bliss balls: hit or miss?

Thanks to Victoria Hobbs, Deakin University for data collection.

It’s time to examine a snack that has been trending for some time; the bliss ball. Are they actually a healthy snack and what sort of marketing tricks to the companies use to lure us in? I look at kilojoules/calories per serve, as well as fibre, sugar and protein per 100g. What are the top 3 ingredients – do they contain sugar, do they contribute nutrients? A good guideline for a snack is generally 300-600kJ, depending on your nutrition goals.
Let’s compare products:

Special K protein bliss bites: 420kJ/serve, moderate fibre, low sugar and a good source of protein (from milk). The fats and protein may improve satiety.
Carmen’s Bliss Balls : ~312kJ/serve (similar calories to an apple), 6-10g fibre/100g, high sugar 39-47g/100g across the range. A source of refined sugar, the primary ingredient is dates. Contain nuts, so a valuable source of protein. However, will 1 bliss ball fill you up? Consider how many you need in order to feel full and note if they take you through until the next meal.
Creative Gourmet Super Balls (fridge section): 525kJ/serve (equivalent to 1.5 apples), moderate fibre 6g/100g (2.1g per serve, an apple delivers up to 3-5g), high sugar 24.5g (mainly from dates as the first ingredient), good source of protein (whey), though also high in saturated fat from coconut cream.
I Quit Sugar’ Superfood protein ball mix:
This product is so directly misleading. Initially appears to be a good contender for a healthy snack: it is high in fibre, low in total sugars (<3g/100g) and 486kJ per serve. Its main claim to fame is being fructose free.
However, THIS DOES NOT INCLUDE the ingredients that must be added to the mixture to actually make the protein balls. Once the rice malt syrup, coconut oil and coconut are added, these protein balls lose the ‘no sugar’ kudos and increase to 640kJ/serve, refined sugars increase to ~25g/100g and they are a source of saturated fat from all of that coconut. This is marketing genius at its best. Not much better than a muesli bar and so very misleading.
Note: I have checked to see if I can locate this product and it is temporarily unavailable. Check other mixes such as these to see if the nutrition information panel reflects ALL ingredients, or dry portion only.
Bounce Peanut bliss balls:
A high energy snack with 880kJ/serve, they are low fibre, high sugar, despite being a good protein source – (derived from ~30% nuts). The second listed ingredient is brown rice syrup. This is OK as an occasional snack if you are very active, but may not fill you up for long and could contribute to weight gain over time.
Bounce Cacao raspberry balls:
High energy at 710kJ per ball, high sugar and moderate fibre. A better choice than the peanut ones, but not by much.
My verdict? Choose the top 2 products, stick to the serving size. Enjoy occasionally and observe if they fill you up enough to last until the next meal. They are similar in nutritional profile to muesli bars. Alternatives such as fruit, low fat dairy, nuts, seeds and grains provide more benefit nutritionally.

Why not make your own bliss balls at home to enjoy occasionally? This way you can reduce the serving size and choose the ingredients that will be healthiest. I like this recipe from shift nutrition:
https://shiftnutrition.com.au/recipe/chocolate-peanut-butter-bliss-balls/ (~300kJ/serve)

DISCLAIMER: I RECEIVE NO FINANCIAL BENEFIT FROM REVIEWING THESE PRODUCTS, THIS IS AN INDEPENDENT PRODUCT REVIEW BASED ON MY PROFESSIONAL OPINION. I HAVE REVIEWED A SMALL RANGE OF AVAILABLE SUPERMARKET PRODUCTS, THIS IS NOT AN EXHAUSTIVE COMPARISON.

April 23, 2023

dairy & toddlers

April 23, 2023

dairy & toddlers

Calcium is an essential nutrient for building healthy bones and teeth. The majority of our body’s store (99%) is found in the skeleton. The major source of calcium in our diet is dairy; though it is present in other foods too. Many parents report that their toddlers drink milk before bedtime and worry that stopping it will upset the bedtime routine. Parents are often concerned that their child isn’t eating enough during the day, especially if dealing with a fussy or selective eater.

There are many good reasons to change the evening milk routine. The evening bottle of milk may fill your child up and affect their appetites, which may contribute to fussy eating. Drinking milk out of a bottle or after teeth brushing can contribute to dental caries. Dairy contains 10 essential nutrients, including protein for growth, zinc for immunity and vitamin B12; essential to nerve cell function. However, it does not contain iron, so children who drink large quantities of milk are at risk of iron deficiency, as milk may replace other foods in their diet. Also other nutrients in milk can interfere with the absorption of iron, when consumed in excessive quantities.

