School Lunchbox Meal Ideas

It’s here- the new school year! Bringing lunch from home is great if it is feasible for your family. It can be tricky coming up with school lunchbox ideas that include variety, foods your kids will eat, and foods that will stay good until lunchtime. I recommend getting a lunchbox that can Child with lunchboxaccommodate a refrigerated pack to keep certain foods cold.

Here are 5 ideas, one for each day of the week, that are dietitian approved:

Sandwich Lunchbox

You can’t go wrong with the tried and true staple.

  • Whole grain or 100% whole w­­­heat bread, nitrate- and nitrite-free lunchmeat, real cheese (steer clear of the heavily processed ones that come individually plastic-wrapped), lettuce, tomato, mustard.
  • 2 mini oranges
  • Whole wheat pretzels

Vegetarian Tortilla Wrap Lunchbox

Although it’s vegetarian, it’s not lacking in protein.

  • Use your kid’s favorite tortilla wrap (spinach, whole wheat, etc), and fill it with hummus or pureed black beans or lentils, sliced red and green peppers, and shredded cheddar or mozzarella cheese.
  • To make a bean puree:  Saute ½ of a white or yellow onion in olive oil in a small skillet. Add pre-cooked lentils, beans, or canned beans and season with salt, pepper, and cumin. Cool after cooking, and stir in chopped cilantro and a little of your favorite salsa. Puree or fork mash the mixture.
  • Tortilla chips
  • Grapes

Lettuce Wrap Lunchbox

Kids like assembling their own foods, and although this might seem outside of the norm in terms of “kid food”, they are delicious.

  • 3 pieces of whole romaine lettuce leaves (approx 6” long ), 3 strips of baked, grilled, or otherwise cooked chicken or steak, thinly sliced carrots, and a mini Tupperware container of Asian salad dressing (be aware that many Asian dressings contain peanuts. If your school is 100% peanut-free, try French or Catalina dressing instead).
  • Clif Z bar or Larabar
  • Dried cranberries
  • Milk

Bagel, Nut Butter, and Jelly Lunchbox

 Again, you can’t go wrong with this kid favorite.

  • Use a whole grain bagel or a whole wheat English muffin. If your school is peanut-free, instead of peanut butter, try sunflower seed butter, almond butter or cashew butter. Add your kid’s favorite jelly (I recommend organic preserves that have less sugar- check at the farmers market too), and even a little drizzle of honey.
  • Carrot sticks
  • Whole grain Goldfish crackers
  • Milk

Cracker and Cheese Assortment

With the right sides, this does make a good meal.

  • Whole grain woven wheat crackers (i.e. Triscuits)
  • Brown rice cake or rice crackers
  • Whole grain round crackers
  • Two types of cheeses, sliced into 2”x2” squares, such as cheddar, swiss, muenster, or whatever you have in the house.
  • Shelled edamame
  • Banana

Each of the above meals includes (at minimum) a source of protein, a whole grain, a fruit, a vegetable, and a dairy serving. Give your child’s lunch experience a special touch by including a little note from you or dad, or put a sticker on one of the baggies or containers. And remember, fueling your child’s body and brain with healthy foods before and during school promotes better learning and school performance.

*Tip to encourage your child to eat the above lunchbox meals:  Share these meal ideas with your child’s friends’ parents. Kids tend to eat better in social settings where they see other kids eating and trying different things.

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Healthy Barbecue for Parents and Kids

Grilling season is going to be wrapping up in the next few months, but not before one of the biggest grill-out holidays of the season:  Labor Day! Summer barbecues are a time to celebrate with good food. You can still have good food and be healthy at your barbecue.

Parents with both of their children sharing food at the Barbecue

Here are some healthy barbecue pointers that I follow for myself and my family:

Choose organic meats. My picks:

  • Organic chicken breast or drumsticks (the drumsticks are only $3.00-$4.00 for 5 large pieces at Trader Joe’s)
  • Organic, local, grass fed ground beef from Fruitful Yield (at about $5.00 per pound, it doesn’t cost much more than non-organic)
  • Trader Joe’s 100% beef, nitrate- & nitrite-free hot dogs
  • Applegate brand organic hot dogs, which can be found in many grocery stores

Choose whole grain or 100% whole wheat hot dog and hamburger buns

You can find these at any grocery store, and really, they don’t taste different. Especially with all the yummy grill flavor coming through, and of course condiments.

