How to Encourage Picky Eater

How To Encourage Picky Eaters

by with No Comment Child & Family NutritionPicky EatingToddler Nutrition

As parents, once of our most basic jobs is to feed our children. It sounds simple enough. However, when your child is especially picky about what they eat, it can become a logistical and emotional nightmare.

When a child has a very limited food repertoire, mealtimes can become stressful. Many parents try to cajole, persuade, beg, bribe, or threaten their children into eating different foods. These actions are rarely met with success, and even if they work in the moment, they do nothing to encourage their child to develop a positive relationship with food.

So how can you make the dinner table less threatening for children who struggle with picky eating, and less stressful for you as parents? Here are some tips to help you achieve that.

1. BE CAREFUL OF HOW YOU LABEL YOUR CHILD

We all live up to the names we are given, good or bad. If you tell everyone that your child is a “picky eater”, he will believe that. Instead, try to avoid discussing the topic in his presence. If that is not possible, be mindful of the words you use. You could say something along the lines of “James is still learning to like eggplant. He may want to try them today. Let’s ask him and see.” If James overhears this conversation, it tells him that food preferences change over time, and he is in control of when to try new foods. This is more encouraging and less stressful than hearing himself referred to as a “picky eater”.

2. TALK TO YOUR CHILD ABOUT HOW TASTE-BUD CHANGE

Let them know it is okay that they only eat a few foods right now, and that it might change in the future. Food preferences are always evolving. If your child understands that, they are more likely to try in the future something they do not want to try today.

3. ENCOURAGE YOUR CHILD TO EXPLORE FOOD WITHOUT THE GOAL OF EATING IT 

Talk about how food looks, smells, feels, what temperature it is, and how it sounds. Encourage them to explore it, with no expectation that they will eat it. It allows them to familiarize themselves with different foods without the stress of having to try them. Try Sensory Fun Food Play Activities here.

4. TAKE IT IN STAGES 

Instead of focusing on getting your child to eat new foods right away, take it in stages.

  • Stage 1 might be tolerating it sitting on their plate. With some children, even stage 1 can be challenge.
  • Stage 2 might be sniffing it.
  • Stage 3 touching. Then licking, and eventually tasting.

Know that it might take weeks or even months to get through all the stages with one food, and that is ok. Just take a deep breath and try to be patient.

5. LET THEM SPIT FOOD OUT 

This might sound controversial. Who wants a child to spit out their food? But if a picky eater knows that they can remove food from their mouth if they don’t like it, they are more likely to give it a try. Teach your child how to politely remove food from their mouth using a napkin, and let them know that it is acceptable to do that if they try a food they don’t like.

6. CHANGE THEIR SCRIPT 

How many times have you heard your child say, “I don’t like it” before they have even tried something? Just the act of a child saying that to himself can reinforce the idea that he does not like the food. New time your child makes that declaration, encourage him to say “I don’t feel like trying it today” instead. It reinforces the idea that they may want to try it in the future, and allows them to feel in control of their choices.

7. ASSIGN ROLES APPROPRIATELY 

Ellyn Satter, Registered Dietitian Nutritionist and Family Therapist, developed the Division of Responsibility in Feeding approach to mealtimes. The crux of it is that roles should be divided up between the parent and the child in the following way:

  • The parent decides what, when, and where the child will eat.
  • The child decides how much they will eat, if any.

In practice, that meals that you as the parent decide when and where mealtimes will take place, and what food to put in front of your child. The next part is the hard part. You have to step back and let your child decide how much to eat, if any. It is not easy to do, but over time it has been shown to encourage children to be more accepting of new foods.

8. GET CHILDREN INVOLVED IN BUYING INGREDIENTS AND PREPARING MEALS 

At the grocery store, ask your child to pick out a new food they might like to try. You could also check out some children’s cookery books from the library, or go online and look at some recipes. Get them involved and excited about mealtimes. Over time, increasing their interest in food will translate into becoming more adventurous at mealtimes.

9. MAKE SURE THEY ARE HUNGRY AT MEALTIMES 

If your child is not hungry at mealtimes, it is going to be even harder to encourage them to eat a variety of foods. Try not to let your child snack in the hour leading up to mealtime. If there is less than one hour to go and your child simply can’t wait, offer them part of their lunch or dinner, or some cut fruit or vegetables.

10. ALWAYS PUT SOME FAMILIAR FOODS ON THEIR PLATE

Remember the goal is to make mealtimes stress-free for your child. You want them to come to the table looking forward to the meal. If they are anxious, they are less likely to be adventurous. By making sure there are always one or two foods on their plate that they like, you remove a lot of the stress for a child who is picky about what they eat.

11. MAKE FOODS APPEALING 

By this, I don’t mean that you have to start creating art with your child’s meal. However, you can make little changes that will enhance your child’s enjoyment.

For example, you could cut vegetables into sticks and give them a dipping sauce, use a cooking cutter to make fun shapes out of sandwiches or sliced cheese, or cut foods into cubes and skewer them onto wooden tooth picks to make kebabs. Children often respond well to giving foods interesting names, like monster juice for green smoothies, or baby trees for broccoli. Also try to make meals colourful and visually appealing, and only put small portions on your child’s plate. Being faced with a huge pile of bland-looking food won’t do much to tease out your child’s adventurous side. I’ve more than 100 activities or ways to make foods more fun.

12. EAT FAMILY STYLE MEALS 

Family style meals involve putting the food in serving bowls on the dinner table and allowing people to serve themselves. Giving your child control over what he chooses to put on his plate can help relieve anxiety and encourage him to be more adventurous about what he chooses to eat. Hotpot or Hakka Lei Cha (客家擂茶) are a great way to do this. Salad bars are another. Just lay it all out and let everyone dig in.

13. MODEL GOOD EATING HABITS 

Children love to copy their parents. If your child sees you eating a diverse range of foods, they are more likely to do the same. This is especially true if you allow the family style meals tip, because they can pick from the same bowls that you picked from.

14. ENCOURAGE YOUR CHILD TO EAT UNTIL HIS BELLY FEELS FULL 

Explain to them what it feels like to have a full belly, and tell them that is the goal at mealtimes. Let them know they do not have to finish all the food on their plate if they feel full before that. If they consistently leave lots of food on their plate, try serving them a little less food.

15. OFFER NEW FOODS OFTEN 

You have probably heard it many times before, but children often need exposure to a new food many times before they will try it. Follow the old adage, “If at first you don’t succeed, try again”.

16. LET THEM KNOW THEY WILL NEVER BE FORCED TO EAT SOMETHING THEY DON’T WANT TO EAT 

With this in mind, children will be less fearful of the dinner table. A relaxed child will be more open-minded, which is what we want to achieve.

17. AVOID MEALTIME BATTLES 

Entering into mealtime battles with your child never ends well. Try to keep mealtimes stress free for your child. You want them to enjoy coming to the dinner table, not dreading it because they might be forced to eat something they don’t want.

18. KEEP MEALTIMES RELAXED 

Try to focus on something other than their eating. If your child tries a new food, offer some encouraging words, but don’t make a big deal out of it. Just keep it business as usual. Avoid cajoling, persuading, begging, bargaining, or threatening your child to eat. DOWNLOAD Mealtime Conversation Starters HERE.

19. IF VEGETABLES ARE A CONCERN, HIDE SOME AND SHOW SOME 

Sometimes, parents of picky eaters are worried about their child’s nutrition intake. If this is you, and your child turns his nose up at vegetables, try hiding some and showing some. You can hide veggies in smoothies, pancakes, or blended sauces. That way you know your child is getting some fresh produce in their diet. Once they like the taste, you can tell them what went into it to help desensitize them to those foods.

Hiding vegetables does not teach your child to like them.

20. TALK TO YOUR CHILDREN ABOUT WHAT FOOD DOES FOR YOU 

Help your children understand the importance of food, that it gives your energy, helps your brain work properly, and makes your muscles strong. While this is unlikely to bring about any short-term changes in their food intake, over time it will help them see just how important it is to make healthy food choices.

21. EXPECT SOME WASTE

The process of encouraging your child to eat a greater number of foods is often long and fraught with frustration for everyone concerned. Part of that frustration is usually directed at the food waste that inevitably accompanies the process. Try to remember that some waste is unavoidable. When it makes you stressed, remind yourself that you are doing a very important job here. You are teaching your child lifelong habits that will impact their physical and mental health.

Food waste is an unfortunate side effect of that, and will hopefully be short lived.

22. IF IN DOUBT, SEEK PROFESSIONAL HELP 

If you re at all concerned that what your child is experiencing is more serious than common picky eating, consult their pediatrician. They may benefit from seeing an occupational therapist. And if your are worried that your child is not getting enough of the nutrients they need, a paediatric Dietitian can help advise you. BOOK 1-1 Nutrition Consultation NOW.

BOTTOM LINE 

All of these tips are designed to help you create a relaxed eating environment in which your child is comfortable and confident. You want your child to have a positive relationship with food. That being said, it is likely to be a long and rocky journey for you as parents. But the effort you put in now will set your child up for a lifetime of healthy eating habits. And in those darker moments when you feel as tough you are doing it all wrong, remember this. Just by reading this post and taking steps to help your child, you are doing an amazing job. Keep going. You can do this. It will all be worth it in the long run.

If you’re still struggling with a picky eater and want to learn more about ending pressure your child to eat then join PEACEFUL MEALTIMES online course for a complete step-by-step process for preventing or reversing picky eating. This is the best of feeding therapy, all rolled into one affordable course with lifetime access and ongoing support.

The Ultimate Gift Guide For Babies And Toddlers

The Ultimate Gift Guide For Babies And Toddlers

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

If you are searching for fun, practical and educational food and eating-related gifts for children and parents, I hope you will enjoy this guide of my favorite feeding tools, books, and gadgets. I used most of them myself and those that I did not are definitely on my wish list.

BABY FEEDING GIFT ESSENTIALS 

A GOOD QUALITY HIGH CHAIR

If you’re getting ready to start solids, or even if you’ve already started and looking for a comfortable, ergonomic and easy to clean high chair for your baby, here is my top 3 recommendations:

1. STOKKE TRIPP TRAPP HIGH CHAIR

The Stokke Tripp Trapp is a high quality wooden chair with an adjustable footrest. It is made to grow with your baby so they can continue to use it into toddlerhood and beyond. Be sure to purchase the Tray and Baby Set for feeding infants 6 -18 months.

 

2. NOMI HIGH CHAIR

The Nomi High Chair is a modern upgrade to the Tripp Trapp. It is light and easy to move or hang on the table for clean-up. The adjustable footrest and seat do not require tools.

You can get 10% off Nomi High Chair with the code YETING: click here to shop.

 

3. IKEA ANTILOP HIGH CHAIR

Another budget friendly high chair. For most babies, the seat is very big and can have a large gap between the baby’s chest and the tray, which means baby will have to lean over to reach for foods. I suggest buying the ANTILOP support cushion that’s sold separately to help fix this issue. This high chair doesn’t have a footrest, so what I suggest is buying a footrest to solve this problem too!

 

EZPZ FIRST FOODS SET

This set consists of 1 EZPZ Tiny Bowl, 1 Tiny Cup and a 2-pack of the Tiny Spoons. This set contains everything you need to get a safe start to solid foods.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

EZPZ TINY SPOON TWIN-PACK

Longer-handled spoons are useful when baby is being fed by a parent or caregiver, but for self-feeding babies, shorter handles, wider handles or handles with guards are better. EZPZ Tiny Spoon is designed to help baby learn how to feed independently. Adult-size spoons are too large for a baby’s mouth, so these tiny spoons have narrow spoon bowls that will help with portion control and prevent overfeeding and gagging. It actually works for both purees and the baby-led weaning feeding methods, therefore you’ll need to invest in at least two or three baby spoons for feeding.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

NUM NUM PRE-SPOON GOOtensils

When babies are just learning to handle a spoon, the food tends to slide right off. These spoons are great for “grabbing” the puree during self-feeding (or baby led weaning).

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

GRABEASE BABY FORK & SPOON SET

These utensils feature short easy to grab handles that make it impossible for your little one to stick too far into their mouth. Additionally, the ergonomically shaped handles are easier for tiny hands to grab. When first starting I like to help them practicing poking and then showing them how they can bring the food to their mouth. This is a great first set, but don’t expect your baby to be proficient until closer to 12+ months.

 

SUCTION PLATES & BOWLS

When introducing solid foods to your baby, messy mealtimes are common. Suction bowls and plates help minimize the mess, so be sure to select baby bowls and plates with great suction.

1. OXO TOT STICK & STAY SUCTION BOWL

This bowl is made of BPA-free plastic so they are unbreakable. This bowl features a secure suction base that sticks firmly to surfaces, so can prevent accidental tipping to help prevent spills. The curved walls are designed to promote self-feeding skill such as scooping.

 

2. MARCUS & MARCUS SUCTION BOWL WITH LID

I also purchased some silicone bowls with lids because I’m constantly putting a bowl of half eaten yogurt or rice in the fridge for later.

 

3. AVANCHY BAMBOO SUCTION BABY BOWL + SPOON

If you’re looking for a bamboo option, which is a safe choice too, this is a great option. It comes with one of my favorite baby spoons and has a silicone suction base, which detaches for easy cleaning.

 

CUP

You might be surprised to learn that babies can start using an open cup as early as 6 months. All three of these cups are excellent options or teaching babies to drink from an open and/or straw cup during infancy.

1. EZPZ TINY OPEN CUP

EZPZ Tiny Cup is only 2 oz, perfect for little hands and the angle of the cup helps to control the flow as babies learn to use open cups. Additionally, the weighted base makes it harder to tip over. This tiny cup is made of food grade silicone, so great for teething. This cup doesn’t seal, so it’s not the best for an on-the-go life.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

2. EZPZ MINI CUP + STRAW TRAINING SYSTEM

This cup is super versatile as you can also use it as an open cup. It’s 4oz so it would be perfect size for toddlers learning to drink from straws as most straw cups are much larger than this.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

3. Weighted Straw Cup

This straw cup is perfect for younger babies learning how to drink out of straw cup. They don’t spill and I love that they have handles. The weight at the bottom can keep the straw pointing down into the liquid which means your baby can drink at almost any angle.

