Qn of the Month: Intakes of Baby-Led Weaning Infants & Traditional Spoon Feed Infants – Are There Nutritional Differences?

Pureed or Baby Led? - Dietitianmom.com

Pureed or Baby Led? – Dietitianmom.com

A: Yes, according to a study published in the British Medical Journal. Led by Morison and colleagues, this New Zealand based study looked at the intake of 51 age-matched and sex-matched infants at 6-8 months of age. One to three day weighted food records and questionnaires were collected from those in the baby led weaning (BLW) group and those in the traditional spoon feeding (TSF) group, which were then analyzed. The result? It was found that while infants in both groups had relatively similar caloric intake, those in the BLW group may be consuming higher fat and higher saturated fat intakes, along with possibly lower iron, zinc and vitamin B12 intakes.

Although the research finding results are exciting, it is important to note the strengths and limitations of the study. Strengths include analysis done by a registered dietitian blinded to which group an infant belonged to, the use of weighted food records and detailed questionnaires, and the age and sex matching of infants. The limitations of this study however include the fact that a small sample size was used, the use of estimated breast milk volumes, and the fact that there was no standard definition or classification used in the study of what constituted a baby led weaning infant.

As mentioned in my previous post on BLW (Qn of the Month: How is Baby Led Weaning (BLW) Really Defined?), research on BLW is complicated by the fact that there is no standardized definition of baby led weaning, with research studies using different definitions. In this study, parents self-reported and classified themselves which group their infant fell into. Also, the lower iron intake levels observed in the BLW group compared to the TSF group may be due to the fact that the BLW infants consumed less iron fortified infant cereals, and were breastfed for much longer (approximately 8 more weeks) than TSF infants. Hence infants in the BLW group would have received less iron fortified infant formula.

It is unclear whether this study looked at the potential differences in nutrients contributed by use of iron fortified infant formula and breast milk intake, which could have a big impact on the final nutrient intake of infants in either group.  Also, since estimated breast milk volumes were used, this study cannot accurately determine the exact differences in caloric and iron intake levels between the BLW and the TSF groups. A future study needs to not only control for potential confounding in terms of the length of breastfeeding in both groups, but may also need to include biochemical tests to determine more accurately the iron status of infants in both groups.

 (Sources:

  1. University of Otago. “Dietary intake differs in infants who follow baby-led weaning.” ScienceDaily. ScienceDaily, 17 May 2016. www.sciencedaily.com/releases/2016/05/160517094206.htm. Accessed Nov 26, 2016.
  1. Morison BJ, Taylor RW, Haszard JJ, et al. How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ Open 2016;6:e010665. http://bmjopen.bmj.com/content/6/5/e010665. Accessed November 26, 2016.)

Yum! Toastie Corn Black Bean Soup

Have you ever tried combining some toasted corn kernels with black beans? It’s a fantastic combination of health, taste, colors and texture. Our family tried out and modified a recipe we found a few years ago and it became a family favorite meal option. It’s super easy to make because it builds on a ready to heat can or carton of black bean soup as the base, with more added beans and veggies to pump up the taste and nutrition. Try it out and see for yourself!

Ingredients:

  • 1 can or carton of ready-to-heat black bean soup (e.g., Campbell’s Red Pepper Black Bean Soup)
  • 1 (15 ounce) can of black beans, drained and rinsed well
  • 1-2 cups of water
  • 1 cup of frozen corn kernels (toasted first)
  • 1/4 to ½ cup of chunky salsa or salsa fresca (or to taste)
  • Pepper as desired
  • 1-2 teaspoons of olive oil
  • Can be served with avocado wedges or guacamole and tortilla chips

Directions:

  1. Add the rinsed and drained black beans into a pot with the ready-to-heat commercial black bean soup. Add in 1 – 2 cups of water (or more depending on how thick you would like your soup). Cook over medium heat until the beans soften further and the mixture thickens.
  2. Add additional vegetables if desired (see notes below).
  3. Heat a separate saucepan over medium-high heat. Add 1 – 2 teaspoons of olive oil and heat the frozen corn kernels, stirring frequently until a toasted corn smell begins and the kernels begin to brown. Remove from the heat. Stir these kernels into the soup pot with black beans.
  4. Add 1/4 to 1/2 cup of salsa (homemade or store bought) in and stir well.
  5. Serve soup with tortilla chips, guacamole or avocado wedges (see additional notes below) a sandwich or side salad.

