Speaker 1: 1:12

Hello everybody, surprise, surprise, welcome to Airway Answers, expanding your breadth of knowledge, and we're kind of doing a surprise live on YouTube and we'll share it with everyone later. We are interviewing the amazing Katie Ferraro. She is a registered dietitian and I'll give her bio, but I'm so excited to talk with Katie today because we're going to be talking about baby-led weaning and this whole philosophy applies so directly and importantly to all of us in the airway field when we're talking about eating natural textured foods, getting our babies off of these processed pureed foods and eating in a natural way which will help the jaw bones grow. So we know, mastication chewing builds and forms bone and most of our patients are deficient in their jaw growth and that is one of the main factors that's caused airway epigenetic problems in the population of patients that we see. So let me talk about who this amazing Katie is.

Speaker 1: 2:13

Katie is a registered dietitian and a mom of seven she's going to talk about that and she specializes in baby led weaning. In 2016, she created the original 100 first foods approach to starting solid foods with baby led weaning. Through her workshops, podcasts, courses and digital content, she's helped tens of thousands of families give their babies a safe start to solid foods using the alternative to conventional adult-led spoon feeding, known as baby-led weaning. Katie teaches families, day providers, healthcare providers how to do baby-led weaning safely, and that's her passion, and she's a nutrition instructor at the University of California, san Diego Extended Studies, and a lecturer in exercise and nutrition science department at San Diego State University.

Speaker 1: 3:04

She loves teaching about nutrition, food and feeding and while working as a dietician specializing in infant feeding, katie's real job is at home with her husband, and she is a parent of seven kids, all age nine and under. So she'll talk about that because I love this. She has a singleton, molly, and she has seven-year-old quadruplets and then she has five-year-old twins. Katie is amazing, so she started baby led weaning with her children, and Katie's work has been featured on CNN, wall Street Journal, nbc News, new York Post, boston Globe, fox 5, peanut BabyList and tons of other places. So Katie welcome.

Speaker 2: 3:49

Thank you, nicole. Thank you for that nice bio. I also, nicole, failed to mention that we're actually in real life friends. I know, nicole, we've been neighbors for actually in real life friends. I know, nicole, we've been neighbors for a very long time, since our kids were little. I remember I met you at a neighbor's house when I just had one baby and I was like these guys are so cool. Because you guys were across the street from your house. You had the baby monitor on. I was like wait, you're allowed to leave the house when they're still in there. And you were like, yeah, you need to lighten up. And I was like, oh, it was like this mom's school. You were totally laid back. You were not endangering our children, but I was like the babies are sleeping and we were checking on them and we were hanging out with adults. It was great.

Speaker 1: 4:23

We had fun. And then I remember when Katie was pregnant with the quadruplets and it was on the news and your story is just so amazing and how you're such an amazing mother to all these kids where I can barely handle my two kids.

Speaker 2: 4:42

I'm a yeller which I think the airway people will appreciate. I'm really good at projecting my voice and my kids like stop yelling so much. So I'm really working on not yelling right now. So that's my, it's my Lenten goal as a Catholic mom.

Speaker 1: 4:51

Oh man, oh man. Well, I want to hear all about like. I think some of our audience knows a little bit about what baby led weaning is. Some people have maybe never heard of it, but I honestly thought of you right off the bat when I was looking on Facebook a couple of weeks ago and one really well-known orthodontist in our field is showing all the pictures of the baby led weaning that she's doing with her two little kids, and I'm like we need to get this word out to all dentists, orthodontists, people in our field. So tell us all about it.

Speaker 2: 5:20

Well, it's kind of wild because it is the healthcare practitioners who are actually doing this approach with their own babies. That's really changing the narrative. Now there is a real, incredible body of evidence that supports baby lead weaning as a safe and reliable alternative to conventional or adult-led spoon feeding. Right, what I call, you know, force feeding your baby by spoon. When you see the pictures of the babies going like this, that is not a healthy, wholesome way to start solid foods. And yet over time, you know we've had speech language pathologists and pediatricians who are like oh, I don't know about baby-led weaning. It sounds like they're going to choke or it doesn't feel like they're going to get enough nutrition. And then they do this process with their own children. They're like oh wait, hold up.

Speaker 2: 6:01

Force feeding babies by spoons or making them suck purees out of pouches is not developmentally appropriate and babies can eat so many more foods than we give them credit for, but we have to wait until they're truly ready.

Speaker 2: 6:13

We also have to prepare the foods safely.

Speaker 2: 6:15

So that's what I do in my line of work as a baby-led meaning dietician is to help parents, caregivers, healthcare providers, daycare providers learn how to properly prepare food so that babies we can set them up for success, so that they can safely feed themselves, so that they can become independent eaters, that they can achieve diet diversity and that we can avoid that like super obnoxious stage of parenting where your kids reduced down to just a few foods that they'll eat, where you're making different meals for different kids.

Speaker 2: 6:42

Baby led weaning has so many benefits which we can get into in this interview, but it also takes a lot of pain away. So I always say I like to take just like one thing off of your plate as a parent, okay, which is having to force feed your kids or play the airplane or the choo choo train game and fight and battle at every single meal, because I hate to break it to you you need to feed these small people for the next like 17 and a half years of their life and multiple times a day. So like it is worth it to do the hard work on their babies when they'll like and accept a wide variety of foods and flavors and tastes and textures, and baby led weaning allows for all of that. So I just love to hear speech, language pathologists, occupational therapists, our colleagues in the dental world, other dieticians embracing this approach and realizing like, oh yeah, and there's research to support it. It makes a lot of sense.

