Helping Picky Eaters Thrive Tips for Creating Stress-Free Mealtimes

Helping Picky Eaters Thrive: Tips for Creating Stress-Free Mealtimes

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

Feeding a picky eater can be challenging, often turning mealtimes into battles filled with stress, tears, and frustration. When a child refuses multiple meals or consistently rejects new foods, it’s natural for parents to feel concerned and even resort to rules like the “three-bite rule” or offering dessert only if dinner is eaten. However, these approaches often increase the stress of mealtimes, leading to more food refusals, tantrums, and anxiety. This guide will help you navigate feeding a picky eater in a way that fosters a positive relationship with food and reduces mealtime stress.

 

WHY DO CHILDREN BECOME PICKY EATERS?

Picky eating often begins as children transition from infancy to toddlerhood, as their growth slows and their willingness to try new foods declines. This can be a normal part of development, but other factors may contribute:

  1. Routine and Structure
    • Consistent mealtime routines help children build an appetite and associate specific times with eating.
    • Regular meals and snacks about 2.5 to 3 hours apart, with only water offered in between, support a balanced appetite.
  2. Temperament
    • Some children may naturally be more sensitive or cautious, and this can affect their willingness to try new foods. Consider your child’s temperament and how it might influence their eating behaviors.
  3. Medical or Sensory Issues
    • Conditions like acid reflux, constipation, or sensory processing challenges can make eating uncomfortable, contributing to picky eating.
    • Mechanical issues, such as difficulties with chewing or swallowing, can also play a role. If you suspect an underlying issue, consult a healthcare provider for tailored advice.

 

THE DIVISION OF RESPONSIBILITY

Registered dietitian Ellyn Satter introduced a model called the Division of Responsibility (DOR), a framework that creates boundaries while honoring a child’s natural appetite and preferences. DOR outlines distinct roles for both the parent and the child, allowing parents to guide mealtimes without pressuring children to eat. By respecting these roles, parents can ease the stress around meals and help children build lifelong healthy eating habits.

PARENT’S RESPONSIBILITIES IN FEEDING 

1. WHEN the child eats

  • By age one, children typically benefit from three meals and two or three snacks a day.
  • Snacks should be scheduled and not constant, as this allows children to build up a natural appetite before meals.

2. WHERE the child eats

  • Family meals at the table provide consistency and foster positive social interactions around food.
  • Studies show that children who have regular family meals tend to make healthier choices, perform better academically, and have a lower risk of engaging in risky behaviors.

3. WHAT the child is offered

  • Parents are responsible for choosing which foods to offer. Aim to provide a balanced meal with diverse food groups. Avoid becoming a “short-order cook” by preparing special meals solely to meet your child’s preferences.

CHILD’S RESPONSIBILITIES IN FEEDING 

1. HOW MUCH to Eat

  • Allow children to decide how much food to eat, respecting that their appetites can fluctuate day-to-day.
  • Avoid pushing children to “clean their plate” to help them develop a healthy relationship with their hunger and fullness cues.

2. IF They Choose to Eat

  • Especially with toddlers and young children, it’s normal for them to occasionally refuse a meal entirely. Trust that they are listening to their body’s signals, and avoid turning this into a power struggle.

 

TIPS FOR REDUCING MEALTIME STRESS

To create a positive and low-pressure mealtime environment, consider these strategies:

1. Respect Your Child’s Appetite

  • If your child isn’t hungry, avoid force feeding. Forcing a child to eat can lead to negative associations with mealtime and weaken their sensitivity to hunger cues and fullness cues.

2. Remove Pressure

  • Avoid incentives or ultimatums like “two more bites for dessert” or “if you finish, you get screen time.” Even well-intentioned praise for eating can increase pressure. Instead, keep mealtimes relaxed and focus on enjoying the experience as a family.

3. Limit Distractions

  • Minimize iPads, TVs, and toys during meals. Creating a calm environment allows children to focus on their food and listen to their body’s signals of hunger and fullness.

4. Get Kids Involved in Food Prep

  • Let children help with age-appropriate tasks like rinsing vegetables, stirring batter, or setting the table. Involving them in meal preparation encourages a positive attitude toward food and can increase their willingness to try new things.

5. Sneak in Nutrients Thoughtfully

  • While “sneaking” vegetables or other refused foods into favorite dishes should not replace exposure to whole vegetables, it can be a helpful strategy for nutrient intake (short term only). Smoothies, sauces, and casseroles are great options for adding hidden veggies or proteins.

 

 

BOTTOM LINE

Picky eating can be frustrating, but it’s helpful to approach mealtime with patience and flexibility. By implementing a balanced approach to your child’s feeding responsibilities, involving them in the kitchen, and setting consistent routines, you’re laying a strong foundation for positive eating habits. Picky eating can be a phase, and with patience, your child will likely develop a healthier relationship with food over time.

I completely understand how challenging it can be to make these changes, and I appreciate the daily struggle of living with a child who has a limited diet. It can be overwhelming and exhausting, and many parents tend to unfairly blame themselves. You’re not alone! If you need more personalized help, I’m here for that too. I’ve successfully worked with many families to create custom action plans to get a child—or the whole family—back on track with healthy eating.

Looking for support in implementing the Division of Responsibility in Feeding in your household? Check out my Peaceful Mealtimes online course here.

The Importance Of DHA For Mom And Baby

The Importance Of DHA For Mom And Baby

by with No Comment Fertility & Women's HealthInfant NutritionMotherhoodToddler Nutrition

When considering the most important nutrients for pregnant moms, many people immediately think of folic acid, iron, and perhaps Vitamin D. Similarly, when it comes to nutrients crucial for babies starting solids, iron often tops the list. While these are indeed essential, there’s another vital nutrient that deserves attention for its role in growth and development: Omega-3s, particularly DHA.

DHA is essential for brain and eye development in babies, and it supports heart health, mood stability, and cognitive function in moms. Let’s dive into why DHA is so important for both mom and baby.

 

OMEGA-3S

Not all omega-3 fatty acids are created equal. Among the 11 types, the three most important are ALA, EPA, and DHA.

  1. Alpha-Linolenic Acid (ALA): ALA is the most common omega-3 fatty acid in the our diet and is primarily found in plant-based sources such as walnuts, seeds (flax, chia, hemp) and oils (canola, soybean, walnut, flaxseed). ALA is a an essential fat because it cannot be made by the body and is needed for normal human growth and development. While ALA can be converted into EPA and DHA, this conversion process is quite inefficient in humans.
  2. Eicosapentaenoic Acid (EPA): EPA is found primarily in fatty fish and seafood. It plays a significant role in reducing inflammation throughout the body, which is crucial for preventing chronic diseases such as heart disease and arthritis. EPA also has benefits mental health, potentially reducing symptoms of depression.
  3. Docosahexaenoic Acid (DHA): DHA is a key structural component of the brain, retina, and many other parts of the body. It is essential for brain development and function, making it particularly important during pregnancy and early childhood. DHA can be obtained either through conversion of ALA or directly from food sources rich in DHA, such as fatty fish, seafood or DHA-fortified foods.

 

THE CONVERSION OF ALA TO DHA

While ALA can be converted into EPA and then DHA, this conversion process, which primarily occurs in the liver, is highly inefficient, with rates reported to be less than 15%.

Additionally, studies have shown that increasing ALA intake during pregnancy does not significantly raise DHA levels in the blood (here, here). Therefore, consuming foods rich in DHA directly (or DHA supplements) is crucial for ensuring an adequate supply of this essential nutrient during pregnancy, supporting both maternal and fetal health effectively.

The active form of DHA found in foods is more beneficial than the converted form from ALA.

 

WHY IS DHA IMPORTANT DURING PREGNANCY?

DHA plays a crucial role in the development of a fetus’s cell membranes, particularly in the brain and retina. Ensuring adequate DHA intake during pregnancy and the first few years following birth is therefore very important. Prior to birth, the DHA required for proper fetal development is provided by placental transfer from the mother. Following birth, babies must receive DHA through breast milk, formulas fortified with DHA, or DHA supplementation (e.g., fish oil).

  1. Brain Development: Throughout pregnancy, DHA requirements increase, especially during the third trimester. As pregnancy progresses, maternal blood volume expands, and both the placenta and the developing baby require more DHA. Therefore, DHA is required to support fetal growth and brain development, especially during the third trimester when the fetus undergoes a rapid “brain growth spurt.”
  2. Eye Development: DHA is also essential for the development of the eyes, as it is the major fatty acid found in the retina, constituting approximately 93% of all omega-3 fatty acids. This high presence of DHA underscores its significance in eye health and visual development.

Studies indicate that during the last trimester, a fetus receives approximately 67 mg of DHA daily from the mother. This requirement increases to 70-80 mg daily during breastfeeding. The substantial demand for DHA during pregnancy and breastfeeding can deplete the mother’s DHA stores to below pre-pregnancy levels by up to 50%, and it can take months to partially replenish these levels. This depletion may pose health risks for the mother, including postpartum depression.

Research has demonstrated that sufficient DHA intake during pregnancy results in several positive outcomes for babies, such as better social behaviour, higher social development scores, enhanced verbal intelligence and reduced risk of pre-term labor, pre-eclampsia, and low birth weight.

 

RECOMMENDATIONS FOR PREGNANT MOMS

When it comes to recommendations for omega-3s, the guidelines can vary depending on the source. To help clarify, I’ve summarized some of the key recommendations below:

The Ministry of Health Malaysia (RNI)

  • 200mg DHA daily

American Pregnancy Association

  • 300 mg DHA daily
The American College of Obstetricians and Gynecologists (ACOG) encourages pregnant women, women who may become pregnant, and breastfeeding mothers to follow the FDA and EPA (US Environmental Protection Agency)’s advice:
  • Consume 2-3 servings of low mercury fish per week, 8-12 ounces of fatty fish in total.

RECOMMENDATIONS FOR MOMS: 

Those who are pregnant or breastfeeding should aim to consume 200 to 300 mg of DHA each day, which means eating 8 to 12 ounces (2 to 3 servings) per week of a variety of fish lower in mercury.

RECOMMENDATIONS FOR BABIES AND TODDLERS

The Institute of Medicine (IOM) has not established specific intake recommendations for EPA and DHA. The current recommendations for total omega-3s intake for babies aged 0-12 months is 0.5g per day, and for toddlers aged 1-3 years old, the recommendation increases to 0.7g ALA per day. These targets can be met if the mother is adhering to her recommended DHA intake and breastfeeding.

American Pregnancy Association

  • Infants (1-18 months & < 15 lbs): 32 mg/lb EPA + DHA
  • Children (1.5-15 years): 15 mg/lb EPA + DHA

FDA

Children should consume two servings of fatty fish per week.

  • A serving size is about:
    • Ages 1-3 years: 1 ounce
    • Ages 4-7 years: 2 ounces
    • Ages 8-10 years: 3 ounces
    • 11 years and older: 4 ounces

RECOMMENDATIONS FOR CHILDREN: 

  • Offer ultra-low mercury fish weekly, aiming for at least 2 x 1 oz. servings of DHA rich options per week.
  • Offer low mercury fish once every two weeks.
  • Offer moderately high mercury fish once every month.
  • Avoid high mercury fish for babies altogether.

 

THE FOOD SOURCE OF DHA

DHA is primarily found in fatty fish and shellfish such as salmon, herring, sardines, and trout. However, it’s important to be mindful of mercury levels, especially for pregnant women and children.

High-mercury fish like fresh/frozen tuna (big eye), tilefish, shark, swordfish, king mackerel, marlin, and orange roughy should be completely AVOIDED  during pregnancy and up to 2 years old for your baby’s safety.

But don’t worry, there are plenty of low-mercury fish options packed with DHA to help you meet your nutritional needs.

ULTRA LOW-MERCURY FISH  

Here are some ultra-low mercury fish (0.06 ppm of mercury or less) and rich in DHA. Offer these fish as often as you like, aiming for at least twice per week.

**The fish in bold are high in DHA with at least 0.4g DHA/100g** (reference)

  • Anchovies 江鱼仔
  • Atlantic mackerel 大西洋鲭鱼
  • Black sea bass 黑鲈鱼
  • Butterfish 奶油鱼
  • Catfish 鲶鱼
  • Clam 蛤蜊
  • Crawfish 小龙虾
  • Flounder 比目鱼
  • Haddock (Atlantic) 黑线鳕
  • Mullet 鲻鱼
  • Oyster 牡蛎/生蚝
  • Plaice 欧蝶鱼
  • Pollock 狭鳕
  • Salmon (Atlantic farmed, fresh, canned) 三文鱼
  • Sardine 沙丁鱼
  • Scallop 扇贝
  • Shad 西鲱
  • Shrimp 虾
  • Smelt 胡瓜鱼
  • Sole 鳎鱼
  • Squid 鱿鱼
  • Tilapia 罗非鱼
  • Trout, freshwater 淡水鳟鱼
  • Whiting 怀廷鱼

LOW MERCURY FISH 

Offer low mercury fish (0.07 and 0.15 ppm of mercury) once every two weeks.

  • Atlantic croaker
  • Cod 鳕鱼
  • Crab 螃蟹
  • Hake 无须鳕
  • Herring 鲱鱼
  • Lobster (American and spiny) 龙虾（美洲和刺龙虾）
  • Pacific chub mackerel 太平洋黑鲭鱼
  • Perch (freshwater and ocean) 鲈鱼（淡水和海洋）
  • Pickerel 狗鱼
  • Skate 鳐鱼
  • Canned light tuna 罐装淡金枪鱼
  • Whitefish 白鱼
  • Buffalo fish 牛鱼
  • Carp 鲤鱼
  • Sheepshead 羊头鱼
  • Tilefish (Atlantic Ocean) 方头鱼（大西洋）

MODERATELY HIGH MERCURY FISH 

Offer moderately high mercury fish (0.16-0.25 ppm) once every month.

  • Halibut 大比目鱼
  • Mahi mahi 鲯鳅鱼
  • Monkfish 安康鱼
  • Snapper 红鲷鱼
  • Spanish mackerel 西班牙鲭鱼
  • Striped bass 条纹鲈鱼
  • Weakfish / sea trout 海鲂鱼

HIGH MERCURY FISH 

The following fish, with mercury levels between 0.25 and 0.45 ppm, are considered very high in mercury and should be completely avoided for babies and pregnant moms.

