The 12-Month Milk-to-Food Transition

Hi Amy!!

Love your blog/column! I am really having a hard time with something and I am hoping you and your readers can help. Here goes!

My baby (toddler, I guess, now?) just turned 12 months old. We have two problems with food:

1) Too much milk. He’d been taking in 35oz of breastmilk, plus solid food. (I exclusively pumped and am weaning myself from the pump now, and he is starting cows’ milk without issues. Right now we are at half breast milk and half cows’ milk in each sippy cup, and we are gradually increasing the cows’ milk.) At his 12 month appointment, his doctor said that he should be drinking no more than 20oz of milk. We are starting to reduce the amount of milk, but we know we need to get more solid food in him, then. Which brings us to:

2) Struggling with self-feeding. He put a puff in his own mouth using his own hands for the first time 4 days after his first birthday. I just about held a ticker tape parade, I was so excited. I had been spending dinner time for the past few months demonstrating eating Cheerios and he. just. would. not. do. it. Now that he has the idea, we are practicing at every meal with things that are easy for him to hold onto and aim at his mouth (like toddler biscuits). The thing is that he’s pretty picky. Generally if I give him something that is not a toddler biscuit or cracker-like carb (I have tried scrambled eggs, pieces of cheese, meat, fruit, etc.) he will cry and/or pick it up, throw it on the floor, and watch the dog eat it. I will put about 10 things on his tray (one at a time) and encourage him to eat it at every meal. After it’s all on the floor (and the dog is full to bursting), I go ahead and feed him whatever baby food he’ll eat to fill him up. (So – back to number 1 – that he won’t need so much milk.)

If he were a 7 or 8 month old baby who was learning to self-feed, I think this would be pretty simple – offer him a few things, let him self-feed, and if he doesn’t go for it, no big deal. Before one food is just for fun, and it’s breastmilk or formula that is important, right? Except he IS one. I feel like the goals of self feeding and less milk are both very important but sort of at odds with each other – if I don’t feed him baby food AND I limit the milk, what do I do when he’s hungry? Put him in the high chair (regardless of the time) and attempt to feed him? Deal with him being very unhappy until the next meal? What about when he wakes up starving in the middle of the night (this happens when he doesn’t eat enough during the day, otherwise he sleeps through the night)?

Other facts that might be important – he is a good size (25.5 pounds, proportional height) and is meeting most other milestones. I just gave him the 12mo Ages and Stages questionnaire and he seems slightly behind in Language and Personal-Social but on track/ahead everywhere else.

Please help me! I have no idea what I’m doing and I feel like I’m doing everything wrong.

Thanks!

Okay, the very first thing you do — THE VERY FIRST THING — is skeedaddle over to Amazon to buy this book, a book I have mentioned before but there is seriously no better resource for picky eaters and their overwhelmed parents: How To Get Your Kid To Eat…But Not Too Much, by Ellyn Satter. Honestly, I think everybody should read this book before even starting solid food with a baby so you’ll know exactly what feeding pitfalls to avoid. Because oh, those pitfalls are soooo easy to fall ass-over-teakettle into.

Basically any and all advice I can offer is cribbed directly from this book, but I promise it is 100% totally worth buying because it will become your Mealtime Bible for many ages and stages to come. Whenever I sense the wheels starting to come off around here in regards to one of the boys’ behavior at the table, I go back to this book for a gentle reminder to stop doing whatever it is that I’m doing that has once again allowed the Food Battles to creep back into our lives. You will never, ever change your kids’ desire to exert arbitrary and game-like control over what they eat, but you can absolutely change the fact that you’re unintentionally playing along.

So, let’s Satter-up your concerns here:

1) Too much milk. Indeed, this is a big one. It’s super-important to remember that cow’s milk is NOT the same, nutritionally speaking, as breastmilk. So there’s no reason to make a bottle-for-cup even switch. Yes, it’s got calcium and vitamin D and fats and calories, but it should absolutely not be the cornerstone of your child’s diet. Too much dairy fat is not good for little hearts, it can be hella constipating, and yes, it’s really, really filling and satisfying. I know it feels like a Catch-22: You don’t want to cut back on the milk until he’s eating more solids, but he probably won’t be hungry or willing to try more solids until you cut back on the milk. Again (BROKEN RECORD), Satter’s book goes into a more detail about the too-much-milk-and-juice pitfall and how to best avoid it. Offer milk in a cup at meal/snacktimes only, with water in between. I promise you he won’t starve and/or collapse into a pile of undernourished, powdery bones if you cut back to 20 ounces a day. (My pediatrician insisted on no more than 16 ounces for toddlers, so hey! He’ll get four whole more ounces than my poor kids did.)

2) Too much pressure! Just reading about your mealtimes sounds exhausting, and it probably is, for both of you. Ten different food items, even one at a time, is way, WAY too many. That’s an overwhelming number of options, and toddlers don’t need every meal to be a buffet. By taking away rejected foods and immediately offering something else, you’re short-order cooking for him, and letting him know that you don’t actually expect him to eat any of this stuff.

(And even if he WAS sampling even half of those options, fast-forward a year or two and try to imagine the reaction you’ll get when you want/need to cook ONE meal for everybody and put that ONE option in front of a kid who is accustomed to at least a dozen to pick-and-choose from.)

