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The Healthy Plate Model

Did you learn the Food Pyramid as a nutrition guide when you were growing up? How about the Four Food Groups? Or was it Five Food Groups? Nutrition models can be quite confusing; however, the Healthy Plate Model is a new tool that is actually very simple to use. It is a way of visualizing how to put together a healthy meal without having to count or measure foods. Kids are now learning this method in schools and it is a model I advocate with families I work with as well.

Here are the basic features of The Healthy Plate Model:

  • Use a dinner plate for older kids and adults. Use a smaller children’s plate for younger kids.
  • Fill half of the plate with fruits and vegetables.
  • The other half of the plate is divided into two sections:
  • 1. ¼ of the plate has whole grains
  • 2. ¼ of the plate has a protein food

Visually, it looks like this:healthy plate model

By including these foods for each meal, and in these proportions, you can ensure a well-rounded diet for both you and your family. Notice that ¾ of the plate is represented by fiber-containing foods, which makes it easy to meet the recommended amounts of daily fiber intake. Although it might seem overwhelming to have that many fruits and vegetables on your plate, this does not always have to be salad. Consider vegetables in pasta sauce, soups, on sandwiches, as coleslaw, in stir fry, etc.

The Healthy Plate Model also promotes satiety, or feeling full and satisfied after eating, which helps prevent overeating. The high-fiber foods and protein moderate the absorption of sugar into the bloodstream. This prevents the sugar “spike” and “crash” that comes with eating too much refined carbohydrates.

Perhaps the most useful aspect of the Healthy Plate Model is that it offers a visual guide that can be applied to every meal, every day. It helps with meal planning, grocery shopping and ensures quality nutrition without having to overthink too many details. Feeding your family meals that represent the Healthy Plate Model will provide good nutrition and promote healthy eating habits. For additional assistance with meal planning using the Healthy Plate Model, or guidance on how this model can improve your family’s health, schedule an appointment with one of our registered dietitians. 877.486.4140.

Tummy Aches, Abdominal Pain, and Stools: What the signs and symptoms might be telling you about your diet

My professor in grad school spoke about how difficult nausea and abdominal pain is to manage. Think about the last time that your sick childstomach felt extremely upset. Have you ever experienced morning sickness during pregnancy? It is incredibly difficult to function on a daily basis when you are feeling that miserable. In addition, it is nearly impossible when you have to make frequent trips to the bathroom. What if this is how your child feels during the school day?

This is how many people feel almost every day, including children. They suffer from stomach aches, nausea, cramping and irregular bowel movements (diarrhea or constipation). Parents are unsure about what to do about this predicament when there doesn’t seem to be a medical reason for these symptoms.

If this is something that you or your child is experiencing, I would encourage you to speak with your doctor and schedule an appointment to see a registered dietitian. A dietitian can perform a thorough analysis of you or your child’s diet as well as eating patterns throughout the day. Following the analysis, recommendations can be made, symptoms can be tracked and adjustments to the diet can be made.

Here are some dietary factors that may be contributing to digestive issues:

  • Excessive intake of quantities of food
  • Inadequate (and sometimes excessive) fiber
  • Excessive sugary beverages
  • Excessive intake of processed foods
  • Excessive intake of sugar alcohols (found in diet foods and beverages)
  • Eating when stressed
  • Eating too fast
  • High fat diet
  • A diet that is imbalanced
  • Food sensitivities- a negative reaction in the body that manifests in response to certain foods.
  • Food intolerances- result from inadequate enzymes (or enzymes that are overwhelmed with volume) in the gut to digest certain components of foods.
  • Food allergies- an immune response in the body to certain proteins in foods.
  • Imbalanced gut bacteria.

Digestive pain is not normal and it should not be acceptable to suffer with digestive pain or other digestive issues. With the proper guidance, you and your family can be feeling much better while improving the quality of nutrition in your lives life. To schedule an appointment with a registered dietitian at NSPT, click here.

How to Make Your Own Baby Food

Are you interested in creating your own baby food? The good news is that it is actually quite possible and simple to make your own baby foodbaby food!