So how much calcium does your child need? 1-3 year olds require 500mg per day, this increases to 700mg at 4-8 years. 1 serve of dairy provides 250mg of calcium, so a toddler needs two serves per day. See the list below to check your child’s diet for adequate calcium.

1 serve of dairy = 250mg calcium:
250ml milk
2 slices cheese – 40g
½ cup evaporated milk
½ cup ricotta cheese
¾ cup yoghurt
1 cup calcium fortified grain or nut milk
Other sources include:
100g almonds
60g sardines
½ cup canned salmon with bones
100g firm tofu – may differ between brands

Whilst your child adapts to the change, it may be a good time to alter the evening routine. Offer a small amount of milk at the end of the evening meal in a cup if concerned that dairy needs have not been met during the day. Perhaps a feeding chair can become the story chair, or moved out of the room if no longer needed. Offer full fat dairy at other times of day, for example – milk in cereal, yoghurt with fruit or cheese and biscuits as a snack, to easily meet the daily requirements. Breastmilk continues to be a source of calcium and other nutrients for breastfed toddlers.

A word on toddler formulae – these are not required for healthy children. Beyond 12 months, children should be eating the same foods as the rest of the family. Formula may take up valuable stomach space and prevent a child from accepting a variety of solid foods. Offer foods from all groups, including adequate dairy; and though toddlers may not eat consistently from day to day, this will help to ensure that your child’s growth needs are met. If you feel uncertain, see a paediatric dietitian for thorough assessment of your child’s diet.
Fussy eating is a normal stage of toddlerhood that usually passes. A healthy child will never go hungry. As parents, offer a variety of fruit, vegetables, meat or alternatives and whole grains over the day to help your child get used to different tastes and textures. Their intake will vary day to day. If your child is a very fussy eater, is not growing well or you feel concerned about lack of variety, see your NEST GP and our Women’s and Infant Health Dietitian and Lactation Consultant, Nicole Bando.

References

Osteoporosis Australia www.osteoporosis.org.au (accessed 18/10/17)
National Health and Medical Research Council. Eat for Health Australian Dietary Guidelines Summary. Canberra: Commonwealth of Australia, 2013. (Available from: https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_book.pdf, accessed 18th October 2017).

April 23, 2023

dairy & toddlers

References

Osteoporosis Australia www.osteoporosis.org.au (accessed 18/10/17)
National Health and Medical Research Council. Eat for Health Australian Dietary Guidelines Summary. Canberra: Commonwealth of Australia, 2013. (Available from: https://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55a_australian_dietary_guidelines_summary_book.pdf, accessed 18th October 2017).

April 23, 2023

netflix game changers: a review

April 23, 2023

netflix game changers: a review

By Nicole Bando, Dietitian & Lactation Consultant, November 2019

I’ll start by saying that I’m all for encouraging people to eat healthier food. There is absolute scientific consensus that we cannot sustain a future population of 10 billion people with our current diet and food production methods. An urgent, systematic review of how we produce, transport and eat food is required. Game Changers rightly touched on the global impact of current food production. However, should you obtain nutrition information from a Netflix documentary? I’d say no, and here is why:

Let’s talk ‘plant-based’:

The term ‘plant-based diet’ is new and what does it mean? Game Changers did not make this clear. If I took my dietitian hat off, the main message I received was to eat lots of vegetables and maybe some beans, absolutely no meat and I’d be good to go. But the reality is far more complex than that. It is true that a vegetarian or vegan diet confers many health benefits (lower risk of heart disease, stroke, diabetes, lower body weight). However, this diet must be carefully planned or serious deficiencies from lack of key nutrients such as iron, Vitamin B12, zinc, iodine and omega-3 fatty acids can develop.

The long-term consequences of deficiencies include anaemia, osteoporosis (brittle bones), loss of nerve function, depression and long-term cognitive impairment. At vital times such as pregnancy and breastfeeding, inadequate omega-3 fatty acids (found in fish, chia, flaxseeds, walnuts, microalgae) can impact a baby’s brain development. Serious stuff, no?

Athletes have far greater requirements than the general population, and risk inadequate iron, energy and protein intakes. This impairs recovery, increase injury risk and has long-term health consequences. The female athlete is risk of consequences including irregular periods, infertility, osteoporosis and a host of cardiovascular and mental health side effects.

None of these risks were mentioned, which is why it’s best to seek advice from a trained health professional, rather than Hollywood. I will give kudos to Game Changers for using some pretty good party tricks, such as finding the strongest man in the world who only eats plants to move some heavy stuff, measuring nocturnal erections of college students and centrifuging blood after a meat vs vegetarian meal. All very convincing, but a little lacking in scientific depth.

