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Daily Dose

Food Myths & Your Baby

1.15 to read

I really enjoy talking to my young parents about feeding their baby and toddler new foods. But what about food allergies they say?   I believe that healthy nutrition and good eating habits begin early on, actually just as a child starts to eat solid foods. The more foods a child is exposed to initially, the better chance a parent has of having a child who eats a variety of foods when they are older.  This means no making yucky faces if you (parent) don’t like spinach - fake it! 

But, with that being said, so many new parents are still under the impression that there is a “list” of forbidden foods. As I talk to them about finger foods and letting their baby explore new foods and textures they are amazed when I say things like, “let them try scrambled eggs” or “what about trying almond butter or peanut butter?”, “try ripping up pancake pieces”. 

I also like to let a 9-15 month old try all sorts of different fruit, veggies and proteins. In fact, “there are really no forbidden fruits” as long as the food you offer is mushy (we adults might say a bit over cooked at times) and broken/or cut into very small pieces. I am most concerned about the size and texture of the piece and protecting the airway than I am about the food itself.  

Over the last 5-10 years studies have shown that restricting foods and delaying introduction of certain food groups did not prevent the development of food allergies.  So, the idea that delaying the introduction of peanut butter until after a child is 2 yrs old, or waiting to give a child fish until they are older, or not letting your 9 month old child taste scrambled eggs, did not prevent food allergies. Some researchers would say it may actually be the converse, earlier introduction may be preventative.  

But the funniest thing to me, it is like old wives’ tales....these ideas have somehow been perpetuated.  The new group of parents that I am now seeing were often still in college and dancing at parties when it was the recommendation to wait to introduce some foods (egg, peanut , fish etc).  How do they hear these old ideas?  Maybe grandparents or friends with older children. Who knows? 

So, for the record, the rates for most common food allergies are still low at 2.5% for milk, 1.3% for eggs and 1% for peanut and less than that for tree nuts.  Don’t limit what you give your child unless you have seen them have a reaction when a food is initially introduced, and if you are concerned, talk to your doctor.  Most people who report having food allergy actually turn out not to have true food allergies after a good history and further testing. 

More about true food allergies to come.  Stay tuned! 

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Daily Dose

Don't Let Your Child Become an Obesity Statistic

Healthy eating begins with the first foods that you feed your infant.An alarming statistic was released today which shows that one in five 4-year-old children are obese and these numbers are even higher in minority children. This study was just published in The Archives of Pediatric and Adolescent Medicine, and followed over 8,000 children looking at height and weight. The findings were quite concerning, showing a trend toward obesity at an age younger than predicted, and numerous long term health problems associated with obesity, such as heart disease, diabetes, high blood pressure and bone and joint problems.

This is a national health issue and a call to action for all families to teach and model healthy eating. One of the problems is that many of the government sponsored food programs provide foods high in carbohydrates, and low in fresh fruits and vegetables, and this promotes obesity. School lunches have also been found to be high in fat and carbohydrate and continue to promote poor food choices. With the bad economy and recession, families have cut back on groceries and may be eating more fast foods, breads and pastas, again providing more carbohydrate than protein. Healthy eating begins with the first foods that you feed your infant. A well balanced diet with grains, fruits, vegetables and meats begins in the high chair and should continue at the family dinner table. The meals may be simple and healthy. Being a short order cook, or providing your child's favorite pizza and fried food on a daily basis, even in a young toddler will have deleterious effects for the rest of their life. Don't let your child become a statistic heading toward lifelong health issues secondary to childhood obesity. Change your own eating habits, improve your children's and remain committed to family meals. We, as parents, cannot afford to raise a generation where obesity is the norm: the change must begin now. That's your daily dose, we'll chat again tomorrow. More Information: 1 in 5 Preschoolers Obese

Your Child

Playing With Food May Help Picky Eaters

2:00

If your child is a picky eater, encouraging them to play with their food may help them overcome the reluctance to try new foods according to a new study.

Researchers in the United Kingdom asked a group of 70 children – ages 2 to 5 – to play with mushy, slimy food while their parents observed, watching to see if kids would happily use their hands to search for a toy soldier buried at the bottom of a bowl of mashed potatoes or jelly. Children who wouldn't use their hands were offered a spoon.

