Child & Family Nutrition Archives - Page 4 of 4

Milk Matters for Children: When, What and How Much?

May 10, 2017

by Ye Ting Tan with No Comment Child & Family Nutrition Infant Nutrition Toddler Nutrition

Milk is a hot topic in parent’s group. When, how much and what type/kind of milk to choose? Due to more and more organic stores in the market, the confusing messages and nutrition myths, more parents are turning to milk alternatives (plant-based beverages) to fulfil their little one’s milk needs.

Unfortunately, the plant-based beverages (fortified or non-fortified) don’t provide enough nutrition. (here)

Your children are growing right before your eyes! Children more than double their height and weight between the ages of 2 and 12. During this time, a base is built for a body that will last them a lifetime.

Milk provides the building blocks children need – 16 essential nutrients, plus energy for fuel to grow. (here)

WHAT YOU NEED TO KNOW ABOUT YOUR MILK CHOICES

Children under 12 months of age should have breast milk or formula for their main drinks.

Milk is key not only for energy as well as tissue growth, but also for building strong bones and teeth and regulating muscle control.

It is safe to introduce cow’s milk between the ages of 9-12 months of age, however, I recommend waiting until 12 months. There are a few reasons why you should think twice about introducing fresh milk too early.

The proteins present in fresh milk are hard for babies to tolerate and digest. (WHO, 2009)
Milk contains too much sodium, potassium and chloride which can tax your baby’s kidney. (WHO, 2009)
Milk is lack of important vitamins and minerals such as iron, Vitamin E and Zinc.
Higher risk for iron deficiency anemia and if your baby drinks too much cow’s milk, he or she is also at a risk for internal bleeding.

That being said, once your baby reaches about 12 months, his/her digestive tract is mature enough to handle milk and reap the many nutrition benefits from it. It’s a nutrition powerhouse full of protein, carbohydrates, Calcium, Vitamin D and Vitamin A.

When they turn one, I encourage moms to continue breastfeeding if they are already, even with the introduction of cow’s milk. If your baby is on formula, you can slowly transition to homogenized cow’s milk (assuming your baby does not have a milk allergy) at one year. Don’t rush, because your baby’s digestive system needs time to adapt to the new proteins and other nutrients present in fluid milk. Start with 1-2 tbsp a day and slowly increase this amount until fully transitioned. Again, you can continue breastfeed as long as possible.

Recommendations:

1-2 years old: 2-3 cups (16-24 oz) of milk per day.

2-8 years old: 2 cups (16 oz) of milk per day.

(Lower-fat milk or fortified plant-based beverages can be offered).

9-18 years old: at least 2 cups (16 oz) of milk per day.

P/S: If your baby is still breastfeeding, he/she may not need as much.

PLANT-BASED BEVERAGES

Plant-based beverages are made from plant foods such as soy, rice, almond, coconut, oat, potato and hemp. They look like milk and are often called “milks” but may not have the same nutrition as cow’s milk.

Plant-based beverages are often lower in protein and energy than cow’s milk. They may also be lower in important nutrient like Calcium and Vitamin D, especially if homemade. Also, these milks often do not contain enough calories, protein or fat for a growing toddler. Some plant-based beverages can also be high in certain minerals that can be harmful if a child drink too much.

Added sugar: Oligosaccharide and cane sugar

1 servings of Pink Lady drink contains 70.5 mg of sodium and 3.8 g (approx. 1 tsp) of sugar.

Read the Nutrition Facts table on each beverage package. Some beverages are fortified (have nutrients added) and some aren’t. The nutrients in plant-based beverages can vary.

CHOOSE A PLANT-BASED BEVERAGES FOR YOUR 2 YEARS OLD

Plant-based beverages are not recommended for children under age 2 because they can be low in important nutrients like fat, protein and calories. If offering a plant-based beverage instead of cow’s milk to a child age 2 and older, choose a product that:

is labelled as fortified or enriched (example: fortified with Calcium or Vitamin D) – Most milks in Malaysia don’t fortified with Calcium or Vitamin D.
provides at least 6 g of protein per 1 cup (250mL)
provides at least 30% Daily Value of Calcium and Vitamin D per 1 cup (250 mL)
contain less than 10 g of sugar per 1 cup (250mL)

Since plant-based beverages are generally low in protein, children 2 years of age and older who are drinking a plant-based beverages as their main milk sources should be offered a variety of lean meats, poultry, fish, beans and lentils, eggs, tofu and nuts to ensure adequate intake of protein.

What types of milk are appropriate for a child under 2 years of age who is allergic to cow/goat’s milk or lactose intolerance

If your child is allergic to milk or lactose intolerant, you may want to consider keeping him/her on formula or a follow-up formula until the age of 2 to ensure proper nutrition. There are soy varieties or hydrolyzed protein/hypoallergenic varieties out there for babies with allergies or intolerances. You should offer the same quantity as you would cow’s milk. Check with your child’s doctor or a dietitian.

In Malaysia, there are 3 main companies providing infant formula – Nestle, Abbott, MeadJohnson.

Do you have a child who has milk allergy or lactose intolerance? You not sure what type/kind of milk to choose for your toddler? Contact Me about starting a nutritional counselling program.

Picky Eating: How to End Mealtime Struggle

March 15, 2017

by Ye Ting Tan with No Comment Child & Family Nutrition Picky Eating Toddler Nutrition

Do you get frustrated after you make a large family meal and your children only take two bites? Or maybe you wish that there were some go-to meals that everyone could agree upon. The good news is that taking control of the dinner hour is within your reach.

So many of my clients face this problem – and maybe you do too.

My daughter complains about what’s served, so I make her a peanut butter sandwich because I know she’ll eat it.

My son refuses to eat, so I give in and stop asking him to come to the table for meals.

My son whines about feeling hungry before bed (even though he didn’t eat at dinnertime an hour earlier) so I give him yogurt and a banana in hopes that he’ll go to bed peacefully and not wake up hungry.

Whether you are dealing with picky eaters, rushed mealtime or other dinner table dilemmas. I have strategies!!

You work full-time and prepares dinner for your family every night. You often struggles to get a meal on the table that everyone will enjoy. One child is quite picky, one doesn’t want to try new things, and no one agrees on the foods they like.

