Transcript: Questions on Baby Led Weaning, First Foods and Poop

During their baby’s earliest days, many mums are spooked by the different colors of poop they are faced with and they often ask me about first foods and what to give their baby. Today, I’m delighted to welcome back Bekah Shephard, nurse and author of ‘a Nurse in Your Purse’ and we talk all about baby led weaning first foods and poop. Bekah shares some of her vast knowledge on these topics and you’ll hear lots of insights from the front lines. Bekah is a registered nurse who has worked with pediatric patients for over 10 years so she’s seen it all!

Helen Thompson: Welcome back to first-time mum’s chat . It was nice talking to you when we talked about the rashes and everything, and it’s lovely to have you back and welcome.

Bekah Shephard: Thank you.

Helen Thompson: So I thought today we’d have a chat about baby’s poo and then we’ll go on to having a bit of a chat about first foods. So, with baby’s poo, I’ve often noticed that newborn poo is very runny and I’m just wondering if that’s normal and how do moms know if it’s diarrhea or not.

Bekah Shephard: Gotcha. Yes. Baby poop is very runny in the beginning and it’s completely normal. It’s not going to look anything like our poop don’t expect it to and if it does, that’s when you run into issues. But normal breastfed baby’s stool is loose, it soaks into the diaper at times, and it can be squishy or mooshy but there should be no pebble like poop or really any formed stool at all in it. The baby might poop every hour for the first few days after coming home, or they might go up to a week without a bowel movement after those first few days, which can be normal for breastfed babies as well.

We usually recommend after about five days of no bowel movement to just check in with your pediatrician, just to make sure everything’s good. Otherwise it’s totally normal for a baby to have anything from every single day to nothing for about a week for breastfed babies. The poop color is going to be crazy.

You’re going to see yellow, you’re going to see oranges, you’re going to see greens and you can see normal browns and then if it’s breastfed, usually it’s going to have the little seedy stuff in it, and it literally looks like sesame seeds are in it and that’s totally normal too. The only abnormal colors that moms should be watching for, are going to be red, black, or white, and then those ones you’re gonna want to have your baby seen, if you see those in the diaper. And telling the difference between the breastfed stool and the diarrhea can be tricky sometimes because they both end up looking very loose.

But if you know what the normal breastfed stool looks like for your baby, then that’s the first step. And then knowing that diarrhea is actually watery stool that occurs multiple times a day. So even though, yes, there are days, especially in the first few days of bringing a baby home, where it seems like the baby’s pooping with every diaper.

It usually tapers off pretty quickly of them doing that. But if you notice that your baby’s stool suddenly increases in number or in its looseness, or if it has mucous or blood, or it smells horrible because breastfed poop shouldn’t smell terrible. It actually has kind of a sweet smell to it. But if it starts to smell foul, then it could be diarrhea.

Or you use all your senses when you’re checking your baby’s poops. So it’s just, it’s just a given. But typically if they’re under three months of age and you suspect diarrhea, then your pediatrician or provider is, is gonna want to know. So you should check in with them. Especially if they have a fever along with what you think might be diarrhea, then it’s best to have them seen.

Cause dehydration in the little ones occurs very quickly. So just better to err on the side of caution, if you’re suspecting diarrhea and they have multiple symptoms going on, like a fever or their extra cranky fussy, then just have them And in my book, I break it down what to do for the baby if they’re breastfed versus formula fed versus being on solid foods and what to do to help with diarrhea and that kind of stuff as well and as well as knowing the signs of dehydration in your baby.

Helen Thompson: I’ve also heard with babies when they’re young, it might not be constipation because they might be five days before they poo. I’ve heard people say that prune juice is good and I’ve sometimes heard people saying, be careful of prune juice. So I know it’s a tough one. I know you mentioned that in your book.

Bekah Shephard: Yeah, prunes and prune juice can help with constipation, yes. Any of the P fruits, so prunes, pears, plums, peaches, all of those are good for helping with constipation. And as a breastfeeding mom, you want to make sure you’re eating those foods to help make sure things stay moving within your baby and that kind of stuff.

But foods that can be constipating as well, you would want to avoid if you’re having issues with your baby and constipation. Cause those will pass to your baby. So, to help prevent constipation, you want to make sure mama’s hydrated. And you can do the prune and or pear juice.