Speaker 1: 7:29

This is so great because I wish I did this approach with my kids. I have one kid who is an extremely picky eater, and when you said you don't have to make different meals for each person in your family, well, I'm doing that and it is so difficult and frustrating and I feel like we almost like miss that gap of like that where a child's very plastic and malleable and open when they're really little and when you start like feeding into their specific needs and not giving them the diverse foods, they lose that ability to really even want to explore foods. What is baby led weaning? Is it actually the types of food you're giving them or is it that they're feeding themselves?

Speaker 2: 8:08

That's a wonderful question. I remember the first time my colleague told me about baby led weaning. It was when my quads were in the NICU and like friends would come and help feed the babies. And I remember her saying like oh, how's it going with your oldest back at home? And I was like it's terrible. I'm trying to feed her solid food. She hates them, she hates me, she only wants infant milk. I'm like failing her Cause you know what kind of mom can't feed her own baby, and then what kind of dietician mom. And I remember thinking like how am I going to feed these four babies when it's time to eat food, when I can't even feed the one that I have at home? And my colleague said, well, why don't you do baby led weaning? And I said baby linguine, what are you talking about? I don't even know what this is. She said, oh, it's this relatively newish approach.

Speaker 2: 8:47

So the term baby led weaning was coined by Jill Rapley. She's a PhD health visitor from the United Kingdom and what she realized? Like in the UK a lot of the work that pediatricians in the US do, the health visitors do there. They travel around and check on how the family is doing and the mom is doing postpartum, like someone checking on you to see how you're doing, like it sounds amazing. And what she realized when babies were starting solid foods that all of this food rejection and food refusal and having to force the baby to eat puree so they get enough. It's not that the babies disliked the food, they disliked the feeding being done to them and so, as a philosophy, what baby led weaning does is it supports your baby's ability to safely feed themselves from their first bites. Now you have to wait until they're truly ready and we can talk about what the reliable signs of readiness to eat are. But Jill Rapley is the co-author of the original baby led weaning book, which came out about 20 years ago.

Speaker 2: 9:39

At this point, and I remember when we were starting baby led weaning with the quads, I was like OK, I looked into it I'm a college nutrition professor and at the time I was teaching at UCSF and my colleagues in feeding I was like research and evidence that supports this. So we went all in on it with the quads and it was such a more positive experience for starting solid foods. I remember my mom kind of snarking on it a little bit. My mom's a dietician and she was over at our house in our old neighborhood where I lived, by you, nicole, and she's like you know, these babies are eventually going to have to learn how to use a spoon. I was like, yes, but feeding is about bringing objects to your mouth and babies do that with their hands first. And I remember her catching her on the phone a couple of days later and she was talking to her friend like oh my gosh, you should have seen the babies. They're eating sardines by themselves and they're eating beets, and it's like it literally makes everyone's life easier. You don't have to make special foods, you don't have to buy baby foods, you don't have to make different foods for different kids.

Speaker 2: 10:35

And this was such a transformative experience for our entire family that I actually switched the entire emphasis of my career to focus exclusively on baby-led weaning. And what happened kind of at the same time was I realized, as the quads were turning one I just counted their foods that they had tried over 100 different foods. And if you look at conventionally adult-led spoon-fed babies so puree babies, babies who have been force-fed by spoon they usually have at most 10 or 12 foods by the time they turn one. And you know, all feeding professionals know, once you cross over that one-year mark, picky eating is developmentally appropriate. Your toddler is going to be a picky eater. But if you only have 10 or 12 foods and you lose those 10 or 12 foods to picky eating, that becomes a very challenging child to feed. But if you have a hundred foods that your baby can eat and you lose 10 or 12 of them to picky eating, it's no big deal because you still have 85 or 90 foods the child will eat.

Speaker 2: 11:24

So that was kind of when this whole idea of my hundred first foods program was born, because we were sharing a lot on social media at the time which I now realize is probably oversharing. But parents were like wait, how do you get all the babies to eat these foods? And like you don't have to buy baby food and they're eating real food, the rest of the food you're eating. So I turned this idea into a digital program, the 100 First Foods approach to starting solid foods. It's taken off around the world.

Speaker 2: 11:47

It is so fun to see you know parents in Singapore, parents on the African subcontinent, feeding the cultural foods that they eat, but preparing them safely and then offering to their baby and skipping over the spoon feeding phase, like you're literally avoiding the pain and everybody wants their children to eat real food. It's just shoving processed baby food down their throat. You know, the idea of commercial baby food has really only been around since the earlier part of the 20th, 21st century. It's like the 20th century, rather, but it's like what do you think? Cave mama fed cave baby. Before there was like a whole aisle of pouches at Target. Babies have always eaten modified versions of the same foods that the rest of their family eats. So in a way, I feel like we're just helping parents to do the thing that we used to do before. We complicated everything with commercial baby food.

Speaker 1: 12:28

It's so true and like, even looking back, like there was a there was a period where women weren't really breastfeeding their babies and now I feel like there's a trend to go back and like nursing. We know it's so important, so I feel like more mothers are nursing babies now. But back in the day, that's how there was good jaw. Growth and development was before the pre-industrial revolution, when foods were not processed.

