Postural Support when Starting Solid Foods with Emma Hubbard, Pediatric OT

Emma Hubbard (0s):

Most importantly, when they're leaning, falling to the side or they're falling forward, their head isn't in a proper alignment So, it increases the risk of them choking on food and it makes it harder for them to breathe. But generally it just makes it harder for them to use their hands at all and see that food.

Katie Ferraro (15s):

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. Your baby, being able to sit on their own relatively unassisted is one of the most important signs of readiness to eat. And yet when I say that parents are always like, well Katie like how many seconds do they need to be sitting unassisted for? And what if they have to use their hand and they tripod?

Katie Ferraro (56s):

Does that count? Well, my guest today is here to teach us all about Postural support when starting Solid Foods. Her name is Emma Hubbard and she's a Pediatric Occupational Therapist from Australia. I am personally her biggest fan on YouTube. I'm like obsessed with her YouTube channel. It's amazing. I was so excited when she said yes to the interview cuz she does a ton of content about what babies need to do and what they go through to get ready to eat and then all the different developmental and motor skills stuff that they're learning as they are transitioning to solid foods and I was so excited when she said yes to the interview. Also, she's 37 weeks pregnant with her third child. So It was like, please keep the baby in there so we actually do the interview. It is a little bit longer than my typical interview episodes are, but like I could not cut anything because it's just so packed with value about the different developmental changes your baby is going through and it's stuff you might not even notice.

Katie Ferraro (1m 46s):

Like I don't even notice half the stuff that she mentioned. Like oh my gosh, you're totally right. And whenever I send over questions ahead of the interview, like half the time or sometimes the guests will write back and be like, oh can you change this or can we remove that question? So one of the questions I sent to Emma was like, I know you watched just as much baby content as I do. Like tell me the things that you routinely see about feeding and starting Solid Foods that are unsafe that you wish parents would stop doing. And she, you guys, she is bringing it like in her. She responds to the question with like a very distinct list of things she does not want to see you do when you start Solid Foods with baby led weaning because it is dangerous, it is unsafe or it's developmentally inappropriate and she does not mince words about it. So if you're not already following Emma Hubbard on YouTube, I highly suggest it.

Katie Ferraro (2m 28s):

And also her website is brightestbeginning.com. She's here to teach us all about Postural support when starting Solid Foods. With no further ado, here's Emma Hubbard.

Emma Hubbard (2m 40s):

Thank you so much for having me. It's so great to talk to you and this will be quite a lot of fun.

Katie Ferraro (2m 46s):

I've been a fan of your YouTube channel for a long time so it's like, like fangirling to see you in real life. This is so cool. So we're here today we're gonna talk a little bit about Postural support, getting ready for starting Solid Foods. But before we do, could you give, give us some background on yourself, professionally, and the work that you do?

Emma Hubbard (3m 3s):

Yep, sure. So I'm a Pediatric Occupational Therapist and predominantly for the last 12 years I've been working with families and children from zero to six years of age. And as an OT I would generally work with kids who are at risk of developmental delay. So the babies that were born bit prematurely as well as children who parents have noticed, they're finding it a little bit difficult to achieve their milestones. So generally, I would be looking at improving the child's ability to do everyday activities. So that is eating, sleeping, using the toilet, using their hands and then lots of play-based kind of skill development as well as dressing and all that kind of stuff.

Emma Hubbard (3m 45s):

But I guess since 2020 my work kind of shifted a little bit. So instead of directly only working directly with families, I started to share everything I kind of learned as an OT on YouTube and make some weekly videos where I share everything I've learned practicing as an OT to try and make that parenting journey for parents a lot easier, particularly in that newborn like that baby development phase and toddlerhood at the moment

Katie Ferraro (4m 11s):

And I was gonna ask coz I feel like I always watch your videos when I'm like focusing on the baby stuff coz we're in baby led weaning but most of your content is on babies, am I correct?

Emma Hubbard (4m 20s):

Yeah, mostly on babies. I'm branching into toddlerhood a bit more now but a lot of the, the feeding stuff that I cover, it's generally around starting solids but then also moving into that picky eating phase in that toddlerhood phase and strategies around that.

Katie Ferraro (4m 36s):

And as a mom of a three year old, are you currently dealing with some of that in real life?

Emma Hubbard (4m 40s):

Yeah, my five year old's actually the worst at the moment cause you know how they go through the phase at two and then again at like the five where they get a bit more rigid with their food. So my three year old absolutely loves food and he's always loved food but it was my five year old who had a bit more rigid So. It goes a bit more white food only and then drops those veggies meats and then she'll bring it back.

Katie Ferraro (5m 5s):

Okay. What's the vibe like in Australia as far as baby led weaning goes? Is it like a popular thing? Did you guys do that? I know you teach a little bit about that in some of your feeding content as well.

