Say "NO!" to the Pouch

I’m sure you’ve seen fruit/vegetable pouches at the grocery store and have seen kids squeezing some type of puree into their mouths through a little spout. There are pouches with fruit, pouches with vegetables, pouches that contain organic produce and even pouches with beans and avocados in them. There are even re-usable pouches you can buy and make yourself at home. If you ask me, the baby food pouch market is a little ridiculous. Did you know that pouches now account for 25% of the baby food market?! Sure, the idea of getting your kids to eat a wide array of foods is great, but what grown adult eats these food items out of a pouch?!

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Now, if you have given your child a fruit/veggie pouch, don’t feel like you have messed up. It is not the end of the world. However, I am here to tell you that your child is in no way, shape or form NEEDS a pouch to eat their fruit and vegetables. This has been on my mind the last several weeks, because I have encountered several parents who were talking about their child eating vegetables and then they followed up by saying '“in a pouch.” That just made my heart hurt, because from a sensory perspective that child is missing out on SO much. Now, if you give your child a pouch of organic, blueberry and acai berry puree on occasion that is fine, but if your child is depending on pouches to “eat” vegetables, we might want to chat offline.

Let’s talk about the pouch phenomenon from a sensory perspective. Let me clarify - I am not an Occupational Therapist, but I have done some sensory food training (the SOS Feeding Method) and I have worked with several OTs over the past eight years. I know just enough to help explain the basics to you. When your child eats food, they are experiencing so much more than it may first appear. They are touching the food and getting to feel it. They are smelling the food and they are looking at the color and texture of the food. They are getting to taste the flavor of the food and they are getting to watch you eat the food as well. There is so much sensory input that is happening when a child eats. When you give that child a pouch of food, they are missing out on ALL of those sensory experiences. They don’t get to touch the food, they don’t get to smell it, they don’t get to see it and the only sense they get to use is their mouth. Can you imagine having to taste something that you can’t smell, see or feel first? That is a rather shocking experience. Add to that the fact that no one else around you is eating out of a pouch. Imagine how you would react.

My main point with this post isn’t to shame you if you give your child food pouches. I simply want to provide you with some reasoning behind why offering your child pouches on a regular basis might not the best idea. If you have a child that is really picky and is struggling with some sensory issues, and therefore, you rely on pouches, consider working with a feeding therapist. I would be happy to work with you and point you in the direction of a great feeding therapist if you need it.

Eating is such a wonderful sensory experience. When we deprive our children of the opportunity to use their senses while eating, we start to see them struggle with eating. So, while you may choose to use pouches on occasion, please don’t rely on them as a normal meal source. The best thing to do is to prepare soft foods for your child and offer them what you’re eating.

Next time you are in the baby aisle, walking by the baby food, keep going and just say “no” to the pouches!

Resources:

Weight Watchers for Children?!

If you haven’t heard already Weight Watchers has launched an app for children. Yep, you read that right, an app targeting 8-13 year olds and focusing on green, yellow and red foods. When I started hearing about this, I was first really surprised. Then that surprise was followed by being slightly upset and then realizing that I shouldn’t be surprised. This “diet culture” that is very pervasive in our world is now reaching our children, who aren’t even in middle school yet.

I can definitely acknowledge that there is an obesity problem facing Americans. From adults to children, as a country we struggle with being healthy, but I strongly believe that an app targeting children and trying to help them “diet” is NOT the answer. This app is called Kurbo. There are lots of articles that are showing up online addressing this app. I am not opposed to the Green, Yellow and Red light method for nutrition education, but it isn’t my favorite. Why? Because children are so literal. If a food is termed as “bad” then they remember that and they don’t want to eat those food items. Children’s processing abilities are very black and white. That is why using the term “good” and “bad” is tough for them. I am in support of the all foods fit method. Focusing on eating more healthy foods, but not overdoing the special, treats.

This picture below is from the Kurbo app and showing how it works. You log your food intake and then the app organizes it into green, yellow and red categories. The part that bothers me is when you consume “too many red foods” then the app will tell you that and “encourage” you to try other “green foods” instead. All of the foods that are listed as “green foods” are fruits and vegetables. That is a great goal, but one can not live on only fruit and vegetables. You need some other forms of protein and fat sources to help your muscles grow appropriately and then a child’s brain develop. Plus, this app is promoting before and after pictures of children who have lost weight. This was extremely upsetting because that is not at all how we want children to gain confidence. Their self worth should not be tied to a picture of themselves.

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My point of sharing this with you all is to bring the focus to this “Diet Culture” that is persistent in our environment. This is NOT the message that we should be sharing with our children … that they NEED to lose weight to “make their parents happy.” Children should never be put on a diet, because research shows that is not helpful for their development and leads to a negative relationship with food and often creates more eating issues as they grow. Having a goal to get children to be more active and choose more nutritionally dense foods in their diets are perfect things to focus on as a family. I think the other part of this that really bothers me is the fact that this is suppose to be used by the child and doesn’t include the family. Whenever I counsel a family with a child who is overweight … the goal is lifestyle modification for the family and it is a whole family affair. The child doesn’t go to the store and purchase food … that is the parent’s role so that education needs to include the parent to help provide more nutritionally dense choices and the child can choose how much of those food items to eat.

No child should ever be told that they are fat and they need some app to help them fix some weight problem about themselves. I am not a fan of weight loss apps and I don’t like how people get caught up in “good” and “bad” foods. The goal with weight loss counseling is working to make small life style changes that are sustainable. Using an app can’t really help with that. As a parent be aware that this app is out there. This is dangerous and not at all helpful to building children up and fostering a positive relationship with food/their own body image. Working with a Registered Dietitian Nutritionist can be a helpful tool to make small changes for the entire family. If you have questions about your child’s weight or concerns about making food changes - reach out and let me know. This can be tough, but with the help of trained professionals there is a way to encourage and foster a healthy relationship with food and help children grow and develop in a positive manner.

Baby Led Weaning #2

I wanted to bring up the topic of Baby Led Weaning again, because we are once again in that phase of life. My youngest is now 6 months old and we have started with table foods. This is kind of a big deal and crazy to think that our little man is half way to his first birthday.

If you can remember, back 2 years ago, I started William with Baby Led Weaning. If you want to read about that experience - CLICK HERE. With this second time around, I feel more comfortable introducing my little one to table foods, but has been a different experience. William was already sitting up independently at 6 months. Samuel is not sitting unassisted yet, but doing great at pivoting on his belly and rolling from back to front and front to back. He has been sitting with me at the table when we eat dinner and loves to be at the table. I have now been placing him in his high chair and giving him soft foods that we are eating at dinner. He loves being there with the family and is always so excited. He is grabbing the food and working on getting it to his mouth. The large majority of food falls to the floor or into the chair, but he tries so hard. He is doing a great job and I am working hard to not compare him with his brother.

