Introducing new foods with infants is a task that can cause anxiety in even the most seasoned parents. Pediatric dietician and author Malina Malkani has dedicated her career to helping parents feel confident in providing children with a healthy start in life. Toledo Area Parent sat down with Malina to discuss what advice she would give parents with introducing common allergens with infants (the topic of her new book “Safe and Simple Food Allergy Prevention”), eliminating mealtime battles, baby led weaning, choking concerns and other child nutrition topics.
Toledo Area Parent: Your website offers a wealth of information on nutrition for families, with a little bit of everything from infant health and baby led weaning and introducing new foods to nutrition for teens and tweens to even nutrition for mom. You also mention that nutrition is your second career. How did your career evolve into a passion for nutrition?
Malina: Yes, in my prior career, I was a New York-based professional singer, actor and dancer, performing in national touring companies, Off-Broadway shows, regional theatre, and some television and film. While I loved what I did, I felt that I wanted my life’s work to help people in a more tangible way. Simultaneously, I was struggling with pressure from within the industry to be slender and look a certain way, and I learned the hard way that denying my body nutrients was not healthy or sustainable. When dieting, I found that I did not have the energy to perform at my peak through eight shows a week. This made me curious about food as an energy source, and the more I learned, the more I fell in love with the science of nutrition, so much so that I ended up going to graduate school and getting my Masters in Clinical Nutrition at New York University.
Toledo Area Parent: Before we get into the new book, let’s discuss some of your other work. Your online parenting courses center around safe baby led feeding and solving picky eating in children. So often, parents might say, “Oh, my child would never eat that.” What words of wisdom can be offered to curb some of those mealtime battles?
Malina: In my experience as a pediatric dietitian (and also as a mom of three), most families have the best success with mealtimes when parents start with a clear understanding of what our roles are (and aren’t!) as caregivers in the feeding relationship.
It’s not our job as caregivers to get kids to eat any specific food, trick them into eating, control or restrict their intake, or sneak any particular nutrients into their food.
Our role is to provide a wide variety of foods at meals and snacks that come at regular, dependable intervals throughout the day, make the eating environment positive and without distractions, role model the eating habits we want to see, and allow our kids to then decide whether and how much to eat.
This requires an element of trust. But most babies and kids are incredible at self-regulating and meeting their nutrient needs when we allow them to do so, and when parents and kids are both clear on their different roles, food battles tend to fall away.
Toledo Area Parent: Moving into your new book, “Safe and Simple Food Allergy Prevention,” many parents may mistakenly believe that they must offer their infant food in a pureed form. Rather, you advocate for simple, wholesome finger foods in a variety of textures. What benefits might parents experience introducing finger foods earlier?
Malina: Baby-led weaning is a way of starting babies on complementary foods using finger foods from the family table (of an appropriate size and texture) rather than spoon-feeding baby food in pureed form.
Potential benefits of baby-led weaning for babies include earlier involvement in family meals and exposure to different flavors, colors and textures, more opportunities to practice fine motor skills, greater early dietary variety and more freedom to follow internal cues for hunger and fullness. Baby-led weaning offers potential benefits for parents too. During baby-led weaning, the baby eats what the family eats (with some minor modifications) which saves time, money and energy because there is no need to prepare multiple meals.
Toledo Area Parent: A common concern when introducing new foods to infants is gagging/choking. Your new book does a wonderful job of explaining how not all gagging is bad. Explain how the gag reflex actually prevents choking, and how parents/caregivers can tell the difference between gagging and choking when feeding.
Malina: Depending on the texture of the food offered, babies may gag more often during the early weeks of baby-led weaning (and perhaps more so than spoon-fed babies). While this can sound alarming at first, it’s usually quite helpful.
Gagging is a noisy, common, built-in safety mechanism that involves bringing food forward that a baby isn’t yet ready to swallow. During a gag, you may hear gurgling, sputtering, or coughing, and babies will often open their mouths, thrusting their tongues forward. A common misconception is that if a baby gags on a certain food, it means they are not yet ready for it. On the contrary, it’s wise to take advantage of the gag reflex earlier on, between 6-10 months when the reflex is stronger and more protective of the baby’s airway. This way, babies can build sensory knowledge of the inside of their mouths, learn how to manage bites of food, and accept many different foods, flavors, and textures before the gag reflex shifts further back into the mouth at around 9-10 months and becomes less protective.
Choking, on the other hand, is generally silent and happens when a piece of food or object gets lodged in the airway and blocks it. A baby who is choking may become distressed, turn blue, and grab at the throat, but no air passes through. Intervention is usually needed to force the food out of the baby’s airway.
The best defense against choking is learning how to offer appropriately sized and textured foods for babies and becoming educated about which foods increase choking risk. Notably, when caregivers are educated on safe food sizing and texture, baby-led weaning is not associated with an increased risk of choking.
Toledo Area Parent: What should readers take away from the nine-day plan for introducing common allergens?
Malina: The truth is that offering top allergens early, often, and consistently reduces the risk that babies will develop food allergies, so it’s important not to delay their introduction. But when it comes to feeding babies, there’s no one-size-fits-all approach that works for everyone, and no one “right” way to introduce allergens. Further, what matters just as much as early introduction is keeping common allergens in the diet consistently, once introduced.
I created the allergen introduction plan as the resource I wish I’d had when my girls were babies, keeping in mind how little extra time, energy, and bandwidth I had during this intense phase of parenting. At the time, all I wanted was for someone I trusted to take the reins and do all of the meal planning, thinking, planning, recipe hunting and research for me! So, in “Safe and Simple Food Allergy Prevention,” the complete allergen introduction plan, 8 weeks of maintenance meal plans, and 80 allergen-containing recipes are designed to meet parents where they are, and allows them to follow along prescriptively or liberally, depending on their preferences and their baby’s needs.
Toledo Area Parent: Finally, Safe and Simple Food Allergy Prevention also has over eighty family friendly recipes that safely introduce common allergens…any can’t miss recipes that your own family loves?
Malina: Yes! It was important to me that all of the recipes are not only baby-friendly and inclusive of multiple top allergens but also family-friendly, because making more than one meal at a time can quickly lead to burn-out. To that end, I’m fortunate to have three brutally honest recipe taste-testers in my home (my three girls, now ages 11, 13 and 15). They love most of the dishes in the book, many of which are staple comfort foods I’ve been making since they were born, but they regularly beg for the Avgolemono (Greek Egg and Lemon Soup), the Almond Cardamom Sheet Pan Pancakes, and the BLW Saag Paneer.
Malina Malkani, MS, RDN, CDN, owner of Malina Malkani Nutrition and author of “Safe and Simple Food Allergy Prevention”
