Qn of the Month: Do Different Brands of Baby Cereal Provide the Same Nutrition?

A: No! Although there are some similarities, there appears to be more differences between different brands of baby cereal products, even between different brand products of the same type of cereal.  How so? Read on.

Generally all infant cereals are fortified in certain nutrients such as iron, thiamine, riboflavin and niacin. Baby cereal products also contain (per serving) similar amounts of macronutrients such as calories, carbohydrates, fats and protein. However, major differences exist. For example, in Canada, Nestle Gerber’s® baby oat infant cereal provides in a (5 tablespoons or 28 grams) serving the following: 15% Daily Value (DV) of calcium, 60% DV of vitamin B12, 100% DV of iron and 0 grams of fiber. But a comparable (1/3 cup or 30 grams) serving of Heinz’s baby oat cereal provides more iron (110% of DV iron), 4 times the amount of calcium (60% DV of calcium), 2 grams of fiber but absolutely no vitamin B12! Not only that, Nestle Gerber’s® baby oat infant cereal contains in a serving 30% DV of biotin, 15% DV of iodide, 15 % DV of zinc and 30% DV of magnesium. However, a similar serving size of Heinz’s baby oat cereal contains no biotin or iodide, only 6% DV of zinc and halfthe quantity of magnesium (15% DV)! It appears that Heinz’sbaby oat cereal is a really good source of iron and calcium per serving, but not so much of the other nutrients.

So the next time you go shopping, make sure to check the nutrition facts panel of the infant baby cereal you are planning to buy, to see what nutrition your baby will really be getting from consuming that particular product!

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Qn of the Month: What Are Key Infant & Toddler Feeding Transitions?

A: Have you ever wondered whether your baby or child is meeting or progressing well in terms of his or her oral motor development? For new mothers, it can be especially daunting knowing when to introduce a different texture or when to start teaching your baby how to drink from a cup. The following are key infant and toddler feeding transitions that are important for a child’s optimal growth and physical as well as oral motor development:

Feeding Transition Age of Occurrence
Establishing breastfeeding Birth to 1 month
Introduction of solid foods 4 – 7 months
Finger foods 6 – 8 months
Introduction to the cup 6 – 12 months
Introduction to table foods (texture) 9 – 12 months
Weaning from breast or bottle 12 – 18 months
Rotary chewing 2 -3 years

Even though it is true that every healthy baby develops differently and often at their own pace, it is still good to keep these general key infant and toddler feeding transitions in mind as you watch and help your baby progress.

[Source: Milano K. How Infant Feeding Transitions Relate to Feeding Difficulties in Young Children. PNPG Building Block for Life. Spring 2016, 39(2): 1-6]

 

 

Ready to Land? Handling Baby Jet Lag

Ready for Baby Jet Lag? - Dietitianmom.com

Ready for Baby Jet Lag? – Dietitianmom.com

This summer I traveled back from Asia with my husband. Like the other trips, this involved a long total flight time of about 16 hours with an additional 2 hour layover in Japan. This time though, I traveled with two children, one being just four months, and the other being three and a half years old. That was a challenge in itself, but I was preparing myself for the bigger challenge: that of adjusting my four month old to the time zone changes, and readjusting my infant’s bio-clock. In a previous post, I had described the excruciating process (involving nearly 2 weeks) of converting my oldest daughter (then 4 months of age) to Eastern Standard Time (EST) after we returned from Singapore in 2013. What my husband and I ended up doing was to move our child’s bedtime half an hour to one hour later every night, so that her long stretch of night-time sleep could be preserved each night. Eventually after about 12 days we got her bedtime to where we wanted it (see post Baby Jet Lag…It’s Real). However this method meant that we as an entire family had to follow her schedule, down to eating our meals at night and having black out curtains.

This time, traveling back with our second daughter to the western hemisphere, I was open to trying a different method. The baby would be sleeping in a crib in the master bedroom and the idea of the whole family following our infant’s pace of time adjustment just didn’t seem feible with a toddler. The toddler would be used to playing in daylight hours, so would be very noisy and may interrupt the baby’s sleep during daytime. It is also likely that the toddler won’t be able to sleep with a baby crying several times at night. So I decided to try a different method: going cold turkey.

So what happened? The first day we arrived home, as our baby ended up staying awake most of the daytime hours. Then that first night she woke up at least 4-5 times at night, about once an hour. Each time she started to cry I had to quickly scoop her up out of the crib and then shush her by feeding her, as I was afraid to wake up my toddler. She would feed a little bit each time and then go back to sleep. In the end I put her in the same bed as me, as it was easier to breastfeed that way since I felt so exhausted from the day’s traveling. In the morning the baby passed some gas so I suspected she was waking up and crying at night more from gas in her tummy, and was really feeding more for comfort since she didn’t feed for long each time she woke up.

The second night she woke up about 3 times. Once it was about an hour after she had slept and seemed to be more from gas or an unresolved burp. I was able to quickly pat her back to sleep. Then she woke up again about 2 hours later. This time I made sure she drank at least 10 minutes on both sides in the breastfeeding session before putting her down, in the hopes that this would settle her the rest of the night. However, I really felt I needed a place to put baby without having to worry about the baby’s crying waking up our toddler. I ended up using a spare room that was away from our toddler’s room and putting an infant bath tub with a pillow for the ‘mattress’ cushion at the bottom. When the baby then woke up a few hours later, I was able to then scoop her up quickly and take her to this other room. I could then close the door. Even though I still fed her via my breast, I noticed she didn’t seem as hungry. The spare room (in this case we used a storeroom) provided some insulation of her crying from our toddler and other neighbors in the surrounding apartments.

The 3rd night, baby woke up about 2 times. The moment the baby awoke and started crying, I took her to the spare room. There I breastfed her only 5 minutes on each side as I wanted to slowly wean her off of being fed breastmilk at night. This seemed to satisfy baby and baby went back to sleep for 3 more hours.

The fourth night was when I went cold turkey. I decided she needed to cut out feeding altogether. I made sure I fed her a lot during the day (about every 2 hours and offered both breasts each session). The baby ended up sleeping quite well, though she did wake up with brief crying spells twice in the night. When she did wake up, I put her in the bed in the storeroom, and closed the door. She cried about 10 minutes the first time and then went back to sleep. Then she awoke briefly an hour later but was able to put herself back to sleep with only a few cries before waking up another hour later this time wide awake and hungry. So by the 4th night, our infant managed to sleep a 7 hour stretch relatively well, and was able to put herself back to sleep without much intervention on my part. In the end our infant got over her jet lag in just 4-5 nights…truly a miracle! The dark storeroom and the white background noise I created likely also helped.

The rest of the family survived relatively unscathed. My eldest daughter managed to get over her jet lag within 3 days. This involved some intentional steps of not allowing her to have an afternoon nap or a minimal one at best, lots of physical activity and waking her up in the mornings at the desired time. I think she would have gotten over it faster if her sister didn’t wake up wailing at certain times in the night the first few nights causing her to wake up and then have difficulty falling back asleep. My husband had broken sleep the first few nights but was able to sleep well by the 4th night, and quickly resumed his working during the daytime. As for me, I ended up just having a few sleepless nights!

I am writing this post to share my experience. Of course every baby is different and the age of the baby as well as the traveling circumstances (e.g., how long the flights are and the duration of travel) will also affect how quickly he/she gets over jet lag. Hopefully as you travel during this winter season, your baby will be able to adjust smoothly to each location and time change! Merry Christmas!

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.)

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!

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.)

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.