  • King mackerel 鲭王鱼
  • Marlin 枪鱼
  • Orange roughy 橙鲷
  • Shark 鲨鱼
  • Swordfish 剑鱼
  • Tilefish (from Gulf of Mexico) 方头鱼（墨西哥湾）
  • Big eye tuna 大眼金枪鱼
  • Bluefish (Atlantic) 蓝鱼（大西洋）
  • Chilean sea bass 智利海鲈鱼
  • Grouper 石斑鱼
  • Sablefish 黑鳕鱼
  • Tuna albacore / white tuna, canned 长鳍金枪鱼 / 白金枪鱼，罐装
  • Tuna albacore / white tuna, fresh/frozen 长鳍金枪鱼 / 白金枪鱼，新鲜/冷冻
  • Tuna yellowfin 黄鳍金枪鱼
  • White croaker / Pacific croaker 白石首鱼 / 太平洋石首鱼

 

NOT A FISH EATER OR PICKY EATER

If you find it challenging to consume fish regularly during pregnancy or you have a picky eater at home, consider omega-3 enriched eggs, which typically provide 75-100mg of DHA per serving.

 

FOR FORMULA-FED BABIES 

For babies who haven’t started solids yet, they rely on breastmilk or formula for their DHA needs. If you’re breastfeeding, prioritize consuming DHA-rich foods to benefit both you and your baby. If formula feeding, opt for a formula with approximately 11.5 mg/100 mL of DHA, similar to the average level found in breast milk. This ensures your baby receives adequate DHA for healthy development.

 

EPA+DHA OR DHA ONLY

A common question is whether babies need both EPA and DHA or just DHA. While EPA is important for immune and heart health at any age, it isn’t stored in significant amounts in the brain and retina. DHA, on the other hand, is crucial for early development, especially for the brain and eyes. This is why healthcare professionals often emphasize DHA when talking about omega-3s during pregnancy and early childhood. However, since healthy fats support overall brain health and neural connectivity, it’s beneficial for babies to have adequate levels of both EPA and DHA.

IF YOU EAT FISH, DO YOU STILL NEED DHA SUPPLEMENTS?

You might wonder if consuming fish provides enough DHA, do you still need to take DHA supplements as part of your plan for nutrition during pregnancy.

Pregnant and lactating women should consume 2-3 servings  of a variety of fish weekly. However, even with this recommendation, you may not reach the desired DHA levels. The DHA content varies across fish species, and commonly consumed fish in Malaysia, like Indian mackerel (kembong), anchovies (ikan billis), yellow-tail and yellow-stripe scads (selar kuning), tuna (tongkol), torpedo scads (cincaru), Indian and short-fin scads (selayang), pomfret (bawal), red snapper (merah), king mackerel (tenggiri), merine catfish (jahan) and stingray (pari) have lower DHA levels compared to fish like salmon, herring, or canned white tuna.

In light of this, DHA supplementation offers a convenient solution to ensure you meet your daily DHA requirements. It simplifies monitoring your DHA intake, guaranteeing adequate levels each day, irrespective of variations in fish consumption.

Cod liver oil contains fish oil but because it also contains vitamin A, it should be AVOIDED in pregnancy.

 

WHAT ABOUT VEGAN? 

Since fish is not a part of vegan diets and may also be excluded from certain vegetarian diets, obtaining enough DHA solely through diet can be challenging. While fish remains the best source of DHA, there are plant-based alternatives (ALA) such as walnuts and flax seeds that are rich in Omega-3 fatty acids.

Unfortunately, the conversion of ALA to DHA is inefficient, making it difficult to obtain adequate levels solely from plant-based sources. Therefore, I recommend considering an Omega-3 supplement containing at least 200 mg/day to ensure sufficient DHA intake. Additionally, for those following a vegan lifestyle, there are now vegan-friendly DHA supplements (Microalgae Oils) available, derived from algae rather than fish, providing a reliable source of this essential nutrient without compromising dietary preferences.

 

WHAT ABOUT ALLERGIC TO FISH?

Finned fish and shellfish are considered two different top allergens. Finned fish include species like salmon, cod, and sardines, while shellfish include shrimp, crab, and lobsters.

If your child is allergic to shellfish, it doesn’t necessarily mean they will be allergic to finned fish, as the two are biologically different. Both types of fish should be introduced EARLY and OFTEN when your child shows all signs of developmental readiness for starting solids, typically around six months.

Fish is among the top 9 allergens. For detailed guidance on introducing allergen-containing foods, refer to my post on How to Prevent Food Allergy When Starting Solids.

Also, fish bones can be a choking hazard. Be sure to carefully check for bones when offering fish to your baby!

 

HOW TO CHOOSE AN OMEGA-3 SUPPLEMENT 

There are various omega-3 supplements available on the market, when it comes to choosing an omega-3 supplement for your child, there are several important factors to consider:

1. Quality and Purity

  • Third-Party Testing: Ensure the fish oil manufacturer provides documentation of third-party lab results showing the purity levels of their fish oil, down to the particles per trillion level.
  • Manufacturing Standards: Check the quality standards the manufacturer uses. Reputable standards include the Norwegian Medicinal Standard, the European Pharmacopoeia Standard, and the Council for Responsible Nutrition’s 2006 monograph. These standards guarantee quality by setting maximum allowances for toxins.

2. Form of the Supplement

  • Child-Friendly Forms: Since children often find capsules difficult to swallow, look for omega-3 supplements in the form of jelly, oil, gel capsules, or chewable tablets.
  • Gummies Caution: Fish oil gummies are popular, but the typical dosage required to meet daily omega-3 needs might be high, leading to a high sugar intake and potential cavities. Be cautious of this and try to balance with other low-sugar options.

3. Dosage and Safety

  • Age Appropriateness: Choose a supplement suitable for your child’s age. Always follow the instructions on the package and do not exceed the suggested dosage.
  • Avoid Choking Hazards: For children under 3 years of age, avoid giving capsules as they are a choking hazard. Opt for gummies or liquid forms instead.

4. Source of the Supplement

  • Refined Oils vs. Fish Liver Oils: Purchase supplements made from refined oils from the flesh of fish rather than fish livers. Cod liver oils, which contain fish oil, vitamin D, and pre-formed vitamin A (retinol), can be problematic due to the fat-soluble nature of vitamin A. Excessive intake can cause serious health issues. Different brands contain varying amounts of vitamin A, so be mindful of the Recommended Dietary Allowance (RDA) for your child’s age:
        • 1 to 2 years: 250 mcg
        • 3 to 6 years: 300 mcg
        • 7 to 10 years: 400 mcg
        • 10 to 12 years: 575 mcg

 

BOTTOM LINE

In addition to their well-known benefits for heart health, cholesterol levels, and brain function, omega-3 fatty acids are especially important during pregnancy and infancy. DHA, a type of omega-3, is vital for the development of the fetal brain and eyes, particularly in the third trimester and early childhood.

Omega-3 fatty acids play a crucial role in promoting various aspects of overall health, including heart health, cholesterol levels, and brain function.

 

References: 

  1. https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/chemical-contaminants/environmental-contaminants/mercury/mercury-fish-questions-answers.html
  2. https://www.who.int/news-room/fact-sheets/detail/mercury-and-health
  3. https://seafood.oregonstate.edu/sites/agscid7/files/snic/omega-3-content-in-fish.pdf
  4. https://www.fda.gov/food/consumers/advice-about-eating-fish
  5. https://www.fda.gov/food/environmental-contaminants-food/mercury-levels-commercial-fish-and-shellfish-1990-2012
Tips To Help Children Be Mindful About Sweets

Tips To Help Children Be Mindful About Sweets

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

When it comes to desserts and treats for children, finding the right balance is crucial. Restricting sweets can backfire. Research indicates that the more attention we give to desserts or treats, the more fixated a child becomes. This fixation can lead to sneaking and increased consumption, potentially causing children to internalize guilt as they perceive sweets as a forbidden food. However, it’s essential to provide useful tips to help children be mindful of sweets, as giving in to these requests may reinforce the behaviour and lead to further demands.

In this post, I will outline a healthy approach to handling desserts or treats with children.

 

WHAT IS SWEETS? TREATS? DESSERTS? 

“Sweets” generally refers to foods high in added sugar, calories and/or saturated fats, often consumed as desserts or treats. This category includes items like candy, cookies, cakes, pastries, ice cream, chocolate, chips, and other confectionery products. While they’re enjoyable to eat, it’s important to remember the tips to help children be mindful about sweets. Sweets shouldn’t be served to children under two years old, and their consumption should be moderated in older children. Nonetheless, sweets are a part of life, and it’s essential for parents to teach their children how to enjoy sweets mindfully.

“Treats” and “desserts” can overlap with sweets but may also include healthier options. Treats are indulgent foods often enjoyed occasionally, while desserts are sweet dishes typically served at the end of a meal. Here are some healthy dessert or treat ideas:

  1. Smoothie
  2. Energy bites
  3. Apples and peanut butter
  4. Frozen yogurt bark
  5. Granola bars

These options provide sweetness and satisfaction while also offering nutritional benefits.

 

TIPS TO HELP CHILDREN BE MINDFUL ABOUT SWEETS  

FLEXIBLE SWEETS POLICY (FSP)

Here are some key points to consider when crafting a FLEXIBLE SWEETS POLICY (FSP) for your family:

1. SERVE DESSERT WITH MEAL NOT AFTER MEAL

“You shouldn’t offer dessert with dinner. They’ll just eat the dessert.”

I know you are worrying that your child will only eat the dessert. And yes, that is a possibility.

But, do you ever remember sitting at the dinner table telling your parents you are full, but you still had room for dessert? I do!

Ellyn Satter, a renowned dietitian and feeding specialist, suggests incorporating a small portion of dessert into dinner to normalize its consumption. Serving dessert with a meal takes away its special power and sends the message that this is just another food we are eating today.

The crucial aspect is to refrain from offering seconds of dessert and allowing children the freedom to consume the meal in any order they prefer. A lot of children will choose to eat the dessert first if it’s offered, but then they will go on to eat the other foods at the meal, too.

By serving dessert with a meal, you’re avoiding the notion of it being a reward only after finishing the meal. Each child should receive one serving of dessert, whether it’s two small cookies, a scoop of ice cream, or a small piece of cake. Surprisingly, in my own experience, serving dessert alongside the meal often results in they eat the dessert first , they will then finish most of their meal.

Instead of using a restriction statement like,

“You can’t have ice cream until you eat your carrots.”

Child learns ice cream are better than other foods and needs to be earned.

Try a neutral statement like,

“Let’s have a scoop of ice cream with dinner, which one do you want?”

Child learns that ALL FOODS can fit into a healthy lifestyle.

Some children might eat the dessert first, like what you are worrying, and some might not even touch anything else at that meal, or some might ask for more dessert. I just want you to know it’s completely normal for children and human beings in general, to enjoy some foods more than other.

 

2. CALL THE NAME

It’s important to note that a treat in one household might not be considered a treat in another. For example, in my home, we often have baked goods like cookies, muffins, energy balls readily available. We also enjoy freezing grapes, strawberries and bananas and occasionally dipping them in chocolate. In my mind, I considered all of these foods as “treats”, others may have different perspectives.

Regardless of how we define treats, I make a conscious effort not to label any food as a “treat” around my children. Instead, I refer to them by their names, such as “candy”, “Ice cream”, “cookie”, “chocolate covered strawberry.” For younger children, I use terms like “everyday foods” and “fun foods” or “not everyday foods.”

By avoiding categorizing foods as “good” or “bad,” I aim to foster a neutral perspective on food. Using terms like “treats” or “junk” can give theses foods a mystique or imply negatively, such as being forbidden or bad. Ultimately, they’re JUST FOOD.

 

3. FREQUENCY AND VARIETY

Dessert or treats can be a regular part of a healthy diet, and as a parent, you have the flexibility to decide how often they fits into your family’s routine. Some parents prefer to reserve dessert for weekends and special occasions, while others are comfortable with more frequent indulgence.

You can aim to incorporate dessert into your family’s meals on 3-4 nights per week without any plan in place. Avoid creating a pattern where children only receive dessert when they eat a good dinner.

Offering lots of “healthier” dessert options can help children feel like they have a choice. Consider options such as homemade oatmeal cookies, frozen yogurt barks, energy balls, or ice cream with nuts and fruits.

Using a positive approach, offer dessert as a choice alongside the main meal.

“Would you like fruits or vanilla yogurt with your dinner later?” 

On evenings when dessert isn’t on the menu, establish boundaries by simply stating,

“We’re not going to have any dessert tonight, but maybe tomorrow”

Emphasize a positive approach by saying “YES” to dessert rather than simply denying it.

“It’s not on the lunch menu right now, but we can save some to have with dinner.” 

 

PORTION CONTROL AND AUTONOMY SWEETS

Occasionally, it’s beneficial to offer unrestricted access to sweets during specific occasions or events where desserts or treats are plentiful, such as parties. For example, at a birthday party, you could place a plate of chips on the table and let your child take as many as they desire. By granting them free rein at the dessert table can be a way to empower them to make their own choices, learn self-regulation, and develop a healthy relationship with sweets.

These occasional opportunities for unlimited dessert consumption align with the tips to help children be mindful about sweets, as you’re teaching your child to listen to their body’s cues of hunger and fullness while also allowing them to enjoy treats in a balanced manner.

 

SETTING HEALTHY BOUNDARIES OF SWEETS

Implement strategies to neutralize the allure of sweets and promote a healthy attitude towards dessert consumption:

    1. Dessert should not come with conditions, such as finishing vegetables or cleaning the plate.
    2. Dessert should not be treated as a reward or bribe.
    3. Don’t soothe a crying child or anxious preschooler by using sweet food to calm the emotions.

 

WHAT WORKS FOR MY FAMILY

We’ve adopted a flexible once-a-day policy regarding sweets. On most days, we indulge in treats like dark chocolate, baked goods, or ice cream, though the frequency may vary – weekends tend to have more, while other days might have none at all.

During parties or event celebrations (CNY), my children are encouraged to freely enjoy sweets, provided they remain at the table while doing so. However, if dessert follows dinner about 2 hours later, we sometimes limit the amount, especially if it’s close to bedtime.