Grosmimi PPSU Weighted Straw Cup & Munchkin Click-Lock Weighted Straw Cup are both of my favourite.

 

BAPRON BABY

A bib is an ESSENTIAL accessory for any baby or toddler, whether you are doing baby led weaning or not.

I have tried so many different styles and my favorites are definitely the ones that are easiest to clean.

  • Bapron bib is made from a waterproof fabric that is super soft, made from an eco-friendly type of polyester. You can rinse the Bapron bibs in the sink right after meals, dry them on the drainboard and they’re ready to go for the next meal.
  • Sleeveless so they don’t weigh your baby down or restrict their range of motion.
  • If your baby doesn’t tolerate a bib, tie-on ones are harder to yank off than velcro ones. Bapron baby bibs tie in the back under your baby’s shoulder blades – not all up in their neck which can be a negative sensory experience.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

SPLASH MAT

Eating solids is a dirty business, both spoon-feeding or baby led weaning. A waterproof  mat to go under your baby’s highchair makes for easy cleaning. The Bapron Splash Mats are made from the same amazing fabric as their bibs. You can rinse them under water and dry in between feeding.

These mats are also perfect for indoor/outdoor picnic, crafts and sensory play, if you’re out and about and they fold down so small you can easily transport them in your diaper bag.

Singapore:You can get 10% off with the code YETING: click here to shop.

 

TOOTH BRUSH

The Nuk™ Brush is a toothbrush-like teether with a nubby textured silicone “brush” at the end. Perfect shape and size for little mouthes. Initially, this brush was designed for teething infants, it has made its way into therapeutic settings as an invaluable tool for oral massage, oral stimulation and sensory exploration. So it is usually used in speech therapy and feeding therapy to help with oral motor skills and to de-sensitize the gag reflex.

The Nuk™ Brush can be perfect tool if you have a child who is struggling with certain food textures or gagging and spitting the food up.

 

BOOKS

Children deserve to learn about good nutrition and develop positive attitudes about eating. These 3 books that teach nutrition are perfect to get you started!

1. LULU’S LUNCH BY CAMILA REID & AILIE BUSBY

 

2. EATING THE ALPHABET BY LOIS EHLERT

 

3. THE VERY HUNGRY CATERPILLAR BY ERIC CARLE

TODDLER FEEDING GIFT ESSENTIALS

1. EZPZ MINI FEEDING SET

If your baby is ready to move to the table (without a tray), a suction plate can be helpful. They are also great to bring to restaurants or in-laws for your baby to eat off of. Also, if your baby or toddler does not like his food to touch, this divided plate is a perfect choice. The built-in separators help keep the servings small and make it easier for parents to offer a variety of foods like puree and finger foods each meal. This set consists of 1 EZPZ Mini Mat, 1 Mini Spoon and 1 Mini Fork.

Singapore:You can get 10% off with the code YETING: click here to shop.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

2. UTENSIL SET

This OXO TOT Fork & Spoon Set is easy for young eaters to learn self-feeding. A flat spot on the handles prevents the fork and spoon from rolling off the table or high chair tray, and the soft grips are shaped to keep them from sliding into bowls or plates. The depth of the spoon is ideal for scooping up food. The stainless steel body is extremely durable.

 

3. LEARNING CHOPSTICKS

Marcus & Marcus Learning Chopsticks is one design that fits both right-handed and left-handed toddlers. They are so easy to use and toddlers can learn using the chopsticks in a day! The rings support them to hold onto the chopsticks and they can be adjusted to a comfortable angle for perfect fitting on each individual hand.

 

4. SNACK CUP

This is perfect for on-the-go snack and great for keeping snacks from spilling, such as cereal.

Malaysia:You can get 10% off with the code YETING: click here to shop.

 

5. LUNCH BOX

Choosing a lunch box can be overwhelming as there are many different varieties, styles and sizes of lunch boxes to choose from, not to mention different materials. We all want to pick a non-toxic lunch box that won’t harm our children, while also making sure it’s easy to clean!

To narrow down your list, here are the things that I believe we should look out for:

  1. BPA-Free – The lunch box should be safe to store food inside.
  2. Stay Fresh – A box that will seal and keep an unwrapped item fresh.
  3. Easy to Clean – I prefer one lid for the lunch box, easy to clean and store when drying.
  4. Sections – Separate spaces to place different foods.
  5. Size – It’s not too big to fit into the child’s school bag, or take up most of the space.
  6. Perfect Portions – Sections that are big enough for the amount of food the child will eat.
  7. Reusable – Save the environment and your pocket, don’t use plastic zip lock bags.
  8. Dishwasher safe – For those days I don’t have time to hand wash.
  9. Easy to store – not too bulky to store when not in use.
  10. Machine Washable – lunch bags can easily be washed in the washing machine.

I personally prefer lunch boxes that seal tight and keep an unwrapped food fresh, eliminating the use of plastic wrap or sandwich bag which saves money and the environment. Also, most children prefer to graze on a variety of foods as opposed to just a sandwich and piece of fruit and so the bento style boxes and accessories are very clever at making the food fun and exciting.

My son has been using YumBox since he was three. It is designed for easy to open, and 100% leak proof – perfect for on-the-go or school lunch or snack!

Another favourite lunch box is from local Malasyia’s brand Wild Mums Enterprise.

Malaysia: Check out Wild Mums Enterprise for Mumu M3: 3-Compartments Detachable Lunch Box and Mumu M3: 3-Compartments Lunch Box.

6. SENSORY FUN FOOD PLAY GUIDE

If you think your child can benefit from Sensory Food Play to help with their eating, check out Sensory Fun Food Play E-book. It has over 100 activities I created with a focus on picky eaters. Join me for lots of fun sensory food play.

 

7. BOOKS FOR PICKY EATERS 

Looking for a great book to help your picky eater? One of the ways you can help your picky eater as a parent is to talk about food at times other than mealtime when things are a bit more mellow and no one is furstrated or hangry. Check out some of my favorite books for picky eaters that help teach confidence, get them excited about trying new foods.

1. I WILL NEVER NOT EVER EAT A TOMATO BY LAUREN CHILD

 

2. DAISY EAT YOUR PEAS BY KES GRAY

 

3. BURGER BOY BY ALAN DURANT

MY FAVORITE GIFT FOR NEW PARENTS 

1. PEACEFUL MEALTIMES ONLINE COURSE

Feeding is one of those milestones that gives parents a lot of stress. That’s why I offer my online course as gifts! I designed this online course to help parents go from feeling overwhelmed and nervous about picky eating and meeting nutrient needs, to feeling confident, calm, and knowledgeable about their children eating independently. BUY THE COURSE AS GIFT NOW.

 

2. FIRST AID & CPR COURSE

Although choking is a very rare risk it is also a very real risk. Knowing basic CPR skills can save your baby’s life and I suggest that everyone (partner, husband, mother-in-law, babysitter…) who helps or is going to help feed your baby should know CPR.

My go-to 2 days First Aid & CPR Training course from @YS First Aid is on now open for register!

If you want to focus on Infant/Child CPR, Choking and Injury Prevention Course, you can check out  @Little Beh’s 急救课.

YS First Aid: ysfirstaid6@gmail.com, 019-689-3413

Little Beh’s 急救课: jbmacademyplt@gmail.com, 016-206-8643

 

3. CERAMIC COOKWARE

Color King 100% Ceramic Cookware (Non-Toxic , No PTFE, No PFOA) is one of the best investments you can make. It will drastically improve your cooking experience and make your meals taste better. It performs well in a range of temperatures from -20°C to 400°C. It works great on gas and electric stoves as well as with ovens. Also, it has excellent heat retention that can preserve the flavor and nutrients of your dishes.

Check out their Facebook Page or contact their customer service representatives for any questions you have at 018-277-7802. 

 

4. CRINKLE CUTTER

This is another tool that I am getting lots of questions about. Some people call it a crinkle cutter because it makes fun grooves on the food.

If you are doing baby led weaning, it doubled as a finger food cutter, because the grooves it makes on food make it easier for small hands to grab and hold it, especially if it is slippery. Some examples of finger foods I created using this crinkle cutter: mango, avocado, kiwi, pineapple, very ripe pear, steamed carrots and apples sticks and slices.

Singapore: You can get 10% off  YAY Crinkies with the code YETING: click here to shop.

 

5. SPIRALIZER

My son love helping me spiralize fruit and veggies into fun shapes and it saves a lot of time spent chopping and slicing. We spiralize raw fruit just for fun and to use in salads and roast spiraled root veggies like sweet potato and beets. Raw spiraled zucchini, carrots, and jicama work great in salads.

Malaysia: Check out the Spiralizer here. 

 

6. MINI COOKIE & VEGETABLE CUTTER

These little tools are my hard-working kitchen helpers. From cookies to veggies and from fruit to sandwiches, they cut everything into super cute shapes that my children love. This newer option comes with silicone holders which makes them even more child-friendly.

 

7. LUCKY IRON FISH

The Lucky Iron Fish is a simple and effective cooking tool that is designed to add natural iron to any liquid-based meals. It’s easy: simply drop Lucky Iron Fish into boiling water or liquid-based meals for 10 minutes to release a portion of your daily recommended iron. Great for postpartum moms who are struggling with iron deficiency anemia.

 

8. POPSICLE MOLD

This popsicle mold puts a fun and creative way to eat a nutritious snack. You can freeze pretty much anything in them, from breastmilk to smoothies. I always use the molds to freeze the leftovers smoothie. No waste and a yummy snack always on hand.

 

9. BOOKS FOR NEW PARENTS

Are you looking for books and resources on nutrition, feeding children, picky eating and baby led weaning?  I wanted to share my favourite child health and nutrition books with you.

1. Child of Mine by Ellyn Satter

The Gold Standard reference for building trust in feeding children and establishing positive feeding, using the Division of Responsibility. A must-read for all new parents.

 

2. Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion and Feeding Disorders by Katja Rowell and Jenny McGlothlin

Family doctor specializing in childhood feeding, Katja Rowell, joins forces with speech pathologist, Jenny McGlothlin, to help support children with food aversion and end meal-time anxiety (for your child and you) once and for all.

 

3. Baby-Led Weaning: The Essential Guide―How to Introduce Solid Foods and Help Your Baby to Grow Up a Happy and Confident Eater by Gill Rapley Ph.D. and Tracey Murkett

Still not sure if BLW is for you? Let Gill Rapley, the generally acknowledged pioneer of baby-led weaning, walk you through this approach.

If you want to understand the history and theory behind baby-led weaning, this could be the one for you. The book goes into the essentials and basic principles of why the method works. It also explains in detail the benefits your little one can get by following baby-led weaning.

The book uses an easy and clear tone. Its claims are backed with science-based facts. The topics are clearly divided, so you can skip forward or just choose a topic you like.

The updated edition includes the latest research on allergy prevention and safety. This thick, big book can be a good reference or a go-to book for your BLW questions.

 

10. COOKBOOKS FOR BUSY PARENTS 

Whether you have a new eater, picky eater or extremely picky eater, there are steps you can take to make trying new food fun, enjoyable and pressure-free. I have some cookbooks to keep you excited about planning your baby’s weaning meals.

1. The Baby-Led Weaning Cookbook: Delicious Recipes that’ll Help Your Baby Learn to Eat Solid Foods―and That the Whole Family Will Enjoy by Gill Rapley PhD, Tracey Murkett

Gill Rapley’s Baby-Led Weaning Cookbook is more than just a cookbook. Before getting to the recipes, you will also be given a comprehensive guide on baby-led weaning.

It’s like a summary of Rapley’s Essential Guide to remind you what to consider while preparing meals. The book details the importance of baby nutrition and safety.

Recipes are made not just for the baby but also for the rest of the family. The book provides a huge range of recipe ideas. It offers simple meals and healthy and nutritious store-cupboard meals to new recipes.

With more than 130 recipes, there’s always something for everyone. Even your family’s picky eaters can find something they might enjoy. This big book has plenty of meal plans from baby snacks, healthy sweets, and filling meals for the family.

There are stories and messages from parents who practice baby-led weaning to keep readers inspired. There are also easy-to-follow tips on minimizing the mess during the baby’s feeding time.

 

2. Recipes to Boost Immunity / Pre-Pregnancy Meal Plans

Two cookbooks with over 100 recipes which are family-friendly to ensure nutritious meals for all.

 

HAPPY SHOPPING!

That’s all for my 2023 gift guide! All of these products are great for baby led weaning and into toddlerhood. Truly an ultimate guide for Holiday or Birthday shopping for your baby, toddler, and any new parents in your life.

Disclaimer: Please note that all opinions are my own and I was not paid to promote any of these products. The post contains affiliate links that allow me to receive a small commission to help run this blog. Thank you for your support and understanding!

Nutrition Boosters Chia, Flax, and Hemp Seeds

Nutrition Boosters: Chia, Flax, and Hemp Seeds

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

Looking for an easy way to add a nutrition boost? Chia, flax and hemp seeds are all in healthy fats and super versatile. Read more about their nutrition benefits, tips of buying and storing, and ways to enjoy.

WHAT ARE SUPER SEEDS?

Frequently called super seeds or super foods – chia, flax, and hemp seeds are super tiny yet packed with nutrition.

CHIA SEEDS

Small, round, and white or black in color, similar looking to poppy seeds, with a neutral flavour. They were a staple food for the Aztecs and Mayans as they were prized as an energy booster, which is actually how they got their name as “chia” is the Mayan word for “strength.”

