Premature Babies: How to Estimate & Adjust Age for Starting Solids

Once Upon a Dance (0s):

This episode is sponsored by Once Upon A Dance. You know, I talk a lot here about helping your baby explore the world through food, but as your child gets older, there are so many other ways we can help them explore, imagine, and build confidence. And one of those ways is through movement. Now, I personally did not grow up doing dance myself. It wasn't a part of my childhood, but all three of my girls did dance. And I have to say it was such a formative experience for them. It wasn't just about learning steps or performing on stage. Dance helped them practice discipline, confidence, creativity, perseverance, and being part of something bigger than themselves. And that's why I love the idea behind Once Upon a Dance, these are interactive children's books that turn story time into movement time. So your child isn't just sitting and listening, they're twirling, leaping, imagining, and connecting with you through the story. Once Upon a Dance offers award-winning dance along stories created by a former dance teacher with her daughter Ballina Kay. As a gentle guide and positive role model, the stories celebrate friendship, family, self-acceptance, empathy, practice, perseverance and kindness, all through whimsical adventures featuring things kids love, like unicorns, bats, puppies, cats and more. So whether you're listening with the baby now or you also maybe have a toddler, a preschooler, or an older child at home who loves to move, this is such a sweet way to bring books, imagination and activity together, swap screen time for connection, get your kids off the couch and into a story. Jump twirl and leap on over to Once Upon a Dance dot com or find Once Upon a Dance books wherever you buy books online. That's Once Upon a Dance dot com.

Whisker (1m 45s):

Today's episode is sponsored by Whisker makers of the Litter Robot, the self cleaning litter box for cat families who do not need one more gross chore on their list. Because You know how every stage of parenting comes with a whole new category of cleanup, right? First it's the pump parts and then the dirty diapers you're getting used to. And when you're starting solid foods, suddenly you're scraping sweet potato out of crevices of the highchair that you never knew existed, right? But for cat parents adding daily litter box duty on top of all of that, that is a lot. And honestly, it's the litter box part. The thing that always made me hesitate about cats, not the cat, the litter, the scooping, the smell, the whole daily maintenance situation. And that's why Litter Robot by a Whisker makes so much sense. It automatically cycles after every use. So you're not scooping every day and you're not handling waste like you would with a regular litter box. I especially love the No Contact Benefit Litter Robot handles the dirty work so that nobody in the house has to be assigned daily litter duty. And with the Whisker app, you can stay on top of things without thinking about litter all day. The app can notify you about your unit, like completed clean cycles, litter and drawer levels, or when the unit needs attention. So whether you already have a cat or you're thinking about getting one, or you just want one less household chore to manage, Whisker helps Take litter box duty off of your daily list, maintain your cat's litter while focusing on your family. Learn more about Whisker litter robot models and their starter kits today so that you can get set up for this busy season of parenting. Take an additional $50 off bundles with the code weaning when you shop Whisker dot com slash weaning. That's an additional $50 off bundles with code weaning at Whisker dot com slash weaning.

Katie Ferraro (3m 40s):

So if your baby was born premature, please hear me, your baby can do this, but not on somebody else's timeline. So not on your friend's timeline, maybe not on their exact six month chronological birthday, but your baby will learn how to eat. They will learn how to self feed and explore those new foods when they're developmentally ready. The timeline just looks the litter bit different. You have to do a small amount of math, but trust me, it is totally worth waiting. 'cause when your baby really does show you those reliable signs of readiness to eat And that adjusted age lines up with it, you're gonna be like, oh my gosh, this is amazing. I can't believe all these foods my baby's eating. Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in baby led weaning.

Katie Ferraro (4m 25s):

Here on the baby led weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using baby led weaning. Have you ever looked at your baby? For those of you in the pre feeding phase, you're not starting solid foods yet and you're like, okay, technically you're like almost six months old, but like there's no way in heck, I think you are really ready to eat solid foods. And if your baby was born early, this question gets even more confusing. 'cause one person might tell you, oh, you gotta start solid foods at six months of age. But someone else might say, well, your baby was born prematurely, So you need to wait.

