Meet SDBFC's Newest Lactation Consultant - Nicole Kreps!

We are so thrilled to introduce you to our newest lactation consultant at SDBFC! Nicole Kreps joined us on April 10th and started to see her own patients on May 8th. Here is my interview with Nicole.  I can't wait for you all to meet her!

Nicole, tell us about yourself!

I was born in New Jersey but raised in the Los Angeles area. After high school I moved to San Diego to attend San Diego State University where I graduated with my Bachelors of Science in Nursing.  I worked as an RN in the Emergency Department, Intensive Care Unit, Recovery Room and as a critical care transport nurse. I have 6-year-old twin boys and a 4 year old daughter. After my youngest was born I took a couple years off to be a full time mom. I eventually complete my Lactation Consultant training at UCSD Extension and am happy to now be working in a field that I am passionate about.

What inspired you to become a lactation consultant?

I faced several challenges in attempting to breastfeed my twins. I was at the point when I thought I was going to quit, but then I remembered that I had been given the phone number for a lactation consultant. Working with her was a turning point for me. She was an important piece of my support network as a new mother. I would like to pay it forward and help other mothers overcome their challenges.

What are you most excited about working for the SDBFC?

I am excited to be part of a group of lactation consultants that are compassionate and knowledgeable. The SDBFC has a strong reputation and therefore also has a wide reach on the population of new mothers in San Diego. I have the potential to help a lot of people reach their breastfeeding goals.

What are your top 3 tips for a brand new breastfeeding mama?

1. Surround yourself with supportive people. Whether it is friend or  breastfeeding support group being able to relate to other people who know what your are going through can be very therapeutic.

2. When people offer to help, take them up on it. Having someone bring dinner or lunch is always a great idea. Keep your body nourished. Breastfeeding is hard work!

3. Cut yourself some slack. We all have an idealistic image of how we would be as a parent and you will be getting lots of advice about what your “should” be doing. No one is perfect. We are all doing the best that we can. Do what works for you. Just keep trying and keep moving forward.

Welcome to the team, Nicole!

IRC Donation Drive Success!

Written by Anna Choi, BS, IBCLC

On March 1st, we asked our community of mothers, families, and friends to help us #givehope to refugee families in San Diego by supporting our effort to collect diapers and women’s hygiene kits for the International Rescue Committee in San Diego. Our initial goal was to collect 500 diapers and 50 hygiene kits in 50 days. Within the first ten days, we had surpassed our diaper goal and were overwhelmed with gratitude as more diapers and hygiene kits continued to be delivered to our office throughout the following weeks. We are thrilled to announce that our final totals were as follows:

3,050 Diapers

40 Women’s Hygiene Kits

$400 in Walmart/Target Gift Cards

We appreciate the generosity of everyone who donated during our collection drive and feel very fortunate to work with such a wonderful community of people. 

On Friday, April 28th, we delivered the donations to IRC staff, at their office on University Avenue, and were greeted with smiling faces and words of gratitude. Elated to see the many boxes and packages of diapers, IRC staff happily restocked their supply room shelves as they discussed how helpful it is to have diapers readily available for refugee families in need. Sainab Warsame, Immigration Case Manager at the IRC, was quick to comment on how nicely put together the women’s hygiene kits were and let us know of her plans to hand out a few of the kits to recently arrived Congolese refugee women on Monday, at the IRC’s Vocational ESL class.

SAINAB WARSAME, IMMIGRATION CASE MANAGER, ANNA CHOI, AND PIPER CHOI

“The hygiene kits will also be given to many women the day they arrive so that they have what they need to hold them over until we take them on a bigger shopping trip,” Chris Williams, Resettlement Director for the IRC in San Diego, tells us.

CHRIS WILLIAMS, RESETTLEMENT DIRECTOR AT IRC SAN DIEGO, ANNA CHOI, AND PIPER CHOI

If you would like more information about how to make a one-time, or monthly, donation to the IRC in San Diego, please visit: https://help.rescue.org/donate/us-san-diego-ca?ms=ws_resq_top_nav_btn_161010&initialms=ws_resq_top_nav_btn_161010

The San Diego Breastfeeding Center is also happy to continue to collect diapers throughout the year, to be delivered to the IRC on a quarterly basis. Diapers must be in sealed, manufacturer’s packaging in order to be accepted for donation. Larger sized diapers [sizes 4-6] are always in high demand and appreciated.