Supplies to make your own baby food:

  • A manual food mill. I personally used one made by KidCo. It is suitable for any soft or steamed fruits and vegetables, as well as cooked quinoa, oatmeal, millet and amaranth.
  • An electric food mill. I utilized an inexpensive, small electric food mill for more advanced textures of food that I needed to grind down slightly, such as soft-cooked meats and pasta.
  • Other options that you may choose to use include food processors and/or coffee grinders. A food processor is able to puree any food into the texture desired. As a result, this eliminates the need for a manual food mill or smaller electric food mill. A coffee grinder is useful for making your own “infant cereal”, using grains such as quinoa, brown rice, millet, amaranth and oatmeal. To do this, simply grind the whole grains in the coffee grinder and then cook them as you normally would.
  • Storage containers. You may use any refrigerator- or freezer-safe containers. There are containers that are designed specifically for storing baby food that closely resemble ice cube trays with a lid. I found these to be very helpful as I could produce 2-4 “cubes” of baby food to send to the babysitter each day.

Once you have acquired the equipment that you need, the next step will be to determine what food you want to make for your baby. Speak with your pediatrician or registered dietitian if you require guidance.

Below are the categories of infant-appropriate foods as well as general directions on how to prepare them yourself:

  • Vegetables: Try green beans, zucchini, squash, carrots, sweet potatoes, peas, cauliflower, broccoli, etc. The important thing to remember is to steam them or bake them until they are very soft and can be easily pureed in the manual food mill.
  • Infant cereal: Choose hypoallergenic grains such as brown rice, oatmeal, quinoa, millet or amaranth. Grind the uncooked grains in a coffee grinder or cook them and then let the grains cool prior to pureeing in a food processor. Cook the grains as you normally would.
  • Fruit: Try soft-cooked apples, pears, plums, peaches, blueberries, bananas, cherries, mangoes, papaya, etc. You can also purchase frozen fruit that can be thawed and pureed.
  • Beans: Once your baby is age-ready to consume beans (8-9 months), you may not need to puree them completely. You may give them cooked beans that are slightly smashed with a fork. Many babies enjoy eating black beans, lima beans, pinto beans and lentils. Observe them carefully as they eat as the skin of the beans may be difficult for them to manipulate in their mouth.
  • Meat: Cook meats for a significant amount of time (10+ hours) in a slow cooker with plenty of liquid to ensure that they are very soft. Puree the meats in the electric food mill or food processor. Meats can be offered to children that are around 8-9 months of age or when your child has the ability to consume foods with a little more texture.

One tip is to add a small amount of breast milk or formula to the cooked product so that your baby experiences a familiar taste when trying new types of foods for the first time. Making your own baby food is a great way to introduce your child to real foods that they will grow up to become familiar with eating. They will be able to consume texture-appropriate versions of the foods that the rest of the family is eating. As a result, making your own baby food can save you time as well as promote healthy eating habits.

If you are interested in creating homemade baby food, but require more guidance or do not have the time, I am now offering personalized home services. I am able to create weekly menu plans for your child. I can even finish personal grocery shopping for you to purchase whole, organic ingredients for your baby’s food. I am also able to come to your house on a weekly basis to make the baby food for you or to guide you with making the baby food yourself. Click the button below for more information:

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What is a Feeding Team?

A feeding difficulty is a complex medical condition. Feeding issues can result in poor growth, nutrient deficiencies as well as developmental delays. Due to the fact that the process of feeding involves numerous systems throughout the body, addressing the issue is multi-faceted. Feeding difficulties can stem from various issues, such as dysphagia, reflux, history of intubation and/or feeding tubes (such as in a NICU stay), food allergies or anxiety.

Feeding difficulties are very challenging for a large majority of families. Parents may become frustrated, overwhelmed and stressed. At North Shore Pediatric Therapy, we have a unique, multi-disciplinary approach to treating feeding difficulties that provides a more effective treatment result.

The feeding team is comprised of four members that represent the following disciplines:

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The following are common reasons for referral to a feeding team for evaluation (1):

  • Limited variety of accepted food/selectivity. See my previous blog on “Problem Feeders”.
  • Limited volume of accepted foods. The child takes very small bites of certain food and then pushes it away.
  • Food refusal, including from the bottle or breast during infancy.
  • Gagging, coughing and/or choking with meals.
  • Difficulty progressing with table food.
  • Aversion to certain food textures.
  • Vomiting with meals.
  • Poor feeding skills or inability to chew and swallow well.
  • Fear or anxiety when eating certain foods or new foods.

If you or your child’s doctor is concerned with feeding issues, please contact a Family Child Advocate at North Shore Pediatric Therapy to schedule a feeding team evaluation for your child. Based on the evaluation, the team will recommend a plan for treatment in which disciplines may need to be involved. Although not all cases will require all disciplines to be involved for treatment, a thorough assessment from a strong multi-disciplinary team will ensure that your child will experience the best possible outcome.

