Archive for Nutrition

Weaning Top Tips from Dietitians

Apple on books small

WEANING TWITTER CHAT

Last night dietitians from all four corners of the world, came together on twitter to chat about weaning. There were more than 500 tweets in 1 hour and lots of tips and experiences were shared so I thought I would capture a few for your benefit.

  • A variety of tastes and textures is key to successful weaning and a lower risk of fussy eating later in life
  • Mum is an important role model. Its important for mum to not influence her little one with her likes and dislikes
  • Having family meals together may help your baby accept new flavours (a spoon for baby and a spoon for mum) and gets them ready for fmaily meals later
  • Never give up, after many attempts they may eventually accept that new flavour
  • Babyled weaning may encourage self feeding but may not be suitable for slow developers. Its ok to combine spoon feeding with self feeding.
  • Spoon feeding has its place if done properly. Let your baby come to the spoon and not the other way round.
  • Weaning is great time for the whole family to start some new eating habits
  • Don’t feel you have to cook new recipes when weaning. Amend family favourites to make sure they are low in salt and sugar
  • Cook in bulk and freeze for days when you are not cooking.
  • Keep commercial weaning foods for when you need the convenience, they are not for everyday.
  • If you are worried about the choking risk, do a first aid course so you know what to do if it ever happens.
  • Expect lots of mess but have fun!

Catch up on the full twitter chat here: Weaning

Healthy Eating for the Whole Family

Eatwell Plate

Sorry its been ages since I have written anything but have been swamped with work.

Oscar is now 1 year old, onto family foods and feeding himself with a lot of mess! A friend asked me recently what she should be aiming for when it came to family foods and thought it was time I shared some tips on this.

Its all about balance…

There is no such thing as a perfect diet but really we should be aiming for a balanced one…a range of foods that provide different nutrients to ensure our little ones grow up happy and healthy. Our diet falls into 5 food groups (more info on each of these below) as shown by the picture. And how much we have from each food group is nicely shown by the slice of the pie!

Imagine you could put all the family meals you have in one week onto one large plate, would it look like this image? Maybe you are eating more meat? Less fruit and veg? Too much dairy?

This picture captures how our diet should look from 2 years onwards so applies to your diet too Mum! Children under 2 will have a larger proportion of dairy in their diets.

Group 1 – Starchy Carbohydrates

  • E.g. cereal foods, pasta, bread, rice, potatoes
  • Give us lots of energy and fibre
  • Try to choose less refined alternatives for slower release energy and more fibre (e.g. brown rice, whole grain pasta)
  • Should account for 1/3 of your diet

Group 2 – Fruit and Vegetables

  • E.g. Carrots, tomatoes, oranges, bananas, broccoli
  • Potatoes are not in this group (they are in Group 1)
  • Give us vitamins, minerals, fibre
  • Try to eat a rainbow. The more colourful, the more antioxidants they contain.
  • Try to eat 5 a day.
  • A portion is a ‘handful’
  • One glass of fruit juice (150ml) can only count as 1 of your 5 a day
  • Should account for 1/3 of your diet

Group 3 – Meat, Fish, Eggs, Beans, Pulses

  • E.g. chicken, cod, lentils, chickpeas, tofu
  • Full of iron and protein
  • Try to eat two portions a day (a portion equates to the size of the palm of your hand) or three a day if you are a vegetarian
  • Choose lean alternatives (trim visible fat off meat and try grilling or roasting instead of frying)
  • Drink a glass of orange juice with your vegetarian protein (e.g. beans & pulses) to help iron absorption

Group 4 – Dairy

  • E.g milk, yoghurt, cheese
  • Great for calcium and good bone health
  • All children should be on full fat milk until 2 years of age. At 5 years of age you can introduce skimmed milk.
  • Adults should choose low fat alternatives where possible
  • Try to have 2-3 portions a day
  • A portion equates to a match box piece of cheese, 1 yoghurt, average glass of milk

Group 5 – Foods high in fat, sugar and salt

  • E.g. biscuits, chocolate, sweets, fried food
  • Try to eat only as treats (on top of and not instead of any of the other groups
  • For better heart health try to choose vegetable fats such as olive oil or rapeseed (or spreads made from them) over animal fats like butter and lard.
  • Don’t worry about fat intake for little ones as they need the calories

TOP TIP: Eating well is all about balance. Have a think of one change you could make to your/your family’s diet after reading this…one more fruit a day, try to eat whole grains etc

Reference

NHS Choices Website – The Eatwell Plate (accessed April, 2012)

http://www.nhs.uk/Livewell/Goodfood/Pages/eatwell-plate.aspx

More learnings after Oscar’s operation

Oscar close up

Oscar’s recovery has been remarkable but he has struggled to drink from a bottle during this time. The specialist nurse had warned me that it might be two weeks for feeding to get back to normal but it has still made me feel stressed that he might not be getting enough hydration. Below are some ways I dealt with the situation

