Charish Barry, MD Charish Barry, MD

Category: Nutrition

A Vitamin a Day…

Posted on by Charish Barry, MD in , ,

 

It has been estimated that just over half of all preschoolers are given multivitamins. We’re pretty sure that’s a good bit more than are served broccoli on any given day. And we’re quite sure we can relate to the reasons why. When the going gets tough, it is often a whole lot easier to reach for a quick fix in a bottle of Flintstones vitamins and forget the fight. The fact that there are so many parents who do just that isn’t so much a food fight, per se, but a reflection on the parental feelings that so many share that what we’re feeding our children is nutritionally inadequate. While we can definitely understand the sentiment, it compels us to address the fundamental question: What role should multivitamins play in your child’s diet, and is it you or your child that stands to benefit from them more?

Who Needs ‘Em, Anyway?

We’ll come right out and say what most nutrition experts have been saying all along: Most children don’t need vitamin supplements at all! Yes, we realize that the perfect, vegetable-loving, cooperative eater we all long for doesn’t exist. But even taking all food fights into consideration, there are nevertheless very few instances in which a child’s diet is likely to leave him truly deficient.

If you need further convincing, we suggest you consider the following facts:

  • The amount your child needs to eat to get enough vitamins and minerals from his food alone is probably much smaller than you think. Even for the pickiest of eaters, it doesn’t take more than a very few picks from each of the basic food groups for children to get their recommended daily dose.
  • Many vitamins can be stored in the body. This means that your child doesn’t have to eat each and every one every day—affording you the option of spreading your efforts at achieving a balanced diet out over the course of a week or two without spreading the vitamins too thin.
  • Ironically enough, parents who are most likely to give multivitamins are also those who are most likely to be feeding their children healthy diets in the first place.
  • Vitamins can be found in some unlikely sources. Calcium doesn’t just have to come from cows, since it is contained in both supplements and many nondairy foods ranging from salmon, tofu, spinach, and sardines to rhubarb, baked beans, bok choy, and almonds—admittedly not all of which are an easy sell at the dinner table, but at least you have plenty to choose from!
  • And finally, many foods these days are fortified. That means that even if your child favors foods that do not come naturally loaded with all of the necessary nutrients, all hope is not lost; it’s entirely possible that food manufacturers have added them in for you. Classic examples include the vitamin D fortification of milk, margarine, and pudding, and the calcium contained in kid-friendly foods such as orange juice, cereals, breads, and even Eggo waffles.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

A Vitamin a Day?

Posted on by Charish Barry, MD in , ,

Do toddlers need vitamins to make up for their picky eating?    You may be surprised at the answer!

It has been estimated that just over half of all preschoolers are given multivitamins. We’re pretty sure that’s a good bit more than are served broccoli on any given day. And we’re quite sure we can relate to the reasons why. When the going gets tough, it is often a whole lot easier to reach for a quick fix in a bottle of Flintstones vitamins and forget the fight. The fact that there are so many parents who do just that isn’t so much a food fight, per se, but a reflection on the parental feelings that so many share that what we’re feeding our children is nutritionally inadequate. While we can definitely understand the sentiment, it compels us to address the fundamental question: What role should multivitamins play in your child’s diet, and is it you or your child that stands to benefit from them more?

Who Needs ‘Em, Anyway?

We’ll come right out and say what most nutrition experts have been saying all along: Most children don’t need vitamin supplements at all! Yes, we realize that the perfect, vegetable-loving, cooperative eater we all long for doesn’t exist. But even taking all food fights into consideration, there are nevertheless very few instances in which a child’s diet is likely to leave him truly deficient.