Katie Ferraro (5m 7s):

And then to make it even more stressful, I know a lot of you with Premature Babies are hearing the message, well, you should actually start solid foods early so your baby can catch up with their weight gain. So now you're standing there looking at this sweet baby, you got the highchair, you got the avocado out, and maybe your camera ready for that first food moment and you're feeling not excited. You are thinking, wait a minute, am I doing this too soon? Or did I wait too long? Or what age am I even supposed to use? In today's episode, I wanna clear it all up for you. Because when it comes to Premature Babies and starting solid foods, we do not base feeding readiness on the calendar or or the exact date that your baby was born, we're gonna base it on your baby's adjusted age and compare that to the other signs of readiness that tell us that your baby's body is really actually prepared to start safely swallowing solid foods.

Katie Ferraro (5m 57s):

And I want you to know this right from the start, that Premature Babies absolutely can succeed with baby led weaning. I've got a few other episodes that I've done with some neonatologists, some growth experts, some specialists in nutrition that specialize in baby led weaning and in Premature Babies, listen to those if you're feeling stressed about it. I'm gonna tell a quick little story about my own personal experience with prematurity. I have a set of quadruplets that were born at 34 weeks. They spent some time in the nicu. They were born six weeks prematurely. So they needed the time there to grow and thrive. And when it finally came time for them to start solid foods, it's like we're gonna go all in on baby lead weaning.

Katie Ferraro (6m 37s):

Except I had absolutely no idea what I was doing back in the day. And I remember thinking, gosh, but they're six months old, but they're not even close to sitting up. How do You know? Like my, my older child, when she was six months, she was sitting up and ready to start solid foods, but she was a full term singleton, not a preterm quadruplet. So I like to start out each of these mini training episodes with the baby led weaning tip of the day. And for today's tip, I want to teach the difference between chronological and adjusted age. Chronological age is your baby's actual age from the date they were born. So if your baby was born six months ago, today, your baby's chronological age is six months. Okay? That part is pretty straightforward. But if your baby was born early, we need to look at your baby's adjusted age.

Katie Ferraro (7m 20s):

So you might also hear this called the corrected age. So for the purpose of this episode, I'll use the term adjusted age. And adjusted age takes into account how early your baby was born. So here's the simple formula. Your baby's chronological age minus the number of weeks your baby was born. Premature equals your baby's adjusted age. So I'll use the example of my quadruplets. My quads were born at 34 weeks gestation, right? A full-term pregnancy would've been 40 weeks, but the max they let you go with quads, at least in the US is 34 weeks. So I went right up to that date, which I felt really grateful for because side note, the average gestation for quadruplets is 28 weeks, also 50% chance of major handicap.

Katie Ferraro (8m 0s):

So this was a very, very high stress pregnancy. I felt very, very grateful to go to 34 weeks. I'm five 10 and a half. I round up, I say five 11, but my husband's five 11, so he does, he likes to be taller, but whatever. I'm five 11 ish. So I used to think like, oh my gosh, it's just because I'm tall. That's why I got to go 34 weeks. And then I met another quadruplet mom through Instagram. Her babies are born around the same time as mine, and she's five foot tall and also went 34 weeks. 'cause I was like, oh, if you're so tall, like You know your placenta can You know, you stretch out more. And that's why I was able to go 34 weeks. And she's like, I'm five foot tall and went 34 weeks. Has nothing to do with your height. So anyway, there goes that theory thir 40 weeks minus 34 weeks means they were born at six weeks premature.

Katie Ferraro (8m 41s):

So when the quads turned six months old chronologically, they were really only like four and a half month olds. All right? So when everybody in my ecosystem, like literally every grandma in my neighborhood who used to come over and help me feed the babies was like, guess what? They're six months. Let's feed feed 'em rice cereal. I was like, gimme the baby back. You we're not doing rice cereal. We're not force feeding these babies by spoon. I'm gonna wait till they're sitting up on their own. And that was when they were six months plus six weeks. It was actually the litter bit beyond that. So they were just past their seven and a half month chronological age when they were really six months adjusted age. So that's when we started looking more seriously at whether they were ready to begin solid foods. And that's because when they were sitting relatively independently kind of coincided with that.

