Podcast

Taste and Flavor Development in Infancy with Erin Ross, PhD, CCC-SLP

  • How babies develop flavor preferences beginning in utero
  • Feeding concerns that premature babies may experience
  • Recommendations for transitioning older infants off of the bottle

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Episode Description

Does your baby have a preference for sweet foods? What flavors of foods are best to offer baby? In this episode we are exploring how babies develop taste and flavor preferences during infancy with Erin Ross, PhD, CCC-SLP. Dr. Ross is a neonatal feeding and pediatric feeding development expert who developed the SOFFI method: Supporting Oral Feeding in Fragile Infants.

About the Guest

  • Erin Ross, PhD, CCC-SLP is a neonatal feeding and pediatric feeding development expert who developed the SOFFI method: Supporting Oral Feeding in Fragile Infants.
  • Her website is located here: www.feedingfundamentals.com and you can follow Dr. Ross on Instagram @soffimethod

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Guest Resources - Erin Ross, PhD, CCC-SLP

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Katie Ferraro (0s):

Okay. I have a quick little BLW win to share with you, especially if you need bibs for your baby. So the bibs I love for BABY LED WEANING our fund from this company called BAPRON Baby, and a BAPRON is a hybrid apron plus bib. And I was just on their site buying some bibs for baby. And I saw this new like bundle sale they have where you can get a set of either two apron and bibs at 35% off or three bays from bibs, which are 42% off. And then check this out. I was playing around at the checkout and the owner Kelsey is so sweet. She's letting my affiliate discount code, Katie10, work on top of that for an additional 10% off. And what I love about BAPRON as they're made out of this amazing, lightweight, waterproof material, you know, some of those really popular, like heavy silicone drop bibs, those can wait up to a pound and they really weigh your baby down.

Katie Ferraro (46s):

And then there's these other bibs I really do not like which are like these big tent, like contraptions, which severely restrict your baby's range of motion at the table. We want to stay away from those. The BAPRON bibs are amazing because they're sleeveless, they're lightweight and they tie under your baby's shoulder blades in the back, not like all up in their neck, which can be a really negative sensory experience. So if you head to https://bapronbaby.com/, shop the sales section, that code Katie10 works on top of the already majorly, marked down big bundles. And they also have these great splash mats. The big piece of fabric we put underneath the baby's high chair to catch the food. The code Katie10 works for those as well. So stuck up bibs, get the splash mat at bapronbaby.com. And once again, that code is Katie10. Happy feeding

Erin Ross (1m 30s):

Learning begins in utero. As you just pointed out with the mother is eating and it's flavoring the amniotic fluid. And so all babies are getting phased in a variety of flavors, which helps their sensory system to start to develop.

Katie Ferraro (1m 45s):

Hey, there I'm Katie Ferraro, Registered Dietitian college nutrition professor, and mom of seven specializing in baby led weaning here on the baby led weaning made easy podcast. I help you strip out all of the noise and nonsense about feeding, leading you with the competence and knowledge you need to give your baby a safe start to solid foods using baby Led Weaning. So what's up with babies eating bland food. Babies actually do not need to eat bland food. I think parents are always surprised when they learn. Gosh, you know, babies have been exposed to flavors since they were in utero, right? Via your amniotic fluid in pregnancy.

Katie Ferraro (2m 25s):

They're getting different flavor compounds and through breast milk, if you're breastfeeding. Babies are being exposed to new tastes and flavors. And so today my guest is Dr. Erin Ross. She's a PhD speech language pathologist, and she's going to be here to talk a little bit about Taste and Flavor Development in Infancy. So Dr. Ross is worked in the NICU setting for nearly 30 years. He's worked as a feeding therapist, but she also has a PhD in research. And her work is about how to apply research from the research setting into the clinical setting. So she's like one of those rare researchers who also works with actual babies. If you guys know each Thursday episode here on the podcast, I always interview another credentialed feeding expert.