Speaker 2: 12:51

And now we have the other day, that book. Jaws, have you read this book? It's like all about how, like not I'm sure totally up your alley, but like someone sent it to me and I'm like this is fascinating, just sucking on queries, we're not developing our jaw strength.

Speaker 1: 13:04

Exactly, and that's exactly where we come from. In our airway focus field is that a big lack of what's occurring or what's not occurring is eating textured foods, chewing on foods, and this is literally one of the hugest factors to the decline of health in human beings. It sounds crazy, but as our jaws are not growing enough, our teeth are crowded, our airways are crowded and everybody is developing health issues. Not everybody, but a lot of people are developing health issues from poor breathing and poor quality sleep because our tongues are basically choking ourselves, and then that leads to an array of health issues like high blood pressure, diabetes, all these things. So if we can start young and get these kids using their jaw muscles, using their tongues, moving around versus sucking on pouches, we can probably change the outcome of health, and I this idea.

Speaker 2: 13:58

I have a baby led weaning podcast and I need you to come on and explain this because this is you know. I think like, okay, you're an SLP, I know your background, you're in the airway space, but we forget about how much is happening in the mouth, right, like we have, you know, pediatric dentists on and they're like it's tied to nutrition, it's tied to sleep, it's tied to chronic disease development and, again, you don't want to stress parents out. It's like if you feed your baby the wrong way, they're going to grow up to have sleep apnea and obesity. But it's like kind of true, and if we can make changes and improve the way we offer solid foods. When you said, I love that you use the word plastic, like babies are this malleable form. Like I love feeding babies, nicole, because they do not talk back to you. Right, big kids like ah, I don't like your pancakes, you burned them today. Babies will eat everything.

Speaker 2: 15:02

And I love you because you brought them new foods and they're exploring it and they're eventually going to learn how to eat it. They don't learn how to eat a hundred foods overnight and wholesome food doesn't magically appear on the table. As parents, we do have a role in making these foods and some parents are like I just don't want to deal with it. But it's like hey, you got to feed this person for the next 17 and a half years of its life, so you do have to learn how to make the food safe.

Speaker 2: 15:22

And an interesting thing about baby led weaning it's one of the few things that appeals to a second time parent Cause, like you know, first time parent member, you registered for everything and you bought like all this crap that you're like dude, they only need like three things like a diaper, a safe place to sleep and some food. Second time parents who did force feeding by spoon with their first and have a picky, eater child, they are looking for an alternative and they are willing to try baby led weaning with the second. And they are the biggest advocates for baby led weaning because they're like my second or third or fourth or whatever kid eats this huge variety of foods because we taught them how to do it and let them experiment with it during that flavor window, that brief period of time when babies will like and accept a wide variety of foods and flavors and taste and texture. So, even if you feel like you've failed yourself on your oldest kid, baby led weaning for subsequent children has been really, really transformational for families that we've worked with.

Speaker 1: 16:13

That is amazing. So what? When does the baby led weaning start? And what you said there's during the age, we know foods are safe. Can you talk about that?

Speaker 2: 16:21

So one thing, when you were just mentioning earlier, like if you think historically you know breastfeeding recommendations right as much as they have altered and dipped and dived and changed, like right now across the board, every major health association promotes exclusive breastfeeding for the first six months of life. That's the point that I want everyone listening to really just put in the back of your, if you walk away with nothing else from these two crazy ladies talking to each other. Six months of life, infant milk, breast milk or formula is sufficient to meet your baby's needs for the first six months of life. So from a nutritional standpoint I'm a dietician, this is my wheelhouse your baby doesn't need anything except infant milk. So when doctors and they do it all the time say things like start feeding your baby purees or rice cereal at four months of age, I maintain that that's an anti-breastfeeding message. You are telling mom there's something wrong with your breast milk. There's something wrong with the way you're formula feeding.

Speaker 2: 17:18

You should start solid foods early. We know nutritionally they don't need it. From a developmental standpoint, our occupational therapist friends will tell us your baby is not sitting relatively on their own until six months of age. And if you can't sit on your own. You're not indicating that you have the trunk strength and the course, the neck, the head and neck control to support a safe swallow. So if you don't need it nutritionally and you can't safely swallow it, we shouldn't start solid foods prior to six months of age. Full stop, end of story.

Speaker 2: 17:44

There is no benefit to start solid foods prior to six months of age. Full stop, end of story. There is no benefit to starting solid foods early. There's only the increased risk for choking. Okay, and a baby has a choking incident when they're four or five months of age.

Speaker 2: 17:54

Guess what? When you bring them back to the high chair at six or seven months and they're truly ready, they remember that. And then they have food refusal, and then they have food aversions and they're in feeding therapy. And my feeding therapy colleagues many of whom are your colleagues will tell you the vast majority of what they see in feeding therapy in toddlerhood could have been prevented if the parents allowed the baby to feed themselves when they were truly ready.

Speaker 2: 18:15

So we need to look at the reliable signs of readiness to eat and it all starts with waiting until your baby is six months of age, or six months adjusted age if they were born prematurely. So if that's a term you're not familiar with, I'll give you the example of my quadruplets were born six weeks prematurely at 34 weeks gestation, when they were six months of age. We have a common friend, nicole, who came over to our house and was like you need to feed these babies. And I was like, first of all, they're not six month olds because they were six weeks early, they're like four and a half month olds.