HEMP SEEDS

It can be called hemp hearts, which have a mild nutty flavour. These seeds come from the Cannabis sativa plant. Before you start worrying about THC (the active ingredient in marijuana) and getting high, hemp seeds contain only trace amounts of THC (0.3%) and is very unlikely to cause any psychoactive side effects or even show up in a drug test. In fact, hulled hemp seeds have GRAS (Generally Recognized as Safe) status by the FDA.

FLAX SEEDS

Flax seeds are thought to be one of the world’s oldest crops. These nutrient-dense seeds and their oil have been used for medicinal purposes for thousands of years. Nutty and grassy flavor, these brown or golden seeds can be purchased whole or pre-ground.

NUTRITION & HEALTH BENEFITS

Despite their small size, these super seeds are loaded with nutrients and linked to numerous health benefits.

CHIA SEEDS

Chia seeds are a great source of fiber, 2 tbsp contain 8 grams of mostly soluble fiber. Chia seeds are high in calcium, magnesium, phosphorus, and ALA. All of these nutrients have been linked to improved bone mineral density.

HEMP SEEDS

Hemp seeds contain all the essential amino acids, making them a complete protein source. However, hulled hemp seeds (hemp hearts) contain very little fiber because the fiber-rich shell has been removed. Hemp seeds are also a great source of vitamin E and minerals, such as phosphorus, potassium, sodium, magnesium, sulfur, calcium, iron and zinc. Hemp seeds contain 3X more omega-6 fatty acids than omega-3 fatty acids, which may benefit skin disease and provide relief from eczema and improve dry or itchy skin.

FLAX SEEDS

Flax seeds are one of the best sources of an antioxidant called lignans, which may protect against cancer. Flax seeds are an excellent source of alpha-linolenic acid (ALA), a type of omega-3 fatty acid that our body doesn’t produce. Flaxseed is particularly high in thiamine, a B vitamin that plays a key role in energy metabolism as well as cell function. It’s also a great source of copper, which is involved in brain development, immune health, and iron metabolism.

Overall, thanks to their high fiber content, healthy fats, and antioxidant content, all three seeds have been associated with a reduced risk of chronic diseases, including heart disease, certain types of cancer, and type 2 diabetes.

HOW AND WHERE TO BUY THEM

All three super seeds can be found in health food stores or at larger supermarkets. Of course, you can also buy these seeds online.

For flax seeds, you have the option to buy them whole or pre-ground. Ground flax seed is much easier to digest than whole flax seed. Due to the outer shell of a flaxseed contains insoluble fiber, which does not dissolve in water, so whole flax seeds may pass through your intestine undigested. Therefore, crushing, milling or grinding the whole flax seeds before consuming can increase the absorption of the nutrients.

You can still buy whole flax seed, grind it in a coffee grinder, and store the ground flax seed in an airtight container for easy use.

For hemp seeds, look for “hemp hearts” or “hulled hemp seeds”, which are just the soft inner seeds with the inedible outer shell removed. Also be aware of where the seeds are from as different countries have varying levels of hemp regulation.

HOW TO STORE THEM

Thanks to their high fat content, these super seeds will last longer when stored in the fridge or freezer, but that doesn’t mean you have to store them that way. The most important thing is to store these seeds in airtight containers. 

  • CHIA SEEDS: last 2 years in the pantry and 4 years or more in the fridge.
  • HEMP SEEDS: 3-4 months in the pantry, 1-2 years in the fridge, and at least 4 years in the freezer.
  • WHOLE FLAX SEEDS: 6-12 months in the pantry and 1 year in the fridge.
  • GROUND FLAX SEEDS: 1 week in the pantry and 1-2 months in the fridge and 6 months in the freezer. If your ground flax seed tastes at all bitter, then throw it away – bitterness is a sign of rancidity!

USING SEEDS IN YOUR DIET

Flax and hemp hearts both have a mild, nutty flavor, while chia seeds have more of an earthiness to them. All three can be easily added to many different foods, such as smoothies, yogurt, overnight oats, salads or baked goods.

Moderation is important. You don’t need to eat a lot of seeds to reap their health benefits. All seeds are high in fat, which makes them high in calories. A serving size of 1 to 2 tablespoons each day is a great addition to a healthy diet and lifestyle.

Here are some ways to incorporate these nutrient-rich seeds into your meals and snacks.

CHIA SEEDS

You don’t need to grind or cook the chia seeds. What makes chia seeds unique is that they form a gel-like texture when submerged in a liquid. As a result, you can use them to thicken sauces and as an vegan egg substitute, such as adding to puddings, smoothies, jams, or baked goods.

For 1 medium egg = 1 tbsp chia seeds + 3 tbsp water

You can also sprinkle dry chia seeds on top of cereals, salads, granola, and yogurt.

HEMP SEEDS

In addition to sprinkling over foods, hemp hearts can be used to make hemp milk and also make for a protein-rich coating for “slippery” foods like avocado, banana, mango.

To really bring out their nutty flavor, you can roast hemp hearts prior to using (they also make for a great nut substitute!).

FLAX SEEDS

As I mentioned earlier, ground flax seed is much easier to digest than whole flax seed, so you want to grind them before eating/using in cooking. You can also buy pre-ground flax seeds, which are often labeled as flaxseed meal.

Ground flax seeds can be added to baked goods, yogurt, oatmeal, pancakes, and smoothies. Like chia seeds, they can be used as an egg substitute in baking recipes – a great trick if your family is vegan or your child has an egg allergy!

For 1 medium egg = 1 tbsp ground flax seeds + 3 tbsp water

BOTTOM LINE

Hemp, flax and chia seeds each have a unique nutrition profile, so there’s no reason to stick to eating only one. They’re an excellent source of plant-based protein, fiber, omega-3 fatty acids, antioxidants, and a number of minerals. If you’re looking for a nutrition boost, mix them up, include one to two tablespoons of one or more types of seeds in your diet each day.

How does your family enjoy eating these superseeds? Share in the comments!

Nutritional Yeast Benefits and How to Use

Nutritional Yeast – Benefits and How to Use

by with No Comment Child & Family NutritionInfant NutritionPicky EatingToddler Nutrition

Nutritional yeast, also called “nooch,” is a popular vegan food product with a savory, nutty or cheesy flavor. When I first heard the term “nutritional yeast”, I thought it was a product used to bake bread that had some vitamins added to it.

Every now and then I use nutritional yeast in a recipe I get asked questions about it so I figured I need a full blogpost explain what nutritional yeast is, reviews its health benefits, and suggests creative ways to use it.

WHAT IS NUTRITIONAL YEAST?

Nutritional yeast is sold as thin flakes, granules, or powder. You can find it in the spice or condiment section at most grocery stores or in bulk bins of health food stores. It has a pale yellow color and may come packaged in a bag, shaker, or plastic container. It’s low in calories and sodium, dairy-free, soy-free, gluten-free, sugar-free, fat-free and vegan so  it fits into a lot of restrictive diets.

HOW IS IT PRODUCED? 

To produce nutritional yeast, Saccharomyces. cerevisiae (a type of yeast) cells are grown for several days on a sugar-rich medium, such as molasses. Once the yeast is mature, it is heated up to deactivate the yeast (which inhibits its leavening properties), then it is washed, dried, crumbled and packaged into small flakes.

TYPES OF NUTRITIONAL YEAST

There are two types of nutritional yeast: unfortified and fortified:

  • Unfortified: This type doesn’t have any added vitamins or minerals. It only contains the nutrients that are naturally found in the yeast itself.
  • Fortified: This type has vitamins added during the manufacturing process to boost nutrient content. Any additional vitamins are included in the ingredient list. Fortified nutritional yeast is the most common type and offers the most benefits. However, it is important to note that different brands have different concentrations and types of nutrients, so read labels closely and adjust the serving size accordingly.

BAKER’S YEAST vs NUTRITIONAL YEAST vs BREWER’S YEAST

Brewer’s, baker’s and nutritional yeasts are technically made from the same species of yeast (Saccharomyces cerevisiae), they are indeed different products.

  • Brewer’s yeast: Brewer’s yeast can be purchased alive and is used to brew beer. Darker in color. The dead yeast cells leftover from the brewing process can be consumed as a nutritional supplement but have a very bitter taste. Brewer’s yeast is rich in a complex of vitamins, including vitamin B, chromium, selenium, and protein.
  • Baker’s yeast: Baker’s yeast is purchased alive and used to leaven bread. The yeast is killed during cooking but adds an earthy, yeasty flavor to bread.
  • Nutritional yeast: This yeast is grown specifically to be used as a food product. The yeast cells are killed during manufacturing and not alive in the final product. It is used in cooking and has a cheesy, nutty or savory flavor.

WHAT ARE THE BENEFITS OF NUTRITIONAL YEAST?

Nutritional yeast gets its name from the nutrients it contains, including protein and a wide array of vitamins, minerals, and antioxidants.

  • PROTEIN: It’s a great source of plant-based protein, with all 9 of the essential amino acids (complete protein). 2 Tbsp = 8 grams of protein.
  • VITAMIN B12 (COBALAMIN): Most nutritional yeasts are fortified with B12. It’s essential for the production of of red blood cells and nerve health. It’s largely found in animal products so if you follow a vegan or plant-based diet, you may not be getting enough.
  • OTHER B VITAMINS: You’ll also find vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B6 (pyridoxine) and B9 (folate). They help to convert food into fuel to keep us energized and while many of them work together they each play their own role in our health as well, from healthy skin and hairs, to working as antioxidants, to their role in mood, sleep and brain health
  • MINERALS: Fortified nutritional yeast also includes zinc, selenium, manganese and molybdenum, which are involved in gene regulation, metabolism, growth, and immunity
  • ANTIOXIDANTS: Glutathione and Selenomethionine can help protect your cells from damage caused by free radicals and heavy metals and help your body eliminate environmental toxins.
  • BETA-GLUCAN (a type of fibre): It may help to lower cholesterol levels, which may benefit heart health. It may also boost the immune system.

WHAT DOES NUTRITIONAL YEAST TASTE LIKE?

It has a nutty, cheesy, salty, umami flavor and is often used to add a cheesy flavor to dairy-free or vegan dishes. Also, it helps to thicken dressings, sauces and soups.

IS NUTRITIONAL YEAST HEALTHY FOR BABIES?

Nutritional yeast is not a common choking hazard and not considered a common allergen. Therefore, it can be a healthy addition to a baby’s diet, especially in families that prefer vegan and vegetarian cooking.

If your baby has a MTHFR genetic mutation, it may be best to avoid nutritional yeast that has been fortified with folic acid, the synthetic form of vitamin B9. The MTHFR mutation causes impaired folic acid metabolism.

HOW DO YOU USE NUTRITIONAL YEAST?

Aside from its many health benefits, nutritional yeast is affordable, easy to use and can be sprinkled on just about anything to produce a delicious nutty, cheesy flavor

It’s versatile and here are some fun ways to use it:

  • Add to soups, stews, chili or sauces
  • Sprinkle on top of pasta dishes, casseroles, baked potatoes, mixed green salad, and roasted vegetables
  • Toss it with homemade fries before baking
  • Toss it into a tofu scramble or scramble eggs
  • Mix it into mashed potatoes or mashed cauliflower
  • Spread toast with olive oil and then sprinkle on top
  • Sprinkle over popcorn or kale chips (no popcorn for children under 4)
  • Combine with soaked cashews, lemon, garlic, salt, pepper, and water to make vegan cashew cheese sauce

Serving sizes for nutritional yeast depend on the recipe, but you typically use 2–4 teaspoons (5–10 grams).

BOTTOM LINE

Nutritional yeast is a really great versatile food. It’s such a great addition to a variety of healthful dishes and can be added to a variety of snacks and meals while providing a delicious umami flavor! Nutritional yeast is very high in Vitamin B12, a nutrient that of often difficult to find in most adult diets as well as a child’s diet. But remember, not all nutritional yeast is fortified with vitamin B12, so it is important to check the label for ingredients.

Does your family use nutritional yeast? What are some of your children’s favorite ways to eat it?

How to Read Nutrition Label If You Are Diabetic

How to Read Nutrition Label If You Are Diabetic

by with No Comment Diabetes

Are you having difficulties choosing the right foods at the grocery? Do you feel lost when you look at the nutrition fact table? Do you understand the list of ingredients? Finding the right nutritious food and understanding food labels is not as easy task especially with the high number of food products on the market. It’s even harder for people with diabetes because food choices can have an impact on blood sugar level. In this articleI will show all you need to know about grocery shopping in you have diabetes.

UNDERSTANDING SUGAR CLAIMS

Claims are used to attract consumers on a particular nutrition aspect of the food product.

Here is a list of the most common sugar claims and their meaning:

  • Free of sugar or sugar free: The food contains less than 0.5g of sugars per portion. For example: chewing gum.
  • No sugar added: The food contains no added sugars. However, sugar substitutes (aspartame, sucralose, sugar alcohols, acesulfame-k) could have been added.
  • Reduced in sugars: The food is processed, formulated, reformulated or otherwise modified so that it contains at least 25% less sugars than the reference amount of a similar reference food. This label is bit tricky because even if it is reduced it doesn’t necessarily mean that the sugar content is low and that this product is a good choice.
  • Fat-free: While it’s not a sugar claim, it’s important to know that some fat-free foods are often higher in sugar than the regular version.

Beware this claim does not mean that there are no sugars in this product! This is why it is very important to look at the food label to check the content of carbohydrate and sugars. For example, if you are buying an applesauce with no sugar added, you are still getting the natural sugar from the apples but no extra sugar has been added.

CHECKING THE INGREDIENT LIST 

The ingredient list shows all the ingredients in a packaged food product. They are usually listed in descending order by weight, beginning with the ingredient that weights the most and ending with the ingredient that weights the least. Therefore, if you see the word sugar or sugar derivatives in the first FIVE ingredients, it would be wise to check the sugar content on the nutrition fact label. The list of ingredients can also be a good place to look for heart-healthy ingredients such as healthy fats; or whole grains.