If you need further convincing, we suggest you consider the following facts:

  • The amount your child needs to eat to get enough vitamins and minerals from his food alone is probably much smaller than you think. Even for the pickiest of eaters, it doesn’t take more than a very few picks from each of the basic food groups for children to get their recommended daily dose.
  • Many vitamins can be stored in the body. This means that your child doesn’t have to eat each and every one every day—affording you the option of spreading your efforts at achieving a balanced diet out over the course of a week or two without spreading the vitamins too thin.
  • Ironically enough, parents who are most likely to give multivitamins are also those who are most likely to be feeding their children healthy diets in the first place.
  • Vitamins can be found in some unlikely sources. Calcium doesn’t just have to come from cows, since it is contained in both supplements and many nondairy foods ranging from salmon, tofu, spinach, and sardines to rhubarb, baked beans, bok choy, and almonds—admittedly not all of which are an easy sell at the dinner table, but at least you have plenty to choose from!
  • And finally, many foods these days are fortified. That means that even if your child favors foods that do not come naturally loaded with all of the necessary nutrients, all hope is not lost; it’s entirely possible that food manufacturers have added them in for you. Classic examples include the vitamin D fortification of milk, margarine, and pudding, and the calcium contained in kid-friendly foods such as orange juice, cereals, breads, and even Eggo waffles.

Getting to Know MyPlate

Posted on by Charish Barry, MD in ,

MyPyramid logo Any parent who has tried to navigate a well-stocked grocery store with a hungry child in tow knows it is a challenge. Weaving through endless aisles of candy, frozen pizza, chips, soda, and sugary cereals without at least one incident of pleading or bargaining is considered a major accomplishment.

But on a daily basis, where is the proper guidance to steer through the numerous food choices?

Getting to Know MyPlate

Since 1894, the United States Department of Agriculture (USDA) has been providing Americans with dietary guidelines. In general, they have focused on eating from specified food groups and emphasized moderation, proportionality, and variety. An updated version of the USDA’s guidelines is called MyPlate. It shows the image of a dinner plate divided into colored sections:

  • Orange—grains (eg, wheat, rice, oats, cornmeal, barley)
  • Purple—protein (eg, meat, chicken, fish, beans, eggs, soy products, nuts, seeds)
  • Red—fruits (eg, apples, bananas, strawberries, blueberries, oranges, peaches)
  • Green: vegetables (eg, broccoli, romaine lettuce, spinach, corn, carrots)

Plus, there is a blue cup to the right of the plate to symbolize dairy foods (eg, milk, cheese, yogurt).

An important feature of MyPlate is that each section is a particular size. This is to highlight the proportions that Americans should aim for when planning their meal, for example:

  • Half the plate should be fruits and veggies!
  • About a quarter of the plate should be grains (especially whole grains).
  • The rest should be protein.

Before Your Next Shopping Trip…

MyPlate provides parents with important concepts that virtually all experts agree on: making healthy food choices and practicing eating in moderation. So before hitting the grocery aisles with your little one, take the time to catch up on the suggestions found on MyPlate! The USDA’s main messages include:

  • Encourage your child to enjoy his food, but to eat portions that are right for his age and activity level.
  • Fill half of your child’s plate with fruits and vegetables.
  • Have your kid drink fat-free or low-fat (1%) milk.
  • Read food labels! Find out how much sodium is in packaged food. Choose lower sodium options!
  • Encourage your child to drink water. Leave the sugary drinks behind.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Choosing Healthy Snacks

Posted on by Charish Barry, MD in , ,

If the snacks at your home have usually been cookies, doughnuts, and soft drinks, it’s time for a change. Two or 3 snacks a day are an important part of your child’s overall nutrition, so you need to make them just as nutritionally sound as her regular meals, while contributing to an overall program aimed at weight loss. Planning snacks ahead of time is helpful—prepackage some appropriate servings to have ready for kids in their lunches or when they get home from school. This is an opportunity to teach healthy choices and practices.

If you keep the pantry, refrigerator, and kitchen table stocked with plenty of low-fat, low-sugar snacks from the 5 major food groups, that’s what she’ll reach for. Of course, occasional treats like ice cream are fine. But for those snacks that your child typically grabs on her own, make sure they’re nutritious ones such as:

  • Fruit
  • Fresh strawberries
  • Low-fat/frozen yogurt
  • Air-popped popcorn
  • Celery stalks
  • Low-fat cheeses
  • Low-fat oatmeal cookies
  • Frozen juice bars (without added sugar)
  • Cucumber slices
  • Crackers
  • Frozen bananas
  • Sugar-free cereals
  • Baked potato chips
  • Unsalted pretzels
  • Bran muffins
  • Dried raisins or apricots

Adding a protein food with these snacks can make them more satisfying. Try adding a boiled egg, cheese stick, yogurt, natural peanut butter, or nuts (if your child is old enough so choking is not a concern).