Katie Ferraro (3m 7s):

And I'm so interested to hear what parts of Dr. Ross is research work, as well as her clinical work we can use in our own families as parents and caregivers, but also in our professional settings. If you listening as another feeding expert. So with no further ado, I want to introduce Dr. Erin Ross. Who's going to be teaching us a little bit about Taste and Flavor Development in Infancy.

Erin Ross (3m 31s):

Well, thank you for having me as quite an honor for me

Katie Ferraro (3m 34s):

As a dietician and former NICU mom, I had a set of premium quadruplets. I've been familiar with your work since that time. That was like the first time I kind of ever paid attention to NICU, nutrition and feeding, and I am so excited to get to interview. Before we get started, could you just share a little bit about your professional background and the type of work that you do and have done over the course of your career?

Erin Ross (3m 53s):

Sure. So I have a master's degree in speech and language pathology. And then when I was in my forties, I actually went back and got a PhD in health services research and then did a two year postdoc in the section of nutrition. So I was able to work with people like you who were researching infant nutrition, and specifically they were more interested in overweight. My clinical background. I've worked in the neonatal intensive care unit since 1990. And I have also worked with children who struggled to eat and did that as an outpatient or also in people's homes for the first, probably 30 years of my life.

Erin Ross (4m 36s):

But I stopped doing that right before COVID.

Katie Ferraro (4m 38s):

Was that as a feeding therapist or is it a different avenue

Erin Ross (4m 42s):

As a feeding therapist. Yes. Yes. And then I have also had the honor of being able to teach about children who don't eat and feeding in the neonatal intensive care unit in many different places.

Katie Ferraro (4m 54s):

So what did you do during COVID? Oh, that was quite an experience for about two weeks. Everyone was out of the neonatal intensive care unit, but then I resumed my work in the neonatal intensive care unit and all of my teaching, which is actually quite a bit of what I do now. I ended up trying to figure out how to put all that online. You've done an amazing job. You did that in two years.

Erin Ross (5m 18s):

Yes. That's pretty much from start to finish. If you saw my first website, it was created by me. I'm sitting, reading a book on how to do WordPress and I loved it. But I have been working with a great team called Tree Ring Digital here in Denver. So That's amazing. Can we just talk about like going back and getting your PhD in your forties is amazing. I'm 43. And I kept saying I was going to do it when my twins go to kindergarten and that's next year. And I'm like, no, I'm not. My, I, my brain doesn't work that way anymore. Like to focus and concentrate. And I think it probably doesn't help that I work in social media where to be honest, people have like six, second attentions fans anymore.

Katie Ferraro (5m 60s):

I, how did you do that in your forties? That's amazing.

Erin Ross (6m 3s):

I don't know. The biggest benefit to me was I was going to the university of Colorado in health sciences center. So the school of medicine is where my PhD was in and that was literally one block away from my hospital that I was working in the neonatal intensive care unit. So that made things a lot easier that I could literally walk down, take a class, walk back, go back to work

Katie Ferraro (6m 28s):

Your research then kind of aligned with the clinical work that you were doing as well. You could be. You were having real life experiences in the NICU and then learning about the theory, etc., in your studies. Is that correct?

Erin Ross (6m 39s):

Yes. So my PhD is actually in, how do you do research in clinical settings with the patients that you see every day. It was designed for people like me, who primarily want to work with families and, and want to work clinically and not want to just sit down and start writing grants and doing PhD work.

Katie Ferraro (7m 1s):

I think that work is important. We need the grant money, but I do agree with you, especially as a practitioner, it's sometimes hard to connect with researchers because I'm like, when was the last time you actually fed a baby? But I understand that the work that they're doing is important, but also I'm a lifelong educator as well. And the college nutrition professor for over 20 years. And I've found that, you know, the best educators are those who practice and the best practitioners are those who are also educators. So I love that you also combine the practice with the research.