Thank you again for helping us show our support for refugee families in San Diego!

Meet SDBFC's Newest IBCLC - Debbie Murai!

We are so thrilled to introduce you to our newest lactation consultant at SDBFC! Debbie Murai joined us on March 6th and will be doing office visits starting today!  Here is my interview with Debbie.  I can't wait for you all to meet her!

Debbie, tell us about yourself!

I was born and raised in Southern California and grew up in Orange County. I moved to San Diego after marrying my high school sweetheart, Mark. I attended San Diego State University and enjoyed working at the Fallbrook Community Clinic. One month after graduating from the nursing program at SDSU I gave birth to my first child, Kyle. About 2 years later I had my daughter Katie and 5 years after Katie I had my third child, Miles.  I really enjoyed being home raising my kids, but I always had the desire to return to nursing when they went off to college. Now that my youngest child is attending college, I am looking forward to helping moms start their journey into motherhood too!

What inspired you to become a lactation consultant?

While  working at the community clinic in Fallbrook, I really enjoyed working with mothers and babies and this first sparked my interest in helping moms with their breastfeeding issues.  When I had my three children and dealt with the challenges and triumphs of breastfeeding, I knew when I would go back to the nursing profession, I would make lactation my focus.  

What are you most excited about working for the SDBFC?

I am excited about being able to help moms meet their breastfeeding goals. I am also really excited about working in the San Diego community.

What are your top 3 tips for a brand new breastfeeding mama?

1. For the first few weeks, ask for help with cooking and cleaning from your friends and family when they visit.  Spend as much time as you can connecting with your baby instead of doing chores.

2.  Trust your instincts.  There will be friends and family giving you advice with the best of intentions.  You can always listen to them, but do what works best for you and your family.

3.   Try to meet other new moms either through a breastfeeding support group or play group so you have other moms to get together with and share experiences.    

Welcome to the team, Debbie!

Donate to the SDBFC Foundation just by shopping on Amazon!

Do You Love Shopping on Amazon?

Did you know that you can donate to the San Diego Breastfeeding Center Foundation with every purchase you make through Amazon?

You can help low-income women gain access to critical breastfeeding support just by purchasing Amazon items online.

Wondering how to do this?

We are asking you to take 60 seconds of your time today to designate the San Diego Breastfeeding Center Foundation as your charitable recipient for Amazon Smile.  All you have to do is go to their website (smile.amazon.com) and choose the San Diego Breastfeeding Center Foundation as your Amazon Smile recipient.  Or you can click on our direct charity link (https://smile.amazon.com/ch/81-1935497) Then as you make your diaper, nipple cream, baby toy, book, etc purchases from this site, the SDBFC Foundation will receive 0.5% of every purchase, at no extra cost to you.  This money will go directly to paying for lactation consultations for families in need.

“I came across the San Diego Breastfeeding Center thanks to Robin Kaplan, who taught my breastfeeding class during my pregnancy. I was worried I was not going to be able to breastfeed when I had my baby, and shared with her my questions and concerns. She pointed out to me that, when and if the time came, I should contact the Center for further assistance. 

After delivery, I discovered many challenges to successfully feed my baby: from painful latch to low milk supply, and I almost gave up on breastfeeding several times. The Center gave me the support, education and materials I needed to continue, in the most loving manner. Since I experienced several problems along the way and needed more than one appointment, it was very helpful for me and my family to have access to this resource for only $25. If this had been any different, I’m certain I would have stopped.

Thanks to the Foundation, my child is receiving the best nourishment I could provide and I am very grateful for that. Programs like this are silent saviors for women like me, since we don’t know we will need them until we do. Hence, the importance of making them affordable for families like mine, that may not be able to pay for the consultations full price. 

- Sofia

 

Amazon Smile Details:

AmazonSmile is a simple and automatic way for you to support your favorite charitable organization every time you shop, at no cost to you. When you shop at smile.amazon.com, you’ll find the exact same low prices, vast selection and convenient shopping experience as Amazon.com, with the added bonus that Amazon will donate a portion of the purchase price to your favorite charitable organization.

To donate to the San Diego Breastfeeding Center Foundation, you can send a check to:

San Diego Breastfeeding Center Foundation

3355 4th Ave.