We have tried a large variety of foods already - Chinese noodles were a big hit, he loved veggie straws, cooked veggies like broccoli was fun to try as well. William loves to try to “help” him eat as well. We are trying to teach William to let Samuel learn on his own.

Key Points with Baby Led Weaning to Remember …

  1. Coughing is good. This is one of the biggest initial challenges with baby led weaning. Most parents worry and freak out when their baby coughs, but coughing is a good thing. The baby is working to protect their airway and learning how to properly do that. Remain calm at the table, we often praise the cough and say “good coughing” with a smile.

  2. Eating is for practice. As I mentioned above so much of the food that I give Samuel never makes it into his mouth. Instead it is all over the floor, in his chair or on his clothes, but that is fine. The goal is smelling, touching, tasting and some eating at meal time. It is a complete sensory experience and the goal is a positive interaction with food.

  3. Keep things positive. Some times the amount of time the baby is in the chair isn’t the entire meal time. There have been a couple of meals, where Samuel was not into eating, was tired and cranky. He sat and tried food for maybe 10 minutes and then when he was obviously done, I asked him “all done?” and then once he was calmer, I took him out of his chair. It isn’t about how long the baby sits in the chair, but instead cultivating a positive eating experience.

  4. Variety. The amazing benefit of baby led weaning is the ability to exposure your child to new foods. Work to eat a variety of foods and then give those to your child as well. We always aim for a vegetable, entree/protein and a fruit at dinner. We try to switch things up and then never order kid’s meals at restaurants. We purchase a regular meal and then share it with the child. Normally the kid’s meal is just chicken nuggets, applesauce, more bland foods with limited variety.

  5. Family meal time. Working to have that family time and sitting together at the table is important for teaching your little one how to eat and how that social event occurs. Children who have family meals do better in school, feel more supported by their family and tend to eat a wide array of foods. This is a win, win, win for all involved.

If you have any questions about baby led weaning, let me know. Check out some of these pictures of our meal time. If you want some additional resources check out - Fortified Family, Feeding Littles, The Baby Led Weaning Cookbook.

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Infant Driven Feeding

I had the opportunity to listen to a CCC-SLP talk about infant driven feeding and working with infants to learn how to eat in a positive manner. I know for most of you this might seem like a simple concept, but for all babies it is an acquired skill.Please recognize that I am not a SLP, but I am a pediatric RD and I have been trained in infant feeding and the SOS feeding method. I am not here to try to diagnose swallow dysfunction, but instead to focus on watching feeding cues and helping to create a positive feeding environment.

A baby in utero starts to suck and swallow as early as 12 weeks gestation. Throughout their time in utero they are sucking in amniotic fluid and then swallowing it and peeing it out. The act of eating is a series of processes - sucking, swallowing and breathing and doing this in a coordinated manner. For those babies born early, they miss out on practicing this skill in utero. We will watch for oral feeding cues around the 32-34 week gestation mark and then often infants will be allowed to start orally feeding ~34 weeks gestation with proper feeding cues.

Well what are feeding cues? Feeding cues include behaviors that a baby is going to show that they are hungry. This could include, waking up, starting to move around/fuss, putting hands in our around their mouth, and rooting whenever anything gets near their mouth. Most of us are familiar with cues to show that a baby might be hungry.

I would say that most adults are less familiar with stress cues. What are stress cues? These are signs that a baby is showing that they don’t want to eat. This would be if they are arching/pulling away from the bottle or breast, if their brow is furrowed, if they are excessively blinking their eyes, crying, trying to not latch onto the bottle or breast, not opening their mouth, putting their tongue to the roof of their mouth or simply not sucking on the bottle or breast. These are all signs that the baby isn’t ready or wanting to orally feed.

For most term infants who are healthy, after the first few days of life they are getting the eating routine down and they learn those skills and take off. With preterm infants, this is a lot harder and they don’t tend to have such positive experiences all the time. Eating is extremely hard work, it is exhausting and if they are sick, have low stores and can easily burn more calories than they are consuming if feedings go longer than 30 minutes. Plus if you are pushing a baby to orally feed, who isn’t ready you can create a feeding problem. That baby can silently choking or aspirate that breast milk or formula and that can lead to an infection, like pneumonia. Unlike older children or adults, babies don’t really cough when they choke. They can still choke on a feeding and you wouldn’t know (we call that silent aspiration).

Why I am going through and sharing this information with you all? Because this has been a topic of discussion in our NICU, because one of the basic things a baby needs to do to go home is eat. So much focus is placed on volume intakes and growth and parents get caught up in volumes and trying to meet numerical goals. Volumes do matter, but honestly for the long term development of a child, volumes don’t matter as much as the quality of the feeding. Is the child calm, able to coordinate sucking, swallowing and breathing and are they able to take an appropriate volume in an appropriate amount of time while keeping their composure. Having well trained RNs who can watch for stress cues and are able to help teach the baby who is eat in a calm way is key to the long term feeding success for that child. Most parents who have term infants, don’t have to stress and worry about feedings in the same way as a parent of a preterm infant. The key is help teach parents how to properly feed their preterm baby so that the baby and the parents are not stressed. Whether you are feeding your preterm or term baby, make sure you watch for any stress cues with PO feedings and then stop a feeding if the baby isn’t able to maintain a calm state. It is not worth force feeding a baby. If you have questions or concern about your child and feeding, reach out to your pediatrician to talk about your concerns and they can help get you in touch with SLP to discuss any oral motor feeding concerns.

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Toddlers and Family Meal Times

It has been a little bit of time since I had written about working with your child and eating. You all know that I am firm believer in Baby Lead Weaning and that is what we did with William starting at 6 months. I plan to do a similar thing with Samuel here starting at the end of August. Over the last 2 years we have worked hard to expose William to wide variety of foods and have him eat whatever we are eating. Baby Lead Weaning worked great for us and we really loved the variety and flexibility with feeding William whatever we were eating that day.

No that 6 month old baby has grown into a 2 year old toddler with opinions on food. As my child has gotten older, I am still a firm believer in baby lead weaning and now things are looking a little different with toddler meal times. For example, this morning for breakfast, I made yogurt, topped with chopped strawberries and toast with butter and jam. I had this out on the table for breakfast. When my toddler got to the table he was all upset that I had given that yogurt and he wanted other yogurt. Then he didn’t want toast, he wanted cereal. So we had tears and I informed him that his breakfast was made and he was welcome to eat it and if not then he would be hungry, but this is the meal that mommy made for him.

If you have a toddler, you understand that they want to exert their independence and then they don’t like change. It is a perfect storm if something deviates from a plan and their “freedom” gets “taken away.” This is a learning opportunity though. I could easily could have given my child what he asked for at breakfast, another yogurt and cereal and I would have avoided tears, but then that power shifted from me to my toddler. Then you know the next morning, we could have the same meltdown again. It wouldn’t have been a long term solution.