Notes:

You can adjust the amount of water you add, depending on how thick you would like the soup. You may also decide to add the salsa individually at the table according to each person’s taste preference.

It is very easy to modify this recipe especially if you would like to add in more vegetables. For example, you could add in  ½ cup of chopped button mushrooms, a diced orange bell pepper  or a 1/4 cup of chopped mini zucchini wedges into the soup at the beginning when heating up the black beans with water. Another delicious alternative is to cook pasta separately then add some into the final soup before serving. Makes a hearty meal!

To adapt this to a toddler’s meal: You can set aside some of the black bean corn soup for your toddler, prior to adding the salsa. This is so that you can decide how much to add of the salsa (if any) before giving to your toddler. Then you can put some cooked pasta and/or broken up tortilla chips (allow the chips to soften into the soup before offering to toddler) into the soup to serve as an all-in-one meal. Alternatively, offer the black beans, pasta and corn on a plate as delicious finger food pick-me-ups!

Qn of the Month: What Are Ways to Cook Beets?

A: For those who are unfamiliar with this supernutritious plant, there are actually a myriad of ways to cook beets, or the taproot portion of the beet plant. These include the following methods:

  • Steaming it and applying a bit of butter and salt
  • Adding it into soups
  • Eating thin raw slices as part of a salad
  • Blending it with juice (e.g., a beets, apple and carrot combination)
  • Incorporating it into Asian soups (e.g., make a beets soup with carrot, red dates and pork ribs)
  • Incorporating it into western soups: For example, chicken soup (chicken, potatos, carrots, onions, beets) or borscht soup (cabbage, beets, dill, onion etc.)
  • My toddler loves having the beets juices (from steaming) added to her rice to make ‘pink rice’!
  • Add a bit of the beets juice to your baby’s solids as well for added nutrition, or even blend down the steamed beets to make a healthy vegetable puree

Some additional Cooking Tips:

  • It might be a good idea to wear gloves when peeling and cutting this root vegetable to avoid staining your hands. Alternatively, wash your hands and the cutting board as soon as you can after cutting and peeling the vegetable.
  • For a shorter steaming time, cut the beets into as thin slices as you can.
  • Although beets can be added into soups for extra flavor and nutrition, be prepared that it will turn your soup a pinkish tinge!

I was pleasantly surprised to find that the cost of beets at the store was not as expensive as I thought. A bunch of beets (3 beets with the attached leaves and stems) was about $3.79 Canadian dollars. This could be because it was still summer/fall at the time I first bought them, so the costs were lower. I cooked the leaves and stems, and still had the beets for 2-3 side dishes over the course of the next few weeks.

Store beets in the fridge and it will keep for about 1-2 weeks (depending on how fresh these were when you first bought them). If you chop off the stalks (leaving about an inch remaining at the top of the beetroot), then cook the beetroot in boiling water for 20-30 minutes or until cooked through, you will also be able to then peel and slice them to freeze and use at a later date!

Kitchen Spotlight: Beets!

 

beets2

Care to Try Some Beets? – Dietitianmom.com

When a friend passed me some huge home grown beets, I was excited to use them. Although I had not incorporated these into my cooking repertoire yet, I had heard that beets were a great healthy food choice and the internet is rife with praise for these red colored giant turnip-like vegetables. However, it made me curious. Just what exactly are the actual health benefits of eating them or what is the current research saying? Here is the result of my investigation:

The taproot portion of the beet plant, beets are known by many other names such as beetroot or sugar beets. It has been in use since Roman times, exists in various cultivated varieties and most people may not be aware that they are actually ingesting beets as it is used as a common food coloring agent called E162.