It’s important to know that there are different names of sugar. Look for words that end in -OSE. These include: sucrose, maltose, dextrose, fructose, glucose, galactose, lactose, high fructose corn syrup.

Unfortunately, it doesn’t end here. The following are all sugar: cane juice, dehydrated cane juice, maltodextrin, corn syrup, caramel, brown sugar, malt syrup, agave syrup, fruit juice concentrate, maple syrup, honey and molasses.

USING THE NUTRITION FACT TABLE

A lot of people tend to focus on the number of calories in a product. While it is important. It’s not only the calories that count. Here are some quick tips when reading the nutrition fact table:

START BY CHECKING THE PORTION OF REFERENCE 

All values in the Nutrition Facts table represent a specific amount of food. Be sure to compare this amount with the amount that you are actually consuming.

For example: If a 240 ml milk brings you about 11g of carbohydrates, evaluate if your intake corresponds to that same quantity or more and this by checking the amount you usually drink.

CHECK THE % DAILY VALUE 

Fiber 

They are found in the right column on the label and can help you make informed food choice. A useful tip is to look at the % daily value of fiber in the chosen product. Fibers play a role in regulating blood sugar levels. Therefore, the more fiber you have in a product the better. As easy way to verify that is to look at the percentage. If a particular food product has 5% or less fiber per portion, it means that the fiber content in this product is low. On the other hand, a percentage equal or superior to 15% means that this product is high in fiber.

Saturated, Trans fats and sodium 

Since people with diabetes are at risk of having cardiovascular diseases, it would benefit to check also the percentage value of the saturated and Trans fats (bad fats) and sodium. In this content, aiming for  5% or less is ideal.

Finally, if you feel hesitant between similar products, use the % daily value to compare and pick the best option. However, make sure they both have the same portion of reference.

LOOK FOR THE FIBER CONTENT AND SUBTRACT IT FROM THE TOTAL OF CARBOHYDRATES 

Diabetes is all about blood sugar control and one way to do that is to know approximately the amount of sugar a product is giving you per portion. This is especially true for those with type 1 diabetes and who have uncontrolled type 2 diabetes. Fiber is highly encouraged int he diet because it’s not digested and therefore it will not affect blood sugar levels. In fact, some types of fibers such as soluble fiber found in oat bran, legumes (beans, peas, and lentils), and fruits high in pectin can actually help control blood sugar levels.

Here is an example of a nutrition label and how we can deduct fiber from the total carbohydrate amount:

As we can read from the label, this product has 10 grams of carbohydrates in one cup. From these 10 grams, 5 grams are dietary fiber. Therefore, the total amount of carbohydrate to be considered is 5g.

BOTTOM LINE

Understanding nutrition labels will make your grocery shopping experience way easier as you will be making more informed food choices. Here is a list of some grocery shopping tips:

  • Don’t go on an empty stomach and check your blood sugar levels before you go.
  • Focus on fresh fruits and vegetables of all colours. Frozen versions are also good but avoid buying sweetened frozen fruits.
  • Try to choose more complex carbohydrates such whole grain products. Aim for 2 grams of more of fiber per portion.
  • If you want to buy biscuits/crackers look for those that have less than 20 grams of carbohydrates per portion and less than 5 g of fat.
  • Explore non-animal sources of proteins such as beans and lentils least once a week. They not only contain protein but they are excellent sources of fibers.
  • Go more for lean proteins, fish high in omega-3 and egg whites.
  • Aim for unflavoured dairy products. Flavored versions tend to be higher in sugar.
  • Pick low sodium or no salt-added products.

If you’re looking for one-on-one nutrition counselling for yourself, feel free to check out my service.  

the-prolonged-breast-milk-jaundice-journey-two-months-photo

The Prolonged Breast Milk Jaundice Journey (Two Months)

by with No Comment Motherhood

经常在社交媒体的群组里看到父母们为了刚出世就全身泛黄的小宝宝在发文求救，寻求最快退黄疸方式。身为父母的我们，每当听到小宝宝扎针抽血时的哭喊声，一定会心如刀割，心急如焚。所以才会到处寻找各种偏方，希望宝宝少受一点扎针之苦。

7年前的第一胎，曾经历长达两个月的母乳性黄疸。所以这一胎，我已提前为肚子里的两个宝宝即将会经历黄疸治疗做好一切的心理准备。

我的双胞胎宝宝终于在5月15日来到了我们的身边。

相信有follow我的 IG 的小伙伴们一定知道，我在过去的两个月里到低经历了什么。我们在COVID-19疫情最严峻的时期频密的往返 KK (Klinik Keshitan)，带宝宝们各种验血验尿，两次进院照灯，最终被refer到了巴生中央医院 (HTAR) 的儿科专科。

新生儿黄疸 (Neonatal Jaundice, NNJ)，正常吗？

新生儿的红血球(Hemoglobin)比成人多，它们的寿命也不长。当新生儿出生后，开始哭泣呼吸，肺循环须提供充分的氧气，这时体内过多的红血球因而被破坏。红血球被分解后，产生未结合胆红素(Unconjugated Bilirubin)。所以这意味着，这时新生儿体内会产生很多的胆红素。一般，胆红素不会引起黄疸，因为肝脏会代谢它并将其排出到肠道中。可是，因为新生儿肝功能尚未成熟，未结合胆红素无法有效经由肝脏代谢排出体外，因此沉积在皮肤表面而导致皮肤甚至巩膜(sclera)变成黄色。所以，黄疸是新生儿时期正常的生理现象。

新生儿黄疸分为生理性及病理性。

生理性黄疸 (Physiological Jaundice)

一般来说，足月宝宝的生理性黄疸通常是在出生后2~3天才出现的，第4天至5天达高峰期，一星期后就会慢慢消退，消退的时间一般不会超过2周。早产儿因为代谢能力差，黄疸消退的时间可能拖比较久，可延长至3周之久。 生理性黄疸通常不需要特殊治疗，除非黄疸出现过早或升高的速度太快、胆红素指数偏高。一般，父母只需在家观察，继续母乳喂养，1-2周后黄疸就会慢慢消退，不会对宝宝造成任何伤害。这就是为什么有些宝宝在满月前黄疸指数就已恢复安全水平，无需天天跑KK验血。

病理性黄疸 (Pathological Jaundice)

如果孩子出生后24小时内出现黄疸，或者黄疸发展迅速、甚至有贫血、体温异常、呕吐、大小便颜色异常（大便颜色是浅灰白，浅黄色，浅绿色；小便颜色是Teh-O色）、不爱喝奶、嗜睡，消退后又复发或者持续时间长，这种多属病理性黄疸，应立即就诊。 因为我曾有GBS positive 的病史，虽然在剖腹产手术前已施打了抗生素，为了安全起见，在出生后，当天晚上弟弟就安排入NICU观察，姐姐则安排在SCN (Special Care Nursery) 观察。第二天一早，弟弟已被transfer回SCN。吃了早餐，我就到SCN探望两个宝宝。  和医生沟通后，宝宝们都很健康，为了排除细菌感染或败血症(sepsis)，需要等待验血报告，另外我特意交代医生一定要观察宝宝们是否有黄疸。 不出我所料，午饭后，我回到SCN 时，宝宝们已经在进行照光治疗(Phototherapy)，所以暂时不能出院。

Audrey
Avery

接着，验血报告显示没有细菌感染，但是宝宝们有黄疸，需要继续照光治疗。在医院呆了4天3夜，医生让我们出院回家，并交代说一定要到住家附近的KK预约回诊，并接受黄疸检查。

Heel Prick Test

在回KK复诊期间，宝宝会被安排做Heel Prick Test。KK 的医生一直会重复的问宝宝的大便和小便的颜色和次数？喝母乳or配方奶？多久喝奶一次？一次喝多少？父母们在家必须把这些给记录好。同时也会检查宝宝的体重， 确保宝宝的体重没有下降

(here)。 

延长性黄疸 (Prolonged Jaundice) 

足月宝宝出生后14天或早产儿出生后21天，黃疸仍旧持续，皮肤和眼白部分比较黄。延长性黄疸通常无害，大多数是因为母乳性黄疸 (Breast Milk Jaundice)，但有些也可能起源于其他病理问题(溶血性黄疸或感染性黄疸)。 两次的入院照光治疗是day 7 和 day 14。需要入院的胆红素水平是257 umol/L以上，而宝宝们的指数也超过了这个level。宝宝们的胆红素水平在照灯治疗后都有显著的下降。可是过后的几天回到KK验血，胆红素水平又往上飙。就这样我们风雨无阻的往返KK验血。 因为持续性黄疸，宝宝们的日龄也已超过了21天，这时KK的医生安排宝宝们采集血液样本和尿液样本来排除其他延迟性黄疸的可能原因，例如泌尿道感染 (UTI)，败血症(Sepsis) ，甲状腺功能低下 ，肝功能衰竭。 引起黄疸的另一个比较严重的原因是肝脏问题：胆道闭锁 (Biliary Atresia) 胆道闭锁 (Biliary Atresia) 是肝脏通向肠道的胆管受到损伤，阻滞了胆汁流出肝脏。若及早发现，可在在60天以内做手术以恢复胆汁引流，以減少死亡或换肝的机率。 这就是为什么 KK 的护士会死缠烂打，穷追不舍，天天打电话来问宝宝的黄疸指数是多少，确定宝宝的黄疸指数下到安全水平才会罢手！

因为延长性黄疸， 所以宝宝们也被refer到了巴生中央医院的儿科专科。来到中央医院也免不了抽血验尿。抽血比在KK 用的Heel Prick Test更加准确。两个宝宝小小的手被无数的针孔扎过，站在门外听到宝宝哭，我只能和老公互相安慰。在排除了以上提到的潜在风险后，两个宝宝体重增加正常，纯母乳喂养，排便次数多，排便量大，尿液清澈，总体情况良好。医生最后告诉我，应该是母乳性黄疸。

母乳性黄疸 (Breast Milk Jaundice) 

一般喝母乳的新生儿，黄疸会持续比较久，这是因为母乳中含有一种女性荷尔蒙，会抑制新生儿肝脏酵素的活性，使其无法代谢处理胆红素，导致持续性的黄疸。 另一方面可能因为新生儿一开始喝母乳，奶量还不是很多，当摄取奶量不足时，可能出现轻微脱水，便便排出延迟，增加肠、肝循环，血液中未结合胆红素增加而出现黄疸。 在这个时候，很多妈妈听到 “母乳性黄疸” 会想要马上停止母乳喂养。

NO! NO! NO!!

事实上，解决母乳性黄疸的方法就是母乳本身！黄疸会随着时间慢慢消退，母乳性黄疸的宝宝应继续母乳喂养。

偏方有用吗？

如今网络媒体资讯发达，在各个群组里，我还是会时不时看到一些完全没有科学根据的 “退黄偏方”。上一胎，因为是新手妈妈，人在国外坐月子，当时宝宝黄，心急如焚的家人到处问人，而以下这几种方式是最多人建议的：

  • 喂宝宝喝羊奶？
  • 喂宝宝喝青葡萄汁？
  • 用黑狗啤酒给宝宝洗澡？
  • 用特制药材包给宝宝洗澡？
  • 坐月子期间不要吃黄色的食物？不要给宝宝穿黄色的衣服？

当然，“退黄偏方” 不只这几种方法而已，只要你在社交媒体的群组里发一个求救贴，底下一定会有很多“我试过了xxx” ”这个对我宝宝有效，黄很快退了” “给宝宝喝XX” 等等的留言。 如果你把前面的文字已读明白了也了解了什么是新生儿黄疸，今天不管你在网上看到，还是听谁谁谁推介超级有效退黄偏方，你都不会随便尝试，因为你知道只有母乳才能解决母乳性黄疸，只是退黄的时间会比较久。

坐月饮食需要戒姜戒中药吗？

在宝宝出生前，我已经和来帮我做月子的老妈说好月子餐要清淡一些，可用姜烹煮，但无需大量使用姜。另外因为需要哺乳+亲喂，暂时也不吃/喝有酒精的食物。在整个做月子期间，不管我是有吃还是没吃姜，酒， 中药，红枣水，宝宝们的胆红素水平还是持续上升，完全不受我的饮食影响。

到目前为止，没有证据表明生姜和黄疸之间存在直接关联；熟食中的酒精本身也不会引起黄疸。红枣水含有丰富的铁和维生素，做月子期间/哺乳都需要大量的摄取水分，所以多补充水分并没有害处。

总而言之，我在整个月子期间吃的均衡适量多样化，红枣水，炒米茶，中药汤，我都有断断续续的喝。姜是适量的用在调味上，也没怎么吃。置于用来炖补的酒，在第一个月里我是完全没有碰，只用了米酒酵素来烹饪。

如果你想在坐月子期间暂时戒姜戒中药，好让宝宝的黄疸退的快一点(有些宝宝是生理性黄疸，两个星期黄疸就渐渐退了)，你也是可以在之后才补上这些食材。

宝宝黄疸指数居高不下，要怎么办？入院照灯须知

不管是生理or 病理性黄疸，只要慢慢增加哺乳次数以及奶量，黄疸自然能改善。总之，多喝奶(每1-2小时)，多排便，多小便，黄疸就会退的很快。如果胆红素超过照光标准(257 or 308 umol/L)，医生就会建议入院进行照光治疗。照光治疗可以安全和有效的迅速降低黄疸，因为蓝光治疗能改变胆红素分子的形状和结构，使它们能随尿液和粪便排出体外。 在治疗期间，宝宝会脱光衣服，只穿上尿布和戴上眼罩，这种光不是紫外线，防护屏会过滤掉可能发出的紫外线，所以爸爸妈妈不需要担心宝宝晒伤。 假如黄疸指数真的非常高，可能需要进行换血(Exchange Transfusion)。因为黄疸指数太高，不及时治疗，胆红素有可能会进入脑细胞，干扰脑细胞的正常活动和功能，伤害到神经系统，造成永久性神经系统损害，脑性麻痹 (Cerebral Palsy) ，听力丧失，智力落后等，更严重的还可能危及生命。

