How do I introduce solids to my baby?

INTRODUCTION TO SOLID FOODS,
By Emma McShane, Dietitian

The World Health Organisation states ‘infants should be exclusively breastfed for six months and after this time continue breastfeeding with appropriate introduction to solids’ (2020).
When breastfeeding is not possible, bottle feeding is recommended.

How do you know if your baby is ready for solid foods?

Your baby has good head and neck control and can sit upright when supported
Your baby shows an interest in food e.g. looks at or reaches out for your food
Your baby opens their mouth when offered food on a spoon
Your baby has an increased appetite, is feeding more often, and wants more breast milk or formula at the end of their usual feed.

VARIETY OF FOODS:
It is important to include a variety of foods from the five core food groups in your baby’s diet.

CEREAL FOODS
Be sure to offer a variety of grains including wheat, rice, oats and corn.
Example of cereal foods: Bread, crackers, pasta, iron-fortified cereals e.g. Weet-bix, all bran

DAIRY FOODS
Yoghurt, cheese, and cow’s milk on cereal.
Cow’s milk should not be given as a drink (instead of breastmilk or formula), for babies under 12 months of age.

MEAT AND MEAT ALTERNATIVES
Beef, lamb, poultry, well-cooked egg, fish, other seafood, legumes (e.g. lentils and chickpeas)

VEGETABLES AND FRUITS
Can be grated, cooked, pureed or mashed.

Introducing Common allergy causing foods:

Common allergy causing foods should be included in your baby’s diet before nine months of age, as research has shown that early introduction may reduce the chance of your baby developing a food allergy.
These common allergy causing foods are: Eggs, Cow’s Milk, Wheat, Soy, Peanut, Tree nuts, Sesame Fish, Shellfish
It is important to introduce one new allergy causing food at a time, early in the day, and then wait a few days to try another new food, so that you can identify any foods that may cause an allergic reaction.
An example of how to introduce an allergy causing food, is to mix a small amount (1/4 tsp) of an allergy causing food e.g. hard-boiled egg or smooth peanut butter into your baby’s usual food e.g. vegetable puree. If there are no signs of an allergic reaction (These signs include: hives, welts, swelling of the lips, vomiting, or change in behaviour), then gradually increase the amount next time (1/2 tsp). If your baby does show signs of an allergic reaction, stop offering the food and seek immediate medical attention.
It is important that once you have introduced these foods, to include these foods in your baby’s meals at least twice a week.

The below is a guide of solids progression, showing texture, quantity and breast/bottle feeds; it may be highly variable for each baby. You may also choose a ‘Baby Led Weaning’ approach, this involves introducing solids through appropriately textured and sized finger foods and allows your baby to explore the food themselves. There is no set way to feed your baby, so do what feels best for your family.
The above is an approximate guide for food quantities and expected number of breast and bottle feeds, this is because there are no set guidelines, as each baby will progress differently. If you feel unsure about how to introduce solids to your baby, a Children’s Dietitian (Paediatric Dietitian) can provide specialised feeding advice.

6 MONTHS

TEXTURES
Coarsely pureed/mashed

QUANTITIES
1-2 tablespoons, twice a day (start with 1 meal and progress to 2 over weeks).

EXPECTED NUMBER OF BREASTFEEDS
Breastmilk is the main nutrition source. Continue breastfeeding on demand.

EXPECTED NUMBER OF BOTTLE FEEDS
If your baby is not breastfed, continue with bottle feeds, as this is still the baby’s main nutrition source. Slight decreases may be seen in the amounts taken.

EXAMPLE OF FOODS
Start with iron-rich foods; as your baby’s iron stores gained during pregnancy start to run low. These foods include fortified baby cereals, eggs, beans, lentils and soft cooked and pureed meat. Introducing allergy causing foods e.g. yoghurt added to pureed fruit and vegetables, Semolina porridge made with breast milk or infant formula.

6-8 MONTHS

TEXTURES
Lumpy, finely chopped, progressing to finger foods

QUANTITIES
Progressing 1-4 tablespoons of food 1-3 times/day by 8 months (slow progression) – up to ½ cup of food

EXPECTED NUMBER OF BREASTFEEDS
On demand

EXPECTED NUMBER OF BOTTLE FEEDS
3-5 times per day at 6-8 months

EXAMPLE OF FOODS
Peanut butter added to mashed foods or porridge, hummus mixed into mashed vegetables, finely shredded, soft meat added to puree vegetables.

8-10 MONTHS

TEXTURES
Grated, diced, chopped finger foods, progressing to regular menu
You’ll find your baby starts to play with their spoon.