Parents and researchers each rated how happy the kids were to get their hands dirty on a scale of one to five, with a higher number indicating more enjoyment. Children could get a total score as high as 20, a tally of the scores from researchers and parents for play with both the mashed potatoes and the jelly.

Researchers also gave parents a questionnaire to assess children's so-called tactile sensitivity, quizzing them about things like whether kids disliked going barefoot in the sand and grass or avoided getting messy.

The study found that kids who liked playing with their food were less likely to have food neophobia (the fear of trying something new) or tactile sensitivity.

"Although this is just an association, the implication is that getting children to play with messy substances may help their food acceptance," lead study author Helen Coulthard, a psychology researcher at De Montfort University in Leicester, U.K., told Reuters Health by email.

Previous research has linked food neophobia to limited fruit and vegetable consumption. Courtland and her team wanted to see if they could establish a link between touching food and tasting unfamiliar foods.

Courtland suggested that parents of picky eaters begin introducing new foods to their child by creating “food art.” Food art is making pictures or images with different foods on a plate.  The first step is letting your child make a picture or design by arranging various colored foods on the plate.  Don’t pressure them to taste their creation, but wait till they are ready to give it a try. Make it a game and eventually begin encouraging them to taste what they have created. Start small and expand to larger food groups and pictures.

Offering as much variety as possible from a young age also helps children experience lots of textures and flavors, which may minimize their fear of unfamiliar foods.

You’re probably going to have to join in on the taste experimentation to show how good these food pictures taste! You might also take a picture of your child with their creation on your phone and then show it to them – to make it a little more fun.

It’s fairly normal for kids to go through a period of refusing to try new foods, though most kids will grow out of this phase by the time they start school. However, there are some children that carry new food aversion on into adulthood. It isn't necessarily harmful as long as the children maintain a healthy weight for their height, pediatricians say.

But over time, neophobia can make it very difficult to enjoy social engagements. Parents that have a hard time trying or enjoying new foods themselves too often pass that trait onto their own children.  Most of the time it’s just a phase that kids go through and finding creative ways to help them work through it eliminates the problem.

Source: Lisa Rapaport, http://www.reuters.com/article/2015/05/19/us-food-fears-children-idUSKBN0O41MD20150519

 

 

 

Daily Dose

Plate Size & Childhood Obesity

1.15 to read

While I have been trying to change up my eating habits a bit and talking to patients about trying some new foods, I came upon an interesting study in the journal Pediatrics.  

The hypothesis for the study, which was done among school children in Philadelphia, was “can smaller plates promote age-appropriate portion sizes in children?”.

There have been previous studies in the adult literature that have shown that dish ware size influences self-serve portion sizes and caloric intake. Whether the same conclusions with children were true had yet to be examined, but it does make sense that it might.

So, the hypothesis was correct and when children were given larger bowls, plates and cups, they served themselves larger portions and in turn more calories. In the study, 80% of the children served themselves more calories at lunch when using adult-size plates and bowls.

This is really great news, in that by changing the size of the plate we might be able to affect a child’s portion size without them even really being aware!

I remember that our kids all had children’s bowls, plates and cups that they loved to use and eventually they either broke, got lost, or we just decided to have everyone eat off of the same plates. But, maybe it would make more sense to continue to have our children use child sized plates until they reach puberty?  Certainly seems that it wouldn’t hurt and if schools did the same thing we might be able to impact some of the obesity problem by just changing one behavior.  It is definitely worth trying!

Daily Dose

Hot Dogs: A Choking Hazard

The AAP recommends the food industry change the shape of a hot dog as it causes choking in children. Dr. Sue says other foods are just as hazardous. Did you read the latest AAP (American Academy of Pediatrics) position statement which addressed the issue of choking among children?   Choking is unfortunately a common problem in the pediatric population and prevention of choking is a topic I discuss with all parents as their children begin eating table food.

