The titles “Dietitian, Registered Dietitian and Registered Nutritionist” are protected in Alberta. Be sure to check for these titles when you are looking for reliable nutrition information. However, the term “Nutritionist” is not protected. Nutritionists may have varying levels of training and formal nutrition education, or none at all. For example, the title “Holistic Nutritionist” is becoming popular. Most holistic nutritionists have a 1 year diploma. I have been asked if my practice is “holistic”. While I do take into account other areas of your life that affect your health and nutrition, I also make sure that my recommendations are evidence-based.

Here’s a great article that explains it more.

Morning Hot Cereal Mix

½ cup oatmeal

½ cup Cream of Wheat cereal

½ cup Red River or other multigrain hot cereal mix

½ cup wheat germ

½ cup oat bran

½ cup raisins

½ cup mixed dried fruit (i.e. any of dried apricots, cranberries, dates, cherries, etc)

½ cup slivered almonds (walnuts would be fine too)

1) Mix all ingredients together in a large airtight container to keep for weeks.

2) To prepare cereal, use ½ cup dried mixture, with 1 to 1.5 cups water to make 1 cup cooked cereal.

3) Mix and heat on med-high until boiling. Continue cooking on low heat until mixture thickens to a porridge-like consistency. This could also be microwaved.

The type of iron in meat is heme iron, of which 15-35% absorbed (depending on if your blood is low or high in iron stores). The type of iron in other sources (vegetables, beans or fortified foods like infant cereals) is non-heme. Two-20% of nonheme iron is absorbed. Absorption of nonheme iron is also decreased by dietary factors like high calcium intake, tannins in tea, and phytates in whole grains and beans. Vitamin C can increase absorption of non-heme iron though, so serving that fortified cereal with fruit is a good idea.

From 7-12 months, babies need 11mg of iron. This is more than an adult male!  It is used to transport oxygen around the body and is important for energy and brain development. Until 6 months, most babies have enough iron stores from birth. This may depend on a few factors. For example, delayed cord clamping during birth can increase the baby’s iron status. And premature babies may have low iron, and need a supplement.

Breast milk is low in iron, yet has a high absorption rate 50%. Formulas are fortified, and about 12% of the iron is absorbed. Cow’s milk is very low in iron, and therefore should not be fed to babies before 9-12 months of age, when the baby is taking in enough iron from foods.

In the past month, I’ve taught two ‘Starting Solids’ group classes. Even though the recommendation to start with meats/alternatives is fairly standard, it still seems to shock parents. “Meat?! Isn’t it hard for babies to digest meat?” No. In fact, it is harder for them to digest grains! Janice Joneja (an allergist and dietitian) points out that from an allergy perspective, it is also more beneficial to start babies with meat. It is likely that you know some people who are intolerant of grains – celiac disease occurs in 1 in 100 people, for example. Yet how many people do you know who are allergic to meat?

You can buy meat in baby food form at stores. Or you can also make your own. I have some frozen ground bison just waiting for this fate! Bison is higher in iron than even beef, and is leaner too. Meat can be boiled to be cooked, as boiling adds a bit of moisture. Then just get out your food processor, blender, etc and blend the cooked meat with some fluid. The more fluid you add, the finer the puree can be. And starting at 6 months, babies can handle a bit more texture than the super runny rice cereal. I will be mixing the baby food with breast milk. You can add formula or water as well. The benefits of adding the breast milk include added nutrition, as well as a slightly familiar taste to your baby.

Want to know more about iron? http://ods.od.nih.gov/factsheets/iron/

Calgary Breastfeeding Matters Group Foundation
161 Chapalina Court SE
Calgary, AB
T2X 3X1
www.cbmg.ca

Motherhood Maternity
456 North 5th Street
Philadelphia, PA 19123

February 10, 2011

Dear Motherhood Maternity Marketing Department;

I am writing on behalf of the Calgary Breastfeeding Matters Group Foundation, to take issue with Motherhood Maternity’s partnership with Mead Johnson’s Enfamil infant formula.

