August 3rd, 2010
Infant and toddler nutrition is a complicated subject and complexity leads to communication breakdowns. One common miscommunication occurs between parents and pediatricians. The pediatrician gives your child clean bill of health. Great! Yet, your child never eats vegetables and prefers white bread to whole grain or just eats 4 or 5 foods. That cherished goal of a perfect diet is dashed not only by the child but, in addition, the physician is not that concerned. You may be mystified, frustrated or even angry, but the physician sees that the child is eating enough based on the growth chart, even though your child may be technically underweight. That physician judges that the child’s height and weight are adequate, the skin, hair and lips look fine, the child is energetic. In clinical short hand, the doctor looks at appearance, height and iron. If your child is consistently getting taller, despite difficulties, enough protein, carbohydrates and fats are entering your child. An iron sufficient child is getting enough iron, a marker nutrient, and the proteins and vitamins that go into hemoglobin production and hence enough of everything.
The focus on carbohydrates, fats and proteins is macronutrient nutrition, the most level of nutrition because macronutrients represent basic needs and calories. From the point of view of macronutrient nutrition, the vitamins, minerals and other important micronutrients, such as antioxidants, fiber and essential fatty acids, take care of themselves because they are in common foods. Macronutrients are measured in grams. When parents focus on nutrition, they tend to worry about macronutrients, eating enough, and micronutrients, eating well. Micronutrients are measured in milli- and micrograms. A milligram is one thousandth the size of a green Monopoly house. Other nutrients such as Vitamins A and D are measured in International Units, a measure of potency but still a small amount.
Parents naturally want to provide a complete diet. The combination of facts and feelings is almost too powerful to resist, not to mention, the power that comes from being older and bigger. The parent’s desire, however, may be different from the child’s once the food is on the plate.
Different desires create the second communication breakdown. The previously fine mealtimes disappear when the parent’s desire to nurture meets the child’s desire for independence. While parents worry about micro and macro nutrients, your toddler is looking for you to acknowledge a different need that could be called developmental or life cycle nutrition. In developmental nutrition, food satisfies hunger and the desire to develop mastery. The differing goals between parent and child are behind most feeding problems. The natural parenting desire to provide macro and micronutrients gets separated from the child’s desire to self feed. The breakdown is not unlike your nutrition disconnect with your pediatrician. Different ideas of nutrition can collide. Just ask Dean Ornish and Dr. Atkins.
The infant’s desire to feed his or herself kicks in at around 6 months. That desire to develop can manifest in refusing baby food or by pushing the spoon away. Your exploring child has figured out that you are not eating pureed carrots but something else, something far more interesting and you are feeding yourself. Your baby who cannot walk or crawl is beginning to separate and the drive for independence often occurs first at mealtime. Standard developmental milestone guides say that children can use a cup at around 6 months, finger feed around 7 or 8 months and use a spoon sometime after that. That’s great if your child follows along. Educated parents look to that kind of guide as a ruler, but your child is the best guide. Guides do not take into account that some children quickly copy older children or favorite adults sooner than anticipated, especially if your relationship is great. Even when a developmental delay clouds the picture, children who refuse to be fed by others are exhibiting standard behaviors known to people who help parents who are just struggling too much at mealtimes. If your child is giving you a hard time, your child probably thinks you are giving him or her a hard time.
When mealtimes collapse into struggles, arents may feel alone, rejected or forced to engage in dramatic actions when their child does not eat. Such feelings of parents are universal, as are the problems. The World Health Organization (WHO) has taken up the task of helping parents feed their children because feeding struggles are worldwide. Visit the WHO website http://www.who.int/childgrowth/training/en/ to find the latest recommended practices. For WHO, after 6 months the best guide on feeding your child is your child. Just pay attention to the trinity of feeding practices: the cup, finger foods and the spoon. Your child will let you know how they want to eat, fingers, spoons or even let y ou feed them if there is no fights and lots of smiles. If your cultural preference is for eating by hand feeding or chopsticks, your child has already figured that out, too. Once you begin to experience refusals and too many games at the table it is time to help your child develop new skills. Then you will have smiles. If mealtimes are not pleasant for you, they are certainly not engaging for your child. If you cannot make mealtimes more productive, speak to a professional who knows about feeding behavior and nutrition.
