4 Infant Supplements to Ask Your Pediatrician About

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Starting your baby on solid foods is exciting — and messy! Most babies start with a very small amount of solids at around 4 to 6 months old, slowly increasing their portion size. Then, at around 9 to 11 months old, you may start noticing a dramatic drop in how much breast milk or formula your baby drinks as he or she starts getting more nutrition and calories from solid foods.

Because of their changing dietary needs over this transition, it is important that infants get the nutrition they need to grow and develop. For some children, this means filling nutritional gaps with carefully chosen supplements.

Iron

Babies are born with a store of iron that lasts them for about 4 to 6 months. The American Academy of Pediatrics recommends that full-term infants who are exclusively breast-fed be given an iron supplement starting at 4 months of age. Talk to your pediatrician to see if your infant needs an iron supplement. Children born premature or with a low birth weight may have reduced iron stores. If so, your pediatrician will probably recommend iron supplements until your baby’s first birthday. Formula is generally iron-fortified, which means formula-fed babies rarely need an iron supplement.

As infants begin to eat more solid food, serving them iron-rich foods such as iron-fortified cereal, meat or beans at least twice a day will help them meet their iron needs. But, if your baby is over 6 months old, is breast-fed and is not eating iron-rich foods, your pediatrician may recommend an iron supplement. To promote iron absorption from plant foods, combine iron-rich solid foods you serve to your child with vitamin C-rich foods in one meal. For example, pair a bean and rice puree or finger food meal with tomato sauce, fruit or a fruit puree.

Vitamin D

Vitamin D is important for healthy bones and prevention of chronic disease. Because low levels of vitamin D are so common, the American Academy of Pediatrics says all breast-fed infants — and formula-fed infants who drink less than 32 ounces of formula per day — should take a supplement. When starting solids, you can mix vitamin D drops in purees as well as add them to formula or water.

Fluoride

Before you determine if your baby needs fluoride, which is important for cavity prevention, you need to know levels of fluoride in your local water supply. Fluoride supplements are only available by prescription, so discuss this with your pediatrician.

Vitamin B12

Vitamin B12, which prevents anemia and supports healthy neurological function, is found in animal products such as meat, fish, eggs and dairy, and is not a concern for most children. However, if you plan to introduce only plant-based foods into your child’s diet, he or she may need a B12 supplement. Formula-fed vegan babies can get their vitamin B12 from a special fortified formula, most often soy-based. Vegan mothers who exclusively breast-feed should be sure to consume adequate vitamin B12 through fortified foods and supplements in order to provide ample B12 to her baby via breast milk.Vitamin B12 is typically included in most over-the-counter infant vitamin drops and many ready-to-eat cereals and milk substitutes.

Before giving your infant any supplements, always consult with your pediatrician. Not all infants automatically need supplements when starting solids. Make sure to introduce your baby to a variety of foods in order to develop his or her palate and meet nutritional needs.

Adapted from: Natalia Stasenko, MS, RD, CDN

Nutrition Tip of the Day

Put meat and poultry into containers on the bottom of the fridge so juices won’t drip and contaminate other foods. Split bigger packages and freeze in meal-size portions for easy defrosting.

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4 Strategies for Smarter Toddler Snacks

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Toddlers are notorious nibblers. Their small bellies mean they can’t eat a lot at one time, and their go-go-go nature means they don’t want to sit at the table too long. Snacking can help add needed nourishment into a toddler’s day — as long as it’s done right. Here are four strategies to be smarter about snacks.

Strategy 1: Snacking on the Go

Many parents carry an arsenal of munchies to dole out when they’re on the go. But too often, snacks are given to distract or occupy kids while running errands or on long drives, not because the kids actually need food. Grazing on the go also makes it hard for children to focus on their food and listen to their internal signals of hunger and fullness. Eating in the car can also be risky. If your child chokes, you may not be able to help right away.

Smarter Strategy: Carry one or two small and easy snacks — such as a banana or small container of whole-grain crackers — in case hunger strikes while you’re out. Try other distractions first (such as a book or small toy) when you need to buy time.

Strategy 2: Timing Is Everything

It’s frustrating when toddlers come to the table at mealtime and don’t want to eat. It’s true that their appetites tend to fluctuate day to day, but snacking also may be to blame. Snacks before mealtime can make kids less receptive to trying new foods at meals. Toddlers also may learn to prefer “snack foods” — such as pretzels and gummy fruit snacks — over “meal foods,” which can make things even tougher.