Some people do apple juice as well. But sometimes doing the actual juice part of it yet for infant, you have to kind of do that portion of it. Whereas when they’re on the solid foods, if you can do the food source itself, as opposed to the juice, then it’s going to be better for that. So, like I said, with breastfed babies, they rarely get constipated though. I mean, they can go up to five days and if you are concerned and oftentimes the doctors will say, you know, moms increase your hydration, increase your intake of foods that are going to help loosen things up. Do the belly massages, do the bicycling legs, do the warm bath, that kind of stuff to kind of help with the constipation. So sometimes our providers would say that you would do an ounce of the prune or the pear juice for every month old that your baby is. So if you have a two month old, you could give them two ounces of prune or pear juice, for the day and it wouldn’t be diluted. It would just be like, kind of a one-time thing until they’re no longer constipated. So that is always an option. Of course, I’m going to say, check in with your provider to make sure that they’re on board with that as well. But for the babies that are on solid foods and things like that, it’s always better to do the actual pureed prunes or pears as opposed to the juice portion of it.

Cause there’s less sugar in the actual food source, as opposed to the juices that they make.

Helen Thompson: What about putting it in the bottle if they’re bottle fed?

Bekah Shephard: You can put it in the bottle to get them to drink it, but you don’t mix it with the formula. You don’t mix it with water. Yeah, you don’t mix it with their formula.

There are some providers that will say to go ahead and dilute it in some water. Most of the providers that I have worked under and worked with just say to do it straight, you don’t have to dilute it. But it does not get diluted with breast milk or formula or anything like that.

Helen Thompson: Because I know it can have a very strong taste as well. Cause I’ve had it before too.

Bekah Shephard: And a lot of times the kiddos prefer the pear over the prune. So that’s why we usually give both options because a lot of times the prune is not quite as successful when it’s in the juice form. Because the kids won’t eat it.

Helen Thompson: Yeah, absolutely. They won’t like the taste of it because it also doesn’t look very nice either. So is there any difference in the stool with a breastfed baby versus a bottle fed baby?

Bekah Shephard: Yeah. If the baby is on formula, it looks different than the breastfed stool. The formula fed stool is typically yellow tannish or brownish. You might see some greens in there as well. It’s often a bit stinkier than breastfed milk as well. And it’s usually thicker too. Almost like peanut butter consistency, but again, you still don’t want to say I use food analogies a lot to describe things.

But again, with the formula, you don’t want to see any pebbles or actual formed stool in the diaper, because then that would indicate constipation. And then again, the same colors, the black, red, and white would be the ones to watch out for whether you’re breastfed or formula fed.

Helen Thompson: And with the constipation, I know you mentioned when we were talking about the breastfed babies, you said not to worry if it was three or four days if they haven’t had a stool movement. Is that the same with formula fed babies?

Bekah Shephard: Nope. It is a little bit different with the formula fed babies. They are going to usually go once or twice a day. They can go a couple of days in between bowel movements, but typically with formula fed babies, you want them going at least once or twice a day.

Helen Thompson: Oh, that’s probably because of what’s in the formula I guess?

Bekah Shephard: Yeah, there’s different stuff in the formula and the body is going to process it different and depending on how quickly it goes through and how much of it’s actually used up by baby.

Helen Thompson: Okay. Cause I personally think breastfed babies is better, but obviously some moms can’t do that and it’s good to have both options.

Bekah Shephard: Yeah. I mean, as long as your baby’s fed.

Helen Thompson: Okay so when should I start giving my baby solids?

Bekah Shephard: They usually recommend around six months. There are still some old school doctors that will do the four months scenario. But a lot of times, in my experience, any of the babies that start at the four months, they ended up having a lot more belly issues and issues with the constipation and that kind of stuff. Just because the belly is just not ready until about six months.

So the, the recommendation is typically six months and there are certain instances where they will have baby start earlier and that kind of thing, but that’s a case by case. So the general recommendation is six months old.

Helen Thompson: Yeah. I know a little bit about this from my childcare background, but I know you should start on very simple foods, like rice formulas that you get.

Bekah Shephard: Yeah. There’s some moms that like to do the baby led weaning where it’s not necessarily purees, but it’s the soft mushy food that they can hold and that kind of stuff. I don’t care what method you choose to start your foods as long as the foods that you’re giving them are age appropriate, they’re mushable, they’re soft, they’re squishy, there’s no chunks and they’re healthy foods. I mean, I, I started my kids on pureed vegetables. And I honestly, I prefer those over the baby rice and the baby meals and that kind of stuff and there’s less ingredients, there’s less chance of a reaction and that kind of thing. Cause that’s another important thing is when you start those solid foods, I had one kid where we started her solid foods, no problems, complete breeze. We had another kid, we started solid foods and we had reactions. So it’s a good idea to be prepared for that.