Now that my children are growing older (aged ten and three), they often regulate their sweet intake on their own, which has been a positive development. Every family is unique, so while my approach may suit us, others may find success with less frequent sweet offerings.

Your flexible sweets policy should be personalized and aligned with what feels right for your family. However, it’s essential to remain open to adjustments if you sense it’s not working or if your child becomes fixated on food.

Signs that your approach is effective include occasional requests or mild whining for sweets, which is normal. Overall, you should feel that your child is CONTENT  with the frequency of treats and doesn’t overly obsess over them. They may eat a lot of something they haven’t had in a while, but when they are done they stop thinking about it.

Conversely, signs that your approach may not be working include a child who CONSTANTLY asks for sweets and never seems satisfied after consuming them. They might resort to sneaking treats or exhibit excessive indulgence in sweets outside of the home. When these behaviors arise, it’s a clear indication that adjustments to the policy are necessary.

 

WHAT IF CHILDREN ASK FOR TREATS ALL DAY LONG? 

Establishing healthy boundaries is crucial when faced with persistent requests for treats or sweets throughout the day. Acknowledge that they want it and let them know they will get more at a later time. Better yet, get down to their level and talk calmly.

“I know you really want a chocolate. That’s not on the menu with lunch, but we can save one for dinner!”

“Did you enjoy your cupcake? Let’s leave some so we can have more tomorrow.”

If you don’t have any left, let them know you’ll put it on the grocery list for next time.

“I know you love cookies, let’s put them on the grocery list.”

As a parent, it’s essential to determine what feels comfortable for you and your family. Consider options such as allowing one treat per day or reserving treats for weekends while maintaining a no-dessert rule on weekdays. Having clear policies in place gives you a solid reason to say no when needed, even though your child may express disappointment.

Remember, children look to you to set boundaries and understand what’s appropriate. They rely on your guidance to navigate their choices, especially regarding treats. While it’s essential to stand firm in your decisions, flexibility is also key. If a day becomes particularly indulgent, such as during a school party followed by treats at home, adapt by offering healthier options like fruit for dessert in the following days. Being mindful of these situations helps maintain balance and reinforces healthy eating habits for your child.

 

BOTTOM LINE 

By following these tips to help children be mindful of sweets, families can create a healthy sweets policy that promotes moderation, autonomy, and a positive relationship with sweets. Remember, prioritizing nutrient-dense foods for the majority of meals provides children with essential nutrients while allowing room for occasional indulgence.

REMEMBER, children under two years of age do not require regular dessert in their diets. Introducing dessert at this age can displace essential nutrients. Therefore, it’s best to offer alternatives like yogurt and fruit. As children grow older, they will have ample opportunity to learn self-regulation around sweets.

Every family is different and some like to eat dessert every night, others on occasion. Tell me your family’s rule in the comments, I’d love to hear. 

how-to-help-your-child-to-gain-weight-photo

How to Help Your Child to Gain Weight

by with No Comment Child & Family NutritionInfant NutritionToddler NutritionWeight Management

So often in the media we hear about the obesity epidemic and how too many children are overweight or obese. But what about those on the flip side of the coin? Some children may have difficulty eating due to selective food choices, aversions, or underlying medical concerns, making it challenging for them to consume enough calories to support their growth and development.

Being underweight is not the same as simply being thin or slender. Some children have a naturally slight build and maintain it with a well-balanced diet and physical activity.

The child’s weight can cause great worry to the parents.

IS YOUR CHILD REALLY UNDERWEIGHT?

Assessing whether your child is truly underweight is the first step in addressing any concerns you may have. It’s important not to let comments from others or comparisons with other children cause unnecessary worry.

If you’re concerned about your child’s weight, it’s best to seek professional advice from your health care professionals. Weight loss or inadequate weight gain can sometimes be a sign of an underlying medical condition, so it’s important to have your child evaluated if you’re worried.

By consulting with health care professionals, you can get a better understanding of your child’s weight status and any potential issues that may need to be addressed. This will help ensure that your child receives the appropriate support and guidance to promote their overall health and well-being.

THIN OR UNDERWEIGHT? CHECK THE GROWTH CHART 

Children demonstrate their thriving and well-being through normal growth and development, which is typically assessed and monitored using growth charts. Public health nurses or pediatricians routinely plot a child’s weight, length, or height on these charts during well-visits and check-ups.

By tracking a child’s growth over time and comparing it to standardized growth curves, health care professionals can assess whether the child is growing at an appropriate rate for their age and identify any potential concerns. This allows for early intervention if there are any signs of growth faltering or deviation from the expected growth trajectory.

There are 4 nutrition indices to define nutritional status of children as measure through anthropometric measurements – body weight and height.

  1. weight-for-age (risk for underweight)
  2. height-for-age (risk for stunting)
  3. body mass index (BMI)-for-age (risk for overweight)
  4. weight-for-height (risk for wasting)

Percentiles (from 3 to 97) represent the normal window of growth we can expect for children.

The 50th percentile shows the AVERAGE – This is where most children are.

It means that below 50th percentile is lower than the average, but still normal. Above 50th percentile is above the average, but still normal too!

Here’s what the percentile values on a growth chart do mean:⠀

A 2 year old boy who places on the 48th percentile on the weight-for-age growth chart means that 52% of all the boys (same age) out there weigh more than him and 48% weigh less than him.⠀

OR

Even if your child is at the 8th percentile for his weight, meaning that 92% of kids his age weigh more than he does, if he has always been at the 8th percentile, then he is likely growing normally. It would be concerning and it might mean there was a problem with his growth if he had previously been at the 50th or 75th percentile and had now fallen down to the 8th percentile

What you should actually look at is how they progress over time on the growth chart and whether or not they’re staying on THEIR particular curve. Children who are growing normally will track their growth predictably on their own personal growth curve. Whether 48th percentile or 8th percentile, it doesn’t mean that his particular weight is good, bad, right or wrong. There is no “goal” to reach here. It just shows that body come in all shapes and forms. Some children are meant to be more petite or smaller, some are meant to be more largely built or much taller. Just look at their parents and family history as a good indicator! Genetics will win!

If time passes and you notice they’ve dropped from the 48th to the 15th percentile, that’s more of a concern! Same thing goes when it’s a big jump from the 60th percentile to the 85th percentile. That’s more of what we would call “falling off the growth curve”. It could be, of course, due to over/under-eating, malabsorption issues or some other underlying medical issue or it could be something as simple as a growth spurt.⠀

The key message here is that there’s no right or wrong percentile for your toddler! Every child has their own established growth curve. Where another child has nothing to do with where your child should be. Having a chubby or a skinny toddler does not mean they are healthy or not healthy. And trying to actively change their natural curve does a lot more harm than good.⠀

Last, the growth chart is a good indicator of your child’s overall nutritional status.  If your child appears to be maintaining a usual and predictable pattern on the curve, you can rest assured that your child is getting adequate calories for normal growth.

It is not just about extra calories.

 

WHAT HAPPENS IF FALTERING GROWTH OR UNDERWEIGHT IS DIAGNOSED? 

If faltering growth or underweight is diagnosed in a child, it can be an indicator of underlying health conditions or developmental concerns. In such cases, the doctor will typically refer the child to a pediatrician, a specialist child doctor, for further investigations.

Additionally, the pediatrician should refer the child to see a Pediatric Dietitian to assess their diet and eating routine. If this referral does not occur, it’s important for parents to advocate for their child and request a referral. They can also choose to seek assistance from a private dietitian specializing in pediatrics.

 

GETTING STARTED 

Sometimes, parents use ineffective strategies to get their child to gain weight and grow, including negative feeding practices, in an attempt to feed them high calorie foods to boost their weight.

First, building a healthy food relationship (not just calories) is more important.

Understand the Feeding Relationship 

A parent’s role is to choose what foods to offer, when, and where. Parents should provide healthy foods and offer regular meals and snacks.

A child’s role is to decide how much to eat and whether or not to eat at each meal.

Zero Pressure

Sometimes your child may refuse meals or snacks. Don’t beg, bribe or threaten your child to eat certain kinds or amounts of food.

Pressuring a child to eat can make them eat less. 

Away from Distraction 

Families should enjoy healthy eating together. Your child shouldn’t be singled out from the rest of the family. Everybody eats at the table together. Your child will focus on eating with fewer distractions. Turn off the TV, computer, IPad, and put toys aside around feeding time.

Stick to Mealtime Schedule

Regular meals and snacks will help your child eat enough food to grow well and be healthy. Offer food every 2-3 hours at planned times.

Offer 3 meals and 2-3 snacks each day. 

Watch Empty Calories

Limit foods like sugary drinks, candies, potato chips and donuts. These foods don’t help children grow well.

Set Mealtime Boundaries

Set some table rules at meal times such as “everyone stays at the table until dad/mum’s finished”, even if your child doesn’t want to eat what you’ve served. Because they are sitting with food in front of them, they may end up picking at it! This is useful if your child wants to rush off and play rather than eat. But don’t force or nag them to eat. You’re just asking them to stay at the table. You don’t want to turn mealtimes into a battle.

Avoid Filling Up on Fluids 

Drinking too many fluids like milk and juice may make a child less hungry for meals and snacks.

Serve no more than 2-3 cups of milk each day. Limit fruit juice to 0-1/2 cup each day.  

Read Label

Limit foods and drinks labelled “light”, “low fat”, “fat-free”, “low calorie” or “sugar-free”.

Watch Your Languages 

Watch your language and conversation around body size and shapes. If you talk about people being fat, on a diet, over-eating, or you are watching your own weight by counting calories or you obsess over food labels and your own body shape, then a child picks up on this quickly. Children mirror a parent’s pattern and chatter. Catch yourself out and avoid this kind of chatter, especially if your child has suddenly started eating less and is starting to lose weight, they may have started dieting because of this unhealthy conversation.

 

CAN FOOD INTOLERANCE AFFECT MY CHILD’S WEIGHT?

Yes, food intolerance can potentially contribute to a child’s low weight if it leads to inadequate food intake or nutrient absorption. For example, lactose intolerance may necessitate restricting certain dairy products, which could impact a child’s overall nutrient intake if suitable alternatives are not provided.

It’s crucial to ensure that any foods omitted from a child’s diet due to intolerance are replaced with suitable alternatives to prevent nutritional deficiencies. Unfortunately, many children may not receive proper guidance on how to replace missing nutrients when certain foods are eliminated from their diets.

Consulting with a Pediatric Dietitian can provide tailored dietary advice to ensure that your child receives all the necessary nutrients for growth and development, even in the presence of food intolerances. A dietitian can help identify suitable alternatives and ensure that the child’s diet remains balanced and nutritious.

 

CAN CONSTIPATION CONTRIBUTE TO POOR APPETITE?

Yes, constipation can contribute to poor appetite in children because they may feel full or uncomfortable, leading to a decreased desire to eat.

To help alleviate constipation and improve appetite, you can incorporate the following strategies:

  1. Offer fruits and vegetables at least five times a day. These foods are rich in fiber, which can aid digestion and alleviate constipation.
  2. Ensure your child drinks at least eight glasses of water each day, and even more in warmer weather. Staying hydrated can help soften stool and promote regular bowel movements.
  3. Replace white versions of breakfast cereals, pasta, rice, and bread with wholemeal or wholegrain versions. Whole grains are higher in fiber, which can help regulate bowel movements and prevent constipation.

Implementing these dietary changes can help manage constipation and promote a healthy appetite in children. Additionally, I have another blog on managing constipation, you can read here.

 

FOODS TO GAIN WEIGHT 

Parents and caregivers often ask: “How can I help my underweight child gain weight with calorie-dense foods?” or“How many calories should my children be eating?”.

They are usually struggling with knowing which foods to feed their child to help them gain weight.

Every Bite Count 

Every bite of food and every gulp of liquid can make a contribution to your child’s ability to gain weight and grow. Offer foods high in calories and rich in nutrients at every meal and snack.

Make some simple switches to double up their energy intake without making them eat more. 

THE RIGHT WAY TO INCREASE CALORIES 

In Malaysia, it’s easy to find highly processed sugary snacks, many are packed with empty calories lacking in essential nutrients like protein, fiber, vitamins, and minerals.

When aiming to increase your child’s calorie intake, it’s crucial to prioritize nutrient-rich foods. Here’s what to look for:

1. High Protein

Protein plays a crucial role in supporting growth hormone levels and may aid in increasing height and weight, especially in children who are extremely picky eaters or experiencing stunted growth. Complete protein sources contain all the essential amino acids necessary for child growth. These include:

  1. Lean meats
  2. Poultry
  3. Fish
  4. Eggs
  5. Milk
  6. Cheese
  7. Yogurt
  8. Soybeans
  9. Quinoa

However, even if a protein source is incomplete, you can still combine different sources strategically throughout the day to ensure your child receives all the necessary amino acids.

Here are some examples of high-calorie protein sources:

  1. Eggs
  2. Greek yogurt
  3. Cottage cheese
  4. Meat, poultry, and fish
  5. Tofu
  6. Beans and other legumes
  7. Hemp seeds
  8. Nutritional yeast
  9. Protein powders (which may be beneficial in some cases, but it’s important to choose high-quality brands)

 

2. Healthy Fats

Healthy fats are essential for providing concentrated calories, supporting brain function, and aiding in the absorption of fat-soluble vitamins like A, D, E, and K. Including a good source of healthy fats in each meal is ideal for overall health. Here are some examples of healthy fats:

  1. Avocado
  2. Coconut, coconut oil, and coconut milk
  3. Olive oil
  4. Full-fat dairy products such as cheese, milk, yogurt, and kefir
  5. Fatty fish like salmon, tuna, sardines, and mackerel
  6. Nut and seed butters (great for adding to smoothies)
  7. Chia seeds and flaxseeds
  8. Tahini and sesame seeds
  9. Butter and ghee
  10. Good quality mayonnaise

 

3. Iron

It’s well known that iron deficiency leads to a failure to grow at normal rates, and with the high rates of iron deficiency even in Malaysia, focusing on iron (and vitamin C for absorption) is critical for underweight/short stature children.

