Transcription:
Introducing New Foods to Kids

Melanie Cole (Host): Welcome to Say Yes To Good Health with Memorial Hospital. I'm Melanie Cole and come join us, as we discuss introducing new foods to kids. Joining me is Ashlyn Housewright. She's the Executive Director of Community Health and Wellness at Memorial Hospital. She's also a Registered Dietician, Certified Diabetes Care and Education Specialist.

Ashlyn, I'm so glad to have you with us again. We did a really great show before together, and now we're talking about introducing new foods to kids. So, first of all, let's start with the littler babies. And why is nutrition so important for these little babies when you should start trying to feed them healthy foods?

Ashlyn Housewright, RDN, LDN, CDCES, CLS, CHWC (Guest): Nutrition, you know, is very important, right? When we think about birth age, so nutrition starts, you know, with breastfeeding or formula, but as we start to explore more with table foods, the American Pediatric Association recommends that that takes place around six months of age. There's some other factors that can go into play. You know, some babies may be developed, they're developmentally ahead, and some maybe are a little bit behind, but really now we're gearing more towards the six month age range. And there's a lot of different practices on what to introduce first and how to introduce foods first. But really you just want to start to expose kids to foods that they can eat for a lifetime. And really you want to eliminate the high processed, high sugary foods. Those aren't, shouldn't be the first foods that we introduce, to little ones. You want to start to do more of the whole grains and colorful foods as you start to explore foods with your little ones.

Host: When I was making my own baby food, we did avocado first and it was a good one. It was easy. Just mix it with little formula or breast milk and make it nice and smooth. And the babies loved it. Now, some parents start with juices and things even pretty early, but the American Academy of Pediatrics recommends not giving juice to your little kids. Right?

Ashlyn: Yeah, that recommendation has really gone away. And that's kind of how I think of nutrition across all ages. You know, fruit juice really should be limited or avoided because most, you can just get better nutrition from eating the actual fruit first. You know, you're going to get the fibers. You're going to get a lot of the nutrients where juice is essentially packed. So it's really high in sugar. So, definitely want to go with, when we think about small children, pureeing that food for them and incorporating a little bit of liquid to that of some sort, is going to be the best route when we think of nutrition.

Host: When can a baby start drinking, like cow's milk and stuff like that, as we're getting into our nutrition and then introducing them to different foods, you know, if we start out with avocados or pears, you know, some pretty innocuous foods, just easy going, easy on the tummy, but then, you know, parents want to know when they start with whole milk or cow's milk or something along those lines.

Ashlyn: Yeah, generally, after the child is one year of age or around that timeframe, we would start to introduce whole milk, cows milk to the child. And that's a recommendation by the American Academy of Pediatrics.

Host: Now, some parents also think putting rice in foods helps baby in their, in their formula, mixing it in there, something like that helps them sleep longer. Have you heard about that? Because I read study where I thought it could contribute to obesity.

Ashlyn: Yes, and we really want to avoid doing that. There's multiple studies out there now that, that doesn't help. When we think about nutrition for the long run, we don't want to be mixing rice with formula, giving it in bottles or anything like that, because it can also affect GI health later down the road as well.

We really want to just start to think of exposing kiddos to as many foods as possible, and then incorporating that into more of a meal snack pattern, for kids. So definitely don't want to be mixing rice cereal, at this point and giving it in bottles or anything like that. You, you know, there, as the child gets older, you can introduce some cereals, whether that be a rice or a wheat type cereal, when they hit that closer to six months of age, and we would be giving that by a spoon. But definitely don't want to mix anything in the bottles.

Host: Yeah, I heard that too. So, now we want to start feeding a variety of foods and healthy foods at that. So when they're little like that, of course we worry about choking hazards. So, first tell us, as we're trying to start all these different foods and colors and textures and things like that with our little ones. What do we have to worry about? What shouldn't we feed them? What should be really well steamed? What can we feed them that, you know, doesn't have to be quite so soft, but I mean like scrambled eggs, things like that? Give us a little beginnings for us.

Ashlyn: So as we start to work with a child first, you know, you really want to just introduce one food at a time. So if avocado is the food that the parent chooses to go with first, just kind of remember at this point, the child's just had liquids. So everything is going from, you know, digestion wise like a liquid.

So we don't want to stray too far away from what they know. So you definitely can start out to a liquid, to more of a pureed consistency and gradually increase the consistency to more of like a yogurt type or pudding like consistency as, as the child tolerates. In the beginning, you do want to introduce one food at a time, just so we can keep an eye on allergies.