And I don’t want to scare moms for like when they start foods, but you need to know that there is a chance of your kid having a food allergy reaction. Cause they’re so prevalent nowadays and that’s a whole other thing, but being prepared and having children’s Benadryl on hand and knowing what dose you need to give them, which is an important thing for when you do your well-child and in my book, I have this little chart thing in there for well-child visits at eight months each month. And I put in there. You know, you need to get at your four month well-child, you know, discuss first foods with your provider so that you can be prepared. And then before you start your solids, make sure you have the Benadryl dosing because the dosing is going to go based on your child’s weight and that’s going to fluctuate every month.

So you have to have that. So knowing having that stuff all prepared and ready to go before you actually start foods is a good idea. In my book, I have little handy charts for keeping track of that and those kinds of questions that you need to ask that when you get there, you’re like, I know there was something I was going to ask. Now I can’t remember. Or you write them down when you think of them. So it’s kind of helpful to have it all in one place. So just important things that you don’t really think about when you get all excited, like, oh, we’re going to try them on the first foods, but you do need to be prepared for in case there’s some sort of reaction and that’s every food that you try.

So, another thing to remember when starting the first foods is stick with one food and do it for three days. So say you’re going to start them on butternut squash, pureed butternut squash. Do butternut squash for one meal for three days. Make sure they don’t have a reaction to it before you move on to another meal.

Yeah. So because then that makes it easier to pinpoint if you’re going to have any sort of reaction and it doesn’t necessarily have to be an allergic reaction, you’re going to want to watch their stool, make sure their stool doesn’t do crazy things, which is going to do a little bit of crazy things. You are going to see a little bit more firmer stool.

Sometimes they have a little bit more issues with constipation. So you have to be aware of what foods like bananas or apple sauce, rice, that cause constipation because those foods are more binding. So just making sure that you’re paying attention to what foods are doing what to your baby by monitoring, not just the allergic reaction signs of, you know, hives and things like that, but also their stool.

Helen Thompson: Going back to the pureed food and stuff you mentioned. If you roast a pumpkin and you make it really, really soft because it’s been roasted so they can pick it up and I’m thinking of things like potato and because they’re soft they can bite on it.

Bekah Shephard: And you can do any of the squashes. You can cut them into like little strips so they got like a long little french fry kind of thing and as long as it’s soft and mushable, then that’s fine. As long as it’s something they can mush easily and they don’t have to chew really in order to be able to follow it, then that’s fine because a lot of them don’t have teeth yet when they’re starting their first foods. So As long as it’s mushable and squishable and soft, it doesn’t matter whether it’s in puree form or if it’s in grasper form, as long as it’s soft and they can mush it with just their gums.

Helen Thompson: Yeah, cause it’s also good for their grasping skills, if they can pick something up and even if they don’t eat it the pleasure of squishing it in your hands, instead of seeing it.

Bekah Shephard: They’re going to put that hand in their mouth and they’re going to realize they have something tasty there, so win-win yeah.

Helen Thompson: And I think that’s much better than feeding them with a spoon. You’re giving them the chance to pick it up and feel it and mush it and throw it on the floor they want to and make a mess and do whatever.

Bekah Shephard: And each baby is different so, you know, mama’s need to not be afraid to try something. If it doesn’t work, try something else. You know, don’t, don’t think you have to stick with just one method because that’s what everybody says they’re doing. Just listen to your baby, you know, watching what your baby’s doing and if it doesn’t work, switch it up a little bit.

And the other thing about starting first foods is a lot of times people will think once you start those first foods, oh, I need to start weaning them off the bottle. No, you don’t. You need to keep them either breastfeeding or on the bottle at least until a year, because that’s still where they’re most nutrients are going to come from.

So don’t, and when we would get called out, moms would be stressed or they’re just not interested in eating, they’re seven months old and they just won’t eat as much as I think they should. They’re not going to, and that’s totally okay. And it’s totally okay if they do, but most of their nutrients are still going to be coming from breast milk or formula until they’re about a year old.

So you have time to get this whole first foods and figuring that out because it’s going to take a little bit.

Helen Thompson: After you mentioned that, how much should you give them to begin with?

Bekah Shephard: Of the first foods? Usually you just start with, with one meal a day, you know, and you could break it up into a small, like if you do one jar of baby food, you could split that up and do a little bit in the morning and a little bit in the evening if you wanted, or you could just do one and they probably won’t eat that whole jar.

