Hello, responding to previous post about my comment.  The reference you
may want to take a look at is "Feeding and Swallowing Disorders in
Infancy" by Lynn Wolf MOT,OTR and Robin Glass MS,OTR.
I did not refer to the window of opportunity being 4 months.  The AAP
recommends STARTING at 6 months.  In fact, I was not referring to the
topic of introducing solids at all.  The issue I referred to was
regarding an infant that has not been suckling but receiving tube feeds
due to a history of aspiration.  If a child is primarily tube fed for
the most of the first year, there are oral motor skills that they need
to accomplish.  There are developmental periods that are more opportune
to learn and master those skills.  A baby that did not receive any
bottle or breastfeeds may not be able to do so if the attempts begin in
the later half of the first year.  Is it possible for them to nurse or
take a bottle? Sure, but that window of opportunity being a newborn,
rooting and possibly sucking are gone or diminished so it is much more
difficult to accomplish.  Page 248 of above reference.  
In my opinion, the window of opportunity to introduce solids to a
breastfed baby begins with the AAP standards.  Maybe that feeding
specialist is not very supportive of lactation?  I have found in
practice that the longer the initiation of solids are delayed past 6-8
months, the increasing risk of refusal.  Is it oral motor skill or is it
preference for the breast?  Problems with feeding can be the first
symptom of an unrevealed medical problem OR a parenting pattern.

Angie Kirkwood RN, BSN, IBCLC

Nurse Feeding Specialist and Certified Lactation Consultant
Children's Hospital of Pittsburgh





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