<![CDATA[Bub Hub Pregnancy & Parenting Forum - Blogs - Sarah Officer]]> http://www.bubhub.com.au/community/forums/blog.php?94045-Sarah-Officer en Tue, 21 May 2013 11:56:30 GMT vBulletin 10 http://www.bubhub.com.au/community/forums/images/styles/BubHub/misc/rss.jpg <![CDATA[Bub Hub Pregnancy & Parenting Forum - Blogs - Sarah Officer]]> http://www.bubhub.com.au/community/forums/blog.php?94045-Sarah-Officer <![CDATA[The Children's Nutrition Blog: Introduction to picky eating]]> http://www.bubhub.com.au/community/forums/entry.php?622-The-Children-s-Nutrition-Blog-Introduction-to-picky-eating Tue, 14 Aug 2012 03:04:14 GMT Picky eating. It's one of those poorly-defined, catch-all terms that spans toddlers who subsist solely on potato chips and bottles of formula, to kids whose only sin is to shirk the green vegetable on their dinner plate.



The first rule when you have a picky eater should be: don't panic!

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Most of us were picky eaters to some extent during our toddler years. I distinctly remember disliking avocado (slimy!) and sweet potato as a child, both foods I now love. I refused to eat fatty spreads (butter and margarine) on my sandwiches or toast until my early 20s, and there was a time as a child where I insisted on eating my sliced carrot raw and my peas frozen.



Can you remember any foods that you didn't like as a child? Are there some foods you still don't like now? I still can't stomach any chewy, sinewy or fatty bits in meat to this day.

What many of us don't realise, as parents, is that our own preferences are accommodated and less visible because we are the ones who do the food shopping. If we don't like it, we don't buy it. No-one puts it on our plate and expects us to eat it!



It's natural for toddlers to go through a picky period. It's also natural for most of them to grow out of it. Some of them don't- many of us know or live with an adult who is a picky eater. Parents naturally worry that their growing child might not be getting all the nutrients they need. Many food and supplement companies play on these concerns to sell us vitamins and fortified foods ('toddler milk', anyone?) that most children really don't need. Sometimes, parents' good intentions can backfire and exacerbate their picky eater's habits.



Children are all different, and the picky eaters amongst them are no exception. I will be blogging a series of mini-lists of tips for parents to try over the next few weeks. There are a few golden rules to keep in mind always, however:


  1. If you are genuinely concerned that your child's diet is inadequate and they may have a nutritional deficiency, see a registered dietitian.
  2. Don't resort to the bottle- the milk bottle, that is! Allowing your picky eater to consume a large part of their daily nutrient intake as bland, easy-to-drink formula or milk will only reinforce their refusal of food. They learn to wait for the bottle. If your child has a nutritional deficiency and takes a supplement or formula on dietitian's advice, make sure to ask how they will work with you and your child to gradually replace the formula with a balanced diet*.
  3. Exposure is the key to solving most picky eating problems. Ensure your child is regularly served the foods that you wish them to learn to eat. Eating meals with your child, where they see YOU eating those foods is also very important. Exposure is one of the key areas where I will be providing tips to try in future posts, so stay tuned!
  4. Could there be an underlying cause for your child's picky eating? Some children have issues with oral-motor skills that might make it hard to chew, manipulate and swallow certain foods. Others have oral sensitivity issues where they are over or under-sensitive to certain food textures. Dental pain can result in avoidance of some foods- teething, tooth alignment or even decay are all potential causes. If you suspect that any of these might be factors in your child's picky eating, you may wish to investigate further with the help of a speech pathologist, occupational therapist or the family dentist.




* You may wish to contact the Children's Nutrition Research Centre for a list of dietitians who have attended SOS workshops and are familiar with strategies to assist picky eaters.


ChatBox Speech Pathology
Children's Nutrition Research Centre ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?622-The-Children-s-Nutrition-Blog-Introduction-to-picky-eating <![CDATA[The Children's Nutrition Blog: More on the nut allergy and breastfeeding study]]> http://www.bubhub.com.au/community/forums/entry.php?582-The-Children-s-Nutrition-Blog-More-on-the-nut-allergy-and-breastfeeding-study Wed, 18 Jul 2012 09:36:42 GMT Professor Katie Allen of the Murdoch Children's Research Institute had this to say in another ABC report on the topic:

"The report only asked [about] breastfeeding, not about maternal dietary practices. Therefore the authors cannot conclude in any way whatsoever about maternal dietary practices including exposure to nuts and its risk of peanut allergy," says Allen.

