Thursday, April 23, 2015

Feeding Baby Series: Time for Food!


Congratulations mamas and papas! Your baby is ready for the joys of table food! Or are they? There is a lot of misinformation out there (much of it generated by the baby food industry) about when to start baby food and what the best first foods are. This post features my advice for the when, why, what and where of offering your little one their first solids.  

When: The recommendation that I follow for starting table foods is 6 months. I started my little guy on solids the week before his 6 month "birthday." The baby food industry would love you start on food sooner of course (more money in their pocket), but in most cases it really is not necessary. Your little one's nutritional needs are met with formula and/or breast milk (if your babe is just drinking breast milk Vitamin D supplementation is recommended however).
Some key things to look for to help you assess if your baby is ready to start eating are:
  • they can sit up unsupported and are able to hold their head steady
  • they seem interested in food and open their mouth or lean in when food is offered via spoon; furthermore, they are able to close their lips over the spoon and keep teeny portions of food in the mouth rather than than back out on the chin.

Why: Waiting for the six-month mark to start your little one on table food is beneficial for several reasons. 1) If you are breastfeeding, it can help you keep your milk supply up longer 2) Your babies’ tiny gut will be more mature which could result in less gas and tummy trouble 3) You will be letting your babies’ healthy gut flora do its job without introducing in new bacteria that alters the GI environment. With all of the buzz lately on gut flora and your health (which I plan to investigate further), I think there might be something to this! With all of this said, about six-months old is when an infant is about to deplete their iron stores so getting in a good food source of iron is recommended. 

What: Jasper's first food was very, very thinned out (with milk) roasted and mashed sweet potatoes. This was followed by Earth's Best Organic Oatmeal (thinned out with milk) and mashed banana (again thinned out with milk!). We added in several of the foods listed below over the next few weeks and gradually stepped up the texture of the food. I truly did not suspect any food allergies with him (however you never know), but the best guidance is to introduce one new food at a time by offering it over a period of 3-4 days before adding in any new foods. During the 3-4 day window, be on the lookout for any signs of a possible food allergy (rashes or lots of tummy troubles including diarrhea or excessive gas). 

Best First Foods for Baby--low allergen risk (ideally organic to reduce pesticide and antibiotic resistant bacteria exposure)

·         Oatmeal/ Multigrain cereal (I'm not sure where I stand on rice cereal, the guidance per the American Academy of Pediatrics is to vary the type of cereal given due to reports of arsenic-derived rice..this is something you may choose to read about further!)

·         Banana

·         Sweet Potatoes

·         Avocado

·         Papaya

·         Applesauce (unsweetened)

·         Peas

·         Butternut Squash

·         Green Beans

·         Pears

·         Plums 

Remember that your little one's gut is still immature....wait a few months before offering lots of super high fiber foods (beans, broccoli etc.) or highly acidic foods (citrus, tomatoes). I will write soon on introducing more adventurous foods later! I have heard some RDS recommend meat as a good first food because the iron is absorbed well. This is an option but a more difficult one, as its not as convenient as iron-fortified cereal or as easy to get in a thin enough form for new eaters.  *Also, offer the foods above in their pure form. No salt needed--in fact early exposures to salt are linked to a preference for it later in life.
Where: Make sure baby is sitting upright to eat (in a highchair or booster) and is offered foods by spoon (helps with hunger/ fullness cues, for this reason putting infant food in a bottle is NOT recommended). Try to include baby at the table for your mealtimes and make the environment as pleasant and non-distracting as possible. Do not make a big deal when your baby does not want the food offered (and honestly, he won't always, especially at first). Just simply stop offering the food and try again later, sometimes 10-15 exposures to a new food are needed. Don’t forget to offer the food from a dish rather than an infant food jar. Your little one is not likely to finish all of the food offered and once you dip the used spoon back in, it should be tossed out after the meal rather than popped back in the refrigerator. Safety first! 

** A word on beverages. Please wait on the cow’s milk until your infant is older than one year of age. In addition, my preference is to wait on offering juice until about that time as well. Juice is not essential for meeting nutrient needs and teaching the healthy habit of drinking water is a wonderful gift for your little one.  Jasper started taking small sips of water by spoon about the same time we started him on solids. If you do choose to offer juice, choose 100% juice (no juice like drinks!), dilute it well with water or offer 4 ounces or less per day.

 

 

Thursday, April 2, 2015

Eating Mindfully


Working as a dietitian is challenging.  Not only am I competing with food fads and crazy diets (including myriad recommendations from Dr. Oz), but I am competing with my patient’s emotional struggle with food. Some of these struggles are from their past (“my mother FORCED me to eat oatmeal—I will never touch it again”) and some are from their present and often linked to the state of their mental well-being (“I overeat when I am feeling sad.”).  These relationships often need to be addressed before the real education on making healthy food choices begins. One of the ways that I choose to address these emotional barriers is with the practice of mindfulness and intuitive eating. And to make sure we are all on the same page, here is mindfulness defined”: “intentionally paying attention, moment to moment, without judging what is happening internally in the body, mind, and heart and externally in the environment (Mindfulness and Diabetes: Working in Tandem, 2015).

How many of you ate a meal while watching television or sitting at your computer today? Guilty as charged. Do you feel like you were truly present to your dining experience? Do you remember the aroma? The taste of each bite of food? Perhaps you scarfed down your sandwich so quickly you don’t remember eating it at all. This is the issue for many of us and it can be harmful to our waistline and overall health.

When working with my patients on eating mindfully, I help them slow down and savor the foods that they are eating. This can be done with a variety of methods. Using the hunger scale (a way to rate your level of hunger before and after eating), putting down one’s eating utensil between bites of food and/or journaling to reflect on foods eaten and the eating experience overall. This is no easy task and one must be extremely motivated and honest with themselves to work on this.

A 2013 study published in Diabetes Spectrum  found that participants who completed a Mindfulness-Based Eating Awareness Training Program , which included meditation, were able to cut back on the amount of calories they were eating daily and experienced improved blood sugar control and a reduction in blood pressure. This is hopeful news and only strengthens my belief that an overall lifestyle focusing on the present moment and mindfulness is essential for  both physical and mental health.

I have a challenge for you. The next time you sit down (or stand, which is less ideal but often the reality) to eat a sweet treat, I encourage you to try this. Start out by taking a bite of your treat and eating it as usual. Do you want another bite? Most likely. For your next bite, let the morsel linger in your mouth for one minute. Think about the taste that you are experiencing. Try to describe it to yourself. After you finish, tap into what you notice about how much you want another bite. Most likely you are more satisfied than when you took your first bite more hastily. Even if this exercise did not work for you this time, I encourage you to try again later.  The more difficult this is for you, the more often you will need to practice.
 
Mindful eating is important to teach our children too so they develop healthy relationships with food. You can practice mindful eating with the little ones by sharing in a snack experience. Before eating, describe how the food looks. Guide the kiddos through eating the snack slowly and chat about the taste and texture, as well as how their hunger level changed after eating.
And that my friends, is my food AND flow wisdom for the day!
 

“The more you eat, the less flavor, the less you eat, the more flavor” ~Chinese Proverb