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Q&A about children's nutrition with nutritionist Angela Dowden - ANSWERS BACK

(59 Posts)
RachelMumsnet (MNHQ) Thu 18-Apr-13 11:15:14

We're running a Q&A this week with nutritionist Angela Dowden, who will be available to answer your questions on children's nutrition.

Do you worry about whether you're giving your kids the food that's best for them? Are you concerned about whether they're getting the right vitamins and nutrients from their food to keep them going throughout their day? Should your children snack between meals and if so what sort of snacks should you be giving them? Post your questions to Angela before the end of Tuesday 23 April and we'll post up her answers on Monday 29 April

Angela Dowden is a registered nutritionist and specialises in family nutrition. A freelance journalist, she writes for about health and diet for national newspapers, magazines as well as many national online titles. She is currently working with the makers of Ribena Plus, a range of no added sugar juice drinks with added health benefits.

This Q&A is sponsored by Ribena Plus

AngelaDowden Tue 28-May-13 15:07:24

RedundantClare

I am struggling with how to approach the subject weight and over eating with my daughter. She is 12 nearly 13 and clearly " big boned" but I know she is a secret eater and find sweet wrappers in her room and pockets. Our approach to food has always been everything in moderation and nothing is banned. She does moderate exercise but is significantly bigger than her peers and at 5ft tall is wearing size 14 clothes.
What do I say to her without giving her a complex?

For any mum this is always such a difficult one, but it’s good to be thinking about it now, when your daughter still has some growing to do, so you can focus on maintaining her weight (which she will then grow into) rather than actually needing her to begin “dieting”, which is likely to set a yoyo pattern for life. It sounds like you have always had a healthy approach to food, and you mustn’t beat yourself up as acquiring sweets and eating them secretly isn’t that unusual behaviour! You don’t need me to tell you that making her feel completely loved and secure is the key point in any conversation you have with about her weight, and for you to be completely uncritical about her size.

One approach would be to say you’ve decided as a family to go on a health drive and to make her feel part of the family effort. If you do all this taking a health approach rather than a weight one and really practice what you preach you should hopefully nip this in the bud. Key things that might help when you’re preparing family meals is cooking from scratch as much as possible including plenty of lean protein, fruit and veg. Serve a smallish portion on to average sized (not huge) plates and wait for her to ask for some more if she’s still hungry.

Exercise is of course important too for a teenager, both for body and mind – so encouraging the ‘moderate exercise’ that you refer to above is a good idea. If you get stuck for healthy meal or snack options, or are looking ways to increase variety then do take a look at the NHS healthy eating website for inspiration.

AngelaDowden Tue 28-May-13 15:10:08

Morepeasplease

My 8 year old dd was a very fussy eater in the past and whilst she has improved over the years she has become very reluctant to try anything new. She says she doesn't like things knowing full well she has never tasted them, particularly if they have any fruit ingredient. Although she seems healthy enough she eats hardly any veg (maybe a slice of carrot or bit of sweet corn per meal) and no fruit, but does drink smoothies(two varieties only - wont try any others). Eats with rest of family at the table ( all good eaters) and really enjoys helping to cook but just still seems afraid to try new things. Have told her that she can just lick something to taste it, or spit it out if she doesn't like it but she seems certain that she won't like it without trying it.( she is bright enough to understand that she doesn't know what something tastes like without trying it). What can I do to encourage a more positive attitude to new foods? How can I get her to try new things? Or should I just leave her and see if she grows out of it? Don't want to make mealtimes more stressful for her, would love her to relax and just enjoy food. But would love to cook any eat a wider variety of meals, for the sake of my other children as well as myself.

Well I’m not sure if I’m supposed to admit this Morepeasplease, but your 8-year-old daughter sounds exactly like my own son, who at just turned 12 is still adamant he doesn’t like certain things, though this has improved slowly but surely. As there are so may positive things with your daughter – she likes to cook, eats with the rest of the family etc – I’d be inclined not to be too much “on her case” at the moment for fear of this approach backfiring. One thing you could try though is to focus on just one food at a time to introduce to try (spinach for example) and every time it is part of family meals to put a little on her plate, or in a small dish on the side. If she doesn’t even try, don’t make a fuss, but make sure the same food experience gets repeated several times before you move onto another food (it may mean you have to et spinach quite often!). Another trick I found particularly useful was inviting round a friend who had a particularly wide repertoire of foods, if your daughter particularly likes or admires that friend, she may copy their behaviour and try new things.

PareyMortas Tue 28-May-13 15:10:45

Well that was worth the wait hmm.

AngelaDowden Tue 28-May-13 15:12:00

MadMonkeys

My 7 month old daughter is dairy intolerant and probably gluten intolerant (we're on an elimination diet to establish that). What should I be including in her diet to replace the calcium etc that she will be missing out on without dairy and gluten?