Further, as the article states, recent research into food allergies actually suggests the opposite is true. Do read the article, and share it on your social media platform of choice!

See my previous post on the topic here.


Children's Nutrition Research Centre
ChatBox Speech Pathology ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?582-The-Children-s-Nutrition-Blog-More-on-the-nut-allergy-and-breastfeeding-study <![CDATA[The Children's Nutrition Blog: Does breastfeeding really raise peanut allergy risk?]]> http://www.bubhub.com.au/community/forums/entry.php?572-The-Children-s-Nutrition-Blog-Does-breastfeeding-really-raise-peanut-allergy-risk Thu, 12 Jul 2012 15:05:24 GMT Splashed across the news today was a study from the Australian National University that reported a statistical link between breastfeeding and nut allergy, particularly peanut allergy. Exclusive breastfeeding for 6 months got an especially bad rap from the study authors, according to media reports.... Splashed across the news today was a study from the Australian National University that reported a statistical link between breastfeeding and nut allergy, particularly peanut allergy. Exclusive breastfeeding for 6 months got an especially bad rap from the study authors, according to media reports. “Breast feeding... may, in fact, be causative of allergy”, the study authors have concluded.



So what's going on?


At first I thought there might be something to it. After all, Australia's own revised NHMRC guidelines are somewhat behind the times in their recommendations on when to introduce solids. The best, recent evidence from scientific studies suggests that there is a 'critical period' for introduction of many different types of solid foods. If the introduction of the food is delayed, it actually increases the risk of allergy. The timing of this 'critical period' for most of the foods studied appears to fall between 4-6 months. So breastfeeding exclusively for 6 months doesn't leave a whole lot of time to introduce those foods. It would therefore seem likely that allergy risk may be higher in babies who are breastfed for 6 months.



I took the time to read the study, only to find that they appeared to have linked any breastfeeding at all with increasing a child's risk of allergy.



The first problem I found with their published study was the authors' claim in their introduction that:



“an increasing number of studies have implicated breast feeding as a cause of the increasing trend in nut allergy”.
Really? They made three citations to support this claim.



  1. A single case report of an exclusively breastfed infant who had had an allergic reaction to peanuts.
  2. A study from 1986 on food allergy and maternal diet.
  3. A study from 1999 on exposure to peanuts in utero and during infancy.




I have a few brief points to make on those citations:



  1. A case report on a single infant is not a study that can be cited in support of a massive, population-wide increase in food allergies among children.
  2. 1986 was 26 years ago. If the authors have to reach that far back, they are probably having a hard time finding studies that support their case.
  3. Even 1999 was 13 years ago. See point 2. (And you feel old now, don't you!)




It is hard to believe that the roughly 10-fold increase in specialist referrals for food allergy and fivefold increase in hospital referrals for food-related anaphylaxis that occurred in Australia over the last decade or so has been matched by comparable increases in the rate of breastfeeding or maternal consumption of peanut products. It's implausible.


Speaking of implausible, here's one more thing that jumped out at me that there was something off with the data in this study:


32% of parents reported breastfeeding exclusively for the first 6 months.


This is more than twice the actual rate of exclusive breastfeeding in Australia (around 14-15%), which suggests that participants misunderstood the question, or weren't entirely truthful. The rate of exclusive breastfeeding in the ACT is higher, but nowhere near that much higher! This point should have been addressed by the authors but wasn't.



They also give credence to the idea that part of the increased incidence in food allergies may be due to increased consumption of peanuts and peanut products by mothers and mothers-to-be, an idea I thought had been pretty well discarded by now.



Then I saw this quote from one of the study authors in the ABC's report on their website:



“What we have uncovered is that from a biological point of view, there are risks for breastfeeding if women eat nuts during breastfeeding and probably during pregnancy," he said.


"It is probably little fragments of nuts, proteins from nuts that mum had been eating. It is not the breast milk itself, it is the other very microscopic amounts of proteins and so on that you get from eating nuts.”

What he should have said was that from a statistical point of view, this study points to an increased risk of allergy among breastfed babies in Australia. And their (retrospective) study had nothing to do with studying proteins in breast milk.


The response from the Australian Breastfeeding Association reported in the ABC's article bordered on incoherent and did nothing to highlight problems with the study's findings. I really hope they can come up with something a bit better and actually have it reported.


I don't think we will have to wait long for a proper analysis of this study. Until then we will have to put up with the media fear-mongering among new parents, with headlines implying that breastfeeding may increase the risk of potentially fatal peanut allergies. That's a real shame.


