I always get questions from concerned parents about their baby’s feeding patterns.  “When should I introduce solids?”, “how do I know my baby is eating enough during the day?” and “should I do baby led weaning or use purees?” are just some of the questions I’ll be discussing with Malina Malkani, Registered Dietitian.  Have a listen!

Have a listen!

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EVA: (00:04)
Hey there, you’re listening to the My Sleeping Baby podcast, which is all about baby and child sleep. I’m so excited to teach you how you can get your little ones sleeping so that you can sleep too and enjoy parenthood to its fullest. I’m Eva Klein, your resident’s sleep expert, mom of three, founder of the Sleep Bible online coaching program, and lover of all things sleep and motherhood. If you’re looking for tangible solutions for your little one sleep woes or you simply want to learn more, this podcast is for you. For more information, check out mysleepingbaby.com and you can follow me on Instagram and Facebook @mysleepingbaby.

EVA: (00:44)
Okay. Melina, thank you so much for being here today. Why don’t you tell everybody a little bit about yourself and, uh, what you do?

MALINA : (00:52)
Absolutely. Thank you for having me. It’s so great to be here. Uh, my name is Melina Malani and I’m a registered dietician. I specialize in nutrition for moms, the babies and kids, and I’m a single mom, two, three girls of my own. They are in the third, fifth and seventh grade at this point. Um, and I’m the author of the book, simple and safe baby led weaning, and recently came out with a course that’s based on my book. Um, so I talk a lot about starting solids on my ins gram account, uh, healthy mom, healthy kids, um, and about picky eating and about some of the different nutrition related issues that pop up when we are talking about feeding kids.

EVA: (01:34)
All right. So a really common question that I know that people are always asking is the right time to introduce solid food. Uh, you know, the four month mark, the five month mark, the six month mark. And I feel like there have been some really big changes in terms of guidelines over the last number of years. Like I can just tell you personally that when I was introducing solid food to my now 10 year old , um, the guidelines and advice was drastically D from introducing solids to my three year old and the advice that I was getting. So what is the right answer? Is it four months? Is it five months? Is it six months? Is it all of the above? Is it any of the above? Tell us what, what the deal is with this

MALINA : (02:20)
Such a great question and such a source of, for so many parents, because like you said, the guidelines have indeed changed so much over the past several decades. There’s been seismic shifts in the research that have then informed their recommendations. And people also have widely differing opinions on when to start solids, but we now know that there are risks with starting too early, meaning before four months and, or starting too late, meaning after six months. And some of the, some of these risks include type one diabetes and increased risk of type one, diabetes, celiac, disease, obesity, some food and texture aversions and delayed oral motor function. And so at this point, what we know the, the major health organizations, including the AAP, the new dietary guidelines, the world health organizations, they all recommend starting solids at around six months of age when the signs of readiness for solid foods are present.

MALINA : (03:23)
But the tricky part is that word around because we can’t say that every baby is ready, right? At six months, we really wanna be looking for those signs of developmental readiness for solid foods. Those are the biggest indication that a baby is ready for solid foods for some babies, that those are gonna show up, you know, maybe closer to five months for some babies, they’ll show up more around six months. If you have a premature baby, you wanna consider their adjusted age when deciding when to start solids. So what this all points to is working really CLO closely with your healthcare team, your pediatrician, and especially if you have a baby who’s at high risk for food allergies for, for these babies, sometimes an allergist is going to recommend even earlier introduction of top allergenic foods like peanut and egg earlier than six months. And so for those babies, uh, they’re gonna wanna start even a little bit earlier,

EVA: (04:22)
Right? And that’s, um, also a massive change in terms of how we are addressing, um, these foods that are common allergies, right? Cuz I know with my 10 year old, the guidance was okay, no, and I’m, I’m paraphrasing here, right? It’s not exact, but it was something along the lines of like don’t introduce eggs until eight months. Don’t introduce meat until 10 months. Don’t introduce dairy until seven months. Like I got this, you know, very, um, clear cut, like step by step guide. And then by the time I had my now three year old, it was literally like put that all in the shredder and give them anything and everything other than honey. Um, and I know that I happen to have my kids around this very pivotal change in terms of how we approach allergies. Um, and, and it’s funny because you know, when one of the first foods I gave my three year old when he was five and a half months was, was peanut butter.