PROBLEM

Your struggle is making family meals that everyone will enjoy.

THE FACT

After reading 20 Strategies to Raise a Mindful Little Eater. You realize that parents and children have different jobs at mealtime (Divisions of Responsibility in Feeding) – and you had never thought about it that way before. Your job is to decide which nourishing foods are served, when dinner time is, and where they will eat. It’s then up to your children to decide what and how much to eat from what you offer.

You are relieved to have a framework for a plan, with separate roles for yourself and your kids. You quickly realize that some small changes can make mealtime more enjoyable for everyone. Now that you knows that it’s your children’s job to determine how much to eat, you can stop telling them to “eat everything on their plate.” Plus, you now know not to let the kids decide where they want to eat, which is often in front of the TV/IPad instead of at the dinner table.

As you continue to read information about picky eating, you learn that children take their nutrition cues from their parents, so you can set a good example by preparing and eating nourishing choices. You admit to yourself that you rarely eat vegetables, and realize your kids won’t either! You also finds out that:

Children’s appetites can be erratic and that’s OKAY! The amount you children eat will vary each day depending on their appetite, fatigue, activity level and if they are having a growth spurt. It doesn’t always mean they are picky – it is normal.
Getting your children involved with grocery shopping, prepping and cooking food can help them become more interested in trying new things.
It can take 8-15 tastes or more before a child will like a new food.
Children may seem picky or may eat a small amount because they are simply not hungry at meal times.
It’s best to offer three meals and two or three snacks at regular times each day and to make sure your children aren’t grazing throughout the day. This will help the children come to the table hungry since even a little milk, juice or few crackers can spoil a child’s appetite.

SEEK SUPPORT

You feel better knowing that you are not the only mom with picky eaters. You learn that up to 35 percent of toddlers and preschools are described by their parents as picky eaters too. If you are 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 you are worried that your child is not getting enough of the nutrients they need, I can help! Check out my Peaceful Mealtimes online course.

Getting your children more involved in shopping, prepping and cooking meals will make them more interested in family meals! Start by cooking these five kid-friendly recipes:

Don’t forget to read this blogpost: 20 Strategies to Raise a Mindful Little Eater.

Do you have a picky eater at home? You need more meal ideas? You need some strategies to deal with your little picky eater at home. Contact Me about starting a nutritional counselling program.

Adapted from the Dietitians of Canada’s Nutrition Month campaign materials.

20 Strategies to Raise a Mindful Little Eater

September 4, 2016

by Ye Ting Tan with 4 Comments Child & Family Nutrition Picky Eating Toddler Nutrition

After being a new-mom, I continue to research articles, support groups, books on breastfeeding, solid foods, baby led weaning, picky eaters, etc. After reading some paediatric dietitians’ blogs, I found my guru – Ellyn Satter. I don’t have to spend hours searching the web for the perfect healthy recipes that my son will actually eat. (Although I still cook yummy foods for him every single meal).

As a dietitian and a first-time mom, I am attempting to raise a confident, independent, healthy and mindful eater. I’ve discovered the challenges of picky eating (in my personal life and my practice), this sounds like every children can be a picky eater, at some point. However, the more articles or resources I’ve read, the more knowledgable and confident that I am now. Aiden is neither a good eater nor picky eater. He has good and bad days. Following the Division of Responsibility for Feeding, I have successfully made it through the first 2 years (fingers crossed !!).

WHAT IS DIVISION OF RESPONSIBILITY FOR FEEDING

The “Feeding Relationship” is a concept developed by Ellyn Satter, a dietitian and social worker. There are separate roles in feeding for the parent and for the child, and if these roles are respected, then the child will be less likely to be picky and will grow up having a healthy relationship with food. Also, it can help to decrease the power struggles and stress around your family table by respecting this relationship.

Successful feeding is when your child willingly participate in family meals, enjoys herself and feel safe and confident enough to taste and eat foods of her choosing (that you’ve provided) in amounts that feel right to her.

PARENT’S FEEDING RESPONSIBILITIES

Three things that you can control as a parent:

What is served – Offer foods from each food group at every meal if you can – Vegetables or Fruit, a Grain Product, and a Meat & Meat Alternatives, and/or Milk & Milk Alternatives.

Example: 1/2 banana, a slice of whole grain bread with peanut butter, and 1/2 glass of milk.

When it is served – By 1 year, the child should be offered three regular meals and 2 or 3 snacks per day. Do not feed constantly throughout the day or the child will not build up an appetite for the next meal. Parent often try to get their child to eat more or increase in weight. However, it backfires, as research has shown grazers can eat up to 50% less than those with more regular meal and snack times.

Where it is served – The child should be eating at the table with the family, with no distraction like TV, IPad, IPhone, etc.

CHILD’S FEEDING RESPONSIBILITIES

The child’s role is to choose whether or not to eat, what to eat from what’s provided, and how much to eat.

Whether If – You child may choose to eat nothing at all (Yay, sound very familiar). If they refuse a new food or a meal, that is ok. Offer a new food with a familiar food so they do have something to eat. Try new food again in a few days. It might take up to 15-20 tries before the baby or child will actually eat the food. Of course, you can be creative to present it in different ways – cooked, steamed, mashed, baked, fresh/raw, etc.

How Much – Allow the baby or child to take the lead role in eating, let them play with the food (it doesn’t matter you are using BLW or TW). If they are finished do not force them to eat more. Many parents are concerned their child is not eating enough, however, child are good at regulating their appetites and will not starve themselves. They may eat a lot one day and almost nothing the next and that is ok. This way you do not set up power struggles with eating.

It is absolutely not your job to make your child eat.

SIMPLE & EFFECTIVE STRATEGIES THAT YOU CAN TRY AT HOME

Here are some simple, yet so effective strategies that you can try at home.

Offer balanced, nutritious, appealing meals and snacks

These will cover your child’s nutrient requirements and allow him to see many different foods, which is part of readying him to try new foods. If you do your job at FEEDING, your child will do their job at EATING.

Don’t cater to your child’s preferences

Don’t narrow the menu to what your child will eat because you will get stuck doing this, perhaps for many years! Offer at least one “safe” food per meal. A safe food is a food like rice, vegetables, or fruit, which you know your child will likely be fine with eating if they are hungry.