Erin Ross (7m 28s):

Nah, well, that's actually why I went and got a PhD because I was reading research and thinking, but this isn't helping me do my job. It's very good research and it's very interesting, but it's not clinically applicable. And I complained enough that my mentors around me kept saying, well, then do something about it, go back and get a PhD. So literally that's why I did it. I didn't do it because I felt the need to leave my young children. My children were in there. I had a 10 year old, a seven year old and a three-year-old I think

Katie Ferraro (8m 2s):

Dr. Ross, can you explain a little bit about the SOFFI method? What does that acronym stand for and what does it do for families in the NICU setting?

Erin Ross (8m 10s):

Yes. Sure. So SOFFI stands for Supporting Oral Feeding in Fragile Infants. And it's something that I created over many years of working with families and trying to change the conversation. It really, for me, because I was working also in follow-up, it really became about helping parents understand this is the beginning. And the message so often in the neonatal intensive care unit space is just get them home, get them home as fast as we can, get them home. And so my belief system was at the time that we could improve their outcomes by doing things differently in the neonatal intensive care unit, helping parents be more responsive to what their babies are sharing with them.

Erin Ross (9m 2s):

And, and when I started looking at how do we help parents become more responsive. It really became the caregivers who work with these families need to become more responsive, right? Which is, is tricky because in the neonatal intensive care unit, we are very protocol driven. We are very technical and it became a way of helping people can stop and kind of move, move a step back and start with a baby is successful, and help the parents understand what success looks like, and then to build on that initial foundational success.

Erin Ross (9m 42s):

And so SOFFI is a program that's designed to train nurses. I've had dieticians, lactation consultants, and certainly feeding therapists will come to our offerings. And now it actually also is being used in many different early intervention settings where I'm training staff within, for instance, the state of Nevada. We just did a contract with them. So because babies oftentimes go home very similar in terms of their needs as they had in the neonatal intensive care unit. We did do a study, which thankfully did show that babies who went home after the nursing staff had been trained in SOFFI.

Erin Ross (10m 27s):

They actually did have fewer feeding problems in that three to five month timeframe after they went home. So that's really been my career focus is to help people to think more broadly about feeding.

Katie Ferraro (10m 43s):

Curious if you could share a bit about how research and your professional credential informal training informs your current practice today. So now that you're done with the PhD, you have that level of knowledge you're applying as research. What does that look like on a daily basis to you in the NICU?

Erin Ross (10m 58s):

Well, it's a really, really good question. What I would say where my PhD helps me the most is in understanding what research tells us and what research does not tell us and understanding evidence-based medicine is what's published, but it's also what, what you learn when you work with babies. Because by definition, almost that research is very defined in terms of time. And so researchers will look at one tiny little sliver of time. My job is to start with a family when the baby's born and to work with the family all the way through the process.

Erin Ross (11m 41s):

And for me now it's through discharge, but because I've always worked in outpatient followup clinics, I also have a very long-term perspective and a lot of research, the neonatal intensive care unit really only thinks about getting babies out the door. And my research really is how do we improve what we do in the hospital? So that babies and families not only go home successfully, meaning like continue a lifelong love of eating. I love to eat. I love nutrition. I love eating good food. And I want our children to be able to do the same thing.

Erin Ross (12m 23s):

Now, and many families struggle with getting their children to eat foods that are more challenging. Fruits and vegetables are the most difficult thing to eat from an oral motor standpoint and from a sensory standpoint. And so it's really understanding that the beginnings of all of that start when babies are born, whether they're in the neonatal intensive care unit or not. So I guess that was a big eye-opener when I got my PhD was recognizing people do one little research piece and it's an important piece, but we need to be able to put that in a bigger context.

Katie Ferraro (13m 1s):

I know you work primarily with children in the NICU setting and our audiences interested in kind of the next stage. I always, I have some friends that are NICU nurses and they're like, don't ask me questions about bigger babies. I don't know anything, but you do. There's a lot of parents of caregivers listed here who have had prematurely born infants, and now they have NICU grads at home. What are some feeding concerns or issues that parents of prematurely born infants should maybe just be aware of as they're getting ready to make that transition to solid foods at the six month or six month adjusted age, if the baby was born prematurely?