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

The Very Hungry Caterpillar and Healthy Eating Habits

Posted on by Charish Barry, MD in ,

Healthy Eating habits taught by The Very Hungry Caterpillar

(NEW YORK) March 8, 2011 – The Alliance for a Healthier Generation and the American Academy of Pediatrics (AAP) have joined with the best-selling children’s book, The Very Hungry Caterpillar by Eric Carle and with We Give Books to help families learn about healthy eating habits at home. The Eating Healthy. Growing Strong. campaign is an important part of the Alliance’s mission to combat childhood obesity.

This spring, more than 17,500 pediatrician offices across the United States will receive free copies of specially created The Very Hungry Caterpillar books, together with growth charts and parent handouts that encourage doctors and parents to have meaningful conversations about the importance of healthy eating.

“Parents and doctors both play an enormously important role in ensuring children develop healthy eating habits early on in life. By joining with the American Academy of Pediatrics (AAP) and the classic children’s brand The Very Hungry Caterpillar, we are starting a dialogue between parents and doctors that will go beyond the waiting room and into the home, enabling 21 million children to make more nutritious choices and lead healthier lives,” said President Bill Clinton, founder of the William J. Clinton Foundation, a founding organization of the Alliance for a Healthier Generation along with the American Heart Association.

In addition to beginning the conversation on healthy eating between pediatricians and parents, the campaign also showcases ways to integrate discussions of healthy active living into family reading time. Tips for parents to discuss healthy active living using The Very Hungry Caterpillar include:

  • Teach your child that apples, pears, plums, strawberries, and oranges are all fruits. Ask them if they can name other fruits.
  • Talk to them about how fruits are good for your body.
  • Talk about how when the caterpillar overeats, he gets a stomachache— so it is important to stop eating when you feel full.

“Parents should read with their children every day, starting when they are babies,” said O. Marion Burton, MD, FAAP, president of the American Academy of Pediatrics. “This campaign provides a wonderful opportunity to teach children about healthy eating habits at a very young age, while fostering a love of books and language.”

The materials are being provided to the campaign by We Give Books, a digital initiative from Penguin—the publisher of The Very Hungry Caterpillar—and by the Pearson Foundation. Visitors to We Give Books will have the chance to read a library of great children’s books for free, any time they like, and each time they read a book at www.wegivebooks.org, the Pearson Foundation will donate a brand-new book to a leading literacy group.

“I am delighted that the Alliance for a Healthier Generation, the American Academy of Pediatrics, and the Pearson Foundation have selected The Very Hungry Caterpillar as a spokescharacter for their important work,” said author and illustrator Eric Carle.  “I’m so pleased that my caterpillar can help to promote healthy eating in the fight against childhood obesity, and I hope The Very Hungry Caterpillar will be a happy reminder for children to grow healthy and spread their strong wings, like the butterfly in my book.”

Don Weisberg, president, Penguin Young Readers Group, said, “We are honored to be part of this important campaign to help educate young children and their families about healthy eating using one of the most beloved and recognized children’s book characters of all time, The Very Hungry Caterpillar.”

Mark Nieker, president of the Pearson Foundation added, “We Give Books is ready to share news of this important initiative with young people and parents across the country. Parents can talk about the importance of healthy eating—and help their kids develop important literacy skills—at the same time.”

For additional campaign information, click here.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Dining In With Newborn

Posted on by Charish Barry, MD in ,

Going home with a newborn in your arms means the beginning of a whole new life for you and your family. Managing the differences between expectations and reality—especially in terms of feeding your baby—can go a long way toward making it not just a smooth transition, but also a time of joy.  To help moms prepare Petite Pediatrics is offering prenatal lactation consults for expecting moms.