San Diego, CA 92103

Donation Drive to Support the International Rescue Committee of San Diego

Anna Choi, BS, IBCLC

Here at the San Diego Breastfeeding Center, we love women; we love moms; we love our community. And perhaps most of all, we love helping the women and mothers in our community. When we heard about the recent travel ban put forth by President Trump’s Executive Order, we knew it was time to reach out to our friends at the International Rescue Committee of San Diego to see what we could do to help. In our discussions with IRC San Diego staff, we learned about the devastating effects the Executive Order was having [and would continue to have] on the ability of the IRC to provide support and basic necessities for refugee families who have resettled in San Diego.  As we read about the decision of the U.S. Appeals Court to uphold the suspension of the Trump travel ban, we celebrated with our friends at the IRC. 

David Miliband, President and CEO of the IRC, tells us:

“We are grateful that we can get back to work resettling refugees who have fled the terrors of war and violence, while also caring for those who remain trapped in conflict zones. As this ruling will almost certainly be appealed to the U.S. Supreme Court, in the meantime, the IRC remains committed to serving our refugee clients here in the U.S. and in more than 40 countries around the world.”

What does this decision mean for the IRC? It means that refugee resettlement cases that were put on hold due to the travel ban can now continue to move forward. Families who have spent years in refugee camps, fleeing war and oppression, can once again look forward to a new life in a safe community. For the IRC San Diego Resettlement Team specifically, it means the arrival of 78 new refugees in the coming days, weeks, and months. Those arriving in San Diego include wives reuniting with husbands, children with parents, brothers with sisters, and friends with friends. It also means an increased need for donations and support from the community. That’s where we, at the San Diego Breastfeeding Center, and you, come in!

Some of the more common needs of the IRC San Diego [aside from monetary donations, which you can contribute here: https://help.rescue.org/donate/us-san-diego-ca ] are diapers and women’s hygiene kits. Those arriving in San Diego include three 2-year olds, two 1-year olds, and several pregnant women. As mothers ourselves, we know firsthand how expensive diapers are, and what an impact the expense can make for those on a fixed income. The first few days in San Diego are very transitionary for newly arriving refugees, and as permanent housing and living expenses are arranged, it can be very helpful for IRC staff to have hygiene kits on hand to distribute, helping newly arrived refugees get through their first few days in a new place. 

So, we’ve challenged ourselves to collect 500 diapers and 50 women’s hygiene kits in 50 days. Donated diapers can be any brand and any size, in unopened packages. Hygiene kits should include the following items: 

• 10+ sanitary pads
• wet nap towelettes
• kleenex
• deodorant
• soap
• lotion
• shampoo/conditioner
• toothbrush/toothpaste
• $10 Walmart Gift Card

Today is day 1. Here is a picture of the hygiene kit I created to give you an idea of what the finished product looks like. Kits can include travel sized portions of the above items, or full sized containers, packaged into a gallon ziploc bag or a grocery bag.

Having visited the IRC San Diego offices and spoken with staff members, I can’t tell you enough how much these donations are appreciated and needed. All donations can be dropped off at our weekly Breastfeeding Support Group, held at our office in Hillcrest {3355 4th Ave SD 92103} every Wednesday from 11:30am-1pm. We will also have a Saturday donation collection on Saturday, March 25th from 10am-12pm, also at our Hillcrest office {3355 4th Ave SD 92103}. The last day to drop off donated items is April 19, 2017.  We hope you will help us reach our goal and stand with us as we support the refugee women and mothers in our local community. 

Introducing the Top 8 Allergens to Infants

Written by Rachel Rothman, MS, RD, CLEC

A frequent question I encounter in my practice and in my Introduction to Solids classes, is how to introduce foods that may be allergenic to babies.  The last 15 years have brought significant attention to allergens, and most parents are now keenly aware of the risks.  However, a drumbeat of new research published on the causes of allergies and allergy prevention has brought new strategies to light and debunked old myths. Until 2008, the American Association of Pediatrics recommended that parents delay exposing infants to certain allergens until after one year of age. The guideline changed because after a review of research and patient outcomes, there was no evidence for waiting. I help many moms and dads make sense of this new world, as they are understandably cautious about what this all means for their child.

 

What are the top 8?

The “top eight allergens” are: cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.  These foods are associated with the eight most common food allergies, though it is possible for an allergy to occur with any food. 

So when can I introduce these foods?