Speaker 2: 18:43

I needed to wait until they were six months plus six weeks. They were seven and a half months chronological age before they were even starting to sit on their own. And you can bet I was getting it in stereo you need to feed the babies. That'll help them sleep through the night. It'll help their reflux go away. It'll help them gain weight, catch up weight. None of that is true. A baby can't use food to grow faster if they don't yet know how to eat food. So waiting until that six month or six month adjusted mark. The second one and I touched on it earlier but being able to sit relatively independently. It doesn't have to be perfect, but if they're slouched down and slumping down, you're an SLP, you know you're going to safely learn how to eat avocado if you're hunched over like this?

Speaker 1: 19:21

Absolutely not.

Speaker 2: 19:23

Waiting until they can sit relatively on their own. Those are the two most important points. And, spoiler alert, most babies cannot sit relatively independently right at their six-month birthday. It'll be six months plus one week, or six months plus two weeks, or even six months plus three weeks. It is unusual to see a full-term, typically developing baby who, after the seven-month mark, is not sitting on their own. If you got to that point, you should check in with your primary care practitioner. Do we need a referral to OT? Just is something going on?

Speaker 2: 19:47

Sometimes, right around seven months, they're sitting up strong enough to then sit in the high chair and start being able to learn how to eat. But again, it doesn't happen overnight. It takes almost six months for babies to get proficient in feeding themselves and be able to get most of their nutrition from food. And that's our goal with nutrition is that by 12 months of age, most of the baby's nutrition is coming from food. And that's a long way to come because at six months of age, 100% of your nutrition is coming from infant feeding. So that six to 12 month mark it's so crucial, but you're so lucky because that's the period when babies will like and accept a wide variety of foods if you know how to offer them and prepare them safely.

Speaker 1: 20:20

Yes, and when you said 100 Foods first year, it's actually.

Speaker 2: 20:29

they have about six months that you've just introduced 100 Foods, because they've only, yeah, six months and it works out. I'm a symmetry person, so what we do is in our 100 First Foods program, you introduce five new foods a week. So on Monday we do a new fruit, on Tuesday we do a new vegetable, on Wednesday we do a new starchy food, on Thursday we do a new protein and on Friday we do a new allergenic food. Five new foods a week, four weeks in a month. So 20 foods a month. In five months.

Speaker 2: 20:54

Your baby has eaten 100 foods. And again, that diet diversity. That's what takes them into toddlerhood, with ability to eat a lot of different textured foods, right For families that eat animal foods. We're doing meats, we're doing plant proteins, we're doing high fiber whole grain foods, not supplements, not Metamucil, not refined white carbs, real, wholesome foods that are affordable, that are accessible, that give you this huge variety of like. Oh my gosh, my baby can eat all these foods. It also helps the adults sometimes broaden their palate as well and try new foods.

Speaker 2: 21:25

And I have a hundred first foods list that parents put on their fridge and they cross them off as they go, because I think fruits and vegetables are important. But if you're only feeding your baby fruits and vegetables. There's no iron in there, you're missing out on a lot of the fiber, you're missing out on other nutrition like zinc, you're missing out on the protein and fruits and vegetables alone. Man cannot persons cannot live on that, so we need the whole grains and the texture opportunities that you offer. When you do this, you know better than anyone, so much better than just having those. You know soft multiple carbs or the pureed foods that require absolutely no participation by the baby, and we love to help our babies, but we need them to help themselves. By developing that jaw strength and moving through a hundred different foods really gives you incredible exposure to that.

Speaker 1: 22:10

Yeah, I think your babies might eat more foods than I eat. They might have a better variety than I do, but so it's a combination. It's not just about the nutrition that's being introduced with a variety of foods, but also the mechanical aspects of the chewing and the swallowing and the different textures. So what does that look like? Like when the baby is about six months old, they're ready to sit up. You kind of feel like you have the cues to start baby led weaning. What does that first day or whatever, look like?

Speaker 2: 22:37

It's brutal because they don't really eat anything right, and that's typical. So my Instagram is baby led wean team and all we do is make reels all day long. I'm like this is what it looks like when babies are sitting up. Here's how you safely prepare the foods. But also, spoiler alert, they're not going to eat that much but and parents will get discouraged, Like I made lamb on day four and I made this beautiful lamb leg and it was soft and shreddable, like you said, Katie, and had all the low sodium broth for extra moisture to help them swallow safely, and they just splashed around in the mat with it.

Speaker 2: 23:06

Guess what? Learning how to eat is a full sensory experience. Getting messy is actually part of the experience. They need to touch it and smush it and taste it and smell it and stick it in their ear and in their hair and eventually they bump into their mouth and they get in there. Oh, that tastes different, oh, that's different. And you know, they, you, the SLPs, you guys know about the munch chew and then the rotary chew and then moving the food to the back of their mouth. It it doesn't happen until they've had lots of experience even getting it to their mouth, and so in our experience we found that it takes most babies about eight weeks before they get the hang of feeding themselves, and this is in offering solid foods one to two times a day.

Speaker 2: 23:42

So if you're just starting solid foods or you're counseling families who are. My suggestion is one to two times per day, about 20 minutes, that's typical. And the goal is not to get enough nutrition in the baby and my dietician friends, we're like so type A and all we worry about is, oh my God, the baby's not getting enough nutrition. Yes, they are. The baby is continuing to get the majority of their nutrition from breast milk or formula, especially during those crucial first eight weeks when you're like, oh my gosh, nothing's happening.