Emma Hubbard (5m 14s):

Yeah, so I guess where I live in Canberra when I worked in the government, baby led weaning wasn't the typical approach that we use. It's more of the traditional spoon feeding approach. I guess the, the main difficulty they would generally say with the baby led weaning in the past was that parents might give kids that food that are inappropriate at their age based on their oral modal school development. But really I've noticed in the last few years the information you are providing really is educating parents on what is appropriate food at that age because you can do finger food, it just needs to be appropriate based on their fine motor skill development as well as their oral motor skill development. I actually, yeah, so no it was an approach that I used with my two kids but it, it will be something that I'll look into with my third kid

Katie Ferraro (6m 0s):

You guys, she is like 37 weeks pregnant and the whole interview was like based on the caveat that she didn't have the baby. So thank you so much for coming to this interview when you're about to have a baby and I like look forward to seeing how it goes with your third baby cuz I feel like with each baby you take different approaches with regards to feeding and you mentioned like the government approach in Australia, in the United States I work very closely with the, our WIC program. It's our government program for women, infant and children and we, it's disseminated at the state level so we have 50 different states and they all handle it a little bit differently but the research supports a child's ability to feed themselves from six months of age plus when they're showing those other reliable signs of readiness to eat.

Katie Ferraro (6m 41s):

So we're here today to talk about Postural support and from your OT standpoint, what does that term Postural support mean and why is it important for babies who are getting ready to start solid foods?

Emma Hubbard (6m 53s):

Yeah so I guess learning to eat food is a skill and it's a skill that a child is gonna like, they gradually improve. So you know in the beginning they don't really eat a whole lot, it's about just exploring and then as they get older they start to can like really start to chew that food and then eat it safely. I guess with introducing solids it's really important that the child has the underlying postural support they need to safely sit and then explore and eat those foods. So there are some signs as you said of readiness that will cover in a bit more detail. But the main thing that I always really think is very important, it's key to safety when eating is that postural support.

Emma Hubbard (7m 33s):

So helping a baby actually achieve that ideal sitting support because if they can't sit then they're just gonna be falling to the side or they're gonna be leaning into that tray or the table that's in front of them, then that means they're gonna be pushing up on their arms so they can't actually use their arms to explore the food. And most importantly, when they're leaning falling to the side or they're falling forward, their head isn't in a proper alignment so, it increases the risk of them choking on food and it makes it harder for them to breathe. But generally it just makes it harder for them to use their hands at all and see that food as well, which is so important when you're starting solids of any sort.

Katie Ferraro (8m 11s):

And I think, especially as a dietician, I know sometimes fall victim to like we focus so much on how much the baby is eating and we forget like the OT standpoint, which is like this is all about learning how to eat and we always remind parents that you know, learning how to eat is a full sensory experience. It's not just about the the volume or the milligrams of iron that gets in the baby's stomach. That's not the point here. It's giving the baby this base to practice this skill, which is such an important point that you make. They, they're not proficient at it overnight and yet I feel like parents come into that second half of infancy with this expectation like this light switch just flipped on and now they need to get all their iron from food and they should be sitting up and they should be eating all this food and then they see other babies on social media and I think my baby's not doing that and there's all this pressure around food but we need need to remember they're not developmentally ready if they're not sitting up on their own.

Katie Ferraro (8m 59s):

In your experience, you know we always talk about the six month mark. When do babies generally attain, you know, your neurotypical full term baby, when could you expect them to be sitting up relatively unassisted in such a way that they can support a safe swallow with that core strength?

Emma Hubbard (9m 13s):

So in six months of age, generally kids are able to sit for a few seconds, it's not even that long and they're propping up on their arms so they're actually leaning forward into their arms and they're using that to sit up. And then you generally have pillows if you like, most parents all around them so that when they do fall over it's not gonna hurt. But if you provide support just at their side or their hips or they're sitting in your lap at six months of age, they can sit but they need that additional support. So yes the recommendation is to start solids at six months but if your child is finding it really difficult to sit, there's no harming waiting for a few weeks just to help practice that skill development.

Emma Hubbard (9m 53s):

And I would say what's really, really important is if you start at that six months mark or your child just needs that additional support, I would always adjust their high chair. So their high chairs in general, which is what I recommend kids sitting when they're starting solids and really use for years to come some performer seating is that it needs to actually support the child in that's ideal sitting position where their hips are at 90 degrees, their knees are at 90 and their feet are ankles are at 90 and that their, like their head is aligned with their body and that means that you're going to need to use rolled up towels at the side of your baby's body and you're gonna make sure that that footrest comes up to actually touch their feet.

Emma Hubbard (10m 35s):

Because once you can help them achieve that, it's gonna be so much safer for them.

Katie Ferraro (10m 40s):

And I think the rolled up towel approach is like it's the easiest high chair hack that can help your baby so they're not swimming around because obviously the, if they're leaning backwards, they're in the exact reclined position that could potentially increase the risk of choking in the way that their airway is opened. And yet it's mind blowing that like there's a best selling high chair that the key feature is that it reclines and I'm like you should never feed your baby in a stroller or in a rear facing car seat. It's, it's reclined at the exact position that could choke your baby. And then the thought that they make a high chair that reclines when we all know a baby should be sitting at a 90 degree angle with their back flat waist at 90 knees at 90 ankles at 90 degrees.

