brain, whether it’s some of your seed fats, which has also got your omega threes in it, your avocado, which has also got your medium chain fats in it. So what I’m really saying is a variety of fats early on in their weaning diet. So within the first month of starting your baby on solids, you can start to add in and mixing in a bit of fat and fat also enhances the flavor. And what is interesting is that it’s also shown that when you mix fat with your vegetables, and this is quite a recent understanding, is that it actually enhances the antioxidant properties of those vegetables for your baby. So I think that’s such a wonderful thing to add, and it increases the satiety and that feeling of fullness and satisfaction because a lot of moms look for solids to create a feeling of fullness in their baby. But the solids are often, so carb-heavy or sugar heavy, and they don’t have a lot of other benefits like the fats. And that really creates a feeling of fullness.

Meg: Now, that’s brilliant, Kath.

Interlude

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Meg: And then, to touch on another kind of controversy around weaning and that’s the whole real push towards baby-led weaning. Now baby-led weaning is classically only started after six months of age because that’s really when developmentally little ones can hold something and start to direct it towards their mouth. So, obviously, if we are talking about an advocating weaning from four to six months of age, it can’t be pure baby-led weaning. So is there a room for both theories and really how does baby-led weaning fit into our idea on weaning little ones?

Kath: So baby-led weaning is really a developmental process in the weaning journey. So we will start initially, I even say to parents, just let your baby kind of lick the food; if you eat in an apple, let your baby have a lick, if you are having a bit of butter nut, mash some in your finger and pop it in their mouth and let them taste. So the first few days, and early weeks will be a lot of tasting of different fruits and veggies and flavors. And then you’ll move on to a little bit of spooning and spoon that into your baby so they might get in about 15mls or so, and have a little meal time. And like you said, up until six months, they’re really not developed mentally able to bring a whole lot of the food to their mouth so they can play with it and touch it. And we encourage, both of us really encourage a lot of interaction with food, so not only using the taste sense for feeding, but also using the sight and the touch, and the smell and even the sound of food. So eating around your child, they hear you that you crunching an apple.

So you really want to engage the senses. And then developmentally as your baby comes six months between six and seven months, you can start placing food in front of the baby, like the advocates in baby-led weaning. And while you are spoon feeding, simultaneously your baby can be engaging with food and the flavors and the taste and making choices visually with what he sees. Because that’s all it really is, is just visual choices and then feeling, and then it becomes a touch choices and then a taste choice when they’ve eventually able to move it to their mouth. So I think the two work very nicely synergistically together. And I really think it’s wonderful to include both on your journey, but at the right developmental time and not doing away with one over the other at any point.

Meg: Yeah, absolutely, you know, one of the approaches that I’ve always advocated for moms, particularly with fussy eaters, but also in the context of what you’ve spoken about is what I call the Two Bowl Approach. So the Two Bowl Approach says I have my bowl, mum and or dad and baby has their bowl in front of them. And what we placed into the baby’s bowl is exactly what is mushed and is pureed, or is mashed in our bowl, but we in whole food. So we would, let’s say we’ve made some macaroni cheese and some cauliflower, and on our side, we’ve kind of mashed it all together, but on their side we keep it separate and we put it as it appears, well as it could taste adult food, well- steamed really soft for them to be able to tack into. The reason why I love the Two Bowl Approach is because it gives a control to both parties.

Now, I was very much one of those moms who liked to have control, particularly when it came to food because I wanted to know how much was going in so that I could tick the food box. You know, many, many moms, that’ll resonate with them. And so I had my control bowl, which allowed me to know that, okay, I’m able to get in whatever three tablespoons or eight tablespoons of food or whatever. And my kids would have their control bowl, which would be for them to play and experiment and feed. And what in the beautiful dance of parenting, we as parents start to relinquish control as we start to hand over to our children. And so they start to take more and more and we start to give less and less. And so they start to control their own feeding more and more along the journey. And I think that Two Bowl Approach just works very beautifully from about seven months onwards. And by the time your baby’s a year old, you probably won’t be too doing too much shoveling at all, they’ll be controlling it mostly themselves.

Kath: And then I love that, Meg. I also just think that’s such a lovely way to engage and in the social aspect of feeding and keep both parties engaged, because a lot of children lose interest in food not because their full or they don’t like the food, it’s just because their attention span is so short. And so by having that Two Bowl Approach, they are keep keeping the attention span going by constantly rediscovering what’s new in that bowl, which is so wonderful. And I think like you said, it is a developmental process and it continues for a long time. You know, there is no like by a year a child must be eating and feeding themselves with a spoon. Some children will do that at a year. Some children will do that at 18 months. Some children will only do that at two, and some children will still like to be fed even beyond two, and that’s also okay. Because it’s such a short space of time and they need to really get comfortable in the journey. And I think that if we allow them to develop just like we allow them to crawl in their own time and walking their own time, so with feeding, we are not, allow them to develop their vegan skills in their own time and it’ll be very individual for each baby.

Meg: Yeah, absolutely. So we haven’t got long left and I just want you in the last few minutes, just really summarized for mums, and for you to come in at each point, the principles are that if you are in a developed world and have got access to good nutrition for your baby, you can start solids between four and six months of age care.

Kath: A hundred percent, yeah, so hundred percent brilliant.