It’s a little extreme to compare the meat industry to the tobacco industry. Whilst the science does tell us that a diet heavy in processed meats can increase the risk of certain cancers, meat isn’t out to get us. I’m confused, aren’t we the ones hunting down the animals and putting them on our plates? My issue is the demonising of one food. Our health crisis is related to myriad factors, including added sugars, salt, overall saturated fat, caloric intake and lack of enough of the good stuff, mainly fruits, vegetables and whole grains. Even that is oversimplifying matters.

The bottom line?

If this documentary made you consider changing your diet to eat more plant foods and reduce meat, processed foods and sugar, awesome.
The Eat Lancet Commission gathered 37 of the world’s leading scientists produced a global document that addresses the environmental and health crisis we face as a planet, with food as the driver for change.
It is ok to keep some meat on your plate, try to reduce total to 300g per week. Include dairy, eggs and fish.
Base your diet on plant-based foods: nuts, legumes, fruit, vegetables, whole grains
Include good fats
Reduce added sugars
And please, seek advice from a university qualified nutrition professional if you are considering a vegetarian or vegan diet, especially if you are in a vulnerable category (pregnancy, breastfeeding, child, adolescent or athlete).
For some hard-hitting evidence-based information, explore this: www.eatforum.org
And a documentary that is right on the money? 2040 by Damon Gameau: www.whatsyour2040.com

April 23, 2023

netflix game changers: a review

By Nicole Bando, Dietitian & Lactation Consultant, November 2019

Let’s talk ‘plant-based’:

The bottom line?

If this documentary made you consider changing your diet to eat more plant foods and reduce meat, processed foods and sugar, awesome.
The Eat Lancet Commission gathered 37 of the world’s leading scientists produced a global document that addresses the environmental and health crisis we face as a planet, with food as the driver for change.
It is ok to keep some meat on your plate, try to reduce total to 300g per week. Include dairy, eggs and fish.
Base your diet on plant-based foods: nuts, legumes, fruit, vegetables, whole grains
Include good fats
Reduce added sugars
And please, seek advice from a university qualified nutrition professional if you are considering a vegetarian or vegan diet, especially if you are in a vulnerable category (pregnancy, breastfeeding, child, adolescent or athlete).
For some hard-hitting evidence-based information, explore this: www.eatforum.org
And a documentary that is right on the money? 2040 by Damon Gameau: www.whatsyour2040.com

April 23, 2023

How do I deal with my toddler’s fussy eating?

April 23, 2023

How do I deal with my toddler’s fussy eating?

1) Is it normal for a toddler to be a fussy eater?
By Melbourne Dietitian, Nicole Bando
As a children’s dietitian, this is a commonly asked question. Many parents feel concerned about the variety and quantity of food their toddler eats. A fussy eater is defined as a child who refuses to try a new food at least 50% of the time. Fussy eating behaviours in the second year of life are normal and part of how your child expresses their new found independence whilst exploring the world around them. It is normal for children to be uncertain of new tastes and textures; an evolutionary mechanism designed to keep us safe from danger! We have a natural preference for sweeter foods as they are higher in calories, another survival mechanism which no longer serves us.
Establishing healthy habits early in life is important for a child’s optimal growth and development, and reduces the risk of obesity and chronic disease later in life. When a child develops fussy eating behaviours, meal times can become stressful for the whole family. There are many strategies to prevent and manage selective eating habits, making meal times enjoyable once again.

2) When should I worry about my toddler’s eating?

Growth slows during a child’s second year, and so their intake reduces. Many parents worry that their child isn’t eating enough, however may have unrealistic expectations of how much their child needs each day. Toddlers have a small stomach capacity and need to graze frequently throughout the day. Remember that a healthy child will never go hungry, and if energetic and thriving, they are likely eating enough. Seek help from your GP, Maternal Health Nurse or Paediatric Dietitian, if your child is:

exhibiting extreme fussy eating behaviours and mealtimes are very difficult
lethargic and lacks energy for daily activities
appears unwell
gagging or vomiting often, or has problems with chewing or swallowing
eating a very limited variety of foods and missing out on entire food groups
unable to drink from a cup from around 16 months
rejecting whole food groups or groups of foods of a similar texture
not growing or developing as expected

3) How can I encourage my toddler to eat what I offer them?
Are you or any other adults in the house fussy eaters? Research shows that eating meals (as often as possible) demonstrates positive role modelling. If children see their parents eating a variety of foods, they are more likely to learn and copy that behaviour. These times give opportunity to chat, as well as share a meal. Try to cook 1 family meal, so that everyone is eating the same food (may need slight modification for texture), together as often as possible. It doesn’t matter if your child doesn’t want to eat or try everything on the plate. Repeated and exposure of a variety of new foods will help your child to develop healthy habits.