EVA: (05:22)
Like it was, and it felt mm-hmm , it felt so weird and strange to me because for, with my first two kids, it was like, no, don’t touch, you don’t wanna be touching those foods, you know, until they’re older because of a fear of allergies, when then a few years later, it’s like, no, you actually wanna give them those foods to reduce allergies. Why don’t you, you know, give us sort of an overview of like what prompted those changes and um, and what the approach now is to, um, introducing foods one at a time, or, you know, in a specific order versus, you know, whatever’s on your plate, give them, give them that what’s what’s your advice as of today.

MALINA : (06:03)
Yeah, it it’s so true. It has shifted. There’ve just been these enormous shifts in the research that have informed the recommendations in terms of when to start offering those top allergen foods. And, and you’re right with now 12 year old, the guidance was very different. And at that point, um, they were saying, hold off on introducing those top allergen foods until one to even three years of age, but there had been some really amazing studies. One of them is called the, the leap study, the learning early about peanut study and this study that in high risk babies, um, when high risk babies were offered peanut between four and six months of age. So very early, um, early and often regularly about two teaspoons of peanut butter, two to three times a week, it reduced the risk of their developing a food allergy to peanut net by 86%. Wow. Which is mind blowing

EVA: (07:02)
That’s mind blowing mind blowing. Is this the study that was done out of Israel? Is that, that one? Um,

MALINA : (07:08)
I, you know what, I can’t speak to that. I don’t remember exactly where it was, where it was. Yeah. Um, but this, this study was, was really a landmark study in terms of, um, BA the recommendations on when to offer peanut. And we have really strong, uh, research on peanut. We have strong research as well, um, and growing research on egg and also some on milk. Um, and so the, the advice now in terms of preventing the development of food allergies is to get those allergens in earlier, uh, then especially then in previous, uh, than previous years. Right.

EVA: (07:43)
Um, that’s so interesting because, you know, I’ll tell you, um, cuz I know that there was, I don’t know if it’s that specific study. I know that there was a lot of research that came out of Israel around allergens because you see, and I’m speaking to somebody like I’ve been to Israel. I, myself, I have family that lives in Israel. I’ve been to Israel like over a dozen times, um, throughout my life. And when I was a teenager, I remember, you know, being in Israel and anytime we’d be at, you know, a restaurant ordering something, I have a be, I don’t have any allergies, but you know, within north America, allergies are very, very common. And so it would, would be this like really funny dynamic where, you know, you’d have this Amer you know, the American making these really annoying requests. Is there a Sesame I’m allergic to, I’m allergic to this and the Israeli waiters.

EVA: (08:32)
Like they can’t deal with it because it’s so frustrating for them because in Israel allergies for the most part, or just not a widespread occurrence, why? Because they have this particular product, um, called Bamba Bamba. Yes. You’ve heard about this Bamba. It’s like a peanut butter Cheeto. , that’s what it is. It’s like think of a cheesy, but it’s with peanut butter and culturally people give their six month olds Bamba. And so because of that, you have this culture that, you know, exposes, that’s been exposing, you know, babies to like nuts and peanuts. Um, since, you know, practically the second that they’re able to eat them. And then, and it’s funny, cuz I remember as a teenager, you know, wondering like, gosh, why does nobody in Israel have allergies? Like this is so this is so strange to me that in north America, peanut allergies are so widespread and in Israel they haven’t heard of them. And then

MALINA : (09:31)
I think that fascinating. Yes. And, and then you

EVA: (09:34)
Fast forward another cup and it’s like, oh, well actually the reason why they’re giving their kids Bamba, like what the, sorry, the re the, the fact that they’re giving their kids this Bamba so early on is actually precisely, what’s preventing so many of these allergies. Isn’t that

