What to do about a Picky Eater

By Rosanne Jones MS RD CDN Pediactric Outpatient Dietitian, Center for Development, Behavior and Geneticis

Your baby is a good eater. When he was born, he took breast milk or formula without problems. He grew and progressed through all the baby foods and textures eating like a champ. Now, he is eating all types of table foods.

Until one day you plop a piece of lasagna (lasagna is just a fictional dislike, it could be any food) in front of him. The lasagna is a no-go; the nose squinches up, the eyebrows furrow and there is an expression of pure disbelief on his face that you have given him this food to eat. He gazes into your eyes as if to say “”help me!””

What do you do? Do you get up from the table to make him a grilled cheese sandwich or open a can of spaghettios? What happens the next time you make lasagna? Will you never make lasagna again? Do you make a second meal right from the start so that your child doesn’t have to eat that delicious nutritious lasagna? The answer is a resounding NO, NO and NO!

Babies grow very fast in the first year, tripling their birth weight, and then the rate of growth slows down from age 2 to the years before puberty. Quite naturally their appetite decreases during the periods of slower growth and increases during growth spurts. The valley between growth spurts can look like picky eating because the food they used to like, they no longer will eat, they pick at their food or they don’t want to try new foods anymore. The truth is they may just be growing more slowly and don’t need as many calories so they eat less.

The real advice is to consistently serve the meals made for the family to everyone in the family. In the wise words of Ellyn Satter, who devised the idea of The Division of Responsibility, ‘‘……trust in your child’s ability to eat what he needs and in his ability to grow in the way nature intended. Once you have done your feeding job of providing nutritious food, it is up to your child to eat what and how much he needs……’’

Other tips for health eating habits:

Pay attention to portion size Kids 5 years old and under require portion sizes about half the size of an adult portion size.

Beware of short order cooking This is food your child will usually eat but is not as nutritious as the meal you have prepared. If your child gets to eat this alternate meal each time, he may not grow as nature intended.

Avoid the idea of kid food You want them to grow up on the same diet as yours.

Be a good role model try new foods in front of your child.

Make dinner conversation about anything other than the meal itself.

So when you do serve that lasagna, put a small portion on your child’s plate along with a favorite veggie. Put something else with the meal like a piece of bread and a glass of milk. Your child will not go hungry if they have all that to choose from. Then button your lip about what he or she is eating or not eating. Relax, serve yourself some and talk about the weather.

Check out Ellyn Satter’s website for other recommended stratigies to work with feeding your child. http://ellynsatterinstitute.org.

Books to help you with a picky eater recommended by Mary Laverty Upstate Golisano Children’s Hospital

Everyone Eats! by Julia Kuo 2012. A colorful board book using familiar but hury animals to introduce young children to foods like apples, honey and carrots.

 

 

More Peas Please by Kate Di Prima and Dr. Julie Cichero 2009.A must-read guide to finding nutritious solutions for fussy eaters from first foods that won’t be spat out to lunch box fixes the envy of the playground. More Pea Please is an across-the-board guide to helping children learn to happily eat a variety of healthy foods. It examines the importance of feeding kids a balanced diet, helping them overcome negative responses to certain foods, and the significance of early feeding experiences on speech development. It also contains loads of easy, fuss-free recipes for delicious, family-friendly meals.

 

 

 

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Healthy New Year’s Resolutions for Kids from Golisano Children’s Hospital

by Mary Laverty, Family Resource Center MLIS, CAS TESL

Kids like to make New Year’s Resolutions just like adults. Involving the children in this fun holiday tradition can be an opportunity to discover shared interests and start conversations. Here are a few healthy resolutions suggested by the American Academy of Pediatrics.

The doctors, nurses and staff of Upstate Golisano Children’s Hospital wish all the children and caregivers in New York State, across the United States and our patients from around the globe a Happy Healthy New Year!

Preschoolers can be successful when they make personal resolutions:

I will clean up​ my toys and put them where they belong.

I will brush my teeth twice a day, and wash my hands after going to the bathroom and      before eating.

I will not to tease dogs or other pets – even friendly ones. I will avoid being bitten by keeping my fingers and face away from their mouths.

I will talk with my parent or a trusted adult when I need help, or are scared.

I will be nice to other kids who need a friend or look sad or lonely.

Kids, 5 to 12 years old can achive these healthy resolutions:

I will drink reduced-fat milk and water every day, and drink soda and fruit drinks only at special times.

I will put on sunscreen before I go outdoors on bright, sunny days. I will try to stay in the shade whenever possible and wear a hat and sunglasses, especially when I’m playing sports.

I will try to find a sport (like basketball or soccer) or an activity (like playing tag, jumping rope, dancing or riding my bike)  that I like and do it at least three times a week!