Choose produce from the farmers market

Add some veggies to your grilling repertoire. Right now in season there is plentiful corn on the cob, eggplant, yellow and green zucchini, onions, potatoes, fennel, all colored peppers, mushrooms, and more. If your kids are old enough, ask them to help wash and even chop some of the veggies for you into large pieces. Toss the veggies in olive oil and sprinkle with salt and pepper. Grill them, turning them once. After removing from the grill, drizzle a little balsamic vinegar over them and sprinkle with chopped parsley. Serve in a large dish- beautiful with all the colors!

Make fruit skewers with yogurt dip

Again, get your kids involved by having them help wash, portion, and skewer a variety of fruits. Be creative and make a rainbow of colors with different fruits. You can make a simple fruit dip with vanilla yogurt (or any fruit flavored yogurt really).

Try pasta salad instead of traditional potato salad

You can make a delicious, healthier version of pasta salad by using whole wheat pasta or quinoa, an olive oil and vinegar dressing, and plenty of veggies, olives, fresh herbs and spices to flavor it.

Manage portions

Of course, there will likely be a variety of not-so-healthy food choices at any barbecue. Make just one plate of food, and make it reflect the Healthy Plate Model:  half of the plate filled with fruit and veggies, the other half split between whole grains and protein. Have a small dessert and drink water instead of soda.

Very important

Avoid over-cooking or charring foods on the grill, as this results in formation of cancer-causing compounds called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). You can avoid these by cooking on lower flame for longer, pre-cook the meat a bit to decrease time needed on the grill, and trim off any charred pieces you do get.

Happy grilling!

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Tips to Get a Child to Try a New Food | Pediatric Therapy Tv

In today’s Webisode, a registered dietitian provides strategies to help your child to try new foods.

In this video you will learn:

  • When is it recommended to offer a child a new food
  • How many exposures to a new food before we expect a child to eat it
  • How to make a child feel comfortable with trying new foods

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now, your host, here’s
Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman, and I’m standing here today with Stephanie Wells, a Pediatric
Registered Dietician. Stephanie, can you give us three tips on how to get a
child to try a new food?

Stephanie: Sure. The first tip would be that you want to offer the new
foods in a low pressure situation. Offer them foods at the table or on
their high chair, and consistently offer them a new food, maybe once per
week. Don’t pressure them to try the new food, but just offer it to them
and encourage them to try it, and let them sort of come around to it. Just
remember that research shows that it takes a child 8 to 15 exposures to a
new food before they might actually eat it.

The second tip would be to have them help pick out a new food that they
might want to try. And they can do that at the grocery store or the farmers
market. And also get them involved in actually preparing the food.

The third tip would be to be a good role model for your children, in terms
of eating the types of foods that you would like them to eat. It can also
be really effective if they eat in a setting with their peers. So if they
have cousins or a play group where they can eat together, and if they see
other kids eating those types of foods, then they will be more likely to
want to eat it themselves.

Robyn: All right. Well, thank you so much for the tips. And thank you to
our viewers for watching. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

Probiotics: What are they and Why are they Important?

Probiotics is the term for food and supplements that contain microorganisms that can colonize the gut, specifically the small and large intestines. We actually have billions of bacteria living in our gastrointestinal tract. We now know that these bacteria have important roles in the body. They are involved in digestion, prevent infection by other disease-causing bacteria, and maintain the lining of the digestive tract. These bacteria can be killed off by antibiotics, and up to 30% of people taking antibiotics experience the side-effect known as antibiotic-associated diarrhea (1). Some research has shown benefits to ingesting probiotics during and after a course of antibiotics to prevent diarrhea, to prevent pathogenic bacteria such a Clostridium difficile (C. diff) from inhabiting the gut and causing illness, and to maintain the lining of the gut. It is especially important for infants and children to have healthy gut bacteria, as they can be particularly susceptible to these side effects. It is also important that infants and children have a strong gut barrier as they constantly put things in their mouths and are still developing their gut-associated immune system. 70% of the human body’s immune system actually lines the gastrointestinal tract, and probiotics can help develop that.

