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Mothers often wonder, and books and web pages disagree, about whether you should hide veggies on a plate in the hope your child will eat them without noticing.  My answers as a registered dietician are the same as my answer as a mom: you should not.

Having a toddler always means power struggles. A main focus of my work with helping families feed their children from infancy to their teenage years is to take the power struggle out of food.

A big aspect of this is removing all forms of pressure, including hidden vegetables. After all, how would you feel if someone hid something in your food? I know I’d be upset! I like to empower kids with choices from what is offered.

Here are a few tips:

  • Parents choose what’s served, then kids choose from what’s offered. Let’s say the meal is chicken, rice and broccoli. The kids can eat as much as they want of any of those foods. If they don’t choose broccoli that’s okay. Really. Continue offering vegetables with every meal, but remove the pressure to eat them. If the rest of the family eats their veggies and there’s no pressure, your kids might surprise you. If they do choose a broccoli, they shouldn’t be pressured to eat it. Don’t create any kind of pressure such as insisting they try a bite, or finish what they take, or eat like everyone else.
  • Involve kids. Let them help choose vegetables to go with dinner. Let them pick something new to try at the grocery store. Let them help prepare the vegetables for dinner. Kids love to grate, cut, wash, pull out of the fridge, etc. Involve them based on their age and ability.
  • Don’t hide any vegetables. Making a pureed soup? That’s great, but tell your kids what’s in it. Everyone, including kids, has preferences. They may or may not like certain vegetables, and that’s their right. I’m sure most parents remember being forced as a kid to eat things they didn’t like. Don’t repeat that behavior for your kids.
  • Grow a garden. Having kids plan and plant a vegetable garden can pique their interest. If they’ve seen the food grow and helped with the process, they often want to try the end result. Container gardening works for this, or a community garden or a u-pick.
  • Offer a variety of forms of veggies, like cooked, raw, roasted, grated, cubed, etc. Providing different forms for a vegetable can be a real hit. Try putting vegetables in smoothies and baked goods, but always tell your child what vegetables are in there.
  • Be a role model. When kids see everyone else enjoying vegetables and the pressure is removed, they will often try some. Be sure to include vegetables with every meal and snack. Making an omelet for breakfast? Throw in some veggies. Load up that sandwich at lunch with veggies, and have some veggies and hummus for a snack. Try having a salad on the side with dinner and incorporating a rainbow of color with your veggies in the meal.
  • Presentation matters. Try serving meals with the makings in different bowls in the center of the table. Everyone can pick and choose what they want. Try using little containers to put cut-up veggies in with hummus for a snack at school or on the road. You don’t have to make vegetables look like various characters and elaborate pictures like you see on Pinetrest, but presenting them with a little thought can go a long way. Some families find using catchy names gets their kids interested — trees instead of broccoli, cauli-power, etc. Remember: the more color, the more appeal.


In short, it’s about building trust. Removing the power struggles from food choices is so important. Don’t deceive children about vegetables being in a dish. If a pureed soup has different vegetables in it and your kids enjoy it, they may not even realize they like these vegetables if they aren’t told what they’re eating. In fact, deception can backfire — children won’t eat something again just out of spite, or they won’t eat a vegetable because they don’t know they like it.


If a child tries a new food and doesn’t like it, it’s fine to spit it out. Just teach them a polite way to do so. Knowing they have the option to spit it out can encourage them to try more. It takes 15-20 times of trying a food to decide you actually like it so it might take a lot of spitting it out before they know whether they like it or not. As long as you provide the option to try vegetables in their own time, it will happen. Don’t lose patience, and don’t lose hope.

My best advice: don’t worry! It won’t be like this forever. When people are really concerned I work with them to look at ways pressure can appear and power struggles develop. We go through their diet to ensure their child is getting necessary nutrients or to find alternatives that the child accepts.

Remember, kids have different eating patterns. This is normal.