MALINA : (09:49)
Fascinating? I know. And, and because Bamba is a, it’s a food, it’s a texture that, that baby can manage in the mouth as a finger food early on. Yeah. Because it’s soft and it sort of melts in the mouth. And so, and it’s fascinating to have sort of, um, stumbled upon that and, and figured out that it, it is a preventative, um, way to, to prevent the development of that food allergy. And it’s, it’s helpful to think about in terms of texture when we’re, when we’re thinking about offering and infant safe foods to babies that they can manage in the mouth mm-hmm , um, that are also allergen foods. Um, cause one of the things that I do a lot is try and help people figure out, well, if we wanna get these top allergen foods into babies early on, how can we modify them in a way that the baby can manage and either yeah. Mash down with gums or, you know, mix into a puree or add into a food that they can actually, um, sell feed. Right. So it’s, it’s interesting that Baba just ended up being something that was so helpful.

EVA: (10:48)
Yes, no. And anyone listening, I mean, it’s in north America, I mean, in Toronto specifically, I’ll just say that it’s not one of these products that you can get in like any red grocery store. Um, but if you wanna know where to get them, guys just send me an email and I can send you I can send you a list of grocery stores that I know that, that Carrie Baba and I’m, I’m happy to help, but, um, no, I I’m so glad that we were able to cover this one because I know I even remember my mom freaking out when she heard that, um, that I, I was giving my son JJ, peanut butter, she’s going, isn’t this too early. You’re not supposed to be doing this. And I said, no, like, actually you’re deliberately supposed to be doing this. She couldn’t believe it. But, um, no, it, I, again, it makes sense. Especially given what, what I, what I saw in Israel growing up, how guys like there’s literally no peanut allergies in Israel practically it’s it’s so it’s incredible. Unbelievably rare there. So, um, yeah. Give your kids Bumba that’s that’s that’s what, or, or peanut.

MALINA : (11:47)
Yeah, there there’s lots of ways to make peanut inate. Totally. And I think that’s one of the things that, you know, blobs of peanut butter are a choking hazard. Of course, whole nuts are a choking hazard, but we can take a little bit of peanut butter. We can thin it out with breast milk, a little bit of breast milk or formula, or even some water that we did teething cracker. Yep. Spread a little thin layer of peanut butter on top of that teething, cracker and hand it over. There’s lots of ways to make peanut stirred into yogurt or, or apple sauce if you’re, if you’re going to puree route mm-hmm . Um, but, but I’m glad that we’re talking about this because it is, you know, of course, if you have a high risk baby, you wanna talk to your allergist about a plan for top allergen introduction, but if your baby is low risk, it’s absolutely one is wanna get that peanut in, uh, as soon as you can, after starting solids, after you, after establishing feeding mm-hmm fantastic.

EVA: (12:39)
No, that, that all makes sense. Now let’s shift gears for a second, cause I wanna, I wanna address another really big question, um, that I know I get from Paris and the question has to do, um, the question is basically how do I, I know when my baby is ready to go through the night without eating, how do I know that she’s not waking up hungry? Um, and then I guess the second part of that question would be, if I introduce solids, is that gonna help my baby sleep through the nights? So I’ll let you jam on that.

MALINA : (13:13)
Yeah. Ah, it’s such a, a hard, a hard, uh, time in a, in a, in a, in a parent’s life mm-hmm because we’re so sleep deprived that sleep deprivation is so difficult to go through. The truth is there’s no evidence that starting solids is going to help every baby sleep through the night. Does it help some babies, anecdotally, you’re gonna, you’re gonna hear from different moms different things because every baby is different. Mm-hmm um, some babies, um, when they start solids, they do end up sleeping through the night because they’re growing. Yeah. Um, and they’re just, they’ve gotten to the point where their stomachs are, are big enough to hold enough food and they can get through the night, but babies wake up for all sorts of different reasons. Yeah. They really do. Mm-hmm they really do. So I think the best thing to do.

