0

The Picky Eating Toddler & You

As promised, here is third and final blog post relating to feeding difficulties.

We all have experiences where our little ones refuse to eat their sweet potato that evening, or only wants to eat a portion of their meal…but when should you be concerned? When should we be worried if our child’s mealtime preferences are more than just a quirk? Below you’ll find a very quick overview of what to keep an eye on, and what you should do if you suspect your child is a Picky Eater. This by no means is the picky eater’s “bible” but I hope that it is informative and helpful to you to know if your child’s picky eating warrants professional help!

Red Flags of Picky Eating
– poor weight gain or weight loss
– ongoing choking, gagging or coughing during mealtimes
– ongoing problems with vomiting immediately before, during or right after mealtimes
– more than one incident of nasal reflux
– history of traumatic choking incident
– history of eating and breathing coordination problems with ongoing respiratory issues
– inability to transition to baby food purees by 10 months of age
– inability to accept any table food solids by 12 months of age
– inability to transition from the breast/bottle to a cup by 16 months of age
– has not been weaned off baby foods by 16 months of age
– an aversion or avoidance of all foods in a specific texture or food group (i.e. will only eat foods when pureed smoothly, or won’t eat any proteins, or won’t eat any orange coloured foods etc.)
– a food range of less than 20 foods (especially if these foods are being dropped over time by the child, with no new foods replacing those lost foods)
– crying/arching at most meal times
– it is difficult for every/anyone to feed the child
– family history of eating disorders

Why Is My Child A Picky Eater?
There could be a number of reasons as to why a toddler will present as a Picky Eater. It may be any one of the reasons listed below or it could be a combination of reasons.

Physiological
– oral motor weakness
– food allergies (some of these you may not know about as yet)
– reflux/GERD
– dysphagia/swallowing difficulties

Psychological
– traumatic experience in the past with certain foods (i.e. a choking episode, an allergic reaction etc.)
– history of being force fed
– traumatic experience orally (i.e. may have been intubated at birth with tubes through the mouth etc.)
– reflux (the knowledge that the food will hurt/burn when it is refluxed)
– anxiety and/or fear

Sensory
– heightened gag reflex
– oral defensiveness (doesn’t want anyone or anything touching the inside of their mouth)
– sensory defensiveness (this can include being defensive of seeing an undesired food or smelling an undesired food)
– sensory processing disorder

Behavioural
– frequent tantrums at mealtimes
– strong dependence on being “entertained” during meal times (i.e. watching the television etc.)
– general attention difficulties (i.e. is unable to focus for the short period of time to eat a meal).
– the toddler enjoys the reaction from the adults around him/her and continue to do it as an attention seeking opportunity).

Other Contributing Factors
– late exposure to solid foods (after 12 months of age)
– family history of picky eating/feeding disorders
– medical history (i.e. toddler may have been a premature baby etc.)
– developmental disorders (i.e. Autism Spectrum Disorder)

Picky Eater or Problem Feeder?
Typically Picky Eaters have two classifications – Picky Eaters and Problem Feeders, with “Picky Eaters” being the umbrella term for both.

Picky Eaters usually have…
– decreased range of foods that he/she will tolerate (however it is usually at least 30 different foods that he/she will eat)
– some foods may be lost due to “burn out” but will be re-gained after a break (i.e. won’t eat bananas after enjoying one daily for a month, but will start eating them again in a few weeks)
– able to tolerate new foods on their plate
– eats at least one food from most food texture/nutrition groups
– frequently eats a different set of foods at a meal than the rest of the family

Problem Feeders usually have…
– restricted range of foods (usually 20 different foods or less that he/she will eat)
– foods that are lost due to “burn out” will not be regained
– behavioural tantrums/melt downs occur when a new food is presented
– will often refuse to eat an entire category of food groups or textures (i.e. no solids, or no crunchy foods)
– always eats a different set of food at a meal than the rest of the family

What Do I Do?
If your child demonstrates red flags of picky eating, it is definitely worth taking him/her to see their Paediatrician. If there are concerns regarding weight gain, or regarding the range of foods that your child can eat, your Paediatrician will refer you to a Feeding Therapist. Usually this person is a Speech Language Pathologist or an Occupational Therapist but there are other allied health fields such as Physiotherapists or Dieticians/Nutritionists who may also be feeding therapists (in other jurisdictions). Keep in mind that there is no “cure all” for picky eating…each child is an individual and their needs are going to be unique. As a result, the team of professionals working with your child (Paediatrician, Nutritionist, Speech Language Pathologist, Occupational Therapist and whoever else may be working with your child) will try to take a very holistic approach to help your child overcome their battle with food!

I hope that this was informative and not too overwhelming!