Katie Ferraro (9m 25s):

Okay? And being able to sit relatively independently. If you've done any amount of study over about the reliable signs of readiness to eat, that's the most important reliable sign of readiness to eat because it indicates that your baby has the head and the neck strength as well as the trunk strength to support a safe swallow. Okay? So I know for some parents that feels like a long time to wait. Okay? Especially if you got grandma's chirping in your ear, okay, you've been, You know, you're excited for this milestone. You see other babies on social media or in your mom group or in your neighborhood, and they're like, they're your baby's age and they're eating. But here's the reframe I want you to keep in mind. You're not behind, okay? Your baby's not behind. You are simply honoring your baby's true developmental timeline. And that's one of the safest, most respectful things that you can do as a parent because starting solid foods is not just about age.

Katie Ferraro (10m 12s):

It's definitely not just about nutrition. And it's not just about like, oh, you want your baby to eat So you can get a picture of them and send it to everybody on the internet. Okay? It's about whether your baby, are they staring at your food? Are they ready to eat? Are they mouthing objects and bringing things to their mouth? Is their nervous system ready? Is their trunk control ready? Is their oral motor skill development there? Okay? For babies who were born early, we give them that extra time, okay? It doesn't mean anything's wrong with your baby, it just means we're going to adjust our expectations, right? I'm sure if you had a baby born prematurely, some of you were expecting it, but most of you were not. When I was pregnant with quads, I knew they were gonna come early. So I had the litter bit of heads up like, I'm gonna be in the nicu, things are gonna be different. But I was surrounded by a lot of moms who were like devastated.

Katie Ferraro (10m 54s):

This was not the birth story I planned to have, but they adjusted their expectations. So I think a lot of times, like the parents of preemies are particularly resilient because they've been dealing with a lot of stuff they didn't intend to deal with for a number of months at this point. But you gotta remind them, hey, learning how to eat is not just put the food in the mouth and swallow. It's a very complex skill and your baby has a lot of skills that they need to bring together. Okay? So I get really concerned when parents of Premature Babies are told, oh, when you have a premature baby, you actually need to start solid foods early so your baby can gain weight. Okay? And I recently did a really important interview with Rosan Meyer, who's a PhD dietician who specializes in growth and catch up weight in particular.

Katie Ferraro (11m 34s):

And she really helped dispel that myth why starting solid foods early will not help your baby with catch up weight. And I'm gonna link to that in the show notes. Definitely listen to that if you are getting that level of pressure, okay? Because if your baby needs extra calories or nutrition for growth, you need to be talking, first of all to a pediatric dietician who specializes in this. And we certainly don't use food, which your baby does not know how to use yet to gain weight. We're not gonna say, okay, add extra food a thing your baby doesn't know how to use yet to help them gain weight. We're going to fortify the milk supply in order to help with catch up weight. And again, a pediatric dietician should be helping you do that. Not social media or the internet.

KiwiCo (12m 11s):

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Katie Ferraro (14m 14s):

So big takeaway for Premature Babies, we're gonna look for six month adjusted age before starting solid foods. And then we're also gonna look for the other reliable signs of readiness. Okay? We're not gonna look at, did your friend's baby already start, or the calendar says it's time to start six months adjusted age plus readiness. Okay? I mentioned that your baby should be able to sit relatively independently, okay? That doesn't mean like cheating and putting 'em in a floor seat or a bump and you're like, oh look, they're sitting by themselves. Okay? We want them to be able to sit relatively on their own, okay? Seated upright with good head and neck control. They should be bringing objects to their mouth, okay? That tells us that your baby is practicing the hand of mouth movement that they need for self-feeding. Did a really good interview with Marsha Dun Klein from the Get Permission Institute about the importance of mouthing.