QUANTITIES
Up to 1 cup of food at each meal
At 9 months: 3 meals
At around 10 months: Introduce mid-meals, roughly ½ to ¾ cup of food (e.g. ½ cup full fat yoghurt with cut up banana).

EXPECTED NUMBER OF BREASTFEEDS
On demand; By 9 months: 4-5 breastfeeds

EXPECTED NUMBER OF BOTTLE FEEDS
3-4 formula feeds at 9-12 months

EXAMPLE OF FOODS
Well-cooked spiral pasta as finger food, hard-boiled egg with mashed avocado, soft grated cheese as finger food, pikelets.

10-12 MONTHS

TEXTURES
Chopped finger foods, Begins spoon feeding

QUANTITIES
Small balanced meals 3x/day e.g. 1 scrambled egg, chopped soft fruit, 1 Weetbix with cow’s milk, plus mid-meal snacks 1-2x/day.

EXPECTED NUMBER OF BREASTFEEDS
On demand; 3-4 breastfeeds per day

EXPECTED NUMBER OF BOTTLE FEEDS
600mL Bottle feed/day

EXAMPLE OF FOODS
Omelettes, cottage cheese and fruit mixed together, bread offered as toast fingers or sandwiches, homemade fish fingers, pesto sauce with pasta.

1-5 YEARS

Family foods (avoid small, hard pieces of food). Can offer cow’s milk as a drink after 12 months.
Example foods: Scrambled eggs, Crumbed fish, vegetables dipped in hummus, pastas, cereals with cow’s milk

References:

Australian Breastfeeding Association. Breastfeeding and family foods. ABA, 2020. (Available from: https://www.breastfeeding.asn.au/, accessed May 31st, 2021).
Australasian Society of Clinical Immunology and Allergy. Introducing foods and allergy prevention fast facts. ASCIA, 2019. (Available from https://www.allergy.org.au/images/pcc/ff/ASCIA_Introducing_Foods_Fast_Facts_2019.pdf, accessed May 31st, 2021).
NIP Allergies in the Bub. Introducing solid foods. Prevent Allergies, 2018. (Available from https://preventallergies.org.au/introducing-solid-foods/, accessed 31st May 2021).
NIP Allergies in the Bub. Around 6 months (not before 4 months). Prevent Allergies, 2018). (Available from https://preventallergies.org.au/wp-content/uploads/2020/10/Food-Ideas-for-Babies-around-6-Months.pdf, accessed May 31st 2021).
NIP Allergies in the Bub. Around 7 to 9 months. Prevent Allergies, 2018. (Available from: https://preventallergies.org.au/wp-content/uploads/2020/06/RECIPE-IDEAS-FOR-BABIES-7-9-MONTHS.pdf, accessed May 31, 2021).
NIP Allergies in the Bub. Around 10 to 12 months. Prevent Allergies, 2018. (Available from: https://preventallergies.org.au/wp-content/uploads/2020/06/RECIPE-IDEAS-FOR-BABIES-10-12-MONTHS.pdf, accessed May 31, 2021).
Castle J., Jacobson M. (2013). Fearless Feeding. Jossey Bass. pp 40-54. Accessed May 31, 2021.
Surwald, D. (2017). Baby-led weaning & introduction of solids. Peninsula Health. Accessed June 10th 2021. Available from: https://www.peninsulahealth.org.au/2017/08/25/baby-led-weaning-introduction-of-solids/

April 23, 2023

Lolly bags, do they matter?

April 23, 2023

Children attend multiple parties every year. If each party provides lolly bags (alongside party food), our kids are likely to consume excessive amounts of sugar, with minimal nutrients. These foods take the place of healthier options and can impact healthy growth, mood & concentration, not to mention the copious plastic packaging that ends up in landfill. We can have a positive impact on our children and planet by choosing healthier party food options & lolly bag alternatives. Why not give these ideas a try for your next children’s party?

– Craft to-do sets e.g. scrapbooking materials
– Colouring in books
– Play-Doh kits
– Pencils and notebooks
– Books
– Seedlings to grow a garden
– Frisbee or sporting equipment such as a ball
– Recipe cards to healthy recipes to make at home

Try providing these in paper bags instead of plastic bags to make your party more environmentally friendly.

By Emma McShane, Dietitian. Edited by Nicole Bando, Dietitian & LC

April 23, 2023

Fruit: how much a day?

April 23, 2023

Fruit: how much a day?

Fruit contains vital nutrients including fibre, slow release carbohydrates, and myriad vitamins, minerals, plant nutrients & antioxidants (prevent damage to cells). The amount of fruit an individual needs depends on their age and stage. The type of sugar found in fruit is generally slow release energy and different to the free sugar added to processed foods, making it an excellent component of the daily diet. Leave the skin on for added fibre, to assist regular bowels and happy gut bacteria. Choose a variety of fresh, frozen or canned in juice. Watch out for products such as fruit straps, stringers & puffs as they tend to be high in fruit puree, concentrates & added ingredients, making them high sugar, low nutrient options.

