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By contactus@priority-pediatrics.com
July 07, 2019
Category: Nutrition
Tags: pregnancy   nutrition   FDA   Mercury   Fish   Diet Advice  

FDA Updates Advice on Eating Fish for Pregnant Women, Children

Megan Brooks, July 03, 2019

The US Food and Drug Administration (FDA) has updated advice on fish consumption for women who are pregnant or may become pregnant, breastfeeding mothers, and young children, putting more focus on the health benefits of seafood.  

"Fish and shellfish are an important part of a well-rounded diet. However, we know many parents worry about mercury in fish and even choose to limit or avoid fish because of this concern. In fact, women in the US who are pregnant are consuming far less than the recommended amount of seafood," Susan Mayne, PhD, director of the FDA's Center for Food Safety and Applied Nutrition, said in a news release.

"Our goal is to make sure Americans are equipped with this knowledge so that they can reap the benefits of eating fish, while choosing types of fish that are safe for them and their families to eat," said Mayne.

Choose Wisely

In January 2017, the FDA and Environmental Protection Agency (EPA) released a reference chart to help consumers more easily understand the types of fish to eat more or less of, based on their mercury levels.

The information in the chart remains the same. However, the revised advice issued July 2 expands information regarding the benefits of fish as part of a healthy diet by promoting the science-based recommendations of the 2015-2020 Dietary Guidelines for Americans. The advice pertains to people aged 2 and older.

"While it is important to limit mercury in the diets of women who are pregnant or breastfeeding and young children, many types of fish are both nutritious and lower in mercury," the FDA said in the update.   

"The revised advice highlights the many nutritional components in fish, many of which have important roles in growth and development during pregnancy and early childhood. It also highlights the potential health benefits of eating fish as part of a healthy eating pattern, particularly for heart health benefits and lowering the risk of obesity," the FDA said.

Fish provides protein; healthy omega-3 fats; more vitamin B12 and vitamin D than any other type of food; iron, which is important for infants, young children, and women who are pregnant or who could become pregnant; and other minerals such as selenium, zinc, and iodine, the FDA notes.

Last month, the FDA announced it would allow certain "qualified" health claims stating that consuming eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) omega-3 fatty acids in food or dietary supplements may reduce the risk of hypertension and coronary heart disease.

The FDA continues to recommend that adults eat at least 8 ounces of seafood per week based on a 2000 calorie diet.

For an adult, one serving is 4 ounces (about the size and thickness of an adult's palm). Adults should eat two to three servings a week from the "Best Choices" list (or one serving from the "Good Choices" list). For children, one serving is 1 ounce at age 2 and increases with age to 4 ounces by age 11.

Women who are pregnant or breastfeeding should consume between 8 and 12 ounces of a variety of seafood per week from choices that are lower in mercury.

The 36 types of seafood on the best choices list include salmon, shrimp, pollock, canned light tuna, tilapia, catfish and cod, flounder, haddock, crab, clams, and sole. Nineteen varieties make the good choices list and include bluefish, halibut, mahi mahi, grouper, monkfish, rockfish, snapper, and striped bass (ocean).

The FDA recommends that everyone avoid seven fish that may be high in mercury: king mackerel, marlin, orange roughy, shark, swordfish, tilefish (Gulf of Mexico), and bigeye tuna.

The updated advisory also cautions that some fish caught by family and friends, such as larger carp, catfish, trout, and perch, may contain unknown amounts of mercury or other contaminants. It advises checking local advisories for information on how often it's safe to eat those fish. If there is no advisory, the FDA advises eating only one serving and no other fish that week.

 
By contactus@priority-pediatrics.com
March 13, 2019
Category: Nutrition
HealthyChildren.org
The only site and newsletter backed by 67,000 AAP pediatricians!
Prenatal Baby Toddler Preschool Gradeschool Teen Young Adult
Focus on National Nutrition Month
March 2019 | Issue No. 183
Beyond Chicken Nuggets: Protein-Rich Alternatives for Picky Eaters
When it comes to getting protein into your child’s diet, you don’t have to get into a power struggle or give in to the daily chicken nugget diet. There are lots of protein-rich alternatives for picky eaters.  
New video: Is your baby hungry or full?