Please remember, that you are the parent and you should feel empowered at meal time that you provide the food and your toddler decides how much they want to eat. Meal time for toddlers is a balancing act between independence and then following directions. You are welcome to give your child choices, but then once they decide something you have to stick with that decision. The other thing that toddlers are is indecisive. For example I bring snacks for the drive home. We eat an apple and I have been bringing a cheese stick. This afternoon, I offered my toddler his cheese stick and he said “no!” I was like “ok,” got in the front seat and we drove off. He then had a melt down because he wanted a cheese stick. I had to remind him that I had offered it to him and he has refused it. I waited until he calmed down, asked him if he wanted it again, when he said “yes” I reminded him to say “please” and then I gave it to him. Again, in that scenario, I kept reminding him that he had said “no” and refused what I offered. Remember, you as the parent get to decide what the child eats and when they eat it, but the child gets to decide how much or if they refuse.

Toddlerhood can be challenging, but I think the key components from Baby Lead Weaning (offering healthy foods, giving 2 choices, deciding when the child gets the food) hold true. Working and teaching the toddler how to communicate what they want and then letting them decide how much they are eating of the offered food item. So if you have toddlers, don’t get discouraged. Stick with your word, don’t back pedal and reassure yourself and your toddler that is the best thing for everyone. Meal time is suppose to be a positive time when everyone is together at the dinner table. Some nights are more positive than others, but even on those rough nights, taking the time to eat together is important.

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Community Supporting Moms Pumping/Breast Feeding

I had the opportunity to meet the creator of the Pumpspotting App this last weekend - Amy Vanharen. This app is such a neat program that works to create a space for pumping/breast feeding mothers to come together. I was able to meet up with the Pumpspotting bus that is touring around the United States. It had come to Carmel, IN at Urban Chalkboard and it was so neat to get see what this company was working towards. Their mission is to make breast feeding and postpartum less isolating and more supportive at every stage of the journey.

Pumpspotting Tour Schedule - CLICK HERE

I honestly wasn’t super familiar with the Pumpspotting App, but I love the idea of having a space for women to support each other and help one another find good places to pump/breast feed their child(ren). If you haven’t seen the app before, definitely check it out.

This also made me think about the whole idea of “mom guilt” that can surround feeding your baby. So many mothers feel like there is a certain standard for the best way to feed your baby and have such emotional feelings about this topic. If you think about it, feeding your baby is one of the most basic and motherly instincts that you experience. Feeding your baby is challenging and whether you are formula feeding or using breast milk it is challenging to feed your baby around the clock. As a Registered Dietitian, I appreciate seeing the evidence and knowing what is scientifically proven when it comes to making nutrition choices a child. Using breast milk for babies is the most natural and the most ideal option for a term, healthy newborn. Formula is an amazing tool that has helped to provide well-rounded nutrition to those infants who need an alternative to breast milk. Working in a NICU, we use formula and additives all the time to help these small, preterm infants grow appropriately because they have increased energy needs. When it comes to feeding your baby, there are so many factors at play and each mom/baby are different and each pregnancy is different. Making that choice that is best for you and your baby is important.

Having a community to help support you as a mother is key. Whether is an app like Pumpspotting, a group like the CityMoms or close friends you trust. Parenting is hard and as a mother feeding your baby is tough. If you choose to breast feed, that can be extra challenging at times as well. I am so happy to see that there are moms out there working to build one another up and support each other! Here’s to you mama and all that hard work you put into caring for your child(ren).

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Help, My Child is Vegetarian!

It can take you by surprise if you child comes to you and informs you that he/she have decided to become vegetarian. This can be shocking to a parent and very overwhelming. For families who eat a lot of meat this can be very challenging as well. Learning how to work through this dietary choice as a family is important. I have experienced this first hand in my own family and then also worked to counsel families who are going through this experience.

My younger sister decided to become vegetarian when she was in college. She made the choice to stop eating meat and if I remember correctly this happened in the summer immediately prior to a family vacation. It was challenging for my family, because my sister was also restricting her overall caloric intake and then struggling with disordered eating. My sister has continued to be vegetarian for several years, but has thankfully overcome disordered eating and still practices vegetarianism in a healthier way now. This was obviously challenging for family to navigate my sister’s dietary preferences with the rest of the family.

It is important to help remind the parents that their child is making a choice about their diet isn’t a personal reflection of them, but instead an expression of their child’s independence. Talking through why their child is choosing to avoid meat, where is the desire coming from and what prompted that change? How does it make the child feel? How can the parent work to support their child’s independence in a healthy way? If you child is choosing to be vegetarian that is great, but they need to be choosing healthy foods. Being vegetarian doesn’t mean they should be eating crackers all day with PB&J sandwiches for every meal. Being a healthy vegetarian means that they are consuming more fruits and vegetables and finding ways to increase their consumption of plant based proteins (beans, soy, hemp, etc). Also making their that the child’s choice to be vegetarian isn’t an excuse to calorie restrict. Sometimes disordered eating is masked by a dietary preference like avoiding meat, or cutting out a particular food group. That is unhealthy and not safe for a growing child. Working with a Registered Dietitian to help facilitate these discussions can be helpful. It is tough sometimes for a parent and child to have an open and productive discussion without a 3rd party to help mediate. It is easy for emotions to get in the way and then creative a stressful/hostile environment.

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  1. Discuss this dietary change and what all surrounded this shift in eating. Having this open communication is key to embracing and working through this new behavior in a positive way. This can be where having another person, like a Registered Dietitian, can be helpful to lead this discussion and help both parties (child and the parent) share their feelings in a non-judgmental environment.

  2. Talk about what this means in terms of the family dynamics at meal time and in regards to food preparation. This is one of the biggest challenges. For most families, if one child is choosing a different diet/eating habits from the rest of the family that makes meals complicated and can add stress. Talking about how everyone in this family matters and there will need to be some compromise to make this work. There can’t be two separate meals each night for dinner and the vegetarian child can’t be eating “special” foods all the time that will make other siblings jealous. Coming up with recipes and meal ideas where the family can “build” their own dinner plate with meat and non-meat options can be one of the best ways to accommodate special requests. For example, if you are having hamburgers, then have meat burgers and veggie burgers available for the main entree. If you are having a grilled meat item, then make sure there is an acceptable non-meat option (grilled mushroom, tempeh or vegetables kabobs).

  3. Brain storm ways for the child to help take ownership over his/her meals (list making, shopping, cooking and cleaning up). Including your child in the meal planning and preparation process is a way to help them assuming responsibility for their meals. If your child is choosing to eat vegetarian then they can help come up with food items they would like include for meals/snacks that are healthy and don’t contain meat. They can also help prepare those items since they are part of the family. I believe that all children need to be involved with the food preparation and these skills help them grow up into independent people.

Talking with your child about healthy eating habits is important. Working to accommodate their dietary preferences/choices is important as well. If you child has chosen to be vegetarian, there has to be some reason behind that change. Maybe is stems from a discussion they had with their peers and it leaves them really be grossed out or concerns about processed meat items. Maybe they are trying to restrict calories and that is presentation of vegetarianism is just a symptom of a deeper issue. As the parent, talking with your child is key to better understand what they are thinking and working with them to make healthy decisions. If you have questions about working with your child and dealing with food choices/dietary changes, let me know and I would love to be able to work with you and your child.

