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The Secret Behind Feeding Relationship

Picky eaters, feeding relationship

In my nutrition counselling practice, I often meet with frustrated and worried parents of picky eaters. Most scenarios, kids are in charge of what, when and where food is served, and parents are trying to bribe or force their kids to eat at least two bites of some nutritious foods.This feeding relationship are completely reversed and parents have no idea.

The Feeding Relationship

The “Feeding Relationship” (Division of Responsibilities in Feeding) is a concept developed by Ellyn Satter, a dietitian and social worker. There are separate roles in feeding for the parent and for the child.

If these roles are respected, the child will be less likely to be picky and will grow up having a healthy relationship with food. 

Parent’s Feeding Responsibilities 

When

There should be structured meal and snack time every day, so that your child knows when to expect another chance to eat. Children should be offered 3 regular meals and 2 or 3 snacks in between. Avoid grazing or snacking throughout the day. This timing structure will help your child build up a healthy appetite for the next meal.

Where

The child should be eating at the table with the family, with no distractions like TV or IPad. When your children eat in front of a screen, they aren’t focusing on their foods, or their inner hunger, or fullness signals; they’re instead focusing on what they’re watching.

What

As a parent, you get to decide what your child eats. Ideally, you should offer foods from each food group (with different colours, flavours and textures) at every meal if you can – a fruit or vegetable, a grain product and a meat or alternative and dairy.

Example: blueberries (cut in half) with slices of bread, cooked egg yolk and yogurt.

At family meals, your child should be served the same foods that the rest of the family is eating.

Baby/Toddler’s Feeding Responsibilities 

How Much and Whether 

It is completely up to your child to take the lead role in eating. The child is responsible for how much or whether to eat the foods that you’ve served. Many parents are concerned their child is not eating enough, however children are good at regulating their appetites and will not starve themselves. They may eat a lot one day and almost nothing the next and that is ok. If they don’t eat much at one meal or snack, they’ll make up for it in the future meals or snacks, or even by the end of the week. Read 20 Strategies to Raise a Mindful Eater. This way you do not set up power struggles with eating.

Remember, it might take up to 15 tries before the baby or child will actually eat the food.

Dietitian’s Thoughts

We need to take a step back and let our kids decide if they are going to eat their food and how much they are going to eat. No pressure, no forcing and no bribing. We, as a parent, have to respect their hunger and fullness cues. If we’re respecting this feeding relationship, the power struggles and stress around your family table will dramatically decrease.

Do you have a picky eater at home? You need more meal ideas? You need some strategies to deal with your little picky eater at home. Contact Me about starting a nutritional counselling program.

Introducing Solids to Your Baby: Baby-Led Weaning Vs. Spoon Feeding

When I was a nutrition student, I was taught at school that there is ONLY one way to introduce solids to baby – the traditional “puree, spoon-fed” way.

After being a first-time mom, I was first introduced to the concept of “Baby-Led Weaning” by a friend of mine when my son was around 6 months of age. I had never heard of this before and didn’t know what to think, the questions keep pooping in my head “what about the importance of iron-rich foods when first starting solids?” and “what about choking?”. I was so curious and I decided to do some research to learn more about it.

What is Baby-Led Weaning?

The name itself is a bit misleading (I was fooled by it for a while) as we usually think of weaning as the process of stop breastfeeding. Baby-led weaning is DIFFERENT. It is the term used to describe a way of introducing solid foods where babies feed themselves starting about six months of age. Breastfeeding (or formula feeding) continues during this process. For their first solid foods, babies are given larger pieces of soft foods that they can grasp and eat instead of the more Traditional Method of feeding where parents spoon-feed mashed or minced foods to babies. The idea behind baby-led weaning is that the baby can share the same (or similar) foods that the rest of the family is eating and that they sit and participate in the family meal while everyone eats.