Most pediatricians will tell you that you can begin to introduce these foods soon after starting solids. I usually recommend starting solids with foods not on the top 8 list, and getting 1-2 months of solids before introducing any of these more common allergens, just to note whether baby has any reactions to other foods.  That might mean you begin to offer the 'top 8' foods around 7-9 months of age.  And if your child is at a higher risk for food allergies, consult with your pediatrician.

When offering one of the top 8 allergens, it will be easiest if you only introduce one at a time, and that you observe and note any changes in baby in the first minutes, hours, or days.  If all goes well, wait a few days before offering another new food so you’ll be able to isolate any food that may be causing an issue.  If you’re concerned that something seems different, consult your pediatrician.

Let’s break down each of the allergens and discuss some ways to introduce:

Cow’s milk: Most of us have heard, no cow’s milk before one year of age.  This refers to the fact that cow’s milk should not be a replacement for breast milk or formula before the first year.  Why?  Cow’s milk has different nutrient properties than breast milk/ formula, primarily a higher proportion of protein and lower amount of fats and carbohydrates, including some differences in vitamins and minerals.  Breast milk contains the perfect proportion of all nutrients.  Cow’s milk should not be used as a replacement for breastmilk or formula. But, cow’s milk can be used in recipes, like soups, baked goods, or other foods before the first year.  Some families choose not to introduce cow’s milk, which is fine too.  This is a hot topic, so stay tuned for a post dedicated to the dairy debate!

Eggs:  Eggs are a staple in my house for my daughter, my husband, and myself.   It was previously thought to hold off on egg whites before one year of age, but like the recommendations for allergens, most pediatricians say you can introduce whole egg soon after starting solids- just be sure the egg is thoroughly cooked!  I love eggs as a finger food- they are so nutritious, and easy for baby to pick up and eat relatively early on.  Making an egg and vegetable scramble or frittata is a great way to include vegetables in baby’s breakfast as well.

Two-ingredient egg and banana pancakes: easy for baby to eat!
 

Peanuts and Tree nuts:  These are among the most highly allergenic foods, so be sure to monitor for reactions when introducing peanuts and tree nuts.  Keep in mind that whole nuts are a choking hazard for children until about 4 years of age.  When introducing nuts, try spreading a thin amount of nut butter on a piece of bread, mixing a bit of peanut butter into oatmeal or putting a very small amount of nut butter on a spoon (too large of a scoop can be a choking hazard, as well).  If your baby loves peanut butter as much as mine did, she’ll be well on her way to learning how to use a spoon!

Fish: Fish is great food for babies because of all of the nutrient benefits- just be sure fish is thoroughly cooked. Fatty fish is an excellent source of omega-3 fatty acids (specifically DHA) which baby needs for brain growth, especially under 2 years of age.  You will want to choose a fish type that is lower in mercury (some fish to avoid include King mackerel, marlin, orange roughy, shark, swordfish, tilefish, ahi tuna, and bigeye tuna).  The EPA has this great guide which lists the mercury content and sustainability level of many types of seafood. Flaked salmon can be a great finger food (or even mashed with avocado or sweet potato), or try making crab cakes or tilapia cakes.

A bit of flaked salmon, sautéed zucchini rounds and potato wedges – a perfect dinner for a 9 month old!
 

Soy: Some pediatricians do recommend waiting to introduce soy until baby is tolerating other foods.  If your baby has already been diagnosed with a soy allergy, you will want to speak with your pediatrician on it’s introduction, and keep in mind many packaged foods contain soy-based ingredients.  Baked or sautéed tofu can be a great finger food, or try adding tofu into lasagna in place of ricotta cheese.  You may want to wait until baby is about 9 or so months of age before introducing soy.

Wheat: Research and opinions are mixed on the introduction of wheat.  Many pediatricians recommend waiting on introducing wheat until other grains have been introduced (like oats, rice, or barley) to see if baby has any reaction to grains.  Wheat does contain gluten, and some babies might have a gluten intolerance or sensitivity, but note this will be different than a true wheat allergy. 

And again, always follow your pediatrician’s recommendations and speak with your pediatrician if food allergies run in your family, as the recommendations may be different.  Families of babies that have a history of an allergic condition, including a food allergy, asthma, allergic rhinitis or eczema, should absolutely speak with their pediatrician before offering any of these foods. 

