BLW premature babies

[ZuzuandZara]

Hi
My dts have just hit 6 months and we are giving BLW a go.

Couple of problems though. They were premature and don't have any hand to mouth coordination and also cannot sit up. It may be a good few months yet before they can sit and I obviously don't want to wait that long!

So far I am giving them bits of food - squashed blueberries, plums, potato, ripe pear, rice cakes etc etc. They are chomping away and gagging and swallowing happily! I just shove the bits of food in and they chew and spit as they want! I feed them in their bouncy chairs which are quite upright.

It seems to be going well so far and obviously isn't 'true' blw as I am feeding them, but solids rather than purees. Any idea if this is the best thing to do?
Anyone been in a similar situation?

tia

I weaned DS (born at 33 weeks) at 6mo, but onto purees. He's now coming up to 8mo but still can't sit reliably, so I still feed him in the bouncy chair. However, he took to weaning really well and so we quickly moved onto lumps and, now he has worked out hand to mouth, finger foods. He has no problems with any of it. Tonight, for example, he had roughly mashed (so v. lumpy) cauliflower and carrot with pasta shells. No gagging.

The only time we have an issue with lumps of food is when he's been having a teething session - I think it hurts when he tries to chew - so if your DTs start refusing bits, this might be the reason.

It sounds much like you've just skipped the purees stage and once your DTs can feed themselves, they will do. My DS 'got' finger foods just before he hit 6mo corrected and now happily sucks on rice cakes, spelt fingers, bits of cucumber, beans, etc.

Great, I think that's pretty much what I wanted to hear!

The girls were born at 33 weeks too, so hopefully, like your DS, in a month or so will start being able to get things in their own mouths!

Thanks for the teething tip too.

For the time being, will carry on shovelling things into little mouths. We're all enjoying it so far

oh listen, you're going to think i'm being a pain here but i'd say no on two counts. it's dangerous to put food in a baby's mouth, really a major choke hazard, and i'm dubious as to the uprightness of a bouncy chair.

the whole point of blw is that they need to have hand to mouth co-ordination, and that you wait until that shows up before weaning them. if you don't want to wait that long (which is fine, it could be a while yet) i'd just stick some mashed or forked food on a spoon and let them get to work on that, so long as they are sitting up in a highchair.

i blw'd both of mine, dd2 was born at 33 weeks as well but could sit up and feed herself before the six months corrected mark.

actually, on that note, when you say six months, do you mean six months plus seven weeks, or six months from birth?

Actually, Aitch, my HV and the dietician have both said that the bouncy chair is ideal to feed my DS in if he's not sitting up yet. I also have a Bliss booklet that advises the same and actually has a diagram showing you how to prop them up properly. This booklet also advises not to delay the introduction of lumps and finger foods (with assistance if necessary) much beyond 7mo. All the advice is based on a premmies actual, not adjusted age.

So I can't agree that giving them lumps of food is dangerous, unless of course they are left unsupervised.

My HV is very good, I'm lucky. I have heard some appalling advice given to mums by HV's on here many times.
Marjori - Have you ever eaten in that position?
I totally agree with Aitch, they need hand/mouth coordination and to be sitting upright.

OK, I hear what your saying about the choking thing and the fact that really they need hand mouth coordination to BLW.

However, we've been going for a week now, and they are doing really well. Really chewing on the lumps, if food goes to the back of their mouths they bring it forward and suck/chew on it again and their is less and less gagging. If fact no gagging for last couple of feeds. I obviously do not leave them unnatended for a second.

They are 6 months actual not corrected. I know that advice says to wean from actual age not corrected.

Will have a look at bliss and see what else I can find.

Thanks for input, I'll be back!

their = there

miss marjoriebanks, you're not going to convince me, sorry. i have a prem child too, and spoke to A Lot of NHS professionals about weaning her and didn't get the same story twice, the answer is that no-one really knows what's best with preemies. having successfully blw'd dd1 it seemed to me perfectly sensible to let dd2 make the decision herself about when was best, and she started self-feeding a couple of weeks before her corrected six months.

re the bouncy chair, you hadn't mentioned propping up before, which is quite an omission when you're giving someone advice i think.

zuzuandzara, have you thought of getting the antilop chairs from ikea, very cheap indeed and excellent for wobbly babies as it is very supportive.