Kathy Klammer is a nurse who is an International Board Certified Lactation Consultant (IBCLC) who has many years of experience working with breastfeeding moms.   She provides Lactation Services and is available for home or office visits within the first few weeks of life, but is also available prenatally for expectant mothers who are anxious about breastfeeding or have specific concerns such as reduction and other breast surgeries as well as illnesses or medications that could affect the breastfeeding relationship. This provides a unique opportunity to discuss concerns, teaching of latch-on techniques and suggestions on how to get off to a good start in the early weeks.

To help prepare you for feeding your newborn, here is some helpful information about breastfeeding and formula feeding.

Breastfeeding

You’ve probably heard it before: “Breast is best.” But is it really?

Yes, from both a nutritional and infection prevention standpoint. Breast milk is currently unrivaled as the ideal food for infants. The infection fighting antibodies it contains just can’t be bottled in even the most expensive of commercial formulas, and breast milk has been shown to reduce a newborn’s chance of developing everything from ear infections, allergies, vomiting, and diarrhea to pneumonia, meningitis, and potentially even sudden infant death syndrome.

True, breastfeeding is “natural.” But that doesn’t mean that getting started with breastfeeding is easy. Those first couple of weeks can be challenging, because in reality, there is usually a period of self-education and on-the-breast training. We recommend taking it step by step, keeping a few precautions in mind, and being patient as you and your baby learn how to do it. Remember, millions of women have successfully breastfed their babies; you can do it, too.

Here are some tips for breastfeeding success:

  • If all goes well with the birth of your baby and you’re both doing well after delivery, start breastfeeding as soon as possible—right there in the hospital.
  • Ask for help – Lactation nurses can assist with techniques to help mom and baby get started in the right direction.
  • Focus on getting the process of “latching” (how your baby attaches to your breast) down pat. First, make yourself comfortable; use pillows for support and put anything you might need during breastfeeding within easy reach. Then get your baby interested in breast milk by rubbing a few drops around your nipple. If baby doesn’t respond, try stroking around his mouth to stimulate what’s known as the “rooting reflex.” If he still doesn’t open wide enough, gently press down on the chin.
  • Don’t settle for “almost on”: Improper latching on can quickly result in sore breasts and a frustrated (and still hungry) baby. Keep repositioning until baby’s tongue is under the nipple, so he can draw the nipple and the darker-colored area around the nipple (called the areola) into his mouth. This will make breastfeeding success more likely for you both.

Formula

So if breastfeeding is so beneficial, is formula even acceptable for feeding your newborn? The answer is yes. In fact, most parents will use formula at some point during their child’s first year. And while formula can’t exactly match the nutritional makeup of breast milk and doesn’t contain the added benefit of infection-fighting antibodies, it nevertheless serves a very valuable purpose for those who are not able or choose not to breastfeed.

There are three basic types of formula—those based on cow milk, those based on soy, and those that are “specialized,” “hypoallergenic,” or “elemental” (which means the formula’s components are broken down for easier digestion). Most babies do fine with the first two types, but some babies may need an elemental formula if they have difficulty digesting the other types.

There is much to consider with baby formula. For starters, here are some tips for making sure your baby gets what she needs from her formula:

  • Formulas are iron fortified because iron is a critical part of a healthy baby diet. Some people mistakenly assume that iron causes stomach pain or constipation in infants. In fact, babies only absorb a small percentage of the iron in their food, and most babies tolerate iron-enriched formulas without a problem. If you have concerns about this, talk with your pediatrician.
  • Consider how often you intend to use formula for feeding before buying a certain type. Also factor in whether you want to pay for the added convenience of ready-to-feed, or if using powdered formula on the road, or at home, better suits your needs and your budget.
  • Stock up so you don’t run out. Before you do this, however, make sure your baby is happy with the formula you’ve chosen.  Check the expiration dates, too; you don’t want to buy more than you can use before that date.
  • It’s worth mentioning that about 10 percent of babies are lactose- or soy-intolerant, a condition called milk soy protein intolerance (MSPI). These babies tend to start fussing soon after eating, spit up, become gassy, or have problems with constipation or diarrhea. If your baby reacts this way to eating formula, talk with your pediatrician.