“居家照光治疗服务”可行吗？

在宝宝们第二次入院前，由于疫情逐渐严重，想要减少出入医院的次数，我有尝试询问医生，我们能否租借仪器回家为黄疸宝宝照灯。医生的回答是 “NO”。他认为照光治疗必须在儿科医生和专业护士的观察和指导下进行，不是租借仪器回家照个一两天就当没事了，而且宝宝隔天还是必须回诊与抽血，追踪治疗。因此，他建议如果黄疸指数居高不下，入院治疗才是最快最安全的方式。

宝宝们入院照灯 

因为疫情关系，宝宝们入院照灯，妈妈是不能入院陪同宝宝过夜。一天只有两次探望时间。所以，两个宝宝入院后，我只好在家把母乳挤出来，然后等到探望时间或一大早送过去医院给护士们。 在这里要提醒大家，如果想要宝宝入政府医院进行照灯治疗，一定要带上平时到KK 产检的Pink Book。因为入院时，医生会问很多问题，关于你整个怀孕过程，宝宝在哪家医院出生，宝宝的各种体征，宝宝的喂奶状况等等。 出入医院那么多次，马来语不好的我，都用英语和政府医院的医护人员沟通，不管我问什么问题，他们都很耐心的回答我。

新生儿黄疸可以预防吗？

不能。新生儿黄疸是正常的生理现象，我们无法在怀孕过程预测哪些胎儿出生比较有可能出现黄疸。不管你在怀孕期间，还是坐月子期间，吃什么用过什么都不会把新生儿黄疸的几率降低。想要黄疸退的快，妈妈们在生产后一定要尽早哺乳，初乳有催便效果，胆红素即可迅速排出体外。

总结

新生儿黄疸有哪个新手爸妈不担心的呢？听信坊间流传的没有科学根据的偏方，盲目使用偏方很可能会给宝宝的肝脏带来更多的负担，延迟让宝宝接受应有的治疗，对宝宝的黄疸并不会有帮助。不管你是在政府还是私人诊所follow up， 是生理性黄疸还是病理性黄疸，一定要听从医生护士的建议，准时回诊。 女儿Audrey 在第41天的验血报告里，胆红素已降到56 umol/L；儿子Avery的胆红素在第51天已降到179umol/L。

新手爸妈们，你们是否和新生儿黄疸对抗过呢？请留言分享！

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Things I Learned About My Body and Mindful Eating During Pregnancy

by with No Comment Fertility & Women's HealthMotherhood

While we often view pregnancy as a “glowing” time, for many women the first trimester brings nausea, food aversions, and fatigue. Mom-to-be may also feel anxious during pregnancy, especially if they’ve previously experienced fertility struggles or miscarriage.

Now that you know I’m in the 2nd trimester of my pregnancy with Baby #2 & #3, I thought it would be fun to talk about what I’ve learned about my body and mindful eating during the first trimester.

MY MORNING SICKNESS VS MINDFUL EATING 

People typically think of morning sickness as throwing up in the morning. The truth is that it can happen any time or, for some unfortunate people, like me, ALL DAY. Sometimes you just have constant bouts of nausea without throwing up, I had that and it’s the worst feeling. It stays in the back of my throat and I feel like puking, but I just can’t.

In addition, during the first trimester, foods I didn’t usually crave were suddenly finding their way into my grocery cart, and foods I normally love and want to eat all the time were push to the back of the fridge. My cravings also changed more quickly than I could keep track off. One minute I was cooking lunch for my son, next I can’t even think about eating that right now.

Your body will let you know what it wants.

Pregnancy is a really amazing time to practice mindful eating because your body is going to tell you exactly what it needs. Before getting pregnant, I was in a good routine with my eating where I was still being mindful, but I didn’t have to pay quite as much attention because I generally needed food around the same time most days, and I had learned what types of foods usually felt best for me at certain times.

But things change in pregnancy. In my first trimester, I pretty much couldn’t eat or smell anything.

BUT, why am I hungry all the time?

Getting “hangry” was always something I was susceptible to, but having hangry also come paired with a face smack of nausea.

Not only did I need to eat more often (with small portion size), but it was much more urgent.

I was totally turned off cooked vegetables, difficult to eat foods high in fat like meat, water or soup fill me up and made me nausea. So, I actually lived off bran cereal with milk, crackers, lemon water, fruit smoothie, pao , etc. I was nauseous but hungry all day long, so bland foods like cereal and milk were my BFF. I was probably dehydrated so smoothie and lemon water were my go-tos. I off fatty foods for a while since these are typically harder on body to digest and I constantly burping.

Pregnancy hunger can sometimes feel chaotic and out-of-control. But it doesn’t have to be this way. The truth is mindful eating can be helpful.

Our body is fully capable of doing what it needs to do to keep us and our baby healthy, and most of all, our body can be trusted.

Mindful eating is the practice of learning to pay attention to (and honouring) your body’s natural cues in regards to food. This means nourishing your body when it’s hungry, noticing and stopping when you’re full, and honouring your cravings.

Up until now, when I am feeling hungry, I eat something. When I am getting full, I slow down, take few minutes, and decide if it’s time to stop eating.

No matter what changes your body is going through, you can learn how to dial in to exactly what your body needs and feel confident to give your body just that.

MY BODY WILL GAIN WEIGHT AT ITS OWN PERFECT PACE 

Pregnancy has been a really good lesson in surrendering to my body. Week by week, some weeks subtle and others not, my body has literally changed before my eyes. One day I would worry I was gaining weight too fast, and the next, I would worry I’m not gaining enough and that something was wrong with babies. I’ve spoken with so many of my friends and I came to realize that this is just one of the brutal realities of being a woman, not just in pregnancy when body changes come fast and furious, but pretty much all throughout the life cycle. But as I near the end of my second trimester, I’ve learned to make peace with the chaos. My body will gain weight at its own perfect pace. It may not be the precise 0.5-1 kg each and every week.

I know that for me, some weeks I gain nothing, and others I’ll jump 1 or 2 kg on the scale. But if you’re listening to your body, just know that your body is doing what’s best for you and baby and your weight will find its happy place in the end.

MY BODY DOESN’T JUST CHANGE OVERNIGHT WHEN I SKIP THE EXERCISE ROUTINE 

Before getting pregnant, I work out every day for at least 30 min to an hour. But I was just anxious at the beginning of my pregnancy that I took about 3 months off the exercise routine. Not 3 days or 3 weeks, it is 3 months. Obviously, it was all worth it. But taking that much time off kind of freaked me out. 

Would I lose all of the strength I had worked so hard to build and have to start from scratch again?

Would I gain 20kg?

Would I just fall out of the habit for good and never go back?

After first trimester, I started doing light yoga stretching and leg exercise. I keep telling myself, I have two babies growing inside me, don’t feel guilty because I took 3 months off the exercise routine. It doesn’t have to be all or nothing. Just listen to my body when I’m ready to get back on my yoga mat.

IT’S OKAY TO FEEL EMOTIONAL 

When I found out I was pregnant, I was more terrified than excited. The fear of bleeding, cramping, not hearing heartbeat, it all messes with my head in a way that no one can really understand unless they’ve been there.

Every doctor’s visits are also scary. Every time I have an appointment, I have to take deep breaths to try to stay calm and positive. I find myself constantly thinking about the babies’ movement and heartbeats. To handle fear in the moment, I am taking one day at a time and feel grateful for every day of my pregnancy, allow myself to enjoy things like a positive ultrasound or big kicks.

Now moms and moms-to-be, can you tell me, what are some of the pregnancy lessons you’ve learned along the way that have helped you through your journey? Leave me a comment below and help a fellow mom-to-be out!

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My Infertility, IVF, Miscarriage Journey & Big Announcement

by with No Comment Fertility & Women's HealthMotherhood

今天的文章将会用中文来表达，因为这样比较能诠释我内心的情感。

THE GOOD NEWS 

你喜欢先听坏消息还是好消息呢？我想你在2021年的第一天可能已经在我的社交媒体上看到了我和你们分享的好消息，我也陆续收到很多followers 的祝福，而且还有很多人私信说很期待这篇文章的出炉。是的，你可以从缩图和标题中看出来了，我想告诉大家的好消息就是 – 我怀孕了！

二胎的备孕过程真的是一条艰辛又漫长的路，我无数次幻想着我该如何写这篇文章，和身边所有人分享这份好消息。此外，这篇文章的另一个目的除了是要记录我这5年的备孕心酸过程，我也想和大家谈谈我的不孕症和流产的经历。

看别人分享怀孕，生孩子，坐月子的文章看多了，但是网络上确实很少看到文章分享和谈论不孕和流产的话题。事实上，4-6对夫妇里就会有一对夫妻面对不孕症问题，10-20%的女性曾经有过流产经历，所以我希望此文章能给正在备孕的姐妹们一些希望和正能量 ，you are not alone! 

MY FIRST PREGNANCY 

一直长居加拿大的我在2011 年硕士毕业后，得到了一份很好的 job offer，于是就打包好行李独自一人来到了新的工作和居住环境，一个人生活。一直以来我和现任老公都是远距离恋爱，我过我的自由生活，他过他的忙碌打工日子。直到2012年的 Chinese New Year，他买了机票就这样飞了一天一夜来到了这个冰天雪地的国家，这是他第一次踏入北美洲，也是他第一次看见雪。短短的两个星期的假期，我被求婚了！

2012年12月，我回国，和他举办了一场浪漫的 Beach Wedding。

之后就开始了我们的远距离婚姻。婚后一直觉得自己还很年轻，想要在工作上进修更多，我就尽情玩乐，享受自由自在的日子。而他决定不再做打工仔，想出来创业。他把工作辞了，隔天就直飞加拿大陪伴我两个月半。

就这样，我们的第一个宝宝是在完全无预警没有做任何的planning的情况下就悄悄的来到了我们的身边。

整个孕期，生产过程，哺乳期也可以写成一篇文章！

Anyway, 2014年5月，我当妈妈啦！

MY INFERTILITY TREATMENT

一直以来，我和老公都是处在远距离婚姻，我们一年见面2次，半年一次，我们只能各自拿最多3个星期的有薪假期。一般正常夫妻，即使什么问题也没有，在自然不避孕的状态下，每个月自然怀孕的几率也大约仅为 15-25% (here, here)。所以，一年只有两次机会的我们想怀第二胎的几率是非常小的。因为第一胎是在没有任何计划的情况下怀上的，而产后的我，身体状况，体力，经期，饮食，生活作息，比任何一个人都还要正常。所以 “不孕不育” “试管婴儿” 这些字眼从来都没在我的脑海闪过。

同时，我决定哺乳儿子至少3年，把最好的和花更多时间在陪伴儿子身上，所以就算没有怀上，我们也没放在心上。

不过，当时身边许多家人朋友都陆续结婚怀孕生子。经常都被念叨：

“什么时候要生多一个女儿呀？”

“你儿子那么可爱，可以再生多一个？”

“你还不赶快趁年轻的时候，快点生，有人帮你照顾？”

“赶快戒奶，喂母乳很难怀孕的？”

“一次过生完，你就可以收工了！”

因为哺乳了将近两年多，而我似乎开始有些介意这些 “好心人” 的叮咛，有没有可能是因为哺乳的关系导致不孕？自己本身曾有贫血症状，每年都会做一次比较详细的 full body check-up。结果不出乎意料，我的 TSH level 显示异常的底，Thyroid peroxidase antibody (TPOAb) 偏高，幸好的是T3和T4, 都属于正常。见了内分泌科，抽了一瓶又一瓶的血，做了 thyroid ultrasound，最后医生说，有可能是 Hashimoto’s disease? 等孩子戒奶了，这些指数可能会慢慢回归正常。但是，我的家庭医生为了安全起见，我每一个月都要抽血monitor我的TSH level。另外，她也建议我去咨询 fertility doctor。

就这样，我半只脚踏入了 infertility treatment 的圈子。我开始上网阅读每一间 fertility centre 的文章，技术，关于IUI，IVF，ICSI 的疗程。原来这圈子的水很深，当你研究的越多，懂得越多，你就知道能够 “自然受孕”，还一年生一个的人，是有多么的幸运呀。

子宫腔内人工受精（intrauterine insemination, IUI）是指将男性精液经过人工筛选之后，选出健康的精子直接注入女性子宫颈或宫腔内，以协助受孕。此一技术使用细小的管道插入子宫颈内，在排卵时注入精子，以便让精子更容易与卵子结合而受精，增加受孕成功率。过程不需手术和麻醉。

体外人工受精（In vitro fertilization，IVF）则是指分别将精子与卵子带到体外，在试管内进行受精和发育成为胚胎后再移植回母体子宫内。通常使用小盘状的培养皿，在适宜的环境下受精。当把卵子和精子均放入到同一培养皿中之后，让精子自由游动与卵子结合，并发育成为小型的胚胎，胚胎在培养箱中一段时间后，则移回母体子宫内着床怀孕。

卵细胞浆内单精子显微注射（Intra Cytoplasmic Sperm Injection, ICSI）是一种人工辅助受精技术，将精子直接注入卵子中以形成受精卵，也是人工辅助受孕的一项科技，特别是有助于男方精子缺陷或精子不够活跃所造成的不孕症，或者曾经使用过IVF技术辅助受孕却不成功的案例。因为透过IVF技术治疗时发现，虽然将精子与卵子放在同一培养皿中，仍存在精子无法穿破卵子外壳而实现受精的情况，可能是精子本身不够有力或质量偏低，精子前冲力道不足，也可能来自女方卵子外壳过厚，导致精子无法穿破。因此使用ICSI能辅助精子穿透卵子外壳。首先在显微镜下选出最健康优质的单精子，并使用非常细小的玻璃管刺穿卵子外壳，将单精子注射进入卵子中。这一辅助受精技术可大幅度提升受精率，也使试管婴儿受孕方式的成功率获得提升。