ADHD and Nutrition Intake

I recently had the opportunity to work with a family whose son was diagnosed with ADHD and I started doing some more in depth research on nutritional intake. Just like with anyone, what you eat can have an impact on how you feel and how your body works. As the years have gone by there has gotten to be more research on the topic of nutritional intake and ADHD.

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Sometimes children with ADHD are not always interested in eating enough food and sometimes medications they are put on cause a decrease in appetite. Making sure that children with ADHD are eating three meals a day with two snacks is important. So working to optimize the nutritional intake of the meals and snacks will help give you the biggest nutrition bang for your buck. Noting the timing of the medication and then when your child is the least hungry compared with being the most hungry. Trying to time nutrient dense meals/snacks around those optimal eating times can be helpful as well.

There are some key nutrients that have been shown to be low in children with ADHD. It is true that for all of us our food intake plays a big role on our behavior. Often children with ADHD had sub-optimal eating habits and parents tend to feed these children whatever foods they will accept and eat, because meal times are stressful. Learning more about what nutrients can be focused on and then working to offer these children well balanced meals and snacks can have a big impact on how that child feels, how they grow and how well their brain functions. The following is a list of nutrients that have been researched and shown to have some positive impact and correlations with improved ADHD symptoms.

Omega-3 Fatty Acids

  • ADHD is a neurodevelopmental disorder and the thought is if we provide a fat supplement this will help with brain neurotransmission and help treat any behavioural dysfunction disorders. Your brain uses fat as fuel and making sure that you are choosing anti-inflammatory unsaturated fats and consuming enough of those has been shown to have a positive impact on behavior outcomes.

  • Food sources that contain high amounts of omega-3 fatty acids include: flaxseed, walnuts, chia seeds, cold water fish (salmon, mackerel and trout). Limit consumption of fish in young children to 2-3 servings per week.

  • What about a supplement? There is a product that has been researched and has a blend of Eicosapentaenoic acid (EPA), Docosahexaenoic acids (DHA) and Gamma linolenic acid (GLA) and children in this study took this supplement over 12 months and didn’t need to increase their medicine dose and reduced their ADHD symptoms. Equazen is available in pill or gummy form through Amazon.

Iron

Zinc

Magnesium

Good For Your Greens

Spring is officially here and we have just wrapped up March and now it is April. That means that things will start to turn green soon and people will plant gardens and fresh produce will start to grow. I love it when seasons change and I especially love being able to enjoy fresh produce that I have grown or purchase from the Farmer’s Market. There are so many delicious fresh vegetables to enjoy and one of the first vegetable items that will be available is fresh lettuce.

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I am not sure how many of you have children, but it can be a struggle for parents to have their children eat vegetables, let alone green vegetables. Depending on the age of your child, it is normal for them to want to be independent and have their own opinions and often this comes out at the dinner table. I wanted to share with you some tips and tricks to help you get more green veggies into your meals and help your “picky child” eat those vegetables that you have prepared.

Green vegetables are good for you, but why? What makes green vegetables healthy? The color green is made from a compound colored chlorophyll and this pigment absorbs like and is critical to the process of photosynthesis within the plant. That process of photosynthesis is the plant’s way of taking sunlight and processing it into usable energy to grow. Without the chlorophyll, the plant couldn’t collect and process the sunlight.

So plants are green, because they contain chlorophyll, but is that what makes them healthy? Not necessarily, the main reason that green vegetables are healthy is that they contain other vitamins, minerals, fiber and antioxidants that are used and metabolized by our bodies to fight off diseases and help us stay healthy and grow strong. The green color serves as a symbol that there are other vitamins, minerals, fiber and antioxidants in that food item and it is good for us.

Ok, so green vegetables are healthy, but how do I get my picky child to try those foods? It can be tough to have a power struggle at the dinner table over vegetables. Honestly, that is not the ideal situation for yourself or your child. The time to start talking about and teaching about how good and healthy green vegetables are, is earlier. When you are grocery shopping, stop and look at all the green produce and talk about the different types of vegetables (lettuce, broccoli, brussel sprouts, asparagus, green beans, etc). Have your child help pick out a new vegetable to try and take it home. Then include your child in the preparation/cooking process for that food item. If your child choose broccoli, have them help you wash it, cut it up and then cook that vegetable. You can talk about the food item and discuss how it looks like tiny trees and how the top of the broccoli is bumpy and how the stalk is smooth. Then at dinner time have your child help serve the broccoli to everyone at the table (including themselves). Then at dinner, make sure that you eat the broccoli as well and talk about how good it tastes. Encourage your child to try 1 bite. Then praise them for helping to cook the food and taking a bite. Then leave it at that. This takes time and it is a process. Don’t feel like your child is going to eat all the broccoli right away, but keep offering that food item to them and keep including them in the cooking process. It is tough, but you are not in this alone and learning about how good for you green foods are is just the beginning of learning to explore and love food!

Check out the picture below with some other tips on dealing with picky eaters! If you have any other questions, feel free to reach out and I would love to work you and your children on trying new foods and making dinner time a more positive experience.

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Breast Feeding Baby #2

I started back to work this week and it has been crazy. It has been a good crazy. My little guy is 7 weeks old and I am back in the working routine. Well, attempting to get back in the swing of things. My wonderful mother is watching the baby at our house this week so that is easing the transition. Being a working mom and organizing the life of two children, one dog and a husband is quite the undertaking. When I head out in the morning I have so many bags … my work bag, my lunch bag, my pumping bag, William’s bag, William’s lunch bag and then starting next week Samuel’s food/bottle bag. I swear I move in and out of the house each morning and evening.

I thought it would be great to touch on breast feeding again. It has been a little while since I talked about breast feeding. I have decided to breast feed my second child. I breast feed my first through 18 months. It was at that point that I ended up being pregnant again and then my milk supply decreased and he wasn’t that interested in breast feeding any more. It was a smooth transition to stopping breast feeding and it was nice to not juggle breast feeding and being pregnant. I made the choice to breast feed my second child, because I feel like that is the best thing that I can do for my baby and I wanted to do that again. If you haven’t already, you should take a moment and read this first breast feeding blog post I did when I started breast feeding William - CLICK HERE.