Children under the age of 3 have the greatest frequency of choking and hot dogs are a major concern for causing choking.  Due to this, the AAP has recommended that food manufacturers “design new food and redesign existing food to minimize choking risk”. They also state that foods that pose a high choking risk (peanuts, hard candy, grapes, apples, popcorn and chewing gum) should also get warning labels. But this may sound crazy, while knowing that choking is a problem in the pediatric population, I cannot understand a recommendation to change the shape of a hot dog.  A hot dog is a hot dog and if flattened it will then be called bologna. Hot dogs are not the issue, as grapes and peanuts cause choking and we cannot advocate changing their shapes.  Rather, it seems to me to be an issue with educating parents and making parents responsible for cutting up their children’s food. Parents need to be parents and take responsibility for protecting their children but not by changing the shape of a hot dog.  Think of all of the different objects that can cause choking, coins, toys, buttons, weird small objects that toddlers find on the floor. We cannot protect our children from all small objects and at the same time, things that we have control over, such as a hot dog or a grape, should be cut into small pieces before giving them to a child.  Lollipops also cause choking and some pediatricians still give lollipops after an office visit.  Hotdogs and lollipops are just what they are, they cannot be changed. We educate parents about using sunscreen (but we did not change the sun) and we are concerned about drowning and advocate fences and pool safety, but we don’t stop going outside or playing in a pool in the summer. Keep talking to parents about the risk of choking, advocate that all parents take infant and child CPR, cut up a child’s food until they are old enough to tell you that they know how to use a knife, but don’t outlaw hot dogs.  I will eat a hotdog at the ballpark or state fair, but not bologna. That's your daily dose for today.  We'll chat again soon.

Your Teen

Energy Drinks

Just about every store you go into these days has a shelf of energy drinks, many of them marketed towards our teenage children. “Many are marketed as energy drinks but should be called stimulant drinks” says pediatrician Dr. Sue Hubbard. Many of these drinks contain large amounts of caffeine.”

Dr. Hubbard warns that too much caffeine in a teenager’s system can cause anxiety, rapid heartbeat, insomnia, nervousness and upset stomachs. “It can also mess up a child’s sleep cycle, which is not good” she says. Dr. Hubbard recommends that parents read the labels of the drinks their children are consuming. She also recommends that if you need to hydrate your child during sports or other physical activity, give them water or a true sports drink, like Gatorade, and not energy drinks.

Daily Dose

Why Family Meals Are Important

It seems so easy to have meal time together, but it needs to begin when your child are younger, so that you will continue to have family dinner time once your children are older and busier.On our last radio show I was fortunate to have the opportunity to interview Dr. Dan Kindlon the author of Too Much of a Good Thing, where he discusses the problems with overindulged children. One of the many interesting points in his book is that he reiterates the importance of family mealtimes.

During Dr. Kindlon's research he looked at common attributes among the teens that he felt were "well adjusted" and successful at both school and outside the home. One of his findings was that these students had regular family meals. It seems so easy to have meal time together, but it needs to begin when your child are younger, so that you will continue to have family dinner time once your children are older and busier. Too many families find too little time to gather for a family meal. The excuses for all of us are many: after school and evening activities, parents work schedule, homework, etc. But there are really very few reasons to skip weeknight and or weekend family meals. It may be more convenient to have meals as a family three school nights and one weekend or all school nights or some combination. But, the bottom line is, the more often families gather for meals and spend time together engagedin dinner table conversation, the better adjusted, more successful and happier the children and teens seem to be. The other great thing about family meals is that they tend to be healthier and cheaper! If youneed recipe ideas, check out What's Cooking with Chef Dad on our Web site. A family dinner is just a click away!

That's your daily dose, we'll chat again tomorrow.

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Daily Dose

No Tech at the Table

1.15 to read

I am a huge proponent of family meals and Chef Dad Tom Fleming is always supplying The Kid’s Doctor with new family friendly recipes. I think many families are now trying to “make the time” to eat together at least several nights a week.  Kudos to those families! 

The problem that I am now seeing is that while families are trying to make a point to eat together, the meal is suddenly being invaded by technology! What I mean by this is that everyone is coming to the table with their smartphone, tablet, iPod, Nintendo DS or any other gadget or gizmo which allows one to be “disengaged” during mealtime. 

