FEEDING ISSUES IN TODDLER'S;"THE FUSSY EATER"

When you are feeling at the end of your tether with a fussy eater, take a deep breath, relax and remember this is a normal phase in your toddler's development which will resolve with time. 

By being anxious you can often make the problem worse, particularly if you are expecting your toddler to eat more than she needs. If allowed to do so, toddlers will eat just enough calories for their own requirements, so you should always respect your toddler's decision that she has had enough to eat. You need to resist trying to persuade her to eat more. All this is of course, easier said than done. 

Remember that it is your responsibility to offer your toddler nutritious food but always allow her to choose how much she will eat. If you have older relatives taking care of her during the day when you are away at work, reassure them that she won’t stay hungry and that it is okay if she does not “clean up her plate”. 

How do I know when my toddler is full?

It may seem obvious but your toddler is telling you that she has had enough to eat of a particular food, course or meal, if she is: 

• keeping her mouth shut when offered food 

• saying no 

• turning her head away from the food being offered 

• pushing away a spoon, bowl or plate containing food 

• holding food in her mouth and refusing to swallow it 

• spitting food out repeatedly 

• leaning out of her highchair or trying to climb out 

• crying, shouting or screaming 

• gagging or retching 

What is the best way to cope with my fussy eater?

Most toddlers go through a phase of only eating a very narrow range of foods. This is a normal part of toddler development called food neophobia - being frightened of new foods. Your toddler needs time to learn that these foods are safe to eat and enjoyable. She will learn this by watching you and others eating those foods. Eventually she will widen the variety of foods she eats but some take much longer than others to do this. To help her on her way, and to keep your sanity, follow these tips: 

Eat with your child as often as possible. Toddlers learn to eat foods they are unfamiliar with by watching and copying their parents and other children eating them.

Make positive comments about the food you are eating. Parents are strong role models and if you make positive comments about foods, your toddler will be more willing to try them. 

Arrange for your toddler to eat with other toddlers as often as possible. Invite a friend from her playschool or neighbourhood over for some snacks. Your toddler may eat better when she is with her own age group. 

Develop a daily routine of three meals and two to three snacks around your toddler's daytime sleep pattern and try to stick to it. Toddlers thrive on routine and knowing what to expect. She won't eat well if she becomes over-hungry, and toddlers who are tired will be too miserable to eat. Don't expect her to eat a large meal just before going to bed. Give her a small snack or drink and save her proper meal until later, after she has woken up. 

Offer two courses at mealtimes: a savoury course followed by a sweet course. The savoury course itself can consist of different items, say a small puri with potato and some rice with dal. For the sweet course, try kheer or halwa if she hasn’t eaten any cereal in the savoury course, otherwise choose fruit based desserts. Toddlers often get bored with too much of one taste and will be ready to try something new. Two courses also give your toddler two opportunities to take in the calories and nutrients needed and means there is a wider variety of foods at each meal. 

Limit mealtimes to about 20 - 30 minutes and accept that after this your toddler is unlikely to eat much more. It is better to wait for the next snack or meal and offer some nutritious foods then, rather than extending a meal for an hour trying to persuade your toddler to eat more. Most toddlers eat whatever they are going to in the first 20 minutes. 

Praise your toddler when she eats well because toddlers respond positively topraise. If you only give her attention when she is not eating, she may refuse food just to get some attention from you. Toddlers like attention, even if it is negative. If she doesn't eat well, take the uneaten food away without commenting and accept that she has had enough. 

Give small portions. Toddlers can be overwhelmed by large portions and lose their appetite. If the small portion is finished, praise your toddler and offer her some more. Offer her a second serving if she asks for one or seems eager to eat more. Typically serving sizes should be one fourth that of adults. 

Offer finger foods as often as possible and allow your toddler to make a mess at mealtimes. Toddlers enjoy having the control of feeding themselves with finger foods. Let her try to feed herself with a small fork or spoon if she wants. 

Eat in a calm relaxed environment away from distractions such as the TV, games and toys. Toddlers can concentrate on one thing at a time so distractions make it more difficult for them to concentrate on eating. While a change once in a while helps, constantly trying to distract your toddler by carrying her around the house or to the window or door while feeding her, may make mealtimes seem like a different kind of play time. 