If you were to get it. I usually pureed our own and I put it into little ice cube trays, and then we’d warm up, like, you know, one ice cube thing. So I’m used to saying give them one little ice cube.

Helen Thompson: Yeah. I think pureed foods the jars can be very sugary. That’s why I’d always recommend to a mum to puree it themselves, like you’re saying, because you know exactly what’s in it.

Bekah Shephard: Recently there’s been a couple of different companies where they’re like, oh, we found this in it or we found that in it. So it was a little scary. And really when you buy a squash, you can make a ton of meals for that for your kiddo out of just one squash. So it’s really, it’s actually more cost-effective, to buy the vegetables yourself, steam them up, puree them and then you have a whole assortment and you know exactly what’s in ’em.

So, but yeah, it usually in the beginning, it’s just starting with and it’s going to be a small meal and it’s just one meal a day for a couple months, and then you can increase it as baby’s interest grows, you know? And sometimes in the beginning, when you first start it, you might feel disappointed because you’re like, well, I made this meal and they only took like two bites and they’re done.

It’s totally okay, baby doesn’t have to eat the whole thing. It’s just getting them used to it and the different textures and that kind of thing.

Helen Thompson: An avocado and banana are good. Aren’t they?

Bekah Shephard: Yes, banana, banana. I just said it like you, they can be constipating so you do want to be careful with those ones. But avocado is fantastic because it’s got healthy fats in it for baby and healthy fats are what, what babies need, absolutely. And it’s super mushable and those ones are easy. You can just slice them and they can try grabbing ’em.

Helen Thompson: That’s easy and even fruit. What about, apple? No, because that’s too hard unless you puree it. Strawberries probably not…

Bekah Shephard: Well, blueberries, unless you’re pureeing them, I would wait. I mean, you can get blueberries and kind of squish ’em kind of thing. And they can norm up a little bit, but I didn’t start blueberries with mine until I think they were probably like 9 months, 10 months or so.

So if you were to do ’em, you’d want to squish them first so that they’re not in the round form.

Helen Thompson: Yes, I’m quite imaginative. I could probably come up with something, but the first time mum, they might be thinking what fruits can we give them?

Bekah Shephard: For my kiddos, I did all the squashes. So you do pumpkin, you do butternut, you can do zucchini and yellow squash. They tend to be a little bit runnier though and once you get past doing the single foods, so, you know, your kiddo doesn’t have any issues, sometimes what I would do is I would add in a fruit to the butternut squash. So I’d add in a few apples and it would sweeten it up a little bit and it was kind of more of like a treat kind of thing. So we would do butternut squash and apples, we would do acorn squash and apples or bananas.

But again, just watch out for constipation. So pay attention to your baby’s poop. Gosh, my oldest is seven. My youngest is four. So it’s been a little bit since I made baby food.

There’s a lot of squashes and really any of ’em. I mean, as long as they’re not too thin and they’re not too thick, you know, any of them could be added a little bit of water to it, or breast milk to it. And they can be thinned up a bit if they end up being too thick.

Helen Thompson: You add a bit of formula to it as well. I suppose you can.

Bekah Shephard: You could. If any of them are too thick and you don’t want to add something else to it, yeah. I loved to with my kiddos they made those little mesh baggies and you’d stick the fruit in them and then you close it up and they just suck on it. My kids loved it. They were great for teething time. Yes. Those were, those were fantastic for teething. So I liked those.

Helen Thompson: Yeah. And also with the pumpkin cubes, they’d be good for teething as well because they can suck on those.

Bekah Shephard: Yep. If it’s in one of those mesh things.

Helen Thompson: A while ago I did a podcast on solids with somebody who is a nutritionist and I can’t remember exactly what it was she said, but she said that she used to take the skin off and just freeze the bananas. And when they were teething, they could actually suck on a banana because it was soft, but also cold, so that it helped with teething as well.

Bekah Shephard: When, if you have a big banana slice like that, absolutely.

Helen Thompson: Because it’s very good nutrition-wise for them to suck on. It’s not sugary. And it’s cold, which can numb the pain of the teething as well.

Bekah Shephard: Yep. I would give my kids for teething stuff too. I’d give them frozen, wet, cold washcloths and they would just know on those and that kind of thing.

Helen Thompson: Yeah, there’s so many different options, that’s why I mentioned the banana. So is there anything else that you’d like to add before we finish off about first foods?

Bekah Shephard: I don’t think so. It is a good idea and I have it in my book, just making sure that you’re keeping track, like I’d mentioned of what foods they’re eating and any sort of reaction.

