does-my-child-need-to-take-probiotic-photo

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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Understanding Lactose Intolerance

by with No Comment Child & Family NutritionDigestive HealthInfant NutritionToddler Nutrition

WHAT IS LACTOSE? 

Lactose is a naturally occurring sugar found in milk and other dairy products (yogurt, cheese and ice cream). When you consume food or drinks containing lactose, an enzyme named lactase in the small bowel will break down lactose into two simple sugars: glucose and galactose. These nutrients are then absorbed in the small intestine.

Image source: http://www.evo-ed.org/Pages/Lactase/cellbio.html

WHAT IS LACTOSE INTOLERANCE? 

However, some people might produce less lactase than the others. If the small bowel has insufficient lactase, the lactose consumed will not be digested properly and will continue through to the large bowel. Lactose in the large bowel will be fermented by the gut bacteria, which produces gases including hydrogen, carbon dioxide and methane. This gas production not only can lead to unpleasant gastro-intestinal symptoms such as distention, bloating, flatulence and constipation but can also draw water into the large bowel resulting in loose stools or diarrhea.

Some people may have a temporary lactose intolerance due to  viral infection like the stomach bug, while others can experience it when they have a digestive disorder like celiac disease. Still others may experience lactose intolerance their entire lives.

SYMPTOMS  

  • bloating
  • abdominal pain due to gas
  • tummy cramps
  • nausea
  • loose stool or diarrhea

If you are lactose intolerant, the symptoms may vary and are dose-dependent. That is, the more lactose you consume, the worse the symptoms become. Symptoms may occur immediately after drinking milk or eating dairy products, or they may be delayed for hours.

Lactose intolerance is NOT an allergy to milk. 

DIAGNOSIS 

To diagnose lactose intolerance, the hydrogen breath test is a simple, non-invasive and reliable investigation test. Lactose intolerance is indicated when hydrogen and methane levels of breath meet a certain criteria following the oral consumption of standard dose of lactose.

Another simple way to diagnose lactose intolerance is an elimination diet which involves removing lactose in the diet and assessing whether symptoms improve, followed by a re-introduction of lactose in the diet to assess whether symptoms return.

WHAT FOODS CONTAIN LACTOSE? 

Read the ingredient list on product labels to find out if the product contains a lactose-cotaining food. Food items to look out for include: milk, milk solids, malted milk, buttermilk, curds, cheese flavours, non-fat milk powder, non-fat milk solids, sweet or sour cream, lactose, whey and yogurt.

Note: 1) the cultures in yogurt help to digest lactose 2)Products that contain lactic acid, lactalbumin, lactate and casein do not contain lactose. 

IF YOU ARE LACTOSE INTOLERANT, SHOULD ALL DAIRY PRODUCTS BE AVOIDED? 

Yes, you will need to modify the diet in order to alleviate the discomfort and symptoms at the beginning. The first step is to remove all sources of lactose in the diet that can cause problematic symptoms, including milk and dairy products.

The second step is to find nutritious substitutions for those items you’re removing:

Note: 1)”Lactose free” means that there is no detectable lactose in the food. 2)”Lactose-reduced” means that at least 25% of the lactose in the product has been removed.

Recent research has suggested that most people with lactose intolerance can consume up to 12 to 15g of lactose without any symptoms. You can still tolerate some foods that contain lactose like yogurt or cheese, even if you are lactose intolerant.

OTHER TIPS ABOUT INCLUDING LACTOSE IN YOU AND YOUR CHILD’S DIET: 

  • Drink milk in smaller quantities. Most people with lactose intolerance can tolerate 1/2 cup milk at a time.
  • Eat small amounts of lactose-containing foods spaced throughout the day.
  • Eat with other solid foods may delay digestion, offering more time for the lactase enzyme to break down lactose.
  • Yogurt may also be tolerated (plain better than flavoured), because the live bacteria in the yogurt partially digests the lactose before consumption. Yogurt is also a semisolid, which moves slowly through the digestive tract.
  • Aged cheese tend to have lower lactose content.
  • Try lactase enzyme drops or tablets from the pharmacy. Tablets are taken before eating foods that have lactose. Enzyme drops can be added to milk before drinking.
  • Soy products do not contain any lactose and can be a suitable substitute for dairy products, providing they have calcium added.

