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The Critical Role of Nutrition in Therapy

This guest blog was written by Betsy Hjelmgren, MS, RDN, CSP, LDN, owner and founder of Feed to Succeed.

Essential to every person, especially a growing child, is healthy nutrition. This is especially true for children who require therapy for health issues. As a registered dietitian, not a day goes by that I Blog-Nutrition-Main-Landscapeam not reminded that proper nutrition underlies the health and well being of every child.

I recently worked with an early intervention (EI) patient with developmental delays. When we first met, he wasn’t meeting the expected milestones for his age, such as walking and talking. His parents and therapists complained that he lacked energy whenever they tried to work with him, and yet, when they encouraged him to eat, he was too tired and weak for this seemingly simple task. I recommended a feeding tube for the short term, and in one month, the child gained three pounds and began to walk and talk.

Of course, not every child who would benefit from working with a registered dietitian requires such intensive therapy. Many children, however, do benefit from an adjustment in their diets so that they have the energy and strength to meet milestones in therapy and can improve outcomes.

A child who doesn’t have the proper building blocks in his muscle and nerve endings needs proper nutrition in order to thrive in occupational or physical therapy, for example. Similarly to a garden, where a plant needs soil, nutrition and water to grow, a child needs proper food, nutrition and care to ensure the best outcome in his development.

While all children who don’t receive proper nutrition cannot function to their highest potential, in some cases, it is not obvious that they are lacking nutrition. It’s once a child responds to a new diet that it is obvious how effective nutrition is. For example, a child who is allergic to cow milk may not be getting enough protein to build muscle and may not be growing as tall as she could. Nutrition guidance, education and support can provide a more well-rounded diet.

Following is a screening tool for parents to use in order to determine when a child would benefit from receiving nutrition therapy:

  • A child who has not gained weight over 2-3 consecutive months or has not grown in height over 3-6 months
  • A child who frequently has a poor appetitive or is extremely picky
  • A child who seems thin, tired or pale
  • A child who has frequent chronic constipation or vomits
  • A child who completely avoids certain food groups
  • A child on a modified or restricted diet.
  • A child who receives supplemental feedings, such as a feeding tube or Pediasure

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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BetsyBetsy Hjelmgren, is the owner and founder Feed to Succeed in Glenview, Ill. She has been a registered dietitian, licensed in the State of Illinois, for over a decade. Registered dietitians are the only nutrition experts regulated by the Academy of Nutrition and Dietetics, and licensed to provide professional nutrition advice. Betsy is credentialed with Early Intervention for qualifying children aged 0-3 years old and is also the mother of two children. Follow her on Twitter @feedtosucceed and on Facebook.

IBS Versus IBD: What Is The Difference And How Can Diet Help?

Does your child suffer from gastrointestinal pain, bloating, diarrhea, or even vomiting episodes? Have you researched the symptoms or spoken with your pediatrician? You may have come across the terms IBS (Irritable Bowel Syndrome) and IBD (Irritable Bowel Disorder). These two gastrointestinal disorders can present with similar symptoms, so it may be confusing to decipher what’s really going on at first. However, there are distinct causes and ways of diagnosing them that determine whether a patient has IBS or IBD.

Irritable Bowel Disorder (IBD)

IBD is a term used for two specific gastrointestinal diseases.  One form of IBD is Crohn’s disease.

Symptoms– Painful “flare-up” episodes. The pain can occur anywhere in the gastrointestinal tract. The flare-ups cause diarrhea and sometimes vomiting, either of which may contain blood. These episodes may be accompanied by fever and/or fatigue. Weight loss can also occur.

Causes– A variety of factors that trigger an autoimmune, inflammatory response.

How it is diagnosed– A gastrointestinal doctor will perform a “scope” (endoscopy and colonoscopy) of the suspected areas affected in the gastrointestinal tract. This involves being sedated, having a tiny camera inserted into the gastrointestinal tract, and biopsies taken. The doctor can diagnose Crohn’s based on what he or she observes from these tests. If the inflammatory sites are located in patches or varying locations along the gastrointestinal tract anywhere from esophagus to anus, it is indicative of Crohn’s.