So in my book, I’ve got a handy little first foods tracker that makes it kinda easy. And just being prepared, it’s fun. And most of the time people are worried about what food should I give them for their first food and should I do purees or should I do baby led weaning.

But, and then they often forget about, okay, if I give them a food, what happens if they do have a reaction? And like with my first one, I didn’t think of that. And then when my second one, luckily we had Benadryl and that kind of thing. So it’s just something to keep in mind, you know, when you’re getting all excited for preparing to start them on first foods, make sure you have the emergency part of it covered as well for any sort of allergic reactions.

Helen Thompson: Okay. That sounds good. It’s always interesting talking about food. I love talking about food because I love my food and I think giving what you’re eating to your baby, to some extent makes it a lot easier. Then, then you don’t have to worry about right well I’ve got to prepare this meal for me. I’ve got to prepare this meal for my husband. Just sort of make it all and just puree it for your baby or make it really small for your baby so you don’t have to worry about doing so many different meals. Cause I think sometimes that can be a bit overwhelming for a mum.

They’re thinking, oh gosh, help. I’ve got to feed my baby, I’ve got to give my baby this, I’ve got to give my baby that. I would say just mix it and just puree what’s left over so you can give it to your baby.

Bekah Shephard: Yeah, pretty much. It doesn’t have to be complicated. It just, it’s gotta be smart. I mean they don’t have teeth and they don’t really know how to chew, so just making it in the form that they’re able to swallow.

Helen Thompson: And make it fun as well.

Bekah Shephard: It’s going to be fun, it’s messy, it’s going to be fun no matter what!

Helen Thompson: Well that’s right and then they throw it on the floor, well, so be it they’re obviously thinking right I don’t want that today. Try it again another day.

Bekah Shephard: Exactly, that stage doesn’t last forever. So just enjoy it while you can because eventually they’re going to start saying they don’t want it as opposed to just playing with it.

So enjoy the state where they just make a mess.

Helen Thompson: It’s good for them to make a mess because they’re learning so many different skills. They’re learning the textures, even though they’re not eating it. They’re not getting the taste, but they’re getting the texture.

Bekah Shephard: Right you’ve had feeding time and arts and crafts all at the same time. So there you go!

Helen Thompson: Exactly and I think that’s the key, because I think a lot of moms get frustrated because their kids are throwing it all over the floor and not eating it and making a mess and drawing in it.

But that’s part of, that’s part of the fun part of being a kid.

Bekah Shephard: Exactly kids are messy and if you’re a mama, you’re going to have to get used to it. Cause it doesn’t stop when they get older.

Helen Thompson: No, it gets worse. So anyway Bekah, thank you so much for coming back, and it’s been a pleasure having another chat with you and I’ve really enjoyed catching up with you and and the Nurse In Your Purse is a great book by the way.

I would highly recommend it to any mom because it’s got a lot of useful tips in it which I really, really like.

Bekah Shephard: I tried to make sure everything was all in one place and tried to make it easy. It’s hopefully a book that, you know, you have all this information, but then you also have all the handy little charts and things that you need to that just kind of make it a little easier.

Helen Thompson: And I know I mentioned this in the last podcast, but I’ll ask you again. Two things. One is if somebody wanted to get your book, where would they go to get it? I mean, I know I’ve mentioned that in the other podcast, but it just in case somebody hasn’t listened to that.

Bekah Shephard: Yeah. You can go to my website. It’s just my name, bekahshephard.com and it pops right up on there. You can buy it from there, or you can even just download a free chapter on there. I have a free chapter about fevers. So if someone want to just kind of check it out, see if there is something that they’re going to like, they can download a free chapter. It’s also on Amazon, it’s at most major book retailers. So it’s kind of, it’s kind of everywhere.

Helen Thompson: One final question. Out of the couple of things we talked about what magical tip, whether it’s from the poop section or whether it’s from the first foods, what magical tip would you give to a first-time mom who’s going through what we’ve discussed?

Bekah Shephard: For poop, I would say don’t freak out. It’s going to be crazy poop. And if you know what’s normal and what’s not, then you’re good. So just relax about the poop it’s okay.

Helen Thompson: Okay, sounds good. So thank you, Bekah and thank you so much for coming back onto the podcast. It was great to have you back.

Bekah Shephard: Thank you for having me.

Bekah shared some great tips on baby led weaning first foods and poop. You’ll find the links to Bekah’s website where you can purchase her book ‘a Nurse in Your Purse’ as well as her Facebook and Instagram details in the show notes which can be accessed at mybabymassage.net/podcast/036.