By providing pregnant women with formula samples, your current partnership threatens the mom and baby breastfeeding relationship . Having a jar of formula easily available during the first days of breastfeeding makes it easy for a new mom to quit breastfeeding and offer the formula instead. Formula companies know this, and attempt to get the formula into the homes of pregnant women. Formula feeding can harm the baby and produce substandard development.

By providing Enfamil through your customer contact information and promoting Enfamil, Motherhood Maternity is violating the World Health Organization endorsed International Code of Marketing of Breastfeeding Substitutes. This Code states that: “(infant formula) should not be marketed or distributed in ways that may interfere with the protection and promotion of breast-feeding.” More specifically regarding the general public and mothers:
5.1 There should be no advertising or other form of promotion to the general public
of products within the scope of this Code.
5.2 Manufacturers and distributors should not provide, directly or indirectly, to
pregnant women, mothers or members of their families, samples of products within
the scope of this Code.

We request that you respond to this letter, and discontinue your marketing relationship with all infant formula companies.

Sincerely,

Jennifer House, MSc, RD
Board Member CGMGF
On behalf of CBMGF

cc: Elisabeth Sterken, INFACT Canada
Yeong Joo Kean, Legal Council IBFAN
Members, Calgary Breastfeeding Matters Group
Managers of Motherhood Maternity stores in Calgary, Sunridge, Crossiron Mills, Northland
Birth Unlimited
Calgary Attachment Parenting Society
Gene Zwozdesky Alberta Minister of Health
Dr. David Swann, Leader of the Official Opposition and Executive Council Critic
Dietitians of Canada

Here are a few suggestions:

January: Eat 7 servings of fruit & veggies per day. To make this happen, have the produce available. Buy lots of fresh and have frozen, canned and dried fruit and veggies available for when you run out.

February: Drink 8 glasses of water per day. You will need to take a water bottle with you all day! One bonus is that you may not feel as hungry when you drink lots of water.

March: Eat breakfast. Helps set your appetite and energy level for the whole day. Try to include at least 3 food groups (ie. cereal with fruit and milk, toast with pb and banana).

April: Avoid white grains. Buy only whole grain pasta, rice, cereals and breads. This will increase your fibre intake, leaving you feel more satisfied, control blood sugars and cholesterol. To learn about reading bread labels, watch my clip from Global TV.

May: Avoid pop and sweetened beverages. Unlike food, our appetite doesn’t compensate for these empty liquid calories by being less hungry later.

June: Plan a healthy afternoon snack. This is a common time for fatigue and hunger that lead to less healthy food choices. Have trail mix, nuts, fruit leather, fruit, yogurt, cheese and crackers available, to hold you over until supper.

July: Meal plan your dinners, week by week. This will save those extra trips to the grocery store and drive-thru as well as the stress of “What’s for dinner?!”. I like to plan 2 fish meals, 1 beef/pork meal, 2 chicken meals and 2 vegetarian meals (eggs/beans). If you need help with this, check out my services as I can make a meal plan for you!

August: Eat with your family at least 1 meal per day. This is a great chance to connect with your family. Adolescents who eat regular meals with their family not only have a healthier diet, but do better in school and are less likely to be involved in risky activities like drugs.

September: Let go of food battles with you kids. Remember it’s your job to provide your child with food at regular times during the day. It’s their job to choose how much they eat or if they eat at all. If you try to make them eat more or less, let the battles begin!

October: Take a Vitamin D supplement October – March. These are the months when we can’t make enough vitamin D through sun contact on our skin. Vitamin D promotes bone strength and may help prevent autoimmune disorders and some cancers.

November: Eat until comfortable. It’s not just what you eat but how much you eat. If you avoid becoming too hungry (by having regular snacks), you can eat until you are comfortable at your meals. Avoid eating quickly, and leave the table before you are stuffed!

December: Eat fish twice per week. The types of omega 3 fats from fish (DHA and EPA) are not only heart healthy, but also needed for developing brains of babies & young children. They may also help prevent postpartum depression.

