I love Halloween and even though my kids are now young adults, I still eagerly buy bags of bite size treats for the little ghouls and goblins that come to my house on October 31st. Perhaps this is sacrilege coming from a pediatrician, but it’s hard to let go of childhood dreams.
Despite my confession, it used to drive me crazy to watch my kids gobble up pounds of candy every fall. My wife came up with a perfect solution to our dilemma. She offered to buy back their candy.
While it’s true that my kids would never sell us a Reese’s Peanut Butter Cup, they did get rid their less favorite candy. At a typical post-Halloween transaction, we would buy about 30 percent of their bounty.
We did include one rule with the deal, however. They were not allowed to use the money to buy more candy!
Most food allergies manifest themselves with non life-threatening reactions such as facial swelling or hives. That being said, it’s important to let the doctor know if your child has had an allergic reaction to a food. This will not only reduce the possibility of a serious reaction in the future, but you will be taught how to deal with such reactions.
Oral allergy syndrome is not a serious food allergy. Instead, it’s a mild reaction to foods that many people have not heard about. It occurs when someone experiences an itchy or tingling sensation in his mouth or throat after eating certain foods. The person does not get hives, facial swelling or other symptoms associated with a potentially serious food allergy.
Oral allergy syndrome is seen in people with spring and summer pollen allergies. It turns out that certain food have an allergen (something a person can be allergic to) that cross reacts in people who are allergic to certain types of pollen. Here are some examples.
If you’re allergic to birch pollen, you may react to apples, pears, cherries, plums, peaches, kiwi, celery, carrots, parsley, hazelnuts and almonds. If you’re allergic to grass, you may react to tomatoes, melons, celery, peaches and oranges.
The most interesting thing about oral allergy syndrome is that the person will not have symptoms if he eats the same food after it’s been cooked. In other words, apples cause symptoms, but applesauce does not. The reason you don’t react to the cooked food is because the allergen is destroyed when the food is processed.
Newborns have a sucking reflex that enables them to nurse or bottle feed. This reflex involves opening their mouths and moving their tongues in and out to “milk” the nipple. When babies start solid foods around 6 months of age, they usually push food out of their mouths because that’s what their tongues are used to doing. It takes a week or more for babies to learn how to use their tongues effectively with spoon-feeding, but they continue with the milking action when taking breast milk or formula.
Sippy cups have been around for as long as I can remember. Straw cups are relatively new on the scene. When babies drink from sippy cups, some of them continue to push out their tongues, which could lead to lisps and other speech problems later on. However, with straw cups, they are more likely to keep their tongues in their mouths, which is theoretically better for speech development.
So which type of cup is better for infants and young children? Here’s what Maia Magder, a speech pathologist at NIH, has to say about the matter: “There is no hard evidence that sippy cups cause speech delays, but it’s important to provide infants with opportunities to move their mouths in more advanced patterns to foster feeding and speech advancement.”
Regular “open” cups are the best for speech development, but babies are pretty messy, so many parents aren’t ready for this step until the toddler years. Here is Maia’s take on getting rid of spouts and straws: “Offering an open cup as early as 8 or 9 months helps with jaw stabilization, which is another important factor in speech development. As for the messiness, like other aspects of parenting, think of it as balancing the new with the old. It’s always important to read a baby’s signs and signals when using cups so that your baby doesn’t choke.”
Although the human body isn’t perfect, there are lots of awesome ways that it functions. One of these is called the gastrocolic reflex. In this context, “gastro” refers to the stomach and “colic” refers to the colon or large intestine.
When we eat, the stomach stretches and begins digesting our meal. The stomach does this by releasing chemicals and contracting to break down the food we have eaten. At the same time, the “machinery” of the intestinal tract is turned on. The rhythmic contraction of the muscles in the stomach and intestine is called peristalsis. If a child is constipated, the onset of peristalsis within the large intestine (especially the rectum) can cause pain as the intestinal muscles contract against large or hard fecal material. If the pain was because of stool in the rectum, having a bowel movement will usually relieve the pain. If the pain was because of stool higher up in the large intestine, stooling won’t necessarily relieve the pain. Sometimes the pain is so severe that parents may worry their child has an appendicitis.
Constipation isn’t the only condition that can trigger pain after someone eats. Lactose intolerance, overeating and celiac disease can cause similar symptoms. However, 90% of the time pain after eating is due to constipation.
The American Academy of Pediatrics (AAP) recommends breastfeeding for the first year. Most mothers are unable to breastfeed their babies for the entire year because of work or family situations. This is perfectly acceptable.
If breast milk is unavailable, babies should be fed an iron-fortified formula. Babies are transitioned to whole milk at one year of age. In most cases, babies do not need the special formulas that are marketed for the second year of life.
The AAP recommends that children drink whole milk until two years unless there is a reason to switch the baby to low-fat milk sooner. Doctors may make this recommendation for clinical reasons or because there is a family history of obesity, heart disease or a cholesterol problem.
The reason the AAP recommends whole milk until two years has to do with a baby’s growth and development. Infants triple their birth weight by one year of age and quadruple their birth weight by two years. During this period, a baby’s brain and nervous system are making amazing gains in size and complexity. Because the brain and nervous system are largely composed of fat tissue, it is reasoned that the baby should have a higher fat diet during this period of time.