The below strategies can help manage fussy eating behaviours:
Parents use a consistent approach with all strategies
Keep calm, avoid a fuss as this gives issue more attention which can lead to a power struggle
Avoid using punishment or bribes e.g. dessert as reward for eating vegetables
Minimise distractions: eat at table, away from television, devices or toys.
The Division of Responsibility: it is the parent’s job to offer a variety of healthy foods at the right times and the child’s role to decide what, and how much to eat.
Offer foods in different ways e.g. broccoli with melted cheese, or stir-fried to promote enjoyment and acceptance
Keep meal times to a reasonable time limit and develop a routine around meals.
A new food may need to be offered up to 15 times before it is accepted. Many parents give up after a few times.
Harness your toddler’s independence and encourage self-feeding, with a mixture of finger foods and mixed textured foods, requiring a spoon or fork
Children love helping and can assist with shopping for the family’s food and simple meal preparation.
Your child’s appetite can vary considerably day-to-day depending on activity and growth. If your child rejects the food offered, avoid offering an alternative, instead reoffer the food at a later stage, perhaps they are just not hungry.
Sometimes children can be filling up on milk and this takes away their appetite for other foods. They may not be fussy, just full.
Toddler formula is not necessary in a child’s diet. It displaces food gives preference to sweet tasting drinks. After 12 months, cow’s milk or a suitable dairy alternative can be provided as a drink. Breastfeeding may continue for as long as mother and child are enjoying it.
Keep high sugar and high fat treat foods to a minimum. These can take place of foods from the other food groups, which means your child does not have the appetite for nutritious foods.

4) Should I force my toddler to eat?
Forcing a child to eat will create a negative association with food, which can have long-lasting effects, such as poor relationship with food, food aversions and worsening fussy eating behaviours, a high level of stress at mealtimes and reinforcing an idea that healthy foods are bad. It also overrides your child’s own hunger and fullness cues, and this can contribute to weight gain and obesity in later life. Forceful behaviour includes coercion, ‘have one more mouthful’ and negotiation, ‘eat this and you can have dessert’. If your child does not want to eat at a particular time, it can be for a whole range of reasons, so if you feel concerned, see your health professional to discuss. Children are excellent at regulating their own appetites and by using the above strategies, you can help your child to create a healthy relationship with food.

April 23, 2023

MASTITIS

April 23, 2023

MASTITIS

By Emma McShane, Dietitian, August 2021

What is Mastitis?
Mastitis is inflammation of the breast tissue, affecting 10-25% of breastfeeding women. The majority of cases occur during the first 6 weeks of breastfeeding, however mastitis can occur at any time during the breastfeeding journey. Mastitis can be caused by engorgement or inadequate milk removal from the breast, resulting in a blocked duct. This causes the milk blocked behind the duct to be forced into the nearby breast tissue, causing inflammation. This inflammation is known as mastitis and can lead to infection. Fast and supportive treatment is needed, as mastitis can lead to early weaning from the breast, or complications such as a breast abscess if left untreated.

Mastitis may occur due to latching problems, sucking issues, sleepy babies, oversupply, or hurried feeds, including limiting a baby’s time at the breast. These factors can affect how much milk is drained from the breast.

How do I prevent Mastitis?

Ensure your baby is well-positioned and attached to the breast.
Make sure your bra is loose and there is no pressure on your breasts e.g. clothing or fingers while feeding.
Feed on demand, offering flexible and frequent access to the breast, as missed feeds or long intervals between breastfeeding can increase your risk of developing mastitis.
Relax whilst breastfeeding to help encourage your milk flow.
Gently massage the breast by stroking towards the nipple whilst your baby feeds.
If your breasts become uncomfortably full, wake up your baby to feed them. If they do not want to feed, express a small amount for comfort.
Hand express to empty the breast.
Practice good hygiene, and if using a breast pump, clean this often, as this will help to prevent contamination.
Check your breasts frequently for lumps, pain, or redness.
Alternate from which breast you begin each feed, as this will help to ensure one breast is drained well at every second feed.
Let your baby finish when they’re ready to ensure they have taken the most milk out of the breast. Avoid timing your baby at the breast.
If you choose to wean your baby, make sure you do this slowly as rapid weaning can cause mastitis.
Stress, fatigue, vigorous exercise, or overall poor health and nutrition can increase your risk of mastitis, so self-care and adequate nutrition is essential.