Children's Nutrition Research Centre
ChatBox Speech Pathology ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?572-The-Children-s-Nutrition-Blog-Does-breastfeeding-really-raise-peanut-allergy-risk <![CDATA[The Children's Nutrition Blog: My child is fat? How helpful of you!]]> http://www.bubhub.com.au/community/forums/entry.php?565-The-Children-s-Nutrition-Blog-My-child-is-fat-How-helpful-of-you! Tue, 10 Jul 2012 04:53:23 GMT


Australian TV and radio personality Chrissie Swan made headlines a little while back when she posed for some beautiful family photos in The Australian Women's Weekly and was subjected to a barrage of online abuse from internet trolls who thought it was a great idea to round on her for being overweight and having a toddler who was heavier than the ideal.

Name: big.jpg Views: 898 Size: 13.2 KB A few days later, Chrissie published a piece in Sunday Life about how she came to realise that her cherubic toddler Leo was growing into a chubby little boy. Funnily enough, it wasn't thanks to the helpful advice from internet trolls. A maternal and child health nurse suggested that Chrissie see a paediatric dietitian for help.

What was missed in all the hype is that Chrissie is no different from most parents out there.

Study after study has shown that most parents fail to recognise when a child is overweight- and that when a child is obese, parents tend to underestimate just how overweight they are. Especially, as in Chrissie's case, when the child has healthy eating and exercise habits. Funnily enough, this phenomenon appears not to be limited to parents: one study of medical students and doctors showed that this group also have difficulty in visually assessing a child's weight. All of this underscores the importance of having all children's weight assessed as part of routine check-ups whenever they see a GP. And of ensuring that GPs (often under-educated when it comes to nutrition and diet) are prepared to refer children to a dietitian when necessary.

What's really sad is that the biggest concern for parents of children who have more body fat than is ideal is not their child's long-term health. It's worrying about the possibility of bullying or self-loathing based on appearance and the terrible impact these can have on a child's emotional health. Who in their right mind would be worrying about the possibility of Type 2 diabetes in 3 decades' time when they picture their child suffering the devastating emotional toll wreaked by bullying? That is something no parent, including Chrissie Swan, should ever have to contemplate. Dealing with a bit of excess body fat should be nowhere near as complicated as our society has made it.

Children's Nutrition Research Centre
ChatBox Speech Pathology ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?565-The-Children-s-Nutrition-Blog-My-child-is-fat-How-helpful-of-you! <![CDATA[Children's Nutrition Blog: Baby-led weaning- A basic guide]]> http://www.bubhub.com.au/community/forums/entry.php?556-Children-s-Nutrition-Blog-Baby-led-weaning-A-basic-guide Mon, 02 Jul 2012 13:10:05 GMT

In the last post I covered a few reasons why it could be a good idea to try baby-led weaning as a way of introducing solids to your baby. Now for some signs it might be the right time to give it a try:



  • Core strength. Your baby is capable of supporting themselves in a sitting position for at least a short period of time.

  • Hand-mouth coordination. Your baby is able to pick up an object that they want, bring the object to their mouth in order to explore it, and then remove it easily and capably.

  • No tongue-thrust reflex. This isn't an issue so much with baby-led weaning but infants who are introduced to solids too early and fed by having a spoon stuck in their face: If a baby cops a mouthful of puree and their tongue immediately thrusts forward and expels most of the food, they probably are not ready to be eating solid foods yet. It's a safety issue: the tongue-thrust shows that the baby does not yet have the oral-motor capabilities required to manipulate food safely in its mouth before swallowing.

  • A strong interest in food. If your baby tries to wrestle away food from your hands at every meal, it's a safe bet they have a strong interest in food! They will lean in the direction of food, grab at food, make lip-smacking noises and look incredibly eager... It's pretty hard not to notice when your baby develops an interest in food!

If your child reaches an age where they really should be capable of eating their first solid foods (i.e. 6 months) and they don't meet the first three of the above criteria, check with a medical professional with expertise in infant development before trying baby-led weaning. Indeed, it would be a good idea to follow it up even if you plan to introduce solids the 'traditional' way.


If your child shows an interest in food before 6 months of age and has all the above capabilities, it may also be appropriate to introduce them to food; the new NHMRC draft infant feeding guidelines acknowledge this fact by allowing a 4-week window either side of 6 months. Your baby may meet most or all of the above criteria and you still feel they are not old enough for solids yet (this happened to me with our son- a great surprise, and a story for another post!). I will give some tips for ways to deal with this in another post.