Katie Ferraro (11m 20s):

It's like it's amazing that they're even allowed to sell these high chairs but at least in the United States high chair safety is really limited to basically the tip test. You know, is it going to tip over backwards and, but there's lots of other dangerous things about high chairs besides tipping over and yet they're never addressed and there's lots of high chairs out there that are unsafe. Is it kind of a similar situation where you are as well?

Emma Hubbard (11m 38s):

Yeah, there's lots of high chairs that are just not not appropriate. I remember when I was doing a video on you two on high chairs like how to choose the good high chair and I saw that there was a big push on this recline feature and I just remember talking to my husband and going, I don't understand why do we need a recline featuring in a high chair.

Katie Ferraro (11m 57s):

I've had parents say that they like it for bottle feeding. I'm like, but that's not what a high chair's for, a high chair is for starting Solid Foods, I can't even believe like that their lawyers let them do it I guess is the other thing like this is just asking for a baby to choke, why would you ever make a reclining high chair?

Emma Hubbard (12m 12s):

Yeah and I dunno how much babies actually genuinely like it when they are starting solids because when you're in that reclined feature you can't actually see the food very well but you can't reach the food. Like if you imagine leaning back and then trying to use your hands to touch the food, it becomes really, really difficult.

Katie Ferraro (12m 31s):

And then parents say oh I have to shove this food in their mouth with a spoon because they can't do it themselves. Well not if we don't set them up for success.

Emma Hubbard (12m 38s):

Exactly. Yeah I would generally when I look at a high chair with a kid, it's always too big for a baby and then I start off with changing the height of the seat because I want their elbows to be resting on the tray so that they're at 90 degrees so they can actually use their hands, which means the seat height generally has to come up and then the side support needs to come in.

Katie Ferraro (12m 59s):

And I wanted to ask you back to the sitting at around six months of age anecdotally, I mean I've worked with so many different babies to start Solid Foods and almost none of them are sitting at a level that I'm comfortable with right at their six month mark. Even if they're born prematurely and we're waiting until six months of adjusted age, it's generally six months plus one week or two weeks or three weeks even. I find again anecdotally that most children neurotypical full term children are sitting if you're not sitting by seven months of age, that's pretty unusual. Would you agree as well? And that would be maybe something to consider talking to your doctor about if your baby's not sitting by seven months of age?

Emma Hubbard (13m 34s):

Like a red flag for sitting is that they're not sitting by nine months of age. So they definitely should be sitting by nine months of age without the need for support. But yeah, it's definitely something worth exploring whether or not they're not sitting at seven months of age often it's just giving them opportunity to practice that skill too. Cuz there's lots of, there's a opinion out there sometimes that you shouldn't help a baby into sitting if they're not able to get into that position themselves. It's not the view in Australia, but we would practice supported sitting at four months of age where you're holding them in your lap and that's mainly because I want them to start using their hands at that point too and then it helps they've got enough head control to maintain that position.

Emma Hubbard (14m 16s):

So

Katie Ferraro (14m 17s):

I like that note about four months in support of sitting and I was just curious if in your experience you've seen like you know baby wearing has benefits to a degree but if the baby's not allowed to be out and freely exploring and getting themselves into the sitting positions because they're being excessively worn, could you perceive that as being problematic for children as they approach this age to get ready to start solid foods?

Emma Hubbard (14m 37s):

Yeah there's lots of baby equipment out there that is amazing and baby wearing is fantastic, particularly in that newborn phase when they're really quiet unsettled and that attachment to you is really calming but with everything it's about moderation. So really kids need to, for them to develop those gross motor skills and like activate their tummy muscles and learn to roll and then like do tummy time and all that kinda stuff. They need time to play on the floor as well. So if you are just wearing the baby all day then obviously it's gonna have some implications on their development because they're not practicing those skills because they're essentially being supported the whole time. So yeah, they'll get some good head control when they wo because some it doesn't always provide direct support to their head but it's not gonna help them achieve those other muscles strength that's required for sitting.

Katie Ferraro (15m 28s):

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

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Katie Ferraro (16m 26s):

So in addition to the sitting stuff, what are some other physiological signs of readiness to eat that you advise parents to look out for with their babies?

Emma Hubbard (16m 35s):

Yep. So it's also good head control that babies need. So the baby needs to be able to actually hold their head upright and steady for a duration of a meal and they also really need to be able to use their hands so they need to be able to reach out and grab things and generally babies can get some voluntary control of their hands from four months of age, but it's not really well developed until about six months of age. So it six months of age they can use their hands a lot better. They generally use though a kind of a fisted grip, so it's a radial palmer grip at that point. So that's where they use their thumbs fingers and their palm to actually hold the item and at this age they're learning to kind of transfer one like a toy or food from one hand to the other.

Emma Hubbard (17m 20s):

So it's kind of, it's not very smooth, it's like yanking it outta their hand. And the other big thing at that age is that they don't yet know how to release so they can't drop something on purpose. It's often like casting it to the side so they just flip their wrist to the side or they kind of just hold it and then they, you'll notice they can't release at all and that's not until around seven months that they start to develop that skill. So they definitely need to be able to reach out and grab food and then bring it to their mouth. And the other helpful milestone is that they have a reduced tongue thrust which is where the tongue stops pushing the food out of their mouth. And that typically happens at around that six months of age. It starts to reduce.