Concerned that your kids aren’t getting what they need because they don’t eat vegetables? Wondering how to empower your kids to eat more vegetables? Contact Jill, Nurture The Future’s Registered Dietitian at This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Published in Child Nutrition
Tuesday, 15 April 2014 16:06

Vegan Pregnancy - Part 2

My last post discussed eating a vegan diet during pregnancy. Now let’s talk more about specific nutrients you need.

Protein should be a focus in the diet of a vegan pregnant mama. If you eat three meals a day and two snacks, I suggest protein with every meal and at least one snack. However, if you eat four smaller meals a day, include protein at every one.

There are many vegan protein sources to choose from. Although there are good options — that include fiber, iron, folate, and choline, etc. — they’re a bit harder to digest than meat, fish and eggs.

Vegans also have increased iron needs because many vegan iron sources contain phytates — antioxidant compounds that bind to the iron and make it harder to absorb.  So I recommend a vegan prenatal multivitamin that also contains iron. 

Through a blood test, your healthcare provider can tell you if you need an iron supplement over and above what you get from food and your prenatal multivitamin.

Vegan diets are usually high in Vitamin C, which increases iron absorption. If you take a prenatal multivitamin and eat high iron foods throughout the day, I don’t recommend an iron supplement unless your healthcare provider recommends it.

Remember that both caffeine and calcium can negatively affect iron absorption.

Zinc is another important mineral during pregnancy. Vegan foods high in iron are typically also high in protein, zinc, folate and choline. 

In pregnancy calcium needs don’t increase — your body absorbs calcium more efficiently.

Vegan diets often have low amounts of calcium. In addition, some vegan foods have phytates and oxalic acid that also affect calcium absorption. However, this is easy to remedy if sources of calcium are made a focus of the diet. Remember that caffeine can also affect calcium absorption.

Although many people meet their calcium needs with dairy, this is not the only way. Good sources of calcium include almonds, sesame seeds, fortified milk alternatives, blackstrap molasses, tofu (if calcium sulphate is listed in the ingredients), collards, figs, kale, turnip greens and broccoli.

Vegans, whether pregnant or not, most frequently ask if they’re getting enough vitamin B12, which typically comes from animal products. However, vegans can get it in fortified products such as red star nutritional yeast (be sure to check as not all nutritional yeast is fortified with B12), vegan meats and fortified milk alternatives.

I always recommend eating whole foods and avoiding packaged and processed foods as much as possible. So I point out that, although vegans can choose fortified foods to get their B12, these are all packaged foods.

However, using B12 fortified nutritional yeast is great because it is easy to add to foods that you are eating throughout the day.

To meet your needs with fortified foods you need to eat at least three fortified foods with B12 each day. A variety of B12 supplements are available. Depending on the dosage you choose, you may not need to take it every day. But don’t worry too much about getting more B12 than needed — you will just pee out any excess amount you take in.

That said, there’s no sense “peeing your money away” on unnecessary vitamins. So base your decisions about supplements on what you get from foods and what works with your lifestyle.

It’s a good idea for every future mother to boost stores of omega 3 before getting pregnant; and while you are pregnant it’s important to conserve them. This is especially important for vegans, who tend to have lower levels of DHA.

For this reason omega 3 is one of the most common supplements I recommend before, during and after pregnancy. Often it’s taken in the form of DHA, one component of omega 3.

Most omega 3 supplements are from fish sources, although you can find vegan forms made from micro-algae — the same source that gives fish their DHA. Taking the micro-algae form is a good option as it reduces concerns about mercury and other contamination.

There are also vegan food sources available, including flax seeds (if they’re ground or in the oil form), chia and hemp seeds, and walnuts.

Omega 3 has another component, EPA, that is readily found in supplements. Both it and DHA are important to both mom and baby, although DHA tends to get the spotlight, as it helps in baby’s brain development.