Meg: And the choice of first foods should possibly be a vegetable. And it doesn’t matter if it is a sweet vegetable or a bitter vegetable, you can go in with what works for your little one. And on that note, Kath, give me your top three favorite weaning foods that you love to recommend.

Kath: I normally love to do one of the orange veggies. So butter nut, pumpkin, one of the squashes and or carrots, and then from a fruits, I love the apples and the pears because they’re very gentle, and I love mash banana. Then, yeah is also fun to bring in as a holding food and cauliflower, broccoli florettes that are a bit softened, are fun for the baby to play around with.

Meg: That’s fabulous. And then Kath, just on that note, you mentioned a couple of fruits there that sometimes have the reputation of causing constipation. At what point should we bringing in water in that weaning journey?

Kath: So water can be brought in, normally I say, once you start giving protein foods; so like your meat, your chickens, your egg, your fish, because protein is quite heavy for the kidneys to process and so by adding a bit of extra water just helps the kidneys to deal with the new proteins that it’s having to be exposed to. And it’s about 10 to 30mls just after meal time that you could give your baby a little bit of water to drink. And because remember your milk is already diluted new, so you can add water just to help the body digest those new foods.

Meg: Okay, excellent. So we’ve mentioned fruit and vegetables coming in. We’ve also mentioned that you can start to add your lovely fats fairly early on and you’ve just touched on proteins. How long should we be waiting to introduce proteins like egg fish, dairy meat, and chicken into our baby’s diet?

Kath: I normally say to moms once you’ve got about 12 to 15 different fruit veggies and fats in your baby’s diet, you can start to introduce a protein. So that’s about between four to six weeks into the weaning process, and you can start. So if you started your baby at four months, it might be five and a half months, if you started your baby closer to five months might be six and a half months, but by the age of seven months you definitely want to have started on introducing most of your protein.

Meg: And which is your favorite protein to start with.

Kath: I normally like to start with egg, and with fish, those are my two favorite very gentle proteins, very easy to digest. And some studies have really encouraged us to introduce it quite early to prevent egg allergies. So if that’s one of your first proteins that would be great.

Meg: And that of course brings us, I mean, into another thorny area right at the end of the podcast, but that I was recommended as you were probably in those 1990s to delay things like egg and fish and nuts until nine months. And that you kind of hangover of the old historical advice still kind of beats around the track. But the reality is that early introduction of allergens are actually very, very important for preventing allergies.

Kath: A hundred percent and I think that it was proven conclusively in the long five year multi-center study that was conducted in Australia. So I think we can’t be given that advice now, that’s actually bad advice.

Meg: Well, Kath, this has been the most incredible morning just being able to connect with you and to really hear all your wisdom. This is not my last podcast because we haven’t touched on breastfeeding and establishing breast milk. We haven’t touched on picky toddlers, there is just a plethora of more topics that we need to talk about. But the main reason behind this podcast as well was to just talk a little bit about the weaning course that has been loaded into the Parent Sense App. That is your weaning course. So do you want to just share with moms a little bit about what they can expect in terms of the Weaning Course?

Kath: Well, I just think it’s so wonderful. It’s a lovely way to almost have you and me and their pockets while they’re going on the weaning journey. And they really get to just hear nuggets of advice that will just make the journey so much easier. I mean, our goal, ultimately with the course and with the book and even these types of podcasts is to allow parents to have fun on this feeding journey with their children. And to cut out a lot of the noise to give them good sound advice. And I think they will find that very valuable along with all the wonderful recipes and meal plans and just the great interaction that they will have with us while during that weaning program.

Meg: So when they do the weaning program, should they join the Weaning Course just before they start weaning? Or can they join when they already have started weaning? What’s your advice?

Kath: Well, I did. Yeah, actually we’ve worked so that they can, whether they do it before they start weaning, but we’ve had many moms come on and have joined it even while they are weaning and have found it so valuable because we talk about so many different topics and concepts over the weeks. And I think at any age it’s valuable, but obviously the earlier the better, and you don’t have to do it on your own.

Meg: Excellent. And do they get time with you as well? Do you answer their questions personally or is it very much just a master classes on video?

Kath: No. So we do have Q&A times where moms can post their questions and we will aim to get as many question as we can. And what’s really nice is that we generally find if we don’t get to all the questions on that day, we are able to post them on the different social media platforms over the week thereafter. So we generally get to everyone’s questions.

Meg: That’s wonderful. Well, moms, if you are thinking about weaning, this course is completely essential.  If you download the Parent Sense App, you don’t have to subscribe to it. The course is not part of the subscription. You actually click on the bottom navigation, you’ll see a little button that says courses, you go on there and you can access Kath’s course directly through there, it’s called Weaning Sense. And it is the kind of really most amazing guide. It’s a five week program that takes you through to introduce your little one onto solids. You get master classes each week and access to Kath’s meal plans, recipes, it is really the ultimate way to wean your little ones. So if you are about to start your weaning journey, this one is certainly for you.

So Kath, it brings us to the end of today. Thank you so much for your time and your wisdom as always. You always amaze me the number of research articles that you are clearly reading through before bedtime every night always fascinates me. You are a wealth of information and I really do appreciate your time.

Kath: Well, thanks for having Meg, it was an absolute pleasure.

Meg: Excellent. Thanks Kath.

Outro
Thanks to everyone who joined us. We will see you the same time next week. Until then, download Parent Sense and take the guesswork out of parenting.