As your 7 month old is dairy intolerant you’ll need specialist advice on a formula milk to carry on using until she’s 12 months at which point you’ll probably be fine giving calcium fortified soya or rice milks as a drink, but I’d advise you get professional advice, for example from a paediatric dietician, as to exactly what to do and what products to use when. If it turns out she’s gluten intolerant too, you’ll need to avoid wheat, rye and barley, which is usually easiest if you only cook from scratch. Looking at the ingredients list on product labels, which should be clearly displayed on most, gives you a good idea of what ingredients are present, allowing you to more easily identify allergenic ingredients. Fortunately, many early intolerances are grown out of – your daughter is likely to grow out of a milk protein intolerance by school age for example.

AngelaDowden Tue 28-May-13 15:14:15

Shattereddreams

My DD age 6 - How many glasses of milk a day is enough as she is milk free? (oatly milk is calcium enriched to same level as milk) but there is no cheese or yoghurt in diet to top it up. I can work out mg of calcium in each glass of milk so how much is enough? (Cmp intolerant non ig)

My DS age 3 - he isn't a fussy eater, he eats anything if mood takes him, such as olives. But he is tiny and falling down centiles. He is too lazy to eat. He has huge tonsils, could this be a factor?

As a guide the RNI (reference nutrient intake) of calcium for a child is 450mg a day, and the amount you really don’t want to fall below is 275mg, so that should give you some guidelines to work by when you’re working out how many glasses of calcium-fortified milk alternative to give. As a pleasant change you could give her no added sugar Ribena Plus with added calcium and remember there's important sources of calcium found in other foods too, like canned fish, nuts, greens and white bread for example. As far as your other question is concerned, large tonsils in a three year old could potentially be an issue if he cannot eat sufficiently because of pain or because breathing takes constant physical effort. But if this were the case I think he’d be very miserable. As it is, perhaps you could give a little encouragement in term of eating with him, making it easy and interesting with finger food, different textures and flavour etc? Do talk to your GP if he is falling down the centiles though as you need to get to the bottom of why he seems reluctant to eat.

AngelaDowden Tue 28-May-13 15:22:08

pcbmc00

Hi my question is again about overweight children my daughter is 3 eats extremely healthy likes all veg and fruit but she is categorised as overweight using toddler bmi. Now she does have treats by grandparents etc. I'm very careful of portion size but if possible could you guide me on what a toddler should eat daily how many snacks etc/ treats per week is ok? Thanks

Hi Pcbmc00 At the age of three your child should ideally be giving you the lead on how much she needs to eat, whilst you offer a healthy selection of foods in the form of three meals and two snacks a day. For all meals it?s good to begin small and let her ask for more if she needs it. With snacks it need not be much than she can fit in her hand. As far as sweet treats like chocolate or cake are concerned, I think it?s important not to ban these altogether, but to give them only once or twice a week, and in small amounts after a main meal rather than as a between meal snack. Treating good behaviour with food isn?t advised as it can lead to psychological associations that mean she?s more likely to crave sweet foods for comfort or reward later. Ensuring your 3 year old is as physically active as possible will obviously help too. If you?re running out of ideas for snacking I worked with the makers of Ribena Plus on a handy tool called the After School Snack Finder to help in such a situation! You simply put in some details about you kids ? age, gender, if they have done sport and so on ? and it comes up with the ideal after-school snack for them. It?s here at after school snack finder.

AngelaDowden Tue 28-May-13 15:30:05

DuchessOfPodd

What can I build my 6 year old daughter up with? She is as skinny as a beanpole in comparison to her chunkier classmates. Her appetite is huge in the mornings when she will happily devour two big bowls of porridge made with semi skimmed cows or goats milk. Other than that we have a battle getting her to eat much of anything else, just a few mouthfuls of meat and veg for our family evening meal. She does like fruit such as apples, tangerines. Her teachers say she eats well at school. She has just had a sickness bug so is even thinner now than usual.

If she’s growing, thriving, happy and healthy (barring the odd cold or tummy bug, which is to be expected), my qualified advice would be not to worry. You say she eats a very good breakfast and eats well at school. If she eats only a little in the evening, this could simply be because she is intuitively eating according to her needs and this should augur well for the future in terms of her being able to regulate her weight and appetite. Do get her checked out with a medical professional just to make sure everything is okay and that she hasn’t been dropping down the centiles too much though. But provided she checks out fine, I think you may just need to accept that she is naturally thin.

AngelaDowden Tue 28-May-13 15:32:38

2012PP

My son is 10 months old & eats pretty much everything (& doesn't have any allergies or intolerances).

When I cook, What should the 'meat/fish - to - carbohydrate' ratio be?

Thanks.

Hi 2012PP, As a general rule, carbs and veg/fruit should make up around two-thirds of a meal with the final third being the meat, fish or other form or protein part. Hope that helps!

Shiraztastic Fri 31-May-13 20:12:55

I love the fact that she has assumed that Madmonkeys dc is not breastfed (no idea if that is the case or not, but it's a pretty big assumption). Ah well, at least she didn't suggest ribena with calcium for that one hmm

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