What is a serve of fruit?

– 1 medium apple, banana, etc.

– 1 cup of canned fruit in juice

– 2 small stone fruit or kiwi

– 30g dried fruit = 4 dried apricots halves, 1 ½ tb of sultanas (include dried fruit occasionally, around once per week).

So how much does a child or adult need per day?

– 1-2 years: ½ serve = e.g. ½ medium apple, ½ cup canned fruit or 1 small apricot

– 2-3 years: 1 serve = e.g. 1 medium apple, 1 cup of canned fruit or 2 small apricots

– 4-8 years: 1 ½ serves = e.g. 1 apple & ½ cup strawberries,

– 9-18+ years: 2 = e.g. 2 medium apple/banana, etc. or 4 small apricots/kiwi/plums.

Aim to mix up the variety of fruit across the day and week. For example, a 4 year old may have 1 medium apple, and 1 small apricot to reach 1 ½ serves.

If your child loves fruit and is eating more than is recommended, it may mean they are missing out on other foods from the core food groups. Also, excessive fruit can lead to tummy upsets, due to the overload of fructose (this does not mean they are fructose intolerant). Try these alternative healthy snacks:

Vegetable sticks e.g. carrot, cucumber and celery with dips
Corn on the cob
Boiled eggs
Cheese on crackers
Yoghurt
Nuts (if older than 5 years)
Snack size canned chickpeas and edamame
Popcorn (if older than 5 years)

See our article on Healthy Lunchboxes for other healthy snack ideas: https://www.nicolebando.com/articles/a-healthy-lunchbox

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

By Emma McShane, Dietitian, edited by Nicole Bando, APD

April 23, 2023

Children, water and other drinks:

April 23, 2023

Children, water and other drinks:

Water is essential for our body’s vital functions; to maintain healthy cells, eliminate by-products and excess electrolytes (salts), regulate body temperature, aid digestion and more. In a child over 12 months, it is the first choice of fluid. Many drinks (other than milk and water) contain sugar (or artificial sweeteners), colourings and limited nutrients. These drinks can impact healthy growth and reinforce a preference for sweet foods. Why not try to flavour water with mint leaves, frozen fruit pieces, orange or lemon rind?

Are sugar free drinks ok?
Sugar free drinks contain large amounts of artificial sweeteners, colours and flavouring to substitute the sugar. They are not a great choice for children as can promote preference for sweet foods. Carbonated drinks are acidic and can erode tooth enamel.

Is fizzy water ok?
Fizzy water is recommended in small amounts, as the bubbles can cause tummy upset. Research has also shown that excessive sparkling water can erode tooth enamel.

What about juice?
Consume in small amounts, for a child this may mean ½-1 glass occasionally. The sugar content of juices is high, as it can take 4 pieces of fruit to make 1 cup of juice! Juicing removes vital components of fruits and vegetables, such as fibre which is important for our bowels and stomach health. When making juice, use 1 piece of fruit and add vegetables such as carrot, celery, cucumber, spinach etc.

Are probiotic drinks ok?
Kefir is a great example of a healthy probiotic drink for children and adults. It’s a great source of Vitamins A, D, protein and calcium. Alternative, high sugar probiotic drinks on the market are not recommended for children.

Smoothie recipe:

Smoothies can be a good way and versatile way to use up fruit and vegetables in your fridge, and cook with your child. Try using this structure to make a smoothie for 1:

Liquid base – e.g. 1 cup milk/alternatives (e.g. soy milk with added calcium)
Add 1 piece of fruit, try frozen for a creamy consistency.
Vegetables – add in 1-2 vegetables such as spinach
Flavour – add a teaspoon of nut butter, cinnamon or 1 tb of cacao.
Extras: 1 tb chia seeds, 2 tb of yoghurt or 2 tb of oats will boost the nutrition of the smoothie.
Add a handful of ice.
Blend and enjoy!!