NOTE: If your child is under 4 years old, avoid small hard and round items that they could choke on, like popcorn, hard candies, gum, jellybean, nuts, whole grapes, fruit pits, etc.

Banana Split: Spoon yogurt in the centre of a cereal bowl, and place banana halves on either side. Sprinkle with strawberries, pineapple (or any other fruit you have on hand), and granola.

Potato Nachos: Microwave thin slices of sweet potatoes until tender. Top with tomatoes, green peppers, grated cheese and mild salsa. Microwave until cheese melts.

Nutbutter Dip: Puree ½ cup nut butter (peanut butter, almond butter, etc) with 1 cup plain yogurt. Yummy as a dip for fruit.

Mini Pizzas: Toast whole wheat English muffin halves. Top with shredded mozza, tomato sauce and veggies or other favorite pizza toppings (ham, pineapple, mushroom, peppers). Microwave until cheese melts.

Aunts on a Log: Fill celery slices with nut butter, and top with raisins.

Bunny Snack: Use canned pear halves, or cut a fresh pear in half and take out the core. Fill the pear centre with cottage cheese. Add raisins for eyes and a belly button!

If you try to force your child to eat more, again it will backfire and they will probably eat less than they really want to. Children have little control over things in life, and the amount of food they eat is one of the things they can control! This can turn eating into a power struggle between parents and children. Children “win” and everyone ends up frustrated every time they sit at the table.

Too much?? If you have been restricting the amount of food that your child is allowed to eat at scheduled meals & snack times, it IS possible that they have reacted by overeating when they get the chance. If your child knows that they will not be allowed to eat until they are satisfied, they will compensate by stuffing themselves when they can. However, if you have allowed your child multiple portions if they are still hungry, and not tried to control the amount of food they eat, then they probably really are still hungry!

Children are the best regulators of their own appetite. We know some days (or weeks) they eat next to nothing and you wonder how they survive. Other days they could eat and eat and eat! This depends a lot on their growth rates, teething, illness, etc. Remember the Feeding Relationship rules. The only role of the child is to determine how much or if they eat what they are offered.

If you are worried because your child is “overweight”, try not to be worried. People come in all shapes, and weight is not always the best indicator of health. If you offer your child mostly healthy foods at regular times, in the portions they choose, they will get the food and nutrition they need to grow to their healthy weight (which will change as they age and grow).

As for multivitamins, if your child is a pickier eater, then they can’t hurt. They provide a bit of nutritional “insurance” although they don’t make up for an unbalanced diet. Children’s multivitamins contain small doses of a variety of vitamins and minerals, so they are not harmful, and may be beneficial for your child. But are also not really necessary for most kids. If it makes you feel better to know your child is taking a multivitamin, go ahead!

If your family does not eat fish twice a week, I often recommend a fish oil supplement. Not just “omega 3″, as this may contain more ALA (from flax, canola, etc), rather than the DHA omega 3 type of fat that is most important for development.

Also, if it is winter in Canada, I would definitely recommend the whole family take a Vitamin D supplement. From October through March, our body can not make enough vitamin D from skin contact with the sun, due to our latitude. If you are especially vigilant about sunscreen in the summer, this also blocks vitamin D absorption through the skin, so you can continue the supplement. While dosage amount recommendations are conflicting among health organizations, 400IU per day should be fine for a child. I prefer “D Drops” or products with little additives that require only one a one-drop dose.

Feel free to contact me if you have questions or comments!

Also try to keep milk at scheduled meal and snack times once your child is in this routine (at about 1 year), to protect their appetites and teeth. If your child does not like cow’s milk, you can try fortified almond or hemp milk once they are two. Before the age of two, it’s best to stick with breastmilk or formula if they continue to refuse cow’s milk (but you can continue to offer it!). You can also try different cups (sippy cup, cup with straw, cup with no lid) and different temperatures for the milk. Yogurt and cheese are also good sources of calcium, but are not often fortified with Vitamin D like fluid milk.