Treatment– During flare-ups, doctors will evaluate and may prescribe steroids, antibiotics, pain killers, and a modified diet that is low in fiber and other foods that may trigger inflammation such as lactose. In severe flare-ups, patients may be hospitalized and required to be on bowel rest, which means consuming nothing by mouth. When not having a flare-up, patients with Crohn’s are encouraged to eat a healthy diet with good sources of fiber. “Trigger foods” should also be avoided in general, which may include high fat or fried foods, excessive amounts of dairy, caffeine, and others.

The other form of IBD is Ulcerative Colitis.

Symptoms– Pain and cramping focused in the lower intestines. Diarrhea, sometimes with blood. Weight loss and fever can occur as a result of severe inflammation and diarrhea.

Causes– Inflammation that can be caused by a variety of factors and becomes chronic. Inflammation is in the colon and may progress continuously up the lower intestine.

How it is diagnosed– A gastrointestinal doctor will perform a colonoscopy with biopsies.

Treatment– Similar to treatment of Crohn’s.

Irritable Bowel Syndrome

IBS is a bit more of an ambiguous condition than IBD, and can be difficult to identify and treat.

Symptoms– Abdominal pain, bloating, gas, diarrhea and/or constipation, general maldigestion and discomfort which may or may not be associated with eating any particular foods.

Causes– Definite causes of IBS are still unknown, but are currently being researched.

How it is diagnosed– IBS is diagnosed by closely tracking symptoms and ruling out all other diagnoses.

Treatment– Individualized modifications in diet and lifestyle which differ from person to person and may change over time. Some IBS sufferers trial “elimination diets” where common problematic foods are eliminated (such as wheat, dairy, corn, eggs, soy, etc.) to see if symptoms improve. Another recent diet therapy for IBS is the FODMAP diet, which eliminates high fructose corn syrup, some legumes, wheat, and various fruits and vegetables, among other things.

If your child suffers from IBS or IBD and you would like more guidance on diet therapies, schedule an appointment with a registered dietitian at NSPT. 877-486-4140.

Cooking Greens Made Simple

Swiss chard, kale, spinach, mustard greens, collard greens, bok choy… the word “superfood” is synonymous with all dark, leafy green vegetables. The super greensreason why is because they pack such a large nutritional punch. In general, dark leafy greens are loaded in vitamin A, folate, fiber, and also provide minerals like calcium and iron. They are even a source of the heart-healthy omega 3 fatty acids. As if that’s not enough, eating your greens can help fight cancer, which you can read more about on the website for the American Institute for Cancer Research.

So we know how nutritious greens are, but what about the taste? And what do you do with those big tough leaves of chard and kale anyways?

Here are some unique recipes to help your family eat more of this nutritional superfood:

Stir Fried Shrimp or Chicken and Bok Choy*

  • 2 cups cooked brown rice (made ahead)
  • 2 T olive oil
  • 2 T plus ½ teaspoon soy sauce
  • 1 pound shrimp, peeled and deveined, tails removed OR 1 lb chicken, diced
  • 6 scallions, chopped
  • 1 T fresh ginger, minced
  • 2 cloves garlic, chopped
  • 3-4 bunches of bok choy, stemmed and sliced
  • 2 T rice vinegar
  • Asian chili sauce

Cook shrimp or chicken in olive oil and ½ teaspoon soy sauce over medium-high heat, until cooked through. Transfer to a plate. Add scallions, ginger, Read more

Healthy Twists on Your Kids Favorite Foods

Let’s face it; kids have their favorite foods and those foods may not be the healthiest choices. Wouldn’t it be nice if we, as parents, could make healthier mango icecreamversions of foods that kids actually enjoyed? Well, you can! These recipes have been kid-tested and approved in my office (and home).