Until next time,

Cayman Mummy

Advertisements
0

Top 10 Tips for Toddler Mealtimes

As promised, here is my second blog post on feeding, continuing on from the Feeding Milestone post I did last week. These are some general parent tips that I share with parents when they express frustrations or concerns with their toddler’s mealtimes.

1. Respect Your Child’s Appetite.
If your child isn’t hungry, don’t force them to eat a meal or a snack. Don’t use food to bribe your child, and don’t force your child to “clean their plate”. This leads to unhealthy mealtime habits and can lead to power struggles over food.

2. Stick To Mealtime Routines
Mealtime routines help to reduce anxiety for children. Children thrive on schedules and routines and it is very helpful for them when they know they have set mealtimes/snack times. Remember as a baby you could predict exactly when your baby would want their next feed? The same goes for your toddler – it’s just that instead of being nursed or getting a bottle of milk, they are getting solid foods. Additionally, you want to discourage grazing throughout the day. This reduces your child’s appetite and a reduced appetite will lead to food refusals!

3. Be Patient With New Foods
It can take 10-12 times for a child to truly know if they dislike or like a food. Also keep in mind that at this age, your toddler’s taste buds are very sensitive. They are predisposed to enjoy sweet tasting food (think of how breast milk or formula taste – both are very sweet) and are extremely sensitive to bitter tastes (i.e. green veggies). The more exposure they have to a food, the less likely it is that they will refuse it over time.

4. Make Mealtimes Fun!
Don’t let mealtimes become a chore. Instead, allow your child to get messy during meals, and explore their foods. Make food art, let your child use dipping sauces, make different sounds when they eat different foods…whatever floats your child’s boat. Also, it’s good to keep in mind that children explore new foods with ALL of the their senses. So if instead of eating the squash, they want to squish it in their hands, rub it on their cheeks and hair, sniff it, inspect it and throw it over the high chair to hear it “plop”….LET THEM! It is how they are learning what squash is! You want mealtimes to be the times of the day he/she looks forward to, not the time that they dread.

5. Grind Up Real Foods
Avoid being a short order cook – use the family pot to introduce foods. Making spaghetti? Grind it up for your little one to enjoy. (Or if you’re like me – use cous cous – instant child friendly pasta that cooks up in a cinch!) The more your child is exposed to the foods you enjoy as a family, the more your child can be a part of your family mealtimes.

6. Ensure Food Is Age and Stage Appropriate
By making sure that your child’s foods are age and food stage appropriate it prevents mealtimes from becoming overwhelming. Additionally, offer small amounts of food at a time. If he/she is still hungry, they can always get more food. This works two fold – it reduces food wastage during their exploration time but it also reduces any anxiety your child may have about the amount of food that they are expected to consume.

7. Try Preparing The Same Food In Different Ways
Provide soft baby carrots at one meal and carrot slices at another meal OR provide meatballs on one day and make a meat loaf the next…switch up the way the food looks to help your child learn that the same food can come in different forms. This also includes “hiding” undesired foods (like vegetables) into desired foods (for example, I fine slice kale and spinach and add it into my spaghetti sauce…not even my husband notices!)

8. Be Creative
If your child is old enough, recruit their help as your “sous chef” to help prepare the meal. Instead of a boring sandwich, make sandwich faces. Create dishes that promote interaction and appeal to your child visually. Remember we all eat with our eyes first!

9. Minimize Distractions
Allow the focus on mealtimes to be on the family meal. This not only involves the actual food but the conversations and interactions at the family table as well. Avoid using the television or other electronics to distract your child while you feed them.

10. Be A Good Example
Eat the way you want your child to eat. You can tell your child to eat their vegetables until the cows come home, but if you don’t eat your vegetables – it’s pretty hard to convince your child to eat them! Even if your eating habits aren’t perfect, do the best you can to show them what well balanced meals look and taste like. You want to teach your child to eat healthily and to have a healthy relationship with food as well.

Until next time,

Cayman Mummy

0

Feeding Milestones for Babies and Toddlers

As much as I wish I could be a stay at home mom, professional blog writer, or professional baker…my day job is actually as a Speech Language Pathologist! It’s a job that I absolutely love (how lucky am I to do something I love every day?!). One of the areas that I deal with as part of my job is feeding difficulties. Recently on my Facebook page, I posted about my frustration in seeing so many Caribbean babies getting cereal in their bottles. This opened up a plethora of questions about feeding milestones, what to do/not to do when transitioning to solids etc. I thought why not turn these feeding questions into a blog post! When I started to put together all of the information I realized what an exceedingly long blog post it would end up being…so in the interest of space and time I’ve decided to break it up into different sections. This being the first of several posts regarding feeding.