Why is it important to use developmental criteria rather than age as a guide when to try baby-led weaning?


The simple answer is that babies all develop at a slightly different pace to one another! It's more important to know that a baby has the ability to safely feed him/herself than to know that they are X weeks/months old.






What are some good foods to try?


The basic criteria for 'starter foods' in baby led weaning are:
  • Baby must be able to pick them up

  • They can be easily and safely gummed into pieces, manipulated in the mouth and swallowed. Soft enough to be fairly easily squished between your thumb and forefinger is a good guide.

This post is by no means an exhaustive list. I'm including only a few examples; you will find many more on websites and forum threads devoted to the topic (including Bub Hub).




Vegetables:


Note: It's a good idea to remove the skin on most fruit and vegies for a baby just starting out on solids, because it's one of the things likely to be too tough to gum into little pieces- it may cause gagging!

Zucchini
Capsicum
Eggplant
Carrot
Sweet potato
Pumpkin

You can try grilling or roasting (brush with olive oil first if the vegetable has been sliced into pieces before cooking), steaming or microwaving.




Fruit:


Mango
Melons
Pears (ripe, soft)
Apple (cooked)
Strawberries




Don't be afraid to introduce your baby to interesting flavours, herbs and spices. A sprinkle of nutmeg or cinnamon on cooked apple or sweet potato; some paprika, garlic or finely-chopped thyme on the eggplant (because who eats plain eggplant?).




Proteins:


Fish (cooked) tends to have a nice, soft texture that lends itself well to baby-led weaning.

Boiled egg

Red meats: While many babies do love to pick up and gnaw on a T-bone, they aren't going to actually eat much -or any- of it! Slow-cooked lamb, beef (or goat, or whatever), cut into manageable pieces, tends to be soft and easy to chew.

Cheese- while this is nice and easy, remember your baby's diet consists predominantly of breast milk or formula, so it's not as if they need a large intake of dairy items. Try and allow your baby to taste a variety of different cheeses.


General tip for all meats: cut across the grain so you don't get long, stringy muscle fibres from the meat, as these can cause gagging.



Safety:


There are a few things that you need to keep in mind:

Supervise. You need to be there, and paying attention, when your baby is feeding themselves.

Some foods will need to be modified. E.g. grapes and cherry tomatoes should be cut into quarters, blueberries into halves. Cherries, lychees and other fruits with similarly small seeds should always have the seed removed. Fish should be carefully inspected for bones. Meat should not be too chewy (e.g. cubes of well-done steak aren't a great idea, but thinly-sliced strips are ok).



One more thing you need to be really careful of when feeding your infant is salt. Tasting a piece of chicken from your curry or a drop of soy sauce on a piece of sweet potato is not going to hurt your baby, but salt is present in high levels a lot of manufactured condiments and a lot of store-bought processed foods (e.g. bread, crackers, cakes, biscuits, sauces, soups and breakfast cereals) that aren't made specifically as foods for babies. Salt intake from foods like these can easily add up. For this reason, it's important to mainly stick to fresh foods that you have cooked yourself when undertaking baby-led weaning.



Finally, wherever possible, buy organic (or grow your own) fruit and vegetables for feeding your baby. Many otherwise great foods can have high levels of herbicide/pesticide residues. Check out the 'Dirty Dozen/Clean 15' guide as an indicator of what fresh foods it's most important to buy organically-grown.



Finally, I noticed that Nutritionist Mum Lisa has also put up an interesting post on baby-led weaning. Check it out!


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Chatbox Speech Pathology
Children's Nutrition Research Centre ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?556-Children-s-Nutrition-Blog-Baby-led-weaning-A-basic-guide <![CDATA[Children's Nutrition Blog: Baby-led weaning, lower obesity risk?]]> http://www.bubhub.com.au/community/forums/entry.php?546-Children-s-Nutrition-Blog-Baby-led-weaning-lower-obesity-risk Wed, 27 Jun 2012 12:46:49 GMT
In the news a couple of months ago was a report that babies whose parents choose a 'baby-led weaning' feeding style may be at a lower risk of obesity than those who are spoon fed.

This makes sense. It's early days yet for research backing baby-led weaning (BLW) over any other style of introducing solids. If the link exists, it's likely to work by allowing the baby to develop a better sense of when he or she has eaten enough. This feeling is called satiety.

A more finely-tuned sense of satiety is also one of the likely mechanisms for the protective effect of breastfeeding against obesity. Just like with bottle-feeding (expressed milk or infant formula), babies who are spoon fed are often given fixed amounts and expected to finish it.