With my first child, he was born at 40 weeks and 1 day and he immediately did great breast feeding. In fact he sucked so hard that I had to wonder if that super suck was even normal. I put him to breast every 2-3 hours and then when working I was pumping every 3 hours. I ended up with tons of breast milk and was able to donate a bunch of it - CLICK HERE for that story. So with my second child, I assumed it would be a similar experience. Well Samuel was born at 37 weeks exactly (that is 3 weeks and one day earlier than William). 37 weeks is technically term, but that makes a huge difference in terms of size of the baby and then the develop of the suck, swallow breath skill. Babies are able to start coordinating that skill of sucking, swallowing and breathing starting around 34 weeks gestation. I was able to put Samuel to breast within that first hour of life and he nursed and did a good job. Over the next few days we continued to work on breast feeding and he did well, but the force that he sucked was far less than with William. So I started pumping while in the hospital to help ensure that milk supply would become well established since Samuel’s suck was more immature compared with William’s. I immediately had lots of breast milk and I have continued to pump 1-2 times a day throughout my maternity leave. Again, I wanted to make sure I had plenty of breast milk to be able to feed him as he got stronger and was able to take more volume.

As many of your know, I work in a NICU and work with Moms who are exclusively pumping or starting to breast feed their preterm baby. I know have a much better understanding how important and challenging it is to balance pumping and then working on breast feeding. It takes time and patience, because obviously you want your baby to latch on and be able to feed perfectly, but lots of time it takes a lot of effort on the part of the mother to help get baby in the right position and then monitoring your let down to make sure that baby doesn’t cough/choke. That was another challenge with Samuel was he struggled for several weeks to learn how to mange my let down. It was forceful and being able to watch for that, unlatch him and then re-latch him after the let down dwindled down.

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Presenting at FNCE

Some of you, if you are Registered Dietitians, are familiar or at least heard of FNCE. The Food and Nutrition Conference and Expo that happens annually around the country. This is the big national convention for Registered Dietitians hosted by the Academy of Nutrition and Dietetics. I have been able to attend FNCE twice, once as a dietetic intern in Boston, MA and then two years ago in Chicago, IL. It was a fantastic experience to be able to listen to speakers, see the amazing exhibit hall and then get to network with fellow RDs. Over the last 7 years of being a pediatric dietitian I have spoken with several other pediatric RDs about the lack of pediatric content at FNCE. There are obviously lots of topics that they are trying to cover and there are normally a few pediatric topics that are addressed, but not a ton. I wanted to make sure that pediatric nutrition continued to have a focus at FNCE and have some quality information to provide to other dieititians. Lots of RDs are being asked to cover NICU/pediatric units in hospitals and some times these RDs aren’t always the best equipped to know how to take cover of these complicated patients.

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I decided to put together a presentation proposal for FNCE with a friend of mine in Louisville, Laura Serke. She is an amazing NICU RD in Louisville and also works as a lactation consultant. I thought it would be awesome to provide a presentation focused on how to handle human milk (or breast milk) in the hospital setting. This would centered around the NICU specifically, but we would also cover the pediatric side of it as well. RDs are often the ones that are asked to help provide guidance on how the transportation, storage and feeding of human milk is delivered to infant patients. Laura was in support of putting together this proposal and then with the help of Salisa Lewis as well (another amazing NICU RD with lots of experience) we finalized our proposal and submitted it back in November of 2018. We worked hard over the course of a couple of weeks to create and finalize this proposal and articulate our thoughts in a way that sounded professional and interesting. It is tough to put together an interesting and interactive presentation on human milk in a way that would get a large group of people excited about the topic! I think we did a great job though coming up with a catchy title and putting all those ideas on to paper.

Fast forward to this past week … we got word back that our proposal was accepted and we will be presenting our presentation at FNCE in Philadelphia, PA in October of 2019. If you are attending FNCE this fall make sure to mark your calendar for our session on October 27th at 10am! It will be a great presentation and worth getting up for! This is the best news that I could have gotten. I am wrapping up my maternity leave and kind of questioning leaving my baby to head back to work, but this was just the push I needed. I love what I do and love educating people about my job and supporting other RDs in that field of pediatric/NICU nutrition. It is tough being a mom, working full time, running a side business and at times I question if it is worth the stress to try to do all these things. Then moments like this where a crazy idea works out and becomes a reality and then I realize “yes” it is all worth it!

So stay tuned to hear about about that presentation and of course pictures and documentation of the event in October of this year!

Brain Boosting Lunches

I had the opportunity to teach another class at Mini Minds! I was so excited to have 4 families that signed up for the Brain Boosting Lunches workshop. I have wanted to put together a class where parents'/caregivers can attend with their child and both adults/children can participate, try new foods and learn something about food.

This has been a learning process to figure out the best way to put together a class that is worth the money, provides a unique experience and is also cost effective. The key has been to find the right price point. There isn’t another cooking/nutrition class in the Indianapolis area where parents and kids are together and get to work with a Registered Dietitian. This is a unique opportunity and I want to make sure that families know that this is available and find it worth their time! It can be challenging to put together a fun, learning filled opportunity for families. The workshop lasts 1.5 hours and costs ~$35. If you are interested in participating in the next one that I offer, let me know!

This most recent class was focused on creative ways to put together a healthy lunch for your child. Lots of parents pack lunches for their children and send them off to school. Some times it is easy to get stuck in a rut of making the same thing over and over again. Finding ways to break out of that boring routine and then making healthy meals for your child is important.

During the class we started off talking about the MyPlate model and the 5 different food groups. We talked about what foods would be in each food group and what foods the kids enjoyed or didn’t enjoy eating. I wanted to include some nutrition education so that when the kids see the MyPlate again in school, they are familiar with the concept and willing to have different food groups at each of their meals.

This workshop session occurred during lunch time and so of course all of the kids wanted to eat and make food! So we jumped right into making our lunches for the day. I provided a handout with information about the food groups and then lunch ideas including some recipes as well for the parents to take home with them! Below is the lunch that we made as a group. We did a special twist on a classic school lunch item - the lunch meat sandwich. I wanted to do something familiar that everyone would like, but have it presented in a different way. These sandwich pinwheels did just that! They worked out great and some of the kids tried some new foods, like tomatoes and hummus and others were interacting with a non-preferred food (like cutting it up) which was great. We paired the pinwheels with some fresh veggies - carrots and cucumbers with hummus as the dipping sauce. I had planned on doing a dried fruit with these as well - like raisins, but those weren’t available at the time so we stuck with the veggies and the pinwheels as our lunch for the day.

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Overall I think the families had a great time and were able to learn some things. I think this also provided a chance for the parents to interact and get to chat with one another. That can be nice to have some support from fellow parents when it comes with dealing with children. This was another successful workshop and I am excited to brain storm as other ideas for the upcoming 2019 year with Mini Minds and get some other dates on the calendar. If you have any creative ideas or have a topic that you would want to learn more about, leave that as a comment below and I would love your suggestions.

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Exciting Opportunity for RD Anna

I wanted share with you all who follow along with RD Anna about some exciting new opportunities. I have had some new endeavors that I am getting involved with this fall. Some of your may remember that I did some outpatient pediatric nutrition counseling at my last job. I really enjoyed working with a feeding clinic and doing some weight loss classes up in Lafayette, IN. I haven't had the opportunity to do any of that in the last several years. I am continuing to work my full time job as a NICU dietitian as well. I wanted to make that abundantly clear as well. This is going to be a fun, side job that I am excited for and have been eagerly anticipating for the past 6 months. 