Speaker 2: 24:10

Yes, every single day they're making micro steps of progress to pick the food up, to smush it, to use their whole hand, their palm or grasp to rake and scoop the foods up. In baby-led weaning we don't cut the foods very small. That's a choking hazard. A six and seven month old baby who doesn't have their pincer grasp can't pick up small pieces of food. And even if they did and got it in their mouth because mom puts it in their mouth, that very small piece of food, that's the exact size of food that could potentially occlude their airway.

Speaker 2: 24:34

So we do the longer pieces of food shaped about the size of your adult pinky finger. The baby uses their whole hand or their pal or grass to rake and scoop the food up and put it into their mouth. Putting anything in a baby's mouth, including a spoon, can be a choking hazard. So we have to prepare food safely, position the child safely in the high chair and make sure that they're really ready to start solid foods. And even when you do, it's real slow but you stick with it for eight weeks. Parents always come back and they're like okay, you're right.

Speaker 2: 25:02

At about the eight week mark, it all started to click. Then you're dropping a milk feed, then the baby bumps up to two to three times a day. Now they're trying all the different textured stuff and they're moving it around their mouth and they're starting to swallow some of it and you're noticing oh my gosh, less nutrition from milk, more nutrition from food. That's what weaning is. But it doesn't happen overnight. Okay, and you get that. Six month, I call it the runway. Okay, and you get that six month I call it the runway, okay.

Speaker 2: 25:26

Also, I call it like preseason and my husband's like please stop making sports references. You're terrible, but like, remember like when the Chargers were in San Diego and you buy season tickets. You'd always like get the season tickets to the preseason and you go watch and be like, oh my God, this is like so ugly and eat. It's like it looks like nothing's happening, but they're practicing and getting better so that when the season opens, when your baby turns one, most of their nutrition can be coming from food.

Speaker 1: 25:51

I like that. I totally get that. The preseason practice.

Speaker 2: 25:54

Thank you.

Speaker 1: 25:55

Nick turn one, tell your husband he's wrong, because that is so great. And I love how you talked about sensory experience. Okay, so we're talking whole body in terms of, like PT, physical core strength to sit up. We're talking about fine motor of the hands, oral sensory motor, and in one of your podcasts you have the best podcast too. We got to talk about that at one point. I think, everybody should take a moment. What is your podcast called? Can you tell everyone, baby?

Speaker 2: 26:21

Led Weaning with Katie Ferraro. It's blwpodcastcom and we're I mean, it's a little insane we're over 450 episodes at this point, but it's like there's so many little teaching points to talk about and people love it, so it's a great source of information if you're interested in learning for Baby Led Weaning and it's all free.

Speaker 1: 26:36

It's so good, it's free. And not only does Katie talk all about her programs, different ideas, there's tip of the day, all this stuff but you also interview all these other amazing people OTs, pts, slps, it's MDs, all different people. It's so great One your podcast. You talked about how when the baby starts, the food might like milk or whatever might drip down the side of the mouth, and when you start introducing like liquids and open cup I think I was listening to the open cup. I'm drinking one and the tendency is like to want to wipe it off, but no, it's really important for the liquid or the food to remain on the mouth. So the baby gets that sensory experience right. Can you talk about that?

Speaker 2: 27:13

Well, and it's the SLPs who are so important in this field. So one of my good colleagues is Dawn Winkleman. She's a speech language pathologist. She's on social media at Miss Dawn SLP. She's also the feeding expert for the feeding gear company Easy Peasy, so I work very closely with them. I know a lot of SLPs OTs will use their products in feeding therapy. They're also great for babies who are starting to learn how to eat solid foods.

Speaker 2: 27:35

Suction silicone, 100% silicone mats and bowls appropriately sized utensils instead of, like you know, a baby spoon that has a long handle and a big old bowl Like that's not appropriate for a baby short, fat, round handle a very small bowl that doesn't cover the entirety of the tongue and basically cut off. You know all the SLP stuff, the airway stuff like we need to have the right tools. And so Dawn, who developed the tiny cup, we both used to use plastic shot glasses for open cup practice because there wasn't a good baby led weaning cup. So they developed the tiny cup from Easy Peasy. It came out in 2018 and it's a two ounce cup. So we help babies practice drinking out of the open cup because we want your baby to go right from the breast or the bottle to an open cup. Right, you can skip the sippy cup, and one of our most downloaded episodes is called six reasons to skip the sippy cup, and SLPs love it, dentists love it, dietitians love it, cause sippy cups were designed by parents for parents. All they do is promote spills at. Prevent spills rather, and nothing else. It's not developmentally appropriate for your child to gnaw on a plastic top Like I know. Your baby knows how to swallow liquids. We're working on having them eat solid food. So this open cup practice and, you know, letting that milk dribble down the side of them, that feels gross, right To have, like milk in your neck folds. You guys have all experienced this with your own babies, but like that sense of discomfort. Next time they go to pick the cup up, they make a slight micro correction so that the milk eventually doesn't dribble down the side of their mouth.

Speaker 2: 28:53

Ideally, your baby can be drinking out of an open cup on their own with no assistance, albeit with minimal spillage, by 12 months of age. So we encourage families to start open cup practice around the six-month mark. I know you have a million things to do as a busy parent. It's just five minutes of open cup practice after meals, starting around six months of age. We start with thicker liquids which are safer and easier for your baby to swallow because they're used to the thicker consistency, like breast milk and formula. If you start with water, which parents love because it's not messy, water is a thin liquid and water can cause babies to gag excessively and a little bit of gagging when you start solid foods is very typical. But we don't want to make the baby gag by trying to force them to drink a thin liquid. By the way, babies don't need free water because they get their hydration and fluid needs from infant milk. But we also don't want them to gag excessively because then they'll start to have negative associations with food and feeding and drinking. So we start with those thicker liquids five minutes a day, with the goal being of drinking out of an open cup independently, albeit with some spillage, by age one. And it really helps cut back on excess milk consumption because talk to any mom or parent caregiver of a one-year-old.