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

April 23, 2023

Dairy allergy & lactose intolerance in children

April 23, 2023

Dairy allergy & lactose intolerance in children

Dairy is a common allergy in babies. In Australia and New Zealand, more than 2% of infants are allergic to cow’s milk protein. Mild or moderate signs of a dairy allergy include:
– Swelling of lips, face, eyes
– Hives or welts on the skin
– Stomach pain
– Vomiting
– Diarrhoea

Severe rapid onset allergic reaction (anaphylaxis): This reaction is life threatening, and immediate medical attention should be sought by calling 000.
– Noisy breathing
– Wheezing
– Swelling or tightness in throat
– Young children may be pale and floppy

Delayed reactions to cow’s milk and other dairy foods can occur, and reactions usually occur hours or days after consuming dairy.
Symptoms may include:
– Eczema
– Delayed vomiting
– Diarrhoea
– Blood in the stool

Lactose intolerance is caused by the lack of the enzyme, lactase, which helps to digest the milk sugar, lactose. It commonly occurs after the age of 5 years.
Symptoms of a lactose intolerance include:
– Vomiting
– Diarrhoea
– Stomach pain
– Gas (wind or bloating)
These symptoms are uncomfortable but are not life threatening. Lactose-free dairy is the best alternative. Very rare lactase insufficiency in babies can present as very poor growth, severe diarrhoea and is a medical emergency.

Secondary lactose intolerance: may occur due to conditions such as gastroenteritis, which damages the gut lining and will resolve once the virus passes. Lactose intolerance can also present with a new diagnosis of coeliac disease; once treated, it will resolve.

Functional lactose overload: may occur in breastfed babies who are receiving large amounts of lactose-rich milk, often in a case of over-supply. This can be managed with the right breastfeeding support, there no need to stop breastfeeding or switch to a lactose-free formula.

If you notice any of the above symptoms in your child, it is important to speak to your doctor, dietitian or lactation consultant, so the appropriate action may be taken.

For up-to-date, evidenced based information on allergies, check out the Australasian Society of Clinical Immunology and Allergy (ASCIA) website: https://www.allergy.org.au/

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

April 23, 2023

looking after yourself as a new mum

April 23, 2023

looking after yourself as a new mum

Weight loss is of common interest amongst women after having a baby, and with a healthy diet and exercise, much of the weight gained during pregnancy will be lost naturally during the first year. Gentle weight loss is recommended only after the first month postpartum, unless very significant pregnancy weight gain has occurred. It’s not the time for restrictive dieting as your body needs to be nourished and cared for. Restrictive dieting can impact bone density and nutrient stores for future pregnancies, as well as energy, mood and overall coping, especially if breastfeeding, due to increased nutritional demands.

HEALTHY LIFESTYLE TECHNIQUES

Meals such as omelettes, baked beans, toasted sandwiches, high fibre cereal with fruit and pre-prepared salad mixes are convenient and healthy
Avoid having ‘extra’ items (such as cakes, biscuits, lollies & chocolate) in the house, when tired it can be difficult to resist them. They will cause a spike and quick crash in blood sugar (and energy levels)
Eat regular meals and snacks throughout the day
Consider online shoppinWhen choosing takeaway, go for healthier options, such as brown rice sushi with avocado and salmon, Vietnamese pho with vegetables, or stir-fries with meat, lots of vegetables and a small amount of rice.

HOW PARTNERS CAN HELP

Prepare healthy snacks for your partner
Plan, shop and prepare healthy meals, stock up the freezer with items such as bolognese, soups, pasta bakes, frozen vegetables and ready-made frozen meals.
Encourage activity – going for a walk is a good way to spend time together, enjoy some fresh air and can also help to settle a fussy baby.
Avoid buying ‘extra’ foods for an energy boost, help to prepare some healthy snacks instead.
Look after baby so partner can take a walk or head to a gym class

April 23, 2023

looking after yourself as a new mum

HEALTHY LIFESTYLE TECHNIQUES

Meals such as omelettes, baked beans, toasted sandwiches, high fibre cereal with fruit and pre-prepared salad mixes are convenient and healthy
Avoid having ‘extra’ items (such as cakes, biscuits, lollies & chocolate) in the house, when tired it can be difficult to resist them. They will cause a spike and quick crash in blood sugar (and energy levels)
Eat regular meals and snacks throughout the day
Consider online shoppinWhen choosing takeaway, go for healthier options, such as brown rice sushi with avocado and salmon, Vietnamese pho with vegetables, or stir-fries with meat, lots of vegetables and a small amount of rice.

HOW PARTNERS CAN HELP

Prepare healthy snacks for your partner
Plan, shop and prepare healthy meals, stock up the freezer with items such as bolognese, soups, pasta bakes, frozen vegetables and ready-made frozen meals.
Encourage activity – going for a walk is a good way to spend time together, enjoy some fresh air and can also help to settle a fussy baby.
Avoid buying ‘extra’ foods for an energy boost, help to prepare some healthy snacks instead.
Look after baby so partner can take a walk or head to a gym class

April 23, 2023

bliss balls: hit or miss?

April 23, 2023

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.

Email: info@nicolebando.com

Call 8840 1652

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