Fish sources seem to be better absorbed and utilized by the body and there is also debate as to how much the foods listed above actually have in them. Our bodies actually convert plant sources of omega 3 to DHA and EPA, making them not as efficient sources of these fatty acid components.

Chia and hemp seeds also contain omega 6. North American diets tend to provide more omega 6, so it is important to ensure a ratio of omega 6 to omega 3 fatty acids in the range between 2:1 and 4:1. Many plant-based vegan oils contain omega 3, 6, and 9, making it even more important to think about the ratio of omega 6 and omega 3.

Some things also affect our body’s ability to make DHA. This includes trans fats — another reason to avoid processed and packaged foods. Alcohol and smoking also have negative effects.

In short, it is possible, with a little planning, to eat a healthy vegan diet during pregnancy.

If you have further questions, please contact Jill, Nurture The Future’s Registered Dietitian, at This email address is being protected from spambots. You need JavaScript enabled to view it.

Despite research that claims a recent improvement, childhood obesity remains a prominent problem which has not declined in the last decade. Unfortunately, many parents unknowingly fuel their child’s unhealthy habits.

Children who are heavy prove more likely to develop serious health risks like high blood pressure, diabetes, and an early death sentence. Even if children are able to lose the weight, personalized health care plan doctors have found that they are often more susceptible to these health risks later on in life.

These five tips will help to fight against childhood obesity, giving them a long healthy life.

1. TV Time

Television has taken over the world with its entertaining escape from reality. However, too much TV can have a powerful impact on children’s obesity.

In a study of obese children, 90 percent had been exposed to television as a brand new baby, while 50 percent were active participants, placed in front of television by their parents. As children grow older, if they are used to spending hours in front of a television, they will lose interest in other activities that could help them to become active and healthy.

2. Role Model

Children learn from example. If they see Mom and Dad vegging out in front of the TV, eating poorly, or ignoring their health, they will most likely follow this set pattern. Kids love to be just like their parents, and with parents setting an influential example of health, kids are likely to adopt this model. Habits that begin when children are young are likely to persist as they age. Depending on the habit, this can be a good thing or a bad thing.

3. Nutrition

No matter how busy life gets, the importance of eating a well balanced diet can never be reiterated enough. Even though a drive-thru meal might be more convenient, it can have serious consequences on a child’s body.

Good nutrition starts with the most important meal of the day: breakfast. Children need breakfast—and a nutritious one at that—to perform well in school. Whether it is a whole grain cereal, which has been linked to lowering BMI, toast, eggs, etc., breakfast should be high in protein and low in sugar. It will keep children alert throughout the school morning while adding nutrients to their growing bodies.

4. Get Outside

Too often children are allowed to spend more time inside playing with electronics than outside exercising. While occupying a child with a video game or tablet sometimes seems like the easiest thing to do, it might be hurting the child’s overall health.

Children need to spend time outside playing, using their imagination, socializing with neighborhood kids, and being active. Activity not only helps to prevent obesity; it also stimulates creativity and cognitive function.

5. Be Honest

While kids should certainly not be obsessing over their weight, they should recognize and understand the importance of health. Along with showing them what to do, talk openly and often about making good food choices and setting an exercise routine. Educate yourselves together by researching good health habits and setting family goals.  

Children need a health precedent set for them, and the best people to advise them are definitely their own parents.

Published in Child Health
Saturday, 08 March 2014 01:22

Vegan Eating in Pregnancy

A vegan diet is safe during both pregnancy and breastfeeding if it’s properly planned.

The key is balance. A well balanced diet – vegetarian, vegan or anything else – ensures you get the nutrients you need.

Often pregnancy prompts women to make healthy shifts in their eating habits. It’s also a great time for partners to start eating better. Adding a baby to the family means parents become their child’s role model, so having nine months to begin making changes can be a big help and create lasting effects.

Different stages of pregnancy require different nutrients, however.

During the first trimester you don’t need extra calories. Good nutrients to focus on are protein and iron. Pregnancy basically doubles your blood volume. All this extra blood means it’s important to get enough iron and protein.