Want to learn more about introducing solid food to your little one?  Join me at the San Diego Breastfeeding Center for my next introduction to solids class on January 28th at 10:00-11:30am. Learn more here

Rachel Rothman, MS, RD, CLEC is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  Rachel specializes in working with children and families.  She lives in San Diego with her husband, Ben, and daughter, Sydney.  You can contact Rachel here.

References:

Introduction of Solids and Allergic Reactions. (2009, December 7). Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Introduction-of-Solid-Foods-and-Allergic-Reactions.aspx

Fliescher, D. M. (2013, January 28). Early introduction of allergenic foods may prevent food allergy in children. Retrieved from https://www.aappublications.org/

Greer, F. R., Sicherer, S. H., & Burks, A. W. (2008, January). Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Retrieved from http://pediatrics.aappublications.org/content/121/1/183

Happy #GivingTuesday! Gift a Local Low-Income Mom with a Breastfeeding Consultation!

Happy #GivingTuesday!

Did you know.....

• While 93% of moms start breastfeeding exclusively at birth in San Diego, only 56% continue doing so at 3 months, largely due to a lack of access to ongoing lactation support.

• Lack of financial resources is reported as one of the main barriers for women to receive qualified breastfeeding support to help feed their babies.

You can help local low-income women gain access to critical breastfeeding support on this #GivingTuesday.

Wondering how your donation can help local breastfeeding moms?

We are asking you to help us #SupportSDMoms by donating your weekly coffee money! 

It’s that simple!  

If everyone reading this blog article donated $10-$20 today to the San Diego Breastfeeding Center Foundation.... the amount they would spend at a coffee shop this week... we would be able to raise over $40,000 on #GivingTuesday. 

Can you help us reach this goal?

All you have to do is click on this Paypal link to donate this week’s coffee allowance and help bring affordable breastfeeding support to hundreds of local low-income moms.

Age-appropriate Portions for Toddlers (and Moms)

This post is by Rachel Rothman, MS, RD, and is the third post in the three-part blog series about introducing solids to your little one.  Rachel is a mom to a toddler, a pediatric dietitian and instructor of “Introduction to Solids” and “Nutrition for Toddlers and Preschoolers” at the San Diego Breastfeeding Center.  Join us for the next Nutrition for Toddlers and Preschoolers class on October 29th at 10:00am.  More information and registration can be found here.

In case you missed it, I discussed the feeding relationship in my previous two posts, and these may be summarized using the division of responsibility. Parents are responsible for the “what, when, and where of feeding; children are responsible for the how much and whether of eating” [1].  In this third post we discuss age appropriate serving sizes – however, as with all nutrition advice, sustainably learning the behaviors associated with this division of responsibility will be as important, if not more influential, than simply choosing specific serving size, as all of our young ones progress at slightly different paces and individual ways.

Most of the food we eat- and the nutrient measurements we rely on – use the idea of serving sizes. But what does a serving look like?

Adults struggle with this because it’s hard to learn at home, and when we eat out, it’s nearly impossible to get consistent feedback.  As children, most parents did not learn to react this way, and an age of abundant and convenient food has limited the effects of our natural impulses.  

When we feed our children, many parents second-guess themselves and their children’s eating behaviors.  Is my child eating enough?  Is my child eating too much?  Here are some helpful guidelines when it comes to your children and serving sizes, starting from the beginning, when first introducing solids.

Tips and guidelines when thinking about the appropriate serving size for your infant and toddler:

- Around 6-7 months, as your baby is first starting solids, it’s important to remember serving sizes are very small.  If you are offering purees, you will want to start by offering 1-2 teaspoons, keeping in mind initially your baby may not take more than a small taste.  You will most likely be advancing to 1-3 tablespoons as your baby moves toward 7-8 months.

- From 6 months to around 1 year, breast milk or a breastmilk substitute should still make up the majority of your baby’s calorie intake.  Offer breast milk or a breastmilk substitute before solids, especially when starting out. 

- All babies are different.  Some babies love solids right off the bat and may take more than 2-3 tablespoons.  That’s okay!  It may take other babies some time to begin their solid intake and they may refuse for a while.  That’s okay, too! The important thing is to continue to offer solids, but let your child decide whether he/she wants to eat.

A typical toddler breakfast: 2-3 tablespoons of yogurt, 1/4 cup fruit and 2-3 small pancakes (and it’s okay if they don’t finish the whole thing!).