  • Add formula/breastmilk to meals wherever you can – I added it to everything I could
  • Thicken some breastmilk/formula and offer it on a spoon – I mixed in banana porridge and offered in addition to all meals
  • Offer yoghurts as desserts or as snacks to ensure your baby still has some dairy
  • Little and often – Offer yoghurts or thickened milk between meals
  • Watch out for wet nappies – these are a sign of hydration status. Your little one should have roughly 6 wet nappies a day
  • Contact your specialist nurse if you have any concerns – Even as a dietitian I wanted to check I was during the right thing. Don’t feel you cant’t call, that is what they are there for.
  • Keep trying with the bottle but don’t force it
Last night Oscar finally accepted his bottle. I felt quite tearful I was so relieved. And he even made some sucking noises (something he could never do before the operation)! It’s funny that accepting the bottle has been such a milestone for us but I guess it accompanies a sense of things returning to normal. We are so grateful to modern medicine and that we have been able to have this operation in the first place.

TOP TIP: Keep an eye on the number of wet nappies if you are worried about your little one’s milk intake

Feeding around a cleft palate operation

Oscar High chair

Oscar had his palate repair operation this Monday. It’s been an emotional and exhausting week but we are relieved to be the other side of the operation. We have been amazed by how quickly Oscar has bounced back. We had our first smile on day 2 and he has been smiling ever since. We are so proud of our little boy for getting through it all and a big thank you to all the doctors and nurses at Great Ormond Street Hospital. A truly amazing and humbling place.

Below are some of my learnings. I hope these can help you if you have a child with a cleft palate. Please feel free to share any thoughts you may have as every child is different and other parents can benefit from your experience.

Before the operation

Oscar’s operation was booked for when he was 7 months old. I was pleased with this as we had ample time to get him used to solids before the operation (we started weaning at 5 months) and would have plenty of time after the operation to progress weaning before he turned 1 year old (the key milestone for getting babies off the bottle and onto family meals).

  • Get to know your child’s eating habits and what they like eating. This will be important when encouraging them to eat after the operation e.g. enticing them with their favourite food.
  • Get your little one well established on solids as the liquids like milk may not be accepted soon afterwards.
  • Introduce the free flow cup. This may provide another option if your baby refuses his bottle
  • Prepare for the nil by mouth period. We knew Oscar would only be going into to surgery after 8.30 in the morning. A few mornings beforehand I started delaying his 7.00 milk feed so he would not be completely distressed on the morning of the operation. Distracting him with a few new toys also helped!

After the operation

It’s an emotional and tiring time but there are things you can do to help.

  • Try to get your baby eating asap after the operation (only if advised by your cleft team). The surgeon informed us that those babies that get eating soon after the operation bounce back quicker.
  • Solids were accepted before liquids. Oscar did not enjoy liquids at all. Apparently this is because liquids are harder to swallow with a sore mouth. Instead we made up some baby porridge with formula so it was runny but could be eaten off a spoon. We also managed to squeeze some puree into his mouth from the ready made baby food pouches.
  • Hydration is important. If they are not drinking, try to sneak liquids into them another way. Add formula or breast milk to purees or prepare baby rice/porridge/cereal with formula or breast milk. We also syringed small amounts of milk into his mouth every now and then.
  • Play with textures. I tried several textures with Oscar before he accepted one. Just keep some milk to hand and mix it in with the porridge until it is just right for your baby.
  • You know your child. Banana porridge was Oscar’s favourite and we had that for all meals for 3 days. He also loves his bouncing chair so we brought this with us to the hospital. He refused to eat anywhere else for the first week. It was a challenge for us as we had to hold it when I fed him so he did not bounce onto the spoon but he was happy so worth it!
  • Try to give milk off the spoon if they won’t accept a bottle.
  • Try feeding little and often. Oscar could not manage much at a time so we fed him whenever he was up for it.
  • Don’t push your baby. I was desperate to get food into Oscar but had to remind myself that he had just had a big operation. Its important for them to eat but you don’t want them to get more upset than necessary. Take a break and try another time

TOP TIP: Don’t worry about how much they are having or giving them balanced meals after the operations. Just feed them their favourite meals and go for the ‘little and often’ approach.

Welcome to My Weaning Blog

Oscar strawberry side view

Our Weaning Adventure

Weaning is an exciting but a daunting adventure that all parents must face when their baby reaches 6 months old. I am a dietitian with professional experience advising parents on how to wean and now I am doing it as a parent. And it’s definitely different being on the other side. I am really excited to share this journey with my little boy Oscar.

Weaning is very important for the future eating habits of your little one and how your baby is weaned really does matter. Research shows that babies weaned on home cooked foods eat more fruit and vegetables as toddlers than those weaned on prepared baby foods. I’m not the best cook but I am good enough, and determined to give it a go whilst having fun along the way!

I hope some of my learnings can help you. Please feel free to share your thoughts and experiences too.