You will need extra calories in the second and third trimester, and when breastfeeding. However, those extra calories don’t add up to a lot of food – only 300 to 400 calories a day. Don’t think of it as eating for two, but rather for the health of two!

During their second and third trimester many women eat four or five smaller meals a day instead of three large ones. This tends to work nicely with consuming those extra calories needed during these stages. But don’t choose convenience foods. Eating less packaged and processed foods and emphasizing whole foods is always the best choice.

Vegans and vegetarians especially need more iron during pregnancy. Some nutrients are also required in increased amounts. These are as follows, including some examples:

  • Carotenoids: yam, spinach, carrot, apricot, broccoli, and cantaloupe.    
  • Folate: driedbeans,avocado,lentils, sunflower seeds, peanuts, broccoli, asparagus, okra, spinach, Brussels sprouts, papaya.     
  • Niacin (Vitmain B3): tempeh, portabello mushroom, pumpkin/squash seeds, peanuts, beans, lentils, green vegetables, and potato.     
  • Pantothenic acid (Vitamin B5): avocado, kale, broccoli, mushroom, beans and lentils.     
  • Riboflavin (Vitamin B2): tempeh, nuts, and green vegetables.     
  • Thiamin (Vitamin B1): oats, wheat germ, and sunflower seeds.     
  • Vitamin B6 (Pyridoxine): nuts, lentils, potatoes, banana, chickpeas, yams, avocado, kale, and sunflower seeds.     
  • Vitamin B12 (Cobalamin): foods fortified with B12 including red star nutritional yeast, milk alternatives, veggie meats, and breakfast cereal.    
  • Vitamin C: kiwi, pineapple, bell peppers, cauliflower, and kale.  
  • Iodine: seaweed and iodine fortified salt (it is mandatory in Canada but optional in the UK and US).    
  • Iron: spinach, swiss chard, dried beans and peas, lentils, pumpkin seeds, cashews, pinenuts, and hazelnuts.    
  • Magnesium: lentils, dried beans, brazil nuts, sunflower seeds, pumpkin/squash seeds.
  • Zinc: dried beans and peas, lentils, pumpkin/squash seeds, cashews, peanuts, quinoa, tahini, and mushrooms.

Note that you don’t need extra Calcium and Vitamins D and K. However, it is important to be getting good sources of these in your diet.

Although food is the best source of the nutrients you need, it’s not always possible to get enough. So I recommend a prenatal multivitamin. Vegan prenatal multivitamins are available.

It’s a good idea for all pregnant women, not just vegans, to take these prenatal multivitamins. And I stress again that a balanced vegan diet during pregnancy can be a very healthy way to keep both mom and baby as healthy as possible.

I will have more advice on how to ensure you get specific nutrients for a vegan pregnancy in my next post.

If you have questions about how to eat a vegan diet in pregnancy or to make sure you are getting the nutrients you need talk to Jill, Nurture The Future’s Registered Dietitian at This email address is being protected from spambots. You need JavaScript enabled to view it..

Friday, 07 March 2014 14:15

Your Breastfed Baby & Colic

Many mothers experience fussiness in their babies once in a while, and this is usually accepted as part of the trials of motherhood. However, some babies have “colic,” which is described as a healthy baby, who is gaining weight steadily, crying inconsolably for over 3 hours, for an incidence that happens more than 3 days a week, for over 3 weeks.  The crying usually starts at around the same time every time and is usually in the evenings. 

It doesn't matter whether you bottle feed or breast feed your baby--roughly one in every five babies experience colic. Colic starts at around 2 weeks and ends at around 4 months old. Some identifiers of colic are:

  • baby pulls up his legs while crying

  • baby's hands may be in a fist

  • baby is very gassy and his stomach is harder than normal.

The worst part about colic is that there is no proven treatment. 

