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Daily Dose

Food Textures

1:30 to read

If you have a baby between the ages of 8-9 months and have already been offering them pureed baby foods it may be time to start some textures as well.  Many parents are a bit “wary” of offering any food that hasn’t been totally pureed, but it is important that your baby starts to experiment with foods that have different consistencies. 

Of course this does not mean you hand your baby anything that they could choke on like a grape, or piece of meat etc. But instead of totally pureeing carrots, why not cook them well, chop them up a bit and put them on the high chair tray. It is fun to watch how they touch and feel the carrots, before they “smoosh and moosh” them and get them to their mouths.   

There are so many foods that are easily offered to a baby to get them used to feeling different textures.  This is the very beginning of experimenting with finger foods, and this doesn’t just mean puffs or cheerios either. I like to encourage babies to feel cold, gooey, warm, sticky, all sorts of different textures which will ultimately help them become better and more adventuresome eaters as they get older.  

Unfortunately, I see far too many little ones (and not so little ones too) continuing to eat totally pureed foods and then becoming adverse to textures as they did not get the experience at an early enough age. 

It is also fun to watch your child as they begin to pick up foods that have been chopped and diced into small soft pieces. In the early stages they have to scoop and lick the food from their fingers and hands, but very quickly their pincer grasp takes over and suddenly they can pick up that well cooked green bean or pea!!  Such a feat and worthy of a home video to send to the grandparents for sure. 

So, put out some mushy food and let them play - I know it is messy but that is what being a kid is often about!

Daily Dose

Is Fruit Juice Healthy?

1:30 to read

I remember when my children were small that it was “routine” to begin offering infants dilute juice around 6-9 months of age.  Over the years the AAP (American Academy of Pediatrics) continued to advise against offering fruit juice to children under the age of 6 months.  Now…decades later, the AAP has just issued new guidelines including the recommendation “not to offer juice to children under the age of 1 year”.

 

The new recommendations will be published in the June issue of Pediatrics in which they write, “while parents may perceive fruit juice as healthy, it is not a good substitute for fresh fruit and just packs in more sugar and calories.”  The article continues to state, “small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under 1 year.”

 

I always diluted juice for my children, even when they were older.  I would just add a few cans of water to concentrated juice and they never even knew it. It just seemed logical to me at the time. But while 100 percent fresh or reconstituted juice may be healthy, it should still be limited depending on a child’s age.  The concern over steadily increasing obesity rates as well as dental health and the risk of cavities makes even fresh fruit juice a culprit for added calories and sugar.

 

The recommendations include:  toddlers should never be given juice from a bottle or in a sippy cup that allows them to consume juice (even diluted) throughout the day. I continue to recommend that the bottle “goes bye-bye” at the 1 year birthday party and a child only drinks from a sippy cup at meals and snacks after that.  

 

The child should also not have a sippy cup to “wag around all day”.   Parents often tell me that “their child drinks water all day long” but again that may keep them from eating a healthy meal if they drink throughout the day. You know how many adult diets recommend “drink tons of water all day” so you won’t feel hungry…same may be said for a toddler who is already a picky eater.  

Small children get plenty of fluids at meals and snacks and are not hydrating for athletics like my older patients. There are no recommendations that young children drink a certain amount of water everyday….although parents swear their child needs 16 ounces a day?

 

In reality children of all ages should be encouraged to eat whole fruits and be educated about the difference between the fruit they choose and juice.  With “juicing” being so popular, they need to know that even “green juice” lacks dietary fiber and may contribute to excessive weight gain.  I agree that fruit juice is better than no fruit…but for toddler ages 1-3 years, no more than 4 ounces of juice a day, children age 4-6 only 4-6 ounces a day and for children 7-18 years only 8 ounces (1 cup) of juice. The recommendation is that a child should have 2-2.5 cups of whole fruit per day. 

 

I still recommend that my young patients only consume milk (low fat is fine) and water on an everyday basis and add juice later on…when their friends happen to tell them about juice boxes etc. If I am going to buy juice at all I recommend 100% fresh fruit juice and if you can, get juices with added calcium (a little extra never hurts!).

Lastly, juice is not appropriate for re-hydration or for the treatment of diarrhea. For those instances it is necessary to use an “oral re-hydration solution”.