In this new video, you'll learn how to understand, recognize, and respond to your baby's hunger or fullness cues. You can practice responsive feeding when breastfeeding, bottle feeding and when providing solid foods. 

Is Your Baby Hungry or Full? Responsive Feeding Explained
Also In This Issue

How Children Develop Unhealthy Food Preferences

The Benefits & Tricks to Having a Family Dinner

Sports Nutrition for Busy Families and Busy Lifestyles

How Often and How Much Should Your Baby Eat? 

Food and Media: Not a Healthy Mix

By contactus@priority-pediatrics.com
June 10, 2018
Category: Nutrition

From www.healthychildren.org:

When do I start giving my baby solid foods?

Lots of parents are excited to start their babies on solid foods. Others are nervous. Starting to eat solid foods (like baby cereal and baby foods, e.g. meats, fruits, veggies, eggs, fish & foul, etc.) is an important part of your baby’s development.

Did you know that babies who start eating solid food too early are more likely to be overweight or obese in childhood and adulthood? This is one more important reason to wait until your baby is really ready before giving him solid foods.

Starting around age 5-6 months, watch for signs that your baby is ready for solid foods.

Pay attention to signs that your  5 to 6 month-old is ready for solid foods. These signs include:

 

Parent 2 Parent:

"When my first baby started eating solids, I fed him fruits first, which was a mistake. It was a struggle after that to get him to eat any veggies! With my second baby, we started with veggies and meat, and now she eats almost anything I give her."

Feed your baby food made for babies.

Simple baby foods, like homemade pureed vegetables, meats, infant cereals, and jarred baby foods, provide the right nutrition for your baby. 

 

Parent 2 Parent:

"I couldn’t afford to buy jarred baby food, so I prepared our food without any seasoning until after it was on our plates. I put little bits of unsalted veggies, meat, or unsweetened fruit in the blender separately for my baby’s meal, and he loved it!"

Prepared “grown-up” meals and fast foods can cause an allergic reaction and don’t give your growing baby the right nutrition. Also, they often have many more calories than your baby needs.

Remember: Babies don’t need desserts or sweet treats. Skip the baby desserts.

 

Safety tip:

  1. If you make your own baby food, be aware  that spinach, beets, green beans, squash, and carrots contain large amounts of nitrates and are not good choices during early infancy.

Have fun with finger foods!

Let your baby try feeding him/herself as soon as he/she’s ready — usually around 8 or 9 months old. Start giving him/ her foods that baby can easily feed self. 

 

Parent 2 Parent:

"Once my kids were eating table food, I put veggies in everything. So, if I make scrambled eggs, there are vegetables in it. That way, my kids always get some."

Try very small soft pieces (smaller than a dime) of things like:

 

Parent 2 Parent:

"We always present what we’re eating. We try to encourage our baby to take a bite when we take a bite. It’s like, ‘Oh, look, daddy has peas on his fork, can you put some on your spoon too?"

You can still feed your baby pureed, mashed, and jarred food, too.

Want more information?

Check out these other tips about starting solid foods:

 

Starting Solid Foods

 

Rice, oatmeal, or barley? What infant cereal or other food will be on the menu for your baby's first solid meal? Have you set a date?

At this point, you may have a plan or are confused because you have received too much advice from family and friends with different opinions.

Here is information from the American Academy of Pediatrics (AAP) to help you prepare for your baby's transition to solid foods.

 

When can my baby begin solid foods?

Here are some helpful tips from AAP Pediatrician David Hill, MD, FAAP on starting your baby on solid foods. Remember that each child's readiness depends on baby's own rate of development.


Other things to keep in mind:

  • Can your baby hold his/her head up? Your baby should be able to sit in a high chair, a feeding seat, or an infant seat with good head control.

  • Does baby open his/her mouth when food comes baby's way? Babies may be ready if they watch you eating, reach for your food, and seem eager to be fed.

  • Can baby move food from a spoon into his/her throat? If when you offer a spoon of rice cereal, baby pushes it out of his/her mouth, and it dribbles onto the chin, baby may not have the ability to move it to the back of the mouth to swallow it. That's normal. Remember, baby's never had anything thicker than breast milk or formula before, and this may take some getting used to. Try diluting it the first few times; then, gradually thicken the texture. You may also want to wait a week or two and try again.