No, still don't agree. I have also heard via MN about appalling advice given to mums, particularly about bfing, but it doesn't mean everything they say is wrong.

Here is the Bliss booklet that I refer to above. (You need to put in your email address and name if you want to download it).

A bouncy chair is ideal to use for weaning a baby who cannot yet sit unsupported (pg 6).

Introducing lumps should not be delayed, and all babies should be offered lumps before 9mo actual age. Babies should be encouraged to play with lumpy foods (pg 12).

Finger food advice is that a baby should be well supported in their seat (does not specify highchair). (pg 15)

FWIW I was terrified of weaning DS because he couldn't sit up. He's brilliant with it though and I've just followed his cues.

zuzu, some advice says to wean from actual advice, some advice says not to... believe me, i have a special interest in weaning and asked dietitians, cons paeds etc. why do you think they need food this early? are they feeding well on milk? are they getting their vits and iron?

Thanks for the link to that booklet. My twins are 6 months next week but only 10 weeks adjusted. Being born at 23 weeks means they are very delayed and can't hold their heads let alone sit up.
I'm still in two minds about whether it's best to start weaning them, it just feels so wrong, they are only 10lb or so at the moment and the size of a large newborn.

Aitch, they are both ebf and getting vits and iron.

When you say why do I think they need food this early, I don't think it is early!
Recommended to wean babies from 6 months so that's what we're doing. I don't feel that they are not ready iyswim. If I wait for them to sit upright it could be 3 more months perhaps.

Also, to add, they are really just tasting and playing, not a lot is going down, although a bit because it is coming out!

Miss, thanks, I have just downloaded that one, and had a quick look, will read properly later.
I'm off out for the day but will be back later.

Aitch, not mentioning propping wasn't a deliberate omission - DS has never needed propping in his bouncy chair. It was more the point that a bouncy chair was recommended even for babies who have little head control, as a baby born very very prematurely would probably be in this situation still at 6mo.

Believe me, if my DS was unhappy about being fed in his bouncy chair, he'd tell me about it. He certainly has when I've tried the highchair - an Antilop one.

If BLW is about following your baby's cues then surely, if they are happy with how things are, then carry on. I'd be giving Zuzu totally different advice if she had come on here saying her DTs were gagging and crying all the time.

look, the person behind BLW, Gill Rapley, says no to bouncy chairs because it's a choke risk, and is also crystal clear about sitting up (supported or otherwise) and the dangers of putting food in babies' mouths. don't make me get the book out...

prem babies aren't so different to term babies that you can just ignore the risk of choking.

Really must go out!...

Duncan, mine are 11 and 12 pounds but sitting well if supported and have good head control and it feels right.
I would go with your instinct, if it feels wrong then wait.
Your DTs are obviously a lot more prem than mine.

"I don't feel that they are not ready iyswim. If I wait for them to sit upright it could be 3 more months perhaps."

but sitting up (possibly supported with a cushion or booster) is one of the signs that a child is ready for blw. you are plucking three months out of the air, truth be told you have no idea when they'll be able to sit up. is it possible that you are tired of the heroic effort it must take to ebf twins, and want to take some of the pressure off by weaning? if so, fine, but best to do it safely.

all this weaning stuff is a social construct, our 'gut instinct' is entirely based on the cues that we receive from the world around us. if we were different people in different countries our maternal instinct might tell us to wean at six weeks or eighteen months... best to stick with the WHO on this one i think, which is that babies are ready to eat at six mos (and i never found a doctor who could even begint to explain why the internal development of my prem child would be accelerated to bring her up to speed by six months on the inside when she was clearly delayed on the outside). extrapolated from the WHO guideline, our NHS says mashed and forked food or finger food from six months if they can handle it, and there is no great consensus with preemies that this means corrected or otherwise. bliss is but one opinion.

zuzu, your definition of 'handling it' means that you pop food into their mouths, but i'm afraid that it is, totally uncontroversially, a choke risk to do that and you would be safer with purees. and i say that as an arch blw-er...

if i was you, i'd hold off on the whole thing until they can sit up in an antilop chair using the booster set that ikea sell. tbh i bet they could do that now... then let them loose on steamed carrot sticks and cucumber etc and let them build up their hand/eye co-ordination using their desire to eat. eating is just another developmental stage, like smiling or walking, let them take their time to learn how to do it, imo.