Speaker 2: 29:55

The two biggest problems are milk and snacks.

Speaker 2: 29:58

Kids that are full of milk allowed to drink 30, 40 ounces of milk. Parents are like milk's good. Well, they have little tiny bellies and if they're constantly full of milk, they're never going to experience what I call the casual hunger that they need at mealtimes. Right, we want our kids to feel a little bit hungry when they come to the table. That's what freaking makes them eat the food that you've so lovingly prepared for them, and then the snacks for the other problem, like constantly grazing throughout the day and never allowing the child to experience that casual hunger completely sabotages mealtime. So, open cup drinking parents like, oh my gosh, but they drink so much less than out of the bottle. Yeah, duh, that's the point. So they drink less milk and get more nutrition from food no-transcript Like. But you know what it always says it's dentist approved and parents find it at Target. How could they possibly sell this at Target if it's not appropriate? Like, almost all of the feeding gear they sell at Target is not developmentally appropriate just so everybody knows.

Speaker 1: 31:11

Yeah, when I went, realized all of this stuff and started looking only for free flow bottles. Even for my kids now, elementary school age, whatever age at a young age, we want all drinking to be free flow with no sucking required to get a liquid out. Well, the wild cup or that 360 cup requires sucking. But I go to Target and I'm in there looking at all the water bottles that they make for any age, even for adults. Everything 99% is sucking. You need to suck to get the liquid out. Well, that damages it, overworks the cheek muscles, can narrow the palate. So I have a whole picture list of different water bottles that are free flow, that are appropriate for like myosalchial purposes.

Speaker 2: 31:52

Oh, I need to get that from you. I know because these kids drinking out of these kids at school with the Stanley cups and the straws are this long. You can't hold your breath for that long when you're like two and three years old and they want to drink out of these long freaking straws.

Speaker 1: 32:03

And they're chewing on them and then the straws boil on top of the tongue, promoting low forward tongue posture, and you know we should be swung with the tongue up on the palate. So yeah, so I love that small open cup that you talk about, and in that podcast it was a really great analogy. She said you know, you want the baby to wrap their hand around the cup without not without having handles. And I think it was Dawn who related to, like when you go to drink your coffee, what if you had two handles on your coffee cup? And now you're trying to drink your coffee with two handles, how do you expect a baby's going to drink? I'm like, oh my gosh, I don't think I'd be able to drink my coffee if I had, like, a double hand. I know.

Speaker 2: 32:39

Or think about the 360 cup, right? Same concept. I remember getting that from Target being like I guess this is what my oldest drinks after a bottle. I don't know Like they sell it at Target, like they like conditioned and trained me to be like this is next. Like no pouches, aisle all the baby food. You don't need it. But with the cups you have to push the top of that down with your upper lip and then suck with your lower lip.

Speaker 2: 33:05

That is not the mechanism that we want babies learning. And at the same time, parents are like well, I'm also trying to do open cup drinking. I was like this is so stressful to your baby to try to learn like four different ways to drink. Like keep it simple, stupid. It's like just for me. I love the Easy Peasy feeding gear because it's so simple and it's like this is appropriately sized for your baby's age and stage. And I do love that they have an SLP, a feeding expert, who designs their products, because they are very thoughtfully and intentionally designed, where most of the stuff in the feeding space is like made out of crap materials and developmentally inappropriate.

Speaker 1: 33:34

Yeah, a lot of plastics. So at what point are utensils introduced in baby-led leading approach?

Speaker 2: 33:41

Great question. There is no fork milestone for babies prior to 12 months of age. So whenever you see a little set that has like a baby fork in it, forget about it. They're just selling you crap. You don't need Some of these products. They say they have a choke guard on it. There's absolutely no data to support that idea. Your child will use their hands to learn how to eat first.

Speaker 2: 33:59

As far as spoons go, you can start introducing a spoon as early as six months of age, and a lot of times people mistakenly think that baby led weaning just means skipping purees. It does not. Purees are a very important texture for your baby to master. It's just not the only texture they can eat. So we can honor the self-feeding principles of baby-led weaning and still offer naturally pureed foods like oatmeal or full-fat whole milk, yogurt, unsweetened applesauce, and we do that using the pre-loaded spoon technique. That's a term that Dawn Winkleman coined, so I want to give credit to her as an SLP and a baby-led weaning expert.

Speaker 2: 34:31

The pre-loaded spoon approach you dip, as the caregiver, the food in the baby weaning spoon. You put it in your baby's hand. You do their hand underhand approach and gently guide the spoon to their mouth. They get the hang of it very quickly. You guys, your babies, have been watching you eat for the first six months of their life. They, they figure out what it's supposed to do. And then the next step is you preload the spoon and you lay it on the side of the suction mat or bowl and the baby goes with their whole hand. Pomergrass picks up the short fat round handle of the baby-led weaning spoon and brings it to their mouth, and then around eight, nine, sometimes 10 months of age babies will start dipping and scooping on their own. And then, as you roll into the 12-month mark that's when we introduce the fork is starting at 12 months of age.