Two approaches to Introducing solids to Your Baby

Baby-led weaning and the Traditional Method of introducing solids have similarities. They both recommend you:

  • Start introducing solids at about 6 months of age (when baby shows they are ready)
  • Let your baby choose how much to eat (Ellyn Satter)
  • Introduce safe finger foods starting at 6 months
  • Encourage eating with the family
  • Move toward offering the same foods as the rest of the family
  • Never leave the baby unattended while eating
Baby Led Weaning Traditional Method
Baby feeds her/himself


Adult feeds the baby to start, often by spoon


Begins with soft, easy to grasp chunks of food (often in "stick" shape) Begins with iron rich foods in soft, minced or mashed form and progresses to more texture as baby is able to manage
Finger foods are introduced in small soft pieces
Semi-liquid foods like yogurt can be offered to baby to eat with her fingers or as a dip for other foods Semi-liquid foods are fed to baby on a spoon with baby starting to guide the spoon to her/his mount when she/he is able
Examples of Food Offered Example of Food Offered
Strips of tender cooked meat large enough so baby can grasp in fist (with some sticking out at the top)Minced tender cooked meat on a spoon
Well-cooked scrambled eggs Mashed well-cooked eggs
Cooked broccoli trees Mashed/minced soft cooked broccoli on spoon or very tender cooked diced broccoli pieces
Banana partly peeled so baby can grip the peep at the bottom Mashed banana on a spoon or diced pieces of banana
Avocado slices Mashed avocado on a spoon or diced pieces of avocado
Stick of cheese or grated cheese Grated cheese
Fingers of toast (long thin slices) or pancakes (make from iron-fortified infant cereal) Iron-fortified infant cereal on a spoon

 

What You Need to Know Before Choosing an Approach?

Age: Start at 6 months

For both approaches, it is recommended to start at 6 months when your baby can sit up and control her/his head movements. Most babies can grasp larger pieces of food and will try to put them in their mouth at this stage.

Baby’s Hunger and Fullness Cues

With whatever method you choose, practice responsive feeding. This means watching for the cues and clues your baby gives you. Follow your baby’s lead and make sure that she/he decides whether or not she/he eats, what she/he eats (of what you offer), how much she/he eats and how fast or slow she/he eats.

Type of Foods: Offer Iron-Rich Foods as First Foods

Babies need a lot of iron (11 mg/day at 7-12 months of age) and that is why it is recommended that the first foods offered to babies be iron-rich. Please read:Best Started Foods for Baby-Led Weaning

With baby-led weaning it may be more difficult to ensure your baby is getting the iron she/he needs. Some parents will start with vegetables and fruit as first foods because they are easy finger foods. However, these foods don’t have enough iron to meet baby’s needs. Offering iron-rich food at least twice a day will help give your baby the iron she/he needs.

Safety: Avoid Foods that are Choking Hazards

The risk of choking is a concern with infants no matter what method of feeding you use. To minimize the risk, always ensure that your baby is sitting up and facing you when eating, learn about how to avoid/decrease the risk of choking and brush up on your infant first aid/CPR to help keep your baby safe.

Dietitian’s Thoughts

Self-feeding usually takes longer than spoon-feeding, so allow time for your baby to eat. Some babies will be better than others at getting food into their mouths and eating it. If you’re trying BLW and find that baby continues to have a hard time, try a mixed approach (TW+FF). Offering some food on a spoon in addition to finger foods may help them meet their energy, iron, and general nutrition needs. It may also help them avoid feeling frustrated if they want to eat but don’t quite have the movements down. I certainly don’t think that you should be made to feel guilty about the way you choose to introduce solids.

If your baby was born early, is not growing well, is developmentally delayed or has a condition that makes chewing or swallowing difficult, then BLW may not be appropriate for them.

Whether you choose to try BLW, traditional approach or a combination of the two, the main goals are: 1) to provide your baby with the nutrients and energy she/he needs; 2) to expose her/him to new flavours and texture; 3) to help her/him safely learn eating skills in a relaxed environment with no parental pressure or distractions.

In the end, the best approach is the one that makes you both feel comfortable and confident. Feeling good about how things are going helps to make the eating experience pleasurable for the whole family.

Do you have any questions about feeding your baby? Worry about choking? Contact Me about starting a nutritional counselling program.

Caffeine and Pregnancy

We want to do what’s best for our growing baby inside of us. Once we get that positive pregnancy result, we clean up every bit of our lives to be sure our babies have the healthiest start possible. And so many of us wonder: is it safe to drink coffee while pregnant?

I’m not a coffee drinker, but I’ve seen the love, devotion, and urgency many mamas have around their morning Joe. We can give up a lot when we’re pregnant, but please don’t touch our caffeine!