MALINA : (14:06)
And, and one of the things that I, I love teaching in terms of starting solids and learning your baby is really letting your baby lead the process mm-hmm . And when we’re talking about signs of hunger and fullness, really learning your own baby’s unique cues for hunger and fullness and following those, responding to those as best you can. Um, because you know, that’s something that’s really important as we, when we’re, when we’re starting our babies in solid foods, teaching them to follow their own internal cues for hunger and fullness and strengthening that self, that internal self-regulation system it’s really, really important. And it’s also going to help as they get older and as they feel more settled and start to sleep through the night.

EVA: (14:54)
Right, right, right. No, I, I agree. I mean, I get a lot of moms reaching out with little ones in that four to six month range asking, um, if I think that their baby is gonna magically start sleeping through the night, because they’re now be beginning to introduce solids and the way that I’ve from what I have seen the general answer is no, , it typically doesn’t make, you know, much of a difference. Now, the one caveat that I’ll say is that with the older babies, that might be a little bit different. So in other words, if somebody has a 12 month old who is barely eating any solid food and is still, um, you know, relying heavily on either breast milk or formula to get through the day, then yeah. That baby might wake up at night, um, for a nutritive, you know, reason, because, you know, we do want babies by a year, you know, to be eating a nice amount of solid food. And if they’re not, then yes, it can cause them to wake up hungry. But at the four month mark, if they’re getting a few spoonfuls of carrots, that’s not gonna make any difference in terms of, um, in terms of getting them to sleep through the night. That’s, that’s what I’ve seen anyways.

MALINA : (16:08)
Yeah. Yeah. It’s true. And, and, and the thing to remember too, breast milk, indoor formula are going to be that number one source of nutrients throughout the first year of life. Mm-hmm and when we’re starting about them, or I’m so glad you mentioned this, cuz when, when they’re starting solids, there are so many goals to that process. Nutrition is yes, it’s one of them, but their stomachs are so tiny and it’s, they’re not, and just much at each given meal, there’s so many, they’re still learning how to eat. They’re learning how to self feed. They’re learning how to negotiate a spoon. They’re learning how to choose swallow and breathe all at the same time. This is a, it’s a difficult, um, and that hard to learn. And so, and it takes time. So they’re not really gonna be it’s. I mean, yes, of course some babies will, will ingest more than others, but really they’re exploring a lot.

MALINA : (16:56)
They’re learning about different textures and flavors. They are exploring with hands. They are getting to know different smells and learning a new type of nutrition, a new way of, uh, nourishing themselves when they’ve been on a liquid diet entirely up, up until that point. There’s a lot going on. there’s a lot going on when they start solids. So you’re, you’re absolutely right. Yes. For some babies, when they start solids, will it mean that they sleep a little bit longer and better anecdotally, some parents will tell you yes, but every baby’s different. Right. Um, and for the majority, the answer’s gonna be, no, they’re gonna sleep through the night when they’re ready.

EVA: (17:34)
Right. Or they’re gonna sleep for the night, you know, when, when they learn how, you know, in other words, when we address like the other puzzle pieces that, you know, need to be in place, like for example, yeah. If you have a baby who is over tired because their schedule isn’t biologically appropriate, introducing solid food, even if your little one is eating like full bowls of spaghetti and meatballs, , you know, before going to bed at some point Uhhuh, if he’s over tired, then that bowl of spaghetti and meatballs, isn’t gonna do anything in the name of getting your little one to through the night, because there are multiple puzzle pieces that can get your little, that need to be addressed and need to be properly in place for your little one to sleep through the night. Um, many of whom don’t have anything to do with nutrition. So yes, nutrition is one of those puzzle pieces that needs to be down pat, but just because that’s down pat, it doesn’t negate the importance of any other puzzle piece. That’s how I look at it. Yeah, yeah,

MALINA : (18:34)
Yeah. I couldn’t agree more. Yeah.