Erin Ross (13m 29s):

Well, that's actually the first really important piece is that we should be thinking about adjusting for prematurity. Now we all know that not every baby is ready at any specific age. So we use adjusted age as a guideline, just like we use the age of four to six months as a guideline. It's really about is the baby interested in food? Are they showing developmental readiness? So do they have better head control? Are they bringing things to their mouth? These are really good indicators that your baby may be interested in in trying some solid foods.

Erin Ross (14m 9s):

I think the other piece of it is it again, I'm going to go back to the research, but it is also what I see in my clinical practice. Many times parents are working with their infant. They're, they're trying to get their infant to eat and to grow, and they're struggling with the growing piece of it. And so they reach for solid foods as the fix. And that's what the research shows is that one of the biggest reasons why parents introduce solids early and do not use adjusted age is because they are worried about weight gain. And so as a dietician, you know, that typically, especially in the beginning, when babies learning about solids, that's not, it's more for understanding the sensory pieces, the oral motor pieces.

Erin Ross (15m 0s):

It's not really gonna fix a weight gain problem. And so I guess the first thing for families is thinking about eating is something that we learned to do. And like every other developmental skill walking, talking expect that your baby will do better when they are transitioning based on adjusted age.

Katie Ferraro (15m 22s):

And it's safer as well. And our audience's quite familiar. We had, if you guys are interested back in episode 110, we had an episode about Catch-Up Weight: Why Starting Solids Early Will Not Help Your Baby Gain Weight. And that was an interview with Rosan Meyer. She's a PhD dietician and a specialist in growth, growth, faltering growth chart interpretation. And she really walks parents through why, no matter what you're hearing starting solids early, it's not going to help your baby gain weight if they don't know how to use food for nutrition yet. And so it's so important that we're reiterating this message about waiting until babies are truly ready. And then if the whole concept of adjusted age is new to you, episode 119 is called Premature Babies: How to Estimate & Adjust Age for Starting Solids. I'll link those all up in the show notes where you're listening to.

Katie Ferraro (16m 3s):

Just for parents of Premature Babies who might be hopping in here and kind of learning some of this terminology, Dr. Ross, we're here today to talk primarily about Taste and Flavor Development in Infancy. And I know I'm always surprised when parents or caregivers say, oh no, but my baby has to eat bland food. And, you know, we know that babies have had exposure to different flavors via amniotic fluid during pregnancy and other flavors via breast milk. And just curious if you could share a little bit about How babies develop taste and flavor as part of neuro-typical development. And then if you want to add how that might differ, if they're born prematurely.

Erin Ross (16m 37s):

In general, it's going to be the same. So learning begins in utero, as you just pointed out what the mother is eating and it's flavoring the amniotic fluid. And so all babies are getting bathed in a variety of flavors, which helps their sensory system to start to develop when you're in the uterine environment, all the way through term, that last trimester is where flavor perception starts to develop. So more of an understanding of what the flavors are, the different flavors and already in the uterine environment, we see babies are preferring sweet flavors and not really preferring bitter flavors, which is important for families to understand.

Erin Ross (17m 24s):

Because a lot of times we think that babies don't like something when we give it to them as they're older. And the reality is that we are predisposed to have some flavor preferences, but everything about food, is learned. And so the way that we overcome those preferences is by just repeatedly offering our children, the kinds of foods that we are wanting them to learn to.