Do you have a child with lactose intolerance? How are you managing? Did you know that I provide one-on-one nutrition counselling service for children and families? If you are diagnosed with lactose intolerance, I can help to ensure you are not missing out on important nutrients such as Calcium. This is particularly important for children. If this is something you’d like to learn more about, check out here. 

Kid Friendly Spinach And Turkey Meatballs

Kid Friendly Spinach and Turkey Meatballs

by with No Comment Digestive HealthPicky EatingRecipesToddler NutritionWeight Management

This is a meatball recipe your family will love. It’s a great way to sneak in some extra veggies for yourself and your kids.

Also, I am adding the All Bran Buds cereal to this recipe, it helps increase the fibre content. Enjoy !

Recipe adapted from All Bran

Kid Friendly Spinach and Turkey Meatballs

Print Recipe Pin Recipe
Prep Time 10 minutes
Cook Time 25 minutes
Total Time 35 minutes
Course Dinner, Lunch
Servings 20

Ingredients
  

  • 3/4 cup all bran buds cereal
  • 1 tbsp milk (cow's milk or plant-based milk)
  • 1 lb or 500g ground turkey
  • 1 egg, lightly beaten
  • 1/2 cup cooked spinach, chopped
  • 1/2 cup onion, finely chopped
  • 2 cloves garlic, minced
  • 1/2 cup parmesan cheese, grated
  • 1 tsp each salt & fresh cracked pepper
  • 1 tsp fresh thyme, chopped
  • 1 tbsp vegetable oil

Instructions
 

  • Preheat oven to 350’C
  • In a small bowl, stir cereal with milk and let soak for 5 minutes.
  • In a separate large bowl, combine cereal mixture, turkey, egg, spinach, onion, garlic, cheese salt, pepper, and thyme. Mix just until combined, avoid over mixing to ensure meatballs will not be tough.
  • Form mixture into 1 1/2 inch balls and place on a parchment lined baking sheet. Brush meatballs with oil and bake for 20-25 minutes or until cooked through.

Notes

Serve these meatballs on their own or in your favourite sauce.
Digestive Woes Examined

Digestive Woes Examined

by with No Comment Digestive Health

It’s a common story. You’re having lunch with friends, and you mention that you’ve been experiencing a health problem. And with that remark, your friend goes into “problem solving mode” by recommending a specific diet or ingredient that they think may help you. Your friend means well, but it’s better to get medical advice from a reputable source to help solve your struggle.

Misinformation affects many of my clients:

“I’m so confused, I have read so many things online and have no idea what I SHOULD eat to get rid of my digestive woes!”

“I keep hearing that I should eliminate grains, beans, legumes, dairy. Well, what is LEFT to eat? Do I need to avoid those foods now too?”

“My friend told me no one can digest dairy. Dairy is meant for baby cows only and that I shouldn’t be consuming it. Do I need to be dairy free too?”

“My daughter is allergic to so many foods, I don’t know how to prepare quick and delicious meals anymore. I’m in a food rut.”

“I’m making two different meals at mealtime. One regular for the family, and then Low FODMAP for me. But, I can’t keep up. It’s so stressful, but I don’t know what to do.”

“I’m constipated on my gluten free diet. My friend said she started taking probiotic to improve constipation, should I do that?”

“I don’t understand why I am gaining all this weight. I need to lose weight, maybe I should go on gluten free diet!”

“I just ate something and I know it was gluten free, but now I feel bloated.”

“I’m so scared to go out and eat because I don’t know how I will feel after or if I will make it home in time for the bathroom.”

“I was told that I need to eliminate lactose and gluten from my diet. But, now, with my Low FODMAP diet, I am at a loss of what to eat and feel just as bad, if not worse.”

“I’ve just been diagnosed with celiac disease and I feel overwhelmed.”

“I don’t want to go out and eat anymore, because I’m scared I will be ‘glutened.”

“I am still SO tired. I have no energy. I thought my gluten free diet was suppose to make me feel better.”

“Food makes me scared. I used to love food and now it causes me anxiety and worry.”

“I heard I can take a digestive enzyme and I can eat big meal, is that right?”