Whole milk contains approximately 4% milk fat. Because children often have difficulty with transitions, it may help to gradually switch your child from whole milk to lower fat milk. Therefore, some doctors recommend that children get reduced fat (2%) milk for a few weeks before switching them to low-fat (1%) or no-fat (skim) milk.
Babies are traditionally weaned from formula after their first birthday. Although you can wean them from bottles when they are older, transitioning them to cups at the same time you discontinue formula is preferable for two reasons. First, it’s better for a toddler’s language development if he drinks from a cup versus a bottle. The reason for this is because babies protrude their tongues when drinking from a bottle. Drinking from a bottle in the second year of life may increase their risk for developing speech problems. Second, if toddlers are weaned from the bottle at 18 to 24 months, they are more likely to stop drinking milk. They have been drinking milk from a bottle for so long, many of them simply won’t drink it from a cup. (Imagine your reaction if you were served a spaghetti sandwich, and you will understand how the “presentation” of a food item can affect ones desire to consume it.)
No one has researched the best way to wean babies, but the following method is the one I’ve been using for the past twenty years:
- After your child’s first birthday, continue to give him formula from the bottle, but start offering whole milk in a straw cup at other times during the day. (Straw cups are preferred to sippy cups because they are better for speech development.)
- After your child has been drinking milk from a straw cup for a week or so, start to dilute the formula in his bottle with water. Replace one ounce of formula with water every few days.
- By gradually replacing the formula with water, you will be making the bottle a less desirable experience. In most cases, your child will figure out that whole milk in a cup is preferable to diluted formula in a bottle.
- After a few weeks, the bottle will only contain water. Some babies may drink it, but most will reject the bottle before this point.
- If your child refuses to drink milk from a cup after you have finished the dilution process, you should discuss this with your doctor.
It is well known that young children are more likely to choke on food than older people. There are two things you can do to reduce the risk of choking in your children. First, avoid foods such as hot dogs and peanuts that are associated with choking. Second, make sure your children are sitting down when they eat. In my office, I remind parents that young children are easily distracted and that sitting at the table helps them stay focused on their eating. I also show parents how hard it is to swallow when a person is looking up. I do this by asking them to swallow saliva while they are looking at the ceiling (this is very difficult to do). I then point out that toddlers frequently look up at people. If children are walking around with food in their mouths and try to swallow while they are looking up, they may gasp and aspirate by accident. Finally, because children may have choking episodes despite your best efforts, you should take a CPR class so you know how to do a Heimlich maneuver should the need arise.
Older brothers and sisters learn quickly that babies only drink breast milk or formula. Once you start feeding your baby jarred foods at six months of age, an older sibling may think it is okay to share his food with the baby. Therefore, make sure to tell your older child that even though the baby is now eating from a spoon, he is still too little to eat “big-boy” food. If your older child is interested in feeding the baby, you can supervise spoon-feeding once the baby has demonstrated that he is a competent eater. Make sure that you stay alert for sharing even though you have warned your older child to keep his “macaroni and cheese” to himself.
Hiccups are caused by a sudden contraction of the diaphragm, which draws air rapidly into the esophagus. The characteristic squeak occurs because the epiglottis closes rapidly shutting off the influx of air.
Young babies frequently get hiccups after a feeding. In most cases, hiccups do not bother babies and require no treatment. They usually resolve in five minutes or less. Because hiccups bother adults, it can be difficult to do nothing while you wait for them to go away. However, this is one of those situations where patience is clearly a virtue.
If hiccups occur during a feeding, they may bother your baby. In that case, change his position or hold him upright and see if a burp will make him feel better. If this doesn’t work, give your baby an ounce or two of sugar water (1/4 tsp sugar to 4 ounces of water). Hold him upright for a few minutes, and try feeding him again if he seems hungry.
Hiccups bother children more than babies. They usually occur after rapid eating, overeating or the ingestion of carbonated beverages. If hiccups last more that five minutes, give your child a teaspoon of granulated sugar. Have him swallow the sugar in one gulp. Repeat this two or three times over ten minutes if necessary. If the hiccups last more than two hours or your child is very uncomfortable, call your doctor.
One of the most common concerns I hear during the second and third years of life is that children become picky eaters. There are a number of reasons why this occurs:
• Children gain less weight in the second and third year and therefore need fewer calories to sustain growth. For example, the average baby gains 15 lbs in the first year of life, but only 10 lbs between one and three years.
• Because jarred foods are watered down, they contain fewer calories per volume than table foods. Therefore, your toddler doesn’t need to eat as much table food to get the same calories she did from jarred food.
• Toddlers love the newfound independence that comes from being able to walk and play. Therefore, they are often more interested in playing than eating.
• Toddlers begin to express their own personal likes and dislikes and will reject food that’s not appealing to them.
• Milk contains a lot of calories. Sometimes toddlers will not eat much because they are getting too much milk. In general, we recommend that toddlers drink between 16 and 24 ounces of milk per day.
• Fruit juices fill children up and contain little nutritional value even if they are 100% juice. Children don’t need juice, but if you use it, be sure to dilute it with lots of water.