Emma Hubbard (18m 1s):

The other thing is interest in food. Now I find that's kind of,

Katie Ferraro (18m 6s):

It's so misleading coz parents will be like well my two month old is looking at my food so I'm gonna start feeding them. Like no it is not an independent, like this is like a Venn diagram here, we need all of these things to connect and then you can do it. But like looking at food does not mean they're ready to eat at two months of age.

Emma Hubbard (18m 20s):

No. And then when parents like, oh they, they try and grab my food, they try and grab everything at four months of age and up and they'll put everything in their mouth at that point because that is how they play and explore cause they don't have those fine motor skills to manipulate toys or food really accurately. So that's good that they're interested in food but it's not a requirement. It's the sitting the good Postural like the head control and the ability to reach and grab food and that reduced tongue thrust.

Katie Ferraro (18m 46s):

I love your focus on the hand stuff too. I mean we've had Gill Rapley the, you know, founding philosopher of baby led weaning and the pioneer of the whole approach on numerous times to talk about, you know, the history of infant feeding and how much it's changed no matter where you are in the world it it's kind of fluctuated and yet we've all kind of settled on the six month mark and she makes an interesting point that a lot of the, she had, you know, if you have to prioritize the signs of readiness to eat the, the disappearance of the tongue thrust reflux is actually the least important because that kind of hearkens back to an era of when we used to start Solid Foods at around four months of age and unfortunately in the United States there's still government published guidelines saying start between four and six months of age and we know developmentally the difference between a four and a six month old is mind blowing and yet a six month old almost certainly has, they don't push everything out of their mouth as a protective mechanism anymore but at four months they certainly do.

Katie Ferraro (19m 37s):

And I'm just curious if you had thoughts on that cuz I know I, we almost never see any tongue thrust still at six months of age if you're waiting till they're actually sitting up in six months of age.

Emma Hubbard (19m 45s):

Yeah and it's not like, yes occasionally the food will come out but it's not really, it's rare that I would say that

Katie Ferraro (19m 52s):

Exactly it's because they don't know what to do with it in their mouth yet. It's not because they're protecting the back of their air word, they're just figuring out what to do and some of it falls out of their mouth just like some of it falls out of their hand even though you point out they can't release yet. I mean they will figure out how to do that and then they will be releasing food all over your kitchen, just wait. But it does come a little bit later.

Emma Hubbard (20m 9s):

It does come a little bit and I guess with the tongue thrust as well, it's something that will naturally decrease over time when you have them mouthing toys and you can help to reduce that tongue thrust by the types of food that you're presenting anyway. But it's, it's quite rare.

Katie Ferraro (20m 22s):

What if they don't mouth toys? Occasionally we'll get parents who are like, listen, I know all these signs and I'm watching my six month old baby and they don't bring up toys and they don't bring objects to their mouth. Is that something to be concerned about if they're not mouthing objects?

Emma Hubbard (20m 36s):

Yeah it, it's definitely something to be aware of. So there definitely should be mouthing objects that they should be mouthing their hands at around two months of age and three months of age and then they start to hold toys at around four and put those in their mouth and I guess if they're not mouthing objects there's a few things you'd look at what position they're actually in. So if you're expecting them to kind of, they're always gonna find it easier to mouth objects if they're lying on their back cuz they can use their hands in that at that age. But if they're lying on their tummy then obviously they're propping up on their arms so they can't use their hands at that point And you also need to look at the toys that you're presenting to your little one. So if the toys are really heavy then they're gonna find it hard to bring it to their mouth in the first place.

Emma Hubbard (21m 18s):

Or if they're really chunky then they're not actually gonna be able to grab it. I guess it's about toy selection and positioning to try and adjust that and see if that helps with their ability to mouth toys. But definitely keep an eye on it because it does have an impact later on.

Katie Ferraro (21m 35s):

I wanted to ask about the high chair positioning. I like that you said, you mentioned bringing the seat up so that the babies elbows are forearms can basically be resting on the tray. Part of baby led weaning if there is a table is we sometimes say bring the baby up to the table, right, the chair, we both like Stokke tripp trapp chair and that was designed to not have a tray on it, part of baby led weaning and the philosophy is to have the baby eating at the same table as the family. But obviously if there's a bar height or a counter height table then it's not safe to have the high chair. It doesn't fit there and you would use the tray. We sometimes hear feeding experts in the United States mentioned the tray being generally at the line of the baby's breast bone. But I've always taken issue with that because they then can't get their arms up on the tray.

Katie Ferraro (22m 20s):

So do you sometimes hear that and

Emma Hubbard (22m 22s):

I've never heard that.

Katie Ferraro (22m 24s):

Not like published. You sometimes hear people like, like just mention it casually. I'm like, no that's actually like really hard to do because if you were trying to eat and your hands were like this and you don't even have your pincer grasp yet, like how could you do it?