Keep the food variety coming, even if your child rejects it

Studies show it takes children 6 to 15 food exposure before they will try to like a food. Don’t get disappointed. Eventually he may touch it, next time he may lick it, next time he may chew a bit and spit it out…. learning to eat can be a slow process.

Don’t be a sneaky chef

Hiding food in other foods can build mistrust in children. Be honest about what is in the food your child eats.

Keep a smile on your face and a positive attitude

Even when you are frustrated, overwhelmed or angry, your young child should not see you lose your temper, as this may change the situation and tempt your toddler to keep getting negative reactions out of you. It may take at least a few weeks to few months to practice the Feeding Relationship.

Don’t show your emotions

No anger, frustration, or annoyance! Your goal is to be steady and not react to any antics.

Be role model

Parents are the greatest role models, so you should eat a variety. Children offered variety will eat a variety

Don’t give negative comment

It can be very harmful. We all have personal tastes (yes, I understand we have some foods that we dislike too). Personal tastes can be influenced (positively or negatively) by parent’s food preferences. So, stop making negative comment about meals at the table. I am sure kids will say “it’s gross or yucky” after hearing someone comment about the foods. Soon, they will refuse to eat it, despite whether they’d been eating it before the negative comment.

Stay on a meal and snack schedule

Staying on a schedule means your child will have plenty of opportunities to eat during the day, which takes the pressure off when he skips a meal. When your child choose to eat very little or not to eat at all at a scheduled opportunity to eat, allow him to be done and remind him when the next opportunity to eat is scheduled.

Don’t push your child to eat more

Pushing extra bites or sips often backfires, especially when children are picky. Nag him to try something new? The effect is the same as pushing for more eating. I personally discourage the “1, 2, or 3 bite” rule. It may work for some children, but for the majority (who are super taster and stubborn). If your child knows they are going to be forced to try a bite of a new food, they already dislike it before they try it. Making them try a bite will not likely get a “I like it” reaction, whether they truly do like it or not, as now it has become a battle field. We also want children to make healthy food choices when they are older and make these decisions on their own. If they were forced to eat certain foods when younger, they are more likely to develop a dislike for that food throughout life.

Try new foods

Eventually, your child will probably be excited about new and different foods, especially if he is conditioned to see a variety of unfamiliar foods early on. Offer food in another form. For example: boiled egg, scrambled egg, fried egg, etc. Be patient and give your child time to explore, touch and taste his food.

Don’t reward your child with dessert or other food

While this can be an effective tactic in getting your child to eat couple more bites or something you want him to, over time, research has shown it doesn’t help children like food. From my personal experience, the more random, the better. I try to stay neutral when it comes to treat foods.

Require your child stay at the table during meals

He doesn’t have to eat. While your child doesn’t have to eat, he does need to learn to politely stay at the table while others are finishing their meal. Children eat better when they stop and sit down to eat. By setting some appropriate mealtime rules with your kids, you can gain control over mealtimes (what’s where’s and when’s feeding) and allow your kids to take care of the rest (whether and how much they eat).

Don’t punish, discipline, shame him for not eating

Children can develop a negative association with eating and food when they are punished for not eating certain foods, or enough. This will not only create negative associations with food, but will also hurt his self-esteem, perhaps encourage long-term picky eating, binge eating or other forms of disordered eating.

Allow self-feeding, even if it is messy

This is the control your child wants. Trust him. The goal is to raise a healthy confident eater. We want our kids to feel capable at the table – grow to be independent eaters, able to choose from the foods provided and how much of each to eat. Also, we want them to develop the fine-motor skill necessary to eat independently.

No force-feeding

This takes all control away from your child, and most children do not respond well to force-feeding or parents taking control of feeding, especially as they get older. If we spoon/force-feeding them, they will not feel capable, nor develop the skills to feed themselves at the appropriate pace.

Invite your child in the selection and preparation of the food

Some kids feel like they have no enough say. Kid might feel bored or no control over what they’re fed, or perhaps they don’t like the way that their foods are placed on their plate or lunch box. I know it is important to set mealtime boundaries and meet your responsibility of – what, where and when, but it is ok to let your kids be part of the “what’s”. I realize that involving kids in meal planning (structure choices), preparing(washing), and cooking (mix ingredients) can make the process longer and maybe a bit more frustrating (kitchen is messy!!). But the benefits are huge and it’s worth it.

Don’t offer large portions

Serve smaller amounts of food. Large amounts can be overwhelming.

Reassure your child

If your child decides not to eat, let him know when the next meal or snack is scheduled.

Don’t label your child “Picky”

Children live up to expectations. If you label your child picky, he will be more likely to live up to it. There are no “good” or “bad” eaters. A good eater eats when they’re hungry, and does not finish his plate for praise, we would like them to continue practicing this mindful eating as long as possible.

REMEMBER

It is absolutely not your job to make your child eat.

For more information:

visit Ellyn Satter Institute or read one of Ellyn’s books:

Secrets to Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook
Child of Mine: Feeding with Love and Good Sense
Your Child’s Weight: Helping Without Harming

Please comment below and let me know if you have any questions about picky eating and which strategies work best for you and your family?

can-give-finger-foods-baby-doesnt-teeth-yet-photo

Can I Give Finger Foods If My Baby Doesn’t Have Teeth Yet?

June 1, 2016

by Ye Ting Tan with No Comment Baby Led Weaning Child & Family Nutrition Infant Nutrition

According to the new infant feeding guidelines, it is now recommended that babies be introduced to a variety of textures within the first few months of starting solids. Spoon-feeding purees is no longer the one and only way. In fact, you can jump right in with soft finger foods (Baby Led Weaning) if you feel comfortable with it.

As a dietitian, I’m often asked this question:

My baby doesn’t have any teeth yet? Can I give him finger foods?

ANSWER: YES !!!

BABIES CHEW WITH THEIR GUMS

Babies can enjoy soft finger foods before they have teeth. They can mash foods into smaller pieces using their gums.

Finger foods are small pieces of food that your baby can pick up and eat easily. Introducing finger foods early, soon after starting solids, helps your baby get used to different food textures, improve coordination and encourages self-feeding. These are important feeding skills. Most babies are ready for finger foods by 6-7 months, some babies start right at 6 months (BLW). Many won’t have teeth (or very many teeth) by this age.