Katie Ferraro (17m 50s):

So, Dr. Ross, you mentioned that, you know, babies have been swathed in flavor since they were in utero. So it's not this big change to offer them different flavors, etc. And you did mention though that what we know from research babies have a predilection for sweet foods. And I'm just curious, when it comes to bitter tastes, we generally recommend to parents, you know, try to offer as many vegetable offerings as you do fruit because obviously fruit gets easier to feed babies. And then we tend to over offer fruit. And then parents will say, my baby only eats fruit. Any tips for parents on keeping that vegetable piece in the mix and continuing to offer, especially bitter vegetables, which, you know, depending on your food culture might not be foods that you eat so frequently, but is that important for baby to be exposed to.

Erin Ross (18m 30s):

It is because if you actually break down the flavors for most vegetables, they will have at least a portion of a bitterness to them because most plants have a portion of bitterness to them. And it's an important piece of our diet in green leafy vegetables, as an example, broccoli and other cruciferous. Is that the right word?

Katie Ferraro (18m 57s):

Cruciferous? Yes. The ones that give you gas, which are a little bit harder for babies to eat, but we can make them safe for babies to eat. For sure.

Erin Ross (19m 4s):

Yes. Well, especially if you steam them, right. And they, especially things like cauliflower can actually kind of disintegrate, but so the thought is said, the reason why we are avoidant of bitterness when we're babies comes from Paul Rosen's work and he has a hypothesis that it's because many of the plants that are poisonous also are bitter. And so it's more of a learning process. So babies will learn by if their parent is eating it, then it's safe. And that's why we can learn about bitter flavors, which I've always really liked that idea because then it puts it into context.

Erin Ross (19m 50s):

You know, why would we be predisposed to like one and not the other

Katie Ferraro (19m 56s):

To ask you about that? Because, you know, you see obviously different depending on what research you're looking at, but anywhere between, you know, children may need between 10 and 15, and 15 and 18 exposures before they "like", or accept a new food. And I've talked at once with Joe Rapley, the pioneer of baby led weaning, and she's come on the podcast and talked about kind of the problem with that messaging. And that parents feel like it's their job to make the child like, or accept the food. So I'm going to continue and continue and continue to offer this to you until you like it. And I think as credentialed feeding experts, we need to be aware that that's sometimes how the message is being interpreted for parents. And I may paraphrase what you're saying. We're not forcing the child to eat it. We're giving them the opportunity and we're offering it over and over and over.

Katie Ferraro (20m 36s):

So they have a chance to learn about the food. Cause you can't just do it once and say, oh my baby doesn't like broccoli. And yet parents do that all the time.

Erin Ross (20m 42s):

Yeah. The average number is generally two to three offerings, but it's really important point that you're bringing up. And that is that there are babies who, even if you repeatedly offer it. You know, 10, 15, 20 times, they just don't like it. And so it, it's an important message. I think for all families to hear is that in the beginning, our job as parents is to offer so that they can learn about it. It's not really to get them to like it. The child should always be in charge of what they're eating and what they're accepting. But so many families feel like, well, if he doesn't eat it, why would I keep showing it to him?

Erin Ross (21m 25s):

Why would I keep offering it to him? And that's, that's kind of the point is that they won't learn about it if we don't offer it to them.

Katie Ferraro (21m 33s):

Exactly. And I think this entire area of diet diversity and all the research that's emerging around the importance of diet diversity from the earliest stages is so important. And back in 2016, I created the 100 FIRST FOODS approach to baby Led Weaning, where we help families introduce their babies to a hundred different foods before they turn one, based on the knowledge that moving into the second year of life, most children will experience some degree of food neophobia and if they only have 10 or 15 foods, as we see with conventional parent led spoon-feeding and you lose those 10 or 15 foods to picky eating, that becomes such a challenging child to feed yet. If the baby has a hundred different foods that they'll likely accept, and they will, it's, it blows your mind what babies will eat. And if you lose 10 or 15, it's not a big deal because you still have 85 or 90 foods that the baby will eat.

Katie Ferraro (22m 19s):

And I'm just curious if for the babies that you work with is the diet diversity message trickling down to the NICU application. Like I know in this latter half of infancy, it's all we're hearing about this diet diversity, diet diversity. But is that something parents of premature babies or should be interested in or concerned about, or do we really want to let them get the like developmental things down so they can safely swallow before we worry about the variety of foods?

