Pearls of Wisdom: Infant Nutrition

Infant FeedingWhen it comes to infants and children, basic nutrition choices have a lifetime impact on overall health and are key for satisfactory growth and avoidance of deficiency states. Adequate nutrition helps in the prevention of acute and chronic illnesses; maximizes physical and mental potential and provides reserves for stress. During infancy, it’s all about milk, whether breast milk, formula or a combination of the two. Breast milk and formulas contain enough nutrients needed by babies in the first year of life. Around 4 -6 months of age, most babies can start consuming solid foods like iron-fortified cereal, mashed fruits and vegetables, and pureed meats. As you introduce more foods, keep in mind that a healthy amount of fat is important for the babies’ brain and nerve developments – unless advised by your doctor for particular health reasons, low-fat options can be avoided.

The feeling of ease between infant and mother is essential to successful infant feeding. When mom can establish a comfortable, satisfying feeding practice, the result is usually emotional well-being of both the mother and infant. Remember that mom’s feelings are readily transmitted to the baby and greatly influence the emotional setting in which feeding takes place. Hence, a tense, anxious, and emotionally labile mother is more likely to develop a difficult feeding relationship with her baby. It’s helpful if she receives appropriate guidance and support from an empathetic family member, friend or physician.

Infant FeedingImmediately after birth, the infant can safely tolerate feedings to ensure a smooth transition from fetal to extrauterine life, to promote maternal- infant bonding and prevent hypoglycemia and electrolyte imbalances. It is critical that your infant receives enough fluids so he will not develop dehydration. Moms who wish to initiate breastfeeding in the delivery room are definitely encouraged to do so. Subsequent feedings either by breastfeeding or bottle feeding are given every 3-4 hours a day and at night. That’s a lot of eating! This is based on the time it takes for the infant’s stomach to empty and varies from 1-4 hours. Do not expect your baby’s feeding schedule to be consistent immediately after birth.  However, by the end of the first month, 90% of babies will establish a more regular feeding schedule. Majority of healthy formula-fed infants will want 6-9 feedings per day by the end of the first week of life. Some babies are satisfied with every four hour feedings, while others who have a faster gastric emptying time will want to eat every 2-3 hours. Interestingly, most breast-fed babies get hungry quicker and require more frequent feedings with shorter intervals. This just reinforces the fact that individual feeding needs vary and one infants’ feeding would not be expected to fit the pattern of another. The best parameter of successful infant feeding is weight gain by the time the baby reaches the second week of life.

Infants cry for various reasons and babies do not need to be fed every time they cry. Usually, sick babies are not interested in feeding and if an infant refuses food, this should act as a red flag to see your pediatrician. If your baby is constantly waking up every 1-2 hours, he may not be receiving enough milk at each feeding or be suffering from infantile colic. This can be addressed during your doctor’s visit and may involve discussions about formula choice and feeding practices. It is important to know that babies cry for reasons other than hunger. Some may just need to be picked up and held, others may continue to cry even after feeding so it’s important to carefully evaluate your infant’s health and behavior for other potential causes of distress. Try to discourage the habit of frequent small feedings, holding and feeding to pacify crying as he may become too reliant on you to calm him.

Infant FeedingThe post-partum period is oftentimes a period of much anxiety and insecurity for first-time parents who may be overwhelmed by the responsibilities that comes with having a new baby. The questions are endless: Am I feeding her enough?  Is she having diarrhea? Should I switch formulas? The list goes on and on. This is why anticipatory guidance sessions should be scheduled between you and your pediatrician. During each office visit, your doctor is already tracking your baby’s weight gain and monitoring whether her weight is steadily increasing. Normally, babies in the first four months of life gain 1 ½ lbs-2 lbs per month and grow 1-1 ½ inches. By the time he is a year old, he would have tripled his birth weight.  Breastfed babies also tend to be chubbier than formula-fed babies in the early months of life however they become leaner by nine months to one year of age.

Parents need to understand the goal of infant’s “self- regulation.” Once the infant establishes a regular feeding schedule, other family members are able to resume their normal daily routine with minimal disruptions. It doesn’t take long to achieve the confidence and calm of an experienced parent. Your baby will give you enough signals and clues as to how she likes to be treated, talked to, held and comforted.  This very special bond, once established will guide you through this challenging stage and the next.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

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Dr. Pearl

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Picky Eaters

Although your toddler is beginning to develop his own taste palate and show preferences for food, he can be quite unpredictable when it comes to what he will eat at mealtime, with variations from day to day. Oftentimes their favorite food, or what you thought was their favorite food, could end up on the floor the next day. Likewise, the meal that ended up on the floor the day prior could turn out to be the food they can’t get enough of. Hot and cold as each day passes – just like the plate you put in front of them!