Below are a few ideas on healthy twists on your kid’s favorite foods:

Rice Cake Pizzas:

  • Brown rice cakes
  • Fat-free pizza sauce
  • Mozzarella cheese
  • Baby spinach, sliced tomatoes and/or diced green peppers

Take out one rice cake and place 1-2 tablespoons of pizza sauce on top. Sprinkle about ¼ cup of cheese and as many veggies as you can get on top. Heat in the microwave for about 20 seconds or until cheese is melted. One “pizza” is approximately 100 calories, which makes a great snack or part of a meal. These pizzas are also gluten-free.

Simple Homemade Mango “Ice Cream”:

  • 2 cups nonfat vanilla Greek Yogurt
  • 1 package (16 oz) of frozen mangoes

Let mangoes sit at room temperature for about 10 minutes to thaw slightly. Place all ingredients into a blender or food processor. Blend until smooth so that the consistency is similar to ice cream, or for about 5 minutes. Serving size is ½ cup, which is 100 calories. This is a great option for a healthy dessert. Mangoes are high in vitamin A and the yogurt is a great source of protein and calcium.

Kale Chips:

  • 4 large kale leaves, washed and stems removed
  • 1 tablspoon olive oil
  • 1 teaspoon sea salt

Preheat oven to 350. After washing kale and removing stems, tear kale into bite-size pieces (approximately 2 inches x 2 inches each). Put kale pieces into a large bowl with olive oil and salt. Toss to coat. Spread out on a rectangular cookie sheet and bake for about 10 minutes or until kale is crispy like chips. Recipe makes 3-4 servings;however, this snack is so healthy that there is really no limit to the serving! Kale is a superfood and is high in many vitamins, minerals and phytonutrients.

These recipes are all winners- for parents as well as kids. They are low in calories but high in nutrients, which is the best combination. What are some of your kid-approved healthy twists on recipes?  I would love to hear about your recipes in the comments section below!

Parents’ Roles in Creating Healthy Eaters

At some point during your young child’s life, you may face challenges that involve getting them to eat well. Often, the first challenge family eating dinnerpresents itself during the toddler years, in which children can become quite picky and more defiant. As kids are exposed to so many unhealthy foods that are specifically marketed towards kids and teens, these foods can cause excess weight gain.

When parents come to me seeking nutritional counseling for their child, we spend a lot of time discussing their role in their child’s nutrition. The reason behind this is because children learn so much about food and eating from the family. Consider the paradigm of nature vs nurture. Yes, there are certain inborn physiological predispositions children may have toward food and eating. This is the “nature” side of the paradigm; however there is also the “nurture” side, in which you influence how your children eat. Your kids have 3-5 learning experiences with you that are related to food each day (meals + snacks), beginning from infancy. Children are only able to eat and learn what foods you choose to present to them and in what manner you present food.

Below are some tips about parents’ roles in developing healthy eaters:

  1. Be the eater you want your child to be. If you want your children to eat fruits and vegetables, then you need to eat fruits Read more

Eating Disorders in Children and Teens

Eating disorders are a scary topic for parents. It is critical to be aware of signs that your child may be at risk for developing an eating eating disorderdisorder. The earlier you can get professional intervention, the better outcomes your child will have. You may be able to prevent the eating disorder from taking over your child’s life and causing serious health affects. The longer a child struggles with an eating disorder, the more difficult it can be for him or her to overcome it. The eating disorder becomes a coping mechanism they rely on to feel in control, and is something to focus on to avoid other issues. Eating disorders are mental health diagnoses, and involve disordered thinking, beliefs, and behaviors around food and body image. They should be treated and managed by a team including at minimum, a physician, a mental health counselor, and a registered dietitian.