Emma Hubbard (22m 34s):

So I would say if you are looking at the height, it should be like elbows, like your shoulders should be neutral. So like just down and your elbows should be at 90 degrees and then the tray should be just underneath there or the table. So I do prefer sitting at the table and eating with everyone else as well. But so I would say it's more around their belly button,

Katie Ferraro (22m 53s):

The tray more around their bigger button.

Emma Hubbard (22m 55s):

Yeah, align in line with their belly button because as you said, if it's at line with their like their chest tight, then their arms are up to the side So, it is actually physically difficult for them to bring their arms up onto the tray. You'll actually need to do that for them but then their arms are up at the side and then that encourages them. It's, it's a very difficult grip and it's using all their shoulder muscles rather than more intricate muscles. So I would say it's difficult

Katie Ferraro (23m 22s):

And so for, I know I'm always looking at the babies that I'm working with. I'm like it's somewhere between their belly button and their breast bone I guess or chest line whatever. But of course you know your table height doesn't change but the babies that come through do so we adjust the seat, we adjust the foot rest so that the baby is safe and then at the table if it works for the type of high chair and table that you have regarding the restriction of the range of motion, one thing I'm concerned about is kind of this proliferation of these huge tent like contraption bibs that parents buy and are marketed to parents as a way to reduce or eliminate the mess of baby led weaning. And you see these babies who can't even move their arms in a tent that's covering the whole tray. I'm just curious if you had any thoughts on those.

Katie Ferraro (24m 2s):

Are those something you guys see in Australia?

Emma Hubbard (24m 4s):

Like I've seen the kids wear bibs like that are painting smocks kind of thing. Like we'd explain them as paint smocks for babies. I don't like they're, they're okay as long as you've got range of movements like you said like but you know the bibs that can catch food. I actually find that they're more of a hindrance because they stop the baby from getting close to the tray. Yep. They don't generally catch the food.

Katie Ferraro (24m 26s):

And they're heavy some of those way up to we, we were weighing them the other day, some of the heavier silicone ones, there's like a trough which by the way is disgusting I think to like catch all the gross food but then they weight the baby down sometimes and then you see them posture wise leaning forward because they've got these really heavy silicone bibs on.

Emma Hubbard (24m 43s):

Yeah no matter which approach you use, whether or not it's baby led weaning or the other approach mess is part of eating and it's actually a really big requirement on getting kids to eat food. So getting your babies to eat food, they need to touch the food, they need to smell the food. It's all about exploratory, like exploring the food and playing with the food and then they'll put it in their mouth. So if there's that focus on trying, I just think as parents you just need to embrace the mess. It was very hard for my husband but it's something you just have to do otherwise you're going to be, you're more likely to give an oral aversion kind of thing to food because you're constantly wiping them and you're constantly, which is really irritating.

Katie Ferraro (25m 23s):

It Is, it's imagine if you were trying to learn how to eat you know, oatmeal and this lady's coming at you with her wet wipe or her washcloth, that is a very negative sensory experience that a lot of parents are type A and myself as well. But getting messy is part of that full sensory experience of learning how to eat and I think once parents hear that message like oh this is okay, this is normal. Especially when we practice open Cup drinking, if it dribbles down the side of their mouth then that's how they learn, oh that feels uncomfortable. Let me adjust the Cup a little bit or tilt my head a little differently. And that's how they learn to improve. We don't need to fix all of our children's problems for them. It's amazing what they can do for themselves.

Emma Hubbard (25m 56s):

No and it's, it's messy because they need to but also their fine motor skills aren't there yet. So like that accurate placement of food using that precise pincer grip which is just their thumb and their index finger and then popping it into their mouth, there's no mess that's not gonna happen for well past a year. Like at 12 months they can develop that ability to have that really precise placement of like a piece of food into a like a bottled container, like a really narrowed neck container which means that they're gonna be a lot cleaner with eating but it's, it's just, it's working with a baby who has limited primary skills and is working out how to use their mouth.

Katie Ferraro (26m 33s):

And they get better with the more practice they get. Which leads me to my next question as they transition from using that whole hand or their palmer grasp eventually getting that pincer grip acknowledging that all babies are different and develop on their own timeline approximately when could parents expect their child to develop the pincer grip?

Emma Hubbard (26m 49s):

So they'll start to develop like an immature pincer grip which around nine months of age which is where they use the side of their index finger in their thumb to hold an item and at that point they can grab like the small food which is why you kind of move to that cubed food at that that nine month mark or like 10 up. I would generally say we again at like nine months their ability to kind of release is difficult so they can do it but they need to push against a surface. So that's why you kind of see them it into their mouth and then drag their hand outta their mouth at that point. So yeah, nine months it'll start to develop 10 months you'll get into more towards that 12 month mark you get that mature pincer grip which is where it's the tip of their index finger and the tip of their thumb.