The World Health Organization defines probiotics as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” (2). The supplement industry, which includes probiotics supplements, is not tightly regulated in the United States. Therefore, it is wise to ask a doctor or registered dietitian for recommendations of brands of probiotics if you or your child needs to take them in supplement form.

Probiotics are found naturally occurring in fermented foods such as:

  • Yogurt
  • Sour cream
  • Acidophilus Milk
  • Kefir
  • Tempeh
  • Sauerkraut
  • Kimchi

Including some of these foods in you and your child’s weekly diet can help ensure healthy gut bacteria and optimal digestion. For more information on probiotics in foods or supplements, and when to use probiotics, contact a dietitian at North Shore Pediatric Therapy.

References

  1. Mack DR. Probiotics. Can Fam Physician. 2005 November 10; 51(11): 1455–1457.
  2. Food and Agriculture Organization and World Health Organization Expert Consultation. Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. Córdoba, Argentina: Food and Agriculture Organization of the United Nations and World Health Organization; 2001. [cited 2005 September 8]. Available from: ftp://ftp.fao.org/es/esn/food/probio_report_en.pdf.

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Exercise Hydration: What is the Right Beverage for my Child?

With so many sports beverage and enhanced water products on the market, it’s good to know when they are actually useful. Many of these products have an ingredient list quite similar to soda, which is not something you typically would give your child or athlete after a workout. However, there are circumstances where nutrient and electrolyte replacement is very important for children and teens.

Child drinking a glass of water

Carbohydrates are an important nutrient to replenish because glycogen is the fuel which gets used up from muscle and liver stores during physical activity. Electrolytes, specifically sodium, potassium, and bicarbonate are important for nerve conduction and respiration. Some amounts are expired through sweat and given off with heavy breathing that comes with intense physical activity. For these reasons, carbohydrates and electrolytes need to be “replaced” after intense, continuous workouts lasting longer than 60 minutes, and can be achieved with electrolyte replacement beverages. This would apply to long distance runners, college or elite athletes in training, and swimmers, soccer, or basketball players who are doing continuous intense cardio training for more than an hour during workouts.

However, for most people hitting the gym for an hour or so, or kids playing in team sports or outside at the playground, nutrient and electrolyte replacement can be achieved from eating a normal, well-rounded diet. Eating a balanced meal or snack within an hour after physical activity is sufficient in this case. Drinking additional sports drinks will only provide extra calories and sugar (or diet sweeteners), and often artificial food coloring.

Use this table as a guide:

Commercial (or homemade*) electrolyte replacement beverage

  • Intense continuous physical activity lasting an hour or more such as running; drink 16-32 ounces of electrolyte replacement beverage. 30 grams of carb should be consumed for every 60 minutes of intense continuous cardio, within 30 minutes of activity. Electrolyte replacement is important if intense physical activity is in extreme heat, when sweating is excessive.

Chocolate milk (carb + pro + electrolytes)

  • College or elite athletes in training for several hours per day who need a quick, small meal + electrolyte replacement during or after long workouts lasting several hours. These athletes should consult with a dietitian who specializes in sports nutrition.

Coconut water

  • Natural electrolyte replacement beverage; high in potassium and lower in sodium and sugar than commercial electrolyte replacement beverages. Appropriate for moderate-high physical activity with sweating, such as spinning class, kickboxing, “boot camps”, outdoor sports in heat with continuous cardio 30-60 minutes, etc.

Water + well-rounded diet

  • As needed during and after any level of physical activity. This is all that is necessary for low or moderate physical activity such as playing outside, playing team sports, hitting the gym for 30-60 minutes, etc. A rule of thumb is 1 oz water for every 2 lbs body wt (50 oz/day for 100 lb person) daily. Increase as needed in heat or more strenuous activity.

*Recipe for homemade electrolyte replacement beverage, from Nancy Clark’s Sports Nutrition Guidebook

1/4 cup sugar
1/4 teaspoon salt
1/4 cup hot water
1/4 cup orange juice (not concentrate) plus 2 tablespoons lemon juice
3 1/2 cups cold water

  1. In the bottom of a pitcher, dissolve the sugar and salt in the hot water.
  2. Add the juice and the remaining water; chill.