I will always wear a helmet when riding a bike.

I will wear my seat belt every time I get in a car. I’ll sit in the back seat and use a booster seat until I am tall enough to use a lap/shoulder seat belt.

I’ll be friendly to kids who may have a hard time making friends by asking them to join activities such as sports or games.

I will never encourage or even watch bullying, and will join with others in telling bullies to stop.

I’ll never give out private information such as my name, home address, school name or telephone number on the Internet. Also, I’ll never send a picture of myself to someone I chat with on the computer without asking my parent if it is okay.

I will try to talk with my parent or a trusted adult when I have a problem or feel stressed.

I promise to follow our household rules for videogames and internet use.

Teens, 13 years old and older, can see heathly success by making resolutions like these:

I will try to eat two servings of fruit and two servings of vegetables every day, and I will drink sodas only at special times.

I will take care of my body through physical activity  and eating the right types and amounts of foods.

I will choose some non-violent television shows and video games, and I will spend only one to two hours each day – at the most – on these activities. I promise to follow our household rules for videogames and internet use.

I will help out in my community – through giving some of my time to help others, working with community groups or by joining a group that helps people in need.

When I feel angry or stressed out, I will take a break and find helpful ways to deal with the stress, such as exercising, reading, writing in a journal or talking about my problem with a parent or friend.

When faced with a difficult decision, I will talk about my choices with an adult whom I can trust.

When I notice my friends are struggling, being bullied or making risky choices, I will      talk with a trusted adult and attempt to find a way that I can help them.

I will be careful about whom I choose to date, and always treat the other person with respect and without forcing them to do something or using violence. I will expect to be treated the same way in return.

I will resist peer pressure to try tobacco-cigarettes, drugs, or alcohol.

I agree not to use a cell phone or text message while driving and to always use a seat belt.

 

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Celebrating the Holidays with Food Allergies

By: Stacey Messé, Pediatric Dietitian, RD, CDN, CNSC

With the holiday season here, we all have a lot of things on our minds.  The holiday season can be filled with joy and laughter, but it can also be filled with stress and worry.  For parents of a child with allergies, this can be a particularly challenging time.  The holiday season is filled with parties, family gatherings, and other special occasions, which usually revolve around food and indulgence. These special occasions present many unknown challenges for a parent trying to manage their child’s allergy. Many holiday foods are laced with peanuts, wheat, eggs, milk, soy and other allergenic foods.

Some simple tips to help ease your mind and make the holiday season more enjoyable:

 If your child will be attending a party, contact the host or person in charge of the gathering.  Come up with a plan to ensure your child’s safety.  You could also offer to bring a dish to pass that your child can have to share with others.

 If your child has a holiday event at school that involves the sharing of food, speak with the teacher in advance or get involved in the planning committee to ensure there are allergen-free options available.

 Pack safe food alternatives for your child so your child doesn’t feel left out if there aren’t allergen-free options provided at a holiday event.

If you are preparing a holiday food or meal yourself, involve your child in the planning, shopping and preparation.  This will be a great opportunity for your child to learn safe cooking techniques, research recipes and check ingredients.

Get creative.  Try fun new recipes to help celebrate the occasion.  There are many cookbooks and recipes that alter or offer helpful ideas on how to accommodate for your child’s dietary restrictions. Try these websites for allergy free recipes and other great resources: www.kidswithfoodallergies.org  and www.foodallergy.org .

Ensure that your child understands that restricting food allergens is a full time job and the holidays aren’t an exception.  Discuss the risk factors with your child and prepare them to speak up when they recognize unsafe foods.  This discussion should be had in advance to help minimize temptation and improve compliance.

Encourage meaningful non-food traditions.  A holiday craft project can be a nice distraction from the common emphasis on food. www.pbs.org/parents/fun-and-games/activities-and-crafts/winter-holiday-crafts-for-kids/

If you will be traveling for the holidays be sure to plan ahead.  Verify an airline’s allergy policy if your child has a severe allergy to ensure safety.  Pack snacks and non-perishable foods to eat while traveling.

If your child has a life threatening allergy always have an EpiPen on hand in case of emergency.

Recommended books for young readers about Food Allergies by Mary Laverty, Family Resources and Services Coordinator, MLIS, CAS ESL, Upstate Golisano Children’s Hospital

Medikidz explain Food Allergies: Superheros on a Medical Mission (2009) by Dr. Kim Chilman-Blair. Young readers learn what to expect, how to react and how food allergies are treated in this graphic novel. A great book for older kids and teens. Includes glossary, further resources, and index.