Emma Hubbard (27m 36s):

So it's when they can like in Australia would give them like like Cheerios so that cuz they melting the mouth and yeah so they're small enough so that we could look at that pincer grip in

Katie Ferraro (27m 46s):

That which is funny, I always take offense when people say oh, Cheerios are a great first finger food. Well no because babies should start eating finger Foods at around six months of age and you know from research that children who have the least amount of practice with finger Foods are actually at elevated risk of choking and because they don't have their pincer grip at six months of age, Cheerios are not inappropriate first finger food. They're a fine food for older babies who've been eating for a number of weeks and months and have developed that skill. But we see parents trying to feed these really small Foods early on, they get frustrated of course cuz the baby can't pick it up and then they just give up and they think well I just have to do this for them. So I think it's important that we you know, realize that are different stages even within the second half of infancy where all these changes are happening and parents also ask about practicing the pincer grip, what exercises can I do with my baby to, they don't say make but what I hear is make them have that and are there exercises you can or should be doing or do you just let nature take its course then they'll figure out how to do it.

Emma Hubbard (28m 42s):

So you will, I'll definitely see kids who haven't developed that pincer grip but it's because of the exposure to food that they've had cuz they develop the pincer grip by practice basically and I like you're not gonna develop that pincer grip as you said at six months of age no matter what you do. But I think it's also very much about the toys selection. So often parents might still be giving their kids toys that were suitable under six months of age. So they're generally larger toys which encourage that whole hand kind of gri. Whereas when they get older, like from seven to nine months old there's kind of a jump in toys and then from nine like 10 to 12 months there's another jump. So in toy selection and generally the toys reducing size as they get older.

Emma Hubbard (29m 23s):

So I would be presenting like cubes to a like blocks that are small but not a choking hazard obviously because then that will encourage them to use their fingers to grab it because they can't actually use their whole hand.

Katie Ferraro (29m 37s):

I love watching your YouTube videos and seeing the babies playing and it's like it looks like they're playing and then you're describing I'm like oh my gosh but all of these like cool developmental things are happening and like as the parent you just, you sit there and you're just letting them play but they're learning so much

Emma Hubbard (29m 48s):

They learn heaps and I think that's what's so like I love about babies is that their development is like there's so much development in that first year and there's so like if you know the little parts of the development I get quite excited. So like when the kids start storing food over the high chair the baby, I actually find that really exciting.

Katie Ferraro (30m 7s):

Oh I love a 10 month old baby who's like dropping food left and right. I'm like no this is totally typical. Like this is what's supposed to be happening and parents like to hear that like well this is annoying. I was like yes it's annoying but like this is exactly what it's supposed to be happening so you're not doing anything wrong.

Emma Hubbard (30m 18s):

Yeah and I like it's a huge cognitive leap and I now know that things exist and they can release toys and I'm like this is amazing.

Katie Ferraro (30m 26s):

They are in control and then they own you. It's all over from there. I'm just kidding. Emma, what are some unsafe positioning or feeding practices that you see? I'm sure you watch as much baby content as I do like things that come to mind that you're like ooh, I wish I could tell them not to do that. That you could share with our audience so we could avoid that.

Emma Hubbard (30m 42s):

Yeah, so I was thinking about that. I think So it, I did have that recline position as one because it does make swallowing so much harder and it increases the risk of choking on food but also from a five minute development it makes it really hard to actually grab the food and put it into their mouth because you're essentially in recline. No one, like even us as adults, we don't sit and recline to eat food. It would be really hard and you'd actually stop eating quicker because it's just too tiring. The other thing I guess I see a lot is parents will have some form of technology on when they're feeding the baby or the child So, it might be TVs, it might be screen time or the parents themselves are engaged in some technology and I guess for us as parents it's important to be present when they're eating and watching the child so we can make sure that they're not at risk of choking.

Emma Hubbard (31m 30s):

But also when you're eating with your baby, it's really important to model that food is safe. So it's important to get in there and eat the food too, to eat with that mouth open so they can see it's safe and what to actually do. But most importantly I guess when what I find when babies are eating and parents go to this kind of option because they're finding meal times difficult and it's a way that they can get food into their baby's mouth without like the child essentially kind of knowing. But the difficulty with that I guess is that the child is then not focusing on the skill of eating, which is something we need them to do. And we also to avoid kind of picky eating in the future, you need the child to be looking and touching and interacting with that food and if it's constantly just being kind of placed in their mouth, they have no idea about that food and there essentially when you present it when they're a toddler, they might reject that food because they'll think that they've never seen it or touched it and then it becomes really difficult.

Emma Hubbard (32m 24s):

And when that technology's on, they're not really tuning into their body signals to actually stop eating food when they're full. So they might actually override that and then that means there's a higher risk of obesity in the future. So the other thing thing I always see is that the parents aren't eating with the child. So, or the family, like they're not doing that family style meal. Now I know that's really difficult when you have a a kid who's eating three times a day, it's not always possible but at least one of those meals it'd be helpful to have them eating with you so you can model that the food's safe.

