Toddler Nutrition Archives - Page 3 of 3 - Simple Balance Nutrition

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 No Comment 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?

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 discussed When to Introduce Your Baby Solid Foods. It is important to wait until healthy babies are at least 6 months old before starting solid foods to maximize exclusive breastfeeding and ensure their digestive systems are mature enough to handle solid foods.

START FROM HOW

Today, let’s talk about HOW to introduce solids. Get your camera ready, you’ll want to capture those funny faces your baby makes. Here are some tips to help make the transition to solids easier:

1. Choose a Good Mood

Introduce new foods when your baby is alert, relaxed and happy. Offering food after breastfeeding (waiting 60-90 minutes) or after a nap can increase the chance that your baby will try a new food.

2. Introduce 1 New Food a Day

Offering a variety of foods can set your baby up to be a more adventurous eater. The ONLY exception is highly allergenic foods. You can start introducing them around 6 months, but wait 1-2 days before adding another allergenic food to monitor for potential allergies.

3. Start with Small Amounts

Offer just 1-3 tsp (5-15 mL) of food. If baby shows signs of hunger, you can offer more.

4. Follow Baby’s Cues

Sit your baby in a high chair at approximately eye level. Hold the spoon a few inches in front of their mouth and wait for them to open up. Feed as slowly or quickly as they prefer and stop when they show signs of fullness. If you’re following Baby-Led Weaning approach, let your baby take the lead in eating. NEVER FORCE YOUR BABY TO EAT, AND REMEMBER NOT TO COMPARE YOUR BABY TO OTHERS.

5. Start with Once a Day

Begin by offering solid foods once daily. Soon, baby will be ready to eat more often. Gradually increase to 2 times per day, then to 3 times.

6. Offer New Flavours

Some babies are cautious eaters and need time to trust that a new food is safe. It can take multiple attempts (approximately 15 times) before they’re willing to eat a particular food.

7. Let Your Baby Explore

Expect a bit of a mess. Messy hands and faces help babies get used to new foods. So let them have fun with it.

8. Be Aware of Changing Appetite

Baby’s appetite will vary daily. From 6-12 months, they will gradually drink less breast milk and eat more solids.

Be mindful of your baby’s hunger and fullness cues. Avoid forcing or over-feeding.

HUNGER SIGNS

Smiles, gazes or coos at the parent during mealtimes to show they wants to continue
Leans toward the spoon or food and opens their mouth
Reaches for or points to food
Shows excitement when food is offered
Focuses on and follows food with their eyes
Sucks or smacks lips
Uses words, sounds, or hand signs to indicate hunger or wanting more (older babies)

FULLNESS SIGNS

Slows pace of eating
Get distracted easily or shows uninterested in food
Moves head away from spoon or closes mouth
Bats at spoon or pushes it away
Pushes food away or throws it on the floor
Plays with food or fidgets
Closes or purses lips when offered food
Spit food out
Tries to leave the highchair
Uses words or signs to signal “all done” (older babies)

FEEDING ESSENTIAL TOOLS

With so many baby-feeding products available, it can feel overwhelming to decide what you truly need to start solids. Here are the TOP 6 essential tools to help you get started:

1. High Chair or Booster Seat

I believe an actual high chair is a must-have. It’s helpful to have a dedicated seat for your baby, and the large high chair tray makes a great food-catcher. The IKEA Antilop high chair with tray is totally affordable.

A booster seat can easily strap onto your own chairs. This seat is foldable for easy storage. I’ve taken it along for visits to the grandparents and to restaurants – it’s super handy.

2. Bibs

You can certainly use the drooler/cloth bibs. However keep in mind they’ll need to be washed after each use.

I recommend getting a set of larger, waterproof, easy-to-clean feeding bibs. I prefer ones with big front pocket to catch any dropped food.

If your baby is an active explorer, your may prefer the Kushies Long Sleeved Waterproof Bib. It allows your little one to fully enjoy mealtimes without the worry of ruining their clothes.

3. Spoons

Make sure that any spoons you use are BPA-free. BPA is a harmful chemical found in some plastics that can leach into food when heated.
Munchkin 6-Pack Soft Tip Infant Spoon: These small, plastic-coated options are much gentle on tender gums. It’s helpful to have several on hand during feedings, one for you and one for baby, to encourage their sense of independence and avoid power struggles.

Once your baby is ready to try self-feeding, consider getting the OXO tot Fork & Spoon Set. This set makes it easy for young eaters to transition their food from bowl to mouth.

4. Dishes

When you first introduce solids, you will need a handful of small, BPA-free plastic bowls.

