Many of the challenges you may face are common to babies with PKU, and those without PKU - You do not need to feel alone!  

The following sections below are common questions parents ask during the process of introducing solids -

• Be patient and try to relax when offering food to your baby.   Many babies refuse new foods when offered; it is normal.  
• Continue to offer new foods.  It can take 8-10 attempts with the same food before a baby accepts a new taste.
• Choose a suitable time when your baby is calm and hungry (but not ravenous and crying).  
• Avoid drinks up to an hour before trying a new food to encourage appetite.  
• For some it helps to pair up a new food with a favourite food to encourage acceptance. 
• Try eating the same new food with your baby and include it in family meals.  If your baby sees others with the same food they are offered, they are more likely to eat it too.  
• Keep meal-times fun by accepting messy play with food.  Babies do grow out of this phase! 

When protein from solid food is introduced and taken in suitable quantities, the amount of breast milk/standard infant formula will be decreased accordingly. This ensures the amount of protein (phe) taken daily is consistent.   

There are no set rules as to when protein-containing foods should be introduced to your baby. Factors including appetite, intake of solid food and formula, nutritional needs, growth, and phe levels, must all be considered. Your dietitian will closely guide you on when is the best time to introduce your baby to protein from solid food and monitor their intake regularly.   

A fruit or vegetable needs to be counted when a typical serve contains enough protein to contribute to your child’s protein intake and affect their blood phe level.  ie. 1 very small banana (60g edible flesh), would need to be counted as it contains 1g of protein.

Your dietitian will advise which fruits and vegetables are counted and which are free.  You can also refer to the PKU Handbook (ASIEM) for more information. 

• Be consistent and calm. Keep the feeding environment the same, remove distractions, smile, and deliver consistent messages in a calm way each time.
• Provide routine – offer their protein substitute at the same time, in their favourite cup/dish, prepared in the same way each day.
• Reassure and praise - a smile and an upbeat voice offers encouragement and sends a positive message to your child about the protein substitute. A non-food reward, such as reading their favourite story or a trip to the park, can be a great way to reinforce positive behaviour for older children.  
• Provide the protein substitute when they are most hungry. They will be more likely to take it to satisfy their appetite.
• Be kind but firm. Smile but do not force them to take their protein substitute. Avoid showing frustration and anxiety as babies and young children quickly pick up on this and use it to gain attention.

Unwell children often lose their appetite, and so their food intake decreases. Generally, for a child with PKU they will be advised to take their usual daily amount of protein substitute and plenty of fluid. This is important to help phe levels stay within the ideal range. With encouragement and support, most children will take their protein substitute, but it often takes a longer time than usual.  

Contact your dietitian for advice if you have concerns.

Tips which may help include- 

• Offer the protein substitute in smaller amounts, more often.   This may help your child to manage the total amount required over the day. 
• Sometimes children will not want to take their protein substitute.  Be firm but do not force them.  Keep their fluid intake up, stay calm and keep trying. 
• Talk to your dietitian about what to offer when unwell.   Express your concerns but remain positive.