Examples of high calorie iron rich foods include:

  • Beef
  • Chicken
  • Fortified Oats
  • Beans and lentils
  • Tofu
  • Dried apricots

 

4. Calcium and Vitamin D

Calcium and Vitamin D are vital for bone growth, especially in growing children. Ensuring an adequate intake of calcium is particularly important for vegan children to support their overall health and growth. Here are some high-calorie sources of calcium and Vitamin D:

  1. Full-fat yogurt
  2. Full-fat cheese
  3. Salmon, rainbow trout, sardines (also rich in Vitamin D)
  4. White beans
  5. Soybeans (edamame)
  6. Egg yolks

 

5. High Fibre

In addition to these sources, quick forms of calories from high fibre starchy fruits and vegetables are essential for providing energy from unprocessed foods in your child’s diet. Some examples include:

  1. Sweet potato
  2. Potato
  3. Winter squash
  4. Banana
  5. Grapes
  6. Pineapple
  7. Goji berries
  8. Raisins, prunes, dates

SOMETHING TO KEEP IN MIND 

Here are some tips to effectively increase your child’s calorie intake:

1. Customize Meals

Prepare meals with added calories specifically for your child without altering the entire family’s diet. For instance, add extra oil or butter to one serving of pasta, spread more nut butter on your child’s bread, serve whole milk with meals, or mix in additional cream and maple syrup to oatmeal.

2. Opt for Individual Servings

Purchase smaller packages and individual servings of foods to minimize waste while experimenting with different options.

3. Consider Portion Size

Recognize that young children have smaller stomachs and may not be able to consume large volumes of food. Choose foods from above that offer higher calorie in smaller portions.

For example, while hummus provides 25 calories per tablespoon, cream cheese offers 50 calories per tablespoon, and peanut butter provides 100 calories per tablespoon. If your child consumes small amounts, opt for calorie-dense options like cream cheese or peanut butter when serving with toast.

4. Maintain Balance

Ensure a balanced diet by incorporating high-calorie foods (that your child actually enjoy) alongside nutritious options. For example, if your family is having grilled chicken for dinner, pair it with high-calorie side dishes like sweet potato fries and steamed broccoli. Then, add extra butter to the portions for the child who requires additional calories.

 

ACTIVE LIFE 

Give your child more time to be active. Being active can make children hungrier for meals and snacks. Limit screen time, like watching TV and using other electronics. Read this post to learn how to increase physical activity level of your child.

 

BLUR PIC

I’ve also got another free FOODS TO GAIN WEIGHT guide you can use for your children to get you started so you can start feeling better about every bite your child takes.

BOTTOM LINE 

If you’re concerned about your child’s weight but they haven’t been diagnosed as underweight, it is important to discuss your concerns with their pediatrician. The pediatrician can review their growth history and determine if further evaluation or dietary adjustments are necessary.

Remember, the need for high calorie nutritious foods may be short term, and it’s essential to prioritise your child’s overall health and well-being. While it’s important for your child to eat, at the same time not to turn mealtime into a battle or power struggle. Creating a positive eating environment can help promote healthy eating habits in the long run.

If you’re struggling to put weight on your child or worried about their nutrition, consider seeking guidance from a pediatric dietitian. A dietitian can work with you to develop a tailored plain to meet your child’s nutritional needs and ensure they are receiving the necessary nutrients for growth and development. Ultimately, the goal is to have a healthy, happy, and confident child.

Are you worried about your thin child? Are you thinking that you might want some one-on-one nutrition counselling, either for you, or your baby or child? Check out my one-on-one nutrition counselling services here. 

Protein Foods For Vegetarian Child

Protein Foods For Vegetarian Child

by with No Comment Baby Led WeaningChild & Family NutritionInfant NutritionToddler Nutrition

If you’re dealing with a picky eater who doesn’t like meat, you might be concerned about their protein intake. There are plenty of nourishing non-meat protein sources to explore. Even if your family isn’t vegetarian, your child’s aversion to meat could come from various reasons. Perhaps they find meat difficult to chew or haven’t discovered a preferred way of eating it yet. It’s also possible that they’re making a connection between their love for animals and the food on their plate.

But here’s the good news! Meat is not the only source of protein! I’m here to break down the protein requirements for children and show you how to meet them, even if your children aren’t keen on meat. With a little creativity and exploration, you can ensure your child gets the protein they need for healthy growth and development.

WHAT IS PROTEIN? WHY DO WE NEED PROTEIN?

Protein is one of the three macronutrients that provide calories (or energy) in the diet, along with carbohydrates and fats. It’s essential for our health because it serves several important functions in the body.Firstly, protein plays a crucial role in building and repairing tissues, including muscle tissue. This makes it essential for supporting muscle growth and maintenance.Additionally, protein is involved in the production of hormones, enzymes, and other important molecules in the body. Hormones regulate various bodily functions, while enzymes facilitate chemical reactions that are necessary for metabolism and other physiological processes.Protein also plays a key role in supporting immune function, helping to defend the body against infections and illnesses.Every protein molecule is made up of smaller building blocks called amino acids.

20 different amino acids

There are 20 different amino acids that the body uses to build proteins, and each protein has a unique combination of these amino acids. Nine of these amino acids are considered ESSENTIAL because the body cannot produce them on its own, so they must be obtained from the diet. The remaining 11 amino acids are NONESSENTIAL because the body can synthesize them from other amino acids or compounds. For example, your body needs to consume enough of the essential amino acid phenylalanine for it to synthesize the nonessential amino acid tyrosine. Additionally, since your body can’t store essential amino acids, it’s crucial to continually provide your body with the protein it requires.<

9 essential amino acids:
  • histidine
  • isoleucine
  • leucine
  • lysine
  • methionine
  • phenylalanine
  • threonine
  • tryptophan
  • valine
Non-essential amino acids:
  • alanine
  • arginine
  • asparagine
  • aspartic acid
  • cystine
  • glutamic acid
  • glutamine
  • glycine
  • proline
  • serine
  • tyrosine

 

COMPLEMENTARY PROTEINS

Animal-based foods like meat, fish, poultry, eggs, and dairy are considered COMPLETE PROTEINS because they contain all nine essential amino acids that our bodies need. Plant proteins vary in their amino acid profiles, and different plant-based foods provide different essential amino acids.

Examples of plant-based complete protein foods include:

  • Ancient grains, like quinoa and amaranth
  • Buckwheat
  • Chia seeds
  • Hemp seeds
  • Soy products (edamame, tofu, tempeh, miso, soymilk)
  • Nutritional yeast
  • Spirulina

Examples of plant-based incomplete protein foods include:

*Legumes – lentils, peas and beans. 

Incomplete proteins can be paired together at meals or throughout the day to make a complete protein. This concept is often referred to as COMPLEMENTARY PROTEINS.

 

MEAL EXAMPLES

Grains + Legumes

  • Black bean soup and rice
  • Whole wheat bread and peanut butter
  • Oatmeal top with peanut butter
  • Pita bread with hummus

Nuts & Seeds + Legumes

  • Hummus (chickpeas and sesame seed paste)
  • Mixed roasted nuts, seeds, and peanuts

Veggies + Nuts & Seeds 

  • Spinach salad with nuts & seeds

By combining incomplete proteins you can ensure that you are getting all 9 amino acids. You don’t need to eat complementary proteins together at every meal. If you ate beans for lunch and then had some raw almonds for a snack later, you would be adding the methionine that you had missed out on during lunch.

As long as you get a variety of protein sources throughout the day can ensure you’re getting all the essential amino acids your body needs.

 

HOW MUCH PROTEIN DO CHILDREN NEED?

Babies from birth to 6 months:

At this stage, babies need at least 8 grams of protein per day. Babies are in big-time growth mode and require sufficient protein to meet their body’s needs. From 0-6 months, babies get all of the protein they need from breast milk or formula.

Babies from 7 to 12 months:

At this age, babies require at least 10 grams of protein per day. It can come from a combination of breastmilk and/or formula and the solid foods that they are eating. If it sometimes feels like more food ends up in the highchair or on the floor than it does in baby’s mouth, that’s normal! Rest assured that they are still getting protein from breastmilk/formula, and some from food, too.

Toddlers from 1 to 3 years:

As your child gets bigger, protein requirements increase. At this stage, toddlers need at least 12 grams of protein per day.  Of course, that’s just a minimum – they can get more than 13 grams! If they are not big eaters, don’t worry: 13 grams of protein equals just 1 egg and a small serving of Greek yogurt. Or it could be a couple of tablespoons of meat, some milk, and a small piece of cheese. It doesn’t take much to meet their needs.

Children age 4 to 6 years:

At this stage, children require at least 16 grams of protein per day. As with toddlers, it’s fine if they get more than this amount. Serve a variety of protein-rich foods at meals and snacks.

 

BEST PROTEIN FOR CHILDREN WHO REFUSE TO EAT MEAT 

For children who want to be a vegetarian, or refuse to eat meat and other animal sources of protein, I often ask them “Are you getting enough protein in your diet?”. Although meat often comes to mind first as a good source of protein, there are other foods that offer plenty of protein as well. The trick is to include protein-rich plant foods at EVERY MEAL AND SNACK can help meet their nutritional needs.

VEGETARIAN PROTEIN

Here’s a list of vegetarian protein sources that you can incorporate into your family’s diet:

  1. Beans (black beans, pinto beans, chickpeas, kidney beans, red beans)
  2. Lentils
  3. Peas & Split peas
  4. Nuts & nut butter (almonds, walnuts, peanut)
  5. Seeds & seeds butter (hemp seeds, chia seeds, sunflower seeds, pumpkin seeds)
  6. Hummus
  7. Soy (soy milk, edamame beans, tempeh, tofu)
  8. Dairy (milk, cheese, cottage cheese, kefir, Greek yogurt)
  9. Eggs
  10. Grains (quinoa, amaranth, oats, barley, bulgur wheat, brown rice, whole wheat bread and pasta)
  11. Protein Powder
  12. Mycoprotein (Quorn, veggie burgers)
  13. Seitan
  14. Spirulina
  15. Nutritional yeast
  16. Vegetables (spinach, broccoli, Brussels sprouts, asparagus, and kale)
VEGAN PROTEIN 
  1. Beans (black beans, pinto beans, chickpeas, kidney beans, red beans)
  2. Lentils
  3. Peas & Split peas
  4. Nuts & nut butter (almonds, walnuts, peanut)
  5. Seeds & seeds butter (hemp seeds, chia seeds, sunflower seeds, pumpkin seeds)
  6. Hummus
  7. Soy (soy milk, edamame beans, tempeh, tofu)
  8. Dairy free milk products (plant-based)
  9. Grains (quinoa, amaranth, oats, barley, bulgur wheat, brown rice, whole wheat bread and pasta)
  10. Protein Powder
  11. Mycoprotein (Quorn, veggie burgers)
  12. Seitan
  13. Spirulina
  14. Nutritional yeast
  15. Vegetables (spinach, broccoli, Brussels sprouts, asparagus, and kale)

Additionally, when opting for vegan dairy alternatives like cheese, yogurt, milk, butter and ice cream, it’s essential to check labels for protein content as it can vary widely among products.

NUTRIENTS THAT MAY BE DEFICIENT IN A VEGETARIAN DIET

It’s important for vegetarians or vegans to be mindful of potential nutrient deficiencies in their diet. Here are some nutrients that may be deficient in a vegetarian diet:

Calcium 

Calcium is an important mineral that’s essential for bone health, muscle function, and wound healing. While dairy products are well-known sources of calcium, there are plenty of plant-based options available as well. Here are some vegetarian sources of calcium:

  • Cheese
  • Yogurt
  • Milk (both dairy and fortified plant-based options like almond milk, soy milk, or oat milk)
  • Tofu (especially tofu processed with calcium sulfate)
  • Beans and pulses (such as chickpeas, black beans, and lentils)
  • Fish canned with bones (such as sardines or salmon)
  • Wholemeal bread
  • Fortified cereals
  • Dark green leafy vegetables (including broccoli, kale, collard greens, and bok choy)
Vitamin D

Vitamin D is an essential nutrient that contributes to healthy bones and also helps to control the amount of calcium in our blood. While oily fish and eggs are notable dietary sources of vitamin D, obtaining sufficient amounts solely from food can be challenging.

Also, in regions with hot climates like Malaysia, it can be challenging to safely expose babies/children to sunlight due to the risk of overheating and sunburn.

One option is to provide vitamin D supplements, as recommended by healthcare professionals. Vitamin D drops or supplements specifically formulated for infants are available and can help meet their vitamin D needs.

Iron

Iron plays a vital role in various bodily functions, including the production of hemoglobin for oxygen transport and supporting a healthy immune system. It’s important to note the difference between heme iron, primarily found in animal sources, and non-heme iron, found in plant-based foods. Since non-heme iron is less readily absorbed by the body, vegetarians may need to consume slightly more iron-rich foods to meet their daily requirements.

Including a variety of plant-based iron sources in meals is key. Some examples of iron-rich vegetarian foods include beans, lentils, tofu, tempeh, nuts, seeds, fortified cereals, and dark leafy greens like spinach and kale. Combining these foods with sources of vitamin C, such as citrus fruits, strawberries, tomatoes, or bell peppers, can enhance iron absorption.

Zinc

Zinc is another mineral with important functions in the body including cell and enzyme production, as well as wound healing. However, phytates found in plant foods like whole grains and beans can inhibit the absorption of zinc. Therefore, it’s essential to include adequate sources of zinc-containing foods in the diet. Here are some good sources of zinc: beans, whole grains, nuts & seeds, fermented soy (tempeh and miso).

Vitamin B12

B12 needs for the formation of healthy red blood cells, cell division, and maintaining nerve structure and function. It is primarily found in animal products, individuals following a vegetarian or vegan diet need to pay special attention to their B12 intake. If dairy and eggs are part of a child’s vegetarian diet, they are likely to obtain sufficient B12 from these sources. However, for those who exclude dairy and eggs, fortified cereals (Cheerios) and plant-based milks can serve as alternative sources of vitamin B12. Additionally, considering a B12 supplement for children following a vegetarian or vegan diet is a wise option to ensure they meet their nutritional needs.

Omega-3 Fatty Acids

Ensuring an adequate intake of omega-3 fatty acids is essential for overall health, including heart health, brain function, and inflammation regulation. While oily fish is a significant source of EPA and DHA omega-3 fatty acids, vegetarians can still obtain these nutrients from various plant-based sources.