Daily Dose

Milk vs. Non Cow's Milk

1:00 to read

Once your child turns one, the AAP recommends that they transition from formula to milk…cow’s milk that is. But, more and more of my patients state that they prefer to drink almond milk, soy milk, rice milk, coconut milk, hemp milk and even goat’s milk. I am constantly having to look up the calcium, protein or fat content of all of these “cow’s milk alternatives”.  In the majority of the cases there is not a medical issue driving the choice of milk, but rather parental preference for non dairy, lactose free etc. etc.  

 

Interestingly, I just read an article from the American Journal of Clinical Nutrition that found that children that drink non-cow’s milk may be “slightly shorter” than those children of the same age who drink cow’s milk. There is an ongoing research project which studied about 5,000 children between the ages of 2 and 6, and looked for height differences between those children “who consumed about 8 ounces of non-cow’s milk per day compared to those who drank the same amount of cow’s milk”. 

 

The children who drank non-cow’s milk were about 0.15 inches shorter than average for their age. Although this is just one study,  it will be important to continue to evaluate this data to see if the height differences continue into adolescence. This is a good study to keep following.

 

While I am always concerned about the calcium intake in children and their long term bone health, here is yet another concern.

 

It may be time to re-think your family’s milk choice and unless there is a medical reason to avoid dairy…..try good old cow’s milk…it may actually make you a bit taller?  

Your Baby

1 Egg a Day Improves Growth in Babies

1:30

While not as common in the United States, an astounding number of children worldwide suffer from stunted growth; mainly due to malnutrition or disease. It is a serious problem that impacts about 162 million children under the age of 5.

A new study from the Brown School at Washington University in St Louis, suggests that just one egg daily may significantly increase growth and reduce stunting in children.

"Eggs have the potential to contribute to reduced growth stunting around the world. They are also a good source of nutrients for growth and development in young children," said Lora Iannotti, an author and researcher in the Washington University study.

Researchers gave eggs to 80 infants between six and nine months of age for one year. Another 84 weren’t given eggs and served as a control group. Compared to these controls, the egg-eating youngsters had a 47 percent lower prevalence of stunting, which is defined as being too short for one’s age. Their length-for-age measurement also shot up by a significant margin.

Why would a daily egg have such a dramatic effect? Eggs are often referred to as “the perfect food.” They contain all of the necessary amino acids, as well as choline, various growth factors and DHA, a polyunsaturated fatty acid important for the brain. All of these are necessary for proper growth and development, and the normal function of the body.

There has been some concern in the past, that eggs may raise an infant’s cholesterol level or induce an allergic reaction.  However, research has not shown these hypotheses not to be true. The food appears to be safe and healthy for infants, says Iannotti.

Eggs are easily available for parents and affordable as a food option. Lots of families are even experimenting with raising chickens for their eggs in communities across the country.

Iannotti believes this study shows that just one egg a day could have a dramatic impact, globally, on the number of children suffering from stunted growth.

The study was published in the June edition of the journal Pediatrics.

Story sources: Pawel Kopczynski / Reuters, http://www.newsweek.com/one-egg-day-boosts-growth-infants-621266

Neil Schoenherr, https://source.wustl.edu/2017/06/eggs-can-significantly-increase-growth-young-children/

Your Baby

Fish Oil During Pregnancy May Reduce Baby’s Asthma Risk

2:00

A Danish study’s results suggests pregnant women that take a fish oil supplement during the final 3 months of pregnancy may reduce their baby’s risk of developing asthma or persistent wheezing.

The study involved 736 pregnant women, in their third trimester. Half the women took a placebo containing olive oil and the other group was given 2.4 grams of fish oil. The women took the supplements until one week after birth.

Among children whose mothers took fish-oil capsules, 16.9 percent had asthma by age 3, compared with 23.7 percent whose mothers were given placebos. The difference, nearly 7 percentage points, translates to a risk reduction of about 31 percent.

In the study, the researchers noted that they are not ready to recommend that pregnant women routinely take fish oil. Although the results of the study were positive, several experts have noted that more research needs to be done before higher doses of fish oil supplements are recommended over eating more fish.

Researchers found no adverse effects in the mothers or babies, the doses were high, 2.4 grams per day is 15 to 20 times what most Americans consume from foods.

One in five young children are affected by asthma and wheezing disorders. In recent decades, the rate has more than doubled in Western countries. Previous research has shown that those conditions are more prevalent among babies whose mothers have low levels of fish oil in their bodies. The new large-scale test, reported in The New England Journal of Medicine, is the first to see if supplements can actually lower the risk.

Before doctors can make any recommendations, the study should be replicated, and fish oil should be tested earlier in pregnancy and at different doses, Dr. Hans Bisgaard, the leading author of the study, said in an email to the New York Times. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood, an independent research unit.

Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe, especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish.

“It is possible that a lower dose would have sufficed," the Bisgaard team said.

The supplements didn't seem to affect the odds of a baby or toddler developing the skin condition eczema, or an allergy such as a reaction to milk or egg products, or a severe asthma attack.

An editorial in the same journal by an expert who was not part of the study praised the research, saying it was well designed and carefully performed. The author of that editorial, Dr. Christopher E. Ramsden, from the National Institutes of Health, said the findings would help doctors develop a “precision medicine” approach in which fish-oil treatment could be tailored to women who are most likely to benefit.

If the findings are confirmed in other populations, doctors could test to see who would mostly likely benefit from fish oil supplements. "The health care system is currently not geared for such," Bisgaard said. "But clearly this would be the future."

If you are considering taking fish oil supplements during pregnancy, be sure and check with your OB/GYN for a recommended dose.

All fish oils are not the same. Some brands of fish oil are of higher quality than others. A reputable fish oil manufacturer should be able to provide documentation of third-party lab results that show the purity levels of their fish oil, down to the particles per trillion level. Also, if the supplements smell or taste fishy, they shouldn’t. High quality fish oil supplements don’t. Avoid fish oils that have really strong or artificial flavors added to them because they are most likely trying to hide the fishy flavor of rancid oil.

Story sources: Denise Grady, http://www.nytimes.com/2016/12/28/health/fish-oil-asthma-pregnancy.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Gene Emery, http://www.reuters.com/article/us-health-asthma-fish-oil-idUSKBN14H1T3

http://americanpregnancy.org/pregnancy-health/omega-3-fish-oil/

 

Daily Dose

Fit Foods for a Healthy Lifestyle

1:15 to read

Wherever you are on your healthy lifestyle journey, you are not alone.  I tell my patients that the key to being healthy is being disciplined in eating the right foods, staying active and getting enough sleep...and that’s for both you and your kids.

Committing to your overall health and wellness should start early on.  When you’re pregnant, it doesn’t always mean you’re eating for two. A growing baby needs nourishment from their mother’s diet throughout the day but experts say nutrition during pregnancy should be about adding extra nutrients and not extra meals. Moms to be need to be eating foods that are good for them and their baby.  You just need to choose the right ones.

Avocados are a power food loaded with critical vitamins and minerals pregnant moms need to pass along to their unborn baby.  Nutrients like folate which helps prevent birth defects of your baby’s brain and spinal cord. Avocados contain powerful antioxidants like lutein an ingredient found in breast milk which is known to protect important cells in a baby’s eye. 

It’s so important for pregnant moms to consume a host vitamins and minerals and avocados are a great resource.  You might say avocados are a very similar to a prenatal vitamin!  And avocados may even help reduce morning sickness!

And the health benefits of avocados don’t stop once your baby is born.  If you’re breastfeeding…avocados are high in monounsaturated fats which are good fats and are important for a baby’s weight gain, growth and brain development. 

Avocados are the perfect first food for your baby.   Between 4 and 6 months you can introduce avocados into your child’s diet.  They work perfectly because they are easily mashed and slightly sweet.  This is a good time to introduce new food textures as well.

What’s the foolproof way to know that your family’s favorite fruit is ripe?  Push lightly near the neck and feel for a gentle yield.  If you’re still not sure it’s ready to eat? Pop the stem button.  If the stem button pops off easily, then the fruit is ready to eat.

Moms and dads…we always put our children first…so don’t forget about yourselves.  Avocados are a fit food fruit.  Studies show avocados may reduce total cholesterol levels while they lower bad cholesterol and increase good cholesterol.

Avocados are also loaded with dietary fiber which may help you lose weight and reduce blood sugar spikes.

The next time you’re grocery shopping, make sure you add a few avocados to your cart.  They’re nutritious, heart healthy and taste delicious.  They’re good for you and everyone in your family! What more could you ask for in a fruit?

For more information, visit worldsfinestavocados.com.

 

 

 

 

 

 

 

 

Daily Dose

Marketing Healthy Foods to Kids

1:15 to read

The marketing of foods to children continues to be a hot topic.  As any parent knows…by the time your child is 3, 4 or 5 years old…they can often point to the box of sugary cereal with their favorite cartoon character on it, or identify a sign (McDonalds, Chic-Fil-A, Pizza) although they are not yet reading.  Companies are very clever when it comes to marketing…especially to children who drive a lot of consumer choices.