-Around 8-11 months your baby continues to grow, so does his/her appetite.  Solid intake may increase, but not by much.  A full day’s worth of solids might be: ¼ cup of fruit, ¼ cup vegetables, 1-3 tablespoons protein and ¼ cup whole grains.  A serving of vegetables, however, may still be closer to 2-3 tablespoons.  

- After one year of age, baby’s growth slows (most babies triple their birth weight over the first year!).  With a decrease in growth rate may also come a decrease in appetite.  Do not be alarmed if intake decreases after one year of age.  It’s most important to monitor your baby’s weight gain and growth. 

Snacks and lunch packed for daycare: 1/2 peanut butter and jelly sandwich, blueberries, oat and spinach muffin, string cheese and nectarine slices.

Additionally, after one year of age, your toddler may be eating more meals and snacks throughout the day.  When thinking about meals and snacks to serve, try to offer something from each food group.  Meals should consist of a fruit or vegetable, carbohydrate and protein, while a snack might consist of a fruit and vegetable and a carbohydrate. Don’t be afraid to think outside the box and try new things.   One of my daughter’s favorite on the go snacks is a mix of chick peas and green peas;  a combination of protein and carbohydrates with a healthy mix of vitamins and minerals.  

Stay positive! Picky eating behaviors often develop during this time and can persist as a phase many healthy kids go through.  If you stay positive and dedicated to offering a broad variety of healthy, whole foods, you have the best chance of continuing to nourish your little one while accommodating their tastes and preferences.

To learn more about introducing solids to your little one, join me at the SDBFC in one of my Introduction to Solidsor Nutrition for Toddlers and Preschoolers classes.  More information can be found here.

[1] Satter, Ellen M.,  Child of Mine: Feeding With Love and Good Sense, Bull Publishing Company; Revised edition (March 1, 2000) http://www.amazon.com/Child-Mine-Feeding-Revised-Updated/dp/0923521518 

Rachel Rothman, MS, RD is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  She lives in San Diego with her husband Ben and daughter Sydney. 

Fall Diaper Donation Drive to Benefit the IRC in San Diego

San Diego Breastfeeding Center is excited to announce our Fall Diaper Drive, which will benefit the International Rescue Committee in San Diego! Beginning on Wednesday, October 12th and continuing through Wednesday, November 30th, we will accept donations of new, unopened packages of diapers at our office in Hillcrest [3355 4th Avenue, San Diego, CA 92103]. Diapers can be dropped off during our weekly Breastfeeding Support Group, every Wednesday between 11:30am and 1pm. If you would like to make a diaper donation, but are unable to drop off during this time, please contact Anna Choi of the San Diego Breastfeeding Center to arrange a pick-up of your donation [annachoi@sdbfc.com].

Chris Williams, Resettlement Program Manager in San Diego, tells us:

The International Rescue Committee [IRC] welcomes more than 1,000 refugees to San Diego each year from war-torn nations around the world, including Syria, Iraq, Somalia, Afghanistan, the Democratic Republic of Congo, and others. Many such families have arrived in just the past few months, and after years, or even decades, in transition, they’re looking forward to a new life and a fresh start in San Diego. IRC provides assistance to these families in a number of different ways, however the first month after arrival can be very difficult, especially for families with young children. Families receive limited financial assistance through the federal government and as such, the IRC really relies on donations and support from the community to help provide for these newly arriving families. What may seem like a small donation of a package of diapers can go a long way in helping people feel safe, welcome, and comfortable in a new place.

As a mother myself, I know how quickly the cost of diapers can add up, and I can’t imagine what it must feel like for these parents to arrive in a new country with uncertainty about how they will provide for their little ones. With that being said, I encourage everyone reading this blog, who has the means to, to consider making a small donation {or a large one!} by purchasing an extra package or box of diapers the next time they are at the store, to donate to the IRC. The IRC has a particular need for diapers in sizes 3 and up and would greatly appreciate donations in these sizes.

For more information about the diaper drive, or to arrange a pick-up, please contact Anna Choi at annachoi@sdbfc.com. Thank you!

How to Help Your Little One Feel Full with Solids

This post is by Rachel Rothman, MS, RD, and is the second post of a three-part series about introducing solids to your little one.  Rachel is a mom to a toddler and a pediatric dietitian. Rachel is the instructor of "Toddler Nutrition" and “Introduction to Solids” classes at the San Diego Breastfeeding Center. Join us for the next Toddler Nutrition class on October 29th at 10:00am.  More information and registration can be found here.