Calibowl. This deep bowl makes it easier for your baby to scoop up their food, while the super suction cup on the bottom prevents it from being tossed to the floor. It also includes fitted lids, making food storage a breeze.

Once your baby is ready to try self-feeding, consider picking up a divided plate like the OXO tot Divided Plate. I like the removable, raised outer ring. which helps keep food on the plate and guides it into utensils.

5. Straw Cup or Open Cup with/without handles

My son wasn’t a big fan of bottle, so I was very anxious to introduce a straw cup around 6 months. He would often bite on the straw, but he would sip from it occasionally. Using a straw cup does not present the same concerns as a sippy cup. In fact, It can help with oral motor skills development and reduce the risk of dental caries since the liquid doesn’t bathe the baby’s teeth. Here are three straw cups that I recommend:
- 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 your baby starts eating solids. Babies learn quickly how to drink from an open cup.

6. Snack Catcher

No more spilled snacks on the floor. This is the perfect solution for on-the-go situations, whether it’s a doctor’s appointment, shopping trip, grocery run, or evening walk.

A HEALTHY FEEDING RELATIONSHIP

Babies learn by observing those around them. When families eat together, it teaches babies that mealtime is a time to connect, share, and enjoy food.

As a PARENT;, your role is to choose WHAT foods to offer. As baby start to eat solid foods, your are responsible for WHEN and WHERE baby is fed.
It is your BABY’S job to determine HOW MUCH they want to eat.

Trust your baby to recognize their hunger and fullness cues. This fosters mindful eating.

Introducing solids to your baby can be lot of fun. Be PATIENT and remember that it might take time for your baby to warm up to new foods; this is completely normal. If your baby enjoys every food from the first bite! Congratulations! you have a wonderful little eater.

Bon Appétit babies!

Happy Shopping Mommies!!

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

Lately, I’ve come across many questions from parents wondering about the right age to start introducing solid foods. Some experts and older guidelines suggest introducing solids between 4 and 6 months, while certain parenting websites say 4 months. Sometimes, this advice even comes from a doctor or other health professionals. Many of us, especially those raised in the 80’s, may have started eating solid foods as early as 2 to 4 months because our parents followed older recommendations. As a first time mom, I totally understand the eagerness to start solids – especially with friends and family sharing plenty of “advices” and “opinions”. It’s easy to start thinking, “maybe 4 months is the right time!” With so many conflicting recommendations, it’s no wonder today’s parents are feeling confused.

WHY DO BABIES NEED SOLIDS?

Introducing solid foods to babies isn’t just about adding variety; it’s essential for both nutritional and developmental reasons. Breast milk or formula will still be a main source of nutrition during the first year, but starting solids around 6 months helps meet growing needs that milk alone can’t fulfill.

1. Nutritional Reasons

Iron Needs: By 7 months, babies’ natural iron stores begin to deplete, and they need iron-rich foods to support healthy growth and brain development.
Critical Nutrients: Beyond iron, there’s an increased need for other key nutrients like protein, zinc, omega-3 fatty acids, and additional energy to fuel their development and growing curiosity.

2. Developmental Reasons

Biting and Chewing: Starting solids helps babies practice essential skills, like biting and chewing, which play a big role in speech and jaw development.
Oral and Motor Skills: Eating solids encourages the development of muscles around the mouth and fine motor skills as babies learn to pick up food, bring it to their mouths, and chew.

ARE YOU STARTING EARLY?

Here are some common reasons parents introduce solids before the 6-month mark:

My baby is too big
My baby is too small and tiny
My baby seems hungry (increased breastfeeding demand)
My baby wakes up multiple times a night
My doctor recommended starting solids
My baby wanted the food I was eating
I wanted to offer something (iron rich foods) alongside breast milk or formula

For those common reasons parents consider introducing solids early, it’s important to remember that breast milk (or formula) provides more calories and far more essential nutrients than any solid food can at this stage. Breast milk is designed to meet a baby’s needs perfectly, offering a balance of calories, fats, proteins, and vitamins that’s challenging to match with solids. Even if your baby is showing increased hunger, breast milk or formula is usually enough to satisfy them until they reach around 6 months.

In light of all this, it’s completely understandable why so many parents are questioning when to begin solids. Next, I’ll dive into why waiting until around 6 months is often best for your baby’s development and health.

TOO EARLY? or TOO LATE?