But, a recent article in Pediatrics shows how marketing may also drive healthy food choices. The study entitled, “Marketing Vegetable in Elementary School Cafeterias to Increase Uptake”, looked at the number of students who chose fresh vegetables from the salad bar at 10 elementary school cafeterias in a large school district over a six-week period.

The study included four different groups. In the first group the schools displayed vinyl banners with branded cartoon vegetable characters. These banners were then wrapped around the salad bar bases. The characters displayed “super human” strength related to eating vegetables (the Popeye of my generation - with his spinach).  The second group of schools showed short television segments which had vegetable characters delivering healthy nutritional advice. In the third group of schools both the salad bar banners and TV segments were used to promote healthy nutrition and food choices.  The fourth group was the control group and received no intervention.  The intervention schools also had decals with the vegetable characters placed on the floor which directed the children to the salad bars.

The results?  Nearly twice as many students ate vegetables from the salad bar when they were exposed to the banners.  More than 3 times as many students who were exposed to both banners and TV segments went to the salad bar (more girls than boys ). Interestingly, the marketing campaign also increased the number of students who chose a vegetable serving in the regular lunch line as well. 

So, it seems that branded marketing strategies may be used in a positive way to promote healthier food choices among young children.  Now we just have to get the advertisers to change some of their branded messaging aimed at young children from the “junk” to the healthy foods, as we have data to show that kids will choose good foods…especially if their super heroes like it too!

Daily Dose

Why Vitamin D is Important!

1:30 to read

As a follow up to the blog last week on children, calcium and vitamin D needs, a recent article in a Canadian Medical Journal reports that children who drink non-cow’s milk, such as soy, rice, almond and goat’s milk have lower serum vitamin D levels than those who are drinking vitamin D fortified cow’s milk.

This study looked at 2800 children between 1-6 year olds, and their consumption of either cow’s milk which is all vitamin D fortified and those who drank non-cow’s milk, in which case fortification is voluntary.  The researchers then looked at blood samples to measure vitamin D levels.

The researchers found that children who drank non-cow’s milk had nearly three times the risk for having low vitamin D levels.

So...bottom line...when I am discussing milk and dairy intake with families I am going to reiterate the need to drink cow’s milk, or children may need to continue vitamin D supplementation  and for most parents, including myself, it is hard to remember to give a vitamin or mineral supplement every day for a child’s entire life!).  A glass of vitamin D fortified milk at meals seems an easier choice in most cases.

Daily Dose

No More Food Battles

1.30 to read

Seems that I spend several times a day discussing “food battles” with my patients and their families.  I guess the longer I practice the more I don’t think we should even have to discuss how often parents “battle” with their kids about eating.  

From the early days of parenting when a baby is first offered either breast or formula, they are not asked “do you like this?”.  It is taken for granted that an infant will eat and grow and  there you have it.  The easiest days of parenting, correct? (except for a few months of sleep deprivation).  But once that baby begins to eat the discussions start about “he makes a face when he eats spinach”, or “she will only eat chicken tenders from Chik-fil-a”, or “he only likes pasta and won’t eat meat”, or even “I make 3 diferent meals for my 3 kids”.  If you have a child older than 9 months you understand what I am talking about. 

Food is necessary to nutrition, growth and health. But, with that being said, parents have to trust that a child WILL EAT when they are hungry.  Really, hunger drives us all to eat, eventually.  That bowl or cereal, or the steamed vegetables or even the dreaded chicken breast will get eaten if your child gets hungry enough. I remember reading somewhere that , “ a parent’s job is to provide food for their children at appropriate meal times, and child’s job is to decide if they will eat it.”  In other words, make the meal whether for your toddler or teen and “forget about it”.  Meal time needn’t be a battle but more a gathering to enjoy being together eating is just a bonus.  

As an adult, when you go to a dinner party, you don’t ask what they are serving before you accept, nor do you tell the host/hostess, I hate lamb!!  (my example).  You just smile and find something to eat and there is not a battle.  We all need to approach family meals as a dinner party. Our children are our guests, and sometimes they like what we fix and other times they push some food around their plate and choose not to eat.  The good news for most children is that there is another meal to follow. 

So, think about it and don’t let certain food likes and dislikes dictate mealtime. The more foods young children are exposed to the better chance they have of EVENTUALLY becoming a well rounded eater.  Children’s taste buds change with time as well, so you will find some foods that a 3 year old loved is no longer the favorite at 13 years of age.   

Well balanced, nutritious, colorful meals are the family goal and “food battles” can be left out of the vocabulary.   

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