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There was the opportunity to create a partnership with a business in Carmel, IN and I had to say yes! I use to work with Megan, Mini Minds business owner, at St. Vincent. She left her job at St Vincent as a social worker to launch her own private practice as a therapist/counselor. I have really admired her journey and I am so excited to learn from her about owning her own business. Mini Minds has grown and expanded into an amazing therapy office servicing the Indianapolis area. Make sure you check out their website and all the amazing services that they offer. Of course, the newest line of services including nutrition therapy and education options. 

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As you may remember I made RD Anna a LLC this past year and then I also worked to get my NPI so that I could start charging insurance companies for nutrition counseling services. This has been a big step for me, because I have never owned my own business before or offered nutrition services for payment before. I am really excited to partner and work with Mini Minds and get to provide nutrition education/counseling for those clients and their families. We are getting started with a workshop class this upcoming weekend on Back To School: Putting Together Healthy Snacks for Your Family. That should be a fun session trying new snacks, talking about healthy options and then even making some delicious recipes. I also have plans for launching a 3 week cooking class series in October focused on shopping and cooking healthy family meals with your children. There are lots of neat things that I am hoping to do in the fall with this opportunity. So stay tuned for those exciting announcements about RD Anna! 

Writing a Nutrition Care Note

So I totally understand that this blog post may not be super interesting to a lot of people. I know most of the people who read this blog are not necessarily clinical dietitians, but this has been something that has been on my mind. I never thought that I would feel passionately about how you should write a nutrition note for a medical record, but now after being a dietitian for 7 years I have opinions. I didn't want to go into clinical nutrition initially, but after working in a hospital for the past 7 years, I definitely feel strongly about a well documented nutrition note. 

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I am not going to go through the whole note writing process, because that is boring to most people, but I do want to touch on the last section - The Nutrition Intervention. This is where you get to write what you did to intervene in the nutrition care of the patient, what goals you have moving forward, what you want to monitor and how you plan on evaluating what you monitor (like your professional opinion on the situation). This section I feel strongly about because it is the one place in your nutrition note, where you get to put on display your nutrition knowledge. It is where you outline how you plan to treat this patient and what you anticipate might transpire in the future. It is where your professional opinion is able to be shared. Lots of times I feel that some RDs just put the minimum information in this section. They just put that the goals are met and what they might like changed. They tend to leave out the part about their professional opinion, they might omit details that better description the nutrition problem listed earlier or they might not share what they anticipate might happen during the next week. That is what I feel like detracts from a well writing nutrition note. 

Example - (1) Diuresis has been as anticipated. Weight was down 1.9% from birth weight. Weight gain goals are ~19g/day.  (2) Infant is on TPN support and we are aiming for 92kcal/kg/day, 4g PRO/kg/day and GIR Of 4-6mg/kg/min. Currently the lipids have been turned off as we work up on enteral nutrition. (3) Infant has been having issues with bilious emesis. Infant does have Gastroesophageal Reflux and will have an upper GI done. Slowly working up on enteral nutrition. Feedings are running continuously to help with tolerance. We are using maternal breastmilk. Encourage and support Mom with pumping. Infant may also get donor breastmilk and this is appropriate as a back up plan through 34 weeks gestation/1500g. Total fluid goals are 130-150mL/kg/day and currently tolerating 142mL/kg/day. Monitor tolerance with feedings and working up on volumes and down on TPN support.

Now if you are not a dietitian, this may not directly apply to you, but this idea about sharing your professional expertise is important for anyone. If there is an avenue through which you can share your career expertise in a specific way in your day to day activities ... you should always take advantage of that chance. Taking the time to thoroughly share that knowledge helps to justify your job and show how you are an important member of the team. I know as a dietitian, I want to be respected and valued as a member of the nutrition care team and how I write my notes plays into that. I know there are similar examples for other jobs. When talking to my husband about writing code for data pipelines that he works with that is something that he can do in a neat and well organized fashion. Taking the time to write "clean code" shows his skills has a computer scientists and shows that he cares about the "product" or code that he creates. 

After going through 4 years of school, a year long unpaid internship and now working for 7 years, you better believe that I am going to highlight my nutrition knowledge in that Intervention section of each and every nutrition note I write! Hopefully this encourages you to find ways to highlight your expertise at your job and take pride in the work that you do! 

Breast Milk Versus Formula

I decided to delve into this controversial debate about breast milk versus baby formula. I thought this might be an interesting blog post for a couple of reason. First of all it had been in the media quite frequently after President Trump tweeted "The failing NY Times Fake News story today about breast feeding must be called out. The U.S. strongly supports breast feeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty." 

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So if you are wondering about this article that President Trump said was Fake News you can find it HERE.  I would encourage you to read through it and see what your thought are. The main accusation against the United States is the reported situation as follows ... "American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children." That might not have been that big of an issue, but when other countries didn't come to back the United States' proposed changes then things got more heated. "When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs. The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced." That is the part that bothered me. I don't think we should go threatening countries to get policy changes. That is something that I think is wrong and seems to be behaving kind of like a bully. 

So that was kind of a crazy response to something like breast feeding. I honestly was quite surprised to read that article. Then there started to be more articles and other opinions written. and I wanted to make sure to share those with you too. I really liked this article by VOX because I thought it did a good job at outlining the main issue that was being debated by the United States and other countries. "The UN group responsible for setting the standards on how countries should regulate food products, the Codex Alimentarius, hasn’t yet decided whether follow-up formulas should be treated like infant formulas — as “breastmilk substitutes.” Calling them a substitute for mother’s milk would mean heavier scrutiny and regulation — something public health advocates want. The US wants to call it a food, not a breast milk substitute,” said Elizabeth Zehner, project director for Helen Keller International’s child feeding project, who was present at the Codex negotiations. “That will leave the door open for all countries to call these products as non-breast milk substitutes, so they will get advertised on TV — and they look just like the infant formula.” 

So that is the main part of the debate ... how to categorize this formula products. I know it seems like a simple issue, but it can have big ramifications. Food is a complicated thing and when it is regulated different can lead to a large variance in products. The supplement industry is that perfect example. That is the under the Food and Drug Administration and anything classified as a supplement doesn't meet the same scrutinized criteria as other actual food items. So companies can put whatever health claims on those products and they aren't held to the same regulations as the food industry. I would say most of the time that can be ok, but I understand the concern voiced in the VOX article about how toddler formulas are regulated, because if they are labeled as "breastmilk substitutes" that would change their nutrition make up and how they are marketed to families. 