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

Changing Parental Behavior May Help Obese Kids Lose Weight

Posted on by Charish Barry, MD in ,

Young children of parents who took classes in nutrition, exercise kept weight off for 2 years

According to study findings reported in the February issue of Pediatrics, it’s hard to help overweight children lose weight, and keeping it off over the long-term is even tougher. But obese children whose parents took classes on the importance of healthy eating and exercise lost weight and kept it off for the next two years, according to a new Australian study.

Researchers said the study shows that targeting parents — rather than the children — can help stave off weight gain in children aged 5 to 9.

“We believe it makes developmental sense to involve only parents,” said lead study author Anthea Magarey, a senior research associate of nutrition and dietetics, at Flinders University School of Medicine in Adelaide, Australia, where the study took place. “It takes the stigma away from the child and supports a whole family approach.”

For young children, parents play a huge role in their eating and exercise habits, Magarey explained. The kids are still spending most of their time at home and eating most meals at home. Parents buy and prepare food, and decide what and how much kids can eat. They are responsible for providing opportunities for children to be active and can set rules for TV and video game use.

The researchers enrolled mostly mothers of 169 moderately obese or overweight children aged 5 to 9 years in a six-month “healthy lifestyle” course, in which parents were taught about portion size and reading nutrition labels, being a good role model for their children and setting limits. (Half of the parents also took a parenting course, although the study authors found little difference between the two groups).

At the end of six months, children’s body mass index (a measurement that takes into account weight and height) dropped an average of 10 percent, as did their waist circumference. Eighteen months later, the children had kept the weight off, the investigators found.

In the United States, about 17 percent of children and adolescents aged 2 to 19 years are obese, a number that has been increasing since the 1970s, according to the U.S. Centers for Disease Control and Prevention.

About 24 percent of U.S. children aged 2 to 5 are overweight, meaning they have a BMI in the 85th percentile or above for their height and age. That number rises to 33 percent among children aged 6 to 11, according to the CDC.

After the healthy lifestyle sessions, parents said they felt more comfortable saying “no” to their children’s demands, setting limits on the type of food the children could eat, limiting the amount of time they spent watching TV or playing video games, and establishing consequences for breaking the rules.

Parents assessed their own current eating patterns and set their own goals for change, such as limiting TV to no more than two hours a day, doing more active family activities and making small dietary changes that can go a long way, such as eating more fruit and vegetables, using reduced-fat dairy products and drinking fewer sweetened beverages such as sodas.

Kathy Kolasa, a professor of nutrition services and patient education at East Carolina University in Greenville, N.C., said she does not believe children have to be excluded from obesity prevention programs because of the risk of stigmatizing them.

But making sure parents know about nutrition, portion size and how to make sure their children are getting enough physical activity is critical.

“In my experience, there are plenty of parents who tell me they know what to feed their kids and that they are eating healthy,” Kolasa said. “When we analyze their diet, they are surprised that they are not following or providing age-appropriate portions and healthy foods for their kids.”

As for the parents included in the study, their weight did not change over the two years.

SOURCES: Anthea Magarey, Ph.D., senior research associate, nutrition and dietetics, Flinders University School of Medicine, Adelaide, Australia; Kathryn M. Kolasa, Ph.D., R.D., professor, nutrition services and patient education, East Carolina University, Greenville, N.C.; February 2011, Pediatrics

Schedule an Appointment at Petite Pediatrics

Dr. Charish Barry offers concierge-style care that is designed to provide highly personalized care to infants, children, and teens throughout the Santa Barbara area. She and her team of highly trained nurse practitioners will take the time to answer any questions you may have. Schedule an appointment at Petite Pediatrics today! Call our Santa Barbara office at (805) 845-1221.

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