Caffeine is a drug and it will cross the placenta. It can limit blood flow to the placenta, as well as increase blood pressure and blood sugar levels. It also puts additional strain on the liver, which is already busy processing the increased hormonal demands related to pregnancy.

Caffeine should be limited since some studies have linked high intake of caffeine may be associated with growth restriction, reduced birth weight, preterm birth or stillbirth.

WHO advises all women of reproductive age to consume no more than 300 milligrams of caffeine per day.

One small (6 ounce) cup of coffee has 75 to 145 milligrams; the same serving size of weakly brewed tea has 18 to 25 milligrams. (Strongly brewed tea has 78 to 108 milligrams of caffeine per 6 ounces (link to chart).

Other sources of caffeine include cola drinks, dark chocolate and energy drinks.

Be careful if you’re planning to switch from coffee to herbal tea. Not all herbal teas are safe during pregnancy.

Avoid chamomile teas and teas with Aloe, Coltsfoot, Juniper Berries, Pennyroyal, Buckthorn Bark, Comfrey, Labrador Tea, Sassafras, Duck Roots, Lobelia, Senna Leaves, Hibiscus and Chicory Root.

In general, tea with Ginger, Orange Peel, Red Raspberry Leaf, Peppermint Leaf and Rose Hip are considered safe during pregnancy, if taken in moderation (no more than 2 to 3 cups per day).

Pregnant women should ask their physician before consuming any natural/complementary health product or herbal therapy.

Are you pregnant? Not sure what to eat? You want to learn more about healthy eating during pregnancy? Contact Me about starting a nutritional counselling program.

Foods to Pack on Family Road Trip

School holiday is fast approaching, and family road trips/vacations are big part of the fun! It can be challenging enough to feed your family nutritious meals and snacks at home, let alone when you’re on the road, or in different countries. Here are my top tips and tricks to help you keep your family well-nourished while on vacation:

Plan Ahead

Before going on a trip, write out a menu for every meal and snack. Pack all foods or ingredients that are included in the menu. Gather proper cooking equipment such as pots, plates, utensils, napkins, wipes, hand sanitizer gel etc. Make sure to bring containers or Ziplock bags to store leftover and use for portable meals and snacks for the next day.

Prepare Ahead

Obviously, you need an insulated cooler and some ice packs. Prepare whatever you can in advance such as homemade trail mix, homemade baking, no-bake energy balls, etc. Keep meal planning simple, making sure to include these meals components:

  • Whole grain: oats, whole grain bread, whole grain wrap or pita, brown rice, quinoa, corn on the cob, yam/sweet potato, etc.
  • Protein rich foods: fresh or cooked meat, nitrate-free deli meat, eggs, peanut/nut butter, beans, lentils, hummus, greek yogurt, cottage cheese, milk, cheese, tofu/tempeh.
  • Veggie or fruit: Any fresh raw vegetables or fruit, unsweetened dried fruit, pre-made salad mixes, fresh pre-washed and chopped veggies (broccoli, cauliflowers, carrots, cherry tomatoes, cucumbers, snap peas, peppers). Apple, bananas, pears, oranges are great because they do not need to be refrigerated. You can also include unsweetened applesauce.
  • Water: Drinking enough water to keep your body hydrated is very important especially after a full day of outdoor activities. Be sure to bring along a reusable water bottle to refill throughout the day.
  • Enjoy small portion of not-so-healthy foods: I follow 80/20  rule while on a road trip or vacation, making sure to reserve one or two meals for my not-so-healthy foods likes pizzas, burgers, hotdogs, ice cream and then striking a balance by serving raw veggies with dip or fruits alongside it, and making more nutritious meal choices the rest of the time.

If you are at a resort or hotel where you are able to access to kitchen (stove or microwave). Here are some quick and easy family road trip/vacation meal ideas:

Breakfast

  • Overnight oats: rolled oats, greek yogurt, milk and fruit (use small mason jars for individual portion and it is portable)
  • Yogurt parfaits: yogurt and homemade granola (1 & 2) and fruits
  • Eggs: hard-boiled eggs, or mini egg muffins
  • High fibre breakfast cereal with milk
  • Pre-homemade whole grain pancakes, French toast or waffles: add your favourite fruit on top

Lunch/Dinner 

You can make a picnic style lunch quickly. A picnic lunch is just a mix of different finger foods that together would make a balanced meal.