Recipe makes 1 quart.
Per 8 ounce serving, recipe provides: 50 calories, 12 grams carbohydrate, 110 mg sodium, 43 mg potassium.
Compared to original Gatorade per 8 ounce serving: 50 calories, 14 g carbohydrate, 110 mg sodium, 30 mg potassium.

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Problem Feeders: When Picky Eating is a More Serious Problem

Following my last post about picky eaters, parents should know that there is a more severe level of picky eating, which has been termed problem feeding. In the medical community, it is often diagnosed as “feeding difficulties”.

Problem feeders have the following behaviors:

  • Young infants who refuse bottle or breast, or drink a small Mother feeds a babyamount then refuse. This results in a decreased overall volume consumed, and eventually weight loss and dehydration.
  • Toddlers and children who eat less than 20 foods.
  • Kids who “lose” foods that they once ate, and do not resume eating them even after a few weeks break. Eventually they may be down to 5-10 foods.
  • Kids who refuse certain textures altogether.
  • Kids who scream, cry, and panic over touching, smelling, or tasting a new food.
  • Kids who are unwilling to try almost any new food even after 10+ exposures.

Why do some kids become problem feeders?

There is an underlying reason why they have a strong negative association with eating, to the point where they will starve themselves before consuming foods outside of their repertoire. There is often a medical diagnosis that contributes to the development of a problem feeder, such as:

In these cases, the child forms “oral aversion” associated with the pain and discomfort they feel/felt as a result of eating or swallowing. This association is made very strongly in the young developing brain, and in the case of problem feeders, overrides hunger. Oral aversion becomes a protective mechanism, which is why they panic over eating new foods. Problem feeders can be underweight or overweight as a result of their rigid food choices, depending on what type and how much food they eat.

The big difference between picky eaters and problem feeders:

Eventually, a picky eater will come around to eat some type of food they are presented with outside of their usual repertoire, if they are hungry enough. A problem feeder will not respond to hunger cues to meet their needs with the food options presented to them if it is outside of their “accepted” foods. Problem feeders will go on a food “strike”, even if it results in dehydration and malnutrition.

Problem feeders need assessment and feeding therapy, which can be effectively achieved with a multidisciplinary team, such as at North Shore Pediatric Therapy. NSPT has occupational therapists, speech therapists, and dietitians to work through sensory, oral-motor, and nutritional deficits as well as mealtime behaviors. We also have social workers for additional support and behavior guidance.  If you are concerned that your child is a problem feeder or a picky eater, contact our facility for an evaluation.

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How to Cope with Night Terrors

Night terrors are a sleep problem that is most common in children ages 2-6 (but can occur at almost any age). They occur occasionally in about 15% of young children and can last 5-30 minutes. You may see your child bolted upright in bed, crying or screaming, sometimes appearing to be awake but with no recognition of who you are. Night terrors differ from nightmares in that your child is not likely to remember anything in the morning.child with a night terror

Because night terrors are considered normal, you do not need to seek treatment (as long as you have ruled out any underlying medical or mental health conditions). However, they are often very scary and distressing for both the children and their parents. What you can do, is identify ways to help your child cope with the stress and promote a calming sleep environment. Children who are overtired, experiencing stressful life events, or have a fever may be more likely to have night terrors.

If you catch your child in the middle of a night terror, it is suggested that you do not try to wake them out of it. This could scare them—especially because of your own stressed reaction. It is usually best to make sure they are safe (gently restrain if needed) and wait until it is over. You can provide comfort, speak softly and calmly, and help them return to sleep (in their own bed).

Steps You Can Take to Ease the Stress of Night Terrors:

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Help! My child is a picky eater!

The picky eater phenomenon is not uncommon, and can be quite challenging and stressful for parents.