I was one of the "lucky" moms with both of my babies having colic, and at first I blamed myself. I thought I did something wrong and that my children were suffering because of what I did.  I just did not understand how my children could be experiencing colic since I took care of myself during both pregnancies and during breastfeeding: I exercised, limited my caffeine intake, rarely consumed any dairy products (I have never liked cow’s milk), ate plenty of fruits, legumes and vegetables and ate organic as much as possible. Yet both of my babies experienced colic during their first four to five months of life, and even though my second daughter is having bouts less frequently, she still has periods of extreme fussiness. The change is that I now know how to treat and even sometimes prevent them. 

Although no one really knows what causes "colic", everyone has their own theory. It really annoyed me when people would tell me I needed to stop eating my kale, cabbage, onions and spicy foods (being from Southern California, spicy Mexican foods have become a part of my heritage!) and that the colic would go away on its own. While studies show that some babies might indeed have an allergic reaction to certain food proteins that resist digestion in the small intestine and find its way into breast milk (usually typical allergens such as dairy, nuts or soy), I didn’t stop eating my kale and onions without looking into other possible problems and how to fix them. Here are some things to consider based on my studies and research:

Incorrect Latch Issues

A good latch is the key to easy breastfeeding! A lot of parents don’t realize that proper latch on the breast is absolutely necessary for a successful feed. This problem happens usually to newborns in the first few days after their mother’s milk has come in. If your baby is not latched on correctly, he could be swallowing a lot of air, thus making him gassy. Moms are also likely to have very painful nipples and even mastitis due to the improper latch. Latch is the easiest problem to solve if it is what causes your baby to have colic. 

My Suggestions:

proper latch is when the baby’s chin is pressed against mom’s breast and their nose is well away from the breast. I like to call the shape baby’s lips make a “fish’s tail”. Baby should also not be making loud sucking noises when he feeds. Contact a lactation consultant, your midwife or doctor if you have any concerns or issues with your baby latching on. 

 

Overactive or Forceful Letdown (Milk Ejection Reflex)

With both of my daughters, I have had an overactive letdown; sometimes so much that I could feel the letdown coming quite painfully. With an overactive or forceful letdown, your milk comes down very forcefully, making it hard for your baby to swallow while breastfeeding. Baby may even gag and swallow a lot of air along with the milk. An overactive letdown can cause baby to be fussy at the breast. Baby may also become unhappy once the flow of milk starts to slow down. 

When baby fills up on the watery foremilk, he may get a stomach ache from the combination of filling his stomach too fast, swallowing air to keep up with the let-down, and the laxative effect of a large quantity of lactose (milk sugar). The enzyme lactase, which digests the sugar, may not be able to handle so much milk sugar at one time and the baby will show symptoms of lactose intolerance—crying, gassiness, and explosive, watery, green poop. While people might that that having “too much” milk is a good thing, it can be very frustrating for both baby and mom.  

My suggestions: 

Keep baby on one breast per feed. If your other breast is too uncomfortably full, pump just enough between feeds to relieve the fullness, but not so much that you overproduce milk (Remember that milk production is a supply-and-demand issue). Make sure that your baby drains that breast completely to get all of the fatty hind milk, even if you have more than one let down. With a forceful letdown, it is usually the first let down that is the most painful.

Find a position that keeps baby’s head above your breast, such as propping baby up in a “sitting” position with your arm supporting him, to prevent choking during the letdown. You can also try feeding your baby while lying down in a side-lying position. 

My last suggestion is to take your baby off the breast when you feel a strong letdown coming. Catch the overflow of milk in a clean cloth, then place baby back on your breast once the letdown slows. This may or may not upset your baby more, so make sure you follow baby's signs cues. 