EVA: (18:37)
And so what’s your thoughts on this whole, um, I guess the world of, you know, baby led weaning versus pure eyes. I mean, I know that you’re a huge advocate of baby led weaning, but, um, I guess what I would love to know is where, you know, fir first of all, um, it’s interesting because baby led weaning when I had, you know, my 10 year old was like, I, I don’t either, either I had my head in the sand and I was living in, you know, under a rock cause I had no idea what it was like, I just knew what the jars were then and that very, very possible cuz when I had my 10 year old, um, I had just finished law school and I was writing the bar and I was article. So it’s very possible that I was living under a rock, but I also know that, um, it wasn’t nearly as much of a thing as it is, you know, today. Um, and so I guess I would love to know, know like your take on, you know, baby led weaning versus pure raises. Can you do both, can they coexist as one sort of as one approach better than the other would, would love to hear your thoughts?

MALINA : (19:43)
Absolutely. You know, and yes I am. I wrote a book about baby led weaning. I am a huge fan of baby led weaning. There are lots of than benefits. There are, uh, there’s a growing body of research pointing to the benefits, but really at the end of the day, it’s about the baby and it’s about the family and baby led weaning is not right for every baby. There are certainly situations in which, um, it’s gonna be easier for the baby and for the family to start with pures and, and the truth is there’s no evidence that a combined approach is detrimental mm-hmm . And a lot of families that I talk to take a combined approach do feel really good about it and there’s nothing wrong with that. And interestingly, a lot of the feeding therapists and the speech language pathologists that I talk to and work with, tell me that a pretty large part of their caseload are toddlers who were baby led weaning babies.

MALINA : (20:39)
And then they get to toddlerhood. They were never offered pures and then they don’t know how to negotiate that texture. Mm-hmm interesting. Pures are we, we eat pures, you know, we eat yogurt, we eat apples, we eat and soup. Exactly. We eat this. And so I do think there’s absolutely a place even in, in baby led weaning. Um, there should be a place for pures, whether it’s on a pre-loaded spoon. I think that the piece of starting solids, I, you know, I, I wish that we could just put away baby led weaning as a, you know, as a team, if you will pure raise as a team and just focus on feeding babies responsibly mm-hmm I think responsive feeding is probably the most underappreciated concept in infant feeding back out there right

EVA: (21:29)
Now. So meaning, you know, I, I have a niece who is, hell is my niece now seven months, I think. And I know when my sister began introducing solids, um, she pureed, you know, I think some sweet potato for her and then fed it to her in a spoon, but, and she showed us this really cute video of, of my niece eating sweet potato for the very first time where she took, like, she loved it so much that she like grabbed the spoon and tried to like stick it, you know, in her mouth, um, that’s responsive feeding, right? Like that is a baby. That’s saying I want more of this. Um,

MALINA : (22:03)
Absolutely. Yeah. Like

EVA: (22:05)
That’s a very good thing. Right?

MALINA : (22:08)
It’s such a good thing. It’s such a good thing. And it, it is strengthening back to what I was talking about before about that internal self-regulation system. Um, you know, I, I started my career actually working at a, at the Bronx VA hospital in weight management and bariatric surgery. And I was, I loved working with the veterans and, and I was, you know, granted, I was working with a population who was struggling with, um, had, had, had lifelong struggles with, you know, eating, eating when understanding that internal self regulation system mm-hmm, understanding when they were hungry, being able to stop when they’re full mm-hmm . And so in my work and infant feeding find, it’s such a hopeful area to think about raising children, who from the very first few bites of food, we are strengthening that internal self-regulation system where when they’re giving us cues that they’re full, we stop feeding.