Speaker 2: 35:11

So focus on the spoon from six to 12 months of age. Most babies are bringing the spoon, doing their dipping and scooping pretty proficiently by the time they turn 12 months, but not if they haven't been allowed to practice. So practice makes progress and letting your baby experiment and explore the spoon, knowing that they're not going to be super proficient at six months of age. But a lot of babies who start at six months of age, when they're showing those other reliable signs of readiness to eat, by the time they're nine, 10 months of age, they're using the spoon pretty proficiently. They're drinking out of an open cup and they've turned the corner now where most of their nutrition is coming from food as opposed to milk. They're rolling into that one year mark with the goal being to get most of their nutrition from food, and that's when we can wean off of formula and onto cow's milk or continue breastfeeding beyond one, if you'd like to, but just acknowledge that at the oneyear mark, most of baby's nutrition can be coming from food and milk provides just a small amount of that.

Speaker 1: 36:00

That's a great summary. So that one-year football feeding season starts Like they're ready. That's right, Okay. So a lot of us work with special needs kids, right? Kids with tongue tie, lip tie, Down syndrome, low tone, all these other issues. Can you talk about how baby-led weaning plays into those children's development?

Speaker 2: 36:19

100% the adapted baby led weaning approach. I highly encourage you to check out the work of Jill Rabin. She's a speech language pathologist out of the Illinois area. She coined the term adapted baby led weaning. When I started a baby led weaning I remember there were lists of oh, here's all the conditions or diagnoses that were baby led weaning doesn't work. I have personally worked with, as have my colleagues, every single one of those conditions, with the exception of a fully tube fed baby. There is no condition in which a baby cannot learn to feed themselves and Jill Rabin, part of her adapted baby led weaning approach, is promoting this philosophy and doing it with research and doing it with credentialed feeding experts to show that all children can and do deserve the right to learn how to feed themselves and do not need to be force-fed. So the Adapted Baby-Led Weaning Approach, ablw.

Speaker 2: 37:08

Jill Rabin recently wrote a book. She co-authored it with Jill Rapley, the co-author of the original Baby-Led Weaning book. Jill Rabin, for sure, is the leader in adapted approach. She works primarily with babies with down syndrome, and so she she talks and educates and teaches a lot about how the timeline might look different, but there are also some other nuances for helping these babies learn to feed themselves. It's not just simply, oh delay, and then they'll figure it out on their own. We know that that's not true, but she has some amazing approaches, so I would defer to her. I have a couple of interviews with her, but she's again online.

Speaker 2: 37:42

Jill Rabin, adaptive Baby Led Weaning and the Adaptive Baby Led Weaning book is a fantastic resource. It's very cutting edge and new too, because we need to stop perpetuating this idea that certain types of babies with certain disabilities or diagnoses can't or shouldn't be allowed to learn how to feed themselves. All babies deserve the right to learn how to eat, but we need therapists who are certified in this. So I'd really encourage you to look into Adapted Baby-Led Weaning and Jill Rabin if you have the opportunity to.

Speaker 1: 38:08

So I listened to one of your podcasts recently with Jill Rabin, which was great. So again, everybody, you've got to download Katie's podcast on baby line weaning and pick whatever top is. There's 450.

Speaker 2: 38:20

I'll send you the ones about adaptive, because I think for your audience that really is the most important. I work primarily with typically developing quote unquote normal nutrition, but I have covered every single condition possible that used to be on that list Cleft, lip cleft, palate, down syndrome, babies with cerebral palsy, babies that have had lip and tongue and cheek ties. There are some adaptations, but we can't just say, oh, they need to be force fed by spoon in order to get their nutrition. That's not true, that's lazy.

Speaker 1: 38:47

Yeah, they need it more or just as much, because if there's low muscle tone or decreased mobility of the tongue, it sounds like this approach will need to be modified in certain ways by a therapist, you know, with a guiding hand. But those are the ones that are going to need that extra muscle use movement. We don't want to deprive them of the ability and the opportunity to strengthen their oral facial muscles by not giving them these types of foods. So your podcast with Jill Raven was really great and she talks about lip and tongue tie. On there, which a lot of our population works with patients who have lip and tongue tie, and she covers a lot of that and she says her and Jill Rapley have been now lecturing all around the world. Oh yeah, they did into Portuguese or I forget what other language.

Speaker 2: 39:33

It was like Polish the other day when I was talking to her, but there it so important too, because actually I did an episode with Jill Raven, who I'm friendly with, and actually met her in person the other day in San Diego, which was cool, because you're like friends with these people online for years, san.

Speaker 1: 39:44

Diego.

Speaker 2: 39:45

We met in person. I know I should have called you. I didn't think about it. Oh, you're so sweet we were talking about.

Speaker 2: 40:04

Oh, she came on the podcast to talk about why speech language pathologists don't believe in baby led weaning. It's this old idea and it's not the younger not to be ageist. I'm older than probably most of the people that have young babies. The younger generation of SLPs are like hold up. There's a real incredible body of evidence that supports this approach. I'm going to try with my own babies and they're like oh well, in SLP school they taught us that like it increases choking.

