Ask The Pediatrician | HealthChildren.Org Q & A with Dr. Tanya

Question

My husband and I are on a gluten-free diet. We would like our baby to also eat gluten-free. Anything we should know?

Answer

By: Tanya Altmann, MD, FAAP

Parents may follow a restricted-grain diet themselves for various reasons, but now some moms and dads are also restricting gluten in their baby’s food.

The Problem:

Since whole grains are important for children, removing all gluten-containing products leaves a big hole in their diets.

What We Know:

  • Recent research shows delaying introduction of gluten to infants does not decrease their chance of developing celiac disease later in life. So there is no reason to eliminate gluten in your baby’s diet unless there is a documented gluten allergy or celiac disease, and you have discussed the plan with your pediatrician.
  • It may be a good idea to limit some “white” foods, such as unhealthy, highly processed gluten-containing bars and crackers, with no fiber and long ingredients lists—these tend to be less nutritious than their whole-grain counterparts. But without a medical reason, you don’t need to eliminate gluten altogether. Instead, offer many different healthy, whole grains such as whole wheat, oats, barley, brown rice, and quinoa.

https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/question.aspx?qid=3586

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Question

Should I sneak fruits and veggies into my preschooler’s food?

Answer

By: Tanya Altmann, MD, FAAP

In addition to whole grains, a variety of vegetables and fruit is important for a young child’s nutrition and palate. Some cookbooks offer sneaky ways to get more nutrient-rich foods into your child, such as black beans in her brownies and cauliflower in her macaroni and cheese. Sounds delicious to me! There are benefits to such nutritious home-cooked recipes, however the whole premise behind sneaking is that kids don’t eat healthfully enough and need an intervention.

Who’s In Charge?

If a parent is worried a child does not eat enough fruits and veggies, and thus needs to get these foods into him, this mindset violates the “division of responsibility” in feeding. Now you, not the child, are trying to take charge of how much of a certain food he eats.

Keeping It Whole

The other thing to remember is that it’s important for children to be exposed to fruits and vegetables in their whole, natural state, so that as the child gets older, she knows she enjoys eating that food and will choose to eat it. That said, if the basics are met, there’s nothing wrong with bumping up certain recipes with extra fruit or veggies to add color, flavor, or texture.

Adding Purees

If you want to add pureed fruit or veggies to recipes, do it for the right reasons. Do it, because it adds a great color or taste or different dimension to a recipe along with the extra nutrition it provides. Whether or not you are adding purees, make sure you are also offering plenty of regular fruits and veggies in their natural form, and not pressuring your child to eat them.

https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/question.aspx?qid=3587

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Question

What is baby-led weaning? Is it safe?

Answer

By: Tanya Altmann, MD, FAAP

“Baby-led weaning” is a trend that lets babies self-feed from the start rather than being spoon-fed purees. Advocates of this trend give finger foods, large pieces of foods, and even whole fruits or vegetables to their infant to lick, play with, and put in their mouth.

Although it is important to encourage babies to eat healthy table food with the rest of the family as soon as possible, there is a serious choking risk when it comes to allowing your infant to put chunks of whole food into her mouth. In addition, babies that are completely self-feeding may not get the calories or specific nutrients they need, such as iron, to support growth.

Advice for Parents

If you would like to try self-feeding around 6 months of age, the best, safest way is to put a few very tiny, soft bites near your baby and let him or her explore. You can give your baby the same healthy foods that you are eating, just make sure it’s a consistency that he can handle, which is usually pureed in the early weeks. As your baby grows, you can move beyond purees to thicker, lumpier items and finger foods as soon as he or she can handle them.

https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/question.aspx?qid=3588

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Question

Should I give my baby food pouches?

Answer

By: Tanya Altmann, MD, FAAP

Many baby-food products are now sold in pouches rather than jars, where you can’t see what’s inside to learn that carrots are orange and broccoli is green. Just a quick glance around a local mall or playground will show countless babies and toddlers slurping their lunches from a pouch. Pouches are indeed convenient for parents on the go and less messy for infants and toddlers to quickly suck down, but they can cause overeating as kids literally inhale their food. Also, slurping fruits and veggies doesn’t get infants or older children used to eating actual, real fruits and vegetables.

Advice to Parents Using Pouches

  • If you do buy pouches: Choose those with fewer than five ingredients. Remember that just because it comes in aBPA-free pouch and is organic, that doesn’t mean it’s always a healthy choice. Even though many pouches tout organic fruit and veggies, a closer look often reveals a higher sugar content than in real produce, and pediatric dentists worry that the sticky consistency may increasetooth decay.
  • When you do use a pouch: Please squirt it onto a spoon so your infant can see and smell the color, flavor, and texture of the whole, nutritious foods that are hopefully there. Also, carry mashed or chopped fruit and veggies in a small reusable container. That’s truly the best way to ensure your child will grow up to enjoy eating actual fruit and vegetables.
  • Remember, feeding trends and popular foods come and go. Stick with whole, nutrient-rich options, be careful of choking hazards, and be sure to check with your pediatrician before following the latest baby-feeding fad!

https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/question.aspx?qid=3585