“I still feel unwell. In order to heal the gut, I heard I should do the ketogenic diet.”

“Someone told me that even though I am celiac, I can eat gluten when I go to Italy.”

You are fighting with an embarrassing problem – excess gas, bloating and diarrhea. Your friend recommended a gluten-free diet and taking probiotics, but your friend is not a doctor or dietitian, so you were curious about this recommendation. Was it the right one for you? Let’s use the three-step approach to solve your struggle with gas, bloating and diarrhea.

PROBLEM

Your problem was that everything you ate seemed to give you gas, bloating and diarrhea. Your friend said to stop eating wheat and gluten, as well taking probiotics, but you weren’t sure if that was the right advice.

THE FACT

After reading a medical website, You were relieved to learn that gas, bloating and diarrhea are all common symptoms for IBS (Irritable Bowel Syndrome). You found helpful advice by searching the term “Gas”  “IBS” “Gluten Free Diet”on these trusted websites: Dietitians of Canada, HealthLinkBC, Eat Right Ontario 

You learned that gas, bloating and burping may be caused by swallowed air, medicines, supplements and certain food or drinks. So, maybe you were not properly digesting your dairy products or one of your supplements is causing the problem?

But you also noted that gas and bloating could be the sign of a condition, such as lactose intolerance, irritable bowel syndrome (IBS) or celiac disease. You were unsure of the reason for your symptoms, and read that it’s important not to self-diagnose. You needed the help of your doctor.

You want to learn more about your friend’s suggestion to give up gluten in case you have celiac disease, so you visited the Canadian Celiac Association website. You learned that if you need to be tested for celiac disease, you need to be eating gluten (a protein found in wheat and other grains) before the test to get accurate results. If you had taken your friend’s advice to remove gluten from your diet, you could get a “false negative” result. Phew! You’re happy that you looked into it before making any changes to your diet. If you do need to go that route, you now knows to work with a dietitian before eliminating foods, since they can help you plan a balanced diet and ensure you meet nutrient needs.

SEEK SUPPORT

Now you know not to self-diagnose or rely solely on advice from websites or well-meaning friends. You will talk to your family doctor about your symptoms. If necessary you will see a gastroenterologist (digestive health doctor). You can also see a dietitian (like me!) to help you figure out which foods may be causing you discomfort.

TIPS FOR A HEALTHY GUT 

How can you apply this newfound knowledge and actually create a healthier gut? Simple-just follow these tips!

Do you have digestion problems that you struggle with? You unsure you should supplement with probiotics? Don’t self-diagnosing? Contact Me about starting a nutritional counselling program.

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

Coconut Blueberry Chia Pudding

Coconut Blueberry Chia Pudding

by with No Comment Digestive HealthRecipes

Chia seeds have become one of the most popular superfoods in the health community. Chia seeds are tiny little brown seeds that can be found at health food stores, grocery stores or online.They are super easy to prepare and are very versatile ingredient that add easily to many recipes.

What is Chia Seed? 

Chia seeds are from the desert plant Salvia hispanica, a member of the mint family. They have been around since 3500 BC and were a staple food used in the Aztec and Mayan diets. Chia means “strength” in the Mayan language. Despite their ancient history as a dietary staple, only recently did chia seeds become recognized as a modern day superfood.

Nutritional Profile of Chia Seeds 

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Per Tablespoon

Chia Seed (12 g)

Calories (Kcal)

60
Omega -3 Fats (g)

2
Omega- 6 Fats

0.5
Protein (g)

3
Fibre (g)

5
Calcium (mg)

160

Health Benefits of Chia Seeds 

Those who sell the chia seeds products will definitely tell you about regularly eating chia seed can improve your health – keeping you fuller for longer and increased energy levels to help with weight loss and diabetic control. Does research back up claims of benefit?

There have been a few preliminary studies looking at these claims but unfortunately, at the moment, the small numbers of research participants involved and short duration of the trails mean none have been convincingly proven. More studies are needed before any strong claims about chia’s health benefits in weight loss, diabetic control or satiety can be made.