除了low TSH level 的问题之外，我也做了HSG X-Ray，检查结果显示我右边的输卵管 “好像” 堵塞了，因为无法在X-Ray里看到造影剂流入到右边的输卵管。最后，医生给的建议是既然你之前能够自然受孕，经期正常，身体状态良好，左边的输卵管运作正常，那么就尝试吃排卵药。

子宫输卵管造影（hysterosalpingography，HSG）是针对输卵管和子宫的一种特殊X光检查。医生会将细导管穿过子宫颈插入子宫，然后注射特殊的对人体无害的不透射线造影剂染料，通过这种造影剂医生可以看出整个输卵管的通畅程度、堵塞的部位和宫腔的形态。

想要怀孕是两夫妻的事。当然，我老公也误打误撞的和我一起踏入了这个圈子，他也去做了精子检查。报告显示精子浓度正常 (concentration)，只是精子异常 (morphology) 和活动力不足 (mortility), 属于中度弱精症。因此，Dr. A (Fertility Doctor) 建议我们可以尝试吃排卵药，打排卵针或尝试人工受精。我们接受了医生的建议，我一共吃了4个cycle 的 FEMARA® (letrozole) 5mg。

大部分患有弱畸形精子症的原因不明确，需要多个方向 (生活作息，药物，饮食) 综合治疗。老公的生活作息一项良好，不烟不酒，不熬夜，不挑食，只是偶尔中午没吃 (工作太忙)。经过一番饮食调理，2018年夏天，我们选择了IUI疗程。在疗程进行前，我也去了当地来自中国的中医师做针灸。

IUI对年龄在35岁以下的女性平均成功率为每周期的10至20%。 35岁至40岁的女性为10%成功率，40岁以上的女性则有 2％至 5％的几率。但是，成功率主要取决于精子质量和受孕女性的子宫健康状况，许多研究证实接受大约三到四个周期IUI疗程有更高的成功率。

护士帮忙施打排卵针

很可惜，第一次的IUI疗程没有成功。

由于 Dr. A 只负责 IUI treatment。于是，家庭医生又refer 我到另外一家fertility centre 做咨询。疗程讲解，抽血，ultrasound，可以做的都做了。这次的fertility doctor – Dr. S 在验血检测里多加了一样就是 AMH (anti-mullerian hormone) (here)。

抗苗勒管激素 AMH浓度是评估女性的卵巢储备和受孕能力的重要指标，这项检测对计划怀孕或继续治疗不孕的女性非常重要。AMH是女性卵巢卵泡产生的荷尔蒙，分泌於卵泡初成形之时；若卵巢卵泡数目越多，血清中的AMH值越高；反之，若卵巢卵泡越少，AMH值就越低，因此透过AMH值可评估卵巢的卵泡库存量。

AMH值低于5属于低水平，数值超过15为高水平，数值落在两者之间则属于中等 (here)。

我的AMH 指数是 13.2 pmol/L，医生说如果要进行 IVF疗程，她希望AMH可以在14 以上。同样的，由于老公本人不在加拿大，要 sign up IVF 疗程，必须两人同行，还要报名上一些辅导课程。医生还是给了同样的建议，先尝试排卵药，于是我又吃了4 个cycle的 Clomid。

半只脚在这个飞也看不到尽头的不孕圈，感觉很孤单，很无奈，很无助，很沮丧。在此时，我已经把自己和不孕症画上了等号。从一开始天真的以为 “自然受孕” 是那么的简单，到今天经历了那么多的打针吃药，检查的轮回，大姨妈还是每个月都准时到访。那种失落感无人问津。

当一个极度想要怀孕却总是每个月看到白板的人，这个时候只要一打开自己的社交媒体账号，朋友圈里的所有朋友都好像同一时间怀孕；只要一走在shopping mall一定会看到经过你身边的每一个人都是大肚婆；在工作上每个星期都会接到关于prenatal and postnatal care 的referral cases；就连身边已年过40岁的两个朋友本来就不打算怀孕生小孩的也怀孕了！这个时候，我的世界只有我一个人，天天都在问自己到底那里出错了！

MY IVF JOURNEY

可能因为自己是理科生，看过无数关于卵子+精子受精的影片，所以一直以为吃一吃排卵药，把卵子养大，打个排卵针，再来把精子处理一下，那么一定会中的！

但是，我和老公从来没有中大奖的命，就连安慰奖也没份儿。

2019年2月，我拿了2个月半的假期回国。在决定回国前，老公已经到几间 fertility centre 去听课也 survey 了费用。回来后，我带着一份份厚厚的体检报告来到了 fertility centre 见 Dr. H。医生给我的诊断结果是 “unexplained infertility”。因为一边的输卵管堵塞了，如果真的要自然怀孕，有可能需要靠点运气和漫长的等待。又抽了一瓶又一瓶的血，所有的指数，子宫内膜厚度，卵子的成长大小都很理想，医生建议不如这个cycle再试试看吃排卵药，打排卵针和直接进入IUI 疗程。

中医VS西医

中医和西医在 infertility treatment上的差别挺大的，中医讲求的是将体质调好，辅助血液循环，提高卵泡的质量以及改善子宫内膜的环境。西医的强项是诊断不孕的原因，能在各种仪器的辅助之下，提供不同的方式协助女性怀孕 (服用排卵药，打促排卵针，调理荷尔蒙失调问题等)。

做了一些 research 后，我决定在进入IUI 疗程前，再尝试多一次针灸疗法来增加受孕几率。毕竟，当时在加拿大咨询的中医师并不是专注于助孕疗程。

针灸真的有用吗？我有吃中药吗？

首先，我咨询过 Dr. S 和 Dr. H，两个医生都没有明确的说不建议或不鼓励，他们处于中立态度，完全取决于我的budget和我的时间。我也翻阅了一些研究报告，在临床研究上，针灸确实能辅助子宫血液循环。不过，我也曾听过一些国内的 fertility doctor 是不鼓励中医疗法也会督促在进行疗程的女性不要乱吃中药以免影响疗程效果。

但是，我还是想要做最后的尝试，毕竟在国内确实有几间不错的助孕中医诊所。为了配合IUI 疗程，我几乎天天到中医馆针灸和服用中医师给的药粉。只要你和中医师说明自己正在疗程中，中医师都会配合西医的疗法。由于我对国内的交通路线不熟悉，所以不管到什么地方都是由老公亲自接送。老公没有任何怨言也很愿意配合我的时间。医师人很亲切，整个针灸过程都让人很放松。

第二次的IUI疗程，我们还是没有成功。

2019年3月正式踏上试管之路

 

 

 

 

 

 

 

 

IUI失败之后，我们回到诊所咨询 Dr.H 后，决定要选择IVF 疗程。回家的路上，我问老公：“你觉得我需不需要再回到中医馆去针灸呢？老公给我的回答是：“如果你觉得压力很大，每天要这样赶上赶下，就不要回去了，我们就听医生的指示，该休息就休息，该打针就打针”。于是，我没有回去接受针灸调理。

促排+取卵

打了10天的针。我对针筒并不会感到害怕，所以全程都是自己打针，儿子在一旁鼓励和观看，老公则躲的远远的。

药物：吃的，塞的，打针的。
取卵前
取卵后

 

 

 

 

 

 

 

 

 

取卵手术需要全身麻醉，晚餐后就要 fasting 了。当天一早梳洗完毕，就出发到诊所去了。Dr.H 在取卵过程中也顺便帮我子宫里小小的息肉 (polyp) 也一起割走了。

通常取卵手术后，会容易有卵巢过度刺激综合症（OHSS），具体表现为腹胀，腹水，严重的会全身水肿。因此在术后，护士会建议患者多喝运动饮料 (如100Plus)，多吃高蛋白的食物等，避免辛辣，油炸和甜食。我的 OHSS 的症状不是很明显。休息了几天，等待诊所的电话。

卵巢过度刺激综合症 OHSS (Ovarian Hyperstimulation Syndrome) 是IVF 的主要并发症之一，因为排卵药物促使过多卵泡发育，但这并发症是可以治疗的。

一共取了21颗卵，有19颗mature eggs同时也做了ICSI。一共有9颗成功受精，能成功让胚胎师决定留下来的只有4颗胚胎。

Day3: 2颗 8 cells grade 2

Day 5: 1颗2BB，1颗3BB

我们决定下一个cycle 就做 FET (Frozen Embryo Transfer)。我选择植入2颗Day 3 的胚胎。植入后的四天，我就直接飞回加拿大工作了。一个星期后的验孕结果是：

隔天我马上到家里附近的 walk-in clinic 见医生，要求做HCG test, 为了确保HCG 有翻倍，放工后，我都到验血中心报道，我一共抽了3次血：

Test 1: 2366 IU/L

Test 2: 3261 IU/L

Test 3: 6596 IU/L

从看见验孕棒 positive 的那一刻起头脑就涌现出许许多多的画面和计划，心里是又兴奋又紧张，感觉像是在做梦一样。

验了3次HCG test，一星期后又用了另一支验孕棒验多一次，确保这一次是真的成功，不是在做梦。指数那么高，会不会是双胞胎呢？内心其实很不踏实，因为真的太久没有看过 positive result了。

MY MISCARRIAGE STORY 

到了大约8-9 weeks 时，我带着忐忑不安和期待的心情去做 dating ultrasound。在房间里sonographer 照了很久很久，我不敢发出任何声音但又很想知道到底有没有双胞胎。结果 sonographer 让我去上厕所，要做阴超。上厕所时，我心里一直在祈祷。在做阴超的时候sonographer 还是一样的安静，照了很久很久，整个房间的气氛很奇怪很凝重，我开始有点不安。结束后，她让我换上衣物，然后对我说：“对不起，我们没有听到宝宝的心跳，胚胎的大小刚好停留在8 week 3 days (正是我做ultrasound 的前一天)，你需要尽快咨询你的家庭医生”。

当下，我的脑袋是一片空白的，一时之间不知道如何反应过来，“没有心跳” 是什么意思？验孕棒不是 positive了吗？HCG 很高呀？在回家的路上，我一面开着车，一面留着眼泪，一直不断的回想，前一天我做了什么，吃了什么，是因为什么原因导致宝宝没有心跳？回到家我整个人瘫坐在床边，一面哭，一面上网查询 “when can we hear baby’s heartbeat?”

接下来的一个星期，只能用 “煎熬” “痛苦” 来形容。我需要一面装着若无其事的样子上班，一面要坚信一个星期后能听到宝宝的心跳声。每一次上厕所都一定检查有没有出血症状，有没有肚子痛。日子过的非常模糊，就这样昏昏噩噩的过了一个星期。

第二次的ultrasound 结果还是显示宝宝没有心跳。Sonographer 完全没有让我看影像，之后radiologist 进来和我解释检查结果。接着到诊所会见家庭医生，医生向我解释了流产迹象和几种不同的流产程序。我强忍着泪水离开诊所，一个人呆坐在车里，眼泪一直流。因为我完全没有任何流产的迹象，医生说我可以等宝宝自然排出体外 (可能需要1-2星期) 或可以尝试用药，暂时先不需要入院做人工流产。这时我的整个世界是崩溃和黑暗的。

老公知道消息后，马上定了机票飞过来加拿大。而我也和老板说了自己的情况，请了两个星期的小产假。因为只有两个星期的病假，我只能选择用药，但在用药的前一天，已经有一些些出血现象。两个星期的小产假，我除了哭，一直都在回忆着这两个月的所有画面，我做了什么，吃了什么。我的心情就好像坐过山车一样，上上下下，突然被狠狠的抛出车外，这一摔，很痛很伤。

2nd TRANSFER & 2 WEEKS WAITING PERIOD 

我曾经天真的以为只要验孕棒出现两条线，就代表你成功了！经历过这次的流产事故，我深深体会到女人能够从孕育一个新生命开始到把一个健康的宝宝带到这个世界上来，是多么的不容易。许多研究发现，流产其实并不罕见；每100名怀孕的女性，就有15人有过流产的经验 (here)。

根据统计，流产发生几率大约在12%～15%之间，其中又以妊娠13周前发生的早期流产最常见 (here)。

休息几个月后，我要求再做多一次 HSG X-Ray。这次 HSG X-Ray 显示，我两边的输卵管是通的。这让我又燃起了 “自然受孕” 的期望。

2019年12月，我决定把事业的中心放在 Simple Balance Nutrition，于是我把工作辞了，回到马来西亚，想给自己一个假期，同时多陪伴家人。结果遇上COVID-19 疫情大爆发，全世界都在抗疫，锁国封城。我们也只能乖乖呆在家。没错，我和很多人想的一样，这是不是上天给我的安排呢？多了和老公相处的机会，那么受孕几率也会大大增加。结果还是一样，每一个月都是失望收场。

2020 年突如其来的疫情，打乱了许多计划，但却给了我很多工作上的新挑战和机会。我本身的性格很执着而且还是个完美主义者，只要我想做的事我一定会做到101%！但是对怀孕这件事，不是我一个人可以控制的。流产后，我用了15个月的时间平抚情绪，调整自己的心态和身心，听到看到别人怀孕，脸上总是挂着一副羡慕的表情，尤其是我特别热爱自己的工作，想在 childhood nutrition，prenatal/postnatal nutrition，儿童挑食，育儿方面多做些深入的研究。

终于，2020年9月，在疫情似乎控制下来时，同时工作上的几项大project 也告一段落，儿子也回校上课了，我和老公讨论后，决定再次鼓起勇气回到 fertility centre 见 Dr. H。