  • Whole wheat crackers or pitas with tuna salad or egg salad, fresh pre washed and chopped veggies with dips (hummus or tzaziki)
  • Whole grain wrap with turkey, cheese and lettuce or spinach, with a piece of fruit on the side
  • Layer ingredients for a hardy salad in a container or mason jar. Put your dressing on the bottom by vegetables like slices cucumbers and carrots. Next add chickpeas, edamame or chopped hard-boiled eggs. Finish with salad greens and pumpkin seeds on top. Shake before serving and add pita wedge on the side.
  • Turkey tacos – pre-made ground turkey with taco seasoning, avocados, lettuces, tomatoes, peppers, salsa, cheese, and taco shells
  • Snack plate: hard-boiled eggs, cheese, almonds, crackers, fruits, fresh pre-washed and chopped veggies with hummus

My Favourite Road Trip Snacks 

  • Fresh pre-washed and chopped veggies with dips (hummus or tzaziki)
  • Greek yogurt with homemade granola and fruits
  • Low-sugar granola bars
  • Homemade trail mix with unsweetened dried fruits
  • Apple with peanut butter
  • Whole grain crackers and cheese
  • No-bake energy balls

Try to limit the amount of less nutritious snacks such as potato chips, candy, chocolate, soda pop, etc. not only because they’re not very nutritious and high sugar/calories, but also because they don’t really fill you up, so you can eat a lot without really noticing. Instead eat these foods mindfully, choosing ones that you love and can’t live without and enjoy it.

Most importantly, remember to enjoy the outdoors and all the great food while spending time with family and friends.

Healthy Fasting During Ramadan

Ramadan is the one month per year where Muslims fast from dawn until sunset every day by refraining from food, water, smoking, medications, and even gum. Pregnant and breastfeeding women, children, seniors, and those on important medications or requiring nutrition care (such as people with diabetes, renal failure, or patients on tube feeds) are exempt from fasting.

During this month, Muslims spend more time getting closer to God, refrain from bad habits, and focus on spiritual growth. It is important to note that fasting is not a “weight loss diet” but is a great opportunity to focus on improving one’s character, changing behaviours and developing healthy habits.

The following are 8 important things to remember while observing the fast

1. Safety First

Pregnant women, nursing mothers, and those who are ill are exempt from fasting. Talk to your doctor before Ramadan begins as it is important for you to discuss your Ramadan plans 1-2 months before with your doctor and seek advice from a Dietitian to tailor specific dietary requirements to your needs. In some situations the fast may need to be broken and can be made up for at a later date.

2. Hydration 

Staying hydrated is key when you’re fasting in the summer months (if you are in Canada or live in Malaysia).

Men, on average, need to drink about 3L (13 cups) of water per day, while women need to consume about 2.2L (9 cups) of water per day.

Break your fast with a glass of water, and drinks about 2-3 large glasses of water at your evening and pre-dawn meals. Also, you may want to stay away from caffeinated high sugar drinks (for example: pop, energy drinks, coffee, tea).

3. Breaking the Fast 

Breaking the fast (iftar) is one of the most important meals and is comparable to breakfast. Fill a third of your stomach with food, a third with water, and leave a third empty. This ensures hydration and prevent overeating at the main meal.

A common recommendation is to eat 5-6 dates soaked in 1 cup of milk. Dates are a potassium dense food, which aids in hydration and restores electrolyte balance. Milk is high in Calcium, and water as is balanced in macronutrients. This combination is perfect for restoring energy.

4. Eat Mindfully at Main Meal  

After breaking the fast with a snack, such as the dates and milk, it is recommended that Muslims to perform sunset prayer (which usually takes 5-10 minutes) before they sit down to eat their main meal. This allows the body to absorb some of the nutrients and suppresses extreme hunger.

Eat slowly and chew very well to help pace yourself. It is quite common to eat a large portion of foods after a 12 hours fast, but remember it takes a 20 minutes for the stomach to tell your brain it is full. Eat till you are comfortably full.

