Why Do Some Feeding Therapists Disagree with Baby-Led Weaning? with Jill Rabin, MS, CCC-SLP, IBCLC

Katie Ferraro (0s):

I have a baby Ezra update for you. So that's the little baby seven month old guy. I've been making all of his hundred first foods for baby led weaning. We're heading into week four, So I, can't believe it. He's almost 20 foods in. He's almost 20% of the way to a hundred first foods. And I've been sharing all the different foods that we're making five new foods a week following my five step feeding framework. So I'm actually following my own 100 First Foods daily meal plan making this baby five new foods a week. So I wanna tell you about week four in case you've just gotten started in the last month or so with baby-led weaning or you started and you're feeling stuck, like you just feel like you're feeding the same foods to your baby. Over and over here are the five new foods that we did in week four from the 100 First Foods daily meal plan.

Katie Ferraro (43s):

This is all part of my Baby-Led Weaning with Katie Ferraro program. I've been updating the weekly menu and the grocery list, refining the recipes to offer easier and more streamlined ways to make all of these recipes. 'cause this should not take a ton of time. And so my goal every week, I'm so proud, I've just been like getting less and less and less and less time on the food prep and making it easier for parents to be able to implement with their babies as well. So week four, new fruit of the week, we're doing banana. you can just do banana strips, the size of your adult pinky finger. Do not feed banana peel to you guys, to your baby. Like you guys, you don't eat bananas with the peel. Please don't offer it to your baby. It's a huge choking hazard. We have a really cool banana, nice cream recipe that you can do a frozen banana product if your baby's teething, they love these, you do it off of a preloaded spoon or out of an open cup.

Katie Ferraro (1m 25s):

On Tuesday we have a new vegetable. This week we're gonna be doing beets personally, not my favorite food. I was like gagging when I was cooking it. So I kinda. My kids were like, mom, the house smells like beets and I know you hate beets, but we do these balsamic beet strips for babies. They freaking love them, even though I think they smell gross. Wednesday, new starchy food of the week. We're doing corn. And so for early eaters, we don't do corn on the cob. Corn meal is a great food for your baby. I'm making these polenta strips, but polenta that you buy, the grocery store has way too much salt But. It's so easy to make it home. Then you fry 'em into these little patties and then little finger foods your babies can pick up and they try corn that way on Thursday. The new protein of the week is chicken. I'm doing my chicken adobo recipe. We've been working on this one four years babies love it.

Katie Ferraro (2m 4s):

Everyone. Everyone in my family loves this one too. And I hope that Baby Ezra likes it as well. And then the new Allergenic food of the week that we're gonna do on Friday is pasta. So that's the way that we introduce the baby to the potentially Allergenic food wheat. So if you want to follow the same 100 First Foods daily meal plan that we're doing, it's all part of my Baby-Led Weaning with Katie Ferraro program. I give you the exact sequence of foods to feeds, as well as have a weekly menu. There's daily recipes, there's a grocery list. I literally took all of the guesswork out of it for you. you can learn how to safely prepare each of the foods very quickly 'cause I want your baby to eat a hundred foods before turning one. you can follow this exact meal plan. Try all the new foods too when you sign up at babyledweaning.co/program. Again, that's babyledweaning.co/program and I hope to see you there.

Katie Ferraro (2m 47s):

So, which foods are not safe for your baby to eat? You guys know I'm usually all about sharing all of the foods that your baby can safely eat, but there are definitely some foods that we steer clear of when starting Solid Foods. I have a free Feeding guide called 15 Foods Never to Feed That will help you recognize which foods aren't safe. Now, most of the foods inside the 15 Foods Never to Feed Guide we avoid because they're choking hazards. But I'm providing you with tips on how to modify those foods so they are safe for your baby to eat. you can download the 15 foods Never to Feed Free Feeding Guide by going to babyledweaning.co/resources. Again, that's babyledweaning.co/resources to download your free Feeding guide 15 Foods Never to feed with the modification tips on how to make those foods safer, happy feeding.

Jill Rabin (3m 43s):

There is a mindset of Therapists that you know, we were always taught, we're in control. We're the ones who feed the babies in the eighties and nineties. Therapists, were doing all the Feeding of the babies. We had special spoons and cups and exercises, and that is the mindset that Therapists had that you know, we're in control of this. And these babies with, especially those with feeding challenges, they can't do this themselves. So we're the ones who who've gotta do it, we're the Therapists we're gonna fix and help this babies with their feeding difficulties.

Katie Ferraro (4m 13s):

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, leaving you with the confidence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning. We have a fair amount of healthcare professionals who listen to this podcast in addition to parents and caregivers, and some of them are doctors or dietitians, but there's also speech language Pathologists or Occupational Therapists who are interested in specializing in infant feeding or who may already be feeding therapists as well.