 

Kylie’s Special Treat: A Food Allergy Fairy Tale (2012) by Letizia Barbetta. A  fairy tale about a girl who loves to paint, dreams of a prince, and has a food allergy. One day she receives an invitation to cook the prince a special treat. She happily bakes him her favorite dessert. Of course, it doesn’t include any of the foods she’s allergic to (milk, eggs, peanuts, and tree nuts). Kylie shows the reader how she manages her food allergies with poise and confidence, follows her dreams and goes on to live happily ever after. A simple baking recipe, food allergy tips and resources for adults are included.
The Peanut Pickle: a Story about Peanut Allergy (2012) by Jessica Jacobs. Living with a peanut allergy is hard, and peanuts are everywhere! Ben ate peanut butter when he was young and he had a bad allergic reaction. At first he was too scared to speak up about his allergy and tell people that he couldn’t be around peanuts. Now, he knows that speaking up is very important, since he encounters food with peanuts at school, at T-ball practice, at birthday parties, and during the holidays. The Peanut Pickle will help children learn how to tell others about a food allergy and explain that they need a safe environment. It will teach them how to deal with difficult and awkward situations that inevitably arise when a child has a life-threatening food allergy. It also includes a guide for parents to help their children with food allergies.

 

 

 

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Discussing Ebola with Your Children

By Dr. Jana Shaw, Pediatric Infectious Diseases, Upstate Golisano Children’s Hospital and the American Academy of Pediatrics webpage HealthyChildren.org

Editor’s Note: This page will be updated with new information as it becomes available.

Ebola has been a focus of daily news since the first infected patient arrived in the US in September. Given the severity of the illness, the news can be frightening to children. Hence it is important that parents and caregivers are prepared to discuss Ebola with their children to alleviate their fears.

It is much easier to catch to the flu or other respiratory viruses than Ebola. For example, based on the Ebola statistics we have right now, it is likely that flu will cause far more illness around the globe than Ebola will.

News Coverage Understandably, there is heavy coverage in the media about the spread of Ebola. However, it is a good idea to limit young children’s exposure to news stories about it. This way, parents can decide what information they want to share based on their child’s level of understanding. Here are some things to remind your children if they are concerned:

  • They are safe.
  • Our health care system is among the best in the world for taking care of sick people.
  • Ebola is rare and does not exist everywhere. When cases are found, the person with the infection is taken to a safe place to be cared for so that he can get better and not make anyone else sick.
  • Doctors and scientists who know a lot about Ebola are working hard to find ways to prevent or cure this illness.

Social Media With many children and teens spending a lot of time on social media, there is also the risk that they could read something online about Ebola that they do not understand and may become unnecessarily alarmed. Pay close attention to what your children are seeing online. Talk to your children and help them avoid graphic exposure to the media.

Keeping Calm News about the spread of diseases can be alarming, even for adults. Keep yourself well informed so that your own fears are under control. Talk with your children in ways that make sense to them so they don’t become overly concerned or afraid.​

Important facts for parents when explain Ebola and other viruses

What is Ebola? Ebola is a viral infection, yet it is very rare and is not easy to transmit from person to person. There is a serious outbreak in West Africa, however, in part due to lack of virus prevention and access to adequate medical supplies.

What are the Signs & Symptoms of Ebola? Ebola typically starts suddenly with a fever but symptoms can also include a severe headache, muscle pain, weakness, diarreah, vomiting, stomach pain, or unexplained bleeding or bruising. The time from infection with the virus to the onset of symptoms is from 2 to 21 days (with 8 to 10 days being most common). A person with the Ebola virus can infect others as soon as they begin to have symptoms. Early-stage Ebola disease may be confused with other infectious diseases (e.g., flu) because the initial symptoms are similar to those seen with other viral infections.

How is Ebola Spread? Unlike the flu, Ebola is not spread through the air or water. The chances of you or your children becoming infected are slim. Ebola is only transmitted through direct contact with the body fluids of an infected person or from objects like needles that have been in contact with infected body fluids. This means it does not spread through air, food, water, or by touching things like money and keyboards.

Can You Get Ebola From a Dog or Cat? At this time, there have been no reports of dogs or cats becoming sick with Ebola or being able to spread Ebola to people or animals. The chances of a dog or cat being exposed to Ebola virus in the United States is very low as they would have to come into contact with blood and body fluids of a symptomatic person sick with Ebola.

Can Ebola Be Prevented? Yes, killing the virus is easy. The Ebola virus can be killed with soap and water, heat, or a disinfectant or sanitizing agent.

According to the Centers for Disease Control and Prevention (CDC), washing your hands frequently or using an alcohol-based hand sanititzer is a good precaution. This is perhaps the most important message for children to learn and share.

Because people in West Africa may not be able to follow these precautions and may not have access to soap and water, Ebola has continued to spread.