Nutritional value: A half cup of sliced cooked beets (about 85 grams in weight) provides a good source of fiber (1.7 grams), protein (1.43 grams) and iron (0.67 milligrams). This is equivalent to a small apple but 4 times the protein content, and more than 7 times its iron content! Beets also provide many other nutrients like potassium, zinc, magnesium, folate, vitamin A, vitamin E and B vitamins. Comparing the raw and the cooked (boiled, drained) versions, the two forms are comparable in nutritional value. The main difference between eating the raw version versus the cooked is that you get a measurable amount more folate (about 40 micrograms Dietary Folate Equivalents more per 100 gram weight).

Beets are a rich source of phytochemical compounds like nitrate, betalain pigments, ascorbic acid, carotenoids, phenolic acids and flavonoids. Research is showing that many of these compounds display strong  antioxidant, anti-inflammatory and chemo-preventive properties. Hence its consumption may be a health benefit in many areas, such as  in the prevention and treatment of certain chronic diseases like hypertension, heart disease, liver disease and cancer. Many of beets’ constituents are potent antioxidants, helping to keep our body’s cells in a state of redox balance. This means intake of these and other fruits or vegetables high in antioxidants help to fight excessive reactive oxygen and nitrogen species generated within the body from internal and external causes.  Beets may also increase the body’s existing internal antioxidant defenses, leading to a synergistic effect. In terms of inflammation, investigations so far are revealing that betalains and beet extracts may help to block pro-inflammatory signaling cascades, weakening the progression of chronic inflammation which is implicated in many chronic medical conditions. The role of beets’ compounds are also being further investigated in areas such as cognitive function and endothelial function both in the laboratory and on actual human subjects.

So the next time you see beets on offer at the store, try them! My husband and preschooler were skeptical trying these, but after cooking it a few different ways, these now make a regular appearance on our dinner table. See upcoming posts on some recipe ideas for ways to serve beets!

(Sources:

  1. Clifford T, Howatson G, West DJ, Stevenson EJ.  The potential benefits of red beetroot supplementation in health and disease. Nutrients. 2015 Apr 14;7(4):2801-22. doi: 10.3390/nu7042801. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425174/. Accessed September 26, 2016.
  2. USDA National Nutrient Database for Standard Reference. http://ndb.nal.usda.gov. )

 

Qn of the Month: What Are The New Sleep Guidelines for Children?

A: In June 2016, the American Academy of Sleep Medicine released new guidelines to guide parents and health care professionals on the recommended amount of sleep that infants, children and teenagers need to receive for optimal health. This came after a 10 month process of an extensive scientific literature review, and multiple rounds of voting amongst a Pediatric Consensus Panel of 13 experts. The findings from the literature research found that those who followed the recommended daily sleep hours regularly tended to have overall better health outcomes such as improved attention spans, as well as better behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. However, sleeping more or less than the recommended hours on a regular basis tended to be associated with adverse health consequences.

Supported by the American Academy of Pediatrics, here are the recommended sleep hours by age in the consensus statement:

  • Infants four to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children one to two years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children three to five years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children six to 12 years of age should sleep nine to 12 hours per 24 hours on a regular basis to promote optimal health.
  • Teenagers 13 to 18 years of age should sleep eight to 10 hours per 24 hours on a regular basis to promote optimal health.

According to the experts, besides having enough total hours of sleep regularly, reaping the benefits of healthy sleep also require having appropriate timing, daily regularity, good sleep quality and the absence of sleep disorders.