Katie Ferraro (4m 54s):

So from time to time we'll hear from SOPs and OTs and sometimes they say things like, we were trained to learn that baby-led weaning is dangerous, or we never learned anything about this approach in our training. So this is all new to me. Or more often it's a feeding therapist who says, I never believe that baby-led weaning was possible in my clinical practice until I use this approach with my own child. So the level of baby-led weaning acceptance among the feeding therapist community, at least anecdotally in my opinion, seems to vary greatly. My guest today is definitely very pro baby-led weaning when it comes to using this approach in a feeding therapist setting. Her name is Jill Rabin. She's a speech language pathologist and an IBCLC. So she's a lactation consultant.

Katie Ferraro (5m 35s):

Jill is the creator of the Adapted Baby Led Weaning Approach (ABLW). And she uses that for children who have feeding challenges and diagnoses such as down syndrome, and she helps them become independent eaters. So Jill co-authored a book on this approach, Adapted Baby Led Weaning with Jill Rapley and Jill Rapley is of course the founding philosopher, as I call her. She's the the person who created the entire baby-led weaning movement. She co-wrote the original baby-led weaning book, but Jill Rapley and Jill Rabin. Their book that they co-authored is called Your Baby Can Self Feed Too Adapted Baby Led Weaning for Children with Developmental Delays or Other Feeding Challenges. It's an absolute must read if you have been told that your baby cannot do baby-led weaning because of a particular medical condition or diagnosis.

Katie Ferraro (6m 16s):

So Jill and Jill were on the podcast in episode two 60, talking about their book and how that came to be. And then Jill Rabin was on in a previous episode. A solo was me and her. So Jill rapidly wasn't there. But episode 198 was when Jill Rabin explained about what baby-led weaning is. So if you wanna know more, go back and listen to those. But today Jill Rabin is here to talk about as an experienced feeding therapist, someone who's been in the field for 37 years. She has been feeding babies for a long time and she's sharing her perspective on why she thinks many feeding Therapists may initially be adverse to baby-led weaning. She has some very interesting insights on the control factor that some therapists think is essential for success.

Katie Ferraro (6m 56s):

But she's also sharing insight on how she believes that the general world of feeding therapist is changing with the younger and newer generation of credentialed feeding experts. So we're gonna be talking about baby Led Weaning as a responsive feeding method. Jill is also a very dedicated and accomplished lactation educator. So there's a conversation in there about how we can support breastfeeding mothers as well. So I, hope you enjoy this interview episode called Why Do Some Feeding Therapists Disagree with Baby Led Weaning with Jill Rabin.

Jill Rabin (7m 24s):

Thanks Katie. So happy to be back again. Okay,

Katie Ferraro (7m 27s):

The last time you were here was early 2022. You and Jill Rapley had just published your book that you guys co-wrote together. Adapted Baby, Led Weaning. What have you been doing work-wise since then? Jill.

Jill Rabin (7m 39s):

Okay, so lots of exciting things since the book was published. The book's actually called Your Baby Can, Self Feed Two. And as of this past August, it's a year old and a really exciting thing that happened is it just got translated into Polish. So there's a, that's actually, I was not a language that I would think would be one of the first languages that would be translated into, but we, we already have a book out that's translated into Polish and Jill, And I have been lecturing about Baby Led Weaning and Adapted Baby, Led Weaning all over the place and in other countries. We've done it here in the us. We've recently just spoke to Japan about a week ago, which was really, really exciting. We've spoken to Cyprus, the UK, Chile.

Jill Rabin (8m 19s):

So we're really spreading the word about Baby Led Weaning and Adapted Baby Led, Weaning, And I. Think the other really cool thing is there's been a lot of interest from other disciplines. We've had dietitians really interested in this. We've had Speech Therapists and Occupational Therapists and we've even, I know you're gonna be knocked over with a feather when I say this. We've actually had some physicians that have attended our webinars. I had an amazing physician in Montreal that had so many questions about Adapted Baby, Led Weaning and Baby Led Weaning and Jill Rapley and Tracy Meit just did this, this workshop in Japan and there were lots of physicians there, So I really think that that's the group that we really need to start to focus on because parents are getting a lot of advice from their, their physicians.

Katie Ferraro (9m 4s):

And I'll include it in the Shownotes for our episode. But you've come on in the past and explained what Adaptive Baby Led Weaning is and then you came on a separate time with Jill Rapley to talk about how you guys kind of wrote this book together. So I wanna make sure if people are interested in this, if you've been told that your child has a diagnosis and that they cannot learn to feed themselves Jill Rabin and Jill Rapidly together are working on this Adapted approach that says, you know, the timeline might look a little bit different, but all babies have the right to learn how to feed themselves even if it looks different than it would in a neurotypical population. Is that like a good summary of Adaptive Baby Led Weaning?

