3/24/09

National Nutrition Month Part 2

I received a lot of great questions last week from various blog-readers and I'd like to post a few of them.

Here is a great question for all the mothers out there with newborn babies and/or future mothers (and fathers). Laura (from the healthy cooking post) answered this question since she has a lot of experience from working with WIC and other various pediatric clinics.

QUESTION:
"I have a 20 month old daughter who only weighs 19 lbs. The pediatrician says if the baby doesn’t start gaining weight soon it could lead to developmental problems. Currently she is in the -3% range for weight, and 40% for height on the charts. But not even being on the chart for weight is kind of scary. So do you know of any healthy way to make a baby grow? I don’t want to just start giving her mcdonald’s and ice cream just to put junk pounds on the kid."

ANSWER
First we have to know how much her baby is taking in caloric wise-how many glasses of whole milk she is getting in a day and what her food intake is? It is likely that the baby is not receiving enough calories. There is a small chance that the parents are giving her enough and she is not growing right now, but may have grow spurt. However, there could be other causes as well.

Based on the age/weight she gave me 19 lbs (8.63 kg) her estimated needs ~900 kcals (102 kcals/kg) for appropriate weight gain and ~11-14 gm protein/day (1.2-1.6 gm/kg/day). This is based on the RDA recommendations.

Age range 12-23 months requires:
Dairy: 4-6 servings (serving =4-6 oz whole milk-NO SKIM or 1%. The baby is still developing fat to cushion the brain up until 2 years of age and fat is important).
Meat and other protein foods: 2 servings (1/2-1 oz meat, 1 egg, 1/4 cup legumes; peanut butter is NOT recommended at this time (choking hazard)
Breads, cereals, and starches: 6 servings (1/4-1/2 slice bread, 1/4 to 1/3 cup rice, pasta, or dry cereal
Fruits and vegetables: 4 servings (3 oz juice (limit to one serving juice), 2-3 tablespoons fruits and/or vegetables. Avoid crunchy foods if the baby is not ready.
Fats and oils: DO NOT LIMIT-but obviously healthy fats-which infant should get from whole milk should be appropriate
I never recommend the 'miscellaneous' category to children-this would be candy's, sweets, soft drinks.
Small amount of appropriate age cookies or cake at a birthday party would be ok.

I do not usually like to recommend Pediasure because it tends to fill the infant up and they would rather resort to the pediasure versus the good food-causing a delay in development.

I think if the baby is being underfed-which is very common, especially in new parents or "health consciou" parents, you should let the physician know and ask for other suggestions. If a baby is born premature, the baby might be right on target, but you still need to add some additional calories to her diet.


I think Laura did a great job answering this question. I'm syre there are lots of mom's/nurses/dietitans who can related to this problem and offer other suggestions. But the theory that "this worked for this person, so it should work for you" doesn't always work. Just like the struggles with "adult" weightloss (or weight gain), what works for one person doesn't necessarily work for other people. Even if you aren't pregnant and this question doesn't or will never apply to you, I think we can all take away that healthy REAL WHOLESOME foods are always recommended, from the first days of life, as opposed to microwaved, boxed, canned, pre-made or frozen. But, when people (or baby) are not receiving adequate nutrients in the diet for various reasons, then supplements are required.

Thanks LAURA!