I would expect that any effect of baby-led weaning in reducing obesity would be more pronounced with babies who are fed primarily commercial infant foods. Why? These all come in a single package size according to the type of food and the age group it's aimed at.

Parents being parents, sometimes it's hard not to worry whether your baby is eating enough. If a baby regularly doesn't finish a serving of food that is supposedly appropriate for their age, a parent who spoon feeds may be more likely to prompt them to keep eating.

A parent who allows their baby to feed themselves (brave souls) never really knows how much their child is eating, because a baby's style of self-feeding regularly involves putting food in the mouth, gumming it, pulling it out, throwing half of it on the floor and squishing it into hard-to-clean crevices in the furniture! Baby-led weaning has always been more about exploring new tastes and refining motor and oral-motor skills than getting a baby to eat a fixed amount of food.

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Green ginger may not really be a food, but boy is it a taste!

One finding of the paper was that babies whose parents practised baby-led weaning were slightly more likely to be underweight. While the reasons for this were not explored, it is important to remember that infants who are delayed in reaching developmental milestones may have a reduced ability to feed themselves and are at potentially higher risk of underweight as an outcome if baby-led weaning is the sole means of solid food consumption.

While baby-led weaning offers a great way to encourage all infants to hone their gross and fine motor skills, infants with developmental delays should always be regularly followed up by the appropriate medical professionals. It may be recommended by a child's paediatrician or dietitian that developmentally-delayed or underweight infants are fed solid foods by their parents in addition to trialling baby-led weaning when developmentally appropriate.

When is it developmentally appropriate to try baby-led weaning with your baby? I'll include a checklist, plus some foods to try, in the next post.


---------------------------------------------------
Sarah Officer. Nutritionist, PhD Candidate.

Children's Nutrition Research Centre (Brisbane parents- don't forget to check out the Raising Healthy Eaters seminars!)

ChatBox Speech Pathology ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?546-Children-s-Nutrition-Blog-Baby-led-weaning-lower-obesity-risk <![CDATA[Introducing the Children's Nutrition blog]]> http://www.bubhub.com.au/community/forums/entry.php?527-Introducing-the-Children-s-Nutrition-blog Tue, 19 Jun 2012 13:14:47 GMT My name is Sarah and I will be blogging for Bub Hub on children's nutrition. Since this is the first blog post, I will tell you a bit about myself and a bit about what I do.

I am a nutritionist and I am completing a PhD with the Children's Nutrition Research Centre (University of Queensland), looking at the relationship between dentition, diet and body composition in preterm and term-born children. I am also the resident nutritionist at ChatBox Speech Pathology in Brisbane, and the mother of a beautiful 2-year-old boy named Setri.


What is a nutritionist?

In my case, I have a Bachelor of Applied Science in Food Science and Nutrition and a Bachelor of Health Sciences (Honours), from the University of Queensland.

There is currently no authority or regulatory body that assesses the qualifications of nutritionists who are not dietitians. This means that there are plenty of people who practice as nutritionists who have dubious qualifications. Always check before you take advice on board!


What does a nutritionist do?

A lot of things! A nutritionist's primary role is to give advice on healthy eating, lifestyle and weight management. This can be one-on-one advice, or advice for large groups of people in the general population (e.g. children, pregnant women, people who work in an office job where they sit down all day).

One very important thing to remember is that people seeking specific, clinical dietary advice for a medical condition should be seeing a dietitian. A dietitian can do the job of a nutritionist, but a nutritionist is not qualified to do the job of a dietitian.


What can I look forward to in this blog?

As a nutrition researcher I am interested in nutrition research. Expect a lot of updates on the latest research in the field of children's nutrition.

Tips for parents of picky eaters.

Myth-busting! There is a lot of BAD information out there (my pet hate). I'll tackle some of the nutrition myths.

Special requests. Is there a topic YOU would like to know more about, and you would like reliable, up-to-date information? Let me know!

Recipes. An awful lot of mainstream nutrition advice is about self-deprivation, which is not a philosophy I embrace for children or for adults. Everyday meals should be all about good health, but I'm not a believer in so-called 'healthy' versions of treat foods that never quite hit the spot. All recipes posted will be for REAL, yummy food!




Children's Nutrition Research Centre
ChatBox Speech Pathology ]]> Sarah Officer http://www.bubhub.com.au/community/forums/entry.php?527-Introducing-the-Children-s-Nutrition-blog