Symptoms:
Please note that some mothers do not get the early signs of a blocked duct, and feel that mastitis comes on ‘out of the blue’.

Treatment:
It is important that if you feel a blocked duct coming on, to start treatment immediately. The most important part of treatment is to allow for effective milk removal, regularly.

It is important to drain the breast often, but gently.
Feed frequently, starting on the affected breast. This is not the time to wean your baby as symptoms can worsen. Allow your baby to drain the breast and also make sure that you are offering the unaffected breast. The milk is safe for your baby to drink.
Change feeding positions as this may help to clear the blockage. You can try positioning your baby at the breast with their chin or nose pointing to the blockage, as this will help drain the affected area.
Gently massage your affected breast, as this will help to improve drainage and symptoms.
Ensure good positioning and latch. A lactation consultant can help you to achieve this.
Use cold packs on the affected breast, as this can help to reduce swelling and relieve pain.
Use warm heat packs sparingly just before bed (only for a few minutes), to help trigger your let-down to help clear the blockage.
It is very important to get as much rest as possible.
Simple analgesia can be taken as needed such as paracetamol or ibuprofen.
When treated promptly, a blocked duct should clear in 24-48 hours.
If the blockage is not clearing within 24 hours, seek advice from your doctor, as antibiotics may be needed if an infection occurs. Please note that antibiotics only treat an infection, not the cause of the blockage.
Milk supply can sometimes be affected when mastitis is occurring, so look out for signs that your baby is getting enough milk including urine and stool output, and that your baby is putting on weight. A change in supply can be addressed with frequent and effective feeding.
A Lactation Consultant can check your baby’s positioning at the breast to prevent mastitis & blocked ducts.
Breast ultrasound can be an adjunct to treatment to help clear the blocked duct.

Nutrition:
It is very important to keep up your fluids, which means consuming >2 litres per day

Breastfeeding is a demanding process on the body that requires more energy and protein than usual. Other important nutrients include iron, iodine, and calcium. A dietitian can help you to meet your requirements.
Try to eat regular meals & snacks across the day, even if feeling unwell.
Simple meal and snack ideas include: Scrambled eggs with toast and chopped vegetables, baked beans on toast, roasted chickpeas, vegetable sticks and hummus or cheese and crackers.
Below is the Australian Guide to Healthy Eating recommended serves for each food group during breastfeeding.

Are probiotics helpful?

Scientific trials have found inconclusive results on the benefits of probiotics to prevent or treat mastitis. There is an emerging field of research to suggest that probiotic use may help to prevent mastitis, however further research needs to be conducted in this area to reach a conclusion.

April 23, 2023

WEIGHT LOSS AFTER BABY AND SPECIAL DIETS/SITUATIONS

April 23, 2023

WEIGHT LOSS AFTER BABY AND SPECIAL DIETS/SITUATIONS

By Emma McShane & Nicole Bando

WEIGHT LOSS AFTER PREGNANCY

There is a lot of pressure from society on women to ‘bounce back’ to their pre-pregnancy weight, however, this is not realistic nor recommended. Some of the weight gained during pregnancy is used to fuel breastfeeding, which is why breastfeeding can help a woman gradually return to her pre-pregnancy weight. Weight loss is recommended at the rate of around 2kg loss per month, as this does not affect breast milk production. It takes 9 months to grow a baby, so it is expected to take 9-12 months to return to pre-pregnancy weight. It helps to be patient, realistic and kind to the incredible body capable of growing a child. Restricting eating can affect not only a mother’s health but can reduce milk supply and impact a woman’s bone health.

Aim to be intuitive with eating (e.g. listen to hunger cues), choose whole foods from the core food groups and avoid too many high sugar and high fat treat foods to help weight loss to occur gradually. See these posts on a woman’s special needs whilst breastfeeding: www.nicolebando.com/blog/nutrition-during-breastfeedi and www.nicolebando.com/blog/meal-snack-ideas-for-new-parents

SPECIAL DIETS/SITUATIONS:

VEGAN & VEGETARIAN DIETS:
Mothers who are vegan or vegetarian are at high risk of nutrient deficiencies, in particular; protein, iron, calcium, Vitamin B12, and omega-3 fatty acids. These nutrients can mostly be obtained from plant-based products, except for Vitamin B12, which is mainly found in animal products. In some cases, a blood test to check levels, and a B12 supplement may be required.

INTOLERANCES/ALLERGIES:
Some babies may have intolerances or allergies to proteins present in their mother’s breast milk. The most common allergies are cow’s milk, soy, eggs, peanuts, and tree nuts. Avoidance of the particular protein in the mother’s diet may be needed. However, each mother and baby duo is different, so seek medical advice from a doctor and dietitian before excluding food group(s). If a mother needs to exclude a particular protein, the nutrients from that food will need to be replaced with alternative foods (e.g. alternatives to cow’s milk for adequate calcium).