There was another story published on NPR on this topic and I wanted to make sure you had access to that as well, CLICK HERE. I think that this debate is not other and the formula industry does have a lot more money to lobby with compared with advocates for breast feeding. They are pushing a product and want to make money. That being said I believe in a baby being fed and healthy and that can be accomplished through either breast milk or baby formula. The debate here isn't necessarily which is better nutritionally, the debate comes down to money and how these formulas are categorized. That will then have a big influence on the products that are manufactured and then marketed to families. I would say our country has come a long way in encouraging mothers to breast feed and educating families on why that is the best thing for your baby. I think like any basic mothering skill, there are so much emotion that gets ties into this topic and can lead to guilt and regret. That is another blog post, but I wanted to make sure that you got some information on this debate and maybe some more insight as to why the President cared if women were breast feeding or using formula. 

 

My Week at Diabetes Camp

I have had the privilege to get to volunteer at the Diabetes Youth Foundation of Indiana’s Summer Diabetes Camp in Noblesville, IN. This is the 4th year that I spent a week at camp serving as the Registered Dietitian on staff. My job isn’t super glamorous, but it is fun. I get to work in the kitchen to organize and prepare the meals for the campers with food allergies. One in sixty Type 1 Diabetic patients also have another auto immune disease like Celiac Disease. So this means that these campers require gluten free options and often other Type 1 Diabetic people have other food allergies (issues with peanuts, dairy, soy, etc). To help accomodate these special needs, I work to provide options for these campers. Throughout the week, I work to prepare meal and snack items that accomodate those dietary restrictions our campers and some staff have. 

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I worked in a camp kitchen before, back in 2008 I was a cook at Camp Lakeview for a summer. There is a special place in my heart for camp kitchen staff. I enjoy being able to give back in this way and help to make some of these speciality food items. I love being at Diabetes Camp, because it provides a place where these Type 1 Diabetics get to be “normal.” Checking your blood sugar is normal. In fact, if you are at camp and don’t have diabtes, that is more abnormal. I have really enjoyed getting to know the staff and campers. It has been fun to go back year after year and see these kids grow up and get to help them learn to love camp as well. 

Like I said it isn’t a glamorous job, but I think it is super important. All of us have to eat and we do it at least 3 times a day for meals and hopefully 1-2 other snacks included in there as well. For someone with Type 1 Diabetes that means that they have to account for everything they put in their mouth, dose their insulin and track what their blood sugars are. That can make meal time a stressful experience. I have to imagine that spending a week at camp where you have medical staff helping to track and manage your diabetes has to be a welcomed relief. A chance to be surrounded with all of these other people with Type 1 Diabetes and get to have fun while knowing your diabetes is being taken care of. 

All in all it has been a great week. Lots of early morings and long days, but it was a ton of fun and I really enjoyed the chance to volunteer. It is always a great way to spend a week! 

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Baby Led Weaning FAQ

I felt lead to write another Baby Led Weaning post and I thought I would answer some commonly asked questions that I often get from parents about Baby Led Weaning. This is a topic that I really enjoy discussing with people. I love food and I think that teaching that love to food to our children is important. I believe that Baby Led Weaning is one of the best ways to help instill within children a love of food. 

  • When can you start Baby Led Weaning? You can start giving your child soft, solids when they are 6 months old, have good head control and can comfortably sit up in a high chair. You also want your child to be showing signs they want to try to eat (reaching for foods that you are eating, watching you eat, etc). You want them to be able to do these things first, because then you know that they have the strength and stamina to handle solids.

  • What do I feed my child? Anything that you are eating. Especially at the beginning start with soft solids (fruits, cooked vegetables, beans, tofu, etc) and then as they get older you can move onto harder food items. There is no need to purchase "special" baby food items, give your child what you are eating!

  • What if my kid chokes? There is a difference between choking and coughing. Coughing is normal for every child. The key is not freaking out. Your child coughing is sign that they took too big of a bite, and they are trying to clear their airway. Do not pat them on the back to “try and help.” That could actually make them choke. Choking is when your children stops coughing and is no longer making noise. That is a sign their airway is blocked and that is the time to intervene. This would be the time to do the strongly pat their back over your knee and help to dislodge that food item. Choking is not common with Baby Lead Weaning. Coughing is common, especially at the beginning. Your child has to learn how to manipulate that food in their mouth to chew, swallow and breath. It is an acquired skill and takes practice.

  • You don’t use store-purchased baby food? No purees? Nope. Don’t spend more money on commercial baby food. It is a gimmick and your child doesn’t need it. Offer your child foods that you eat at the dinner table. Start with soft foods, cut in long pieces so they can grab them with their hands and feed themselves. It is great to teach your child independence and encourage them to try new foods. Begin with cooked vegetables, soft fruit, soft grain items like puffs or mumums. These items turn into purees in their mouth and they can safely manipulate them. This also means that you make 1 meal and everyone gets to eat it!

  • My kid has no teeth, how can they eat table food? Children want to eat what you are eating, why feed your child something different. Yes, your child may not have teeth, but that is why you start with soft food items that they can eat on their own. This teaches them how much food they can fit in their mouth and how to properly chew and swallow. They don’t need teeth for these soft food items you are feeding them.

  • What if my kid gets messy? Your kid will get so messy, but that is part of learning. Eating is more than just putting the food in your child’s mouth. It involves the smell, the texture, the taste and the different flavors. This also allows the whole family to sit down together at the table. You don’t have to feed your child separately. Family meal times have been proven to help strengthen those family connections and help child grow into better, more well-rounded individuals.

  • What if my child doesn't like the food? That is fine. It takes children upwards of 15 times of being exposed to a food to really determine if they dislike it. Always offer foods that they like and new foods as well. Remember, if you child chooses not to eat, that is fine. There will be another meal in a few hours and they will not starve.

  • What is the biggest challenge with Baby Led Weaning? Trying to work in variety. I think it is so easy to get in a food rut, but trying to mix things up and trying new recipes is key. Getting your child to try 100 foods by the time they are one is totally possible.

This is from the  Fortified Family website  and Katie Ferraro's website/books are amazing!

This is from the Fortified Family website and Katie Ferraro's website/books are amazing!

I think a lot of times as parents we are the ones that end up holding our kids back. We are the ones who limit their creativity or keep them doing crazy things. Yes, some times it is merited to protect them, but with food I feel that it is so important to let them explore, get messy and learn to eat all the different food items. If you have any other questions about Baby Led Weaning, feel free to reach out to me!

 

My Nutrition Journey

I thought that it might be fun to have today's post focus on my nutrition journey to where I am today. Most of the time I am writing about interesting nutrition topics (that are near and dear to my heart), but I thought I might give you a little back story about my own journey to becoming a NICU dietitian.

I initially was interested in OT/PT in high school, but after job shadowing several PTs and working in a nursing home once a week for a semester in high school, I decided that wasn't for me. It didn't really enjoy touching people that much. I kind of preferred keeping my distance from the patients that I was working with. My mother encouraged me to look into nutrition and specifically dietetics. She kept telling me that having a credential, like the letters RDN after my name, would open up lots of doors for me. She was right! I went to Purdue and double majored in Dietetics and Nutrition, Fitness & Health. I was most interested in sports nutrition and that is where I wanted to work. I wanted to help athletes optimize their nutrition to improve their performance. After completely 4 years at Purdue, I did my internship through the Purdue Coordinated Program and graduated in August of 2011. After the completion of my internship, I took the RD Exam and passes and started working at St Elizabeth Hospital in Lafayette, IN. I originally wanted a job in sports nutrition, but quickly realized those positions were few and far between. Lots of them preferred a Master's degree as well. I decided that getting a job, starting to earn money and gaining work experience would be most worth my time. Unfortunately, a Master's in nutrition doesn't guarantee that you make significantly more money.