You baby is likely ready for finger foods when you see the following:

He can sit upright with minimal support.
He is very interested in watching people eat and the food on your plate.
He can eat thicker purees (the consistency of mashed potatoes).
He can bring food to his mouth using his hand.

SAFE FINGER FOOD IDEAS FOR BABIES

Choose soft foods that baby can grasp easily with fingers or hands. Offer your baby different kinds of finger foods from all 4 food groups.

Vegetables (soft cooked) and Fruits

Soft cooked vegetable (grating, cut into bite-sized pieces or strips): Carrot, broccoli, green beans, yam, sweet potato, potato, cauliflower, zucchini, squash
Soft, ripe, peeled fruit (grating, cut into bite-size pieces or strips): apple, pears, ripe slices of kiwi, mango, papaya, melon, cantaloupe, banana, fresh or canned unseated peaches, ripe avocado, oranges, thawed frozen fruit and berries
Seedless grapes don’t have to peel but should cut into four bite-size pieces

Grain Products

Whole wheat toast, bagels or buns (cut into strips)
Pieces of roti or tortilla
Unsweetened oat ring cereal like Cheerios
Cooked pasta
Rice balls

Milk Products

Grated or small cubes of pasteurized cheese

Meat & Meat Alternatives (soft and well cooked)

Ground meat or poultry
Small (pea sized) pieces of tender meat or poultry
Fish (de-bonded and flaked)
Quartered meatballs
Well cooked eggs (cut in to pieces)
Small cooked beans (black beans and navy beans)
Larger cooked beans (kidney beans – cut in half)
Tofu
Smooth nut or seed butter (spread thinly on a cracker or bread to make it easier to swallow)

Mealtimes will be messy and slow at first. This is part of learning how to eat.

FOODS TO AVOID

Hard and sticky foods can cause choking and should be avoided.

Whole nuts or seeds
Raisins
Popcorn
Gum
Hard candies or jellybeans

No HONEY during baby’s first year. Honey may cause botulism, a type of food poisoning, that could make your baby sick.

BOTTOM LINE

It is amazing to watch what little ones can handle with their gum. So go ahead and offer finger food versions of a wide variety of food that your family eats. I enjoy watching my boy, Aiden, discovers the amazing variety of tastes and textures that food comes in.

Are you still waiting for your baby to get a tooth? For more help with baby led weaning and how to help you baby succeed with eating, be sure to check out my 3 months TRANSFORM program.

How to Start Solid Foods

May 19, 2016

by Ye Ting Tan with No Comment Baby Led Weaning Child & Family Nutrition Infant Nutrition Toddler Nutrition

Last blog we talked about When to Introduce Your Baby Solid Foods. It is important that parents wait until their healthy babies are at least 6 months of age before starting solid foods to maximize the time that they exclusively breastfeed and to ensure that their digestive systems are mature enough to handle solid foods.

Today, I am going to write about HOW to introduce solids. Get ready for your camera, take a video and watch the funny faces that your baby makes. Here are some tips that make it easier for you to transition your baby to solids:

Good Mood. Offer new foods when baby is alert, relaxed and happy. I like to offer food after breastfeeding (wait 30-60 minutes) or waking up from nap. This may increase the chance of your baby trying a new food.
Give your baby 1 new food a day. Offer a variety of foods, can set your baby up to be a more adventurous eater. The ONLY exception is the highly allergenic foods. You can start serving them regularly to your baby around 6 months, but you have to wait 1-2 days before adding the next new allergenic food. This makes it easier to tell if baby is allergic to the food.
Start with small amounts. Offer 1-3 tsp (5-15 mL) of food. Offer more food if baby is still showing signs of hunger.
Follow baby’s cues. Have your baby sit in a high chair and make sure that you are at approximately eye level. Hold the spoon a few inches in front of your baby’s mouth and wait for baby’s mouth to open when you offer food. Feed as slowly or as quickly as baby wants. Stop feeding when baby shows signs of fullness. If you go with Baby Led Weaning approach, you just let your baby do the eating job. NEVER FORCE BABY TO EAT. NEVER COMPARE YOUR BABY TO ANOTHER.
Start by offering solid foods once a day. Baby will be ready to eat more than once a day soon. Gradually increase to 2-3 times per day and then again to 3-4 times per day.
Try new foods and flavours. Some babies are cautious eaters and need time to trust that a new food is okay to eat. Babies may need to be offered a food many times (approximately 15 times!!!) before deciding to eat it.
Let your baby touch and explore new foods. Please expect a mess. Messy hands and face help baby get used to new foods. Let’s them have fun.
Baby’s appetite will change from day-to-day. Some days a baby will eat a lot, other days not as much. From 6-12 months, baby will slowly start to drink less breast milk and eat more solid food.

“Be cognizant of your baby’s hunger and satiety cues and do not force your baby to eat or over-feed”.

SIGNS OF HUNGER

Lean forward or reaches for food
Sucks or smacks lips
Open mouth when food is offered
Chew on hands
Follows foods with their eyes
Gets excited when they see food
Reaches out to grab for food

SIGNS OF FULLNESS

Turns head away from food
Closes mouth when food is offered
Covers mouth with hands
Fusses or cries
Spits food out
Pushes food or spoon away
Throws food, plate or bowl
Tries to leave the highchair

FEEDING TOOLS

There are so many products out there for feeding your baby. It can get overwhelming to know what exactly you need for starting solids. Here are the TOP 6 must have tools to get you started:

1. High Chair or Booster Seat

I think getting an actual high chair is a must, it is nice to have a dedicated seat for baby, having that big high chair tray makes a great food-catcher. This IKEA Antilop high chair with tray is totally affordable.

A booster seat can strap to your own chairs. This seat is foldable for easy storage. I took it with me to grandparents visits and to restaurants.

2. Bibs

You certainly can use the “drooler/cloth” bibs. However, they need to be washed in the laundry after a one-time use.

I recommend you get a separate set of larger, waterproof, easy-to-clean feeding bibs. I like the ones that have a big pocket in the front (to catch solid food).

If your baby is an active explorer, your may prefer Kushies Long Sleeved Waterproof Bib. This will allow your baby to enjoy his mealtimes to the full, without you having to worry that he is ruining his clothes.