CLOSE PREGNANCIES & MULTIPLE BABIES:
Mothers who have close pregnancies are at higher risk of nutrient deficiencies, as the nutrient reserves in the body may not have been fully replenished before the next pregnancy. Iron is at most risk of deficiency, as the body may not have had time to fully replenish the stores lost during pregnancy. Supplementation of this nutrient, as well as calcium, magnesium, zinc, and essential fatty acids may be needed but it is important to seek support and guidance from a dietitian who can accurately assess your dietary intake and blood levels of these nutrients. Women who have had multiples (e.g. twins) have greater demands for nutrition and need an additional 2000kJ in energy, per baby, as well as increased vitamin and mineral needs.

BARIATRIC (WEIGHT LOSS) SURGERY:
There have been multiple studies that have investigated the impact of bariatric surgery on breastfeeding. People who have had bariatric surgery may be at greater risk of nutrient deficiencies, as the surgery can change how nutrients are absorbed, so it is important to check levels of vitamins and minerals before, or at the start of pregnancy, to see if supplementation is needed. A study investigating the composition of breastmilk, comparing nourished mothers who had undergone weight-loss surgery and those that had not, found there was no significant difference in nutrient composition between the two. This, however, takes into account that it is important to still consume a balanced diet. As some bariatric surgeries may result in ongoing complications e.g. reflux or reduced food consumption or absorption, which all may affect nutrient intake, it is important to seek support from a dietitian.

PREMATURE OR LOW BIRTH WEIGHT BABIES:
Breastfeeding is important in babies who are premature or of low body weight as breastfeeding can reduce the risk of the baby developing medical complications. The production of milk components starts in pregnant women before 22 weeks of pregnancy, so even with very premature babies, most mothers can produce colostrum. Breastfeeding may be difficult if a baby is in the neonatal intensive care unit, requiring some mothers to express breastmilk. There are multiple barriers for both mother and baby to overcome when breastfeeding a premature, or low birth weight baby, such as a delayed or traumatic start to breastfeeding, and maternal stress. Recent studies however have shown that there is a higher rate of breastmilk feeding amongst very low birth weight infants, often due to mothers recognising the fragile health of their baby and the benefits of breastfeeding.

Good nutrition at this time is vital to cope with the energy demands of expressing and or breastfeeding, to maintain supply and provide energy to cope during a stressful time, and to replete nutrient stores used during pregnancy. Follow the general nutrition advice set out above. If you have experienced a bumpy start to breastfeeding, seek guidance from a lactation consultant.

NAUSEA & VOMITING IN PREGNANCY:
Some women experience severe nausea/vomiting during pregnancy that can affect the quality and quantity of food consumed. It is important during this time to eat high-energy and protein foods such as eggs, dairy, and meats/meat alternatives. Try having cold foods, as hot foods and their smells can exacerbate nausea. If nausea/vomiting continues, seek advice from a doctor and dietitian to see if supplementation of specific nutrients is needed. A woman who has experienced severe nausea and vomiting in pregnancy may be at greater risk of vitamin and mineral deficiencies and will need extra help to replenish her stores.

April 23, 2023

WEIGHT LOSS AFTER BABY AND SPECIAL DIETS/SITUATIONS

By Emma McShane & Nicole Bando

WEIGHT LOSS AFTER PREGNANCY

SPECIAL DIETS/SITUATIONS:

April 23, 2023

Kids & dairy; how much?

April 23, 2023

Kids & dairy; how much?

Dairy foods naturally contain 10 essential nutrients including calcium, potassium, phosphorus, magnesium, carbohydrate, protein, vitamin A, riboflavin, vitamin B12 and zinc, essential healthy blood and immune systems, eyesight, muscle and nerve function, skin, energy, growth and repair. Unless you have an allergy or intolerance, or prefer to avoid dairy for personal reasons, it is a great source of nutrition that is vital for strong & growing bones at every life stage.