Jill Rabin (9m 36s):

Absolutely. And I would say. One other thing I would add is with Adaptive Baby Led Weaning, we often use a team approach. So we're gonna need like a motor therapist, like a physical therapist to help with positioning may. We might need a dietitian and a feeding therapist and we're gonna use different sized shaped and textured foods based on the skill of that baby. So whatever we use is gonna be safe yet therapeutic. And with babies that have more motor challenges, we're gonna have to use bridge devices like a silicone feeder or a preloaded spoon because they have trouble getting food to their mouth. Once those skills improve, we get rid of all those bridge devices and they'll do baby Led Weaning just like their peers.

Katie Ferraro (10m 13s):

So you And I connected a few years ago and one of the things I loved like instantly when we first chatted is that you are a speech and language pathologist SLP, who is also pro baby Led Weaning. And admittedly not all feeding therapists, not all SLPs are pro baby Led Weaning and So I would just like to get your take as someone, Jill Rabin has worked with the zero to three population for over 37 years. What is it in the SLP and maybe possibly the OT training curriculum that kind of sows these seeds of distrust in future feeding therapists where they'll say things like, oh, I don't do baby Led Weaning, or they don't trust that a baby can feed themselves. Why are so many feeding therapists at their core opposed to the baby led approach?

Jill Rabin (10m 54s):

Okay, so first I think it starts with what really is baby Led Weaning. I think a lot of people don't truly understand what Baby Led Weaning is. And I'll give you an example of that. Jill And I did a two part webinar for Get Permission Institute and Jill did Baby Led Weaning first. And then the next week I did Adapted Baby, Led Weaning. I was on the webinar watching Jill speak. And I was watching the chat as they were watching her and many of the comments that I were seeing, and it was mostly Occupational, Therapists speech, Pathologists, lots of therapists, a lot of them were saying, wow, I thought I understood what baby Led Weaning was until I saw this webinar. So I think a lot of people have their own idea of what that means.

Jill Rabin (11m 34s):

I think people think you either do strips of food and real pieces of food or you just do purees and spoons and they don't realize that baby lead is, we're not anti puree and we're not anti spoon. We just don't believe that anyone has to feed that baby that pureed food. They can do it themselves. So I think that it was eyeopening for a lot of therapists. I think the other reason that we see a lot of distrust is with baby Led Weaning is besides not really understanding what baby Led Weaning is and how it can be done safely, there is a mindset of therapists that, you know, we were always taught, we're in control. We're the ones who feed the babies in the eighties and nineties Therapists were doing all the feeding of the babies. We had special spoons and cups and exercises and that is the mindset that Therapists had that you know, we're in control of this.

Jill Rabin (12m 20s):

And these, these babies with, especially those with feeding challenges, they can't do this themselves. So we're the ones who who've gotta do it, we're the Therapists we're gonna fix and help this babies with their feeding difficulties. I think also we do know that how we feed babies goes along with the culture at the time. If you look at the ages and nineties when were babies starting solids, they were starting solids at four months. The only way you're gonna spoonfeed a four month old as Jill Rapley always says is, is if you're putting it in their mouth 'cause they can't do it by themselves. So now we shift forward to 2023 and we have baby Led Weaning and responsive feeding methods. The our culture is very about waiting until babies are six months waiting for babies cues, letting babies feed themselves.

Jill Rabin (13m 6s):

The culture has changed. So I think the Therapists that are more resistant to this are going to be more of the Therapists that are my generation because they haven't learned this, they haven't done it with their own child. I think it's going to change because I think now we're seeing lots of Therapists who have babies and they're doing this with their own babies and then they're feeling in turn more comfortable in doing it with their patients.

Katie Ferraro (13m 29s):

Hey, we're gonna take a quick break, but I'll be right back.

Jill Rabin (13m 40s):

That's a great point. So many of these SLPs who take our program or get interested in baby led, meaning they're like, I was kind of on the fence about it and pediatricians, it's the same story until I had my own baby. And I decided to explore Baby Led Weaning And I realized, oh my gosh, you don't have to manually force feed a spoonful of white rice cereal down a four month old throat. Like that is not a natural way for a child to learn how to eat. And yet that's what is taught even still in the dietitian curriculum. And we can talk a little bit about, you know, how curricula differ, but it's when you do it yourself and you realize, huh, if I wait till the baby's really ready, which much of that, you know, we owe that to the body of work that Jill Rapley did, which is really, really emphasizing the importance of waiting until six months or even beyond when the baby is showing those, as she says, the reliable signs of readiness to eat.