In my previous post, I addressed a parent’s responsibilities for the “when” (setting meal time) and the “what” (the food to be served) of feeding.  This approach is generally referred to as the feeding relationship: Parents are responsible for the “what, when, and where of feeding; children are responsible for the how much and whether of eating” [1].   The relationship is between parent and child, and between the child and the food they eat.  Now that we’ve established the parent’s responsibilities, we can move to the child’s responsibilities – whether to eat, and how much to eat.  

By controlling the WHAT, parents introduce foods, and should be actively monitoring how children respond. Getting started is fairly simple: you offer the food, and your child decides how much and WHETHER they want to eat it.  Yep, that’s it.  

However, this will surely bring a challenge (and for some, the harder obstacle to overcome) to be okay with how much and whether your child accepts the food.  

 

Start Small

When introducing solids to your little ones, starting small is essential to help him learn to physically accept solid food and learn to taste, chew, and swallow effectively.  If you choose to start by offering purees, offer a small amount of a pureed food to your little one.  If the child opens his/her mouth toward the spoon, help guide the food into his/her mouth.  If the child turns away from the spoon, trust his/her instincts that he/she does not want that food or is simply not ready.   If you choose to use the baby led weaning approach, start by placing food in front of your child on his/her high chair tray or the table. Trust that your baby knows what he/she needs.  And keep in mind, especially when starting out, breast milk or a breastmilk substitute will make up the majority of your little one’s calories and nutrition until he/she is close to a year old.  Your job is to help them learn how to eat.  You are letting them know they can choose how much and whether they would like to eat.  

When you move beyond purees and toward more complex foods, offered more frequently, this approach can, and often will, get more challenging.   As your child gets older and enters toddlerhood less of his/her nutrition may come from breast milk or a breastmilk substitute.  However, this is when it is more important than ever to keep in mind your child’s ability to self regulate.  As you offer more food at a given meal, you’ll be looking for signs that your child feels hungry.  That feeling (rather than a specific amount of food) helps your child to learn appropriate eating habits.

 

Experiencing Hunger and Feeling Full

Allow your child to experience the physical and cognitive effects of being hungry before eating - his/her young body’s regulatory reflexes come from feeling hungry and then knowing when he/she full.  

Research shows that children who are taught in this manner develop positive food attitudes, interest in eating a variety of foods, an intuitive sense of how much to eat, and long term skills for healthy eating and meal planning.[2]

There are a few things you can do to encourage your child to feel hungry and full, such as only offering a meal or snack every 2-3 hours (allow your child to feel hunger and sensation of fullness) and only offering water in between meals (rather than juice or sugary beverages).  

Eat Meals Together

Sit and have meals with your child, as time allows, and eat the same foods as they eat.  Not only will you be in a better position to monitor your baby’s preferences, but you can encourage her choices and ease her frustrations through words and sounds.  When your child tries a new food or enjoys an old favorite, you can show him that his choices matter to you.  Another benefit is cognitive: take the opportunity to teach your child the names of the foods he’s eating!

Lots of Exposure to the Same Foods

Keep in mind it can take up to 20 exposures of a new food before a child accepts it.  This is true when introducing solids to an infant as well as more complex foods to a toddler.  Before you rule out a food and dismiss your child as disliking it, keep offering it.  Chances are, after enough exposures, your child may have a change of heart.   While some degree of pickiness is normal, if you feel concerned with your child’s feeding habits, consult your pediatrician or a registered dietitian.

With the principles above, you’ll be on your way to raising a healthy eater!  Stay tuned for our next post, “Age-appropriate portions”.  If you’d like to keep exploring this topic with us, we’d love to see you in our next  Introduction to Solids class.

[1] Satter, Ellen M.,  Child of Mine: Feeding With Love and Good Sense, Bull Publishing Company; Revised edition (March 1, 2000) http://www.amazon.com/Child-Mine-Feeding-Revised-Updated/dp/0923521518

[2] Satter, “Eating Competence: Definition and Evidence for the Satter Eating Competence Model” Journal of Nutrition Education and Behavior ● Volume 39, Number 5S, September/October 2007  http://www.ellynsatterinstitute.org/cms-assets/documents/101150-596171.ecdefandev.pdf

Rachel Rothman, MS, RD is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  She lives in San Diego with her husband, Ben, and daughter, Sydney.  You can contact Rachel here.