  • Is baby big enough? Generally, when infants double their birth weight (typically at about 4 months of age) and weigh about 13 pounds or more, they may be ready for solid foods.

NOTE: The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby's diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire. Dr. T does recommend supplementing solely breast fed infants with vitamin D and iron supplements during the first year.

How do I feed my baby?

Start with half a spoonful or less and talk to your baby through the process ("Mmm, see how good this is?"). Your baby may not know what to do at first. Baby may look confused, wrinkle the nose, roll the food around inside the mouth, or reject it altogether.

One way to make eating solids for the first time easier is to give your baby a little breast milk, formula, or both first; then switch to very small half-spoonfuls of food; and finish with more breast milk or formula. This will prevent your baby from getting frustrated when he/she is very hungry.

Do not be surprised if most of the first few solid-food feedings wind up on your baby's face, hands, and bib. Increase the amount of food gradually, with just a teaspoonful or two to start. This allows your baby time to learn how to swallow solids.

Do not make your baby eat if she/he cries or turns away when you feed baby. Go back to breastfeeding or bottle-feeding exclusively for a time before trying again. Remember that starting solid foods is a gradual process; at first, your baby will still be getting most of baby's nutrition from breast milk, formula, or both. Also, each baby is different, so readiness to start solid foods will vary.

NOTE: Do not put baby cereal in a bottle because your baby could choke. It may also increase the amount of food & calories your baby eats and can cause your baby to gain too much weight. However, cereal in a bottle may be recommended if your baby has reflux. Check with your child's doctor if you suspect baby needs cereal.

Which food should I give my baby first?

For most babies, it does not matter what the first solid foods are. By tradition over past generations, single-grain iron-fortified cereals have been usually introduced first. However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. Although many pediatricians will recommend starting vegetables before fruits, there is no evidence that your baby will develop a dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this. If your baby has been mostly breastfeeding, your baby may benefit from 1st baby foods made with meat, which contains more easily absorbed sources of iron and zinc that are needed by 4 to 6 months of age (beef, veal, lamb, pork, chicken, turkey, fish, etc). Check with your child's doctor.

Baby iron-fortified cereals are available premixed in individual containers or dry, to which you can add breast milk, formula, or water. Whichever type of cereal you use, make sure that it is made for babies and iron fortified.

When can my baby try other food?

Once your baby learns to eat one food, gradually give baby other foods. Give your baby one new food at a time every few days. Generally, meats and vegetables contain more nutrients per serving than fruits or cereals. Please continue foods already given as part of your baby's daily variety.

There is no evidence that waiting to introduce baby-safe (soft), potentially allergy-causing foods, such as eggs, dairy, soy, peanuts, or fish, beyond 4 to 6 months of age prevents food allergy. There is scientific evidence for just the opposite_giving these foods between 6 & 10 months of age appears to reduce a baby's chances of food allergy bby allowing baby's immune system to develp tolerance to foods. If you believe your baby has an allergic reaction to a food, such as diarrhea, rash, or vomiting, talk with your child's doctor about the best choices for the diet.

Within a few months of starting solid foods, your baby's daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; pureed nut butters; soft cheeses; yogurts; soft biscuit pieces and fish. Please delay cow's milk until age one year and offer no honey in the first year of life.

When can I give my baby finger foods?

Once your baby can sit up and bring his/her hands or other objects to the mouth, and pick up small pieces with forefinger and thumb, you can give baby finger foods to help her/him learn to feed her/himself. To prevent choking, make sure anything you give your baby is soft (easily crushable between parent fingers), easy to swallow, and cut into small pieces the size of baby's thumb tip. Some examples include small pieces of banana, wafer-type cookies, or crackers; scrambled eggs; well-cooked pasta, rice and legumes; well-cooked, finely chopped chicken; and well-cooked, cut-up potatoes or peas.

At each of your baby's daily meals, baby should be eating about 4 ounces, or the amount in one small jar of strained baby food. Limit giving your baby processed foods that are made for adults and older children. These foods often contain more salt and other preservatives.