Picky eaters have the following characteristics/behaviors

  • Eat a limited number of foods (20-30).
  • Avoid classes of foods such as red meat or green vegetables.
  • May reject foods they previously accepted, but will re-accept these foods after a two-week break.
  • Will try some new foods after being exposed to the food several different times.
  • Will touch and play with new foods, although they may not eat it at first.
  • Picky eaters usually eat enough to support growth within normal ranges.  (1, 2)

How To Encourage Your Picky Eater, To Eat More:

To alleviate some stress, first examine if your expectations for your child’s eating is realistic. Kids are naturally wary of new things (think “stranger danger”), including new foods. Picky EaterTheir first reaction to something they have never seen, smelled, touched or tasted before is to not trust it. Do not be discouraged if your child doesn’t love hummus, spinach, and salmon right away. It takes an average of 8-15 exposures to a new food before the child will actually eat it (2). Also, toddlers and teens particularly want to exert their sense of control and opinion, including what they will (and won’t) eat. In other words, sometimes a strong-willed child will refuse to eat what you want them to just because it gives them control over that aspect of their environment.

Typically developing young children will eat according to their innate hunger and satiety cues. That is, they will eat what they need when they are hungry and not when they are satisfied. Imagine how you might feel if you were full from dinner, and someone comes at you with a spoonful of food telling you to take another bite. Imagine you are really full, and the thought of taking another bite makes you sick. Now this person starts yelling at you and threatening to punish you. How would you feel? It can be difficult to let go and trust your child’s appetite. Your job as the parent is to provide healthy meal choices, regular mealtimes and snacks, and a positive eating environment without toys or TV.

Finally, using bribes like “one more bite and you can have dessert”, and punishments such as “you can’t play outside if you don’t finish your plate” are not effective in the long run. Doing these things negates children’s natural ability to eat what they need. It also creates a negative, untrustworthy dynamic between the child and the caregiver at the table. Picky eaters will continue to thrive and meet their nutrition needs when provided an optimal mealtime environment. A dietitian at North Shore Pediatric Therapy can counsel families to help picky eaters.

However, there is a difference between a picky eater and a problem feeder. Problem feeders have more rigid food preferences, a dwindling number of accepted foods, and will refuse food (and drinks) that are not part of their repertoire to the point of malnutrition. These children require more intensive evaluation and therapy, and benefit from multidisciplinary treatment available at North Shore Pediatric Therapy. I will further discuss problem feeders in my blog next week.




  • Carruth BR, Skinner J, Houck K, Moran III J, Coletta F, Ott D. The phenomenon of “picky eater”: a behavioral marker in eating patterns of toddlers. J Am Coll Nutr 17:180-186, 1998.
  • Carruth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. J Am Diet Assoc. 2004 Jan;104(1Suppl1):s57-64.

Is My Child Getting Enough Protein?

Parents often tell me they are concerned that their infant, toddler, or child isn’t getting enough protein. Protein is critical for human growth, particularly during times of rapid growth- infancy and puberty. If your child is seemingly not eating enough protein, you may be concerned.

The good news is that kids can meet their daily protein needs more easily than you might think!

Infant Protein Needs:

Infants need more protein per kilogram of body weight than any other stage of life. However, breastmilk and infant formulas provide adequate protein, given that your child is taking enough volume. You will know that they are taking enough volume if they are growing within normal limits on the growth chart at pediatrician visits. Children eating protein foodsPreemies who need “catch-up growth” or infants who have special health care needs have especially high protein needs, and should be managed by a pediatric dietitian as well as their doctor.

When solids are introduced, offer a variety of pureed meats and/or beans at 8-9 months. You can make your own baby food by simmering meat in a crock pot (with enough water to cover it) for 8-12 hours or until very tender. Then once the meat has cooled, blend it in a food processor, adding liquid such as breastmilk, formula, or water as needed to make a smoother consistency. Infants over 8-9 months can also pick up and eat soft beans such as black beans. Make sure they are soft enough to mash easily in their mouth and watch closely for choking. You can mash them a little with a fork before putting them on their tray to make them easier to eat.

Toddler Protein Needs: 

Toddlers between the ages of 1 and 3 years need 1.2 grams of protein per kilogram of body weight. For example, if your child weighs 30 lbs, or about 14 kg, he or she needs about 16 grams of protein every day. Here is how your child can achieve this:

8 ounces, or 1 cup, of 2% milk has 8 grams of protein.
1 egg, prepared any way, has 7 grams of protein.

Your toddler practically met the entire day’s protein requirements in breakfast alone!