Self-feeding is half observation, half instinct, but either way the non-stop Cheerio demonstrations are not necessary. Your son likely just thinks you’re either playing a weird, uninteresting game with him…or he’s sensing the pressure to self-feed when he doesn’t want to self-feed for whatever reason. (He’s overwhelmed by the options, he’s holding out for milk or purees, he’s just not that hungry.) Your job is to put food in front of him. It is his job to eat it. Yes, even after 12 months, even after weaning, even with less milk than before.

So edit down the offerings — waaaay down. Start feeding him what you are eating, or make him a finger-food meal of no more than three, maybe four things. (Protein, grain, fruit/vegetable, milk.) Put the food on his tray at the same time and…you’re done. The end. Back off. No frantic hovering and “HERE COMES THE AIRPLANE, NO? OKAY, HOW ABOUT THIS? OR THIS! YAAAAYYYYY YOU TOUCHED A PEA CLAP CLAP CLAP!”

Eat with him. Family meals do make a huge difference, and will be more effective than a million pincher-grasp demonstrations. If you’re skipping breakfast and waiting until naptime for your lunch, change that and make those meals social and pleasant, together. (And not like a singularly focused feeding boot camp.) If he refuses to touch anything, keep him in his seat until you’re done eating and have him “keep you company.” Spoon-feeding purees after 12 months is…eh, I dunno. I certainly spoon-fed yogurt, soup or applesauce as part of a meal to my non-utensil-users, but offer them at the same time as the finger foods — not as a last-resort, stressed-out concession at the end. (He’ll know to wait for it!)

I swear to God, he’s not going to starve. He’s not going to fall off the growth chart. Toddlers in general eat VERY LITTLE, and they eat it very sporadically, but they 100% can self-regulate their intake. Schedule regular, set snacktimes in between meals — I’m not a fan of grazing buffets in between meals but we do have a morning and afternoon snack that is also eaten at the table. Toddlers and little kids need snacks, for sure. This SHOULD take care of the going-to-bed hungry thing because at SOME POINT, he’ll stop skipping feeding opportunities and eat. It might take awhile. There might be some anger and crankiness as he fights the all-milk diet change, but again: HE WILL NOT STARVE. (And like sleep, good eating habits and attitudes about food are so, so (sososo) important, and worth it in the end.)

3) The texture/motor skill issue. I think I sense an unspoken third worry at the end of your letter — that his refusal to self-feed and pickiness is a sign of sensory delays or some other out-of-the-ordinary problem.

My dear friend went through a health scare recently and her doctor gave her the best analogy I think I have ever heard: “When you hear the beating of hoofs on the street outside your door, you think horses, not zebras.” Right now, sensory problems and the like are the zebras. Correctable feeding/mealtime problems are the horses.

Noah was — and is — my pickiest eater, yes. Noah had sensory/texture issues and oral/fine motor delays, yes. I also made a TON of mistakes when it came to feeding him as a toddler because I didn’t know any better. I short-order cooked, I begged, I pressured, I got annoyed, I bribed and bargained. I tried to shove a spoon in his mouth thinking that if he just TASTED it, he’d LIKE it. I gave in and catered to his food whims meal after meal and fed him a lot of packaged, processed garbage because it said “BABY” or “TODDLER” on the package and all sorts of other things that I now cringe just thinking about.

Then I bought Satter’s book on the recommendation of…well, EVERYBODY. Blog readers, friends, his speech therapist, etc. We went cold turkey into her Division of Responsibility plan (my job = buy, prepare, serve food. his job: eating it, full stop.)  It was hard, since he was over two years old and established in his unbearable pickiness. He skipped meal after meal in protest. One day he drank a glass of milk and a yogurt smoothie and that was it. And then the next meal he ate spaghetti and meatballs WITH SAUCE and then fish and rice for dinner. The next day he went back to Cheerios for breakfast and refusing everything else. And I refused to care, and that child is still 90th percentile for height and a perfect 50th for weight. He is still picky, yes, but not THAT picky. (I’d say he’s probably a fair-to-average eater now, and is only “picky” when compared to his little brothers, who are both AMAZING eaters. Ike, too, has suddenly come alive with the joy of EATING ALL THE THINGS.)

Since I see a lot of small things you can change about your mealtimes — you’re putting sooo much pressure on yourself (and indirectly, on him), so Change #1 should be a deep breath and a step back — I wouldn’t be calling up the occupational therapist just yet. If you can’t let go of the worry, by all means try some fun sensory-based activities with him. Let him play with “weird” textures like Play-Doh, shaving/whipped cream, and containers of dry rice/beans. Hide small toys inside and have him dig them out. Likewise, have him practice his pincher grasp with non-food items — play along but don’t hover and pressure him. Keep it relaxed and low-key and fun. For his mouth, get him a battery-powered toothbrush and let him play with it. (If he’s reluctant to put it in his mouth, let him put it in yours.) Switch to sippy cups with straws for maximum oral-motor-pre-speech-muscle development.

(And seriously, buy Satter’s book. It will CHANGE YOUR LIFE. Or at least, make your life feel a lot less stressful and focused on the capricious, evil whims of a toddler’s eating quirks.)

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