Smarter Strategy: Avoid snacks in the hour before meals. If your toddler’s hunger doesn’t seem to match up with your mealtimes, consider moving meals earlier or serving your child a portion of the meal, such as the veggies, while you finish prepping.

Strategy 3: Make Snacks Nutritious

Many snack foods that are marketed to kids are full of refined flour, added sugar and salt. Those foods are OK to eat occasionally, but they don’t provide the nutrients your child needs the most (such as calcium, iron and fiber) and they teach kids to associate “snack” with “treat.”

Smarter Strategy: During most snack times, serve the same kinds of foods you serve at mealtime, such as fresh fruits and vegetables, whole grains including whole-wheat tortillas or bread as options, sources of protein such as hard-boiled eggs and hummus, and dairy foods such as yogurt and cheese.

Strategy 4: Establish a Snack Schedule

Letting kids nibble all day not only ruins mealtime appetites, but also can set up unhealthy habits. Like adults, kids can learn to snack out of boredom. Mindlessly munching also can lead to a pattern of overeating.

Smarter Strategy: Establish scheduled snack times. Most toddlers can go two hours between meals and snacks, so a mid-morning, mid-afternoon and evening snack may work well. Asking your toddler to wait may be tricky at first if munching on demand is the norm. By sticking to dependable meal and snack times, your child will feel reassured that there are plenty of opportunities to eat.

Adapted by: Sally Kuzemchak, MS, RD

Nutrition Tip of the Day

If You Have Excess Belly Fat, Get Rid of it! Not all body fat is equal. It is mostly the fat in your abdominal cavity, the belly fat, that causes problems. This fat builds up around the organs, and is strongly linked to metabolic disease. For this reason, your waist size may be a much stronger marker for your health than the number on the scale. Cutting carbs, eating more protein, and eating plenty of fiber are all excellent ways to get rid of belly fat.

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TV Ads and Posters Really Do Make Kids Eat Their Veggies

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Kids eat more vegetables when exposed to ad campaigns portraying them in a positive light, according to a study published online in Pediatrics. Researchers developed salad bar banners and television ads that portrayed vegetables as cartoon characters and placed them in elementary schools. Over 90 percent more students exposed to the banners chose options from the salad bar while over 200 percent more students exposed to both media techniques visited the salad bar, compared with students in schools that did nothing. These findings support previous research suggesting ads influence children’s school lunch choices, and researchers encourage food service operators to develop effective marketing campaigns to promote healthful eating habits.

Hanks AS, Just DR, Brumberg A. Marketing vegetables in elementary school cafeterias to increase uptake. Pediatrics. Published online July 5, 2016.

Tip of the Day

Eat Fatty Fish! Pretty much everyone agrees that fish is healthy. This is particularly true of fatty fish, such as salmon, which is loaded with omega-3 fatty acids and various other nutrients. Studies show that people who eat the most fish have a lower risk of all sorts of diseases, including heart disease, dementia and depression.

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8 Ways to Get Picky Eaters to Become More Adventurous

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Getting kids to eat new foods sounds simple enough (“Just take one bite”). However, parents and caretakers know that for many children, new foods — with their new appearances, smells, tastes, textures, temperatures and names — can be scary. So, how can you get kids to develop positive relationships with food instead of mealtime battles? Try these eight fun tips to lay a foundation for stress-free, adventurous eating habits before the first bite.

Story Time

Learn about foods and recipes from around the world, including what children in different cultures eat. Read about food-based professions such as bakers, farmers and chefs. Watch cooking shows and videos with your kids about cooking and food prep.

Scrumptious Smells

Smell is a significant and sometimes forgotten part of the eating experience. Playing games to positively engage with food smells outside of mealtimes can demystify the experience. Use spice jars to guess scents or add vanilla extract to bubbles before blowing them outside. These non-eating activities will build happy associations with new smells before you use them in recipes.

Unleash the Artist

Make art projects using food. Use fruit to make stamps: halved strawberries make heart-shaped stamps, and halved apples are star-shaped. Use a string to make garlands or jewelry from uncooked pasta, popcorn or cranberries. (Popcorn and chunks of food can be choking hazards in young children.)

Flip the Script

Do you find yourself telling friends and family, “My child is a picky eater”? Train yourself to use hopeful language instead: “My child is learning to love new things.” Instead of “He doesn’t like it,” say, “He hasn’t had it enough times.” Using positive statements will validate your child’s feelings in your mind while recognizing that opinions can change.