3. Spoons

Make sure the spoons contain any plastic, the plastic itself is BPA-free. BPA is a harmful chemical contained in plastic, and it can leach into food when the plastic itself is heated.
Munchkin 6-Pack Soft Tip Infant Spoon: A small plastic-coated options is much easier on tender gums. Have several on hand during feedings (one for you and one for baby) to foster baby’s sense of independence and avoid power struggles.

Once your baby’s ready to try self-feeding, you may want to get OXO tot Fork & Spoon Set. This set makes it easy for young eaters to get their food from bowl to mouth.

4. Dishes

When you’re first introducing solids, you will just need a handful of small, plastic bowl (BPA-free, of course).

Calibowl. A deep bowl makes it easier for your baby scoops up their food and the super suction cup on the bottom keeps it from being tossed to the floor. It includes fitted lids, which makes food storage a snap.

Once your baby’s ready to try self-feeding, you may want to pick up a divided plate like this one from OXO tot Divided Plate. I like the removable, raised outer ring keeps food on the plate and helps guide it into utensils.

5. Straw Cup or Open Cup with/without handles

Aiden wasn’t a big fan of bottle, so I was very anxious to start introduce straw cup around 6 months. He would bite on the straw very often but he would sip from it time to time. Using a straw cup does not have the same concerns as a sippy cup. It can actually help with oral motor skills development and will not cause for dental caries because baby’s teeth are not bathed in the liquid. Here are three straw cups that I use:
- Playtex Sipsters Stage 1 Straw Cup,
- Munchkin Click Lock Weighted Flexi Straw Trainer Cup
- Playtex Sipsters Stage 3 Insulated Spill Proof Straw Cup

Offer water in an OPEN CUP as soon as when your baby starts eating solids. They learn quickly how to drink from an open cup.

6. Snack Catcher

No more spilled snacks on the floor or car seat. Perfect idea on-the-go: doctor’s appointment, shopping, grocery shopping, evening walk, etc.

A HEALTHY FEEDING RELATIONSHIP

Babies learn by watching people. When families eat together, baby learns that mealtime is a time to come together, eat and share.

As a PARENT it’s your job to choose WHAT foods to offer. As baby start to eat solid foods, your are responsible for WHEN and WHERE baby is fed.
It’s BABY job to choose HOW MUCH food to eat.

Trust baby to know when he is hungry and full. Your are teaching baby to listen to his body (mindful eating).

Introducing solids to your baby is lots of fun. Try to be PATIENT and know that it may take a while for your baby to warm up to certain new foods — this is completely normal. You may have a baby that loves every food from the first bite! In this case, congratulations! you have a super good little eater.

Bon Appétit babies!

Happy Shopping Mommies!!

Next, we will be talking about The First Food. Stay tuned.

When to Start Solid Foods

May 3, 2016

by Ye Ting Tan with No Comment Baby Led Weaning Child & Family Nutrition Infant Nutrition Toddler Nutrition

Recently, I’ve been reading a lot of questions asking what is the right age to start introducing baby to solid foods. Some experts or old guidelines say between 4 and 6 months, some parenting websites say 4 months, sometimes this recommendations even come from a doctor or other health professionals. Well, we were raised in the 80’s, some of us may start to eat solid foods at 4 months of age (our parents followed the old recommendations) or as early as 2 months after birth. I totally understand, as a first time mom, we are eager to start solid foods, friends and family love to give “advices” and “opinions”. It makes us start thinking “Uh… 4 months…maybe it is the right time”! Today’s parents are sure to be confused with all this conflicting recommendations. I would not be surprised.

Here is what I often hear why parents feed baby solid foods prior to 6 months:

My baby is too big
My baby is too small and tiny
My baby seems hungry (increased demand to breastfed)
My baby wakes up multiple times a night
My doctor said my baby should begin eating solid food
My baby wanted the food I ate
I wanted to feed my baby something (iron rich foods) in addition to breast milk or formula

My response to these common excuses is Breast Milk has more calories and significantly more nutrients than any type of solid foods that you can feed your baby.

TOO EARLY? or TOO LATE?

If you start baby on solid foods too early (prior to 6 months of age), baby may:

Drink less breast milk – solids tend to replace breast milk in baby’s diet. The more solids that baby eats, the less milk he takes from mom, which results in low milk production.
Not be ready to chew and swallow safely – gag reflex hasn’t fully developed, may increase the risk of choking.

If you start baby on solid foods too late, baby may:

Be slow to accept new foods and flavours
Have a hard time learning to eat new textures
Not get all the vitamins and minerals (e.g., iron) needed

WHAT IS CURRENT RECOMMENDATIONS

Here are the top organizations that recommend starting solids at 6 months when babies show signs of readiness.

World Health Organization (WHO)
Health Canada and Canadian Paediatric Society
American Academy of Paediatrics
American Academy of Family Physicians
Australian National Health and Medical Research Council
The AAP Section on Breastfeeding
American College of Obstetricians and Gynaecologists
Academy of Breastfeeding Medicine

Exclusive breastfeeding is recommended until 6 months to make sure that your baby’s digestive tract is mature enough to digest solid foods, as well as protect your baby from gastrointestinal and respiratory infections (APP 2012, Nylor & Morrow, 2001).

Breast milk is the ONLY food or drink your baby will need for the first 6 months.

DEVELOPMENT SIGNS FOR READINESS

Watch for SIGNS that your baby is getting ready to start solids:

Able to sit upright (with support pillow/towel is fine) and hold his/her head up well (without support)
Open mouth when food comes or turn head away when full
Good oral motor skill – pick up foods and put in his/her mouth (able to self-feed)
has lost tongue extrusion reflex (baby stops pushing the food out of his/her mouth with his/her tongue). If your baby still have strong tongue extrusion reflex, you may want to wait a week or two and try again.
Show interest and reach for your food at meals and snacks
Chewing on non-food items, such as toys, tethers and fingers

GESTATIONAL AGE

Another things to consider is your baby’s gestational age. If your baby was born prematurely, he or she may not be neurologically ready for solids until 6 months after his or her normal due date. Aiden was born 2 weeks early, so I decided to start solids about two weeks after his 6 months birthday, same as Audrey and Avery, they were born 4 weeks early, they start solids about 6.5 months.