Make conscious food decisions – remember the “Balanced plate”: ½ plate vegetables and salad, ¼ grains and starch (e.g., rice, pasta, potato), ¼ protein (e.g., chicken, fish, beef, lamb, lentils and eggs)

  • Protein with high absorption factors, such as egg whites, fish, skinless chicken, and whey protein.
  • Complex carbohydrates such as lentils, beans, quinoa, brown rice, and whole wheat pasta are released slowly, making you feel satiated for a longer period of time.
  • Avoid simple carbohydrates, such as white bread, fruit juice, chocolate bars, and other packaged goods, as they will digest quickly and make you hungry sooner.

5. Healthy Snacks 

It is recommended to eat at least two small snacks between breaking the fast and going to sleep. Since the timing for eating is so small, it is best to focus on faster digesting foods. Some great snack choices:

  • Low fat greek yogurt with 1 piece of fruit
  • A whole grain sandwich (egg salad, tuna, cheese, peanut butter)
  • A cup high fibre cereal with a cup of low-fat milk
  • A piece of fruit with a handful of nuts
  • Popcorn (unsalted and unbuttered)
  • Whole grain crackers with low-fat cheese
  • Hummus dip with vegetable sticks

The last snack before going to bed should be higher in complex carbohydrates and good fats such as avocado, nuts, and seeds.

6. Maximizing Energy for The Day

Pre-dawn meal (Suhoor) is a very important meal for fasting Muslims. This is when Muslims wake up 1-2 hours before their fast begins to eat one last meal (between 3-4 am). If this meal is properly balanced, it can help those fasting to remain high energy for the morning-noon portion of the day.

It is better to prepare this meal before going to bed so you can sleep for as long as possible. A meal high in complex carbohydrates, fibre, slower digesting protein (such as the casein in Greek yogurt), and good fats is ideal to slow gastric emptying.

7. Limit Sweets 

Due to the festive nature of Ramadan where lots of family and friends often gather at sunset to eat together, high sugar and fatty sweets are usually a regular after dinner.

Try to initially fulfill your sugar craving with one of the healthy snacks listed above and then have a small amount of the traditional sweets or other healthy alternatives.

Traditional Sweets (pictures) and deep fried foods (fried samosas, fried chicken, fried spring rolls, fried banana (pisang goreng) and fried potato chips) are high in sugar and fat which can make you feel sluggish and fatigued. Other high-fat cooked foods including oily curries and greasy pastries (Kuih bahulu, Apam balik)

Picture from MalayMail Online

Healthy alternatives

  • Baked samosas, baked spring rolls, oven baked potato chips
  • “Dry frying” – using a non-stick pan or non-stick food sprays
  • Grilled or baked meat, chicken, fish as a healthier alternative – while retaining the flavour and taste of the food

8. Adjust Exercise Routine

If you are planning to continue your exercise routine, it is recommended to shift your exercise  to the end of the day when food is eaten. During Ramadan, the frequency, duration and intensity of exercise likely will need to decrease.

One-day meal plan example

  • 9:00 pm (breaking fast): 5-6 dates soaked in 1-cup milk or small soup
  • 9:05 pm: Complete sunset prayer
  • 9:10 pm (main meal): 1-cup brown rice + skinless chicken breast + sautéed veggies with olive oil, and a fruit for dessert + 1-cup water or soup
  • *2-cups water
  • 10:30 pm (snack #1): Fruit with low-fat yogurt + 1-cup water
  • *2-cups water
  • 11:30 pm (or 15 min before bedtime, snack #2): Half-cup rolled oats + walnuts + blueberries + 1-cup milk or kefir + 1-cup water
  • 4:00am (Suho0r: 20 min before holding fast): sprouted grain bread + 2 eggs + ½-1 avocado +  Greek yogurt for dessert + 1-2 cups water

After 30 days of fasting, Muslims from around the world celebrate Eid. The day starts off with morning prayers and the celebration continues with friends, family and lots of food.

Ramadan provides a chance for Muslims to “cleanse” their lifestyle from bad eating habits and junk food. Since the window for eating is tiny, it is important for those that are fasting to cut out nutrient poor foods and focus on eating nutritious ones.

Overall, balanced food and fluid intake is very important during these fasting periods. In order to prevent weight loss or muscle breakdown, your meals must contain decent levels of energy-rich foods, which should include carbohydrates and some portion of fat.