And so I honestly recommend when I'm working with parents, that if the vegetable that you're having with your meal is a great option to introduce to your child. So let's say you're having sweet potatoes. That's going to be an easy item to puree to that liquid type consistency, and then migrate up as the child tolerates.

So then maybe it's more of like a mash type consistency, not as liquidy, but more of that like pudding or yogurt type consistency. And then it can essentially be put into small chunks where the child can work on picking it up or using a utensil to pick up the item. So don't think you've got to be doing a bunch of different meal production as you start with food introduction. It can really be just a small spinoff of what's already incorporated into the parent's meal, and that's going to provide great benefit as we, as the child gets older as well, because they're already eating things and enjoying things that the family enjoys. And then after we have like a few fruits and vegetables down and introduced to the child and we have those to work with, that's when I would recommend incorporating some sort of grain source, whether that's a soft bread or a pasta, and you just want to keep the items small, and then increase the size of the item as the child tolerates and is able to, you know, do the pincher grasper finger motion to pick up foods and put in their mouth or start to use utensils. But softer foods like eggs, cottage cheese, yogurts, you know, the softer fruits and vegetables, bread items, meltable items like crackers. Those are all great things to start to incorporate. And then you can start to get into meal and snack patterns as well after that.

Host: I miss those days. I loved those days, little yogurt and they get it all over their mouths. And it's so fun to feed little babies. Now, you, you mentioned this briefly, but how long do we wait when we were talking about looking for allergies and you know, that's all changed too. We could do a whole show on detecting that, but, how long do you wait? So, if you started with say pears and you want to go on to carrots, whatever it is, how long between each do we wait?

Ashlyn: If there is a food allergy history within the child's medical background, I would encourage parents to reach out to their pediatrician for guidance. But if, as you see the child, you know, within a day or two days, tolerating foods without symptoms and with, and I mean, you know, anaphylactic type symptoms, but also skin rashes as well.

If you see none of those symptoms, potentially the child could even have diarrhea or things like that. So, those are the things you want to monitor for. If you don't see any of those type of symptoms in your child, that's when I would recommend that you start to migrate onto the next foods. Food allergies related to fruits and vegetables is pretty low, and that's why we kind of recommend navigating, starting with those first.

And also now the recommendations for introduction of high allergen foods are sooner to help with that exposure. So, just taking guidance from your pediatrician on when they think it's appropriate for your specific child, to introduce some of those high allergen foods into their diet. But really low risk when we think about our fruits and vegetables.

Host: So our fruits and vegetables, we want our kids, as you said, not to drink the juices, we want them to eat them. But what about things like smoothies with vegetables and fruits, where you're just pretty much grinding them up, not necessarily pureeing them, but now we're talking about maybe one year olds, two year olds, and we're going to sort of move up the line here as we do this.

Ashlyn: Yeah. So, introducing other foods or combination type foods like smoothies, that's a great option to recommend. Just remembering, those foods still have sugar in them. So, portion control when we think about what we might combinate into the smoothie and portion control of the serving size. And that's another great thing to mention when we talk about introducing foods to little ones is the serving size.

A lot of times when I work with parents, they think they need to be serving their kids large portions or similar portions to what the family might be consuming for them to actually count that as a meal. But a good rule of thumb is just a tablespoon of an item per age is what can classify as a serving size.

So if you're working with a one-year-old, they don't need a large half cup portion of mashed potatoes. Or a protein source, really, you can start out less as best and just introduce like one tablespoon of a food item at a time. So, we don't have to start out with large quantities. And that really helps a child not be overwhelmed by the food item that's offered, but also help with small meal plate set up as well.

So thinking along the lines of serving sides, one tablespoon of a food item per age would be classified as a serving size for a little one.

Host: Boy, I remember the days of putting water on Cheerios to make them soft enough so that little babies could on that pincer grasp really try and grab those little Cheerio's and putting water, cause I was so afraid of the choking, but it really is a very time, introducing these new foods to your little ones, you can see what they like and what they don't like.

And like you said, there are things to watch out for and keep in touch with your pediatrician. So, Ashlyn, as we're talking about nutrition for kids and, and the importance of trying these new foods, we're going to talk about picky eaters here, but how many servings of fruits and vegetables, grains, and things should our children have? Is the pyramid still what we go by?