I started working at St Elizabeth hospital and covered the cardiac, pediatric and NICU units. I also worked in outpatient pediatrics. This is where my love for pediatric nutrition started to develop. I really enjoyed being able to make nutrition changes and see the changes within a few days. I really loved working in pediatric outpatient and developing a relationship with those patients. After almost 3 years, I took a new job in Indianapolis, IN at St Vincent Women's Hospital working in the NICU. This was a huge leap of faith for me, but it has proven to be such a blessing. I knew that I enjoyed the NICU, but I being able to work in pediatric critical care full time has been such an amazing experience. I love being able to work with these critically ill patients, provide them with the best nutrition and then watch them grow, over come the odds and thrive to go home with their families. 

Photo taken by our pediatric surgeon (Evan Kokoska) for an album The People of Peyton Manning Children's Hospital.

Photo taken by our pediatric surgeon (Evan Kokoska) for an album The People of Peyton Manning Children's Hospital.

I have been able to do so many neat things over the years. I have been at St Vincent's Women's Hospital now for almost 4 years (as of April). I have had the opportunity work with lots of amazing people. I was able to give a talk at the Indiana Academy of Nutrition and Dietetics Conference (IAND) last year on NICU Nutrition and the role of the RD in the NICU. I have been able to serve on the Academy of Nutrition & Dietetics (AND) Test Writing Committee for the new Certified Specialist in Pediatrics and Critical Care Exam (CSPCC). I had the opportunity to write a chapter in a Nutrition Communication book that will be published in the next year through the Academy of Nutrition & Dietetics. I have been able to serve on the IAND State Board on the Nomination Committee and exited to be on the local CIAND Board this upcoming year. I have been able to mentor lots of interns and excited to see them pursue their dreams as RDs. I have worked with amazing people and I am so excited for what is ahead for my career. 

Looking back on it, I am so thankful to have parents who cared about my future. Who pushed me to pursue my interests, paid to put me through school and supported me as I took leaps of faith with job and opportunity that has come my way. I have been a Registered Dietitian for 6 1/2 years and it has been such a fun journey! 

First Birthday Party

It is hard to believe that we are now celebrating William's first birthday. It has been awhile since I have posted about William. I did several pregnancy posts throughout my pregnancy and then some breastfeeding and baby lead weaning posts over the last year. I wanted to take a moment and put together a fun post highlighting William's First Birthday. William was born on 12/23 and yes it is SUPER close to Christmas. We wanted him to have a separate birthday celebration and so we officially celebrated his birthday on 12/16. 

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This party was mainly for use (William's parents), family and friends. William won't remember this party, but I know he will lose seeing the pictures when he is older. I wanted to do something fun and have this get together as a "thank you" for all the support from our amazing friends and family. 

Photo was from William's 12 month photo shoot we did with Karre Ann Photography in Noblesville, IN. 

Photo was from William's 12 month photo shoot we did with Karre Ann Photography in Noblesville, IN. 

So here are the party details. The theme - Dr Seuss! It kind of started with Cat in the Hat and expanded to include all Dr Seuss characters. We held the party at our house and there able to get some cupcakes made that we super cute. Shout out to Abby's Cakes for her amazing work. The menu included deviled eggs (green eggs/ham), cheese sticks (with the cat in the hat on them), relish tray, fruit salad, cheese ball. 

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For the decorations we put up a wall decal of the Cat in the Hat that my Mom had used at a baby shower she hosted previously. It was great to have that to use again. I also got Dr Seuss books that we used on the table as decoration. I painted the letters "ONE" for some other decorations. We got a little Cat in the Hat plush toy to serve as a decoration. I also made the Christmas tree Dr Seuss themed. I had the ornaments all red, white and blue and then made some fabric embroidery hoops with Dr Seuss fabric on the inside.  

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I put together a few goody bags for the 3 kids that were able to come to party. I used blue bags with a hat on the front of them and filled them with some goodies (Dr Seuss pencils, stickers, playdough and snacks). It was an easy and fun way to send the kids home with some treats. 

It was such a great day to get together with family and friends and we have been so appreciative of everyone's love and support. It is so special to get to have William in our lives and get to celebrate him on this special first birthday. 

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Halloween Goodies

Crunchy leaves, spooky decorations and lots of sweet treats. That basically sums up this time of year. Halloween is just around the corner. With a little 10 month old running around our house, Halloween is even more exciting. We have a great family costume planned - it includes a farmer, a pig, a spider and a spider web. Any guesses ............... if you were thinking Charlotte's Web you would be right! 

When it comes to Halloween goodies we tend to reach for lots and lots of candy. In fact, Americans will end up purchasing 600 million pounds of candy on Halloween. For those trick-or-treaters that come to your door, their number one choice for Halloween treats is chocolate. About 157 million people participate in Halloween and 141 million purchase Halloween candy. That equates to 45% of the US population handing out candy to trick-or-treaters (source). So it is obvious that lots of people are purchasing candy, the kids that are trick-or-treating love it and we are eating lots of extra calories around this time of year. 

Have you ever wondered how many calories are in some of your favorite candy bars? Want to know more - CLICK HERE for the article. 

  • Reese's Cup (110 calories) - You would need to run 7 minutes (at 10 minute per mile pace) 
  • Butterfinger (85 calories) - You would need to do 10 minutes of Zumba
  • Regular M&Ms (67 calories) - You would need to do 9 minutes of jumping jacks 
  • York Peppermint patty (60 calories) - You would need to do 25 minutes of yoga
  • 3 Muskateers Bar (63 calories) - You would need to do 26 minutes of pilates 

Do you have to hand out sugary treats? No, there are lots of options for things that you can pass out at your house. I love highlighting the Teal Pumpkin project every year, because for lots of families Halloween ends up being stressful. For families who have food allergies or food intolerances this is tough to have to sort through all the candy and pick the "unsafe" treats. The Teal Pumpkin Project has some great resources in terms of signage for your house, ideas for non-food related treats and spreading the word about food allergies. Last year I put together a great blog post with more treat ideas and a video about the Teal Pumpking Project - CLICK HERE to check it out. I loved this infographic and just had to share it with you. 

Teal Pumpkin.jpg

If you think the Teal Pumpkin Project is a neat idea, but you also want to hand out candy, that works too. That is what I do every year. I have a bowl of goodies filled with non-food related treats and then another bowel with candy goodies. That way I have options for everyone and I feel better about the large amount of candy that all these kids are eating on Halloween.