Sort by Color

Chop brightly colored fruits and vegetables such as red cherry tomatoes, green kiwis and purple grapes into small pieces. Practice sorting them by color while saying the color aloud. This can cultivate an acceptance of new textures by allowing your child to focus on the game rather than on his or her discomfort with new foods. As with popcorn and apples, be aware that whole cherry tomatoes and grapes are considered choking hazards in young children.

Name It

Which do you think your child would rather eat: steamed carrots or X-Ray Vision Coins? In the same way that descriptions on restaurant menus can influence what you order, creative names in the kitchen or cafeteria can pique a child’s interest.

Shine the Spotlight

Many kids love being the star, so use that instinct to explore new foods. Take videos of your child speaking to his or her ideal audience — a younger sibling, a stuffed animal, a favorite superhero — about trying new foods.

Get in the Garden

A garden not only improves children’s knowledge of produce, it increases their consumption of fruits and vegetables. From flipping through seed catalogs in the winter, to starting seeds in the spring, to weeding and harvesting all summer long, gardens can be joyful and patient teachers.

Adapted from: Holly Larson, MS, RD

Tip of the Day

Be an active parent! Whether you’re watching a soccer game or at the park, get moving with your kids. Play with them on the jungle gym or walk up and down the sidelines of the game.

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Easy Foods Kids Can Grow in the Garden

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Parents and caregivers know how challenging it can be to get kids to eat enough fruits and vegetables, but gardening may help. An expanding body of research shows that when kids help grow fruits and vegetables, they are likely to eat more produce and to try different kinds, too. The benefits of gardening don’t end there. Gardening helps kids engage their curiosity, learn to be resourceful and gain self-confidence. It is also a great way to get the entire family outside for fresh air and physical activity.

Consider Your Kids

Depending on their age, children take to gardening differently. For example, preschoolers tend to be fascinated with exploring dirt, seeds and the garden hose, while older children are more interested in how a single seed turns into an edible plant.

Make Kids Part of the Planting Process

Ask children which fruits and vegetables they’d like to grow. While older kids can read seed packets and start to understand growing regions, younger ones may not understand that it’s probably not possible to grow oranges in northern Maine. Suggest fun, reliable plants such as purple carrots and striped beets, and make sure you plant a couple of sure bets for your region of the country.

Go Herbal

Herbs are perhaps the easiest plants to grow and can be a good place to start to interest kids in gardening. Herbs grow like weeds, so you’ll probably have more than enough. Choose one or two herbs to start, such as parsley, basil or rosemary. Don’t worry if you have too much by summer’s end. An excess of basil can be made into pesto, frozen in ice cube trays and stored in the freezer to use during the fall and winter. And, all herbs can be dried.

Dig What Grows Below Ground

What’s more fun for a kid than yanking a carrot she planted out of the ground, washing it and taking a bite? Beets, another “underground” crop are colorful and can be a great way to get a child to try a new vegetable. Potatoes are easy to grow and are kid favorites.

Gardening for the Space-Challenged

No yard? No problem! Try using large pots placed on the patio or porch to grow foods such as tomatoes, salad greens and even cucumbers. Most herbs can grow in small pots on indoor windowsills. Picking herbs is a great task for younger children. And, if they are old enough, let them cut the herbs with kitchen shears.

Take Gardening to the Extreme

Children are fascinated by very small and very large objects … including vegetables. Whether in the ground or in a pot, cherry tomato plants grow to the perfect height for little hands to pick the deep red orbs. Small kids may find it exciting to watch how low-maintenance, easy-to-grow and brightly colored butternut squash and pumpkins grow and expand during the season.

Keep Gardening Year-Round

The gardening experience doesn’t have to end with the last harvest. Make growing edible fruits and vegetables a year-round activity. Read through seed catalogs during the cold winter months with your kids and decide what to grow next summer. Buy a grow light and get started on those tomato, bean and squash plants in the early spring. Kids will be fascinated by the growing process, whether it’s indoors or out.

Adapted from: Elizabeth M. Ward, MS, RD

Tip of the Day

Clean as you go! Like to cook but don’t like to clean? Clean as you go. Fill up the sink with warm, soapy water and wash dishes as you cook. It will make clean up go much smoother!