What you can do If your baby is showing obvious signs of being ready for solids about 4-6 months?

It is normal to see a 4 to 5 month old baby is very eager to participate at mealtime, however it does not mean that he or she is ready to eat solids. In fact, it is just the normal developmental stage to explore everything with their mouth. There are a few things you can do to let your baby participate in mealtimes without starting solids:

Let your baby sit with the family at mealtime in booster seat or high chair. It helps them to get used to sitting on booster seat or high chair until you are ready to serve the first ever foods in their life.
Offer your baby spoons, cups, bowls and other baby-safe eating utensils to play with during mealtimes.
The use of open cups (starting from 6 months) is now considered a gold standard. Offer baby a cup of water or expressed breast milk (about 1-3 oz). Your baby can entertain himself at mealtimes while learning to use a cup.

BOTTOM LINE

Most babies will become developmentally and physiologically ready to eat solid foods between 6 and 8 months of age. Watch for signs of being ready for solids, not by the calendar, as well as it is definitely not just mum, dad or mother-in-law forcing it on them.

Baby, Bon Appétit !!

Aiden likes making a mess at mealtime.

I will be posting “How to Start Solid Foods” soon, stay tuned!!

How to Manage Constipation in Your Child (6 months or above)- Part II

April 22, 2016

by Ye Ting Tan with No Comment Child & Family Nutrition Digestive Health Infant Nutrition Toddler Nutrition

Constipation in children is extremely common. I don’t deal with constipated children a lot in my practice, even my son, he is such a “regular” boy. Most parents are overly concerned about how often their child has bowel movement, because they have been taught that a healthy child should have a bowel movement every day. This is not TRUE.

WHAT IS NORMAL?

It is very important for parents to recognize there are many “normal” patterns for bowel movements in children.

Bowel movements decrease down to about 1 or 2 each day from age 2 months to 3 years.
Children 3 years or older have about 1 bowel movement each day (here).
Bowel movements change in thickness, number and colour when a change is made to what your child eats (e.g., when babies are starting solid foods or cow’s milk).

Your child is not constipated if his or her stools are soft and pass easily, even if it has even a few days since last bowel movement.

WHEN YOU SHOULD WORRY?

When the bowel movements are 1) dry and hard 2) difficult or painful to pass.

The frequency of bowel movements is not as important as whether the child can pass stools easily.

CONSTIPATION IN INFANT 6-12 MONTHS

In infants, any changes in diet may result in stool inconsistency and/or change in frequency of bowel movements.

COMMON CAUSES OF CONSTIPATION

Changing from breast milk to formula or cow’s milk.
Introducing new formulas. Some formulas may be more constipating than others.
Incorrect formula-to-water ratio (preparation method).
Introducing solid food(s) – Breastfed babies may be more prone to constipation when solid foods are introduced (at 6 months). This is because their tiny tummies are used to process the easily and highly digestible breast milk.

CONSTIPATION IN CHILDREN AGE 1 YEAR AND OLDER

Constipation can make bowel movement painful, so your child may try to prevent having one. Once a child begins to be afraid of passing bowel movements, the cycle of chronic constipation has begun and bowel movements become more and more abnormal.

COMMON CAUSES OF CONSTIPATION

Toilet training. Refuse going to toilet, due to not wanting to take a break from play or not wanting to use certain facilities such as the school toilets or travelling.
Diets low in fibre.
Lack of fluid intake. Sometimes the normal amount of fluid a child drinks is not enough, such as when the weather gets hot or the child increases his or her physical activities.
Excessive intake of dairy products. Milk does count as part of the fluid but be aware that too much milk can be a contributing factor to constipation as it means that a child will be eating less foods and thereby less fibre.

If high intakes of any foods create a lack of fibre or fluid intake, then constipation may result.

MANAGEMENT OF CONSTIPATION

Bathroom Routine

Children who are toilet trained should practice sitting on the toilet for 5-10 minutes every day after each mealtime (same time every day).
No distraction. Make sure parents or siblings aren’t coming in and out the bathroom when it is “their toilet time”, so that they can relax and make sure that they sticks to their morning bathroom routine consistently every morning. It usually takes up to weeks or months for them to start going consistently.
Do not ignore the “urge” to go to toilet as this can lead to harder, larger and drier stool. Make sure they have enough privacy and time to pass stools comfortably.
It is important to teach your toddler to “listen to your body” or “listen to your bottom” and go to toilet when they get the message. Then , you can take them to the bathroom right away. Parents should listen or watch the signs:
- Suddenly stop whatever activity they are doing
- Suddenly squat or sit down
- Leave the room or hide in a corner
- Stiffen up, extend their bodies upright, stand on their tip toes and tighten the muscles in their bottom
- Face turns red or change tone of their voice
- Unable to pay attention to you
Make sure your child’s feet are resting on something, such as a foot stool. It helps relax the pelvic floor muscles, which can help move the bowels.
Keep some reading or picture books in the bathroom and encouraged your child to look at them and try to relax.

Increase Fibre Intake

It is important your child eat a healthy and balanced diet. The recommended intake of fibre are 19 g of fibre per day for a 1-3 year old and 25 g per day for a 4-8 year old (here).

Offer at least one serving of vegetables or fruit at each meal or snack. In this way, your kids should get adequate fibre daily.
Gradually increase fibre intake. Going from a low fibre intake to their desired goal too fast can cause symptoms include abdominal pain, bloating, and gassiness.
Choose whole grains – e.g. whole grain bread, whole wheat pasta, brown rice, whole grain cereal, oat, quinoa, barley, etc.
Choose legumes – e.g. beans and lentils.

The best way to introduce more fibre to your child’s diet is to do so by adding some of those fibre-containing foods slowly. For example, provide a serving of fruit at lunch for a few days, then add a high fibre cereal (at least 3 g of fibre per serving) at breakfast until you reach the goal. Also, If your child is constipated and you are feeding him the rice-based infant cereal, then try bran- or oat-based cereal instead.

Avoid Binding Foods

Avoid white starchy foods, banana and cheese. Most white starchy foods are low in fibre, e.g., white rice, white bread, white pasta and breakfast cereals. These foods will bind the stool so that it is harder to pass and this can also cause pain when passing.