Katie Ferraro (14m 22s):

'cause you're right at four months of age, the only way to get that food in the baby's mouth is to shove it in there. But just 'cause you can shove a spoon of food in your mouth doesn't mean that you should be doing that to the baby. So

Jill Rabin (14m 31s):

Absolutely And I think parents are always in a rush too. Like, oh my baby's so advanced. I always say, who? Why are you rushing this? Who cares? Take your time, let your baby get the benefits of breast milk If you're breastfeeding. Like there is no rush to be doing this at four months. And I do think I'm, I'm hearing a lot more push for four months again, because physicians are misinterpreting the,

Katie Ferraro (14m 51s):

The allergy, the allergy, the misinterpreting the allergy guidelines. Absolutely. They don't understand that the introduction of Allergenic foods, especially for peanut at four months of age, the data doesn't show that it's any more protective against peanut allergy development than if you wait until six, it's 4, 2, 6 months of age. Well, a four month old can't feed themselves in a six month old can. So if our goal is to not have the baby choke on anything besides infant milk, we should wait until six months of age. But parents are getting a message, oh my gosh, I have to do it so much earlier. And it's opening up this, this huge area of confusion and, and a lot of opportunity to be honest for supplement companies who are selling products that have the allergens in them and telling parents, oh, you can't feed the baby food, but you should dump this thing in their milk. No, you should wait until that baby is safe and ready to eat those foods. But you should do those Allergenic foods early and often.

Katie Ferraro (15m 34s):

And I appreciate you pointing that out. That it's, it's the confusion about Allergenic foods that's putting us backwards towards starting solids at four months of age, which we know every major health body recommends exclusive breastfeeding until six months of age. Breast milk is sufficient to meet your baby's needs for the first six months of life. They don't need food.

Jill Rabin (15m 48s):

And And I hear this, I'm hearing this, I'm gonna say pretty much weekly now. So it's, it's that's, that's happening a lot that, that misinterpretation about the allergy. So parents are thinking they need to start at four months and they go to that four month checkup and they're like, oh, I just got the green light to start solids And. I'm like, what? You don't need to be starting solids at four months. So it's, it's causing a problem for sure.

Katie Ferraro (16m 8s):

I just interviewed Richie Gupta about a new study that she did with her group outta Chicago and it looked like only 13% of parents are getting the message from their doctor that they should start Allergenic foods early and often. So there's like this subset that are getting it like the wrong information, it starting too early and then the rest of them are like never hearing it from their doctors. And and the reality is, we were talking before the recording that you know, more than 90% of physicians in this country have never had a dedicated nutrition class. So pediatricians do a lot of very important wonderful things and, and many different things with the whole body. But if you go to your doctor and ask for infant feeding information, the likelihood that they've had any formal training in this is almost zero. And they are sometimes still perpetuating these outdated and dangerous recommendations.

Katie Ferraro (16m 48s):

Starting Solid Foods before a baby can sit up on their own increases the risk of choking

Jill Rabin (16m 52s):

100%. And and you know, actually I teach a transition to Huss class and my first slide is it's a picture of a physician at the top. It says, I learned everything I know about nutrition in medical school. And at the bottom it says, says no doctor ever because they learn nothing. But I will say some trend that something that's changing now is in medical schools, they are now starting to do training about nutrition. Here's what they're doing. They're doing it here in at University of Chicago. They're doing it at Northwestern, they're doing it at Tulane in New Orleans. What they're doing is they're bringing in local chefs to teach medical students recipes and ways to present healthy food because they feel that if a doctor can give recipes and specific foods versus just saying, oh you need to eat healthier is gonna be more impactful because people are going to be more likely to listen to their physician in any way.

Katie Ferraro (17m 40s):

Or if they referred to a dietitian who is literally trained in how to use food as medicine, the doctors wouldn't have to be going to all these food as medicine institutes. But that's probably a conversation for another time.

Jill Rabin (17m 51s):

In my opinion, every pediatrician's office and every GI doctor's office in the United States should have a dedicated dietitian to their practice. Oh

Katie Ferraro (17m 58s):

And all of the payers should reimburse for those services that the dietitians are qualified to provide get don't get paid for So. I got my own soapbox about that. And I do appreciate. We have a lot of pediatricians in our program who are like, yeah, you're right. Get over it. Katie, I didn't learn about nutrition in medical school. How do I do baby Led Weaning safely? I want them to be learning from a dietitian or a speech language pathologist or an Occupational therapist who's trained in infant feeding. I don't want them learning it from bloggers and from social media sites. So

Jill Rabin (18m 21s):

I couldn't agree more.

Katie Ferraro (18m 23s):

Okay. So I teach College Nutrition. And I teach nutrition throughout the lifecycle. And we have, as you And I know who work in baby Led Weaning a very real incredible body of evidence that supports a baby's ability to self feed when they are developmentally ready to start foods. And yet the nutrition textbooks still say asinine stuff like start Solid Foods between four and six months of age or white rice cereal is a good first food. I actually, in our nutrition world just got the very first sidebar about baby Led Weaning. I wrote, it's heavily laden with research and references. It will finally be in the next edition of the lifecycle textbooks that dietitians use the first ever mention of an alternative to adult led spoon feeding. Like we're only there right now. It's worth the very, very tip of, of changing this. It's in the textbooks, the future practitioners are learning about it.