A book explaining viruses and infections

Recommended by Mary Laverty, UGCH librarian

Infections Diseases by Anne Rooney 2011 published by Smart Apple

Kids will learn about the bacteria, protists, and viruses that have caused some of the world’s most wide spread infectious diseases as well as about important scientific advancements in the treatment of these diseases and the individuals who invented the cures. Young readers will walk away from this book with a deeper understanding of how diseases spread and how to combat them.

 

 

 

 

 

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Some Tricks for Enjoying Halloween !!!

   By Mardie Ninno –  Margaret L. Williams Developmental Evaluation Center, Kohl’s Autism and Related Disorders Program       

 Most children really enjoy Halloween!!  They love the pumpkin faces, the candy they get trick or treating, the costumes, and many of the older children love the scary movies and haunted houses that seem to be everywhere during October.  But for some children, especially children with Autism Spectrum Disorders or children with sensory or anxiety disorders, Halloween can be a really difficult time. Many of these children are uncomfortable with new and different routines, foods, clothing, etc, and Halloween certainly brings with it many novel and unusual sights, activities, and even foods.  Children with sensory issues may be hypersensitive to such things as the feel of the insides of pumpkins, the texture or fit of their costumes, or the unexpected and eerie sounds and music that might accompany a Halloween Party or trick or treating.  So how can families celebrate Halloween in ways that will help their children with these issues to feel comfortable and hopefully actually enjoy the season?

Offer Choices  so your children can decide what would be fun for them to do at Halloween.  Listen to their comments about what they would and would not like to do, and make sure they are an active participant in the decision making.

Prepare, prepare, prepare your child ahead of time!  All of us are more comfortable when we know what to expect, and for children on the Autism Spectrum, this is crucial.  Think about what activities your family would like to participate in. 

Outside Activites Do you want to visit a pumpkin patch that involves going on a wagon ride?  Then you might want to read books about visiting a pumpkin patch, look at the web site of the farm you will be visiting with your child, or look for You Tube or other videos of this activity.  Share these visuals with your child.  Remember, children with Autism tend to process visual information very well, so showing rather than just telling them what the pumpkin patch will be like will be even more effective.

 Costumes Do you want to dress up and go trick or treating in your neighborhood as a family?  Again, introduce your child to the idea of dressing up in a costume way before the big day.  Show them pictures of costumes in catalogs or on line.  Visit the costume section of a store to see costumes.  Help your children to choose their own costumes, and then let them have lots of opportunities to wear them before Halloween.  Some children may have difficulty with the tags, seams or textures of their costumes, so be sure to have them try on the costume before they have to wear it.  That will avoid melt downs and upsets by children whose bodies just don’t feel good surrounded by a slippery fabric or too tight hat.

Trick or Treating  Think about walking your trick or treat route with your children ahead of time, so that they are familiar with where they are going.  And practice the actual act of trick or treating at home.  Trick or treating can be broken down into these 4 easy steps:

  1. Knock on the door
  2. When someone answers, say “Trick or Treat”
  3.  Open your bag so that the person at the door can put in candy or a treat
  4. Say thank you

You might want to make a visual card to take with you to remind your child of these steps.  Or you might want to program these phrases into your child’s communication device.  Or you might want to write a social story about what trick or treating will be like and read it several times at home with your child.

Decorating Pumpkins: Some families like to decorate pumpkins together.  Your child with sensory issues may not like the feel of the insides of the pumpkin.  Or your child may be frightened or disinterested in this activity.   If that is the case, consider one of these options:

  • Offer your child gloves to wear or a spoon to use for the pumpkin scooping
  • Provide other craft materials to decorate the pumpkin that the child does like.  These might be markers, paints, colored tape, stickers, etc.
  • Dress up your pumpkin with your child’s clothing or toys.  Put her hat on the pumpkin’s head or have the pumpkin pose with a favorite stuffed animal.

 Halloween Treats If your child does not like the treats that are likely to be handed out at trick or treating or at Halloween parties, consider bringing foods that he/she will like.  Or bring non-food treats you know your child will enjoy.  You can also try introducing your child to new Halloween foods such as pumpkin cookies and candy corn at home ahead of time.  Your child will be more likely to try a new food in the comfort of his own home than in a strange place.

            Halloween can be a really fun time for families.  Thinking about the activities you would like your family to do ahead of time and preparing your child for them will go a long way to making sure it’s a real treat for everyone!

Armond Goes to a Party: A book about Asperger’s and Friendship by Nancy Carlson and Armond Isaak 2013 recommended by Mary P. Laverty Golisano Children’s Hospital in-house Librarian

A perfect book to share with children nervous about going to a party or any new social event. The colorful pictures and realistic dialogue make this a perfect read for guests and hosts alike.

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