Increase Fluid Intake

Water is the only things that helps your child get over their constipation.
Babies 6 – 12 months:
- Offer up to 1 oz (30 mL) of fruit juice between feedings to a maximum of 4 oz (125 mL) in 24 hours.
- Sips of water from an open cup (about 2-3 oz or 60 – 90 mL at a time).
- Note: Juice and water should not replace regular feedings.
1 – 3 years Children:
- Recommended total fluid intake: 4 cups (900 mL) per day (here).
- Offer 500 mL (2 cups) of milk per day with meals and snacks.
- Offer water throughout the day.
- Limit 100% fruit juice to 1/2 cup (125 mL) per day (OPTIONAL).

Natural Laxatives

Why juice? Juices containing high amounts of sorbitol can help draw water into the bowels to make stool easier to pass. Prunes, pears and apple juices usually contain higher amounts of sorbitol compared to other juices and therefore can have some benefit in relieving constipation.

Offer “juice water” (diluted fruit juice) which mean 95% of water and a tiny splash or real 100% fruit juice. Limit 100% fruit juice intake to no more than 1/2 cup per day.
Mix prune puree with a favourite food (cereal or crackers).
Ground flax seed. Mix in cereal, soup, smoothie, baked goods, or yogurt. Dosage: 1 tbsp per day (toddler); 2 tbsp per day (older children).

Increase Physical Activity

We all know physical activity is a natural bowel-stimulator. Get your child off the couch, turn off the TV and hide the iPad. Checkout the Physical Activity Guidelines.

Medications & Laxatives & Fibre Supplement

Talk to your doctor and/or pharmacist before using any of these methods, as doses are weight-dependent. Follow the instructions carefully for the dose and the amount of the time you child should be taking them. As a dietitian, I will focus on “real foods” rather than supplements.

Prebiotic & Probiotics Supplement

Currently, there is no enough evidence or research to show that pre/probiotics supplement help with constipation. However, foods like cheese, milk and yogurt with probiotics are safe for most people including children.

Do you have a constipated baby at home? If you have any questions please leave me a comment or Contact Me.

How to Manage Constipation in Your Baby (Under 6 months) – Part I

April 11, 2016

by Ye Ting Tan with No Comment Child & Family Nutrition Digestive Health Infant Nutrition

Being a first-time mom, I know it is heartbreaking when your baby is constipated. I remember when Aiden hasn’t had bowel movement for 3 days, I began to worry. Is this normal for a 4 months old exclusively breastfed baby or is he constipated? After talking to my lactation consultant, I know this is normal for EBF baby to have infrequent bowel movement.

Most babies grunt and get red in the face when having a bowel movement. It is completely normal. However, your baby is constipated if his poo is dry and crumbly or like pellets, and it can cause him pain and discomfort.

WHAT IS NORMAL?

There is NO necessary to give your baby fluids other than breastmilk or formula before 6 months of age.
It is normal for exclusively breastfed infants to have more frequent bowel movement than formula-fed infants in the first 2 to 8 weeks after birth.
In some exclusively breastfed babies over six weeks of age with normal growth and development, bowel movements may be infrequent and soft, ranging from one every two days to two weeks (here), or even three or four weeks. These infrequent stools can be normal in infants who are effectively transferring milk (changing from breast milk to formula or cow’s milk) and appropriately gaining weight.

WHEN YOU SHOULD WORRY?

If your baby is constipated for more than 2 weeks, If he has a fever, start vomiting, decrease appetite, have blood in stool and weight loss, follow up with your baby’s family doctor to make sure there are no other red flags.

TIPS FOR MANAGING YOUR INFANT’S CONSTIPATION AT HOME

Continue breast feeding. Breast milk is easier to digest than infant formula because it is specific to the needs of human infants. It helps promote bowel regularly, mature the digestive tract and protect it from infection. If an exclusively breastfed infant has dry and hard stool, hydration should be assessed and the infant referred to a family physician or lactation consultant (if you have concerns about breastfeeding).
Small and frequent feeds. Infants have small stomach. For better digestion, offer smaller feeds, more often throughout the day. For example, if you normally offer 6 ozs every 4 hours, try offering 3 ozs every 2 hours. This method may reduce gas and fussiness as well.
Preparation method. If your baby is using formula, ensure that the formula is being properly prepared. Formula that is over concentrated can lead to difficulties with digestion as well as other medical problems. An extra ounces of water can be offered a couple of times a day to ensure adequate hydration.
For some formula-fed babies, the answer is switching formulas. The iron in formula is often blamed for constipation, but this is no evidence that there is a link between the two. And babies need the iron to reduce the risk of anemia. Some babies, however, are intolerant of cow’s milk and do better on different iron-fortified formulas. You should switch infant formulas only under your family doctor’s guidance.

Many breastfed babies do have infrequent bowel movements however this does not mean that they are constipated.

OTHER NON-NUTRITIONAL TIPS

Soft tummy massages. Starting in their navel, in a clockwise direction and moving outwards. Do several massages throughout the day, until your baby has a bowel movement.
A warm bath (if he enjoys bathing). This will make them feel relaxed and you can continue the massage technique and relieve their discomfort.
Cycle baby’s legs. You can try moving your baby’s leg in a cycling motion while they are lying on their backs to help loosen stools.
Check with your family doctor to see whether it’s okay or necessary to use an over-the-counter stool softener.

Do you have a constipated child at home? If you have any questions please leave me a comment or Contact Me.

Foods to support your child immune system

Foods to Support Your Child’s Immune System

March 21, 2016

by Ye Ting Tan with No Comment Child & Family Nutrition Infant Nutrition Toddler Nutrition

The immune system plays a very important role in your overall health (and the health of your children). It defends against viruses and bacteria. It’s made up of interconnected white blood cells, antibodies, bone marrow, the spleen, thymus and lymphatic system, which work together in harmony to find and destroy pathogens (the things that cause illness).

With Covid-19 in the news, you’ve probably seen many articles and blog posts about “how to boost your child’s immune system”. As a parent, I can imagine that you’re especially curious about this if you have children who are in school, as we want to protect our children from all the viruses or bacteria going around them.

But here’s the thing: the idea of boosting the immune system with supplements or specific foods is misleading and scientifically inaccurate (here). Do you know an overactive immune system is linked with autoimmune diseases such as lupus or multiple sclerosis. “Immune boosting” is a marketing term, not a medical term.