Be aware that if you are eating out, your toddler may not be prepared to try any of the food on offer, as it may all be unfamiliar to her. Take something that she will eat with you to tide her over until her next meal or snack. Packing a small chapatti with cheese spread, a banana or a tomato sandwich in a favourite lunchbox might make it easier for her to eat in unfamiliar surroundings. 

Involve older toddlers in food shopping and preparing for the meal such as putting things on the table. This will encourage a positive attitude to food and mealtimes. 

Involve your toddler in simple cooking and food preparation (if you have the time and patience) – give her a ball of chapatti dough to roll and flatten or pick out some pea pods for her to shell. By handling and touching new foods without pressure to eat them, your toddler will become familiar with new foods and may be more likely to try them. 

Change the venue of your toddler's meals. For example, have a picnic outside. This will make eating a fun experience for your toddler and will allow them to see others enjoying food. 

What shouldn't I do?

Don't rush a meal. Some toddlers eat slowly and rushing your toddler to eat can reduce her appetite. 

Don't pressure a toddler to eat more when she has indicated to you that she has had enough. Never insist she finishes everything on her plate. 

Don't take away a refused meal and offer a completely different one in its place. A toddler will soon take advantage if you do. In the long run it is always better to offer family meals and accept that your child will prefer some foods to others. Always try to offer one food at each meal that you know she will eat. 

Don't offer the sweet course as a reward for eating the first course. You will make the sweet course seem more desirable than the savoury one. 

Don’t punish your child for refusing to eat. She may start disliking food in the long run. 

Don’t bribe and reward your child to finish up her meal. She will expect something in return each time she finishes her meal. 

Don't offer large drinks of milk, squash, fizzy drinks or fruit juice within an hour of the meal. Large drinks will reduce your toddler's appetite. If she is thirsty, give her a drink of water instead. Try to phase out bottles so that all your toddler's drinks, including milk, are given in cups or glasses. 

Don't offer snacks just before or just after a meal. Don't give a snack soon after a meal if your toddler hasn't eaten well at her main meal. It is tempting to do this just to ensure that your toddler has eaten something. However, it is best to have a set meal pattern and wait until the next snack or meal before offering food again. 

Don't assume that because your toddler has refused a food she will never eat it again. Tastes change with time. Some toddlers need to be offered a new food more than 10 times before they feel confident to try it. Or try a different way of preparing food; if she doesn’t take to paneer cubes try grating them into stuffed parathas, she might prefer boiled chickpeas chaat (kabuli chana chaat) instead of chana masala gravy. 

Don’t have varied routines and patterns while feeding your toddler. Be consistent – if you have more than one person taking care of meals for your toddler, make sure that everyone follows the same routine and sets similar limits. Mealtimes which vary from grandparents or a baby sitter to parents will only confuse your toddler. 

Finally, don't feel guilty if one meal turns into a disaster. Put it behind you and approach the next meal positively. Parents also learn by making mistakes. 

What should I do if I am still worried? 

If you are still doubtful, make a list of all the food and drinks your toddler consumes over a week and then review it. If your toddler's diet includes foods from all the food groups (read our article on how to feed your toddler for more information) and some variety within each group then you can reassure yourself that the problem is not as bad as you thought. 

If you continue to worry about how much your toddler eats or if you think she might beunderweight, talk to your doctor -- who may be able to reassure you that there is no problem. Occasionally there are medical reasons why your toddler may not eat and a doctor can assess this. 

Regards,

                                                               

COMMON COLD(BABIES)

One of the saddest things for a new parent is watching their baby suffer through his first cold. Your baby will be uncomfortable, snuffling, and probably will have trouble feeding. 

It's hard to watch, but there's a lot you can do to alleviate the discomfort. And you can be assured that it's called the common cold for a reason, and it's usually not serious. Experts estimate that your baby will get between eight and 10 colds in his first two years alone. That's a lot of tissues and long nights. 

What causes colds? 

Colds are upper respiratory tract infections caused by one of many different viruses. They're most commonly spread when someone with a cold sneezes or coughs and unleashes a cold virus into the air to be inhaled by someone else. They can also commonly be transmitted through hand-to-hand contact, so always wash your hands after blowing your nose. Babies tend to get a lot of colds because they're born with immune systems which function at about 60% of capacity. 