Katie Ferraro (19m 4s):

But what is the situation for Feeding Therapists? That's what's happening in the dietitian world for OTs or SLPs And I know you can't maybe speak as much to the OTs 'cause you are an SLP, but if they wanna go into infant feeding, are they learning the current best practices or are they kind of like dietitians and totally behind the curve on the latest research and updated guidelines about safely starting Solid Foods?

Jill Rabin (19m 21s):

That's a tough question. So here's what I would say. So first of all, in most of the universities I'm, I think some are changing. There's not a lot of information given specifically about approaches like baby Led Weaning versus, you know, conventional spoon feeding. I think it, it talks more about swallowing and things like that and oral motor skill development. don don't know if they necessarily get into approaches of how to, how to offer solid foods to babies, And I think depending on where a student goes to school and and the knowledge and expertise and training of that professor, that's gonna have a lot of impact on that, on that student in terms of the information they gather. I have a friend who's a, who runs a speech pathology program at Mass General Hospital in Boston and she always tells her students all the time that a lot of times what you learn in graduate school, what you actually use in practice, you're not gonna have gotten any of that information from graduate school that's gonna come from doing coursework on your own and and doing additional coursework.

Jill Rabin (20m 17s):

And that's exactly what happens with Feeding Therapists. They get the basic foundational information in graduate school and then they have to start taking feeding courses. So a therapist's perspective of feeding is going to be dependent on what types of feeding courses are they taking? Are they taking behaviorally based feeding courses that are about like, okay, the child takes a bite and you reward them with a toy. Or are they learning responsive feeding tactics Like, like Marsha Dun Klein's get permission approach. So it's it's or Jill Rapley BLW or my ABLW or your class is all about BLW. It's going to depend on where you're getting that feeding information and what your perspective might be. So I think that the reason a lot of Therapists are anti baby Led Weaning is number one, they haven't gotten training from responsive feeding professors or people who understand that approach.

Jill Rabin (21m 6s):

And then if they're older Therapists and they haven't, they're not part of this generation and they fed their children the way I fed my children conventionally with a spoon. And I did Rice cereal way back in the day. So I think a lot of it, it comes from the type of training you get, how old you are, there's so many different factors and it's really, really frustrating because I can tell you as a, as a feeding therapist, I'm always reading everything that's current. I wanna read all the information. That's how I discovered Jill Rapley. Someone said you should watch this D V D about baby Led Weaning. And it changed my whole career because I, I saw so much value in the way that those children were learning to eat solids And I needed to use that approach with my population that struggled with feeding So I think a lot of it's training and age, I'm hoping it's going to get better.

Jill Rabin (21m 52s):

We still have a very, very, very long way to go.

Katie Ferraro (21m 55s):

You bring up an interesting point about, especially in the feeding therapist world, right? There's always the, the behavior base versus responsive feeding practice. And when I look, I was just doing some research, I know your background, but I was working on like formalizing my intro and And I was like, oh, Jill Rabin is an IBCLC. Of course you are because your background also in feeding recognizes another responsive feeding method. Breastfeeding is inherently a responsive feeding approach, right? You learn all about and your lactation educator teaches you about honoring the baby's fullness and hunger cues and looking for them and observing for them why at six months of age do we rip away all of that autonomy and decide that the feeding, as Jill Rapley says, must be done to the baby That's conventional adult led spoon feeding like baby Led Weaning is just an extension of the responsive feeding method.

Katie Ferraro (22m 42s):

Like every lactation consultant in the world should be pro baby Led Weaning because it's just an extension of that responsive feeding method. You start out with breastfeeding, the baby turns their head away from the breast when they're full, right? The baby cries when they're hungry. Those same responsive techniques are inherently in that child as they transition into Solid Foods. And we have to acknowledge that And I think it's really on the breastfeeding world to be promoting this as well. Would you agree?

Jill Rabin (23m 6s):

Absolutely. And I think I I would say that most lactation consultants that I know ev they're all on board because again, it's, it makes sense to us, right? It's, it very much goes hand in hand going from child directed feeding to child directed feeding, right? And you know, babies that breastfeed determine their own hunger and satiation. Why shouldn't they do that with Solid Foods as well. So it absolutely, it, it makes total sense. You know, when I see people now spoon feeding babies that look just look so funny to me 'cause I'm like, oh you don't need to do that. They can do that themselves. Hey

Katie Ferraro (23m 32s):

We, I always tell parents we used to smoke on airplanes too and that's a really weird thing now too. Like, oh we used to do it and we don't do it anymore because it's wrong. Right?

Jill Rabin (23m 41s):

Right. And And I And I think that my lactation background has a lot to do. It just makes sense baby Led Weaning is the obvious next step after breastfeeding for sure.