Don’t be disappointed !! There are some benefits of eating chia seeds. They contain ALA, the plant source of Omega-3 fatty acids, which are known to benefit heart and brain health. Normally, we get Omega-3’s fat from oily fish, however, eating chia seeds(ALA, plant source of Omega-3 fats) can help improve our ratio of Omega-3: Omega-6 fatty acids. We need both, but we tend to have higher intake of Omega-6 fatty acids. In a 2007 study, chia seeds were shown to reduce the risk of cardiovascular disease for individual with Type II Diabetes

Chia seeds are very high in fibre, particularly soluble fibre, which is great for keeping our gut healthy.

They also contain a variety of vitamins and minerals as well as reasonable amounts of calcium, manganese, phosphorus and protein per servings.

Chia seeds are naturally gluten free. So it can be used by people with celiac disease.

How to Use Chia Seeds 

Ground 

You can grind chia into a fine powder.

Whole

Unlike flaxseeds, you do not have to grind chia seeds to access their nutrition. You can eat them whole and still get their nutrients. You definitely can eat a spoonful straight.

Soaking 

When mixed with water, chia absorbs 12 times its weight, forming chia gel. When soaking, you “sprout” them and it releases the “enzyme inhibitors” that are used to protect the seed. This not only makes it much easier to digest, but also your body can access the dense nutrients inside the seeds. However, it won’t hurt to eat them straight !!

Egg Free Baking

If you are looking for recipes of egg free diet or vegan diet, chia seeds can be use as an egg substitute in your baking recipes.

To replace one egg, mix together:

  • 1 tbsp of chia seeds + 3 tbsp water
  • Let the mixture sit for 15 minutes

Chia has a mild nutty flavour. Chia seeds can be easily incorporated into our diet for extra boost of nutrition. Here are a few ideas to get you started:

  • Cold, ready-to-eat cereal
  • Oatmeal
  • Yogurt
  • Granola
  • Power ball
  • Smoothies
  • Muffin
  • Salad dressing

The Bottom Line 

A healthy diet isn’t defined by one food or nutrient alone.

We know chia seeds have many health benefits based on their nutritional profile, even though we don’t quite have solid research yet to prove that chia has significant positive effects on chronic disease, I think it is still a good idea to include them into your diet. Other thing to remember is to always incorporate more seeds (not just chia, but also flax, hemp, sunflower, pumpkin) in your diet.

Eating 1 to 2 tbsp a day is considered a healthy amount, provided it fits with your overall lifestyle balance.

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Have you tried Chia Seeds?

Do you like them?

What is your favourite way to eat them?

Coconut Blueberry Chia Pudding

Coconut Blueberry Chia Pudding

Print Recipe Pin Recipe
Prep Time 30 minutes
Cook Time 10 minutes
Course Snack

Ingredients
  

  • 2 cups Milk (You can use cow milk or any other milk alternatives – coconut, soy, almond, cashew)
  • 1/2 cup Chia Seeds
  • 1/2 cup Greek Yogurt (I use plain greek yogurt, you can use vanilla or coconut greek yogurt)
  • 1/2 cup Unsweetened Coconut, shredded finely
  • 1/2 cup Honey
  • 1 tsp Vanilla Extract
  • Fruit – Berries, Bananas, Peaches, or Plums for topping.

Instructions
 

  • Pour milk and honey into a small saucepan and set over medium heat on the stove, stirring often until steaming (about 5 to 10 minutes)
  • Remove from heat and transfer to a glass bowl. Stir in chia seeds, shredded coconut and vanilla extract and whisk together. Let sit for about 15 minutes at room temperature.
  • Once cooled, cover with plastic wrap and put in the fridge to chill for at least 12 hours.
  • After 12 hours, remove from fridge, stir in greek yogurt and whisk until incorporated.
  • Serve in small dishes with your favourite fruits.
Constipation above 6 months

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

by with No Comment Child & Family NutritionDigestive HealthInfant NutritionToddler 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. 

Constipation under 6 months

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

by with No Comment Child & Family NutritionDigestive HealthInfant 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. 

prebiotics-and-probiotics-supplements-photo

Health Benefits of Prebiotics and Probiotics

by with No Comment Digestive HealthSupplementation

Recently, I have seen lots of mommy asking about probiotic supplements? Many health benefits about probiotics have been advertised, but it is often hard to know what is true? Does your child need probiotic supplements? Before you learn about probiotics, have you heard about prebiotics? What are their health benefits? Read on to learn the difference between prebiotics and probiotics and their health benefits.