Erin Ross (22m 43s):

I actually think they go hand in hand because the variety and trying different foods actually helps the oral motor skills to develop. And that's it. I guess another message is that we need to try things for us to develop skills. And yet some families are worried that their child may not do well with a certain texture. And so they don't give it to them. It becomes, you know, the chicken and the egg conversation. And that's one of the nice things about the BABY LED WEANING is that the child again is in charge. And so the child gets to decide to put things in their mouth and when the child is in charge they're more in control.

Erin Ross (23m 26s):

So I don't think that the diet diversity is trickling down. I think one of the challenges in the neonatal intensive care unit is families have so many things that they're worried about and being, you know, trying to learn about the language and about, you know, this is a whole new world to me.

Katie Ferraro (23m 45s):

Expect there's a whole separate set of rules in the NICU. That is you have to learn a new language. I love the way you said that.

Erin Ross (23m 52s):

Yeah. But when you just said that my brain started going ding, ding, ding, because I think these are the kinds of messages we can give families in their discharge information. We give them packets on safe sleep, and we give them little packets on car seat safety. And I don't see why we shouldn't be giving them information on, on the first year of life.

Katie Ferraro (24m 17s):

Exactly. Because when you go home, it's, it's not all over. I know we had, I don't know if you're familiar with Dr. Terri Major-Kincade, but she came on the podcast in episode 158, talking about How Premature Babies Can Succeed with BLW. And what I loved about her work is that she runs a NICU follow-up clinic. And again, having had NICU babies, we have quadruplets and thank God they came home one at a time because like, they just send you home with these babies. And you're like, but I, everything was so regulated in the NICU. And, and they teach you, you know, learn to watch your baby, not watch the monitors because I would watch some monitors, oh my God, this kid is, you know, whatever the terminology was. I'm not, I'm a NICU nurse. I love the work that they do, but it's so scary and they don't get phased by anything. And they're like, listen, when you go home, you're not going to have these monitors. You have to learn how to observe your actual baby.

Katie Ferraro (24m 59s):

And I was like, oh my gosh, I need follow-up training. And so like the followup clinics and the discharge instructions are so important, especially from a nutrition standpoint. And we just don't have a great network of follow-up unfortunately, post NICU. And a lot of parents, they're not, as you, maybe they go just to a regular pediatrician who doesn't understand the growth tracking, etc., and gross chart interpretation. There's, there's so many issues there. And so many parents end up feeling unnecessarily, you know, "bad" about their baby's nutrition status. When really it's just, if they have had some more education on how to interpret the growth chart and understanding that the percentiles work there, if there are a hundred babies, not everyone can be number 100 and you don't want your baby to be number 100 if they used to be on the fifth percentile. So I think this transition to the home life is so important, especially in feeding because you're right, you are worrying about so many things besides feeding in the NICU.

Katie Ferraro (25m 47s):

I remember like the lactation consultant coming in and I was like, for real, are you going to do this right now? Like my child's having a heart procedure. Like I think breast milk is important, but I've got some other things going on. And I'm curious how you deal with that because feeding sometimes does get pushed to the side when the life is on the line and obviously feeding keeps our babies alive. How do you deal with that with your colleagues?

Erin Ross (26m 6s):

Well, I've worked in the same hospital for 32 years, so that helps, you know, I have a very strong relationship with all of them, all of the people that I work with. And so we now conceptualize eating as a developmental, a neurodevelopmental activity. And so I typically meet with families the first week that they are there and I'm not all I'm talking about is, wow, your baby's born, they're already learning. And so this is, you know, one thing that you can do to help your baby. And then we've come back for a bit later and talk about watching their baby and understanding what their baby's communicating to them.