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Kids and Portion Control

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When kids follow MyPlate recommendations for daily servings of foods, they are well on their way to healthy growth and development. Unfortunately, many kids today seem to be suffering from “portion distortion.” When talking about what kids eat or drink, keep these definitions in mind.

What Is a “Serving Size”? What Is a “Portion Size”?

A serving is a specific amount of food or drink that is defined by common measurements, such as cups, ounces or tablespoons. Examples include recommended servings from MyPlate (the amount kids should eat) and the serving size on a Nutrition Facts Label, which is the basis for all the other nutrition information on the label. In many cases, the serving size listed on the Nutrition Facts Label is different from the MyPlate recommended serving size. In fact, many of the MyPlate serving sizes are smaller than those listed on the Nutrition Facts Label.

A portion is the amount of food that happens to end up on the plate. Think of portion size as the actual amount of food kids choose to eat at breakfast, lunch, dinner or as a snack. Portions may be larger or smaller than the recommended serving size.

Visualizing Appropriate Portion Sizes

One reason kids may not be eating appropriately sized portions based on the recommended MyPlate serving sizes is that they may not recognize what a reasonable portion looks like. What does one-half cup of pasta look like? What about three ounces of chicken or two tablespoons of peanut butter? The good news is that kids don’t need a measuring cup or scale to measure the portions they should eat — instead, they can visualize them by using familiar objects, such as a tennis ball or CD, that are similar in size to recommended serving sizes. Before they eat or drink, they can think of the relevant object and choose a portion that matches its size.

Here are some tips to help you and your kids visualize portion sizes:

Food Portion Size About the Size of…
Grains Group
Bread 1 ounce or 1 regular slice CD cover
Dry cereal 1 ounce or 1 cup Baseball
Cooked cereal, rice or pasta 1 ounce or ½ cup ½ baseball
Pancake or waffle 1 ounce or 1 small piece (6 inches) CD
Bagel, hamburger bun 1 ounce or ½ piece Hockey puck
Cornbread 1 piece Bar of soap

 

Fruits Group
Orange, apple, pear 1 small fruit (2½ inches in diameter) Tennis ball
Raisins ¼ cup Golf ball

 

Vegetables Group
Baked potato 1 medium Computer mouse
Vegetables, chopped or salad 1 cup Baseball

 

Dairy Group
Fat-free or low-fat milk or yogurt 1 cup Baseball
Cheese 1½ ounces natural cheese or 2 ounces processed cheese 9-volt battery
Ice cream ½ cup ½ baseball

 

Protein Foods Group
Lean beef or poultry 3 ounces Deck of cards
Grilled or baked fish 3 ounces Checkbook
Peanut butter 2 tablespoons Ping-pong ball

 

Oils Group
Margarine 1 teaspoon Standard postage stamp
Oil or salad dressing 1 teaspoon Standard cap on a 16-ounce water bottle

Helps Kids Listen to Their Bodies

One core strategy for healthy eating at all ages is listening to internal hunger and fullness cues. Discuss what it feels like to be hungry and what it feels like to be full with your child. A discussion about the difference between physical hunger and boredom, sadness or tiredness is appropriate for older children. When kids listen to their bodies, the chances of overeating are lessened. Help them understand it is OK to stop eating when they feel full, even if there is food left on the plate.

Adapted from: Ellen Shield, MED RD LD and Mary Mullen, MS, RD

Tip of the Day

Remember to wash fresh fruits and vegetables! Rinse fruits and vegetables before preparing or eating them. Under clean, running water, rub fruits and vegetables briskly to remove dirt and surface microorganisms. After rinsing, dry with a clean towel.

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Fish Intake During Pregnancy Increases Risk for Childhood Obesity

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High intakes of fish during pregnancy increase the risk for overweight and obesity in offspring, according to a study published online in JAMA Pediatrics. Researchers monitored 26,184 women and their children for fish intake and BMIs, respectively. Those who ate fish more than three times per week while pregnant had children with higher BMIs through early childhood and increased their children’s risk for rapid weight gain when compared to those who ate less fish per week. Researchers suspect chemical pollutants found in fish may alter fat metabolism and thus contribute to weight gain.

Stratakis N, Roumeliotaki T, Oken E, et al. Fish intake in pregnancy and child growth: a pooled analysis of 15 European and US birth cohorts. JAMA Pediatr. Published online February 15, 2016.

Tip of the Day

Growing family? When a woman is pregnant, she has a higher need for some vitamins and minerals. It is important for expecting mothers to make healthy choices from each food group.

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