1. Cerezo CS, Lobato DJ, PInkos B, LeLeiko NS. Diagnosis and treatment of pediatric feeding and swallowing disorders: the team approach. Infant, Child, & Adolescent Nutrition. 2011;3(8):321-323.

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Food-Related Activities for Kids

The way in which a child learns about food, health, and what foods they enjoy is influenced by what they are exposed to in their daily vegie rainbowenvironment. Younger children learn so much through playing freely with toys and with other children. All children learn from what they witness their parents do and say. Children at a preschool age through adolescence are influenced by their peers as well as a variety of media (television, movies, magazines, and Internet).

The important thing to recognize is that healthy eating is not necessarily intuitive, especially in today’s society. Consider all the ways in which your child is influenced about food. They see commercials on TV, observe eating experiences in the home and see what foods their friends eat. As a parent, these are things you can control in the feeding dynamic:

• What foods you buy, prepare and offer to your kids
• What foods you eat with them
• When, where and how you set up mealtimes

Being a good role model for your children when it comes to nutrition and mealtimes is a critical way in which their learning is shaped. If you wish to take it one step further, there are food-related activities you can do with your kids that “speak their language”. These activities help them learn the importance of eating healthy, and that it is acceptable to try new foods. Here is a list of things to try with your kids:

Food Activities For Toddler/Preschool Children:

  • Read simple books about food and eating.
  • Let your children watch you make meals. Talk to them about what you are doing. Allow them to do simple things like stirring and pouring.
  • Color pictures of healthy foods.
  • Have play food and even a play kitchen. Play with them and make sure to pretend eating the healthy foods you want them to eat.
  • Have them name foods that are the different colors of the rainbow. Make a “rainbow” meal.

Food Activities For Elementary Children:

  • Talk about the food groups as well as the basics of why each is important.
  • Take your children to the grocery store or farmers’ market and have them pick out fruits and vegetables.
  • Have them read you the recipe steps when you are cooking meals.
  • Plant simple vegetables with them in a garden. Harvest them together and use them in a meal.
  • Have “theme meals” (fiesta, rainbow, dippers, shapes, etc).

Food Activities For Middle School Children:

  • Ask them to help you with cooking.
  • Have them to develop meal ideas that you can then prepare.
  • Ask them to explain how foods affect health, then have a discussion about why nutrition is important.
  • Take them to the grocery store or farmers’ market and have them pick out fruits and vegetables.
  • Ask them to write a menu for the family dinners for a week.

Food Activities For High School Children:

  • Have them prepare simple recipes.
  • Let them experiment in the kitchen.
  • Offer to let them invite friends over for dinner.
  • Have positive conversations about what is occurring in their lives during breakfast or dinner.
  • Have a cooking competition in the family in which each family member creates a dish and everyone votes on the best one. In addition, you can ask your teens to participate in “taste-testing” new recipes and they can rate them on scorecards.

If your child has nutrition-related health issues or has a poor diet, schedule an appointment to see a registered dietitian at North Shore Pediatric Therapy. 877-486-4140. Our registered dietitians can utilize these activities along with other therapies and educational tools to help improve your child’s health.

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Finger Foods for Little Fingers

When infants are transitioning to solid foods, it is important to remember that this transition process is a learning experience for the baby with finger foodchild. Feeding involves many systems in the body, including the brain, sensory processing system, muscles of the mouth, tongue and throat. Feeding also involves the entire digestive system. The transition to solid foods follows a continuum of developmental stages that coordinate with the infant’s ability to handle new types of foods, textures and methods of feeding.

When children reach the age of around 8-10 months, most of them develop a fine motor skill known as the “pincer grasp”. This is when the child is able to pick up small objects using the pointer finger and thumb. In addition, according to speech-language pathologists, when children reach the age of around 9 months, infants develop the oral reflex to bite down on more advanced textures of foods in the mouth. In other words, if they are given a food other than a smooth pureed texture, they will instinctively bite down and mash it with their gums at this age.

Given the above developmental skills, it is appropriate to introduce finger foods to your infant once they are around 8 or 9 months of age. They will be able to practice their pincer grasp as well as their chewing reflexes. It also teaches them to self-feed.

Here are some ideas for finger foods for little fingers:

  • Ripe banana slices, cut into quarters
  • Soft cut-up fruits (no skin or seeds), such as ripe pears, ripe peaches, kiwi, soft melon, blueberries (may even cut in half), plums, etc.
  • Soft cooked vegetables, such as sweet potatoes, cauliflower, cooked carrots, squash, peas and beets.
  • Avocado pieces
  • Toast bits
  • Crackers that can easily dissolve in the mouth with minimal chewing
  • Cheerios or puffed rice cereal
  • Cooked pasta bits
  • Cooked and mashed beans
  • Very soft cooked meat. Cook the meat in a Crockpot or slow cooker for 8+ hours with plenty of liquid until the meat is falling apart. Give very small pieces of meat to your child, one at a time, and make sure they are swallowing the pieces by offering water sips.