Walnuts, flaxseeds (linseed), hemp seeds, chia seeds, and soybeans are excellent vegetarian sources of alpha-linolenic acid (ALA), a precursor to EPA and DHA. Additionally, oils such as hemp, rapeseed (canola), and flaxseed oils contain ALA and can be incorporated into cooking or salad dressings.

Omega-3 enriched foods, including eggs and certain dairy alternatives like milk, yogurt, bread, and spreads, can also provide a convenient source of omega-3 fatty acids for vegetarians. When choosing these products, look for labels indicating omega-3 enrichment to ensure you’re getting the desired nutrients.

Iodine

Iodine is an essential micronutrient that play a role in helping our bodies to make thyroid hormones. It can be found in dairy products, eggs and white fish and shell fish. If your children do not consume, it’s essential to consider fortified sources of iodine, such as milk alternatives or supplements.

 

CAN MY CHILD FOLLOW A VEGAN DIET?

Ensuring that vegetarian and vegan children receive adequate nutrition for healthy growth and development is crucial. While studies have shown that the growth of vegetarian children is comparable to meat-eating children, vegan children may sometimes be slightly shorter and lighter, though still within normal ranges.

A vegan diet excludes all animal products, which can increase the risk of deficiencies in certain nutrients, including calcium, vitamin D, iron, zinc, omega-3 fats, vitamin B12 and iodine. Vegan diets can sometimes be bulky and high in fiber, which may fill up toddlers’ stomachs without providing enough calories. Including energy and nutrient-dense foods like avocados, vegetable oils, seeds, nut butters, tofu, and pulses can help increase the nutrient and energy density of their diets.

WHAT TO OFFER VEGETARIAN CHILDREN?

For vegetarian children, offering full-fat dairy products such as milk, yogurt, and cheese, as well as eggs, can provide nutrient-dense sources of protein, fats, and energy. It’s essential to ensure a balanced and varied diet for children following vegetarian or vegan lifestyles to meet their nutritional needs for growth and development.

While a vegetarian or vegan diet may pose challenges in meeting nutritional needs, careful planning can ensure that it remains balanced and provides all the necessary nutrients for your child’s health and well-being. With attention to fortified foods and diverse plant-based sources of essential nutrients, a vegan diet can be nutritious and suitable for children.

At the same time, I believe the emotional and social aspects of a vegan diet are crucial considerations, especially for children and teenagers. It’s essential to support your child’s dietary choices while also being mindful of their emotional well-being and ensuring they have a positive relationship with food. Open communication within the family about the reasons behind their dietary preferences and strategies for navigating social situations can help foster a healthy approach to veganism. If there are concerns about eating disorders or challenges with social interactions related to the diet, seeking support from a healthcare professional or counselor may be beneficial.

 

DO MY CHILDREN NEED PROTEIN POWDER? 

NO, typically children do not need protein powder. Protein powders often contain additional ingredients that are unnecessary for children, including excess protein. Children generally obtain sufficient protein from their regular diet.

While it’s okay for children to consume a smoothie made with protein powder OCCASIONALLY, it’s not necessary to specifically incorporate protein powder into their diet. Regular food sources usually provide an adequate amount of protein for children’s nutritional needs.

If you are living with a picky eater, why not join PEACEFUL MEALTIMES.

 

BOTTOM LINE

Well-planned vegetarian diets can be nutritious and provide all the necessary nutrients for good health at every stage of life. However, careful planning is essential to ensure that all nutrient needs are met.

With the help of a dietitian, parents can create balanced and diverse vegetarian meal plans that meet their child’s nutritional needs and preferences. By working together, parents can ensure that their children thrive on a vegetarian diet and enjoy optimal health and well-being.

A multivitamin may be necessary to ensure they are getting essential nutrients. Always prioritize your child’s health and well-being by seeking professional advice when making dietary choices.

What are your favourite plant-based protein foods?

The Importance of Breakfast For Children

The Importance of Breakfast For Children

by with No Comment Child & Family Nutrition

Mornings can be hectic for many families, especially those with school-aged children. Finding time for the importance of breakfast for children and a proper breakfast can be difficult in the rush to get everyone ready and out the door on time. Unfortunately, many children often end up skipping breakfast altogether. But did you know that breakfast is one of the most important meals of the day, skipping breakfast can actually make it harder for children to focus and learn at school?

 

WHY IS BREAKFAST IMPORTANT FOR CHILDREN?

Eating breakfast has a big impact on the importance of breakfast for children and how well children do in school. Studies have found that children who eat breakfast tend to have higher test scores, remember things better, and stay more focused than those who skip it.

Here’s WHY…

Just like our muscles need food for energy, our brains do too. While our muscles can use energy stored from yesterday’s meals, our brains prefer fresh energy from what we eat now.

When our brain doesn’t have enough glucose (blood sugar) for fuel, we can’t concentrate as well or feel as awake. Eating breakfast helps bring our blood sugar levels back to normal after not eating while we were asleep. That’s why people say breakfast is the most important meal of the day. So, breakfast basically tells our bodies and brains, “Wake up! It’s time to get moving.”

Furthermore, breakfast isn’t just about fueling your body; it’s also packed with essential nutrients. Children who eat breakfast are more likely to get all the nutrients they need. Studies show they eat more fruit, drink more milk, and consume less unhealthy fats than those who skip breakfast. When children skip breakfast, they often don’t make up for those missed nutrients later in the day, like B vitamins, iron, calcium, vitamin D and protein.

Starting the day with a healthy breakfast might even help prevent obesity. Research suggests that breakfast eaters are less likely to be overweight. Breakfast helps regulate appetite, hormone levels, and the number of calories we burn throughout the day. So, it’s a win-win for health and wellbeing!

 

WHAT SHOULD YOU GIVE YOUR CHILD FOR BREAKFAST? 

To ensure the importance of breakfast for children and that your children get the nutrition they need in the morning, aim for a balanced breakfast featuring a mix of wholesome foods.

CARBOHYDRATES are essential fuel for the brain, helping kickstart thinking and learning. Look for whole grains, milk, fruits, and veggies. Check for “whole wheat” or “whole grain” listed first on the ingredients to identify whole grain products.

PROTEIN is crucial for maintaining energy levels and feeling full until lunchtime. Include foods like meat, beans, eggs, milk, yogurt, and cheese to ensure your breakfast is packed with this important nutrient.

While FRUITS are a staple breakfast item, let’s not forget about VEGETABLES. Research shows that children need repeated exposure to new foods before they’ll eat it willingly. So, if your child isn’t into veggies, try incorporating them into breakfast as well.

Making vegetables a regular part of every meal, including breakfast, can help normalise their consumption and highlight the importance of breakfast for children. Plus, young children often eat more earlier in the day, making breakfast the perfect time to introduce or reintroduce veggies.

Here’s a list of healthy breakfast options that children will enjoy. Just pick a carbohydrate food for fuel and a protein or healthy fat to keep that energy flowing throughout the day.

The Importance Of Breakfast For Children Cold Cereal

Cold Cereal 

Cold cereal is a convenient and quick breakfast choice for many families, especially for picky eaters. However, it’s important to be mindful of the sugar content in many commercial cereals, particularly for babies and young children.

Opting for lower-sugar cereal options can help reduce their intake of added sugars. Additionally, adding nutritious toppings like fruit, nut butter, seeds, or even yogurt can enhance the nutritional value of the breakfast and provide a good dose of essential nutrients. This way, you can still enjoy the convenience of cereal while ensuring that your child starts their day with a balanced and nutritious meal.

The Importance Of Breakfast For Children Pancakes

Pancakes/Waffles

Pancakes or Waffles are a great option for easy meal prep on busy mornings. Here’s a neat trick: Make your favourite pancake/waffle recipe and let them cool on a cooling rack. Then, layer the pancakes/waffles between wax paper in a freezer-safe container and freeze them for later.

When school mornings get hectic, simply grab a pancake/waffle or two from the freezer and pop them in the toaster. They’ll warm up quickly and be ready in a snap!

To boost the protein, healthy fat, and fiber content of this school breakfast idea, consider adding your little one’s favourite fruit and nut or seed butter as toppings. It’s a delicious and nutritious way to start the day!

The Importance Of Breakfast For Children Muffins

Muffins

When school mornings are rushed, sometimes the only option is to eat breakfast on the go. These muffins are the perfect solution for busy children as they can be easily enjoyed in the car. Prepare these muffins ahead of time and freeze them for those hectic mornings. They’ll be ready to grab and eat, ensuring your child starts the day with a nutritious meal even when time is tight.

The Importance Of Breakfast For Children Banana Bread

Banana Bread

Banana bread is an excellent choice for a school breakfast that can be prepared ahead of time. It’s simple, delicious, and sure to please your children. Plus, its high fiber content will keep them feeling full and satisfied while promoting good gut health.

After baking and cooling the banana bread, I suggest slicing it and freezing it for convenience. On busy school mornings, simply defrost some banana bread slices for a quick and delicious grab-and-go breakfast option. It’s a stress-free way to ensure your children start their day with a nutritious meal, even when time is short.

The Importance Of Breakfast For Children Oatmeal

Oatmeal

Oatmeal is a fantastic breakfast option for families because it’s so versatile. You can prepare a base oatmeal and then let each person customize their own toppings according to their preferences. Whether it’s fresh fruit, nuts, seeds, honey, or even a sprinkle of chocolate chips, everyone can make their oatmeal just the way they like it. It’s a delicious and customizable breakfast that’s sure to please everyone at the table!

The Importance Of Breakfast For Children overnights oats

Overnight Oats

Overnight oats are a fantastic choice for giving your children a nutritious kickstart to their day. Packed with fiber and essential vitamins and minerals, oats provide a wholesome foundation for a healthy breakfast.

You can prepare them ahead of time, making busy mornings a breeze. Get your children involved in breakfast prep by letting them customize their oats with their favorite toppings. From fruits to nuts to seeds, the options are endless, making this breakfast idea incredibly versatile and fun for the whole family!

The Importance Of Breakfast For Children Hard boiled eggs

Hard-Boiled Eggs

Hard-boiled eggs are a fantastic option for breakfast meal prep since they can last in the fridge for up to a week and are easy to make. They’re packed with protein and can be incorporated into many breakfast dishes.

For a well-balanced school breakfast, I recommend serving hard-boiled eggs with some fruit, like sliced oranges, bananas, or berries, and whole grain toast. This combination provides a good balance of protein, carbohydrates, and vitamins to keep your child fueled and focused throughout the morning.

The Importance Of Breakfast For Children Toast

Toast

Toast is a versatile breakfast option that pairs well with a variety of toppings. Whether you prefer classic toppings like peanut butter or jam, or you’re more adventurous with toppings like avocado or scrambled eggs, there’s something for everyone. Toast allows for endless creativity and customization, making it a delicious and satisfying breakfast choice.

The Importance Of Breakfast For Children Smoothies

Smoothies

Smoothies are a fantastic school breakfast idea! They’re not only delicious but also packed with nutrients for children. Plus, smoothies are highly customizable, allowing you to mix in all sorts of ingredients to suit your child’s taste.

To boost the protein and fiber content of your child’s smoothie, consider adding some Greek yogurt and/or chia seeds. These ingredients provide an extra nutritional punch to keep them fueled until lunchtime.

For some smoothie inspiration, check out this blog post for ideas tailored specifically for picky eaters. With a little creativity, you can create smoothies that your child will love and benefit from nutritionally!

Chia Pudding

This chia pudding recipe is super easy and only needs 3 ingredients! Just spend 5 minutes preparing it the night before school, then pop it in the fridge overnight. In the morning, it’s ready to serve!

Yogurt Parfaits

Yogurt parfaits are not only a fun and easy school breakfast option that you can prep ahead of time, but they’re also packed with protein and probiotics, which are beneficial for your children’s digestive health.

Get your children involved by customising these parfaits! Let them add their favorite nuts, seeds, or fruits to make it extra special. This not only makes breakfast more enjoyable, but it also encourages them to explore new flavors and textures.

Granola Bars

Store-bought granola bars often pack a punch of sugar and lack other important nutrients like protein and fiber, leaving them less filling for a school breakfast.

Homemade granola bars loaded with protein, fiber, and healthy fats, keeping your child feeling full and satisfied throughout the morning. Best of all, you can make them ahead of time and tailor them to your child’s taste preferences!

 

HOW TO ENCOURAGE NON-BREAKFAST EATERS TO EAT BREAKFAST AND RECOGNIZE THE IMPORTANCE OF BREAKFAST

You, as parents, play a big role in demonstrating the importance of breakfast for children and showing them that it can be both important and delicious. Here are some ideas to help encourage your child, especially if they’re not big on breakfast:

  1. Lead by Example: Sit down and enjoy breakfast with your child. Show them that breakfast is a nice time to start the day together.
  2. Try Smoothies: If your child isn’t keen on traditional breakfast foods, try making a tasty smoothie with milk, yogurt, and fruit like a banana. It’s a fun and healthy option.
  3. Small Meals: If your child isn’t hungry first thing, offer a small breakfast like a bowl of oatmeal/cereal , a piece of fruit, small scoop of yogurt with fruit or an hard-boiled egg.
  4. Preparation: If mornings are hectic, prepare breakfast the night before, such as overnight oats, hard-boiled eggs, muffins, pancakes, or French toast, etc. These quick options can be paired with a glass of milk or eaten on the go.
  5. Get Creative: For picky eaters, think outside the box. Try nasi lemak, roti canai, yogurt parfait, granola bar, etc.
  6. Respect Independence: If your older child refuses breakfast, don’t stress. They might be asserting their independence. Offer them a piece of fruit or toast to take with them on the way to school. Alternatively, let them pick out their own healthy breakfast options when you’re grocery shopping. Giving them a bit of control can help them feel more invested in their morning routine.

 

BOTTOM LINE 

Breakfast plays a crucial role in emphasizing the importance of breakfast for children, impacting their health, mood, and academic performance. It provides the essential nutrients and energy needed to fuel their bodies and minds for the day ahead. While mornings may be busy, it’s worth investing the time and effort to ensure that your child starts their day with a nutritious breakfast.

By fostering healthy breakfast habits and incorporating creativity and patience into your morning routine, you can set your child up for success and help them thrive both academically and physically. It’s a small but significant way to support their overall well-being and development.