Katie Ferraro (32m 57s):

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

5 (33m 5s):

Behind every work of art there's a story. Okay sure it sounds kind of obvious when I say it like that but think about it. How many times have you stood in an art museum maybe with a date or with your mom looked at an artwork and thought, I don't get it, I'm Amanda and I know the feeling all too well To me, knowing the story behind an artwork is a huge part of knowing how to look at it and appreciate it. And on my podcast Art of History, that's exactly what I share with you In each episode we view history through the lens of some really great works of art. There is so much we can learn about the people and things which someone way back when deemed worthy of recording for posterity.

5 (33m 49s):

And let me tell you on the podcast, we have barely scratched the surface. Join me as we dive deep into the bigger picture behind some familiar and maybe not so familiar works of art, no prerequisites required. Check out art of history wherever you get your podcasts.

Katie Ferraro (34m 11s):

Moms, you should slow down and you need to nourish yourself and take a pause and eat a meal. You're not only modeling that behavior for your child to mimic, but you're also taking care of yourself. Which we all know you can't take care of someone else if you're not taking care of yourself.

Emma Hubbard (34m 25s):

Exactly. That's very true. And I guess the main thing, which is like the force feeding and I know that comes from a point where you're just desperate to get your child to eat more food and have them to have one more bite. But that like all the research shows that it actually doesn't necessarily help in encouraging your little one to eat more. If anything it's gonna lead to stress for you and for your little one. And when your little one's stress actually suppresses their appetite can also lead to them overeating, which is that obesity risk in the future leads to food refusal and like picky eating. So I know it comes from a place of like well meaning is trying to get your kids to eat, but there's other things that I would try and do before going to that level.

Katie Ferraro (35m 7s):

I love, especially your point about technology, I find it parents ask me these questions too and I find it hard to say the technology thing without sounding judgmental because they're only using it because they feel that they have to. But I love your language of when they're engaged with the technology and not engaged with the food, they're not focusing on the skill of eating and just that reminder of how important it is to look and touch and interact with the food. It's hard right now you guys, but what Emma saying is you're helping to prevent that picky eating down the road. And that's I think kind of the, the secret sauce of baby led weaning is that yes, it's a little bit harder than baby force feeding a baby by spoon right now, but you are doing the legwork to help your child develop a wholesome relationship with food and to enjoy food and mealtime and you are saving yourself so much heartache down the road if you're putting the work in now to help prevent picky eating and allowing your child to explore that food and taste it and touch it during that flavor window when we know babies will like and accept a much wider variety of foods than they do in toddlerhood.

Katie Ferraro (36m 11s):

Technology does play a role and I thank you for that, that reminder that this is a skill that they're practicing but we have to give them the space and the grace to do that in their own time in a way that's developmentally appropriate for their age.

Emma Hubbard (36m 24s):

Yeah and I think taking that pressure off yourself that in the first like from six to 12 months food is seen as complimentary so they're still getting all that Nutrition that they need. But I think if you know that when you are eating, like getting your baby to eat food, there's actually like 32 steps to eating. So if they're actually moving up those steps and they first tolerate looking at the food and then they tolerate smelling the food and then touching the food and then they put it in the mouth, you are winning, they're, they're getting closer and closer to actually eating that food and exploring that food. They don't necessarily like any interaction with the food is a win. Any meal time that you have with your little o

Katie Ferraro (37m 1s):

One Emma best opt-in title ever 32 steps for your baby to learn how to eat. Like I would, I would give you my email address in a heartbeat for that to know from a developmental standpoint, like I know nutritionally right at six months of age all of their Nutrition is coming from infant Milk and by 12 months of age most of their Nutrition should be coming from food. And so somewhere in the middle there are about nine months, it should be about half half. Yes. But in your world it's like all of these little steps that are happening, it's helping you get to that point where they're moving from an infant Milk only diet to a Solid food only diet, but it doesn't happen overnight. There's all these incremental steps and the only thing you can do as a parent is give your child more opportunities to practice getting proficient at that skill Yeah, exactly. It is.

Katie Ferraro (37m 41s):

It's all about practice. It's a gradual approach but they will get there And it's worth sticking it out you guys because you do not have to short order cook for your child, it will help reduce the severity. We say there's nothing you can do to absolutely prevent picky eating, but we do have the data and the research to support that baby led weaning can help reduce the severity and the intensity of the picky eating, which is all we want for you is to not have your life be ruined by that short order cooking and that dread and the anxiety around food and the picky eating and then the feeling of like, well I have to put the iPad in front of them and I have to try all these tricks to get them to eat just one more bite. If we set the stage properly at the six month mark, the baby will do the things that they are anatomically equipped to do and they want to do and nutritionally they'll get there, they will get most of their Nutrition from food but it doesn't happen overnight.

Emma Hubbard (38m 28s):

No it doesn't. And I think that's what's so great about what you present as well is showing parents how to actually present the food at each age range. Because like you said, if it's too difficult for them to pick up and and eat, then they will get frustrated and they're not gonna explore that food. And then as parents you get frustrated with that whole approach as well and then you like I'm done and then you revert to these other methods. So I think just educating yourself on how to actually present food safely to your little one based on their developmental school level is gonna have a huge impact on their willingness to try food

Katie Ferraro (39m 1s):

Emma. Where can our audience go to learn more about your work and your business?