Katie Ferraro (23m 50s):

Hey, we're gonna take a quick break, but I'll be right back.

Jill Rabin (24m 1s):

And I'll go a step further. And I've had professionals Disagree with me on this. But when, especially when I'm talking with doctors and we're talking about trying to undo this message that we start Solid Foods at four to six months of age. If the World Health Organization, the American Academy of Family Pediatricians, if the, you know, every major health body in the world says exclusive breastfeeding till six months of age is what we're going for. When you tell a parent to start Solid Foods at four months of age, to me that is an anti breastfeeding message. You are telling the mom that her breast milk is not sufficient to meet the baby's needs you are.

Katie Ferraro (24m 31s):

You are helping her work away from her goal of exclusive breastfeeding till six months of age. 'cause there's absolutely no role for food in the human diet prior to six months of age. All it does is reduce supply, increase anxiety, increase the risk of choking, increase the risk of food allergies. I mean there's absolutely no drawbacks to starting early And I think if everyone claims to be pro breastfeeding, well you can't be pro breastfeeding and tell parents to start Solid Foods at four months of age. Those are mutually exclusive properties.

Jill Rabin (24m 57s):

That's genius. I love that. Katie, I absolutely agree with you. And, I, And, I. Think another misconception by pediatricians and by parents is that six to nine months they think that these kids should be getting massive amounts of volume. They don't understand that that time that baby is still getting most of their nutrition from breast milk and formula. That six to nine months is all about learning skills and different tastes and flavors of foods. It's not about push, push, push for volume and guzzled food down. And, I think that is another thing. Like parents really think that once you start solids, their babies should be getting massive amounts of volume of solid food.

Katie Ferraro (25m 33s):

They think a hundred percent of the nutrition needs to come from iron at six months of age. Like again, I think it's important for pediatricians to talk about iron, but you're stressing parents out that there's a light switch that switches off at six months of age and all of a sudden there's no more iron coming in and they need to be eating meat. Like no, they need to be learning how to eat foods that contain iron. And the breast smoker formula will continue to be an important source of iron as they go through the Weaning period. It means starting on time and giving your baby enough time to learn how to eat So that they can do all of these things eventually. It doesn't happen overnight.

Jill Rabin (26m 0s):

And if we give them that time to learn those skills, they do take in more volume. So if they get three great months of practice by nine months, they're taking in a lot more volume and they're gonna able be able to eat those iron rich foods. So, I think that we, we have a long way to go and teaching medical professionals and healthcare professionals about baby Led Weaning and how it works and how beneficial it is for babies. But it, it's, we still have some work to do.

Katie Ferraro (26m 24s):

Okay. I remember when I started Solid Foods, I struggled a lot with Spoon Feeding my oldest. So when my next babies who were quadruplets, they were born in 2016, started researching about Baby Led Weaning, what it was at that time, there was Jill Ripley's book, a lot of other like ancillary stuff about what Baby Led Weaning is and why it's preferable to, you know, conventional spoon Feeding. But there were not a good, good resources or any really on how to do baby Led Weaning. And you know, fast forward now we're what, seven years later? I specialize in baby Led Weaning. It floors me though that I'm seeing lists of conditions or diagnoses that say, well baby Led Weaning, it's either contraindicated or not indicated. I know from personal and professional experience, right? These conditions that are oftentimes on these lists, which are erroneous say things like, oh your baby can't do baby lid Weaning.

Katie Ferraro (27m 5s):

If they have a Lip or a Tongue tie or if they have Down syndrome or a Cleft Palate. I mean those babies can learn to feed themselves. And we've talked about this before, but their timeline just looks different. What do you say to Feeding Therapists who parrot these outdated lists and say things like, oh, it's not safe for this population or that type of baby can't do baby Led Weaning. Is this like the control thing that you think Therapists have trouble letting go of? Or, or why are those lists still circulating? I

Jill Rabin (27m 29s):

Think part of it is they don't know how to do it. They don't, and that's why I often encourage people, you know, watch a webinar that I do. I often show even on my Instagram, I show how I get from point A to point B and how I work with children. I originally, when I started Adapted Baby Led Weaning back in 2010, it was after I saw Jill's, she had a little 23 minute D V d that was the best thing ever. And and again, changed my entire career and changed my whole perspective about Feeding. And what I found is I originally developed it for children with Down syndrome because I was seeing so many kids, you know, in their toddler years and even up until the age of three they're being spoonfed just smooth pureed foods by an adult. And I was like, okay, we gotta do something to change that.