Warning signs your child may have or be developing an eating disorder:

  • Rapid weight loss
  • Eating the same things every day, often in very controlled amounts
  • Self- imposed rules around eating Read more

5 Things a Dietitian Can Do for You and Your Child (that you might not know)

When you think of a dietitian, you probably think of healthy eating and weight loss. But dietitians are trained to manage many more  areas of health than that! Pediatric nutrition is a highly specialized field since infants and children are continuously growing and developing.nutritionist Furthermore, there are several diagnoses that are specific to infants and children which require unique nutritional management. Do you know what a pediatric dietitian can do for you and your family?

5 Things a Dietitian Can Do for You and Your Child (that you might not know):

  1. Help with breastfeeding. Dietitians who specialize in pediatric nutrition can seek specific training and education on breastfeeding. They can then educate parents on technique, what to expect, and how to seek continued support. For new parents, it is best to learn as much as you can about breastfeeding before the baby is born, and a trained pediatric dietitian is a great resource. After the baby is born, the dietitian can continue to provide education, troubleshoot problems with breastfeeding, and perform frequent weights to ensure the baby is taking in enough volume to support expected growth. Dietitians can also help breastfeeding moms who may need to make changes to their diet if baby is showing signs of food allergy or intolerance to something in mom’s diet.
  2. Special nutrition care for preemies. Preemies have nutrition needs that are different from babies born full term. They also have different growth goals. Some preemies, especially those born before 32-34 weeks, may have difficulty with feeding. If they are not taking enough volume to support growth goals, a dietitian can help strategize to ensure the baby gets adequate nutrition. This support can also be helpful when the baby transitions to solids, as well as during the toddler years when kids tend to become more picky.
  3. Help uncover food allergies or food sensitivities. Food allergies and sensitivities are difficult to accurately test for, even with blood work. If your child has chronic symptoms without a clear cause, such as eczema, runny nose, ear infections, diaper rash, diarrhea or constipation, fussiness, or aversion to eating, a food allergy or sensitivity may be investigated. A dietitian can guide you through eliminating foods that might be causing symptoms, and also provide a nutritionally-complete diet plan.
  4. Provide nutrition care for digestive problems. Often, digestive issues can be improved by making diet changes. A dietitian can make nutrition recommendations to help with reflux, diarrhea, constipation, bloating, and stomach aches. Dietitians are also trained to manage nutrition for GI disorders such as ulcerative colitis, Crohn’s, Celiac, IBS, and more.
  5. Manage nutrition for children with special healthcare needs. Pediatric dietitians are trained to provide proper nutrition for children with a wide variety of diagnoses in which nutrition, growth, and/or feeding are affected. Examples include Trisomy 21, cardiac defects, cerebral palsy, developmental disabilities, trauma, chronic respiratory issues, tube feedings, and more.

If you or your child’s pediatrician have concerns related to your child’s nutrition, growth, or feeding abilities, contact one of our registered dietitians to set up an evaluation. Our pediatric nutrition experts can help your child achieve his or her best potential. 877-486-4140.

Spring Clean Your Family’s Diet

Spring is here and, just like we give the house a good spring cleaning, this is a great time to do the same for your entire family’s diet. junk food garbage The growing season is beginning which means farmers’ markets will be opening in the next few weeks or months. In addition, we will be able to finally get outside more after a long, cold winter.

Here are a few ways in which you can help clean up your family’s diet this spring:

  • Eat more foods that “clean you out”. Think fiber. Foods that are high in fiber include fruits, vegetables, whole grains and legumes. Fiber binds fat in the gut and blood stream and carries it to be excreted in waste. Speaking of which, the more waste you are able to eliminate, the more toxins you are also disposing of as well.
  • Focus on foods that support detoxification processes in the body. The body has major organs that detoxify our system, specifically the liver, kidneys, skin and gut. Certain foods have phytonutrients that support these detoxification processes. These foods include lemon juice, onions, garlic, asparagus, apples and brassica vegetables like cabbage, cauliflower, broccoli and brussell sprouts.
  • Drink plenty of water. I recommend that kids drink milk with meals and water only between meals. Water helps “flush out” toxins. Drinking water throughout the day provides our blood and cells with fresh fluids continuously for optimum function. Drinking water throughout the day prevents sluggishness that accompanies inadequate hydration.
  • Get rid of sugar. If sugar is present in your family’s diet more than once per day, consider decreasing what sweets you keep in the house. Eating sugar in moderation is fine, which is about once per day. Remember that sugar is in many more foods than just candy and cookies. It is a major ingredient in many cereals, granola bars, yogurts, fruits snacks and beverages.
  • While you’re at it, clean out the food pantry. Just go ahead and toss or donate any foods that are not “clean”. This includes processed foods (think boxes and bags of snacks) and refined flours and sugars.

For more ideas on how to clean up your family’s diet, schedule an appointment with one of our registered dietitians today. 

Ways to Help Your Kids Eat Fruits and Vegetables

Most babies start out loving fruits and vegetables as some of their first foods. But somewhere during the toddler years, their feelings girl eating fruitoften change. Or maybe fruits and vegetables fall off your kids’ radar later in childhood. What can you do?

Ways to Help Your Kids Eat Fruits and Vegetables:

  1. Prepare them in kid-friendly formats. Think of some of your kid’s favorite foods, and then think about how you can make fruits and veggies like those foods. For example, most kids love potato chips. Try making baked kale chips or zucchini chips. Another example is ice cream. Try making homemade mango or strawberry ice cream by blending nonfat greek yogurt with frozen mangoes or strawberries.
  2. Make them appealing. This sounds like a no-brainer, but consider the difference between a pile of pale green canned green beans or peas compared to fresh, bright green ones arranged into a smiley face or Read more

3 Reasons Your Child Needs A Meal Schedule

Today, there is the great debate among parents to whether or not put their kids on a schedule. Should I give my child a daily routine or Family eatinggo with the flow of what they want, when they want it? In terms of feeding, schedules are very important for kids that are over 6-12 months old. Prior to 6 months old, feeding really should not be done on a schedule, but rather on demand. Breast or bottle feeding on demand helps infants learn to respond to hunger and satiety cues. In addition, it allows them to eat what they need to grow to their potential. At this age, eating is very instinctual and babies know best how much to eat and when to eat, with the exception of some cases of medical or developmental issues.

During the transition to solids, between 6-12 months of age, I advise parents to introduce a routine of “meals” from the beginning. Feed the infant at the same time as the rest of the family’s mealtime(s) every day. Then, as the child gets older, continue sticking to regularly scheduled family mealtimes and snacks that occur around the same time each day.

Below are three reasons why a meal schedule is crucial for children:

  1. Teaches good mealtime habits. Ask any parent and they will say that they have experienced mealtime struggles at some
    point. One way to eliminate mealtime struggles is to have set expectations from the beginning of introducing solids. Teach your young child that when it’s time to eat, we come to the table, sit in a high chair or booster seat and have a variety of healthy foods to eat. It makes the connection for them from the very beginning that sitting at the table means that it is time to eat.
  2. Prevents “grazing”. Grazing happens when we eat randomly all throughout the day. This can lead to over-eating unhealthy foods for older kids and it may actually lead to under-eating for younger kids. When children eat little amounts here and there, they fill up just enough to decrease their appetite for well-rounded meals.
  3. Promotes healthy digestion. Eating on a schedule means that we are filling up the gut at meals and then giving it time to empty before filling up again. The rhythmic filling and emptying of the gastrointestinal tract is the ideal pattern to stimulate regular bowel movements. Furthermore, a regular pattern of meals helps keep blood sugar balanced throughout the entire day, which helps to improve energy, concentration and moods.

If your family struggles with implementing mealtime schedules or routines, contact one of our registered dietitians to schedule an appointment. A registered dietitian can help you implement ways in which you can get your family back on track and address any nutrition concerns.