1 serve equals:
1 cup (250mL) of dairy milk or milk alternative (with 120mg of added calcium per 100mL) ½ cup (125mL) of evaporated milk 2 slices hard cheese (40g) ½ cup (120g) ricotta cheese ¾ cup (200g) yoghurt
Non-dairy alternatives:
100g almonds/almond butter 60g sardines ½ cup canned salmon with bones 100g firm tofu – may differ between brands
The transition from breast or bottle to dairy can feel confusing. It may be surprising to know that not every feed needs to be replaced with dairy. See below for children’s dairy needs:
1-2 years: 1- 1 ½
2-3 years: 1 ½
4-8 years: boys 2, girls 1.5
9-11 years: 2.5, girls 3
12-13 years: all 3.5
14-18 years: all 3.5

E.g. For a 2-3 year old, this equals ½ a cup of yoghurt, 1 slice of cheese and ½ cup of milk spread over the day. Remember that under 12 months, milk cannot be given as a drink. For more information about toddlers & dairy, see this article. Try to include natural yoghurts, with added fresh fruit & avoid high sugar options, such as flavoured milks, yoghurts and toddler milks. Children under 2 years require full cream milk and thereafter may switch to reduced fat.

Milk alternatives & fortification:
If a child is allergic to dairy choose an alternative milk that is fortified with calcium, for growth, healthy bones and teeth. Look for plant milks that contain 120mg of calcium per 100mL. Not all plant milks are created equal (with a large variation in carbohydrate, protein, vitamin & mineral content), so seek additional advice if needed. See our article; ‘Alternative Calcium sources if you can’t have dairy’ for recommended brands and this comparison of plant milks.

If your child is breastfed beyond 12 months, aim to incorporate dairy a couple of times per day. Breastmilk is also a good source of calcium.

References:
Eat for Health. Recommended number of serves for children adolescents and toddlers. 2015. Accessed 22nd September 2022. Available at https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/recommended-number-serves-children-adolescents-and

Nutrition Australia. Dairy foods – how much is enough?. July 2021. Accessed 22nd September 2022. Available at:
https://nutritionaustralia.org/fact-sheets/dairy-foods-how-much-is-enough/#Is-dairy-recommended-under-the-Australian-Dietary-Guidelines?

Bonyata K. (2018). Nutrition for Breastfeeding Toddlers. Kelly Mom. Accessed 24th September 2022. Available from:
https://kellymom.com/nutrition/starting-solids/toddler-foods/
By Emma McShane, Dietitian, edited by Nicole Bando (APD, IBCLC), October 2022

April 23, 2023

Transitioning from breast or bottle: your toddler’s dairy needs

April 23, 2023

Transitioning from breast or bottle: your toddler’s dairy needs

Transitioning from breastfeeding or formula to family foods is a natural progression for a baby. A breastfed baby may continue to breastfeed beyond the first 12 months of life, whilst including dairy and family foods.

If your child is 12 months or older, it is safe to give your child whole cow’s milk (or fortified dairy milk alternatives) as a drink. Do not give cow’s milk as a drink 12 months of age, continue to breast or bottle feed. Beyond 12 months, formula is no longer required, this includes toddler formula, which is ultra-processed and creates a preference for sweet foods & takes up tummy space for core food groups, making fussy eating more likely.

Beyond 12 months:

By 12 months, a breastfed baby may include dairy in cereal, yoghurt and cheese as a snack. Continue breastfeeding as you wish, as breastmilk continues to provide ongoing benefits for health and immunity, and is a source of calcium and other nutrients.

A bottle fed baby may only be including a morning and night bottle of formula by 12 months. The morning feed can be replaced with a larger breakfast; add milk into cereal such as oats or Weet-bix, or try yoghurt and fruit or cottage cheese on toast. Incorporate dairy into snacks, e.g. small bowl of natural yoghurt with fruit, cheese and crackers or ½ cup of full cream milk, either after some meals or offered as a snack. . Offer dairy 3 times a day to ensure adequate calcium for growing bones.

What about the night time bottle?

Many parents report that their toddlers drink milk before bedtime and worry that stopping it will upset the bedtime routine. Parents are often concerned that their child isn’t eating enough during the day, especially if dealing with a fussy or selective eater.

Is toddler formula necessary?
Toddler formula is not required for healthy children. Formula may make your toddler too full to accept a variety of other solid foods. It is ultra-processed and creates a preference for sweet tasting foods. As it takes up tummy space for core food groups, fussy eating is more likely. Toddlers do not grow as much in their second year of life and will have variable appetites, which means some days they may eat more than others. Continue to offer a variety of foods across the core food groups to your toddler and trust their appetite, to meet individual growth needs. If you are feeling worried about your toddler’s intake, see a paediatric dietitian for support.

