Nicole Bando | Dietitian & Lactation Consultant

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Nutrition and Breastfeeding Articles

‘It is hard to know what to believe with so much conflicting nutrition
information. ​I provide you with the latest evidence-based facts.’

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How to talk to children about nutrition & weight

As a Melbourne based Paediatric Dietitian, I discuss this very emotional topic with parents frequently. I like to to use positive language and practical strategies to encourage my families towards healthy change. Here are my tips for addressing the hard topic of nutrition and children’s bodies:

– Take action: it may be time to change family eating & lifestyle habits. Offer balanced meals and snacks based on the core food groups. Avoid having too many treat foods in the home. Be active together. Change as a family creates a positive environment for learning and avoids focus on an individual, which can create pressure, anxiety and fuel risk of disordered eating and negative body image.

– Talk about body image concerns: what we can do and the sort of people we are is more important than looks or weight. This is a great podcast: https://www.abc.net.au/…/teaching-your-kids…/12625036

– Avoid making negative comments about your body or your child’s body. As an adult, avoid crash diets as this role models unhealthy eating behaviours. Say positive things about your own body.

– Avoid blaming or shaming the child for their food choices or preferences. Remember that young children will eat what is on offer in their immediate environment and parents can change this.

– Talk about feelings of hunger and fullness. Children are excellent at reading their own cues. Remember it can take 20 minutes after eating for the hormones (chemical messengers) to send a message to the brain that the stomach is full. Encourage everyone in the family to recognise these signals, this can help to avoid 2nd portions when they may not be needed.

– Depending on the child’s age – use phrases such as: ‘eating fresh and colourful foods help us to grow strong & concentrate at school’ or talk about what they love. If your child loves soccer, then ‘eating ‘grow’ foods like meat, chicken and eggs makes our muscles strong to kick the ball’ and ‘go-go foods like bananas and Weet-bix give us the energy to play soccer or swing on the monkey bars.’

– Primary school aged children: don’t talk about weight, take action that involves changing the family habits

– Make changes gradually, growth occurs over time and small changes make a big difference

– Work with a paediatrician and paediatric dietitian for expert guidance.

A note about older children who may be feeling conscious about their bodies. Talk openly, answer their questions and understand why and how they are feeling this way. Social media has an incredible impact on our children’s body image & perception of self. Seek advice if you are concerned. Focus on health and growth, rather than ‘weight’. If children are overweight, it is recommended they maintain their weight, whilst their height catches up.

– Avoid demonising foods. Treat foods have their place and should be enjoyed in small portions, occasionally

Children’s vitamins: are they necessary?

By Nicole Bando, May 13, 2021

Myriad colourful, fizzy, chewable children’s vitamins line pharmacy shelves, causing parents worry that their child may be lacking in vital nutrients. As a Paediatric Dietitian & Lactation Consultant, I am often asked ‘should I give my child a multivitamin?’ In most cases, a healthy child who is eating across the food groups does not require additional supplementation. Many foods are fortified with vitamins & minerals, so your child may be consuming more of these nutrients than first considered. There is no evidence that additional vitamin and mineral supplementation benefits health. In fact, taking an excess of certain vitamins, such as fat-soluble A, D & E can have negative health effects. Fat-soluble vitamins accumulate in the body, unlike water soluble vitamins, such as Vitamins B & C, where excess is generally filtered out through the urine (N.B. there is still potential for toxicity in large quantities). For example, excessive Vitamin A in children can cause skin irritation, vomiting & an enlarged liver.

Ultimately, the best advice is to make sure that your child is receiving enough nutrition from food & supplements cannot replace the value of whole foods. If your family could do with some guidance to make sure that everyone is maximising their nutrition potential, see a family dietitian.

In certain cases, vitamin supplements are necessary, such as:

  • Vitamin D deficiency (darker skin, inadequate exposure to sunlight, exclusively breastfed babies)
  • Iron deficiency, which may occur in extremely fussy eating or vegan/vegetarian diets
  • Vegan/vegetarian diets
  • Certain diseases which may reduce absorption of nutrients
  • Multiple allergies, where whole food groups can be excluded
  • Slowed growth
  • If needed, a blood test can show if there is a deficiency in certain nutrients (e.g. iron, Vitamin D).

Your dietitian or paediatrician will advise if this is the case. Products are roughly categorised into multivitamin preparations, single nutrients (e.g. iron), probiotics and then marketing categories, such as ‘immune boosting’ or ‘brain development’. Here’s a brief overview of a few popular multivitamins:

  • Centrum Kids & Swisse Children’s Multi: if needed, these are both good multivitamin options that give a general coverage of key nutrients, including small amounts iron, zinc and negligible calcium. Centrum Kids contains Vitamin A in excess of the recommended daily intake for children (RDI). Swisse Children’s Multi contains a large proportion of the RDI.
  • Blackmores Super Kids Multigummies: Mostly B vitamins, small amount of zinc & iodine. No iron, calcium or Vitamin A. Sugar-free.
  • Nature’s Way Vita Gummies: B vitamins, Vitamin A close to RDI. Small amount Vitamin D, some E. No calcium, iron, zinc. Most children get enough B vitamins, so these vitamins would generally be lost in urine. Contain sugar.

What’s the bottom line?
Unless your child fits into one of the above categories, or you have concerns that their diet may be inadequate, a multivitamin is likely not necessary. Seek professional guidance.

Acknowledgements:
Rodney Whyte, Senior Pharmacist, Monash Health

Sources:
NHMRC, Nutrient Reference Values for Australia and New Zealand
Royal Children’s Hospital, Vitamin A: https://www.rch.org.au/immigranthealth/clinical/Vitamin_A/
Dr Anthea Rhodes, RCH Paediatrician & Director, Australian Health Poll https://blogs.rch.org.au/news/2016/09/13/blog-vitamins-and-kids-do-they-really-need-them/

Do I need to burp my newborn baby?

It depends. As a Melbourne lactation consultant, this is one of the top questions I am asked by lovely new mums about their beautiful newborn babies.

A breastfed baby takes in less air than a bottle fed baby & will generally bring up a burp in any position, without assistance. If your baby seems unsettled during or after a feed, try burping bub for a few minutes to see if it helps. If baby is settled, don’t worry about it – trying to burp a settled baby can lead to an unhappy baby!

A bottle fed baby may take in more air during feeding. Help your baby control the milk flow with ‘pace feeding’. Use a narrow neck teat, hold bub quite upright, hold the bottle horizontally and give breaks during feeding (see video link below). If baby is unsettled, burp during the feed or after. There is no evidence for/against burping; one small powered Indian study showed no significant reduction in colic in newborn babies who were burped.

When it comes to baby, there are no special rules – always look to baby for cues as to what they may need & follow your own instincts. If your baby is fussy during breastfeeding or bottle feeding, a session with a lactation consultant may help.

https://education.possumsonline.com/video/about-paced-bottle-feeding-renee-keogh