Sorry to wade in but I do not get how babies can practice good head control in their bouncy chairs - while feeding.

I think a bouncy chair could be restrictive - as it could stop a baby throwing their head back.

I think the risk of choking is too high.

I would also wait for the hand eye co-ordination.

I don't think anyone is ignoring the risk of choking Aitch. I suspect Gill Rapley is covering her own arse with the advice, because BLW in itself has to be a bigger choke risk than purees.

The key has to be supervision. For a prem baby or a term baby.

Duncan, I've followed your blog with interest. Lovely to see how well your boys are doing. The booklet advises 5-7mo for weaning a prem, so if you want to wait, wait.

My DS was born at 34 weeks and wasn't ready for BLW at 5 1/2 months (actual age) when I weaned him. He was sitting at 6 1/2 months so was quite steady when we first started weaning but not steady enough. When he was 11 months he decided BLW was the way forward and wouldn't let me feed him (unless it was yoghurt!). We started with purees but with a few lumps and went on from there.

I thought the whole point of BLW was that they chose what to eat and put it in their mouths not you putting it in their mouths.

oh for goodness sake. yes yes, gill rapley, twenty five years an HV and former deputy head of unicef child health initiative, she doesn't know anything about anything... what a craven fool she is, advising people not to put food in their children's mouths because if they don't have the hand/eye co-ordination to pick the stuff up they likely don't have the internal co-ordination to cope with a choke.

you are completely ignoring the entire logic of BLW here, in order to justify what you did. don't bother, what you did was successful, you're happy with it and so was your baby and no-one died, so that's great for you.

but what zuzu took from your earlier advice was that she was fine to carry on as she is doing, and tbh that cannot be allowed to stand, because it's just straight-up dangerous to put food in babies' mouths, especially if the mother has already said that they don't have the co-ordination to get it there by themselves.

I'm not saying Gill Rapley is a fool, just that she needs to give that advice as BLW is inherently riskier in terms of choking than purees. I just don't see how putting bits of food in a baby's mouth is in anyway different from spoon feeding them lumps. One is hugely dangerous apparently, the other is fine.

And if we shouldn't ignore Gill Rapley, then why can we on the other hand set aside the advice of Bliss, written by paediatric consultants, as 'just one view'.

i'm not ignoring bliss, even they say 5-7 months by your account. so they are not dogmatic about 6 months, and they don't recommend finger food until the child can sit supported. you do see that nothing i'm suggesting counters their advice, don't you? if zuzu is determined to wean at this stage, she should follow the bliss advice and give purees on a bouncy chair if necessary.

and when 'popping' an unmashed piece of food into a child's open mouth there is clearly a bigger risk that it will travel directly to the back of their throat and cause a choke than if a child is bobbing forward for some lumpy mash off a spoon and taking it off with his lips. i'm not sure why you're determined to argue this, it's a total no-brainer.

Ok, I see what you (and Gill Rapley!) are saying, although my practical experience so far (a whole week!) is good and I am not worried about choking, but honestly I do understand what you're saying!

Aitch - 3 months is a guesstimate from the other prem babies I have come across in the last 6 months of being a mum, I know it's very different for everyone.

"is it possible that you are tired of the heroic effort it must take to ebf twins, and want to take some of the pressure off by weaning?"

I find that really rude and patronising. It is not a "heroic effort" to ebf, I am incredibly lucky that I find it easy and I LOVE it. Not in the beginning, but it is now. I am certainly not trying to take pressure off ebf, just trying to do what I think is right, which is why I've asked for advice which I will take on board. The thought of stopping breast feeding my girls makes me very indeed.