THERE IS NO SINGLE PRODUCT THAT CAN BOOST IMMUNITY

Scientists are still a long way from understanding the complex interplay of parts that allow the immune system to perform at its optimum level, which means there’s no product you can take to “boost” it. Instead, it’s important to focus on supporting your (and your childrens’) immune systems so they function normally. There are many things we can do to support immunity, such as getting enough sleep, being physically active, minimizing stress and eating nutritious foods. As a busy mom, I love finding foods that are not only nutritious and convenient, but also immune supporting.

The easiest way to get these nutrients is by eating a healthy and balanced diet.

Certain nutrients, such as zinc, selenium, iron, protein, vitamins A, C, D and E are critical for the function of immune cells. However, I can’t promise you that you can totally shield your children from getting sick by eating foods with these nutrients. In fact, you can build up your children’s immune systems with nutrient-dense foods. Certain foods have the exact nutrients that can help your children’s immune systems be as strong as possible, so when they are exposed to the inevitable germs, they are ready to fight.

FOODS CONTAIN THESE IMPORTANT NUTRIENTS

Orange vegetables and fruits

Carrots, sweet potatoes, pumpkin and cantaloupe are among the best sources of beta-carotene, a precursor of vitamin A. Beta-carotene has several health benefits, including the antioxidant activity that protects cells from free radical damage and help enhance immune function (here). In fact, beta-carotene plays a role in making white blood cells, which are responsible for hunting down and quashing viruses. Pairing these foods with a healthy fat, such as olive oil, avocado, or nuts and seeds, can help the body absorb them better.

Berries

Berries are full of antioxidants, which help your body fight oxidative stress caused by free radicals. This helps keep our immune system fighting! There are many different berries you should try to include in your children’s diet: strawberries, blueberries, raspberries, cranberries, and blackberries, to name a few. Don’t worry; when berries aren’t in season frozen berries are just as nutritious. You can add them to yogurt and oatmeal, or eat them as a nourishing snack.

Dark leafy greens

Choose kale, spinach, chard, arugula or collards. Dark leafy greens are high in carotenoids (similar to beta carotene), and have similar immune-supporting effects. If your children not a fan of salads? Use leafy greens in smoothies, muffins or stir-fry.

Nuts

I’m often asked which nut to eat and I say, “mix it up!” Each nut has a different nutritional value, so choose a variety for the best immune support. Almonds, peanuts and hazelnuts contain vitamin E, which helps increase T-cell count (T-cells directly kill infected host cells and regulate immune responses) (here). Walnuts are significantly higher in omega-3 fat than any other nut. Enjoy some trail mix, or add nuts to salads, pasta or cereal. Or enjoy them in a granola bar or energy ball. Nuts can be choking hazard for babies and young toddlers, so make sure to serve your little one slivered or sliced almonds, or natural nut butters spread thinly on toast.

Seeds

Serve your children a variety of seeds, such as pumpkin, sunflower, sesame, hemp, and flax seeds, to support their immune systems. By eating a wide variety of seeds, you’ll be getting vitamin E, zinc, and omega 3 fatty acids, all of which help the immune system fight off invading bacteria and viruses. You can add seeds to smoothies, yogurt and salads, spread pumpkin or sunflower seed butter thinly on toast.

Oatmeal

Oats contain immune-supporting nutrients like selenium and zinc. But they also contain a special type of fibre called beta-glucan, which increases immune defense by enhancing macrophages (cells that detect and destroy bacteria and viruses) (here). Start your day with oatmeal.

Eggs

Protein is needed for proper immune system functioning, and eggs are the gold standard for their high-quality protein. When scientists measure protein quality – known as “biological value,” it’s often evaluated compared to eggs, which are given the perfect score of 100 (here). Eggs are also a source of immune-supporting selenium and vitamins A, D and E. So, scramble up a few eggs for breakfast today.

Fish

Fatty fish such as salmon, tuna, trout or sardines are excellent choices. They contain a winning combination of vitamin D and omega-3 fats, which both support the immune system. Vitamin D deficiency is associated with an increased susceptibility to infection (here), and omega-3 fats are part of the structure of all immune cells (here). Try canned tuna in a sandwich; enjoy some salmon sushi roll; or try a bagel with cream cheese and smoked salmon or trout.

Fermented foods

Choose kefir, fermented vegetables (sauerkraut or kimchi), kombucha or yogurt made with active cultures. These foods contain probiotics, which mediate and regulate the immune system (here). Researchers are still trying to figure out which specific probiotic strains to use for different health problems, and the pieces of this puzzle remain incomplete. If a specific probiotic is marketed as an immune-booster, don’t believe the hype. Science isn’t there yet.

Tumeric

You know that perfect buttercup-yellow hue of mustard? That comes from turmeric, a spice that contains curcumin, which has been linked to an enhanced immune response. There’s one problem. Curcumin is unstable and not well absorbed by the body. However, researchers found a solution: when using turmeric, add a dash of black pepper. It helps increase the bioavailability of curcumin by 2000% (here) Try turmeric in stir-fries, curries, stew or make a turmeric latte, known as golden milk.

IN ADDITION TO WHAT YOU DO EAT, IT’S ALSO IMPORTANT TO GET YOUR BODY HYDRATED

Staying well hydrated can provided just the right balance for hormones, enzymes and cells to function properly, especially Malaysia’s weather is extremely “hot” and humid. Also, it reduces lung and nasal secretions so that your body can efficiently move virus and irritants out of your body instead of getting stuck inside where they can multiply in a nice cozy host (you).

WHAT ABOUT PROBIOTIC SUPPLEMENTS

Giving your child a probiotic supplement isn’t the answer. There’s just not enough research out there on various strains of probiotics and what their functions are in the body. Probiotic supplements won’t prevent infections from happening, and the risk in taking them is that each and every probiotic strain has a specific use and may actually suppress the immune system, which could cause problems.

BOTTOM LINE

Don’t stress about loading your children up with specific immune-boosting foods or a whole bunch of vitamins and supplements during flu season (or any time of the year), because there’s no such thing, and it turns we don’t want to “boost the immune system” either!

Instead, focus on staying nourished with balanced nutrient-rich meals and snacks, including the foods mentioned above.

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.