Speaker 2: 40:15

Well, here's all the research that shows there's no higher risk of choking when you start solid foods with a baby led approach compared to conventional adult led spoon feeding. But here's the kicker that only holds true when parents are educated about reducing choking risk, and so that's that's our goal as credential professionals. You can't leave it up to TikTok and Instagram. I mean, we're all there to promote our messages and that's where parents are learning. But there's so many unsafe feeding and food preparation methods and messages being put out there that do increase the risk of choking. But the research shows us if parents are educated and learning from the right resources, there's no higher risk of choking.

Speaker 1: 40:50

So if someone wants to start a baby led weaning approach which it sounds amazing this sounds like what we all we should all be doing with our babies. Should they be guided by a registered dietitian or someone? Are you certified in this approach or how do we know how to?

Speaker 2: 41:06

help guide them. You should always look at where you're getting your food and nutrition information from. The registered dietitian is the nationally recognized credential the only one in the United States that indicates that that practitioner has had the requisite amount of scientific background. This is science, nutrition science. As a dietician, I'm a practitioner of food. I have a credential and an undergraduate degree. I also have a master's degree, but dieticians now, as of this year, following in the footsteps of SLPs, actually are required to have a master's degree, and I have had advanced training in pediatric food allergies and a lot of baby-led weaning stuff.

Speaker 2: 41:39

You start doing it with your own kids and then you realize, wait a minute, there's really no rules about this stuff. There's no certification. So I call myself a baby-led weaning dietician. There's no certification for it yet. It's something that we're definitely working on.

Speaker 2: 41:53

But just a blogger or a mom who's fed one baby I mean I see so many unsafe things. I really like for my own mental health, have to unfollow so many people just because I'm like that's not safe, you're going to choke the baby and then I can't help myself. I want to help them. So I would highly recommend that you do seek the help of a registered dietitian, also SLPs who are feeding therapists. So if they've had advanced training in infant feeding and they're feeding therapists, many of them are pro baby led weaning at this point, and occasionally you come across an occupational therapist who also has training in infant feeding and maybe a feeding therapist, but my thing is like babies shouldn't have to be in feeding therapy for parents to learn about this.

Speaker 2: 42:29

So my goal is to bring baby led weaning as a evidence-based approach to really elevate Jill Rapley's message. Jill Rapley is what I call the founding philosopher of baby led weaning. Right, she put out what it is and why it's better. My goal is to show parents how to do it safely. So if you're interested in this approach, a great place to start is a free online video workshop I have. It's called baby led weaning for beginners. It's 75 minutes long, but it walks you through all the ins and outs of what's safe, what's not, what to do, when to start, what to look for, and I give everybody on that pre-training a copy of my original 100 first foods list so you'll never run out of ideas of foods that your baby can eat. You can sign up for all of that. It's via my website, babyledweaningco. I'm also on Instagram at babyledweanteam.

Speaker 1: 43:15

Babyledween. What was that for the Instagram handle, Team Baby?

Speaker 2: 43:18

Lead Ween team, because we're here to help you. We're all in this together. You got to feed kids, let's work with the babies, we'll start them out on the right feet.

Speaker 1: 43:27

So someone maybe downloads your watches, your video, downloads your 100 foods, your book. Should they also work with you directly, or work with a registered dietitian who is trained in baby lead weaning directly? Or they can just do this on their own just by kind?

Speaker 2: 43:38

of following I have a program called Baby Led Weaning with Katie Ferraro. It walks you through the 100 first foods, shows you how to make them all safely. We have 100 first foods daily meal plan because some parents are like can you just tell me which food to feed in which order? It's 20 weeks of meal plans. It's all there for you at babyledweaningco. But whatever you do, I do encourage you to get your food and feeding information from credentialed professionals who are trained in this approach.

Speaker 1: 44:02

So, exactly, so. Okay, this is amazing, tell me once more babyled the website.

Speaker 2: 44:09

Our URL is babyledweaning and it's L-E-D. It's not babyledweaning, babyledweaningco. Everything is linked up there that you need. And that free workshop is babyledweaningco.

Speaker 1: 44:22

Everything is linked up there that you need and that free workshop is Baby Led Weaning for Beginners, and I also have a paid program if you're interested in learning how to actually make all of the food safe. This is so amazing, so awesome. I am so excited to air this, show this to everyone and have them. Thank you and thank you for weaning to collaborate right.

Speaker 2: 44:34

No one profession is equipped to help your baby safely start solid foods right. You need to know the airway stuff. You need to know the jaw development stuff from the SLPs. You need to learn the food stuff from a dietician, the postural support and the crossing midline and the sitting up from an occupational therapist. So I love this collaborative approach and I am really interested in learning more from you about chewing and jaw development and how we can incorporate textures to help babies do this so we can prevent so many of the things that you guys see in your population in the airway space.

Speaker 1: 45:04

Yeah, this is so great. Well, we'll probably have to get together and do this again like a few times, because I even have more questions for you.

Speaker 2: 45:09

It's so interesting and I wish we can talk forever, so we will probably have to do it again.

Speaker 1: 45:15

Totally, but honestly, like I feel like I wish I did this approach with my kids and I didn't, and there's like a little bit of guilt, but now I'm like paying for it, because now I'm like you only eat chicken nuggets, like to one of my kids, you know, and it's like you know. So I want to spread this message to other people, younger parents, who you know, or our therapists, who can help patients learn these different ways to eat Well.

Speaker 2: 45:37

thank you so much for covering this topic. I appreciate it. It was really great to chat with you.

Speaker 1: 45:40

Thank you. Have a great rest of your day. I appreciate it.

Speaker 2: 45:43

Take care Bye.