For more breakfast ideas, check out my FREE RESOURCES page to download Breakfast Ideas for Children.

What is a Pediatric Dietitian and How Can They Help

What is a Pediatric Dietitian and How Can They Help?

by with No Comment Consultation
Hey there, I’m Ms. Yeting, a Pediatric Dietitian, and the founder of Simple Balance Nutrition. If you’re struggling with your kids’ eating habits, you’re not alone. Feeding children can be a real challenge! That’s why I’m passionate about ensuring every parent has access to a pediatric dietitian like myself—I’m here to lend a hand!

My specialty? Working alongside parents to revolutionize how they feed their children and how their children eat. Together, we can empower your children to embrace new foods, enjoy a diverse range of options from various food groups, sit down to meals happily without any battles, and cultivate a lifelong healthy relationship with food and their bodies.

If you’re ready to dive in and work with a pediatric dietitian one-on-one, you can book an appointment with me right here. Whether you’re dealing with picky eating, a child seemingly “addicted to sugar,” weight concerns, or just need help getting nutritious meals on the table, you’ve come to the right place.

In this post, I’ll walk you through what a pediatric dietitian does, why it’s crucial to seek out a specialist in pediatric nutrition for your children, and how you can go about finding one. Plus, I’ll give you a sneak peek into what you can expect when working with a pediatric dietitian, so you can be confident in finding the perfect fit for your family.

So, if you’re ready to kickstart your journey towards happier, healthier eating habits for your children, let’s get started!

 

WHY CHILDHOOD NUTRITION IS IMPORTANT 

The global obesity crisis has worsened in recent years, with research pointing out how more and more children deal with this harmful condition. Pediatric dietitians and nutritionists are here to help prevent children from developing unhealthy body mass indexes and to support those who are on their weight loss journey.

A century ago, the notion of a child needing a dietitian would have been met with skepticism. Back then, the food they ate was generally more nutritious and less processed. Plus, the idea of seeking professional guidance for children’s diets wasn’t widely accepted.

Fast forward to today, we are dealing with more obese children than ever with pre-diabetes and diabetes, inflammatory bowel syndrome, autoimmune diseases, skin issues, and a variety of food intolerances and allergies. It’s a serious global issue that demands attention.

Despite the gravity of the situation, the importance of addressing children’s dietary preferences and involving pediatric dietitians in the conversation has become increasingly evident. Parents are recognizing the significance of seeking expert guidance to ensure their children’s nutritional needs are met and to tackle health challenges head-on.

In essence, while the prevalence of childhood obesity presents a significant challenge, the role of pediatric dietitians has never been more crucial. By working together to promote healthier eating habits and address nutritional concerns, we can strive towards a healthier future for our children.

 

WHAT DOES A PEDIATRIC DIETITIAN DO?

A pediatric dietitian is dedicated to collaborating with children and their families to enhance their dietary habits, nutrition, and feeding routines. There are various reasons why a child might benefit from consulting a pediatric dietitian, which I’ll delve into below.

During the initial consultation with a pediatric dietitian, a comprehensive nutrition assessment is conducted. This typically involves:

  1. Reviewing the child’s medical history in detail.
  2. Assessing growth parameters such as height, weight, and growth charts to track progress over time.
  3. Evaluating the child’s weight and height history to identify any trends or concerns.
  4. Gaining insight into the child’s typical dietary intake and preferences.
  5. Engaging in thorough discussions and asking pertinent questions to better understand the child’s unique needs and circumstances.

Based on this assessment, the pediatric dietitian will develop dietary modification recommendations and work closely with the family to implement these recommendations effectively. The frequency and duration of follow-up visits will vary depending on the individual needs of the child.

Overall, the primary goal of a pediatric dietitian is to support children and their families in optimizing their nutritional intake, fostering healthy eating habits, and addressing any dietary concerns or challenges they may encounter along the way.

 

WHEN TO SEE A PEDIATRIC DIETITIAN 

Wondering when it’s time to seek guidance from a pediatric dietitian? Here are some common scenarios where their expertise can make a significant difference:

1. Picky Eating

If mealtimes at your home resemble battlegrounds due to a picky eater, a dietitian can offer valuable support. They can help alleviate mealtime stress and create strategies to encourage your child to explore new foods. Picky eating is often seen in toddlers and preschoolers but can persist if left unaddressed, potentially impacting growth. Early intervention with a dietitian’s comprehensive assessment can help set your child on the right path. Check out my online course PEACEFUL MEALTIMES to help your children start trying new foods.

2. Starting Solids and Baby-Led Weaning

Navigating the transition to solid foods can be daunting for new parents. A dietitian can provide guidance on your baby’s nutritional needs, appropriate food choices, and transitioning through different textures. For those considering baby-led weaning, a dietitian can offer tailored advice and meal ideas to support this approach.

3. Nutrient Deficiencies

If your child is diagnosed with a nutrient deficiency, such as iron or vitamin D, a dietitian can help rectify the imbalance through dietary adjustments or supplements. Iron deficiency, particularly common in toddlers consuming excessive milk alternatives, requires careful management to restore optimal levels.

4. Constipation

Constipation is a prevalent issue in children, often influenced by diet. A dietitian can analyze your child’s dietary habits and recommend adjustments to promote regular bowel movements. They may suggest incorporating probiotic-rich foods or supplements and offer easy-to-follow recipes for constipation relief.

5. Child Athletes

Proper nutrition is vital for young athletes to support performance, recovery, and growth. A dietitian specializing in pediatric nutrition and sports can provide tailored guidance to optimize your child’s nutritional intake, considering their high activity levels and rapid growth.

6. Weight Concerns

If there are concerns about your child’s weight or growth, a pediatric dietitian can conduct a comprehensive assessment to determine if intervention is necessary. It’s essential to approach discussions about weight sensitively and privately, focusing on overall health rather than appearance to prevent negative associations.

7. Food Allergies

Children with food allergies may require guidance to ensure they receive adequate nutrients while avoiding allergens. A dietitian can assist in identifying suitable alternatives and designing a balanced diet that meets their nutritional needs.

8. Other Health Concerns

There are numerous other reasons to consult a pediatric dietitian, including general growth and nutrition concerns. If you have any concerns about your child’s diet or nutrition, consider discussing them with their pediatrician to explore the possibility of a referral to a dietitian.

Remember, the expertise of a pediatric dietitian can play a pivotal role in addressing various dietary challenges and promoting optimal health and well-being for your child.

 

HOW TO FIND A PEDIATRIC DIETITIAN 

When seeking a pediatric dietitian to address your child’s nutritional needs, consider the following avenues:

  1. Word of Mouth: Tap into your social network by asking fellow parents in your child’s daycare, kindergarten, or school for recommendations. Parents who have already engaged the services of a pediatric dietitian may offer valuable insights, or the educational institution itself might have information on reputable professionals.
  2. Pediatrician Referral: Consult your child’s regular pediatrician for referrals to pediatric dietitians in your area. Pediatricians often collaborate with dietitians and can provide trusted recommendations based on your child’s specific needs.
  3. Virtual Pediatric Dietitians: If you’re seeking assistance for non-medical nutrition issues such as picky eating or healthy meal planning and prefer a virtual option, you can consider working with a remote pediatric dietitian. Virtual consultations offer convenience and accessibility, allowing you to connect with a qualified professional regardless of geographical location.
  4. Local Dietitian Recommendations: If you’re having difficulty finding a local pediatric dietitian, reach out to other dietitians in your area for recommendations. Many dietitians maintain professional networks and can direct you to colleagues who specialize in pediatric nutrition. Additionally, dietitians often refer clients to specialists outside their own expertise, ensuring you receive tailored support.

By exploring these avenues and seeking referrals from trusted sources, you can connect with a qualified pediatric dietitian who can address your child’s unique nutritional needs and support their health and well-being.

 

BOTTOM LINE 

A pediatric dietitian is a registered dietitian specializing in working with children, equipped with extensive experience in pediatric nutrition. They offer invaluable support and guidance across various nutrition-related challenges, including picky eating, introducing solids, weight and growth concerns, addressing nutrient deficiencies, and devising healthy meal plans tailored to children’s needs.

Whether you opt for a local or virtual dietitian depends on your specific circumstances and preferences. The crucial factor is finding a professional with a solid background in pediatric nutrition, ensuring the best possible care for your family.

With over 13 years of dedicated experience in pediatric nutrition, I’m here to support you every step of the way. Whether you’re ready to schedule a consultation or simply have questions about your child’s nutrition, feel free to reach out. I offer a range of free resources to kickstart your journey towards better health and nutrition for your child.

Don’t hesitate to contact me for personalized assistance or to learn more about my qualifications and expertise. Your child’s well-being is my top priority, and I’m committed to providing the support and guidance you need to navigate the challenges of pediatric nutrition with confidence.

Safe Ways to Introduce Nuts to Baby

Safe Ways to Introduce Nuts to Baby

by with No Comment Baby Led WeaningChild & Family NutritionFood Allergy

Undoubtedly, introducing nuts to a baby can be scary, as they pose both a choking hazard and rank among the top nine allergens.

However, introducing nuts to your baby between the ages of 6 and 12 months can actually help lower their chances of developing an allergy. So, how can you safely introduce nuts to your baby?

WHAT CAUSES AN ALLERGY

An allergy occurs when the immune system erroneously recognizes a protein in a specific food as a potential threat. Subsequently, the immune system becomes activated and releases substances like histamines to combat this perceived danger. This immune response triggers inflammation, which results in the symptoms of an allergic reaction.

BENEFITS OF NUTS FOR BABY 

Nuts offer a wealth of nutrients and health benefits, and there are numerous ways to include them in a baby’s diet.

Different nuts have different nutrient profiles, but generally, they are rich in fats crucial for a baby’s growth and development. Additionally, they provide essential protein for muscle growth and tissue repair, along with fiber to support a healthy digestive system. Nuts are also a source of important micronutrients such as calcium, iron, folate, vitamin E, zinc, and more.

WHEN TO INTRODUCE PEANUTS AND OTHER NUTS TO BABY 

Back in 2000, parents were advised to avoid the introduction of allergenic foods for the first 1 to 3 years of life, with the belief that this would reduce the risk of developing allergies. However, recent research has shed light on this matter, revealing that delaying the introduction of allergenic foods not only fails to provide protection against allergies but can actually raise the risk of developing them.

A significant study called the LEAP study, conducted in England from 2006 to 2014, focused on infants at high risk of developing peanut allergies, including those with severe eczema, an egg allergy, or both. This study found that babies who were introduced to peanuts before the age of one and consumed them regularly in their diet had an 86% reduction in peanut allergy compared to children who avoided peanut.

Specifically, the group of children who avoided peanuts had a 17% incidence of peanut allergy, while the group that regularly included peanuts had a substantially lower rate of 3%. These findings underscore the importance of early and consistent introduction of allergenic foods like peanuts to reduce the risk of allergies in high-risk infants.

In early 2017, the National Institute of Allergy and Infectious Diseases (NIAID) release new guidelines specifically addressing peanut allergies. These guidelines received endorsement from prominent organizations such as the American Academy of Pediatrics, National Institute of Health and the American Academy of Allergy, Asthma, and Immunology, Malaysian Society of Allergy and Immunology , Canadian Society of Allergy and Clinical Immunology .

These guidelines recommend the introduction of allergenic foods at around 6 months of age, when babies are developmentally ready for solids (not before 4 months), and that all babies should have these foods by 12 months. This includes babies at high risk of allergy, unless an allergy to that particular food has already been confirmed.

Furthermore, once allergenic foods are introduced, it is beneficial to continue offering them regularly, approximately twice a week, as this practice helps in maintaining tolerance and reducing the risk of developing allergies.

WHAT NUTS CAN BE INTRODUCED TO BABY 

PEANUTS VS TREE NUTS

Peanuts and tree nuts, despite both being categorized as ‘nuts,’ do not share a botanical relationship and originate from distinct plant families. Surprisingly, peanuts aren’t true nuts; they belong to the legume family, such as soybeans, chickpeas or kidney beans. Interestingly, most individuals with a peanut allergy can typically consume other legumes safely.

  • Peanuts
  • Almonds
  • Brazil nuts
  • Cashews
  • Chestnuts
  • Hazelnuts
  • Macadamia nuts
  • Pine nuts
  • Pecans
  • Pistachios
  • Walnuts

We know that peanuts are not related to tree nuts, so most people tend to be allergic to either peanuts OR tree nuts. However, approximately 1 in 3 individuals with a nut allergy are allergic to both peanuts and tree nuts.

It’s now known that there is some cross-reactivity can occur between different foods, as well as between pollen and certain foods or latex and certain foods. So, having a tree nut allergy doesn’t necessarily indicate an allergy to all types of tree nuts, but it significantly increases the risk of being allergic to others. For this reason, each type of nut needs to be introduced separately, ideally leaving 2-3 days between each one.

NUT BUTTERS

You have the option to prepare your own nut butter or purchase a commercially available brand of any of the nuts listed above. If opting for a store-bought variety, ensure that it is free from any additives like sugar, salt, oils, or preservatives. It should only contain the specific nut you intend to introduce.

After individually introducing each type of nut to your baby, using mixed nut butter can be a convenient method to continue exposing your baby to a variety of nuts simultaneously, rather than incorporating each nut separately. This approach simplifies the process of diversifying your baby’s nut consumption while ensuring they receive a broad range of nut-related nutrients.

A useful tip for nut butter: If your nut butter is too thick and clumpy, you can transfer a small amount to a microwave-safe bowl and heat it in 20-second intervals, stirring each time, until it becomes slightly warm. The heat will aid in smoothing out the nut butter and making it thinner in consistency.

GROUND OR FINELY CHOPPED NUTS

Another way to introduce nuts to your baby is by finely grinding them and then sprinkling them on top of pureed foods, oat cereal, avocado, banana, or other solid foods. To grind the nuts, you can take a small handful and pulse them in a blender or food processor until they are finely chopped. It’s essential to check the size of the nuts while pulsing every 20 seconds to avoid turning them into a paste or nut butter. Alternatively, you can finely chop a small quantity of nuts on a cutting board. Once you have the finely chopped nuts, you can sprinkle them onto your baby’s food, leave them as they are, or stir them in for added texture and flavor.