Emma Hubbard (39m 5s):

The main point would be going to our website, which is brightestbeginning.com. So that's an online educational resource for parents that really covers everything from early development, sleep teething, eating and potty training and generally, so the courses that are on there as well as the blog posts have been written by allied health professionals who specialize in their field So, it's OTs, there's physiotherapists and speech pathologists or speech and language pathologists I think they're called in America and it's all kind of evidence based. So that's a nice handy resource for parents. Then you can also find me on YouTube. So under Emma Hubbard there I post weekly videos. They're quite short, but it's just sharing some tips to try and make your life easier.

Emma Hubbard (39m 49s):

And then there's also my Instagram post, which I'm not a hundred percent at posting on all the time and that's broadest,

Katie Ferraro (39m 57s):

You're not missing anything. If I may, I mean YouTube we're like I was telling you when we were met before, like we just launched our YouTube channel, but I I love your YouTube channel. I think it is so important for parents because they don't get infant development classes like in becoming a parent. Just like with Nutrition in the United States, more than 90% of physicians have never taken a Nutrition class and people here go to their doctor to learn about stuff for their babies and they hear all sorts of wackadoodle stuff that's not based in any science. And so I firmly believe that credentialed professionals like yourself and myself when you're using these platforms to teach parents about the evidence behind these recommendations, like they're not getting that anywhere else. It's really cool that we have these platforms at our disposal to teach these topics that parents aren't getting.

Emma Hubbard (40m 42s):

It is and so rewarding cuz you just, so I often think it's just something that, you know, when you're in it all the time, you don't know that it's very like specialized knowledge, but it can make such a difference, which is so nice. Just a really small tweak and it can make such a different in, in a baby's life and a parent's life and then that engagement and interaction with the parents and child is so much better.

Katie Ferraro (41m 4s):

I love it. I, I was so scared when we started YouTube that I couldn't handle the comments, but people are so nice and they're so grateful for the knowledge and it's like such a cool way to interact with parents and ask their questions and answer their questions like I think it's wonderful and I think all of your resources are amazing. What are some of the courses that you offer for parents who are interested in learning more?

Emma Hubbard (41m 23s):

Yeah, so we've currently got a postnatal exercise program, which was developed by a physiotherapist, a women's health physiotherapist. Then we've got a baby development one, which I've made, made. So it's currently, we're in the process of expanding it. So it's currently zero to six months, but it's gonna cover zero to 12 months. So that's how to teach your child like how to support your child to achieve their milestones as well as like some just newborn essential tips that covers a lot of information and then we are in the process of working with the speech pathologist to develop a, like how to get your toddler talking a bit like just some skills and some advice on that. So it's lots of fun and I should be to sleep once soon.

Katie Ferraro (42m 2s):

I know you're gonna be living it. I wish you all the best with the tail end of your pregnancy here. I hope you have some time off planned for yourself and I will be stalking your YouTube to wait until your baby is ready to start Solid Foods. So it's, it's not that long away. Six months from now you'll be hearing from me.

Emma Hubbard (42m 18s):

Yeah, it'll be fun. It'll be fun to do it

Katie Ferraro (42m 20s):

All. It'll be interesting to see what you do differently with the third child versus second and first and, and you have two other kids at home who need you and, and how you will go about as a child development expert helping your baby develop this next step. I think that's one thing people love. Like people are voyers as you know, they wanna see what you're doing in your real life. I don't know if you find that those videos kind of do the best. People just wanna see, I know for me, what does the lady with seven kids make for dinner? Like, well, it's not that impressive because when you do it for work all day long, it's like, you know, gosh, we're having the same chili again tonight or whatever it is. Yeah. But people love to see the behind the scenes. So I love, I love seeing all of your videos and I would love to see your baby grow up on your videos too.

Emma Hubbard (42m 59s):

Thank you. It should be good. Hopefully like each time it gets a bit easier, so hopefully this one's easier.

Katie Ferraro (43m 6s):

I hope so. And I don't know if I could say that that's always the truth, but theoretically I could see that being true. So, well thank you so much for your time. I really appreciate it was such a pleasure to meet you and chat about all of this developmental readiness stuff to eat.

Emma Hubbard (43m 18s):

Thanks Katie. It was lots of fun.

Katie Ferraro (43m 21s):

Well, I hope you guys enjoyed that interview with Emma Hubbard. She is an absolute delight, so knowledgeable about all of the developmental things our babies are going through. I particularly loved like the specific timelines, like not that we want you to compare your baby to other babies, but like on the whole, here's what you can expect your baby to do at this month. And if it's not happening by this time, then maybe you wanna look into it. If it's potentially a problem or if your baby is doing it, then fine. We're doing a great job. Let's move on to the next thing. All of the resources that Emma mentioned today, including her YouTube channel, her website, her courses, I'm gonna link them all up in the show notes for this episode, which you can find at BLW podcast.com/284. Thanks so much for listening.

Katie Ferraro (44m 1s):

I'll see you next time.