Like all things – we should start with the basics! When you know what the timeline of feeding transition is from birth through toddlerhood, it’s easier for you to pinpoint the area that your little one may be having the most difficulties.

O-3 Months
– Babies should be solely breast and/or bottle fed. There are oral reflexes in place for suckling and swallowing.
– It is important that during this time baby establishes an appropriate latch.
– Force feeding baby to drink X amount of ounces should be discouraged.
– Follow the baby’s lead on when he/she demonstrates signs of being full.
– Bottles should never be squeezed, nor nipples cut to encourage the baby to drink more or to drink faster.

4-6 Months
– Babies begin to suck and are no longer suckling.
– Breast/bottle feeding is no longer automatic, it begins to become voluntary.
– Babies begin to reach for bottle or spoon when hungry. May also be able to put hands on bottle, and some may even be able to hold bottle at this age.
– If your baby demonstrates signs of readiness, he/she may begin to take pureed food from a spoon.
This is the age range where babies begin to demonstrate signs of being ready for solid food, however the Cayman Islands Children’s Health Task Force does not recommend solid foods until 6 months of age (unless otherwise advised by the child’s primary paediatrician).

6-9 Months
– Babies should be able to open their mouths and wait for the spoon to enter.
– Many babies can drink from a straw at 9 months. Babies are also ready to transition to sippy cup or preferably, regular cup at this time. This is the perfect time to start bottle weaning!
– By now, a munch pattern using an up/down motion should be observed during meals, however a rotary chew (think of a cow chewing on cud) may begin to develop at this age.
– Baby should quickly and efficiently remove food from a spoon using their top and bottom lips and should also lean their head forward to accept the spoon.
– Babies should be able to hold their bottle or cup in both hands.
– Baby should be able to demonstrate stable head control in a sitting position(no head bobbing) and stable trunk control for independent sitting.

10-12 Months
– At this age, feel free to shift foods from pureed to finger food textures.
– Further development of grasping patterns should also be observed.
– Oral motor skills are also being developed. Your little one may be learning to move his/tongue from side to side, may be starting to munch and may also begin biting (not just on food either!).
– Your baby may also begin seeking independence at this age and may not want you to feed him/her any more.
– Your baby may begin to demonstrate some taste preference shifts and may reject “baby food” flavours. This is the perfect age to begin exposing your baby to the family pot and allowing him/her to explore the flavours and textures that the family enjoys.

13-15 Months
– At this age, your toddler’s biting skills continue to develop. Cognitively, toddlers may also try biting objects or people.
– Chewing should be demonstrated (with or without teeth), although not fully mastered.
– Toddlers should be able to bite through a hard cookie.
– Chopped table food should continue to be provided.
– Bottle use should be discontinued. Cup and/or straw use only at this age. Your toddler should be fully weaned from the bottle by 15 months (ideally).
– At this age, toddlers typically engage in “co-feeding” with their caregiver (i.e. while the toddler is self-feeding, caregiver is also putting food in their mouths in between)
– Toddlers typically can grasp a spoon with their hand and will make attempts to bring it to their mouths, although they may have difficulties with keeping the food on the spoon.
– Toddlers should be able to hold their cup with 2 hands.

16-18 Months
– At this age, your toddler should tolerate more challenging foods that require chewing, such as proteins and vegetables.
– By 18 months most toddlers should be able to chew with their mouths closed (although they often do not).
– At this age your toddler should not have large amounts of food or liquid leaking or spilling from his/her mouth during mealtimes.
– Your toddler should be an efficient finger feeder at this time.
– Your toddler will make attempts to assert their independence during mealtimes and will enjoy practicing using their spoon/fork (although still not great about keeping a lot of it on the spoon still).

Two Years Old
– By age 2, your toddler should be able to manage any type of food he/she likes.
– He/she should be drinking from a regular cup with very little spilling.
– He/she should also be able to feed himself/herself fairly well with a spoon or fork.
– Some “fine tuning” will continue over the next few years.

I hope you find this milestone list useful and informative! Stay tuned for my subsequent posts dealing with feeding, as I’ll be talking about the different stages of baby foods, red flags of picky eating and feeding “do’s” and “don’ts”

Until next time,

Cayman Mummy

0

Totally Fresh and Totally YUMMY (reblog from Eco Chic Cayman)

I LOVE the teas from Totally Fresh – they are so refreshing. I also love the fact that they provide so many nutritional benefits (perfect for a breastfeeding mama like myself). My favourite is the moringa lemongrass – I love to boil a big pot of it, add a few teaspoons of Cayman honey and ice it!

Support local agriculture and the local economy and check out Totally Fresh Cayman!