ARE NUTS A CHOKING HAZARD FOR BABY?

Whole nuts pose a choking hazard and should not be offered to children under the age of 4. Additionally, chunky nut butter with large lumps should be avoided for the same reason. To ensure safety, serve nuts to young children in alternative forms such as puffs, nut powder, finely chopped, in the form of flours, thinned nut butter, or incorporated into purees. These preparations minimize the risk of choking and make nuts more suitable for young children’s consumption.

ARE NUTS A COMMON ALLERGEN?

Peanuts and tree nuts are all classified as top food allergens, so it’s important to be vigilant about any potential reactions when introducing foods containing nut ingredients to your baby. Allergic reactions can occur within minutes to hours after consumption, so it’s advisable to offer such foods at a time when you can closely monitor your child for a few hours, rather than during dinner.

Be attentive to possible symptoms of an allergic reaction, which may include itchy rashes, hives, vomiting, difficulty breathing, swelling of the lips and tongue, and, in severe cases, anaphylaxis. Promptly contact your pediatrician if any of these symptoms occur.

FEEDING TIPS WHEN INTRODUCING NUTS 

  1. Nuts pose a choking hazard for babies and young children, so it’s important to avoid offering whole nuts, chunks of nuts, or large dollops of nut butter to ensure their safety.
  2. Serve nuts earlier in the day: When introducing a new type of nut, offer it during breakfast or lunch so you can closely monitor your baby for any potential allergic reactions.
  3. Start with a small amount: You don’t need to give your baby a large serving to check for reactions. Begin with a small quantity to gauge their tolerance.
  4. Never rub on your baby’s skin: This will not help to identify a food allergy and can actually increase the risk of an allergy developing.
  5. Keep it on the menu: After successfully introducing a specific type of nut into your baby’s diet, aim to include it regularly in their weekly meal plan. This consistent exposure can potentially reduce the risk of developing allergies later in life.

HOW TO INTRODUCE PEANUTS OR TREE NUTS TO BABY 

Begin by introducing one type of nut early in the day, allowing you to closely monitor for any potential symptoms. To ensure safety and to thoroughly assess for any overlooked reactions, it is recommended to reintroduce the same variety of tree nuts or peanuts the following day, preferably around the same time. To monitor any allergy reactions, it’s best to wait 1-2 days before switching to a different type of nut.

Here are some of my favourite ways to introduce peanuts and tree nuts to your baby’s diet:

FOR TRADITIONAL WEANING 

  1. Add a small amount of warm water to a teaspoon of nut butter. Blend until you reach a smooth consistency, never serve a globs of nut butter as it can pose a choking hazard for young children.
  2. Infant cereal or oatmeal: Mix nut butter or finely chopped nuts into baby’s meal for added flavor and nutrition.
  3. Purees: Add a small amount of nut butter or finely chopped nuts to homemade baby purees for added texture and nutrition.
  4. Smoothies: Blend nut butter into a fruit or yogurt smoothie for a creamy, nutty flavor.

FOR BABY LED WEANING OR FINGER FOODS 

  1. Pasta tossed with pesto (if making at home, you can change which nuts or seeds you use as the base).
  2. Nut butter thinly spread on toast, pancakes, or waffles strips.
  3. Sprinkle finely chopped nuts on slices of banana, avocado, sweet potato wedges, oatmeal, applesauce, or yogurt.
  4. Mixed finely chopped nuts into the batter of pancakes, waffles, and muffins. Use a small amount of almonds to replace some of the regular flour used in baked goods.
  5. Nut butter yogurt dip.

The above methods offer versatility in introducing nuts to your baby’s diet, allowing you to choose the most appropriate option based on your baby’s age and preferences.

RELIABLE DIAGNOSIS OF FOOD ALLERGY IS IMPORTANT

It is important that allergies are accurately diagnosed and confirmed by a medical doctor. Your child’s doctor may conduct skin prick tests or blood tests to assess allergen-specific IgE levels, which can aid in confirming or ruling out potential allergens. However, it’s important to note that while these tests can establish the presence of an allergy, they do not predict the severity of an allergic reaction in individuals with allergies.

It’s also worth mentioning that some other forms of allergy testing lack scientific evidence and are therefore not recommended.

BOTTOM LINE 

Many foods are suitable for young children, but whole nuts are a choking hazard until at least age 4, and spoonfuls of nut butters can be too sticky for little mouths. The good news is that there are numerous delicious ways to serve nuts, providing healthy fats, protein, and essential nutrients. Nuts are rich in vitamins and minerals like Vitamin E and iron, making them a valuable addition to children’s diets for enhanced nutrition. I hope this blogpost can help you safely incorporate nuts into your baby’s diet while minimizing risks and promoting healthy eating habits.

Did you know that I offer personalized one-on-one nutrition counselling for children and families? If this is something you’s like to learn more about, check out my service.

Can My Baby Get Enough Iron Using Baby Led Weaning

Can My Baby Get Enough Iron Using Baby Led Weaning

by with No Comment Baby Led WeaningInfant Nutrition

While I’m a fan of Baby Led Weaning (BLW), the concern about not getting enough iron intake is real, especially since many moms like to offer fruits and veggies as starter foods for their babies. In fact, this is one of the top mistakes parents make when practising BLW!

Iron deficiency is estimated to be the most common deficiency worldwide. It can lead to anemia, impaired growth and development, as well as impaired cognitive function, including delayed attention, learning difficulties and social withdrawal. According to Malaysia’s National Health and Morbidity Survey (NHMS) 2022 Maternal and Child Health report, 46.5% of children between 0-5 years old were anemic. Therefore, in contrast to the popular saying, “food before 1 IS NOT just for fun.”

INCREASED NEEDS

By the age of 6 months, your baby’s iron stores, acquired during pregnancy, begin to deplete. This depletion is influenced by factors such as the mother’s iron levels during gestation, delayed cord clamping at birth, and the baby’s gestational age at birth. Around eighty percent of the baby’s iron stores accumulate during the third trimester of pregnancy. If your baby is born “overdue,” it can be one of the advantages in this context.

While breast milk contains a smaller quantity of iron (0.5 mg/L) compared to formula, but the iron present in breast milk is significantly more easily absorbed – approximately 50% absorption, as opposed to the 10% absorption rate in iron-fortified formula. Consequently, both breastfed and formula-fed infants receive comparable amounts of iron.

As infants reach six months of age, they continue to obtain some iron from their breast milk or formula, but introducing solid foods becomes crucial to provide a supplementary source. These solids are commonly referred to as “complementary foods,” as they complement the nutritional intake from a baby’s milk.

The question then arises: How much additional iron do babies require, and where should they get it from to ensure adequate intake?

HOW MUCH IRON DOES MY BABY NEED?

So, how much iron does a full-term, healthy-weight baby need?

In North America, the Recommended Dietary Allowances (RDA) for iron

  • BABIES 0-6 MONTHS: 0.27 mg/day
  • BABIES 6-12 MONTHS: 11 mg/day
  • TODDLERS 1-3 YEARS: 7 mg/day

In Malaysia, The Recommended Nutrient Intake (RNI)

  • BABIES 6-11 MONTHS: 9 mg/day (10% bioavailability); 6 mg/day (15% bioavailability)
  • CHILDREN 1-6 YEARS: 6 mg/day (10% bioavailability); 4 mg/day (15% bioavailability)

Therefore, I think it depends where you are. The good aiming point is about 7-8 mg of iron daily for 6-12 month olds who consume meat. For vegetarian babies, a better target is probably 9-11 mg per day.

It is important to note that 11mg (RDA) is an average requirement (from breastmilk/formula and food) for ages 7 to 12 months. Babies’ iron needs don’t suddenly surge overnight, it’s a significant increase that we should strive to approach as quickly as possible. There can be a big difference in size and appetite between a 7 month old and a year old child. 12-month olds will need more iron than seven-month olds, but they can also eat more food, so they will work up to this amount gradually. The great news is that babies progress very quickly to consuming a fair amount of food with BLW.

Furthermore, you do not need to be counting the exact amount in milligrams of iron your child consumes each day – this is wearisome and stressful. The main goal is to provide as many iron-rich foods throughout the day as possible.

SIGNS OF IRON DEFICIENCY

If you’re worried that your child isn’t getting enough iron, here are some signs and symptoms of iron deficiency you can watch for:

  • Slow weight gain
  • Little or no appetite
  • Pale skin
  • Always tired
  • Cold hands and feet
  • Brittle nails
  • Poor immunity (often sick or frequent infections)

To prevent anemia, the American Academy of Pediatrics recommends conducting a blood test on all 12-month-olds to assess their iron levels. In Malaysia, if you’ve concerns about your child’s iron intake or notice signs of deficiency, it is advisable to consult a doctor and request a blood test.

If the levels are significantly low, it is necessary to provide your child  with iron supplements for a few months, as relying solely on food is unlikely to be enough to restore iron levels to normal levels.

CAN BABY LED WEANERS GET ENOUGH IRON (RESEARCH)

According to Baby-led Introduction to Starting SolidS (BLISS) study, two hundred families from New Zealand were divided into two groups: the BLISS group and the control group.

In the BLISS group, parents were taught to prevent choking, growth faltering and how tonsure an adequate intake of iron-rich foods while self-feeding. They were encouraged to offer at each meal:

  • High iron food (e.g., red meat and fortified cereals)
  • Energy-rich food (e.g., cheese or avocado)
  • Easy-to-eat food ((e.g., fruit or veggie)

A study originating from the BLISS trial, titled “Impact of a Modified Version of Baby-Led Weaning on Iron Intake and Status: A Randomized Controlled Trial,” examined the effects. Nutrient intake at 7 and 12 months of age was assessed through weighted 3-day diet records. Additionally, the iron status of the babies was analyzed using a blood sample taken at 12 months of age.

The results indicated that 83% of babies in both the control and BLISS groups had adequate iron levels, with 5% in the control group and 7% in the BLISS group showing signs of anemia. No significant differences were observed between the two groups in terms of iron levels and stores at either 7 or 12 months of age.

This is indeed promising news! With additional education on the safe implementation of BLW, it has the potential to serve as a nutritious and safe approach to introducing solid foods.

So, Can BLW Babies Get Enough Iron?

The short answer is YES! It is possible.

The main source of iron for traditionally weaned babies is iron-fortified rice cereal, which is usually skipped in BLW. But, baby led weaners can absolutely get enough iron in their diets! In fact, BLW babies typically consume meat if it’s part of the family’s diet, whereas traditionally weaned babies might not eat meat right away at the beginning of starting solids. As long as parents focus on offering iron-rich foods at each meal, there is no significant difference in the iron status between babies following the BLW approach and those being fed purees.

Vegetarian and vegan infants might encounter more challenges in obtaining sufficient iron, yet this goal is achievable through strategic planning by parents. By conscientiously providing iron-rich foods or incorporating rice cereal, the necessary iron intake can still be achieved.

WHAT FOODS ARE HIGH IN IRON

There are two types of iron sources: heme and non-heme. Heme iron, is found in animal products like meat, fish, and poultry, the human body has a high absorption rates at approximately 20%. Conversely, non-heme iron is found in plant sources like soy, lentils, beans, and even eggs, but it is less easily absorbed by the body, with only around 10% uptake. It is crucial to recognize that iron sources vary in their bioavailability.

I don’t believe in focussing on numbers and exact amounts of iron/foods to give, as this approach can lead to unnecessary stress. However, I do think it is useful to know the amounts of iron found in realistic serving sizes of some of the foods mentioned below. Here are a few examples along with approximate iron levels:

HEME-IRON FOODS:

  • Liver (chicken, turkey, lamb), cooked* = 6.2-9.7 mg
  • Ground beef (75 g) = 1.3-2.2 mg
  • Ground chicken/pork (75 g) = 0.8-1.2 mg
  • Chicken (75 g) = 0.4-2 mg (dark meat has higher levels than white meat)
  • Sardines, canned (75 g) = 1.7-2.2 mg
  • Tuna, light, canned in water (75 g) = 1.2 mg

*While liver is an excellent source of iron, it contains an excessive amount of preformed Vitamin A, which could be toxic. The Upper Limit recommended for ages up to 3 years is 600 micrograms, whereas just 1 oz of liver contains over 5,000 micrograms. Plus, the liver is the filter for our body, and it can also contain metals.

How to serve heme-iron foods in BLW:

  • Ground meat sauce
  • Baby burgers or meatballs
  • Offer no-added salt canned sardines as finger food
  • Pressure or slow-cooked pork or beef roast, shredded
  • Pork ribs or chicken legs (removed of gristle)
  • Boneless chicken thighs, cut into finger-sized strips
  • Fish or salmon cakes

NON-HEME IRON FOODS:

  • Eggs (2 eggs) – 1.2 – 1.8 mg
  • Edamame (1/2 cup) = 1.9-2.4 mg
  • Tofu (¾ cup) = 2.4-8 mg
  • Lentils (¾ cup) = 4.1-4.9 mg
  • Beans (white, kidney, navy, pinto, black, etc.) (¾ cup) = 2.6-4.9 mg
  • Hummus (¼ cup) = 1.4 mg
  • Oatmeal, instant, cooked (¾ cup) = 4.5-6.6 mg
  • Wheat germ (1 tbsp) = 1.2 g
  • Spinach, cooked (½ cup) = 2.0 -3.4 mg
  • Hemp hearts (1 tbsp) = 1.4 mg
  • Blackstrap molasses (1 tbsp) = 3.6 mg

How to serve non-heme iron foods in BLW:

  • Eggs fried and sliced in strips or scrambled
  • Firm tofu strips sautéed or roasted.
  • Blend soft tofu into smoothies for variety.
  • Add blackstrap molasses to baking.
  • Sprinkle wheat germ or hemp hearts on yogurt or blend into a smoothie.
  • Serve hummus on a strip of toast.
  • Black beans are a good finger food to practice the pincer grasp.
  • Smush larger beans like chickpeas with your finger, so they’re not a choking hazard.
  • Bean or lentil patties.
  • Nut butters on toast fingers.