 

Sensitivity to cow’s milk proteins

This is NOT lactose intolerance. Lactose intolerance is the inability to digest the sugar lactose found in milk, while Cow’s Milk Protein Intolerance (CMPI) is an immunological reaction. Babies who are sensitive to dairy in mom’s diet are sensitive to specific cow’s milk antibodies in the form of proteins (not lactose) which pass into the mother’s milk. Cow’s milk (either in the mother’s diet or added into formula) is a common source of food sensitivity in babies. If your baby is sensitive to dairy in your diet, it will not help to switch to lactose-free dairy products. The problem is the cow’s milk proteins, not the lactose. 

CMPI can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea, bloody filaments found in stool, constipation, hives, and/or a stuffy, itchy nose1

My suggestions: 

If your baby is only a little sensitive to dairy proteins, you may be able to relieve baby’s symptoms by eliminating only the obvious sources of dairy: milk, cream, yogurt, butter, cheese, sour cream, ice cream, cottage cheese. You may even be able to eat small amounts of dairy without it affecting baby.

If your baby is highly allergic, it will be necessary to eliminate all sources of dairy proteins, which requires a careful reading of food labels. Also, a large amount of babies allergic to cow’s milk proteins are also allergic to soy1,2 and some may even react to goat’s milk, sheep’s milk, and even beef. 

 

Sources of Cow’s Milk Protein:

Beef, butter, butter fat, buttermilk, casein, cheese, cottage cheese, cream, ghee, half & half, kefir, lactoglobulin, lactose, all forms of milk (condensed, sweetened, whole fat, non fat, evaporated, skim, malted), nougat, pudding, sour cream, whey, whey proteins, yogurt. 

**Also make sure to avoid deli meats since many of them do contain dairy products or may have been contaminated with dairy during the process. 

Sources of Soy: 

Edamame, soybeans, soy proteins, soy milk, soy bean oil, tofu, tempeh, soy sauce, tamari, soy flour, miso, soy lecithin, and soy isoflavones.

 

It can take up to 2-3 weeks for the proteins to completely exit the mother’s system1, but sometimes baby can show improvement within as little as a week2

Once the trigger foods have been eliminated from your diet for some time, you can try slowly reintroducing dairy products. If baby still reacts, it is best to wait until baby is around 6 months old and his digestive system is stronger before reintroducing dairy into your diet3.  

The main concern with a CMRI elimination diet is the fact that dairy is a major source of calcium for many breastfeeding mothers, and without dairy it may be difficult for them to maintain the 100 mg daily recommended dose.

However, it is possible to consume enough calcium without dairy. Here are some sources of non-dairy calcium: 

Collards- 1 cup boiled and drained – 357 mg calcium

Rhubarb – 1 cup cooked– 348 mg calcium

Sardines – 3 oz / 85 grams – 325 mg calcium

Spinach – 1 cup boiled and drained – 291 mg calcium

Turnip Greens – 1 cup boiled and drained – 249 mg calcium

Blackeye peas – 1 cup cooked – 211 mg calcium

Kale – 1 cup boiled and drained – 179 mg calcium

Bok choy – 1 cup boiled and drained – 158 mg calcium

Beans, baked– 1 cup – 142 mg calcium

Okra – 1 cup boiled and drained – 136 mg calcium

Shrimp – 3 oz / 85 grams canned – 123 mg calcium

Crab – 1 cup canned – 123 mg calcium

If you are not sure that you are getting enough calcium through diet alone, consider a calcium supplement. If you do this, make sure that the supplement you choose is combined with magnesium in a 2:1 ratio so that your body will readily absorb it. 

**Before starting any elimination diet, please consult a nutritionist or your doctor to ensure you will be getting enough nutrients and to make sure you will not be deficient. 

 

Sources:

"Dairy and Other Food Sensitivities in Breastfed Babies." Kelly Mom. 26 July, 2011. Web. Mar 2014. 

"Cow's milk protein allergy through human milk." National Center for Biotechnology Information. March 19, 2012. Web. Mar 2014.

"Eating Like a Cow: Breastfeeding & Cow's Milk Protein Intolerance." Childhood 101. n.p. Web. Mar 2014.

Published in Feeding Baby

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