One big question we always get is, “How do you keep lunches cold?” (Shown here are Bentgo boxes that we love! You can find them in our Amazon shop under Lunch.)
Here are some tips from USDA:
Don't forget that these safety guidelines apply to any food out of the fridge, even snacks you send with your preschooler or diaper bag snacks.
Foodie Judy here! Yesterday a member of our Feeding Littles Clients Only Facebook group asked how to teach a child how to swallow a pill, so we thought we’d give you a tutorial here!
Why do some kids need to swallow pills? Some medications only come in pill form or kids may not like/tolerate the liquid or chewable version. Sometimes important medications cannot be crushed or cut. Teaching your child (age 4+) to swallow a pill can be a very helpful skill, especially if they are dealing with a temporary or chronic illness or if they need to take a supplement and it doesn’t come in a palatable liquid, powder, gummy or chewable. (See our blog post for more on supplements.)
Here are our steps for helping to teach your child how to swallow a pill:
Remember that we all develop differently. Some kids are not ready for this at age 4.
A few additional points that we want to add:
Many parents don't realize that It is recommended to avoid or modify choking hazards until your child is 4 - that’s about the age when most kids have adequate oral-motor strength to properly handle these foods. Choking hazard foods are either very hard so difficult to chew, or they're round and juicy like grapes, cherries and cherry tomatoes, which more easily slide to the back of the mouth.
Even if your baby is eating anything and everything well, it's still need to avoid choking hazards. Of course, you as the parent have to decide which foods are best for your child - we just share the info so you are aware of the potential risks.
The most uncommonly known choking hazards are raw carrots and raw apples. We recommend cooking or shredding them with a cheese grater to make them safer.
A short list of choking hazards is below. A complete list with thorough safety explanations and precautions can be found in both of our online courses in a handy dandy printable.
* Gagging is good as long as it improves with time!
Your baby should - and needs to - gag in order to learn how to eat safely.
Let's talk about the biggest source of stress for parents when they start Baby-led Weaning (BLW): the gag reflex. Babies who self feed starting at 6 months have to have larger pieces of food (around the size of an adult finger) that they have the ability to pick up, which inherently leads to a fear that baby will choke.
Major governing bodies and health associations have always recommended offering finger foods around 6-7 months of age, and a recent study suggested that BLW does not increase risk of choking over spoon feeding as long as choking hazard foods like whole grapes and whole nuts aren't offered. However, it doesn't stop parents from being concerned about safety, since most of us are not comfortable with watching a baby gag.
Gagging is not the same as choking. In fact, gagging is good because it means that your baby's body is automatically protecting her airway. You will know baby is gagging and not choking if you can hear sound and if baby is working the food out quickly. Choking does not involve sound (no air = no sound).
Most babies gag frequently for 1-2 weeks when starting BLW. Fortunately, as they get more proficient at lateralizing the food to the side of their mouths to chew it before swallowing, gagging greatly reduces. Essentially, as your baby practices and learns that she can not just swallow whole food, she will gag less as and lateralize/chew more. The more gagging and practicing she does, the less she will gag in the long run.
Instead of fearing the gag reflex, we want to teach you more about what it is, how it protects your child, and how to help your baby learn to chew safely. Our online course Infant Feeding: the Baby-led Way goes into even more detail about gagging and shows you multiple videos of what it looks like!
Coughing and gagging are similar.
Did you know that gagging is considered one of two oral protective mechanisms? The other such mechanism is coughing. So, your baby protects her airway by coughing or by gagging.
Your baby will cough reflexively after the following things occur:
Gagging is a good thing.
We are very comfortable seeing our baby cough, since most of us cough at some point during the day. Gagging, on the other hand, seems much scarier because we assume that it means the baby is choking on food.
Remember, gagging is not the same as choking. Furthermore, gagging is simply a protective oral reflex, just like a cough!
The purpose of the gag reflex is to protect the baby from ingesting items too large to be handled by the esophagus. Think of it like a gate keeper - NONE SHALL PASS!
The gag reflex works by touch-pressure receptors located on the tongue or on the pharyngeal wall. These receptors perceive food that is too large to pass to the esophagus and cause a reverse peristaltic movement in the pharynx. This can also cause a cough. Remember, since it's a reflex, it does it automatically without your baby doing it on purpose.
The site for the elicitation of the gag reflex changes with increasing age, but our gag reflex never goes away - it is there to protect you. You may have gagged as an adult when your throat was swabbed for a strep culture or if you took too big a bite of food.
In a newborn, the gag reflex at the mid-tongue area. As the baby matures, the site gradually moves back to the pharyngeal wall or the posterior portion of the tongue.
As a feeding therapist, if I see a gag reflex that is too easily stimulated, it indicates a hyper-responsive reflex that may interfere with feeding. Conversely, if a gag reflex is not present, the baby may be neurologically depressed and feeding may not be indicated for safety reasons. These children may need to receive nutrition through a feeding tube.
That is why encouraging a child to play in their mouth with toys such as a Fluxy is so important - it familiarizes baby with her gag reflex.
We want to encourage babies to put their hands in their own mouth. (Yes, it seems gross, but it's actually an important developmental step!) Biting down hard on a toy like the Fluxy or another long, safe teether on the area where the molars will eventually arrive is essential. This allows for great oral awareness, developing jaw grading and strength, and desensitization of the gag reflex in a way that most babies allow (because many don't want us in their mouths)!
So, gagging is good, and the more your allow your baby to gag on long teething toys before feeding begins and in the early stages of introducing food, the faster she will understand where her gag reflex is and will learn that food needs to be routed to the back of her gums, not straight down her throat. What's most important is that gagging improves with more exposure to real food.
Furthermore, the more you see gagging, the easier it will be on you. Most parents get really nervous by it when they see it at first, but by a few days in it's much more commonplace...and then baby does it less as she gets more skilled.
How can you help your baby right now?
Let your baby explore her gag reflex as much as possible, and don't be afraid to gently go in baby's mouth (with clean hands, of course!) and feel along the back gum line (where the molars will eventually be). Here's what you can do right now to help your baby with safe eating:
Megan and Judy, co-owners of Feeding Littles, bring you helpful info on food, nutrition, picky eating, and feeding young children. Megan McNamee MPH, RDN is a Registered Dietitian Nutritionist based in Scottsdale, Arizona. Judy Delaware, OTR/L is an Occupational Therapist specializing in feeding therapy with children 3 and under in Boulder, Colorado. Megan and Judy are both moms of two and love helping families develop a healthy appetite for all foods!