备孕饮食+生活作息

在饮食调理上，我对 fertility diet 做了很多的研究，读了很多论文，该吃的备孕 supplement 照样吃。在平时的饮食上，身为饮食治疗师，一切讲究均衡，多样化，适量为主。有在follow 我 IG 的朋友们，一定知道我热爱瑜伽，我天天都一定会抽至少半小时的时间运动。

自制滴鸡精

在移植前，我也吃了至少3个月的 homemade 滴鸡精直到开奖。

这次采用的FET 疗程是以 natural cycle 进行，所以在移植前是完全不需要吃/塞任何药物。移植当天，由于疫情关系，老公完全不能进入手术室，我一个人换好衣服，躺在手术台上等待时，我看见在电脑萤幕里的两颗健康的胚胎，心里一直在默念祈祷，希望今天我可以把你们两个宝贝一起带回家。

这次我们一共移植了最后仅有的两颗 Day 5 的胚胎。移植后，开始服用Duphastan，一天两次。

为什么移植两颗胚胎呢？

其实这是我的决定。努力了那么多年，年纪也越来越大，每一个月最煎熬的就是等待验孕开奖的那两个星期，一次又一次的失望，压力大到无法形容。

上次移植了两颗胚胎没有成功，research 了很多流产和 IVF 不成功的原因，医生无法给出任何解释，有可能是精卵质量不好，染色体异常，高龄，又或者是自己没有足够的休息而导致流产的。

这一次，因为不想明年再交 freezing fee，也不想再为了生育这个问题搞得我们夫妻压力重重。干脆直接移植最后两颗胚胎。如果不成功，可能我们会从新开始新的 IVF 疗程，或认命。既然上天给了我一位那么可爱，乖巧，暖心的男孩儿，我不应该要求那么多。所以直接拼了！Dr. H 很随和，她不会给任何太过主观的意见（除非是她真的觉得不适合，她会直接和我说），她也知道我的专业，我在做任何决定前，一定是已经 research 好了，才来告诉她。当时，我和她说想要移植最后两颗胚胎的时候，她给了我很正能量的鼓励同时叮咛我有可能是双胞胎，也告知了怀双胞胎的风险！

再来说说移植后的事情，之前老是听别人说移植胚胎到子宫后不敢立马上厕所，连洗澡都不可以，怕胚胎流出来，其实这个真的不用担心。我移植完后直接就在手术台上问护士我能不能在这里躺一下，躺了大概15-20分钟，我害怕下一个要移植的妈妈要进来了，就慢动作的去上厕所排尿换衣回家。回家后在家前3天基本都是躺着多，但是吃饭会起床到楼下餐桌吃饭，不时的在客厅走走坐坐，我个人观点是没有必要一直躺着，不时起床走一下，可以促进子宫血液循环，帮助宝宝着床，3天后我就开始做一些文书处理工作，写写文章。

第二次移植和第一次移植的心态和心境有所不同。可能第一次移植时，时间太赶，压力太大，没有足够的休息，而且我还长途跋涉的飞回加拿大。这一次，一切放慢脚步，看书，写文章，看连续剧，写计划书，吃饭，睡觉，和儿子读绘本等。

就这样等到了第十天。我十分明白这两个星期对期待受孕的夫妻而言，是最难熬的过程。

在开奖的前一天，我心血来潮，因为家里多了一支普通的验孕棒，我就想说，那不然来验一下吧。其实心里很清楚，如果是白板，也不要伤心太久。老公天天都对我说：“不管结果是什么，我们只要秉持着一颗平常心就好”。我们已经尽力了，一定要放松心情。这天早上，老公和儿子已起床吃早餐，准备要去上学上班，儿子上来看一看我是不是睡醒了，顺便和我道别。而我，告诉儿子：“来，我们来做一个 scientist 的实验好不好，你帮妈咪把这个stick放入这个有尿尿的杯子里，看看会不会变颜色”。

因为有太多太多次的失败和失望。我这次真的很怕看到“白板”。一面刷牙洗脸一面等成绩，很快的，试纸显示两条线，我立马再看一下说明书，确实是有很清楚的第二条线，我告诉儿子说：“mommy 的肚子很像有baby了，不过这个是 secret，不可以告诉任何一个人哦！”

第二天，也是一样趁老公在楼下吃早餐，我又叫了儿子上来再做一次 scientist 的实验，这次用的是 ClearBlue 的 pregnancy test。看到positive的那一刻我简直难以按耐内心的兴奋，但是心里还是很害怕，拿着验孕棒下楼告诉老公后，他的第一个反应是：“怎么办，现在是怎样，等下快点打电话给诊所，看看下一步要做什么，你不要再做家务了，饭也不用煮了，你快去楼上躺着”。

发了简讯给诊所的 nurse，他们要我马上回诊所验血。下午护士打电话告诉我成绩，这次的HCG 成绩是 623.4 IU/L。指数没有上一次移植的高，我问了问护士姐姐，她说，只要是超过600 IU/L，医生就很高兴了。于是，她要我继续吃药 – Duphastan 同时开始吃 Aspirin。

MY RAINBOW BABIES 

在 week 7 day 1 时，我和老公带着很忐忑的心情回到诊所见Dr. H。我们一路上都没怎么说话，紧张的情绪完全都写在我们的脸上了。在躺上要照 ultrasound 的那张床上时，脑袋是一片空白的，我只乞求胚胎可以成功着床，可以听到宝宝的心跳。因为周数太小，所以我们照的是阴超。眼前的电视荧幕出现了子宫内有小小的一粒黑点，然后 Dr.H 就说：“爸爸要不要进来看一下”。老公走过来，在我身后，看着黑白银幕里的宝宝 (其实我知道他看不懂)，接着我很紧张的问 Dr. H有心跳吗？她播放心跳的声音给我们听，她说：“有心跳呀，而且很好。Eh….我是不是放两颗呀？好像有两个胚胎哦，两个都有心跳，周数也差不多”。当下她移过去看到第二个胚胎的时候，我眼眶泛泪，内心激动不已，很想跳起来抱着她 (反而不是自己的老公)，但是因为 social distancing 的问题，加上她是全副武装的穿着PPE，我也只好掩饰内心的激动和兴奋。

My rainbow babies

MY THOUGHT

为了结束这个冗长的文章，我想只有亲生经历过这一切的姐妹们才能真正的体会到，我们到底经历了些什么。相比之下，我的个人经历和故事并没有其他姐妹们来的坎坷。在 infertility 这个圈子，我属于 secondary infertility (续发性不孕症) 。

通常不孕症又可分为原发性不孕症 (primary infertility)和继发性不孕症(secondary infertility)。所谓原发性不孕症就是指从来没有怀孕过的病人，称为原发性不孕症；而继发性不孕症就是指过去曾经怀孕过，但是结果是流产，子宫外孕、死胎、死产，或是正常生产之后，而再也没有怀孕的病人，都称为继发性不孕症。

踏入这个圈子后，我才发现好多姐妹们都比我坚强，勇敢和更加努力，有些经历了7-8次的IVF 疗程，2-3次的流产事故，花了大笔的积蓄只为了生下一个健康的宝宝。

我十分可以理解不易受孕的女性往往为生育问题而整日忧心忡忡，心情随着每月的月经来潮而跌入低谷，看到别人或亲友怀孕，享受当妈妈的甜蜜滋味，有些还说是意外怀孕的，自己就会莫名奇妙的变得很沮丧，甚至开始埋怨自己的肚皮不争气。长期累计的压力很容易造成忧郁症，忧虑过多，反而降低受孕几率。如果身边的人对你心理和情绪上造成了极大的压力和反感，那么请暂时远离他们吧！

如果你看到这里，我也谢谢你的耐心，希望你对 “生殖医学” “不孕不育” ”试管宝宝” “人工受孕” 这些字眼不要有太多的避讳。如果你是家婆，岳母，七大姑八大姨，或是同事，闺蜜，千万千万不要追问身边已婚女性 “什么时候要生？” ，“什么时候要生二胎/三胎/收工？”，也不要给一堆不正确的助孕资讯，推销一些不需要又昂贵的保健品。如果一对夫妻在无避孕的情况下已经尝试12个月或更长的时间，我强烈建议你们尽早咨询妇科或助孕科进行生育评估检验，一定要相信科学，相信你的医生。

最后，姐妹们，如果你有任何关于不孕症饮食，试管婴儿，流产，怀孕，孕期保健品等问题，请留言。 在接下来的一段时间内，我将做更多的这些帖子和更新，因此请务必继续关注我的文章。

Have you or someone you known struggled with miscarriage or infertility? Let’s keep the comments respectful and support one another here!

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Does My Child Need to Take Probiotics?

by with No Comment Child & Family NutritionDigestive HealthInfant NutritionSupplementationToddler Nutrition

You’ve probably heard that probiotics are important for good digestion and immune function. But does that mean you should supplement your child’s diet with them? Which probiotic strains offer the best support for your child’s digestive system or help relieve constipation?

 

WHAT ARE PROBIOTICS?

Probiotics are a combination of live beneficial bacteria (and/or yeasts) that naturally live in our bodies. We all carry a mix of good and bad bacteria. Probiotics exist naturally in certain foods and are also available as dietary supplements in powder, capsule, and tablet forms. According to the World Health Organization and the Food and Agriculture Organization of the United Nations, probiotics are “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host.”

So we know that probiotics are good for us. Should we rely on probiotic-rich foods alone? Do we need supplements? If so, which strain? At what dose? For how long? And for what specific benefit?

 

THE PROBIOTIC STRAINS ARE KEY 

When we say “probiotics,” we’re not talking about a single type. There are many different species,  and within each species, multiple strains. The strain level is crucial because different strains serve different purposes.

GENUS: A genus is a biological classification of living organisms. The term comes from the Latin genus meaning group. A genus contains one or more species. Examples of common probiotic genera include Bifidobacterium and Lactobacillus.

SPECIES: ‘Species’ refers to a type of microorganism existing within a genus or family. For example, acidophilus is the name of a species within the Lactobacillus genus.

STRAIN: A probiotic ‘strain’ is a genetic variant or subtype of a species. Different probiotic supplements contain different strains, which may be classified under the same species and genus. However, one acidophilus is not equal to another acidophilus. It’s the strain level that matters when you choose a probiotic in order to help with a specific health condition. If you neglect to pay attention to the specific strains in the kids probiotic, you may not be able to gain the health benefits you desire, and as such, be wasting your money.

Different supplements contain different strains. Two products may both include Lactobacillus acidophilus, but only specific strains are proven to benefit particular health conditions. If you don’t pay attention to the strain, you might not get the benefits you’re expecting and end up wasting money.

Bifidobacterium longum BB536;

Bifidobacterium breve M-16V;

Bifidobacterium infantis M63;

Lactobacillus acidophilus LAC 361;

Galacto-oligo saccharides (GOS)

THE NUMBERS OF THE PROBIOTIC STRAINS MATTER

Probiotics are measured in colony forming units (CFUs), which indicate the number of viable (live and active) bacteria cells. Product labels may express amounts as, for example, 1 x 109 for 1 billion CFU or 1 x 1010 for 10 billion CFU. Most probiotic supplements contain 1 to 10 billion CFU per dose, but some products contain up to 50 billion CFU or more. However, a higher CFU count doesn’t necessarily lead to better health effects.

Manufactures should list storage conditions on the label. Stability testing is typically conducted under the same temperature conditions as the recommended for storage.  Because probiotics must be consumed alive to provide health benefits and some bacteria can die over time, look for products that specify the number of CFUs at the end of the product’s shelf life (the expiry date), not just at the time of manufacture.

When choosing a probiotic for your child, the amount of each strain matters. Most research suggests that a minimum of 1 billion CFU (1 x 109) per strain is needed to produce a therapeutic effect. So you need to think in billions when selecting a supplement.

Some children’s gummies and probiotics snack bars may not contain enough CFUs to be therapeutically effective.

For infants, the dosage should be 5-10 billion CFU per day. For children over the age of 2, the desired dosage should be 10-25 billion CFU per day.

CONSIDERING YOUR CHILD’S AGE IS IMPORTANT

Infants have less diverse gut microbiome compared to older children and adults. It’s estimated that young babies have approximately 10 different bacterial species, whereas adults may have over 1000 species. In babies born vaginally, microbiome is predominantly made up of Bifidobacterium species, whereas in adults, it is more commonly  dominated by Lactobacillus species.

After the age of 2, a child’s gut microbiome starts to resemble that of an adult and becomes significantly more stable.

As a result, for children over the age of 2, you’ll want a probiotic supplement with a higher dosage of beneficial bacteria. At this stage, you don’t necessarily need to stick to kids-specific products and brands, many adult formulations may be appropriate.

If you’re breastfeeding, it’s also worth assessing your own gut health, as beneficial bacteria can be transferred from your intestines to your baby through breastmilk.

 

WHEN MIGHT YOUR CHILD NEED A PROBIOTIC SUPPLEMENT?

 Probiotics can be helpful in certain situations. Here’s what research shows:

Antibiotic-Associated Diarrhea

Up to 40% of children on antibiotics experience diarrhea (here, here). Antibiotics wipe out both good and bad bacteria in the gut. Probiotic strains like Lactobacillus rhamnosus GG and Saccharomyces boulardii can help restore balance and reduce the risk of diarrhea. Take the probiotic a few hours after the antibiotic dose to avoid inactivation.

Acute gastroenteritis (not related to antibiotic use)

If your child gets a stomach bug, these same strains—L. rhamnosus GG and S. boulardii—may shorten the duration of diarrhea by about one day (here).

Constipation

The evidence is still limited. Some studies show slight improvements in stool frequency, but there is no strong consensus on which strain or dose is most effective (here).