Erin Ross (26m 46s):

So we're setting those ground work foundational pieces before we ever even start looking at feeding. Some of the families I've worked with, we've worked for eight weeks, 10 weeks before we ever do anything with feeding. I would say that we have learned over the years to break the process down. And the same thing happens as babies are starting to go home. When we start talking to them about adjusting for prematurity, we also, I have, I have learned one other thing to remind families. And that is, as you said, pediatricians are very busy and they have a tendency to hand out packets of information.

Erin Ross (27m 27s):

And those packets are based on the visit that you're there for, right? Your two month visit your four month visit. But those visits are based on immunization schedules. And most babies are being immunized based on their age, not their adjusted age. So when you go in and you're there for your four month visit, you're actually, they're not adjusting for prematurity when they hand you the packet that everybody gets it four months. And I always say your pediatrician knows about adjusting for prematurity, but that doesn't mean that they will always highlight that premium. And you're going to walk home with a packet that is probably talking about things that the baby's not ready to do yet.

Katie Ferraro (28m 9s):

And all it does is make the parents feel bad that their baby's not there because they compare themselves to what they think is the standard baby. Cause that's what was on the tear off that the man gave them in the pediatrician's office,

Erin Ross (28m 19s):

Right? And that's, you know, that's a constant message, right? For families because they have to look at developmental milestones. And now my baby's not doing any of these things or, you know, same thing with eating and, and with gross. And it just keeps coming back to them. And even though I try to constantly reframe the language when families say to me, well, when is he going to catch up? First thing I say is, well, he's not behind because he's on his developmental schedule. And his, you know, the fact that he's doing his development outside of you, instead of inside of you, you shouldn't be penalized for that. So let's, let's change our language.

Erin Ross (28m 59s):

He is, you know, the differences will disappear after about two years, but that's because the milestone slowed down. So, and then I just say, if you go to a park and you watch two year olds, you're not able to say that child is two years in that child's two years, three months. But if you're at a restaurant and someone comes in with a brand new baby, most of us are able to say, Ooh, that baby is brand new. So, so a lot of it is just helping them to understand the reason why we adjust now. And the reason why we stop adjusting is more just that things start to slow down

Katie Ferraro (29m 37s):

As a PhD in SLPD. I know you're incredibly knowledge about feeding milestones. You've mentioned some of them in our talk today for our parents who are a little bit later than the parents. You see making that gradual transition from a solely infant milk diet. Now they're in the second half of infancy or adjusted if necessary, they're starting to increase the baby's reliance on food for nutrition. Curious if you had any words of wisdom about transitioning off of the bottle for older infants?

Erin Ross (30m 2s):

Well, the first I would say is to start offering the solids first start holding off on the bottle. The second would be then to if weaning is your goal. And with bottle feeding, usually after a year, it is, we would start saying, you know, offering liquids in a cup as part of the mealtime, and then separating the snuggle cuddle time with the bottle so that you can give the bottle when the child is still sitting at the table. And that starts to disassociate the transitional object piece of the bottle becoming in and of itself, a comfort object and the nutrition coming from the bottle.

Erin Ross (30m 48s):

You brought that up a couple of times where parents feel like, oh, but I have to give my baby bland foods. And I always say, if you are a lover of spicy things like I am, if you're in a culture that eats a lot of spicy foods, like you live in India or you're, you know, somewhere in Mexico, that's what your baby's was, has been exposed to. And as a feeding therapist, working out of the, the NICU setting, many times we have a mismatch there where a parent has now come to the U S and they're trying bland foods, because for some reason we have that message and their baby is doing well, and we turn it around and we start offering more highly spiced foods because that's what the baby has been exposed to and they do much better.

Erin Ross (31m 38s):

So it really is reminding ourselves that babies around the world are experiencing all kinds of different flavors. And we put restrictions on them just based on what we think. But as you pointed out in the first year of life, babies will eat almost anything. I mean, now at least try almost anything.