Jill Rabin (28m 11s):

Indirectly what I found is not only did that work for kids like that because all of that practice of hand to mouth was engaging core, working on eye hand coordination, you know, gnawing on strips was working on jaw strength. I saw so many positives therapeutically for this down syndrome population. But then what I saw is, wow, this works for kids who have feeding aversion. So if you have a preemie that was really aversive to eating and was aversive to the bottle and aversive to the breast, when you transition to a more child-directed feeding approach with solids, that eradicates, that aversion. I kept seeing how it could transfer to many different things. Some interesting things I found too is if a child has a Tongue tie, baby Led Weaning is amazing for kids with Tongue Ties because we do so many strips and we're doing so much side biting of those strips, we're working on side to side Tongue movement, right?

Jill Rabin (28m 59s):

So that's a great, great skill to work on and that's something that's hard for children who are Tongue tied. You're working on jaw strength, you're creating a bigger jaw. I also feel like it's extremely beneficial for babies who have Cleft because you're doing so much jaw work and movement of your face by eating big foods and and changing your jaw to bite small foods. You're, you're doing so many oral structural shaping things just by the foods that you're presenting versus just swallowing food that's put in your mouth. So it's so untrue that children who have feeding challenges can't do this. You just have to adapt it to the skill of that baby and it can be done safely. And in my book we totally explain how you do that. So I, again, I feel like a lot of Therapists are much more on board.

Jill Rabin (29m 41s):

I've gotten a lot of great feedback from Therapists who have read my book, And I even. I will jump on Zoom calls with Therapists and their patient And I, guide them on next steps of how to do things. Or I'll just talk to the therapist on their own and tell them what to do. So So I, I think that it's slowly changing, but again, we have more work to do.

Katie Ferraro (30m 2s):

Well, what do you want to see happen in the world of feeding therapist with regards to education and training about this topic for future practitioners? Like if you had a magic wand and you could just wave it at certain curriculum in their training or research dollars, wherever the resources may need to go, what needs to change in order to get more Feeding Therapists on board with this approach? Because we know it is a responsive feeding method that does work

Jill Rabin (30m 25s):

Well. I think number one, like you said, I think we need people who really understand feeding therapists dietitians. They need to be training medical professionals early on. They need to be in the medical school and they need to be teaching pediatric residents and family practice residents the importance of how children learn to eat, the importance of eating together. We've gotta change our culture around how we eat and how children learn to eat. That's number one. And we need to start early on. We have to teach medical students before they're jaded. And those pediatric and family practice residents, they need that, that knowledge first. We also have to work collaboratively, right? So, I can't do everything on my own. I couldn't do half the things I did without the dietitian I work with.

Jill Rabin (31m 7s):

When I'm working with a kid who's being tube fed and maybe that child's iron deficient or maybe they're constipated. I need to work with a team. We need to work collaboratively. What's very concerning to me now is I'm seeing two things that are awful. I'm seeing Therapists that have a minute of experience and they're super savvy marketing people and they're starting a, a social media account and they're doing all kinds of promotion about all the things that they know and they do. And they've seen 10 babies in their career

Katie Ferraro (31m 37s):

And they over pathologize normal nutrition and they scare parents into thinking they need all these crazy tools to start Solid Foods. I, I understand the tools are important in a therapy setting, but when 99% of your audience is a neurotypical child, they don't need those things to learn how to eat.

Jill Rabin (31m 51s):

They do not And. I also hate the, you absolutely can't do this product. you can only do that. I hate those statements like, you know what it was neurotypical babies, they're gonna be okay if they drink from a sippy cup once in a while. They are, it's not ideal, right? We'd rather them drink from a straw cup or an open cup. But there's so many like, you can't do this. There's so many rules that people come up with that have no, no scientific basis behind it. I think the other thing that is absolutely awful that I'm seeing happen a lot is there are companies that are, they have an approach, right? That they use whatever that approach. It might be a a specific feeding approach. It might be a a gross motor approach, whatever that approach is. Someone takes their course, which is generally pretty expensive.

Jill Rabin (32m 32s):

And then that person has that title that they can put on their website, oh, I'm a blah blah blah trained therapist. And you're getting people that are taking this coursework and it's outside of their scope of practice. And then they are telling patients that And I, this just happened to one of my patients. They were told by a lactation group, you don't need to work with a feeding person or a speech pathologist with this oral motor stuff. I took this advanced practice course. And, I. We can do the same thing with your baby. Well actually no they can't. So that's a terrible thing. I think you need to be super cautious. Parents don't know this, right? If if you go to someone's website and you're like, oh my God, they're a blah blah blah certification, this certification, it's great to take that coursework, but taking a one day course or a two day course and saying you're expert in that area is not,

Katie Ferraro (33m 21s):

That is one thing I'll say about OTs and LPs do a ton of that dietitians don't, that's not a thing. But I've noticed that so much. I'm like, where are they getting all this extra training from? I'm like, oh my God. It's like a two hour webinar that they took and they say they're like trade in this sensory, whatever it is. And they all sound super official. I mean there's, there's plenty of like hack fake credentials and nutrition, that's for sure. But you do bring up a very interesting point and while the work that lactation consultants do is very important, you are an IBCLC because you're also a speech language pathologist. So there's many lactation educators who are not even eligible to sit for the IBCLC exam because they don't have the other required credential that must precede that. Which is an indicator that you've had advanced training in feeding.