Atopic Dermatitis / Eczema

Several studies and reviews have looked at the role of probiotics in preventing and treating atopic dermatitis. While some of the research has provided mixed reviews, many studies have found that infant at risk for developing eczema have benefited from taking probiotics with the  Lactobacillus rhamnosus GG strain (here). Other beneficial strains include Bifidobacterium lactis UABLA-12 and Lactobacillus acidophilus DDS-1 (here)

And, the protective effect of probiotics may be strongest when given to pregnant mothers.  Three studies using Lactobacillus rhamnosus GG given to pregnant women for 2-4 weeks before labour and continued treatment post-birth found significantly lower rates of eczema/atopic dermatitis during the first 2 years of life (here, here, here) so we probably want to make sure that moms are getting a good supply of these beneficial bacteria before baby is even born.

A New Zealand study was the first randomised controlled trial to show that Lactobacillus rhamnosus HN001 can be beneficial for childhood eczema. The key is to start supplementation with rhamnosus HN001 early from 35 weeks of pregnancy until two years of age (here).

The health benefits of rhamnosus HN001 include reduced risk of childhood eczema by 44% up to age 6. The protection continued even after supplementation was stopped by the child’s 2nd birthday. This confirms that not all probiotics are the same. Rhamnosus HN001 is also thought to reduce symptoms of postpartum depression in women.

Functional Gastrointestinal Disorders

A recent systematic review focused on probiotics and functional gastrointestinal disorders in children birth – 18 years yielded no studies on infants and young children (birth – 2 years old). While their search included studies on probiotics that reported on gastrointestinal outcomes such as abdominal pain, stool frequency, stool consistency and bloating/flatulence, these studies did not include infants and young children. Therefore, as evidence is not available for infants and young children, no probiotics can be recommended to improve functional gastrointestinal disorders for those 2 years and under at this time (here).

Infantile Colic

Colic is difficult to understand, and even more difficult to treat.  As a parent who has lived through colic, I know and understand the desperation in trying to find a solution. Research shows that a specific bacterial strain called Lactobacillus reuteri 17938 has been associated with decreased crying spells in exclusively breastfed infants during the first three months of life (here, here, here, here. here, here).

Immune Health 

As parents, we’re always looking for ways to reduce the number of colds and flus that find their way into our lives! Maintaining a healthy population of gut bacteria, along with a healthy diet and lifestyle may be key to staying healthy during cold and flu season. A recent meta-analysis of probiotic use (specifically Lactobacillus and Bifidobacterium strains) in children and adults revealed significantly fewer numbers of days of illness per person, shorter illness episodes by almost a day, and fewer numbers of days absent from day care/school/work (here).

 

WHAT TO LOOK FOR IN PROBIOTIC SUPPLEMENTS 

If you’ve decided to buy a probiotic supplement for your children, prepare yourself for a dizzying array of options. The particular brand you purchase doesn’t matter as much as a few key criteria, which I’ve outlined for you below:

  • “Live, active cultures.” Make sure the supplement you choose contains this actual phrase right on the bottle, so you can be sure you’re getting an effective product. Some brands of probiotic supplements even come refrigerated to help protect these living cells.
  • High bacteria count. The concentration of bacteria in probiotic supplements is measured in CFUs (that’s “colony forming units.”) Look for a probiotic supplement that has, at a minimum, 1 billion CFUs (on the “expiration” or “use by” date on the product label).
  • Multiple strains. Balance matters! Different strains of probiotics can have different health effects. A supplement with eight or ten different strains of bacteria may help to diversify the bacteria that make up your kids’ microbiome.
  • Enteric coating. This refers to a hard coating on the outside of the pill that lets it survive the journey through the harsh, acidic stomach. An enteric coating means that bacteria are released in the intestines, where they can thrive.

FOODS CONTAINING PROBIOTICS

Many parents forget to consider probiotic strains that can be included in the child’s diet to enhance gut bacteria diversity. If you’re choosing a probiotic supplement to provide general support for your child’s immune health or digestive function, please focusing on foods first.

Common foods containing probiotics include yogurt, Kefir, kimchi, sourdough bread, sauerkraut, kombucha, miso, tempeh, fermented vegetables.

YOGURT VS PROBIOTIC 

The most common probiotic strains found in yogurt are L. bulgaricus and S. thermophilus. Yogurts labeled with “live active cultures” must contain at least 100 million live active bacteria per gram to meet the standard.

When introducing probiotic foods to your child, the key is to start low and go slow. This helps minimize potential side effects such as bloating and gas. Start with just half a teaspoon every second day and slowly build up from there. To support a healthy gut and encourage microbial diversity, aim to include a variety of probiotic-rich foods in your child’s diet and don’t forget about prebiotics, the fibers that feed those beneficial bacteria.

BOTTOM LINE

There is a growing body of anecdotal evidence supporting the use of probiotics in children. However, the health benefits of probiotics are strain-specific, a strain that may help with one condition could be ineffective for another. Because of this, and the limited amount of high quality research, there is no clear recommendation on whether children should take probiotics routinely, especially for long periods of time.

It’s also important to understand that probiotics are not without risks. Children with compromised immune systems may be at risk for infection, and others may experience side effects such as gas and bloating. In very ill infants, probiotics could potentially lead to serious complications. Always consult your child’s pediatrician before starting any probiotic supplement.

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.

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Does My Child Need to Take Multivitamins?

by with No Comment Child & Family NutritionSupplementationToddler Nutrition

If your toddler has a meltdown at the thought of eating more than two bites of something green, you’re not alone. Getting children to eat a well-balanced diet isn’t always easy. This leads many parents to wonder: Should I start giving my child vitamins? At what age? Which brand? What should I look for in a multivitamin?

The good news is, for most healthy children, vitamins are usually unnecessary.

According to the American Academy of Pediatrics, children who eat a normal, well-rounded diet typically do not need vitamin supplements. But we all know that reality can look very different. After dinner, your toddler’s plate may resemble a crime scene. Did they actually consume any of that broccoli, or did it just get pushed around?

 

REASONS TO GIVE YOUR CHILD A MULTIVITAMIN 

It’s common for parents to worry about whether their child is getting enough nutrients to achieve good health, their first route will immediately jump to a multivitamin. In my Peaceful Mealtimes online course, I teach parents how to evaluate their child’s diet, and many are surprised to find their “picky eater” is actually getting more variety than they initially thought. However, some children may benefits from supplementation under certain circumstances, especially if they:

  • are extremely picky and struggle to eat a variety diet
  • have food allergies or intolerances
  • follow a vegetarian or vegan diet
  • show abnormal growth patterns
  • have medical or digestive conditions that impair nutrient absorption, such as celiac disease, cystic fibrosis, inflammatory bowel disease (IBD) or cancer

If your picky eater has a poor appetite or has been omitting entire food groups for a prolonged period, you will likely need to temporarily support them with a multivitamin. Picky eaters are often at risk of low intake of nutrients such as zinc and iron.

Children who follow vegetarian or vegan diets may require specific supplement (e.g.,  vitamin B12, which is found only in animal foods). Similarly, for children who don’t consume seafood, I often recommend supplementation with Omega-3 fatty acids (DHA and EPA). If a child is allergic to dairy or does not consume dairy products, I would typically recommend vitamin D and calcium supplements.

If your child is experiencing declining or stagnant growth on their growth curve, it may indicate that they are not properly absorbing nutrients, possibly  due to medical or digestive problems, or that their appetite is low due to a nutrient deficiency (e.g., iron deficiency anemia).

Children with inflammatory bowel disease or celiac disease may have difficulty absorbing several vitamins and minerals, including vitamin D, calcium, iron and zinc. These conditions can damage parts of the gut responsible for nutrient absorption. Additionally, children with cystic fibrosis may struggle to absorb fat and, as a result, may not absorb fat-soluble vitamins (A, D, E, and K). Children taking certain medications that interfere with nutrient absorption may also need supplement.

Giving a multivitamin that includes a wide range of vitamins and minerals without targeting your child’s specific needs is like shooting in the dark. You’re unlikely to see good results! Instead, work with a dietitian to analyze your child’s diet and identify any specific nutrient gaps. Targeted supplementation based on individual needs is far more effective.

 

THE RISK OF TAKING TOO MUCH SUPPLEMENT 

MegaDose 

Supplement marketing often targets parents and even children, pushing the idea that multivitamins are a must for every picky eater. This type of marketing can be very misleading, especially if your child is generally healthy and eats a reasonably varied diet as is. As a result, parents may end up spending money on something unnecessary, or risking giving their child too many vitamins. Overconsumption of certain vitamins, particularly the fat-soluble ones (A, D, E and K), can lead to toxicity over time. Be very careful with multivitamins that provide 100% or more of the recommended daily intake of any nutrient, even if the ingredients list appears ok.

Not a magic pill 

Some parents use multivitamins as an “insurance policy”, to feel better about their child eating. But, supplements can mask underlying nutrition concerns, such as consistently poor dietary variety. No multivitamin can replace the long-term benefits of a balanced, whole-food-based diet.

Avoid artificial colours and sugar 

Many popular multivitamins are full of sugar, dyes and fillers. Look for options without artificial sweeteners like high fructose corn syrup or Aspartame. Also, note that sugary gummies can contribute to dental cavities.

Never refer to vitamins as ‘candy’

Many children’s vitamins look and taste like candy. Always keep them out of reach and never refer to them as candy. Accidental overconsumption can be dangerous. Stick to the dosage instructions, usually one per day.

 

WHAT AGE SHOULD A CHILD START TAKING VITAMINS? 

I know we all want to do the best for our children but if your child eats a healthy, well-balanced diet, they don’t need multivitamins. However, infants have different nutrient needs than older children and may require supplements. For example, breastfed babies should receive a Vitamin D supplement, as breastmilk alone may not provide adequate amounts.

It’s important to speak with your pediatrician or dietitian before starting any supplement.

WHAT TO LOOK FOR? 

In Malaysia, the National Pharmaceutical Regulatory Agency (NPRA) under the Ministry of Health Malaysia (MOH) is the only agency to regulate the registration, licensing, surveillance and quality control as well as Good Manufacturing Practice of supplements.

Every health supplement registered with MOH has two key features. The first key feature is the MAL Registration Number that starts with “MAL”, followed by 8 digits, and ends with the and “N” (e.g., MAL 12345678N). The letter “N” at the end of the MAL registration number indicates the type of product, which in this case stands for “supplements”.

The second key feature of registered health supplements is the presence of a MOH Hologram sticker on the packaging. This hologram sticker ensures authenticity and product safety.

When selecting a child’s multivitamin, you’ll be looking two options: with and without iron. The choice is yours based on your child’s diet and the perspective of their pediatrician. Most vitamins are water-soluble, which means that your child will simply eliminate whatever they don’t need in their urine. But vitamins A, D, E, and K are stored in the body’s fat. This means that there is a risk of toxicity (levels higher than the recommended). So, when buying a multivitamin, be sure to look at the label. You want to avoid multivitamins that contain more than 100% of the daily value of vitamin (especially of the fat-soluble ones).

Try your best to avoid any artificial colours and dyes that come in a multivitamin or supplement. Be aware that again, there are a lot of multivitamins that are very much like candy and full of sugar.

Third-Party Testing

Not all supplements are created equal. Supplements that undergo third-party testing are sent to independent lab to verify that they contain what they claim and are free from common high-risk contaminants. However, it’s important to understand the limitations of third-party testing:

  1. Third-party testing does not determine whether a product is effective or safe for everyone, nor does it guarantee that the supplement won’t interact with other supplements or medications.
  2. Not all third-party testing is created equal. Some supplement companies may pay for certification with minimal or no actual testing.
  3. The most trusted third-party certifications include ConsumerLab, NSF International, and USP (United States Pharmacopeia). These certifications are difficult and costly to obtain, which is why many companies choose not to pursue them.
  4. Products tested by these organization often more expensive, as companies may raise prices to offset the certification costs.
  5. Just because a supplement doesn’t have one of these certifications doesn’t necessarily mean it’s a poor-quality product. It’s still wise to research the manufacturer’s reputation. If in doubt, contact the company or the lab they use to inquire about their testing procedures, so you can make an informed decision.

Form

Multivitamins come in a variety of forms:

  • Chewable tables 
  • Gummies
  • Liquid
  • Powdered

The best option depends on what your child accepts most easily, as well as the nutrient content of each form.

For example, many children enjoy chewable gummies, however gummies typically contain more sugar than other versions. That said, if gummies are the only form your child will consistently take, it may still be a worthwhile option. Just keep in mind that gummy vitamins usually don’t contain much (or any) iron, and they can pose a choking risk for children under 4 years old. If you choose gummies for a younger child, cut them into smaller pieces to make them safer.

Chewable tablets tend to have higher levels of iron, making them a better choice if iron is a key nutrient concern for your child.

Liquid and powdered supplements are available in a variety of flavours, and many parents find that mixing them into a smoothie or yogurt is an easy and effective way to serve them. The key is consistency, making sure your child takes the mixture daily!

Of course, you’ll also want to consider factors like cost, availability and convenience. Each family’s situation is different, so weigh the pros and cons and consult a doctor or dietitian for personalised advice.

 

BOTTOM LINE

For most healthy toddlers, a balanced diet is the best source of nutrients. Whole foods offer more bioavailable and better-absorbed nutrients than supplements. If your child is growing well, eats a decent variety of food, and has no diagnosed health or nutritional issues, they likely do not need a multivitamin. However, if you’re concerned about your child’s eating habits or nutrient intake, I recommend speaking with your doctor or a dietitian.

If you have a picky eater or feel overwhelmed trying to feed your toddler well,  check out my Peaceful Mealtimes course online course. You will learn practical ways to introduce more fresh, whole foods into your child’s diet, so you may not have to rely on a multivitamin for long.

For more tips and tricks when it comes to feeding your family, head over to Peaceful Mealtimes online course to learn more.