How do colds affect babies? 

Few things are more frustrating than a baby with a cold. A sick baby will probably have a fever (up to 101 degrees F / 38 degrees C), cough, reddened eyes, a sore throat, earache, and runny nose. Your child may also be irritable and lose his appetite. Babies under six months old can't breathe through their noses when they're all stuffed up, so they have trouble breathing and eating. 

Children aren't usually developmentally ready to blow their own noses until about the age of four, so you'll have to help younger children clear the mucus. If the cold persists and is not treated properly, it can lead to more serious bacterial infections like pneumonia, bronchitis, flu or ear infections. If your baby has been sleeping through the night, you'll be reminded of those first few weeks of life. He'll probably wake up several times during the night due to his discomfort and difficulty breathing. Expect to be up with your baby, comforting him and wiping his nose. 

How long do colds generally last? 

Symptoms generally abate after three to 10 days, though in very young babies they may last up to two weeks. Most babies who have some exposure to older children will experience six to 10 colds during their first year; it may seem as if his nose is runny all winter long. If your child goes to a daycare center or a play school, he can experience as many as 12 colds per year! 

Can I help prevent my child from getting colds? 

Breastfeeding is one of the best ways to protect your baby's health, since as long as he's breastfeeding, he's getting your antibodies and your natural immunities. This isn't a foolproof way to protect your baby's health, but when breastfed babies do become ill, their cold symptoms are generally mild. 

You can also try to protect your child by keeping him away from those who are ill and by asking all sick family members to wash their hands thoroughly before handling your baby or his things. 

If you or your spouse smoke, give it up, and refrain from taking your baby to areas where someone has been smoking. Children who live with cigarette smokers have more colds and their colds last longer than their peers who aren't exposed to smoke.

When should I consult the doctor? 

Do so at the first sign of illness if your child is less than three months old. In an older baby, call your doctor if a cold persists for more than three days; if your child's temperature climbs above 102 degrees F / 39 degrees C; or if he has an earache, breathing problems, wheezing, a persistent cough, or a persistent, thick, green mucus running from his nose. 

How do I treat a cold? 

There's little you can do except ride it out. Help your child get plenty of rest and if he has been weaned offer liquids (increase the amount of vitamin C-rich fruit juices). If he's feverish, you can give him paracetamol suspension under a doctor's direction. Don't give him any cold remedies without consulting your doctor. In children under one year of age, over-the-counter cold medications often do more harm than good, and cough medicines have been shown to be no better than a non-medicated syrup for easing symptoms. 

Nonetheless, there are some remedies to ease his discomfort: 

• If your baby is congested, elevate the head of the mattress with an old towel or two. Sleeping at an incline may help relieve your baby's postnasal drip. (Do not use pillows to prop your baby up -- they can pose a suffocation hazard -- or pillows under the mattress.) 

• Because babies are too young to blow their noses, the best way to help them breathe more easily is to wipe their noses. You can also apply petroleum jelly to the outside of your baby's nostrils to reduce irritation. If your child is having trouble breastfeeding with a stuffy nose, you may like to ask your paediatrician to prescribe saline drops to apply to each nostril 15 minutes before a feed. Some parents then use a suction bulb to clear the nose of salt water and mucus. 

However, you can also prepare saline water at home by adding a pinch of salt in about 30 ml of boiled cooled water. Make the solution in a clean bowl and keep it well covered. Saline water drops do not have any side effects and can be easily used several times a day. 

• Try a cool mist vaporiser to moisten the air. Or take your baby into the bathroom with you, turn on the hot water or shower, close the door, and sit in the steamy room for about 15 minutes. Remember to change your baby into dry clothes after the steam bath. 

• If your child has a stuffy nose without any other symptoms, check his nostrils for foreign objects. You never know: even little ones are capable of putting things up there. 

• Add a couple of drops of menthol, eucalyptus or pine oil to a vaporizer to relieve nasal congestion in babies older than six months. 

Colds are a fact of life. Once you've survived your baby's first one, you'll know what to expect with the next.