Katie Ferraro (34m 3s):

That's a safe assumption, right? Or that's a safe assessment. Yeah,

Jill Rabin (34m 6s):

It's just different background, right? I mean there's lots of lactation consultants that may not have had a science background in college. Right? They, I I know one that was a marketing major dude,

Katie Ferraro (34m 15s):

The one I had with my oldest was a paralegal. Yeah. And she walked into my, into the room. She was a lactation, she did not have an IBCLC, I'll just put it that way, and said, I think you should try formula And. I was like, I'm so confused because you claim to be a lactation educator. I'm also 24 hours postpartum so my milk has not come in and you just told me I need to do formula like for real. And the hospital is paying you for this and my insurance is paying the hospital for this. Like there's a lot of misinformation in all of our spaces. That's certainly for sure.

Jill Rabin (34m 44s):

And, I think this certification stuff that's on the therapist. Don't pretend that you can do something that you can't do.

Katie Ferraro (34m 50s):

Why would you want to? You're gonna get sued,

Jill Rabin (34m 53s):

Right? And And I, it's so frustrating to me 'cause I see so many people too. They're saying they're Tongue tie experts. Taking a one day course on Tongue Ties does not make you an expert. It does not. And And I think it's very unfair to parents. I see a lot of parents that, that they'll see somebody five or six times and then they get referred. If you can't handle something, you have to acknowledge that and be honest with yourself. You have to do what's in the best interest of your patient. It's not about your ego, right? We're all there to help people. And, I think that is an awful thing. I see so many people that spend months doing things that are not helpful when they could have seen somebody different from the get go that really could have made a difference. And it's, it's really upsetting to me.

Jill Rabin (35m 34s):

And I think that that's one of the biggest issues that we have with professionals is they're all over the place. They're, they're thinking they, they can do everything. You, you can't be a jack of all trades, master of none. You, you can't So I think that Therapists have to be a lot better about staying in their scope of practice and creating a network and knowing where to refer somebody when it's outside of their comfort zone.

Katie Ferraro (35m 55s):

Hey, we're gonna take a quick break, but I'll be right back.

Jill Rabin (36m 6s):

Well Jill, thank you so much for taking the time to talk about these topics. I appreciate your expertise. I know you've been in the field as I said, 36 years 'cause I saw that somewhere on your website, but you said it's 37 years And I. I appreciate all of your insight. I appreciate your expertise. And I, appreciate you taking the time to share these ideas with our audience. Thank you so much.

Katie Ferraro (36m 26s):

Well, I hope you guys enjoyed that interview with Jill Rabin. I love how matter of fact she is. She's like, this is what I think. She's a straight shooter. I love that. I'm gonna put all of her resources on the Shownotes page for this episode, which you can find at BLWpodcast.com/370. Thank you to our partners at AirWave Media. If you guys like podcasts that feature food and science and using your brain, check out some of the podcasts from AirWave Media or online at BLWpodcast.com. Thanks for listening and I'll see you next time.

Jill Rabin (37m 3s):

If you're interested in doing Baby-Led Weaning, but you're not exactly sure, like what does that mean? What does it look like? Where do I start? My online program called Baby-Led Weaning with Katie Ferraro has everything you need to give your baby a safe start to Solid Foods and get them to eat over a hundred foods before they turn. One, whether you're terrified of choking or maybe you've started but you feel like you're feeding your baby the same foods over and over 'cause you don't know what to feed next. Or you're looking for guidance on how to prepare foods safely for your baby's age and stage. My program has exactly what you need. There's five hours of concise self-paced video training. you can knock this thing out during nap time this week. You also get access to my hundred first Foods content library so you can see and learn exactly how to prep all of the a hundred foods as well as my original a hundred days meal plan.

Jill Rabin (37m 46s):

I've been refining this program for the last seven years, just today of Mom Road to me and told me that the a hundred days meal plan has been a game changer for her busy lifestyle.

Katie Ferraro (37m 55s):

When you join the program, you also get access to over a hundred phase two combination food recipes. So you're gonna try out the trickier textures, push your baby's Palate. And what's cool about these recipes is your whole family will enjoy them. So everything you need to give your baby a safe start to Solid Foods is inside of the program. It's created by me, a registered dietitian who specializes in infant feeding. If you're tired of hunting and pecking around the internet trying to piece this stuff together on your own, I put it all in one convenient place for you. I invite you to check out the baby Led Weaning with Katie Ferraro program. That's at babyledweaning.co. Again, that website is babyledweaning.co and click on program to learn more.