I certainly remember many a family dinner where I could barely get three words out of any of the boys (they would tell me that they had already used up their 700 words that day), despite the numerous “open ended” questions that I peppered them with.  We would even try to play those games like, “best thing that happened today” or “worst thing that happened”, I think the Obamas call this “thorns and roses” as they too enjoy families meals. 

With 3 sons and a husband I sometimes felt like it might be possible that those 4 males would eat together and never even say a word. (they tell me that when I was gone this was often the case and they did not view that as a problem!) 

At any rate, part of the value of the family meal is conversation and that means with those who are gathered at the table. Emailing, texting, game playing etc. during dinner needs to be not only discouraged but forbidden. That goes for both the adults (me included) and the children. 

I realize that there are many important world events happening during meal time…one might miss some one’s post on facebook, or a tweet or a text for a few minutes. But the need for continuous information from a gadget, or constant communication via texting does not have a place at the family meal. 

It used to be that we talked about no TV during meals. I remember that rule was rarely broken during my childhood except for events like the Kennedy assassination or the men landing on the Moon.  For our family we tried to continue the same rule and it was broken for events like Super Bowl, early space shuttle launches and landings and for terrible tragedies like 9/11. But we tried to keep the TV out of the dining area.  

I now I find that I have to remind my children and myself to “check all electronics” at the door before coming into dinner. If I don’t, I sometimes look down the family table and see heads bent looking at a sports score, or replying to a text about a party later that night or reading an email about work (me included). But if we all just leave the gadgets turned off/silenced and away from the table the conversation gets going. 

There is not such a rush to “go to the next event” and the work issues are put aside for 15 - 20 minutes. We can enjoy the rare occasion that all 6 of us get to be together and actually converse in real time. The time a family can spend together talking over breakfast, lunch or dinner is too important and precious to be shared with others not present until the meal is over. 

So, start the rule, No Tech at the Table, and enjoy family mealtime.   

Daily Dose

Lead Found in Baby Food

1:30 to read

I know many of the parents of the children I care for are concerned about the latest news from the Environmental Defense Fund which showed that about 20% of baby food samples tested over a 10 year period had detectable levels of lead.

 

This non profit group looked at data that the FDA had collected from 2003-2013 which included 2,164 baby food samples. While none of the baby food samples seemed to exceed the FDA’s “allowable” levels of lead, it is still quite concerning. At the same time the FDA is in the process of reviewing their standards to reflect the latest science surrounding the potential risks to young children who are exposed to lead.  

 

While lead testing is routinely performed in young children (1 and 2 yrs), the CDC currently  considers a blood lead level greater than 5 micrograms/deciliter as elevated, but no lead level is “safe”. 

 

Lead exposure has been shown to have neurocognitive effects - which means IQ, the ability to pay attention and academic achievement…and the effects cannot be corrected.

 

The study did not name baby foods by brand.  Root vegetables (carrots are one) had the highest rate of lead detection (65% of samples), followed by crackers and cookies (47%) and the then fruits and juices (29%). Only 4% of the cereal samples contained lead.

 

This report will cause a lot of parental anxiety, but really doesn’t tell us much about what to do?  Lead based paint is still the number one source of lead exposure, followed by water, which may also have contributed to lead in food…. but there is still lots of be determined.

 

In the meantime, the take home message is “feed your babies and toddlers a wide variety of baby foods” and when possible eat fresh foods. One hypothesis is that baby foods are more processed which may contribute to the higher lead content.  It is easy to cook and “mush” up your own food to feed your baby and it really does not require a fancy food processor.  If you can mush it your baby can eat it!!! The only concern about the introduction of food is basically it has to be soft enough not to be a choking hazard. So no whole nuts, chunks of meat, uncooked hard veggies…you get the idea.

 

Just because your baby doesn’t seem to like certain foods, don’t get stuck feeding them just a few foods…but continue to offer a variety of healthy foods..some of which they may eat more of than others. Every day will be different.

 

So…don’t go throw away all of your baby foods but think if you might be able to substitute fresh foods, don’t offer fruit juices to your babies and toddlers and most importantly eat healthy foods. That’s the best thing for you and your child.  

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