Tag: Healthy eating

Let the Games Begin!

Published on by onesource4wellness1 Comment

At 5 ½ months the quints are starting solids!spoons

How do you know when to start solids?

There are several signs that a child is ready to start solids:

  • At least 4 months old (Check!)
  •  Significant weight gain.

The quints have definitely doubled their birth weights)

    • Theo is now 14½ lbs.,
    • Bella is 11lbs,
    • Lily is our little one at 10½ lbs.,
    • Kali is 12 lbs., and
    • Ellie is just shy of 12 lbs.
  • Able to make chewing motions and loss of “extrusion reflex.”

The extrusion reflex is when an infant uses their tongue to push solids from their mouth. An infant’s mouth develops in sync with their digestive tract. Therefore, if the little one is able to push food to the back of their mouth with their tongue and simultaneously swallow their gut is ready to accept the food.

  • Able to support their own heads with good neck strength. bumbo

In preparation for solid food we began feeding the kids in their bumbo seats. At first this was a disaster! The bumbo is designed to teach little ones to use their core to sit up, so you can imagine what happens when they are all tensing their abs during mealtime. Spit ups and blowouts galore! But, thank goodness this did not last long. A week’s worth of feedings and they got the hang of it.

I attribute the great gains in their neck and head strength to their time in the bumbo seats. Even big brother, Theo, with his 95th percentile noggin can hold that coconut up proudly!

  • Good appetite and often still hungry after their feeding.

This is definitely the case for Theo, Kali and Lily who often are quite upset to be sucking air at the end of their bottles.

  • Curious with what Mom and Dad are munching on.

So, needless to say after reviewing the list above, I was confident that the quints were physically ready for solids.

Which foods do you start with?

There is a bit of a debate on which food is best to start with. Currently, there is no strong evidence to support a specific sequence of introduction. Nutritionally, the best foods to start with are those that are highest in iron. This is because around 4-6 months of age a child’s iron stores are becoming depleted. This is especially true for premature infants because their time to accrue these stores was cut-short. Additionally, foods high in zinc and vitamin D are especially important because these nutrients are traditionally low in breast milk.

Traditionally, people start with iron fortified rice cereal. However, from my research this appears to be merely a generational tradition and in fact meat is a much better first food. This article from Dr. Greer, one of the quints’ physicians at the Madison NICU, offers a great explanation! Rice cereal is very easy to digest and has a very low allergy risk, but the iron from the food is not as easily absorbed and this food is high calories and low in nutrition. Plant-based iron (non-heme iron) is not used by the body as easily as that from an animal source (heme iron). Additionally, meat is a great source of zinc.  I believe that chicken is a fantastic first food, followed by beef.

The quint’s sequence will be as follows, with a new food every three days: Baby-Bullet-Batchbowl

I chose butternut squash and sweet potatoes because they are fairly high in vitamin C. The body uses vitamin C to help the absorption and use of iron. Zucchini was next as their first dark green vegetable because it is easy to digest and a low allergy risk. Their first grain will be gluten-free oatmeal because it is naturally high in iron and B-vitamins.

This delicious faire will be homemade with an awesome Baby Bullet, courtesy of a fellow quint mom. I puree the vegetables using breast milk and the meats using bone broth. Both are fantastic sources of vitamins and minerals and freeze very well! In just one hour, I had a month’s worth of food for the kiddos.

Let the games begin!

Frank and I thought we would catch this monumental meal on film. This video illustrates why it is important to feed your little one their bottle before trying solids. Can you guess which quints had eaten first?

If you guessed Theo and Lily you were right! They were cool and calm during their trial. Ellie and Bella were quite the opposite and approached meltdown mode. Kali, well, Kali enjoys mealtime in whatever order it is presented.

The other very important reason to offer solids after their milk is because breast milk should remain the primary source of nutrition for infants until at least 1 year of age, and thus you don’t want to ruin a feeding with an unfortunate food trial. I do promise you that Theo, Ellie and Bella all recovered from this feeding experience.

So, at the conclusion of food trial #1, all of the quints tolerated chicken. I would say that Lily, Ellie and Kali even liked it. I believe Bella will come around to liking it, too. As for Mr. Theo…I’m pretty sure he just wants a butter burger and some crinkle cut fries.

Eating for…Six

Published on by onesource4wellness2 Comments

“Let food be thy medicine and medicine be thy food.”  -Hippocrates

Food-Is-Medicine

This is a statement I passionately believe in. Medicine is defined as “the science or practice of the diagnosis, treatment and prevention of disease,” and thus nutrition is also the science of the diagnosis, treatment and prevention of disease.

This is especially true when educating and counseling persons with chronic diseases, such as diabetes, high cholesterol, high blood pressure, kidney disease and the list goes on and on. Tweaks in what these persons eat on a daily basis can dramatically improve their disease state.

Many of you are probably waiting for the link to pregnancy, well here it comes. While I continue to believe in the power of nutrition, my view of food has shifted during pregnancy. I believe food during pregnancy is very similar to food for the elite athlete; it is its most basic form- fuel.

While dietary quality is of the utmost importance during both pregnancy and athletics, but quantity often is slightly more important. I have been intrigued by the amount of energy (Calories) required to grow and sustain life, let alone 2, 3, or 6 at one time.  The average adult woman needs approximately 1600 Calories per day and the average adult male needs nearly 2000 Calories per day. These amounts of course vary depending on an individual’s metabolism, body composition and daily physical activity. But, the average woman pregnant with one child needs approximately 300 additional Calories per day beginning in their 2nd trimester. However, this is not the case with multiples. This additional energy requirement starts in the 1st trimester and quickly escalates with each fetus:

  • Twins: 3,500 Calories
  • Triplets: 4,000 Calories
  • Quads: 4,500 Calories
  • Quintuplets: 5,000 Calories

One may be jumping for joy at this amount, because it’s like Thanksgiving everyday! Unfortunately, when you add in morning sickness, indigestion and limited belly capacity, this feat requires a bit of creativity.  Again, it is important to remember that quality is a close second to quantity and thus the type of Calories consumed is also very important.

The average dietary composition is 50-55% Carbohydrate, 25-30% Fat and 15-20% Protein. During pregnancy, this also shifts to approximately 40% Carbohydrate, 40% Fat and 20% Protein. Fat, primarily from unsaturated sources high in omega 3’s, like DHA, is critical for neurological development. Protein is known as the building block for life and food sources that maintain a complete amino acid profile, animal-based proteins, are ideal. The percentage of carbohydrates decreases during pregnancy, and my assumption for this decrease is two-fold: 1) To account for the increases in necessary fat and protein and 2) To limit edema, or swelling and bloating. Carbohydrates tend to pack on water has they are stored and extra L.B.’s from fluid tend to be unappreciated, especially later in pregnancy.

Overall, we know that nutrition is an individualized science and all of the energy goals have to be adapted to the individual. I believe the best outcome for measuring a person’s nutrition during pregnancy is maternal weight gain. Future mom’s of multiples are to gain an average of 2-2.5lbs per week beginning with week one, so that by 30 weeks mama has gained nearly 80lbs. Maternal weight gain is highly associated with fetal growth and gestational age, which we know are the two variables that often influence fetal complications.

So, for you “bump” lovers out there I will be sure to post a pic or two in the coming weeks along with some updated ultrasounds. Until then, hang tight…patience is a virtue (lol). And, for you nutrition geeks and foodies out there, much like myself, there will certainly be future posts on nutrition tips and meal planning for mom’s of multiples.

Five Buns in my oven

Written by: Cassie Vanderwall, MS RD CD CDE CPT