If you want to give your baby fresh food, use a blender or food processor, or just mash softer foods with a fork. All fresh foods should be cooked with no added salt or seasoning. Although you can feed your baby raw bananas (mashed), most other fruits and vegetables should be cooked until they are soft and then cooled, then refrigerated or frozen and dated until needed. Refrigerate any food you do not use, and look for any signs of spoilage before giving it to your baby. Fresh foods are not bacteria-free, so they will spoil more quickly than food from a can or jar.

NOTE: Do not give your baby any food that requires chewing at this age. Do not give your baby any food that can be a choking hazard, including hot dogs (including meat sticks, or baby food "hot dogs"); nuts and seeds; chunks of meat or cheese; whole grapes; popcorn; chunks of peanut butter; raw vegetables; fruit chunks, such as apple chunks; and hard, gooey, or sticky candy.

What changes can I expect after my baby starts solids?

When your baby starts eating solid foods, baby's stools will become more solid and variable in color. Because of the added sugars and fats, they will have a much stronger odor too. Peas and other green vegetables may turn the stool a deep-green color; beets may make it red. (Beets sometimes make urine red as well.) If your baby's meals are not strained, baby's stools may contain undigested pieces of food, especially hulls of peas or corn, and the skin of tomatoes or other vegetables. All of this is normal. Your baby's digestive system is still immature and needs time before it can fully process these new foods. If the stools are extremely loose, watery, or full of mucus, however, it may mean the digestive tract is irritated. In this case, reduce the amount of solids and introduce them more slowly. If the stools continue to be loose, watery, or full of mucus, consult your child's doctor to find the reason.

Should I give my baby juice?

Babies do not need juice. Babies younger than 12 months should not be given juice. After 12 months of age (up to 3 years of age), give only 100% fruit juice and no more than 4 to 6 ounces a day. Offer it only in a cup, not in a bottle. To help prevent tooth decay, do not put your child to bed with a bottle. If you do, make sure it contains only water. Juice reduces the appetite for other, more nutritious, foods, including breast milk, formula, or both. Too much juice can also cause diaper rash, diarrhea, or excessive weight gain.

Does my baby need water?

Healthy babies do not need extra water. Breast milk, formula, or both provide all the fluids they need. However, with the introduction of solid foods, water can be added to your baby's diet. Also, a small amount of water may be needed in very hot weather. If you live in an area where the water is fluoridated, drinking water will also help prevent future tooth decay. Generally Metropolitan water is fluoridated and helps build strong teeth. Commercial bottled water is generally not fluoridated and does not build strong teeth, nor prevent tooth decay.

Good eating habits start early!

It is important for your baby to get used to the process of eating—sitting up, taking food from a spoon, resting between bites, and stopping when full. These early experiences will help your child learn good eating habits throughout life.

Encourage family meals from the first feeding. When you can, the whole family should eat together. Research suggests that having dinner together, as a family, on a regular basis has positive effects on the development of children. TV, cell phones and other electronics should be off and elsewhere during family meal times.

Remember to offer a good variety of healthy foods that are rich in the nutrients your child needs. Watch your child for cues that he/she has had enough to eat. Do not overfeed! Babies will not eat the same amount every meal, nor even every day, but research shows babies will consume what they need from a healthy variety of foods offered them over a number of days. Babies feel hunger and they feel satisfied when full and need no encouragement to eat more than they want.

If you have any questions about your child's nutrition, including concerns about your child eating too much or too little, talk with your child's doctor.

Additional Information from HealthyChildren.org:

By contactus@priority-pediatrics.com
May 03, 2018
Category: Nutrition
Tags: nutrition   Healthy Weight   Webinar  

Join HealthyChildren.org and leading childhood obesity expert Dr. Sandra G. Hassink for a free informational webinar
on what you can do as a parent to help your child achieve and maintain a healthy weight. A question and answer session will follow.
 
Registered participants have a chance to win a free copy of Dr. Hassink's new book, Achieving a Healthy Weight for Your Child: An Action Plan for Families, published by the American Academy of Pediatrics.
Register Now!

 

Join HealthyChildren.org and leading childhood obesity expert Dr. Sandra G. Hassink for a free informational webinar on what you can do as a parent to help your child achieve and maintain a healthy weight. A question and answer session will follow. Registered participants also have a chance to win a free copy of Dr. Hassink's new book, Achieving a Healthy Weight for Your Child: An Action Plan for Families, published by the American Academy of Pediatrics.