TIPS TO GET ENOUGH IRON WHILE USING BLW (6-12 months)

  1. Continue providing adequate breast milk or formula as the baby’s main source of nutrients. At this age, solid foods serve as complimentary options to to boost baby’s nutrient intake and gradually prepare their digestive system for a complete transition to solids.
  2. Ensure that every meal includes a source of iron, both heme and non-heme iron.
  3. Incorporate fortified powder infant cereal baked into finger foods. You can also substitute half of the flour in your pancake recipes with fortified infant cereal.
  4. Pair iron-rich foods with vitamin C rich foods, to increase the absorption of non-heme iron in the body. Consider top[ing fortified pancakes or cereal with fruit compote; serve lentils in stewed tomatoes and adding spinach to a fruit smoothie.
    Other good sources of vitamin C, including bell peppers, tomatoes, broccoli, citrus fruit and berries, etc. Ground meat in a tomato-based sauce forms an ideal combination.

  5. Cook with cast iron cookware. Cooking with cast-iron pots and pans safely introduces additional iron to the prepared dishes. If you don’t have one, you can try a product called the Lucky Iron Fish®. This is a simple, reusable and effective cooking tool that adds extra iron to your daily foods, soups or drinks. It is an affordable solution, especially for those with iron deficiency anemia.
  6. Cook with garlic or onion. Preparing meals with allium-containing ingredients (such as garlic and onions) can help increase iron absorption.

BOTTOM LINE 

Regardless of which feeding approach you choose, it is recommended to introduce iron-rich foods at around 6 months of age depending on their developmental readiness for trying solid foods.
A baby following the baby led weaning approach can indeed obtain sufficient iron intake, by offering a variety of iron-rich food sources.

For more help with baby led weaning and how to help you baby succeed with eating, be sure to check out my 3 months TRANSFORM program. 

Know the Difference between Gagging and Choking When Starting Solids

Know The Difference Between Gagging and Choking When Starting Solids

by with No Comment Baby Led WeaningInfant Nutrition

Many parents are terrified of feeding their baby beyond purees or finger foods.

“Is there a risk of my baby choking if I introduce finger food?”

“What is the difference between gagging and choking?”

“How to prevent my child from choking?”

“What should I do if my baby starts choking or gagging?”

“How can I overcome my intense fear of choking when feeding my baby?”

DOES BLW INCREASE THE RISK OF CHOKING? (WHAT THE RESEARCH SAY)

A 2021 review study quoted: “Fear of choking was an important factor in parents’ decision not to implement BLW; however, this fear was not supported by the literature.”

Today, I will provide a breakdown of two studies that have examined the risk of choking associated with Baby Led Weaning as a method for introducing solids.

THE BLISS STUDY

BLISS stands for “Baby-Led Introduction to Starting Solids”. This clinical trial on choking was published in the “Pediatrics” journal and titled “A Baby-led Approach to Eating Solids and Risk of Choking” This study included 206 families.

During the study, parents completed questionnaires at 6, 7, 8, 9, and 12 months of age regarding their baby’s choking and gagging experiences. Additional follow-up questions were asked to parents who reported incidents of choking to gather information about the type of food consumed and how the choking was resolved.

The findings revealed that approximately 35% of babies experienced at least one episode of choking between the ages of 6 and 8 months. There was no significant difference in the incidence of choking between the two groups at any of the assessed time periods.

However, it was observed that babies who started with Baby Led Weaning initially experienced more frequent gagging at 6 months, which decreased by the time they reached 8 months. On the other hand, babies in the puree group exhibited an increase in gagging incidents by 8 months, likely due to their progression to consuming finger foods. It is important to note that the gagging stage is a normal part of learning to eat and cannot be entirely avoided.

Regarding cases where medical assistance was required due to choking, two babies choked on milk, while one choked on food that was placed in their mouth by a caregiver (it is not recommended with Baby Led Weaning). This highlights the fact that choking can occur with any type of food or substance.

Furthermore, the researchers discovered that both groups frequently offered choking hazards to their babies, and not all parents closely supervised their babies during feeding.

ANOTHER STUDY PUBLISHED BY Dr. Amy Brown

This observational study was titled “No difference in self-reported frequency of choking between infants introduced to solid foods using a baby-led weaning or traditional spoon-feeding approach. “

The survey also inquired about instances of choking experienced by the babies, including the frequency and the type of food involved (smooth puree, lumpy puree, or finger food).

The results indicated that 13.6% of the babies (155 out of the 1151) had experienced choking incidents. However, no significant correlation was found between the chosen method of introduction (BLW or traditional) or the frequency of spoon-feeding purees and the occurrence of choking.

It is noteworthy that among the babies who experienced choking, those following a traditional weaning approach had a higher number of choking episodes associated with finger foods and lumpy purees compared to babies following either strict or loose BLW.

This observation raises potential hypotheses: BLW mothers might exhibit lower anxiety levels, leading to less overinterpretation of choking incidents or excessive assistance during feeding, which can pose risks. Alternatively, the higher incidents of choking among traditional weaning babies could be attributed to their lower exposure to finger foods in the early stages, resulting in less practice when the gag reflex is more sensitive. This finding emphasizes the importance of introducing finger foods from the beginning, regardless of whether purees are included in the feeding approach.

Overall, based on the research, it suggests that the potential risk associated with BLW is not significantly higher compared to a traditional approach when initiating solid foods.

IS MIXED FEEDING SAFE?

Both Health Canada and the National Health Services (NHS) in the UK actually recommend a combination approach when introducing solids, which includes offering both finger foods and purees right from the start.

Despite some adamant claims made by Baby-led Weaning Facebook groups suggesting that this method increases the risk of choking, both research findings and personal experiences from my clients and my own child have not supported this belief.

Therefore, if you choose to incorporate both pureed foods and finger foods into your baby’s diet, there is no need to strictly adhere to the label of “Baby-led Weaning.” The important thing is to follow responsive feeding practices when spoon-feeding purees, being attentive to your baby’s hunger and fullness cues to avoid overfeeding. Additionally, make sure to offer finger foods during each meal to provide opportunities for your baby to practice self-feeding.

Ultimately, what matters most is following a feeding approach that suits your baby’s needs and abilities, regardless of the specific labels or guidelines, while prioritizing their safety and nutritional needs.

GAGGING

WHAT IS GAGGING?

Gagging is a natural reflex that helps prevent choking by stopping us from swallowing. It’s a normal and important part of learning to eat solid foods for babies. Gagging brings the food up to chew more before it goes back down, ensuring that only well-chewed food reaches the back of the throat to be swallowed.

Gag reflex effectively keeps larger food pieces near the front of the mouth, only allowing very well-chewed foods to the back to be swallowed.

During the initial stages of introducing solid foods, your baby’s gag reflex is positioned at the front one-third of their tongue. However, as they gain experience and exposure to different solid foods, the reflex gradually shifts further back. Eventually, it settles at the top of the throat, where the gag reflex is typically located in most adults.

WHAT TO DO IF YOUR BABY IS GAGGING

If your baby is gagging, avoid patting their back or attempting to stick your fingers in your baby’s mouth to remove the food, as this could cause the food to move deeper and potentially result in choking. Instead, demonstrate coughing the food up and spitting it out. Remember to stay calm and relaxed, as your reaction can influence your baby’s response to gagging and make the eating experience less enjoyable for them.

Never interfere! Allowing your baby to stay in control and figure it out on his own.

HOW TO PREVENT GAGGING

To help prevent gagging, there isn’t much you can do during your baby’s mealtime. However, you can start preparing them for learning how to eat by bringing them to the table around 5 months of age. Offer them a “hard munchable” item to chew on, such as a rib bone, celery, or a raw carrot. Although they won’t actually consume it, this will make your baby feel included in the family meal and increase their awareness of their mouth and how it functions. It can also strengthen their mouth muscles and potentially reduce a highly sensitive gag reflex.

WHEN TO GET HELP FOR GAGGING

If your baby continues to gag with every bite after a few weeks of introducing solid foods, it may be necessary to seek assistance from an Occupational Therapist or Speech-Language Pathologist.

Occasionally, babies may gag to the point of vomiting, which is also relatively common. To minimize this, try spacing out milk feedings from solids to ensure their stomach is not overly full during mealtime. This can reduce the likelihood of vomiting and prevent significant calorie loss.

If your baby consistently gags and vomits when eating solids exclusively, it might be beneficial to take a break from introducing solids for now. Your baby may not be quite ready, so waiting until they reach six months of age and then trying again could be a good approach.

For babies older than six months, consider offering purees for a week or two before reintroducing finger foods. While babies can still gag on purees, it might be easier for them to manage initially. Remember, it’s important to follow a baby-led approach if it aligns with your preferences and situation.

CHOKING

WHAT IS CHOKING?

Choking occurs when food accidentally enters the airway instead of the esophagus (food pipe).

During choking, a baby will not make much noise or may be completely silent as their air pipe becomes blocked. It is important to remember that loud gagging noises can be a positive sign in such situations.

When a baby is unable to obtain oxygen due to choking, their breathing is compromised, and their lips and face may turn blue.

IS CHOKING NORMAL FOR BABY LED WEANING

Fortunately, choking is significantly less common than gagging.

When reviewing the research, it is worth noting that approximately 13%-35% of babies in these studies were reported to have experienced choking at least once. Personally, I consider myself fortunate as I never had this experience with any of my children.

WHAT TO DO IF BABY CHOKES?

Choking is much more serious than gagging, and requires immediate intervention.

If there is another adult or older child present, quickly shout for their help and instruct them to call ambulance. In the absence of someone else, immediately make the call yourself while initiating infant CPR. Taking an infant first aid course can provide you with the knowledge and skills to handle such situations with confidence, even though the chances of it happening are unlikely.

KNOW THE DIFFERENCE BETWEEN CHOKING AND GAGGING

GAGGING 

Loud and red = gagging, let baby work it out

  • Face may turn bright red
  • Tongue will thrust forward
  • Making gagging noises
  • Sputtering coughing
  • No life threatening

It is advisable to avoid overreacting when your baby experiences gagging during mealtimes, as this may create fear and increase stress for both you and your baby. It is recommended to allow your baby a moment to handle the gag reflex independently without any intervention from you.

CHOKING

Silent and blue = choking, baby needs your help immediately

  • Face will start to go blue
  • Unable to make noise
  • May attempt to cough
  • Loss of consciousness
  • Can be life threatening

Choking occurs when food passes beyond the gag reflex and obstructs your baby’s airway, leading to either partial or complete blockage. This can result in a significant reduction or complete cessation of oxygen reaching the lungs, making it difficult for your baby to breathe. Choking is a severe situation that demands IMMEDIATE intervention, and if your baby is choking, it is crucial to promptly initiate infant CPR.

CHOKING HAZARDS 

It is important to note that BLW does carry a potential risk of choking compared to offering purees, especially when certain types of foods are introduced. Choking incidents occur when the airway becomes obstructed, which can happen if a baby bites off a piece of hard food that perfectly blocks the air passage. Therefore, careful attention must be given to the size and texture of foods offered during BLW. It is crucial to closely supervise your baby during mealtime and consider taking an infant CPR course as a precautionary measure.

HERE’S A FULL LIST OF POTENTIAL CHOKING HAZARDS

  • Raw hard vegetables (carrots or beets)
  • Raw leafy greens
  • Fibrous and stringy foods (celery, pineapple, or asparagus)
  • Firm fruit with and without peels (apples)

  • Fruits with pits or seeds, that haven’t been removed (whole plum or peach)
  • Whole grapes
  • Whole blueberries
  • Whole cherry tomatoes
  • Dried fruits (raisins, dried apricots)
  • Chunks of firm meat (steak)
  • Fish with bones

  • Whole hotdogs or sausages
  • Cheese sticks

  • Whole nuts and seeds
  • Think globs of nut butter

  • Hard candies, mints, or cough drops
  • Gummy bears
  • Popcorn
  • Marshmallows
  • Hard chips or nachos
  • Chewing gum
  • Snacks with toothpicks or skewers

ALTERNATIVE WAYS OF SERVING:

  • Steam vegetables and fruit.
  • Peel and grate hard vegetables and fruit like carrots, apples, and zucchini.
  • Grate cheese.
  • Always remove pits and seeds from fruit.
  • Slice small and round foods into quarter lengthwise.
  • Thinly spread any nut or seed butter on toast.
  • Remove bones from fish or meat.
  • Serve fresh, frozen, or canned (rinsed) corn instead of popcorn.

Well it’s possible for your baby to choke on food (or toys/coins/may other objects), there is a lot you can do to prevent choking.

TIPS TO PREVENT CHOKING WITH BLW

  1. Ensure that your baby is developmentally ready for solids.
  2. Positioning: Make sure your baby is sitting upright during mealtime and avoid a reclining position. Provide proper support by using a high chair that keeps your baby well-supported. Using rolled-up towels if needed to ensure proper positioning, with the tray (or table) positioned between their nipples and belly button.
  3. Minimize distractions: Avoid having toys or the TV on during meals as it may distract your baby and increase the risk of choking. Also, discourage running around with food once baby starts walking.
  4. Supervise mealtime: Always watch your baby while they eat and avoid sitting them on your lap during meals. It is important to have a clear view of your baby’s face while they are eating to ensure their safety.
  5. Let them self-feed: Never put a piece of food into your baby’s mouth. If you put food into their mouth, it may immediately fall to the back, without baby having a chance to control it with their tounge and chew it. Let them feed themselves. Also, never attempt to fish food out of their mouth.
  6. Offer safe size of food: Avoid round items like raw hard pieces of vegetables and fruit. Instead, either grate them or slice them thinly. Whole grapes, blueberries, or cherry tomatoes should also be sliced lengthwise into quarters, so they are not a round shape.
  7. Offer soft foods: Test the foods to make sure you can mash them with gentle pressure from your thumb and forefinger. This is called the “squish test“. If the food is harder, make sure it’s in a safe shape (ex: grated or sliced thinly)
  8. Take an infant CPR course.

BOTTOM LINE

It’s very important for parents to recognise the difference between gagging and choking and the different ways each scenario should be treated.

Remember that gagging is a normal reaction that weaning babies have as their gag reflex is triggered while learning to eat. Choking is when their airway gets blocked, and requires immediate first aid and medical attention.

Hope this was helpful. Please check out more about food textures, finger foods and choking on my IG highlights.

Did you know that we offer personalized nutrition counselling for kids and families? If this is something you’d like to learn more about, please visit here.