(Sources:

  1. Recharge With Sleep: Pediatric Sleep Recommendations Promoting Optimal Health. American Academy of Sleep Medicine. http://www.aasmnet.org/articles.aspx?id=6326. June 13, 2016. Accessed September 30, 2016.
  1. HealthDay. “How much sleep children need by age.” Chicago Tribune. June 13, 2016. http://www.chicagotribune.com/lifestyles/health/ct-child-sleep-recommendations-health-0613-20160613-story.html. Accessed September 30, 2016.)

Constipation Matters (Part 2): Prevention Tips for Toddlers

potty-1-frog

Constipation Prevention Tips – Dietitianmom.com

To prevent constipation in adults, the 3 ‘Fs’ are usually recommended: Fluids, Fiber and Frequent Exercise/Activity. Well, it’s the same for babies and toddlers as well. Some time ago, I had posted an entry on some tips for combating constipation in babies (see post Constipation Matters (Part 1): Prevention Tips for Babies). Here is the follow on post with more tips for toddlers:

Fluids
Even if a toddler is already established and used to drinking water, as a parent you can still encourage frequent water intake by offering fluids at meals, water with snacks and making sure water is readily accessible with a water bottle or cup at hand in the play area at all times. The toddler will then know that there is always water available when she wants or needs it, and can regulate his/her own intake. Some days I go into the play area and see the water cup untouched and other days a third or more of the water in the sippy cup (non-spill of course) gone within a few hours! So it is really difficult to predict when or how much your toddler will want to drink on any given day. But reminders to drink water throughout the day and role modeling lots of water drinking yourself definitely helps! Sometimes I also have little water drinking competitions with my daughter, to see who can finish a cup of water faster. She enjoys this but of course you need to make sure she doesn’t drink so fast she chokes on the water!

Fiber
Some recommend not giving a toddler too much bran and bran containing foods as the high fiber content may possibly fill the child up more and make the child less hungry for other foods, compromising his/her nutritional intake. Personally I don’t think this is true. When my toddler was 17 month old, she ate Shredded Wheat squares, Total Cereal flakes, brown rice, whole wheat pasta and whole wheat bread, and still had room for foods like milk, fruits and vegetables. So I think it is safe to switch completely to whole grain products and breakfast cereals. The key I find is to watch the amount of crackers and Cheerios a child can get at snacks as well as his/her overall milk intake during the day, as these have a greater likelihood of filling the child up and making him/her less hungry to eat properly at meals. In fact, at around 15 months of age, I cut out giving milk at snacks (but I still give 3-4 ounces at meals) as I found that it was affecting her intake at lunch and dinner. Don’t forget that fiber comes from providing lots of fruits and vegetables into the diet too. These can be fresh, frozen or dried (examples are dried figs, raisins and apricots). Just ensure your toddler has a higher fiber intake with an intake of plenty of water!

Frequent Movement/Activity
I don’t think parents need to worry about this one! It’s probably more about how to restrain excessive activity and movement…Toddlers with their newfound freedom and independence love to move and explore on two feet the surrounding environment, not to mention climb, crawl, dance and play. So let them!

Qn of the Month: How Can I Tell My Baby Is Full?

A: An age old question is, “How can I tell my baby is full?” Just as important as the previous post (How Can I Tell My Baby is Hungry?) is being able to tell when your baby is full, so that baby gets just the amount of intake he/she needs for optimum growth and development.

Some signs to watch out for in the infant include:

  • Falling asleep after emptying or softening at least one breast
  • Infant pushing away from the breast or fussing with back arching
  • Reduced sucking
  • Infant drawing head away from the nipple
  • Infant’s body relaxes with extended and relaxed hands/arms

Young babies under 3 months of age may not give clear signs of hunger and fullness, but these cues are usually clear by 3 to 6 months of age. For optimal health and growth, parents should check to see if their baby is still hungry after a pause in feeding by looking for satiety cues. This is important before continuing forward in the feeding, especially in babies that are bottle fed. Parents are often eager to have a baby finish an entire bottle of expressed breast milk or formula, simply because they see the contents in the bottle, instead of letting the baby decide when or how much to take at a feeding.