References:

Nicholas K. How to transition from formula to milk: 5 tips. Peanut app. 2022. Available at: https://www.peanut-app.io/blog/how-to-transition-from-formula-to-milk
Centers for disease control and prevention. Weaning. Nutrition. 2021. Available at: https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/weaning.html
Nicole Bando. Dairy & toddlers. Nicole Bando Paediatric & Family, Dietitian & Lactation consultant. 2019. Available at: https://www.nicolebando.com/articles/previous/3

By Emma McShane & Nicole Bando, November 2022

April 23, 2023

Easy meal and snack ideas for new parents

April 23, 2023

Easy meal and snack ideas for new parents

By Emma McShane & Nicole Bando

New mothers need quick, convenient, and nutritious snacks and meals (see ideas & sample meal plan, below).
Choose carbohydrate foods that provide a slow, sustained release of energy, such as wholegrains e.g. wholemeal bread with seeds, oats, fruit, dairy, and starchy vegetables, such as sweet potato. These foods manage appetite and help to avoid sugar crashes. Avoid large quantities of high sugar, high-fat foods; these provide a quick release of energy, followed by a crash in blood sugar and energy levels, which can increase feelings of hunger and impact mood levels. Of course, the occasional chocolate or treat is OK.

Include a couple of pieces of fruit, and vegetables at least twice per day, dairy/dairy alternatives three times each day, lean meats (or alternatives), and healthy fats e.g. omega 3 & 6 fatty acids (from fish, nuts, etc.) three times each day.
For more information about the nutritional needs of breastfeeding mums, see these articles: Breastfeeding & Nutrition: www.nicolebando.com/blog/nutrition-during-breastfeedi and Weight loss after baby and special diets/situations: www.nicolebando.com/blog/weight-loss-after-baby-and-special-dietssituations

EASY IDEAS:
Meals:

Omelettes loaded with frozen vegetables and cheese.
Stir-fries with frozen vegetables and rice noodles.
Pita bread with vegetables and low fat cheese as a cheats pizza
BBQ chicken in wraps with salad mix.
Meals that can be eaten hot or hold such as frittata, zucchini slice
Serve grain foods like rice, pasta, quinoa or couscous with main-meals such as stir-fries, curries and casseroles.
Buy meat and vegetables already diced

Snacks:

Boiled eggs
Individual serves of yoghurt
Cut-up vegetable sticks and fruit
Nuts & seeds
Canned fish, canned beans and lentils
Leftovers – on their own or in a toasted sandwich
Cheese and crackers

Download my easy list, below:

April 23, 2023

Does Vitamin C help with colds?

April 23, 2023

Does Vitamin C help with colds?

Vitamin C plays an important role in the body’s immune system, it protects cells from the damage caused by toxins or pollutants. Vitamin C is a water-soluble vitamin, meaning that it’s not stored in our body, so needs to be consumed daily. More than we need is generally lost in the urine, so supplements can end up being expensive wee! Did you know that an orange per day almost meets an adult’s Vitamin C needs?

Research has shown that vitamin C intake through diet and supplementation can help to lower blood pressure. In a recent trial looking at vitamin C intake supplementation in preventing and treating pneumonia, there was no clear conclusion that supplementation was beneficial. Supplementation does not prevent you from catching a cold, but may help to shorten the duration of symptoms by half a day.

Bottom line?

There is no need to supplement with Vitamin C throughout the year for the general, healthy population. If you feel concerned, seek professional advice. If you have a cold, it doesn’t hurt to take a supplement whilst unwell. To make sure you get enough, include these Vitamin C-rich foods:
– Citrus fruits e.g. oranges
– Tomatoes
– Capsicum
– Strawberries
– Broccoli
– Brussel sprouts
– Potatoes

References:

TH. Chan. The Nutrition Source. 2020. Vitamin C [online]. Harvard, School of Public Health. Available at https://www.hsph.harvard.edu/nutritionsource/vitamin-c/ [accessed 19 June 2022].

Lykkesfeldt, J., & Poulsen, H. (2010). Is vitamin C supplementation beneficial? Lessons learned from randomised controlled trials. British Journal of Nutrition,103(9), 1251-1259. doi:10.1017/

Stephen P Juraschek, Eliseo Guallar, Lawrence J Appel, Edgar R Miller, III, Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials, The American Journal of Clinical Nutrition, Volume 95, Issue 5, May 2012, Pages 1079–1088, https://doi.org/10.3945/ajcn.111.027995

Padhani ZA, Moazzam Z, Ashraf A, Bilal H, Salam RA, Das JK, Bhutta ZA. Vitamin C supplementation for prevention and treatment of pneumonia. Cochrane Database of Systematic Reviews 2021, Issue 11. Art. No.: CD013134. DOI: 10.1002/14651858.CD013134.pub3. Accessed 28 June 2022.

By Emma McShane (Dietitian), edited by Nicole Bando (APD, IBCLC), July 2022

Email: info@nicolebando.com

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