Remember to always watch your infant carefully when they are eating, especially as they try more advanced textures. They are at high risk for choking when they are just learning to handle these new foods, so it is important to keep these things in mind:

  • Offer very small bites of food, such as the size of a Cheerio or a quarter of a banana slice.
  • Offer very small quantities of food. At this young age, children are not always aware of how to regulate the amount of food in their mouth. They might enjoy something so much that they stuff in more than they can handle, which is a choking hazard. Give them a little at a time on their tray.
  • Offer soft or textures that can easily dissolve. Avoid sticky or very hard textures.
  • Offer sips of water to help with the swallowing process.

For more information on feeding infants or children, make an appointment with one of our registered dietitians at NSPT.

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Sample Activities to Increase Oral Awareness!

Development of oral facial muscles is important for a child to accurately produce speech sounds. Poor coordination and strength of articulators can adversely affect skill development for speech sound production. When looking at oral development it is important to ensure the child is provided a variety of movement opportunities to build a variety of oral skills. Movements should include movements of the jaw, tongue, and cheeks to build strength and coordination.

Father practicing oral awareness with child

Below are sample activities to do at home to increase oral awareness and movement

  1. Gather two sets of 5 items varying in size, texture, shape, and temperature. For example; ice, a tongue depressor, straw, teething toy, and straw. Encourage your child to use each of the objects in oral-exploratory play. Imitate your child’s movements and comment on what your child is doing and how it makes the mouth feel.
  2. Mirror play! Have your child sit with you in front of a mirror. Explain that you will be playing a “clown” game. Feel free to dress up in silly hats or clothes to play the game! Instruct your child that you will be taking turns making silly faces in the mirror and copying each other. With your models, make sure you do a variety of tongue movements. Stick your tongue out, move it side to side, lift up the tip up to touch your nose. Have your child practice the movement 2-3 times before it is his or her turn to put the clown hat on.
  3. Play musical “chairs”. Choose objects around the house that include a target sound. For example if the target sound is “b” you could find a book, bear, bottle, bread, and bowl. Place pieces of paper on the floor, with the item on the paper, in a circle. Have the child walk from sheet to sheet until the music stops. Once the music stops, have your child say the target word they land on. You can also write the word on the pieces of paper to increase print sound awareness.
  4. Cut an egg carton in half lengthwise, turn it upside down, and color or paint each of the 6 protruding sections a different color. Next, find a puppet or an animal with a large mouth. Find small “food” items to feed the puppet. These could be marbles or pretend food. Tell your child that you are going to sing silly songs to help feed the very hungry animal! Model a sequence of three sounds varying in intonation tapping the egg cartons to pace each sound as they are sung. Different intonation patterns can include rising/falling pitch or increase/decreased loudness on individual sounds. For example, “ ba BA ba”. Think of the NBC studio signature tone. Once the silly song is imitated you can feed the hungry animal! Using rhythm and a singsong voice has been proven to help facilitate speech output.

These activities will encourage oral motor development in a fun and exciting way. Your child will be learning and exploring and improve his oral awareness in the process!




Eat These, Not Those: The Toddler Edition

When you think of the typical diet of a toddler, there are some common foods come to mind; however, the food industry has created many toddler-suited kids with cupcakes foods that may not always have a toddler’s nutrition needs in mind.For every not-so-great toddler food, there is a better choice.

Below is a list of toddler foods that have more nutritious alternatives:

  • Say no to: Flavored yogurts packaged for on-the-go.
    • These may contain artificial food coloring and some have up tp 20 grams of sugar or more per serving.
  • Instead, tryPlain yogurt with fruit and a little maple syrup or honey stirred in. Only feed honey to kids that are older than 1 year of age.
  • Say no to: Fruit snacks.
    • These often have artificial food coloring and minimal nutritional value as they are made of sugar or corn syrup, gelatin and other chemicals.
  • Instead, try: Dried fruit. Dried fruit is a great source of fiber. Try a variety, such as cranberries, blueberries, mangoes, strawberries, cherries and peaches.
  • Say no to: Processed meats.
    • These are often high in sodium and most have nitrates. Nitrites used as preservatives can form carcinogenic compounds during digestion.
  • Instead, try: Nitrate and Nitrite-free hot dogs and lunch meat. High quality products that are made of 100% meat without additives are a better alternative to processed meats. You may also forgo the processed part and stick with whole, cooked meats.
  • Say no to: Juice, especially if it is not made with 100% juice.
    • Kids do not need juice every day for nutrition. Drinking juice displaces room for other healthy foods.
  • Instead, try: Plain milk with meals and water throughout the day.
  • Say no to: “Puffed”snacks.
    •  Again, these snack foods often do not offer much nutrition and can take-up room for other more nutritious foods.
  • Instead, try: Whole grain crackers, brown rice cakes, or whole grain cereal pieces.
  • Say no to: Processed cheese.
    • If cheese comes in a package, read the label and take caution if there is anything other than milk, salt and enzymes.
  • Instead, try: Real blocks of cheese, grated or sliced by yourself or by the deli.
  • Say no to: Peanut butter products.
    • Read labels. If you see the words “hydrogenated” or “partially hydrogenated”, the peanut butter includes trans-fats. These are particularly unhealthy fats that are highly susceptible to oxidation in the body, which leads to generation of free radicals that can contribute to cardiovascular disease and cancer.
  • Instead, try: Peanut butter or other nut butters that have only nuts listed in the ingredients.
  • Say no to: Cereals, specifically those with 10 grams of sugar or more.
    • The sugar content of some of kids-themed cereals should ultimately be categorized within the dessert aisle, rather than the cereal aisle.
  • Instead, try: Whole grain cereals with less than 5 grams of sugar per serving.
  • Say no to: Fast food, specifically the burger, French fry and chicken nugget variety.
    • Fast food, especially fried fast food, is high in sodium, calories and saturated and/or trans fats. Fast food is often chosen out of convenience.
  • Instead, try: Packing a lunch from home when you know you will be on the go.
  • Say no to: Candy, especially when given as a reward.
    • Many parents use candy as a bribe for potty training, for eating vegetables or for staying quiet in the shopping cart at the grocery store.
  • Instead, try: Dried fruit or a non-edible reward like stickers, stamps, crayons or hildren’s books.

It is the caregiver’s responsibility to make good nutrition choices to offer to children. Children, as they mature,  will then choose foods from the foods they are most often exposed to from an early age.  For more information on feeding toddlers or how to manage picky eating, contact one of our registered dietitians to schedule an appointment.

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Swallowing Disorders vs. Feeding Disorders in Children

Swallowing Disorder and Dysphagia are terms that are used often to specifically describe difficulty eating as a result of physiological or anatomical baby eatingissues. These issues result in the inefficiency or inability of a child to safely ingest an age-appropriate diet that meets all nutritional needs. For example, an infant who is unable to coordinate the actions of sucking, swallowing and breathing to nurse may aspirate during meals (when liquid or food enters the windpipe, and may eventually reach the lungs). This could be due to physiological dis-coordination and anatomical weakness. We all have experienced a “Dysphagia moment” before due to this type of dis-coordination which results in “down the wrong pipe” discomfort and, usually, a coughing fit. However, this example is just that- one example of the multitude of ways a child’s swallowing pattern may be negatively altered and result in Dysphagia. It is not always obvious (i.e., silent aspiration will not result in a coughing fit) and has many causes and signs.

What Is A Feeding Disorder?

A feeding disorder is a more broad term that is used to describe the difficulty a child may have accepting a varied and age-appropriate diet. A feeding disorder may best describe a child who shows strict texture and food preferences. A feeding disorder may also describe a child who shows signs of aversion to being fed or feeding themselves. Feeding disorders in children can sometimes develop due to a child’s history of Dysphagia and the uncomfortable eating situations they have experienced. This history will likely impacted their flexibility and acceptance in trying new foods.

How To Identify Swallowing And Feeding Disorders?

A very broad and simplified way to differentiate between these types of feeding difficulties is to consider where the breakdown lies. A child who experiences difficulty getting food from a plate to their mouth for manipulation exhibits a feeding disorder, whereas a child who experiences difficulty getting food safely from their mouth into their digestive system exhibits Dysphagia.

Feeding and swallowing difficulties must be identified and treated as soon as possible for the greatest success of a child. If you have any concerns with your child’s abilities or behavior during meal times, seek out the advice of your pediatrician. An evaluation with a Speech-Language Pathologist, Nutritionist or Occupational Therapist may be warranted to ensure the development of age-appropriate feeding skills and the acceptance of a varied diet.

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