Katie Ferraro (31m 58s):

And you want to take advantage of that. Cause it's not always going to be like that week. I call it the honeymoon feeding phase like this, this is an important, this flavor window concept is so important to take advantage of. And I know there's, you know, professional disagreement about exactly when the flavor window opens and closes at the end of the day, our Babies can eat so many more foods than we oftentimes give them credit for. And I think that's the takeaway message here.

Erin Ross (32m 19s):

Yeah. And I think the other addition that I would add to what you just said is that we have to understand why children between one and two years of age become so challenging in terms of eating. And it's actually because their brain is growing and they're thinking about the world completely different. And they're recognizing, hey, I have an opinion and oh, not only do I have an opinion, but I can share that opinion. Which of course, in their threes and fours become now, you should agree with my opinion, but in that first year to two years, what the brain is doing, what the cognition, the way cheldren are thinking starts to change.

Erin Ross (33m 1s):

And that's where the food pickiness begins. I truly believe that because it's, you know, they have opinions about what clothes they want to wear. And no, I don't want to put my shoes on. And I mean, everything becomes kind of their negotiation with you around what, what, why get to control and what are you thinking

Katie Ferraro (33m 20s):

And it's developmentally appropriate. I think we need to stop demonizing picky eating. I die. All these bloggers are always trying to fix picky eating. It's like it's developmentally appropriate for your toddler to be expressing independence in the foods they do want to eat or do not want to eat. And I completely understand, you know, extremely picky eating and, and underlying eating disorders and the importance of feeding therapy. And we've had so many experts on talking about that, but your general run of the mill neuro-typical child is a picky eater. A one-year old, thank your lucky stars. That's normal,

Erin Ross (33m 50s):

Right? That is part of neurodevelopment. And the piece that you're doing so well for families is helping them to understand. So what is their role? You know, their child is going through this phase because they're supposed to, and how do we, as parents react to that, we need to understand that that instead of, oh, you don't like these foods, I will stop giving them to you. It becomes, oh, okay. So today you weren't interested in this food and we keep trucking along as parents. We want to just keep thinking about variety is how children learn. And so today they may not try it tomorrow. They might, they might love it for two days and then they might reject it for four.

Katie Ferraro (34m 32s):

So where can our audience go to learn more about your work and then also to support your business because you have done amazing things in the online space over COVID congratulations.

Erin Ross (34m 43s):

Well, I have a website www.feedingfundamentals.com. We are actually just starting to do some information for families. I've really focused my attention on trying to help providers, nurses, especially in the NICU nurses and therapists, to understand the importance of, of helping parents build that lovely foundation. That's part of why I call it fundamentals, but I now have a new mom on my stuff. And she is the one who is saying, wait a minute. Well, what do we tell parents? And well, how come we can be helping parents?

Erin Ross (35m 24s):

And so I would say that that, that piece is going to just start, you'll see more of it that way. And then I also have that in the Facebook space. So feeding fundamentals.

Katie Ferraro (35m 36s):

Well, I hope you guys enjoyed that conversation with Dr. Erin Ross. I think her work is so interesting that she is working in the NICU in clinical setting for more than 30 years, and yet has that lens of a researcher as well, that she can kind of apply in her practice. And I know for one, I'm excited to learn more from her. We were talking about a lot of different educational opportunities that she has. If you are a feeding professional, she's gonna be working on more family centered stuff as well, but I'll link to all of her trainings and her online content, because she's really done an amazing body of work, especially during COVID. I did nothing during COVID. I feel like except like keep the ship alive. And she like felt this just amazing online research portal for other practitioners.

Katie Ferraro (36m 16s):

So I'll link that all up https://blwpodcast.com/episodes/250. You can also find links to more of Dr. Ross's work there. And I'll link to some of the other episodes that were mentioned in this podcast episode, because I know this is especially of interest to parents of Premature Babies with doctor Erin Ross. Her background is in NICU work. So blwpodcast.com/episodes/250. Thanks so much for listening. Bye now.

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