Ashlyn: So several years ago, the pyramid was changed to the plate. So, we do go off the plate method. They thought individuals could relate more to a plate than they could a pyramid. But for most, the, the guidelines are still the same. Obviously the recommendations for the age of the child with the amounts of foods, you know, does vary based on age.

But really the gold standard when we think of fruits and vegetables for adults and kids is more than five servings a day. And so really, you know, a serving would really be like a piece of fruit, the size of a tennis ball and three servings of vegetables greater than a half cup. Obviously that's different for our younger kids, but when we start to think about adolescents, that would be what we are thinking of.

We really lack a lot of color in our eating. And so the more fruits and vegetables, the better. I often say I've never met anyone, you know, in my practice that is overeating on fruits and vegetables.

Host: Yeah, no kidding. I'm an exercise physiologist and I've heard the same. Oh, well, you know, some of those fad diets that are out there and they say, oh, limit your tomatoes and your carrots. I don't know anyone that ever put on weight, eating tomatoes and carrots, but okay. I digress. So now we're getting our kids to eat all of these different foods to try them. I read something once that there's a certain number of times that you get like a picky eater to try a food before they can officially say they don't like it. Can you tell us a little bit about how many times, if we want our kids really to eat spinach or carrots or something, and they don't like it the first time. Are we done trying or do we keep trying?

Ashlyn: You keep trying. It really, just with any behavior type change, it takes 10 tries, to really define a, a like, or dislike to something. And so that's what I recommend with parents is, you know, working on trying foods and it's not just one time, it's, it's multiple times of exposure and maybe in different ways.

And it's talking about the foods. You know, there are there just definitely some tips to make introducing new foods to older kiddos, less stressful. And some of those just go back to, you know, giving advanced warnings to kids as far as you know, what to anticipate next. If we are going to be trying new foods, especially around the dinner meal time, giving them advanced warning of like, okay, tonight on the menu, we're going to do pasta. And we're all going to be trying asparagus tonight for the first time, and then we're going to have fruit with it. So when we're serving new foods to our older kids, we always want to serve two foods that they know they are going to eat. So, in that example, maybe we know they're gonna eat the pasta dish, and we know they're going to eat the fruit, but asparagus is going to be new and it's going to be new for everyone.

So, giving that advanced warning of when we are going to be trying something new. Also giving your child choice, when it comes to trying new foods. So, tonight, you know, your choice is between asparagus or brussel sprouts, what would you like to try tonight? And so giving them some of the ownership of what the family is going to be trying.

And not every meal always has to make sense either, especially if you're struggling with extreme picky eating, you know, their foods that they might eat might be, you know, Ritz crackers and string cheese. And so that might be something that you're incorporating into every meal. So, you notice, so, you know, your child's going to be eating something, but there's going to be also time for exposure to a new food as well.

And then timing meals, right. You know, meals and snacks should be wisely so trying to avoid a lot of grazing in between mealtime. So we know kids are going to be open to trying food at meal time. And then other things too, you know, make the meal time setting attractive, when we start to try new foods, so some kids benefit from cutting foods into different shapes or different sizes, making it more of a social or fun event and keep those distractions to a minimum at mealtime. So, those are just some general tips that I have when working with parents on trying new foods. But also being their motivator. You know, if we're trying a new food at dinner time, everyone's going to be trying that new food at dinner time. So, getting mom and dad and grandparents and other brothers and sisters involved as well.

Host: What great information. So, do we force them to eat what everyone's eating or do we make them something special? Now, my mom used to say, cause I'm the youngest of six, Ashlyn, so she was not a short order cook. She was like, no, no, no, here you go. This is what we're eating. Eat it or don't because breakfast is a long way away.

That's what she used to say. And, you know, sometimes we had to sit there in our chairs till we ate. What are we doing these days as far as really finicky eaters? If our kids want something different, if they won't eat what we've made, what do we do?

Ashlyn: Yeah, I think when we're talking about extreme individuals that are avoiding certain foods, you always want to make sure there is something that, you know, they're going to eat at meal time. And so that might, maybe make there be a little bit of short order cooking or straying away from maybe what the entire family is eating and you might have to piece apart a certain meal, but you always want to make sure there is something that your child is going to eat at meal time. And then as far as trying new foods, that would just be an addition or a bonus. And there are several things that can play into the, the picky eating.