Adolescence Protein Needs:

During adolescence, kids need 1 gram of protein per kilogram of body weight. So for example, a child who weighs 100 lbs needs about 45 grams of protein. Adolescents typically have a good appetite, so eating enough protein is usually not a problem. If your teen is skipping meals, restricting food, or losing weight suddenly, you should talk to your pediatrician or registered dietitian to make sure they get the nutrition they need.

Alternatives to meat that provide protein*

Cottage cheese – ¼ cup has 7 grams protein
Yogurt – ½ cup has about 5.5 grams protein
100% whole wheat bread – 1 slice has 5 grams protein
100% whole wheat pasta – ½ cup has about 4 grams protein
Quinoa – ½ cup has about 4 grams protein
Black beans – ¼ cup has 4 grams protein
Peanut butter – 1 tablespoon has 4 grams protein
Sunflower seed butter – 1 tablespoon has about 3 grams protein
Hummus – 1 tablespoon has about 1 gram of protein

*protein amounts may vary by brand

If you or your pediatrician have concerns about your child’s nutrition intake or growth, contact a pediatric registered dietitian for a nutrition assessment and recommendations. The dietitian can get your child back on track and help alleviate any stress you have as a parent regarding your child’s nutrition.

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Preemies: Special Little Ones with Special Nutrition Needs

When going through pregnancy, most mothers expect to have nine months to prepare for a newborn. Caring for a preemie, however, is not something that pregnancy books and newborn care classes cover.

In terms of preemie nutrition and feeding, the following information can help prepare you or provide insight into what you may be experiencing:

Mother eating with infant

1. Nutrition support

This refers to an alternate route of nutrition for your baby. Babies may require nutrition support if they have low birth weight or other medical complications. If born before 34 weeks, he or she may not be able to coordinate sucking, swallowing, and breathing during oral feeding. Your baby may receive breastmilk or formula through a tiny tube that goes into the nostril or mouth and down to the gut (enteral nutrition). In cases of very early preemies, many have to receive parenteral nutrition, or nutrition through an IV (intravenous). This is because their digestive system is not yet developed enough to handle the full volume of breastmilk or formula that is required to sustain growth. There can be a number of factors that limit an infant’s ability to tolerate enteral nutrition, and parenteral nutrition becomes necessary.

2. Fortified breast milk or special formulas

Being outside the womb early presents challenges and demands on the infant’s body that can increase nutrition needs. Preemies with low birth weight need more calories, protein, vitamins and minerals than infants born at full term, to promote “catch up growth”. Human breastmilk has been analyzed from mothers of preemies and mothers of term infants, and preemie breastmilk actually contains more calories, protein, vitamins and minerals than term breastmilk. Often times, preemie breastmilk needs to be fortified further to meet the infant’s needs. There are also formulas designed for premature infants in the event that breastmilk is not available. Proper nutrition is critical for the development of vital organs like the lungs, heart, brain, and gut. Neonatologists and registered dietitians assess each baby in the NICU for nutrition needs, and create individualized recipes and feeding regimens. Sometimes these special recipes and feeding regimens need to be continued once the baby goes home from the NICU, and parents get educated by the medical team on how to do this.

3. Swallowing or oral feeding issues

Babies develop the ability to coordinate sucking, swallowing, and breathing around 33 or 34 weeks. There are a number of circumstances that may impact this developmental stage for preemies born prior to that. The baby may require a ventilator for oxygen, which would not allow oral feeding to occur. Or, the baby may require nutrition support during this time for a variety of reasons, and oral feeding attempts may not be possible. These scenarios can have lingering effects on how the baby feeds and swallows in the future. Babies may require special feeding techniques or “thickened” liquids if they have swallowing difficulties. Sometimes babies develop oral sensory issues and aversion to oral feeds, in which case tube feedings may continue until this is overcome.

An article published in Neonatology in 2008 titled “Strategies for feeding the preterm infant”, by Dr. William Hay, provides a review of preemie nutrition (for free full text, click here). As your infant gets older, his or her nutrition needs will change. Growth should be monitored closely by your child’s doctor.  Nutrition is critical, and expert care should be provided to ensure maximum development. If you or your doctor has concerns about growth, nutrition, or feeding, schedule an appointment with a dietitian at North Shore Pediatric Therapy.

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