Starting solids too early—before 4 months (17 weeks)—can pose several health risks. Research shows that introducing solids TOO EARLY can increase the chances of:

Infections and Digestive Issues: Babies’ digestive systems are still maturing, and introducing solids too soon may cause gastrointestinal discomfort and infections.
Food Allergies: Introducing certain foods too early can increase the risk of developing food allergies later on.
Obesity: Early solid feeding can influence long-term eating behaviors, potentially contributing to a higher risk of childhood obesity.
Kidney Strain: Babies’ kidneys aren’t fully developed in the first few months, and early solids can strain these organs, leading to imbalances in minerals they’re not yet ready to process.
Reduced Breast Milk Intake: Solids may replace breast milk in the baby’s diet, potentially reducing milk supply and lowering access to the essential nutrients and antibodies breast milk provides.
Choking Risk: Babies’ swallowing and chewing reflexes are not fully developed before 4 to 6 months, increasing the risk of choking on solid foods.

Waiting too long to introduce solids—beyond 7 months—can present its own set of challenges. By this age, babies start needing additional nutrients that breast milk or formula alone may not fully supply. Research shows that delaying solids past 7 months can increase the risk of:

Iron Deficiency: Babies’ iron stores begin to deplete around this time, and solids provide essential dietary iron that helps prevent deficiency.
Food Allergies: Both early and delayed introduction to certain foods are associated with a higher risk of developing allergies.
Texture Sensitivity and Food Fussiness: Delayed exposure may make it more challenging for babies to accept new textures and flavors, potentially leading to picky eating.
Difficulty with Essential Nutrients: Waiting too long can mean babies miss out on critical nutrients like iron and zinc, which support growth, brain development, and immune function.

WHAT IS CURRENT RECOMMENDATIONS

Top health organizations recommend introducing solids around 6 months when babies show signs of readiness.

World Health Organization (WHO)
Health Canada and Canadian Paediatric Society
American Academy of Paediatrics (AAP)
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

These guidelines advocate for exclusive breastfeeding until around 6 months to ensure the digestive system is mature enough to handle solid and to protect against gastrointestinal and respiratory infections (APP 2012, Nylor & Morrow, 2001).

Exclusive breastfeeding or formula feeding for the first 6 months provides all the essential nutrients a baby needs, with breast milk or formula remaining their primary nutrition source until they reach this milestone.

DEVELOPMENT SIGNS FOR READINESS

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

Around 6 months of age
Sitting with minimal support (with pillow or towel)
Good head and neck control, able to hold head upright and steady
Bringing hands and toys to their mouth
Appears interested in food, possibly by reaching for or leaning forward towards food
Your baby can swallow food (look for loss of the tongue thrust reflex)

GESTATIONAL AGE

It’s important to consider your baby’s gestational age when deciding when to introduce solids. Premature babies may not be neurologically or physically ready for solids until approximately 6 months after their original due date, rather than their birth date. For instance, my elder son, born 2 weeks early, began solids about two weeks after turning 6 months. Similarly, Audrey and Avery, born 4 weeks early, started solids around 6.5 months. Adjusting based on gestational age allows babies to begin solids when their developmental milestones and readiness are more in line with their age-adjusted peers.

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

It’s common for babies around 4 to 5 month to show interest in mealtimes such as reaching for food. However, this curiosity doesn’t necessarily mean they’re ready for solids. In fact, it is part of their normal development to explore by putting objects in their mouths. Here are some ways to involve your baby in mealtimes without introducing solids:

Include Them at the Table: Let your baby join family meals in a booster seat or high chair. This gets them used to mealtime routines and sitting in their designated seat, preparing them for when it’s time to start solids.
Provide Safe Utensils: Give your baby spoons, cups, or bowls to play with during mealtimes. This helps them get familiar with eating utensils in a fun and exploratory way.
Introduce Open Cups: Offering small amounts of water or expressed breast milk (1-3 oz) in an open cup starting at 6 months is considered beneficial. This lets your baby practice drinking skills while engaging at the table without starting on solid foods.

BOTTOM LINE

Most babies are developmentally and physiologically ready to start eating solid foods between 6 and 8 months of age. It’s important to look for signs of readiness rather than strictly following a calendar. Remember, the decision to start solids shouldn’t come from pressure from parents or in-laws but should be based on your baby’s cues.

Baby, Bon Appétit !!

My children love making a mess during mealtime, and that’s perfectly normal! It’s all part of the learning process as he explores new textures and flavors.

As you embark on this exciting journey of introducing solid foods to your little one, remember that patience and observation are key. Every baby is unique, so trust their cues and enjoy the experience of discovering new flavors and textures together.

For more tips, resources, and support on feeding your baby and fostering healthy eating habits, be sure to check out my Instagram. Happy feeding!

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.

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.