But a lot of times it's just increasing that exposure and getting the kids involved. You know, kids can really start to take part in the kitchen as early, you know, from like the one to two year old age range. So, the more the kids, children can get involved in the kitchen and participate in some of the helping with the meal production and shopping, the more apt we're going to be to try. So for young parents or, you know, individuals who don't have kids yet; that's what I would encourage you to start to think about is how can I get my children involved in eating, and grocery shopping sooner so they can make more nutritionally dense food choices as they grow.

Host: Well, it's true and getting your kids even involved in the gardening. If you grow tomatoes, you know, if you grow carrots or radishes or brussel sprouts are so pretty on the, you know, on their stock there and get your kids involved in that, and then say, let's pick these, bring them in and cook them. Another thing that I've heard before too Ashlyn, is while you don't want to make it a competition, you can say, let's go the grocery store and, and pick out one new vegetable to try, but then everybody's going to look up a recipe online and we're going to see who's we're going to try this week or something like that to see, you know, kind of get everyone involved in picking a way to cook it because not everyone knows how cook kale or, you know, broccoli or some of these things, and maybe they've had them over cooked. So, that's the reason they don't like broccoli or brussel sprouts or asparagus. Right? So, getting them involved is a really great way. Now I know that we've done a show on family meals, but when we're talking in specifically about picky eating that eating together, you've mentioned it a few times today to foster that love of a variety of foods and healthy eating.

Ashlyn: The whole family should really show support when it comes to the eating, whether the child is, has some picky tendencies are not. Just the more, the whole family is on board for eating together, maybe doing like you had mentioned, which is a great idea, some recipe development or searching out some recipes together. We think about food and food is involved in almost every aspect of our lives, you know, from, you know, dating to weddings, to birthday parties, to sleepovers. So, the more that you can prepare your child for, you know, eating in different situations and different foods, just the better outcomes they're going to have from a social life standpoint as well.

Host: Well, that's really true. What a great point. Now, if our kids are picky and they're, we've introduced them to a bunch of different new foods, but they don't like the healthy stuff. They don't like the way it looks and in my kids' school, they, they had to say don't yuck my yum, which was, you know, in other words, don't say that what I'm eating is gross. Do we try to hide nutritious foods in other foods, like with smoothies and stuff? Or are you not a fan of that?

Ashlyn: Yeah. The Sneaky chef type method.

Host: Yeah Sneaky chef that I heard about.

Ashlyn: Yeah. So, you know, there naturally, there's ways to get more nutrients into certain foods and I'm okay with definitely exposing kids to those types of things, if they don't know about it, but it's not going to fix the issue long-term and that's what you want to think about your child isn't always going to be an age where you can hide carrots and spinach, finely chopped in their lasagna or in their smoothie. So if you notice that your child is struggling with picky eating, to the point where maybe there's just a handful of foods that they're eating, that's when I would really encourage you to maybe seek some, some just additional support from a therapy team, whether that's a Registered Dietician, Speech Therapist, but there are health professionals that specialize in a feeding therapy programs.

And that's where, you know, if you feel like you want to make an impact and you don't want to always be hiding food in your child's eating plan then that's maybe when you should consult their pediatrician and just see if there's other resources out there that could benefit your family.

Host: Best advice in the last 30 seconds here, Ashlyn, introducing new foods to our kids, helping them out of their picky eaters, wrap it all up for us.

Ashlyn: My best advice would be you got to do this as a family, you know, and start young. Huge impacts happen within the first months of life when we think about nutrition and then just grow and grow and grow when the child is little. So, the more color you can expose your child to before the age of 10, just the, the more impact it's going to have on them overall as they go through life and become a more healthy eater. So, just really, work on this as a family, make it fun, get the kids involved in the, in the kitchen. And, and just know that what you do now, when they're little is what's gonna help them as they grow up and have their own family in the future.

Host: Rock on. And that's really the best point of all. It does help to create those lifelong habits and also creative eaters. And you can take your kids anywhere and know that they'll eat. So, introducing the food's, getting them to try healthy foods, unusual foods, foods with different textures and tastes is so important as they grow.

And thank you so much Ashlyn for joining us today. And that concludes this episode of Say Yes To Good Health with Memorial Hospital. For more health tips, please visit our website at mhtlc.org and search treatments and nutritional support to get connected with one of our providers. If you found this podcast informative, please share on your social channels and be sure to check out all the other interesting podcasts in our library.

I'm Melanie Cole.