Richard is a Registered Dietitian offering nutritional services for children between 6 months and 5 years of age. His interests are feeding problems in typical and atypically developing children experiencing pickiness, refusals, failure to thrive or other weight gain concerns. His work is based using developmental, play and family strategies to address eating problems in families with young children and children with developmental delays. He is currently researching a method to help parents wean their children off the bottle. He can be reached at: richard@brooklynlearning.com and by phone at 917-232-5373. www.brooklynlearning.com
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I really don’t want to get off topic here nevertheless the following comment is certainly sort of general in characteristics and also more of a question. I have been I read My family and I have been following his international best selling book Fit For Life for years and have changed our eating habbits as a result of that book. We also love the juicing. pure I feel a lot better. I know he’s got a completely new book called living without pain and I can’t wait to have my hands on that however , things i wondered about is his recommendation on this vitamin mineral supplement known as livethesource. From what i read he’s for no reason supported a supplement in the past consequently my question for you is so why this one and how come now. I know that this has newer and more effective patented nano technology but could it be that extraordinary? Has anybody around had any kind of knowledge about this? I expect a reply, Thanks and in addition thanks to you people who operate this web site, you have done an admirable job and i for one will be visiting often.
We are glad you like our website. As for your expected response, here is an answer to your question about supplements. Eating a basically balanced and varied diet with food from protein, whole grain carbohydrates, dairy, fruits and vegetable food groups, should give you most , if not all, of what you need. Dietitians like people to get nutrients from food not supplements because food is more complex and full of known and unknown health giving factors. My favorite example is lycopene, a potent antioxidant that makes the red in tomatoes and watermelon. Lycopene supplements are costly. Tomato sauce is inexpensive and is likely to be laced with garlic, herbs and fiber so you get extra benefits. The same is true of many other unprocessed foods. Eggs are another goldmine and less of a concern than previously thought. To learn about food sources of particular nutrients go to the USDA’s reliable website http://www.nal.usda.gov/fnic/foodcomp/. If it is not listed, it is a very exotic food.
The direction to get nutrients from foods is especially true if you are eating whole grains and juicing. There are some exceptions. If you are not eating animal products you need to pay attention to B12, Vitamin D and other nutrients. B12 comes from animal foods and dairy and those who avoid them need a supplemental source. Just about everyone needs more Vitamin D, the sunshine vitamin, because of its role in osteoporosis and role in disease prevention. If you physician gives you and your family a clean bill of health and few warnings, you are likely doing a good job and probably eating better than most Americans.
The problem with special supplements or doses is that there are often based on overblown claims. At the very least, a commercial health website should present some research studies supporting their claims. There is online help for the public. The National Library of Medicine runs the MedlinePlus website. It is run by the National Library of Medicine and gives maximum doses and addresses other concerns by providing the scientific consensus view of the supplement or nutrient. You can google it. It is reliable and easy to use. If you can read scientific abstracts, you get a broader view at PubMED, a listing of research articles, another free site. Vitamins, minerals, herbs and similar products are usually good in moderate amounts. Too little creates deficiencies and too much can create other problems. As for herbs, they may be natural and but some herbs are so potent that overdosing causes problems. Be careful. A reliable source of information on herbal medicine is the American Botanical Council. (www.herbalgram.org). Perhaps, you can locate a physician familiar with supplements and herbs if you want to go this route. Herbal medicine is really a topic unto itself as is the absorbability of pills. In the meantime, ask your pharmacist. They are trained in the ways medicine is absorbed.
As to why the authors of Fit for Life are currently recommending supplements instead of relying on the exclusive use of whole foods, you will have to ask them.