WHAT IS THE DIFFERENCE BETWEEN PREBIOTICS AND PROBIOTICS? 

Prebiotics are non-digestible carbohydrates that act as “food” for probiotics. Eating prebiotics will help probiotics grow and remain in our digestive system.

Probiotics are healthy/good bacteria that naturally live in the colon of our digestive systems. Probiotics help to keep a balance between the good and bad bacteria that live in your colon. Certain probiotics have been linked to specific health benefits.

TYPE OF PREBIOTICS 

The most common prebiotics include:

  • Fructo-oligosaccharides (FOS) or fructans
  • Galacto-oligosaccharides (GOS)
  • Inulin (a types of FOS)

PREBIOTICS IN NATURAL FOODS 

Inulin

Due to the pleasant taste characteristics and low-calorie status, FOS and inulin have been added to many food products. Inulin has a creamy, catlike texture that makes it a good fat substitute. You will find it in many spreads, salad dressings, dairy products.

FOS, GOS and inulin are found naturally in these foods:

Vegetables

  • Artichoke
  • Asparagus
  • Bananas
  • Garlic
  • Leeks
  • Onion
  • Tomatoes

Grains

  • Barley
  • Rye
  • Whole Grains

Roots

  • Chicory Root (菊苣根)
  • Dandelion Root (蒲公英根)
  • Elecampane Root (土木香根)

Galacto-Oligosaccharides (GOS)

  • Fermented dairy products like yogurt, buttermilk and kefir
  • Breast milk (Hooray!!!) – breastfed babies suffer fewer infections than formula-fed babies

HEALTH BENEFITS OF PREBIOTICS 

Prebiotics act as “food” for probiotics which help to keep a healthy balance of bacteria in the digestive system. Eating prebiotic-containing foods often contain fibre and other nutrients. It also enhances calcium absorption. More research is still needed to find out if prebiotics are linked to other specific health benefits. However, if you do not consume foods that are naturally rich in prebiotics, you can still have a healthy gut by following a healthy and balanced diet

WHERE CAN YOU FIND PROBIOTICS 

Probiotics are healthy bacteria that are either in supplements form or added into certain foods like yogurt, cheese, milk, juice, and cereal. The most common probiotic bacteria added to foods are Lactobacillus and Bifidobacterium species. It is better to read the ingredient list and make sure the product contains the right bacteria. To understand the strains of probiotics, read here.

NAME TO LOOK FOR 

Look at the Nutrition Facts or ingredient lists or products packaging for the names:

HEALTH BENEFITS OF PROBIOTICS 

There are many potential health benefits of adding probiotics to your children’s diet.

It is not yet clear how much probiotics will give you health benefits. However, it is recommended that regular, long-term use is needed to keep healthy bacteria in your digestive system. Please noted that the positive effects of probiotics vary from person to person and strain(s). Individuals who do not consume foods with probiotics can still have a healthy digestive system by eating a healthy diet.

SAFETY CONCERNS 

There are many brands and strains of probiotics that can be found at the pharmacy these day which can leave parents confused. Like many other supplements, over-the-counter prebiotics & probiotics are poorly regulated. That means that there are no rules for how much prebiotics/probiotics there should be in a food or how to label them on food packaging. If you decide to take a supplement, please check to make sure it has NPN, DIN or a DIN-HM number (somewhere on the bottle). Remember, being regulated does not guarantee that probiotics are effective. It only means that the product contains what is stated on the label and that they are safe to take.

It is recommended to choose the probiotic supplement is meant specifically for children – chewable or in a drink form, and it should be refrigerated. Remember to read the instructions regarding how much to give your children and pay attention to the expiry date.

BOTTOM LINE 

Probiotics for your baby or child are a must if they have been on antibiotics. If you have a colicky baby or have troubles with constipation or eczema, I would try probiotic supplement. I would also recommend probiotic supplement for formula-fed babies or those born by C-section (who aren’t exposed to natural vaginal bacteria).

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.