Katie Ferraro (14m 57s):

You might be like, oh, that baby puts everything in their mouth. But she really goes through why it is so important for babies to be bringing things to their mouth before they learn how to eat. Like you cannot learn how to eat food if you cannot bring things to your mouth. And she, we talk about the parents that we work with who are like, my baby's not bringing things to their mouth yet, but let me shove food in their mouth. Like, no, that doesn't work. The readiness picture looks like six months of adjusted age sitting relatively independently. The baby's got good head and neck control, they're bringing objects to their mouth. They're gonna be starting to be interested in your food. Now I know some of you're thinking like, well, what if my baby was like only the litter bit early, like after my quads, I had a set of twins and they were born at 38 weeks gestation. And I remember when they turned six months chronological age, we were on vacation And I was feeling particularly lazy.

Katie Ferraro (15m 38s):

And I was like, I'm not really in a space to wanna start solid foods. They're kind of sitting up. But like I waited till they were six months plus two weeks when we got home to start solid foods. And I told myself I was like adjusting for their age. And that's perfectly fine too. Now you don't wanna wait too long because we do have data that shows if you wait too long, babies will have less likelihood to take advantage of that flavor window, right? That all important window where your baby will like and accept a wide variety of foods and flavors and taste and textures. Plus there's considerations for food allergy prevention that we need to take, You know, advantage of. So it is the litter bit of a timing thing about waiting until your baby is ready, but not like waiting too long when You know, 'cause you don't wanna offer them real foods. Okay?

Katie Ferraro (16m 18s):

So this is where I wanna be really honest with you. I, I feed a lot of babies, right? I've helped tens of thousands of families give their babies a safe start to solid foods. And I've never once thought like, wow, that family really ruined everything by waiting an extra week until they started solid foods. Okay? Sometimes waiting that extra week gives the mom the litter bit extra confidence, gives the baby some time to get the litter bit stronger and the litter bit more resilient at the table. Okay? Starting solid foods too early can make feeding feel scary. And it can be as few as one choking incident that sets a baby on a slippery slope of food, aversion of food, refusal of needing to be in feeding therapy.

Katie Ferraro (16m 58s):

I've definitely seen that it leads to more stress. There's literally no upside to starting solid foods early, okay? It makes parents feel like, oh, baby led weaning is not working. If you take a baby who can't sit up on their own yet, of course they can't safely feed themselves real food and they'll be like, oh, this baby led weaning thing doesn't work, and now I need to force feed the baby by spoon. Waiting is wisdom. Final words, wait until your baby is six months adjusted age. Make sure they're showing you those reliable signs of readiness to eat. And once your baby is ready, you can start offering safe, age appropriate foods in a way that allows your baby to self feed. All right? You can start slowly letting your baby learn. Expect that not much food is actually going to get swallowed at first, And that is perfectly fine because breast milk or formula is still continuing to provide your baby most of their nutrition even after you start solid foods.

Katie Ferraro (17m 47s):

If you need help on exactly how to prep foods safely and what do the foods look like and what do I do before my baby's even ready to start solid foods? I put everything you need to get started with baby led weaning all in one place in my program called Baby Led Weaning with Katie Ferraro. I've got a very big robust pre feeding section in there. Parents of Premature Babies love the pre feeding stuff because there's lots of activities and exercises that you can do before your baby starts. Solid foods to help increase success, to help maximize success once your baby does start solid foods. 'cause you don't start practicing on day one, you start practicing in the pre feeding period before your baby's even ready.

Katie Ferraro (18m 27s):

So check out the program. There's a $50 off coupon code if you wanna get started today. That's in the description where you're listening to this. I'll put all the resources from today's episode up on the show notes@blwpodcast.com/119.

Airwave Media (18m 41s):

I also wanted to say a very special thank you to our partners at Airwave Media. If you like podcasts that feature food and science and using your brain, check out some of the podcasts from Airwave Media or online bw podcast.com.

Katie Ferraro (18m 55s):

You can check out that program at baby led weaning.co/program. Use that $50 off discount code to get started in the pre feeding phase so that You know when your baby's truly really, really ready to start and when they are ready. I've got everything you need So you literally don't even have to think about which foods to safely offer your baby. So thanks so much for listening. I'll see you guys next time. Bye now.