PS Thanks for this amazing review EcoChicCayman – I couldn’t have blogged any better 😉

Totally Fresh Cayman

For all you tea lovers you are in luck! Totally Fresh Cayman produces and brews the finest Moringa Loose Leaf Tea on the island! My personal favorite is the Moringa Lemongrass Iced Tea.  James Pedley, the owner, grows Moringa on his farm.  He has two signature teas Moringa and Moringa Lemongrass.  Due to limited supply herbs such as mint and basil can be requested by special order.  James is dedicated to growing the finest ingredients for his high quality island tea.  Coming soon are new tea flavors, herbs and produce.  Just this year James introduced his line of Moringa Loose Leaf Tea and Iced Tea at Camana Bay’s Farmer’s Market.  It is quickly becoming an island favorite.  Additionally, the Greenhouse Cafe was one of the first restaurants to begin serving his Moringa Lemongrass Iced Tea as a staple part of their drink menu.  It was there that I was first…

View original post 359 more words

0

Breastfeeding Benefits for MOTHERS

I meant to post this at the beginning of Breastfeeding Week – but better late than never! It’s well known the benefits of breastfeeding for BABIES, but did you know that breastfeeding also provides significant health benefits for mothers?! Definitely something to consider if you’re on that line between breastfeeding or formula feeding. Here are some of the wonderful health benefits breastfeeding mothers can look forward to…

1.) Breastfeeding helps to reduce the size of the mother’s uterus after child birth. It not only helps it get to closer to what it was pre-pregnancy size, but also does it more quickly as well!

2.) Breastfeeding acts like a natural tranquilizer for mom. I can personally attest to this one! Nursing and even expressing can be a great way for moms to calm down and relax during a stressful day. Had a rough day? Take baby to bed – the both of you will fall asleep very contented!

3.) Breastfeeding can reduce your chances of breast cancer. Breastfeeding your baby for 4-12 months can reduce your risk of breast cancer by 11 percent. Breastfeeding through toddlerhood (24 months or longer), your risk of breast cancer reduces by a whopping 25%!

4.) Breastfeeding reduces your risk of developing ovarian and endometrial cancers. There is definitely a trend between “female” cancers and breastfeeding and the research is piling up showing that the risk of developing many of these types of cancer reduces significantly with breastfeeding.

5.) Breastfeeding reduces your risk of osteoporosis. Women who have not breastfed are 4 times more likely to develop osteoporosis than women who breastfeed!

So for people who tell you that breastfeeding is too harsh on a mother’s body – check out the research behind these few positives and tell them it’s the other way around – breastfeeding helps to PROTECT a mother’s body! Happy Breastfeeding!

Until next time,

Cayman Mummy

0

Homemade Goodness

So Cheeks has made it to the solid food phase and so far she’s enjoying every mouthful of it! She is a girl after my own heart though – she prefers the homemade stuff over the store bought, which is fine by me!

Making baby food is really not as time consuming as one might think though…it freezes well and you can easily portion it out to your baby’s needs. Not only is it extremely cost effective to make your own but its also better for baby! Just look on the ingredients listed on some of the baby foods and cereals on the market – I wouldn’t want to eat that stuff much less feed it to Cheeks!

I think homemade cereals are the most scary for new parents to make – at least it was for me…so I’m going to show you just how it easy it is to make your baby’s cereal. You can do any grain using this method – oats, millet or barley even. Today I’m using organic brown rice.

20130710-172921.jpg

This bag of rice can make a ton of rice cereal – the equivalent of about five boxes worth of rice cereal but costs about the same as two boxes of the regular rice cereal or one box of the organic rice cereal. Talk about a money saver!

20130710-173027.jpg

Here I’ve added one cup of brown rice to the short cup on my fabulous baby bullet that I inherited from a friend. I’ve attached the milling blade to do this part. If you don’t have a baby bullet, a blender, food processor or even a coffee grinder (one that’s never been used, preferably!) could also be used.

20130708-231838.jpg

You want to mill it so that it becomes a fine powder like above. You can see the side by side comparison between the brown rice powder and a popular white rice cereal (notice the lack of colourful crystals in the milled brown rice cereal).

20130708-232141.jpg

In a decent sized pot, add the rice powder and four times the amount of water (in this case, 4 cups of water). Bring to a boil while stirring frequently. Then reduce it to a simmer and cook it between 20-30 minutes. Stirring occasionally to reduce the occurrence of lumps and to prevent the cereal from sticking. You want to keep the ratio to about 1:4 – one part rice to four parts water. When the rice is finished cooking, it should yield a thick cereal that looks like this…

20130708-232653.jpg

Allow it to cool and voilà! Homemade Brown Rice Cereal! You can blend it again if you want it super smooth, and you can thin it out very easily as well. No chemicals or crystallized who knows what…just simple, wholesome goodness. I hope you give it a try!

Until next time…

Cayman Mummy