MALINA : (23:05)
Um, I think we, we do infants, a disservice, and this comes into play a lot with sleep. We do them a disservice when they’re distracted or when we think they need to eat more. And we’re either, you know, shoving in a bite when they’re distracted or not looking or pressuring them to eat more because we think they need to sleep more or because we think, yeah, because we think it’s gonna help them sleep more because we think they need more calories in them. That babies are really, really incredible. Yeah. At meeting their needs, their caloric needs, their nutrient needs, their nutrient needs. When we allow them to tell us when they’re full mm-hmm and those cues can look different from baby to baby. So that can be a little bit of a learning curve, especially for a new parent is trying to figure out like, what are, you know, is, is my baby just getting fussy and doesn’t wanna sit in my chair anymore or are they really full? And that can be a challenge that we have to learn over time. Um, but the more we can follow those cues for hunger and fullness and let the baby lead the better the, the, the whole outcome, whether you’re doing finger foods, whether you’re doing periods, whether you’re doing both, um, taking that baby led approach is really, really beneficial. Mm-hmm

EVA: (24:18)
Amazing. No, I think, I think that that is so bang on. I think that it gives nuance to this, um, supposed debate of pure rays versus baby led weaning when really it’s not one or the other, it’s just a matter of feeding your baby when they’re hungry and allowing them to be responsive. Right. And show you cues of when they’re hungry and when they’re full and allowing us to respond to those cues. Right.

MALINA : (24:46)
Absolutely. My, my dear friend and an incredible feeding therapist, her name is Melanie pot. She’s at my munch bug. Uh, is that her handle? I can’t remember her handle off the top of my head, but you could, you could pop it in the show notes. All right. Um, she talks about it as she says, it’s a dance, it’s a dance. And so when we think of about it, you know, when you’re, when you’re dancing with someone, you’re, you’re feeling the music and you’re responding to the music. It doesn’t matter if it’s finger food or, or spoonfed or whatever. You’re just responding to the person, to the music, to the situation. And that’s what we do when we’re feeding babies or that’s that’s ideally I think how it goes, it’s a dance, you listening to their cues. Yeah. I love that. I love that.

EVA: (25:29)
I love it. Amazing Melina. This has been so unbelievably helpful. Um, love all this. Where can people find, find more of you, you know, if they, if they want you in your life. Um, I know you mentioned that you have a course. I would love to hear more about it and where people can find out more information about it.

MALINA : (25:49)
Thank you so much, Eva. It’s been such a pleasure to chat with you. I feel like we could do this all day. I’ll have to come back. absolutely topics. Um, yes, I am@healthy.mom dot healthy dot kids on Instagram. I post almost every day about issues related to infant feeding, pediatric Nutri and picky eating. I do have a book simple and safe baby led weaning. And then my course just came out. If you go to baby led, feeding course.com, you can find the baby led weaning course. And then I actually also just released a 12 week meal plan. And this meal plan, if you’re just someone who wants someone that you trust to do all the thinking for you in terms of what foods do I offer when through that whole first 12 week, beginning to babies, starting solids and feeding journey. If you wanna figure out it in this, this meal plan includes both, uh, pures and finger foods, but what food do I offer? When, how do I cut it? How do I texture it? What do I put in it? When do I offer the top allergen foods? How often I just mapped out all of that for you in this 12 week meeting, uh, 12 week, 12 week of meal plan is over 30 recipes and there lots of guidance and it’s only $17. So I figured it was something that would just be super helpful if you just want someone else to do the thinking. Yeah. And that can be found@startbabyledfeeding.com.

EVA: (27:16)
Amazing. And I will post all of this in the show notes for everyone to grab, because it sounds like such helpful resources for, um, not even just first time moms. I feel like that would’ve been so helpful for me the third time around when, you know, feeding was so different than the first time around. And I was very overwhelmed. I was going like, oh my gosh, what, what the hell am I gonna do? So hold on a second. I can just give him a piece. Some my chicken, what, what should I be feeding him now? Am I giving you too much? You know, too much pure a, so that, that sounds like a very helpful resource. Thank you so much, Melina again, thank you everybody for listening in and you all have a wonderful day.

MALINA : (28:00)
Thank you so much. It was a pleasure.

EVA: (28:06)
Thank you so much for listening. If you enjoyed this episode, please subscribe, leave a review and share this episode with a friend who can benefit from it. I also love hearing from my listeners. So feel free to DM me on Instagram @mysleepingbaby, or send me an email at eva@mysleepingbaby.com until next time have a wonderful restful nights.

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