Most toddlers are — plain and simple — picky eaters. Others eat only certain foods – or refuse to do so as a way to assert independence. The amount of food they consume from one meal to the next can also change constantly and this inconsistency can cause a good deal of frustration to a parent or caregiver. The good news is, over time, your toddler’s eating patterns will reach equilibrium. Continuing to offer them healthy food choices and allow your youngster to find something he likes with or without you pushing them to do so will establish a regular and healthy diet.

Until they reach the age of four years old, children have not mastered the grinding motion essential in chewing food, so offer your picky eater safe finger foods such as baby crackers or a thin slices of banana; stay away from foods that could be choking hazards such as nuts, grapes, hard candy, hot dogs etc. Allow him to enjoy feeding himself and sit with him while he eats. This gives him a sense of independence and establishes a routine of sitting with the whole family during meals. Parents can utilize this time at the dinner table to model healthy eating habits that you want him to adopt as he gets older.  Remember that showing your children what to do and how to do it is much more effective than telling them without backing up those words with actions.

If your child refuses one food from a food group, offer him another form of the same food group. For example, try giving him chicken, pork or fish if he refuses to eat beef. If he won’t drink milk, substitute this for low-fat cheese or yogurt. Try pairing a food that he loves with a food that he refused in the past. Keep offering a food that was refused before repeatedly with breaks in between. Sometimes, it may take a few attempts before he actually develops a taste for it. Make food attractive and playful. For example, serve food with bright colors or make smiley faces or animal shapes using cut vegetables or fruit strips. Try to kick up a notch the nutritional value of dishes by adding healthy ingredients. For instance, you can add non-fat dry milk to shakes and soups or mixing fruits and vegetables like zucchini, sweet potatoes or apples to muffins, breads, meatloaf or pasta. Finally, be a good role model by practicing healthy eating habits and having sit down meals as a family at least 3-5 times a week.

Children have different nutritional requirements than adults.  Your child’s food portions are smaller compared to yours. A child who is thriving and energetic is more than likely getting enough food substrates to sustain both his growth and his energy requirements. If you have serious concerns about your child’s eating habits and are worried about his growth and development, make an appointment with your pediatrician. He can show you where your child’s height and weight is on the growth curve relative to other children his or her age, offer some reassurance and determine whether it’s necessary to pursue further workup or testing to look for any underlying medical problems.

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.

Pearls of Wisdom: Dr. Pearl’s Bookshelf

With warmer weather springing up in most states around the country, it’s a good time to stroll to your local library and introduce your children to new stories and/or picture books. My patients’ waiting room often echoes with children repeating their parents’ recitals of “One Fish, Two Fish, Red Fish, Blue Fish…”  This brings back memories of reading aloud with my own two children, now ages 15 and 12, so I thought I’d share with you BabyLeggers some of our favorite children’s books.

Parents also frequently ask for recommendations of clinical books that offer developmental, practical and medical information.  Such basic reference guides are well worth keeping on hand and I bet you will find yourself consulting them again and again as your children grow. So today, I present to you the first installment of “Dr. Pearl’s Bookshelf.”

Happy reading!

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Children’s Books:

Children

Charlotte’s Web, Goodnight Moon, The Very Hungry Caterpillar, The Cat in the Hat, The Lion, the Witch and the Wardrobe, The Secret Garden, Madeline, Chicka Chicka Boom Boom, The Tale of Peter Rabbit, Are You My Mother, Little Bear and A Wrinkle in Time

Clinical Books for Parents:

Most of the clinical books are available on the American Academy of Pediatrics’ website — www.aap.org — in their bookstore.

Parents

Building Resilience in Children and Teens, Patient Education for Children, Teens and Parents, Managing Infectious Diseases in Child Care and Schools, Caring for Our Children, Nutrition: What Every Parent Needs to Know, Home Strength Training for Young Athletes and Nelson Textbook of Pediatrics.

Please go to the BabyLegs Facebook post about books for parents and children and tell everyone what books you and your children love!

 

All information contained in this blog and on our web site(s) should be independently verified by you by a medical professional of your own choosing and you should always conduct your own research and due diligence before making any decision related to the subject matter of this blog or our web site. 

———–

Dr. Pearl

 

Dr. Pearl Cenon

A pediatrician in private practice in New Jersey for over 15 years, Dr. Cenon (we like to call her Dr. Pearl) also has two children of her own. Dr. Pearl’s husband, Kevin McDonough is also a pediatrician and they work together. She writes basic posts about topics that interest many parents, from skin care and nutrition to seasonal issues, such as allergies and colds. Her kind, approachable tone in each blog post will have you looking forward to the next one.